全文获取类型
收费全文 | 3441篇 |
免费 | 200篇 |
国内免费 | 58篇 |
专业分类
耳鼻咽喉 | 45篇 |
儿科学 | 384篇 |
妇产科学 | 22篇 |
基础医学 | 301篇 |
口腔科学 | 1篇 |
临床医学 | 406篇 |
内科学 | 390篇 |
皮肤病学 | 8篇 |
神经病学 | 449篇 |
特种医学 | 78篇 |
外科学 | 159篇 |
综合类 | 542篇 |
预防医学 | 485篇 |
眼科学 | 28篇 |
药学 | 246篇 |
1篇 | |
中国医学 | 39篇 |
肿瘤学 | 115篇 |
出版年
2023年 | 32篇 |
2022年 | 58篇 |
2021年 | 136篇 |
2020年 | 111篇 |
2019年 | 87篇 |
2018年 | 90篇 |
2017年 | 100篇 |
2016年 | 122篇 |
2015年 | 125篇 |
2014年 | 201篇 |
2013年 | 268篇 |
2012年 | 218篇 |
2011年 | 219篇 |
2010年 | 170篇 |
2009年 | 148篇 |
2008年 | 168篇 |
2007年 | 169篇 |
2006年 | 157篇 |
2005年 | 133篇 |
2004年 | 100篇 |
2003年 | 75篇 |
2002年 | 66篇 |
2001年 | 71篇 |
2000年 | 62篇 |
1999年 | 45篇 |
1998年 | 48篇 |
1997年 | 49篇 |
1996年 | 38篇 |
1995年 | 42篇 |
1994年 | 39篇 |
1993年 | 41篇 |
1992年 | 24篇 |
1991年 | 24篇 |
1990年 | 34篇 |
1989年 | 31篇 |
1988年 | 20篇 |
1987年 | 23篇 |
1986年 | 18篇 |
1985年 | 25篇 |
1984年 | 24篇 |
1983年 | 19篇 |
1982年 | 18篇 |
1981年 | 10篇 |
1980年 | 15篇 |
1979年 | 6篇 |
1978年 | 6篇 |
1977年 | 3篇 |
1975年 | 2篇 |
1973年 | 3篇 |
1968年 | 1篇 |
排序方式: 共有3699条查询结果,搜索用时 46 毫秒
1.
目的:探讨小儿化脓性脑膜炎的临床疗效和临床观察。方法回顾分析76例小儿化脓性脑膜炎患者的临床资料。结果76例患儿中,54例患儿治愈,16例患儿好转,6例患儿转科治疗。治疗前患儿脑脊液检查外观混浊的检出率和球蛋白阳性的检出率分别为73.7%和92.1%,显著高于治疗后的外观混浊的检出率7.9%和球蛋白阳性的检出率5.3%,治疗前后对比差异具有统计学意义(P<0.05)。结论对接诊的疑似化脓性脑膜炎的患儿及早地诊断、治疗,可以有效减少患儿并发症及后遗症的发生,提高患儿的治愈率。 相似文献
2.
The clinical syndrome of tuberculous (TB) meningitis leading to ischemic strokes is rarely seen today in immunocompetent adults native to North America. This entity is also notoriously difficult to diagnose because the presenting symptoms are often nonspecific. The authors describe a case of a man with TB meningitis which progressed to recurrent ischemic cerebral infarcts. 相似文献
3.
4.
新型隐球菌脑膜炎的诊断探讨及文献复习 总被引:3,自引:0,他引:3
目的:探讨新型隐球菌脑膜炎(CNM)的临床特点及诊断方法。方法:对18例CNM患者的临床资料进行回顾性分析并文献复习。结果:18例患者均经病原学确诊。大部分CNM患者为亚急性起病,临床表现无特异性,误诊率高,首诊误诊率为72%,其中误诊为结核性脑膜炎的占69%。结论:脑脊液中找到新型隐球菌是诊断该病的重要依据,多种快速检测手段结合可提高早期诊断率。 相似文献
5.
Poncet病(病例报告及文献复习) 总被引:4,自引:0,他引:4
目的 探讨Poncet病的诊断与治疗。方法 通过病例报告及献复习,综述了Poncet病的发病机理、临床表现。结果 提高对Poncet病的认识。结论 临床上对风湿性或类风湿性关节炎病人均应与本病鉴别。 相似文献
6.
A Decision Rule for Predicting Bacterial Meningitis in Children with Cerebrospinal Fluid Pleocytosis When Gram Stain Is Negative or Unavailable 总被引:1,自引:0,他引:1
Bema K. Bonsu MBChB Henry W. Ortega MD Mario J. Marcon PhD Marvin B. Harper MD 《Academic emergency medicine》2008,15(5):437-444
Objectives: Among children with cerebrospinal fluid (CSF) pleocytosis, the task of separating aseptic from bacterial meningitis is hampered when the CSF Gram stain result is unavailable, delayed, or negative. In this study, the authors derive and validate a clinical decision rule for use in this setting.
Methods: This was a review of peripheral blood and CSF test results from 78 children (<19 years) presenting to Children's Hospital Columbus from 1998 to 2002. For those with a CSF leukocyte count of >7/μL, a rule was created for separating bacterial from viral meningitis that was based on routine laboratory tests, but excluded Gram stain. The rule was validated in 158 subjects seen at the same site (Columbus, 2002–2004) and in 871 subjects selected from a separate site (Boston, 1993–1999).
Results: One point each (maximum, 6 points) was assigned for leukocytes >597/μL, neutrophils >74%, glucose <38 mg/dL, and protein >97 mg/dL in CSF and for leukocytes >17,000/mL and bands to neutrophils >11% in peripheral blood. Areas under receiver-operator-characteristic curves (AROCs) for the resultant score were 0.98 for the derivation set and 0.90 and 0.97, respectively, for validation sets from Columbus and Boston. Sensitivity and specificity pairs for the Boston data set were 100 and 44%, respectively, at a score of 0 and 97 and 81% at a score of 1. Likelihood ratios (LRs) increased from 0 at a score of 0 to 40 at a score of ≥4.
Conclusions: Among children with CSF pleocytosis, a prediction score based on common tests of CSF and peripheral blood and intended for children with unavailable, negative, or delayed CSF Gram stain results has value for diagnosing bacterial meningitis. 相似文献
Methods: This was a review of peripheral blood and CSF test results from 78 children (<19 years) presenting to Children's Hospital Columbus from 1998 to 2002. For those with a CSF leukocyte count of >7/μL, a rule was created for separating bacterial from viral meningitis that was based on routine laboratory tests, but excluded Gram stain. The rule was validated in 158 subjects seen at the same site (Columbus, 2002–2004) and in 871 subjects selected from a separate site (Boston, 1993–1999).
Results: One point each (maximum, 6 points) was assigned for leukocytes >597/μL, neutrophils >74%, glucose <38 mg/dL, and protein >97 mg/dL in CSF and for leukocytes >17,000/mL and bands to neutrophils >11% in peripheral blood. Areas under receiver-operator-characteristic curves (AROCs) for the resultant score were 0.98 for the derivation set and 0.90 and 0.97, respectively, for validation sets from Columbus and Boston. Sensitivity and specificity pairs for the Boston data set were 100 and 44%, respectively, at a score of 0 and 97 and 81% at a score of 1. Likelihood ratios (LRs) increased from 0 at a score of 0 to 40 at a score of ≥4.
Conclusions: Among children with CSF pleocytosis, a prediction score based on common tests of CSF and peripheral blood and intended for children with unavailable, negative, or delayed CSF Gram stain results has value for diagnosing bacterial meningitis. 相似文献
7.
含补金片方案治疗结核性渗出性胸膜炎疗效观察 总被引:1,自引:0,他引:1
目的:探讨结核性渗出性胸膜炎的治疗方法。方法:96例初治结核性胸膜炎患者随机分为2组,对照组应用普通化疗方案2HRZE(S)/4HR;治疗组在对照组基础上,强化期加用补金片治疗。观察6个月,分析两组疗效。结果:治疗2周、4周及8周末胸水吸收总有效率治疗组为83.33%、91.67%和95.83%;对照组为64.58%、72.92%和79.17%,治疗6个月胸膜肥厚与粘连发生率治疗组为14.58%,对照组为41.67%,两组比较均有显著性差异(P〈0.05)。结论:补金片可促进胸液吸收,加快临床症状消失,防止胸膜肥厚粘连,以及防止肝损害等,值得临床推广。 相似文献
8.
经CT和临床确诊的20例结核性脑膜炎进行回顾性分析。作者根据CT改变将其分为三种类型:(1)脑炎结节型;(2)结核瘤型;(3)脑积水型。并就CT诊断结核性脑膜炎的价值与限度进行了讨论。 相似文献
9.
本文报告国内首例由波氏假阿列色菌(Pseudallescheria boydii)引起的真菌性脑膜炎,对其从脑脊液中培养出的波氏假阿列色菌进行了形态特点、培养特性、超微结构及抗原性的研究。该病例经用二性霉素B与5-氟胞嘧啶联合治疗后痊愈。 相似文献
10.
Amir Kimia MD John S. Brownstein PhD Karen L. Olson PhD Victor Zak PhD Florence T. Bourgeois MD MPH Kenneth D. Mandl MD MPH 《Academic emergency medicine》2006,13(7):767-773
Background: The Centers for Disease Control and Prevention is incorporating laboratory data into real-time surveillance systems. When normal patterns of laboratory test orders and results are modeled, aberrations can be detected. Because many test orders are available electronically well before results, atypical patterns of test ordering may signal outbreaks.
Objectives: The authors sought to characterize baseline patterns in the ordering and early results of lumbar punctures, motivated by the possibility of using these data for real-time surveillance for early detection of meningitis or encephalitis outbreaks.
Methods: Retrospective cohorts of pediatric emergency department patients at a single hospital (1993–2003) and from the National Hospital and Ambulatory Medical Care Survey (1992–2000) were used for analysis.
Results: Test ordering exhibits seasonal patterns, with monthly peaks in January and August (p < 0.0001). For the hospital cohort, the rate of cerebrospinal fluid pleocytosis exhibits seasonal patterns (p < 0.0001), with a peak from August to October. This is strongly associated with the rate and pattern of clinical neurologic disease (p < 0.0001). A long-term secular decline in daily test ordering is evident, dropping from 5.3 to 2.9 in the hospital sample, and from 371.8 to 185.3 in the national sample (p < 0.001). The long-term rate of pleocytosis has declined (p < 0.0001), though the yield of testing for pleocytosis has improved (p = 0.0104).
Conclusions: Laboratory test patterns correspond with those of clinical disease and are a promising source of surveillance data. Using such data for real-time monitoring requires specific adjustments for patient age, periodicities, and secular trends. 相似文献
Objectives: The authors sought to characterize baseline patterns in the ordering and early results of lumbar punctures, motivated by the possibility of using these data for real-time surveillance for early detection of meningitis or encephalitis outbreaks.
Methods: Retrospective cohorts of pediatric emergency department patients at a single hospital (1993–2003) and from the National Hospital and Ambulatory Medical Care Survey (1992–2000) were used for analysis.
Results: Test ordering exhibits seasonal patterns, with monthly peaks in January and August (p < 0.0001). For the hospital cohort, the rate of cerebrospinal fluid pleocytosis exhibits seasonal patterns (p < 0.0001), with a peak from August to October. This is strongly associated with the rate and pattern of clinical neurologic disease (p < 0.0001). A long-term secular decline in daily test ordering is evident, dropping from 5.3 to 2.9 in the hospital sample, and from 371.8 to 185.3 in the national sample (p < 0.001). The long-term rate of pleocytosis has declined (p < 0.0001), though the yield of testing for pleocytosis has improved (p = 0.0104).
Conclusions: Laboratory test patterns correspond with those of clinical disease and are a promising source of surveillance data. Using such data for real-time monitoring requires specific adjustments for patient age, periodicities, and secular trends. 相似文献