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1.
An increased number of patients is at risk of Candida spp. bloodstream infection (CBSI) in modern medicine. Moreover, the rising of antifungal resistance (AR) was recently reported. All consecutive CBSI occurred in our Hospital (consisting of 1,370 beds) between 2015 and 2018, were reviewed. For each case, Candida species, AR pattern, ward involved and demographic data of patients were recorded. Overall, 304 episodes of CBSI occurred, with a median (q1:first-,q3:third quartile) of 77 (71-82) CBSI/year. Over the years, a significant increase of CBSI due to C. albicans compared to non-albicans strains was recorded in medical wards (from 65% to 71%, p=0.030), while this ratio remained stable in others. An increase of resistant strains to multiple antifungals such as C. guillermondii was noticed in recent years (from 0% to 9.8%, p=0.008). Additionally, from 2015 to 2018 an increase in fluconazole-resistance was recorded in our Hospital (from 7.4% to 17.4%, p=0.025) and a slight increase in voriconazole-resistance (from 0% to 7% in 2018, p=0.161) was observed, while resistance to echinocandin and amphotericin B remained firmly below 2%.This study suggests a rapid spread of antifungal resistance in our Hospital; therefore, an appropriate antifungal stewardship programs is urgently warranted.  相似文献   
2.
目的:探讨联合应用宏基因组学和培养组学技术对米氏克雷伯菌合并白色念珠菌感染所致不明原因发热患者的病原检测、分离和治疗措施。方法:分析济南市疾病预防控制中心联合山东大学齐鲁医院对2019年7月1日收治的1例米氏克雷伯菌合并白色念珠菌感染导致的不明原因发热患者的诊疗过程,并复习相关文献。结果:该患者主动脉层术后持续间断发热,经抗真菌治疗后效果不佳,经宏基因组学测序联合培养组学技术分离病原提示疑似米氏克雷伯菌合并白色念珠菌感染,调整使用头孢哌酮钠舒巴坦钠联合卡泊芬净抗感染治疗后,患者发热症状消失,实验室指标恢复正常后出院。结论:米氏克雷伯菌感染较少见,且易误诊为其他克雷伯菌,应用宏基因组学联合培养组学技术可尽早明确该病原所致感染,以进行针对性的抗感染治疗。  相似文献   
3.
Both diabetes and fungal infections contribute significantly to the global disease burden, with increasing trends seen in most developed and developing countries during recent decades. This is reflected in urogenital infections caused by Candida species that are becoming ever more pervasive in diabetic patients, particularly those that present with unsatisfactory glycemic control. In addition, a relatively new group of anti-hyperglycemic drugs, known as sodium glucose cotransporter 2 inhibitors, has been linked with an increased risk for colonization of the urogenital region with Candida spp., which can subsequently lead to an infectious process. In this review paper, we have highlighted notable virulence factors of Candida species (with an emphasis on Candida albicans) and shown how the interplay of many pathophysiological factors can give rise to vulvovaginal candidiasis, potentially complicated with recurrences and dire pregnancy outcomes. We have also addressed an increased risk of candiduria and urinary tract infections caused by species of Candida in females and males with diabetes, further highlighting possible complications such as emphysematous cystitis as well as the risk for the development of balanitis and balanoposthitis in (primarily uncircumcised) males. With a steadily increasing global burden of diabetes, urogenital mycotic infections will undoubtedly become more prevalent in the future; hence, there is a need for an evidence-based approach from both clinical and public health perspectives.  相似文献   
4.
目的 利用一个菌株-多个化合物(OSMAC)方法研究海洋来源真菌Cochliobolus lunatus的次生代谢产物及其抗真菌活性。方法 利用氮源丰富的GPY培养基诱导海洋来源真菌Cochliobolus lunatus产生新的酯肽类化合物,采用正相硅胶柱层析、凝胶柱层析、半制备高效液相色谱(HPLC)等方法对化合物进行分离纯化,利用核磁共振波谱学(NMR)和X-Ray单晶衍射手段并参考文献对化合物进行结构表征,利用各种活性模型对其进行系统的生物学活性评价。结果 从海洋来源真菌分离获得环十酯肽化合物cyclopeptolide 1,并报道其晶体结构,发现其具有抗真菌活性(MIC=16 μg/mL),并与临床药物氟胞嘧啶在抗真菌实验中显示协同效应。结论 cyclopeptolide 1在抗真菌药物研发领域有望成为重要的先导化合物。  相似文献   
5.
The incidence of microbial keratitis (MK) is variable worldwide with an estimated 1.5–2 million cases of corneal ulcers in developing countries. The complications of MK can be severe and vision threatening. Therefore, proper diagnosis of the causative organism is essential for early successful treatment. Accurate sampling of microbiological specimens in MK is an important step in identifying the infective organism. Corneal scrapping, tear samples and corneal biopsy are examples of specimens obtained for the investigative procedures in MK. Ophthalmologists especially in an emergency room setting should be aware of the proper sampling techniques based on their microbiology-related basic information for each category of MK. This review article briefly describes the clinical presentation and defines in details the best updated diagnostic methods used in different types of MK. It can be used as a guide for ophthalmology trainees and general ophthalmologists who may be handling such cases at initial presentation.  相似文献   
6.
Background/PurposeAccurate identification of Candida species is increasingly important in the era of emergence of Candida auris. We aimed to compare the identification performance of two matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) systems (Vitek MS and Bruker biotyper MS) and an oligonucleotide array for uncommon blood yeast isolates and demonstrate the susceptibilities among those isolates.MethodCandida species isolates from blood culture other than Candida albicans, Candida parapsilosis, Candida tropicalis, Candida glabrata, and Candida krusei identified by biochemical methods were collected from multiple hospitals and further identified by an oligonucleotide array based on the internal transcribed spacer-1 (ITS-1) and ITS-2 sequences of the rRNA genes, Vitek MS and Bruker biotyper MS. The minimal inhibitory concentrations (MICs) of these clinical isolates were determined by the Sensititre YeastOne (SYO) system.ResultsAmong 136 isolates, Candida guilliermondii was most common (52, 38.2%), followed by C. lusitaniae (13, 9.6%) and C. haemulonii (12, 8.8%). The oligonucleotide array, Vitek MS and Bruker biotyper MS correctly identified 89.7% (122), 90.4% (123), and 92.6% (126) of these isolates, respectively. Elevated minimal inhibitory concentrations (MICs) of fluconazole were observed for C. haemulonii (MIC90: 256 mg/L), and C. guilliermondii (MIC90: 16 mg/L) with 28.4% of uncommon Candida isolates with MIC ≧ 8 mg/L.ConclusionsFor uncommon Candida species, the unmet need for current databases of two commercial MALDI-TOF MS systems is highlighted, and the oligonucleotide array may serve as a supplement.  相似文献   
7.
【摘要】 白细胞介素17A在银屑病的发生发展中具有关键作用。目前,有多种白细胞介素17A及其受体拮抗剂在多个国家上市并应用于银屑病的治疗,取得了明确疗效。然而,该类生物制剂在临床试验阶段及上市后,仍然有多项不良反应报道,包括上呼吸道感染、念珠菌感染、中性粒细胞减少和炎症性肠病等,严重者甚至可危及生命。本文综述3种白细胞介素17A及其受体拮抗剂司库奇尤单抗、ixekizumab和brodalumab的临床安全性。  相似文献   
8.
摘要〓目的〓探究紫苏醇的杀菌效果,探讨其在消毒领域的应用价值。方法〓采用悬液定量杀灭试验方法,观察紫苏醇对部分消毒指标菌的杀灭效果。结果〓用浓度为4 000 mg/L的紫苏醇溶液对悬液内金黄色葡萄球菌作用5 min,杀灭对数值均>5.00|用浓度为3 000 mg/L的紫苏醇溶液对悬液内大肠埃希菌和白色念珠菌作用5 min,杀灭对数值均>5.00。结论〓紫苏醇溶液对部分消毒试验指标菌具有很好的杀灭效果,可进一步探讨其在消毒领域实际应用和使用安全性。  相似文献   
9.
Candida albicans (C. albicans) biofilm is a common etiological factor in denture stomatitis. The purpose of this study was to investigate the effects of incorporating 2-methacryloyloxyethyl phosphorylcholine (MPC) as a protein repellent into a new high-impact denture acrylic (HIPA) resin on the surface roughness, solution pH, and C. albicans biofilm adhesion to the denture base. The new acrylic denture resin base was formulated by mixing MPC into HIPA resin at mass fractions of 1.5%, 3%, and 4.5%. Surface roughness was measured using a Mitutoyo surface roughness tester. C. albicans biofilm growth and viability were assessed via colony forming unit counts. The pH of the biofilm growth medium was measured using a digital pH meter. Adding MPC to the HIPA resin at percentages of 1.5% and 3% increased the roughness values significantly (p < 0.05), while adding 4.5% MPC resulted in no difference in roughness values to that of the control group (p > 0.05). All experimental groups demonstrated neutral pH values (pH ≅ 7) and were not significantly different from each other (p > 0.05). Incorporating 2-methacryloyloxyethyl phosphorylcholine at 4.5% resulted in a significant (≅1 log) colony-forming unit reduction compared with the control group with 0% MPC (p < 0.05). A fungal-retarding denture acrylic resin was developed through the incorporation of MPC for its protein-repelling properties. This newly developed denture acrylic material has the potential to prevent oral microbial infections, such as denture stomatitis.  相似文献   
10.
Background Candida auris is an emerging multidrug-resistant fungal pathogen associated with bloodstream, wound and other infections, especially in critically ill patients. C. auris carriage is persistent and is difficult to eradicate from the hospital environment.AimWe aimed to pilot admission screening for C. auris in intensive care units (ICUs) in England to estimate prevalence in the ICU population and to inform public health guidance.MethodsBetween May 2017 and April 2018, we screened admissions to eight adult ICUs in hospitals with no previous cases of C. auris, in three major cities. Swabs were taken from the nose, throat, axilla, groin, perineum, rectum and catheter urine, then cultured and identified using matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS). Patient records were linked to routine ICU data to describe and compare the demographic and health indicators of the screened cohort with a national cohort of ICU patients admitted between 2016 and 2017.ResultsAll C. auris screens for 921 adults from 998 admissions were negative. The upper confidence limit of the pooled prevalence across all sites was 0.4%. Comparison of the screened cohort with the national cohort showed it was broadly similar to the national cohort with respect to demographics and co-morbidities.ConclusionThese findings imply that C. auris colonisation among patients admitted to ICUs in England is currently rare. We would not currently recommend widespread screening for C. auris in ICUs in England. Hospitals should continue to screen high-risk individuals based on local risk assessment.  相似文献   
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