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1.
近年来,随着类风湿性关节炎发病机制及某些致炎因子的发现,出现了一系列新药。环氧合酶-Ⅱ特异性抑制剂与传统的非甾体类抗炎药相比具有疗效好、副作用小的优点;早期联合使用改变病情性抗风湿药在近期内有较好的临床疗效。此外重组可溶性肿瘤坏死因子受体融合蛋白 (etanercept)、人体抗肿瘤坏死因子-α单克隆抗体(adalimumab)和阿那白滞素(anakinra)等生物学治疗及中药治疗均显示了新的治疗前景。 相似文献
2.
Robert L. Goldstone 《Topics in Cognitive Science》2019,11(4):902-913
Cognitive science continues to make a compelling case for having a coherent, unique, and fundamental subject of inquiry: What is the nature of minds, where do they come from, and how do they work? Central to this inquiry is the notion of agents that have goals, one of which is their own persistence, who use dynamically constructed knowledge to act in the world to achieve those goals. An agentive perspective explains why a special class of systems have a cluster of co‐occurring capacities that enable them to exhibit adaptive behavior in a complex environment: perception, attention, memory, representation, planning, and communication. As an intellectual endeavor, cognitive science may not have achieved a hard core of uncontested assumptions that Lakatos (1978) identifies as emblematic of a successful research program, but there are alternative conceptions according to which cognitive science has been successful. First, challenges of the early, core tenet of “Mind as Computation” have helped put cognitive science on a stronger foundation—one that incorporates relations between minds and their environments. Second, even if a full cross‐disciplinary theoretic consensus is elusive, cognitive science can inspire distant, deep, and transformative connections between pairs of fields. To be intellectually vital, cognitive science need not resemble a traditional discipline with its associated insularity and unchallenged assumptions. Instead, there is strength and resilience in the diverse perspectives and methods that cognitive science assembles together. This interdisciplinary enterprise is fragile and perhaps inherently unstable, as the looming absorption of cognitive science into psychology shows. Still, for many researchers, the excitement and benefits of triangulating on the nature of minds by integrating diverse cases cannot be secured by a stable discipline with an uncontested core of assumptions. 相似文献
3.
Transradial interventions (TRI) are becoming increasingly popular because of accumulating recent evidence suggesting improved survival and reduced morbidity. Complications, though rare, do occur, especially for operators on their learning curve. The complications are best prevented by utilization of proper technique. Forearm hematoma are preventable and easy to treat, but a delay in detecting and managing them can lead to disastrous consequences compartment syndrome being the most dreaded one. This review deals with tips and tricks to prevent as also treat the common and rare complications. 相似文献
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大量动物实验证实,缺血预处理可产生强大的器官保护作用,但动物实验向临床试验转化的进展和结果不尽如人意.对缺血预处理介导的神经保护的分子机制进行研究,寻找可转化到临床的安全且有效的预处理诱导方式,对于提高卒中和手术患者神经组织对缺血缺氧的耐受力,实现安全和有效的神经保护具有重要意义.文章从预处理活化受体、线粒体、转录因子和蛋白激酶等方面对缺血预处理介导神经保护的分子机制进行了综述. 相似文献
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Andre R. Dur?es Milena A. O. Dur?es Luis C. L. Correia Roque Aras 《Arquivos brasileiros de cardiologia》2013,101(5):466-471
Heart valve prosthesis unquestionably improve quality of life and survival of
patients with severe valvular heart disease, but the need for antithrombotic therapy
to prevent thromboembolic complications is a major challenge to clinicians and their
patients. Of the articles analyzed, most were retrospective series of cases or
historical cohorts obtained from the database. The few published randomized trials
showed no statistical power to assess the primary outcome of death or thromboembolic
event. In this article, we decided to perform a systematic literature review, in an
attempt to answer the following question: what is the best antithrombotic strategy in
the first three months after bioprosthetic heart valve implantation (mitral and
aortic)?After two reviewers applying the extraction criteria, we found 1968 references,
selecting 31 references (excluding papers truncated, which combined bioprosthesis
with mechanical prosthesis, or without follow-up).Based on this literature review, there was a low level of evidence for any
antithrombotic therapeutic strategy evaluated. It´s therefore interesting to use
aspirin 75 to 100 mg / day as antithrombotic strategy after bioprosthesis replacement
in the aortic position, regardless of etiology, for patients without other risk
factors such as atrial fibrillation or previous thromboembolic event. In the mitral
position, the risk of embolism, although low, is more relevant than in the aortic
position, according to published series and retrospective cohorts comprised mostly of
elderly non-rheumatic patients.The current evidence is limited to have a consistent and safe level of evidence
regarding the best therapeutic strategy. Based on these studies, 75 to 100 mg/day of
aspirin is interesting as antithrombotic strategy after implantation of aortic
bioprosthesis, regardless of etiology, for patients with no other risk factors such
as atrial fibrillation or previous thromboembolic event. As for mitral bioprosthesis,
the risk of embolism, although low, is more relevant than in the aortic position,
according to published series and retrospective cohorts - usually elderly non
rheumatic patients. 相似文献
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9.
目的:开发特殊使用级抗菌药物点评系统,提高特殊使用级抗菌药物的临床使用水平,降低细菌耐药率。方法:利用易语言和数据库技术,建立特殊使用级抗菌药物合理性评分表,特殊使用级抗菌药物点评系统。对2010年1-6月和2013年1-6月特殊使用级抗菌药物使用病历的越级使用情况、病原微生物送检情况、抗菌药物使用合理性(药物选择、用法用量、联合用药)、会诊单例数、平均使用金额和特殊使用级抗菌药物使用强度进行回顾性统计并分析。结果:系统实现了特殊使用级抗菌药物处方点评功能,系统应用后抗菌药物越级使用率从14.9%下降至2.3%(P=0.000);病原微生物送检率从47.3%提高至93.9%(P=0.000);抗菌药物选择合理率从88.1%上升至96.9%(P=0.000);会诊单申请率从40.2%提高至97.3%(P=0.000)。特殊使用级抗菌药物使用强度从164.3下降至84.2(P=0.042);平均使用金额从1 210.4元下降至964.1元(P=0.032)。结论:特殊使用级抗菌药物点评系统提高了特殊使用级抗菌药物管理水平,有效地降低了特殊使用级抗菌药物费用支出。 相似文献
10.
肝移植已经成为肝细胞癌根治性治疗的重要手段,但术后复发与转移严重限制了肝细胞癌肝移植的疗效。近年来,国内外学者围绕肝移植术后免疫抑制剂的应用与肝细胞癌复发转移的关系进行了一系列研究。现就肝细胞癌肝移植术后免疫抑制剂的临床应用策略及建议作一简述,以更好地指导临床。 相似文献