全文获取类型
收费全文 | 414030篇 |
免费 | 37456篇 |
国内免费 | 12534篇 |
专业分类
耳鼻咽喉 | 2414篇 |
儿科学 | 7857篇 |
妇产科学 | 5029篇 |
基础医学 | 38231篇 |
口腔科学 | 7212篇 |
临床医学 | 45136篇 |
内科学 | 59153篇 |
皮肤病学 | 4670篇 |
神经病学 | 23422篇 |
特种医学 | 8950篇 |
外国民族医学 | 64篇 |
外科学 | 30820篇 |
综合类 | 72708篇 |
现状与发展 | 49篇 |
一般理论 | 69篇 |
预防医学 | 36321篇 |
眼科学 | 7133篇 |
药学 | 40272篇 |
501篇 | |
中国医学 | 42671篇 |
肿瘤学 | 31338篇 |
出版年
2024年 | 504篇 |
2023年 | 6809篇 |
2022年 | 9597篇 |
2021年 | 16515篇 |
2020年 | 17055篇 |
2019年 | 14752篇 |
2018年 | 14092篇 |
2017年 | 15153篇 |
2016年 | 15798篇 |
2015年 | 15284篇 |
2014年 | 28062篇 |
2013年 | 31850篇 |
2012年 | 25190篇 |
2011年 | 27422篇 |
2010年 | 22966篇 |
2009年 | 21091篇 |
2008年 | 20538篇 |
2007年 | 21683篇 |
2006年 | 19105篇 |
2005年 | 17442篇 |
2004年 | 14641篇 |
2003年 | 12681篇 |
2002年 | 9977篇 |
2001年 | 9178篇 |
2000年 | 7462篇 |
1999年 | 6216篇 |
1998年 | 4473篇 |
1997年 | 4069篇 |
1996年 | 3814篇 |
1995年 | 3828篇 |
1994年 | 3266篇 |
1993年 | 2786篇 |
1992年 | 2456篇 |
1991年 | 2205篇 |
1990年 | 1845篇 |
1989年 | 1757篇 |
1988年 | 1667篇 |
1987年 | 1347篇 |
1986年 | 1090篇 |
1985年 | 1234篇 |
1984年 | 1203篇 |
1983年 | 747篇 |
1982年 | 935篇 |
1981年 | 764篇 |
1980年 | 720篇 |
1979年 | 553篇 |
1978年 | 436篇 |
1977年 | 364篇 |
1976年 | 379篇 |
1975年 | 240篇 |
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
1.
Rolf Svedjeholm Gabriele Ferrari Farkas Vanky Örjan Friberg Jonas Holm 《Acta anaesthesiologica Scandinavica》2023,67(10):1373-1382
Background
Glutamate plays a key role for post-ischaemic recovery of myocardial metabolism. According to post hoc analyses of the two GLUTAMICS trials, patients without diabetes benefit from glutamate with less myocardial dysfunction after coronary artery bypass surgery (CABG). Copeptin reflects activation of the Arginine Vasopressin system and is a reliable marker of heart failure but available studies in cardiac surgery are limited. We investigated whether glutamate infusion is associated with reduced postoperative rises of plasma Copeptin (p-Copeptin) after CABG.Methods
A prespecified randomised double-blind substudy of GLUTAMICS II. Patients had left ventricular ejection fraction ≤0.30 or EuroSCORE II ≥3.0 and underwent CABG ± valve procedure. Intravenous infusion of 0.125 M L-glutamic acid or saline at 1.65 mL/kg/h was commenced 10–20 min before the release of the aortic cross-clamp and then continued for another 150 min P-Copeptin was measured preoperatively and postoperatively on day one (POD1) and day three. The primary endpoint was an increase in p-Copeptin from the preoperative level to POD1. Postoperative stroke ≤24 h and mortality ≤30 days were safety outcomes.Results
We included 181 patients of whom 48% had diabetes. The incidence of postoperative mortality ≤30 days (0% vs. 2.1%; p = .50) and stroke ≤24 h (0% vs. 3.2%; p = .25) did not differ between the glutamate group and controls. P-Copeptin increased postoperatively with the highest values recorded on POD1 without significant inter-group differences. Among patients without diabetes, p-Copeptin did not differ preoperatively but postoperative rise from preoperative level to POD1 was significantly reduced in the glutamate group (73 ± 66 vs. 115 ± 102 pmol/L; p = .02). P-Copeptin was significantly lower in the Glutamate group on POD1 (p = .02) and POD 3 (p = .02).Conclusions
Glutamate did not reduce rises of p-Copeptin significantly after moderate to high-risk CABG. However, glutamate was associated with reduced rises of p-Copeptin among patients without diabetes. These results agree with previous observations suggesting that glutamate mitigates myocardial dysfunction after CABG in patients without diabetes. Given the exploratory nature of these findings, they need to be confirmed in future studies. 相似文献2.
《The Journal for Nurse Practitioners》2022,18(5):580-582
Obstructive sleep apnea (OSA) is a sleep disorder common among patients with type 2 diabetes (T2D). The aim of this quality improvement project was to increase identification and referral for sleep study for individuals with T2D at moderate to high risk for OSA. Pre- and post-intervention patient samples were analyzed to compare the number of referrals for sleep study. Results demonstrated that none of the patients pre-intervention were referred for sleep study compared with 77% of patients post-intervention. This project demonstrated implementing an evidence-based tool to screen patients with T2D for OSA leads to higher rates of detection and referral. 相似文献
3.
BackgroundFindings on the usefulness of massage therapy (MT) in postoperative pain management are often inconsistent among studies.ObjectivesThis study’s aim is to conduct a meta-analysis of randomized controlled trials (RCT) to clarify the effects of massage therapy in the treatment of postoperative pain.MethodsThree databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) were searched for RCTs published from database inception through January 26, 2021. The primary outcome was pain relief. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The random-effect model was used to calculate the effect sizes and standardized mean difference (SMD) with 95 % confidential intervals (CIs) as a summary effect. The heterogeneity test was conducted through I2. Subgroup and sensitivity analyses were used to explore the source of heterogeneity. Possible publication bias was assessed using visual inspection of funnel plot asymmetry.ResultsThe analysis included 33 RCTs and showed that MT is effective in reducing postoperative pain (SMD, −1.32; 95 % CI, −2.01 to −0.63; p = 0.0002; I2 = 98.67 %). A similar significant effect was found for both short (immediate assessment) and long terms (assessment performed 4–6 weeks after the MT). Remarkably, we found neither the duration per session nor the dose had an impact on the effect of MT and there seemed to be no difference in the effects of different MT types. In addition, MT seemed to be more effective for adults. Furthermore, MT had better analgesic effects on cesarean section and heart surgery than orthopedic surgery.LimitationsPublication bias is possible due to the inclusion of studies in English only. Additionally, the included studies were extremely heterogeneous. Double-blind research on MT is difficult to implement, and none of the included studies is double-blind. There was some heterogeneity and publication bias in the included studies. In addition, there is no uniform evaluation standard for the operation level of massage practitioners, which may lead to research implementation bias.ConclusionsMT is effective in reducing postoperative pain in both short and long terms. 相似文献
4.
5.
《Vaccine》2022,40(30):4038-4045
PurposeAs protection from COVID-19 following two doses of the BNT162b2 vaccine showed a time dependent waning, a third (booster) dose was administrated. This study aims to compare the antibody response following the third dose versus the second and to evaluate post-booster seroconversion.MethodsA prospective observational study conducted in Maccabi Healthcare Services. Serial SARS-CoV-2 Spike IgG tests, 1,2,3 and 6 months following the second vaccine dose and one month following the third were obtained. Neutralizing antibody levels were measured in a subset of participants. Per individual SARS-CoV-2 Spike IgG titer ratios were calculated one month after the booster administration compared to titers one month following the second dose and prior to booster.ResultsAmong 110 participants, 56 (51%) were women. Mean age was 61.7 ± 1.9 years and 66 (60%) were immunocompromised. One month after third dose, IgG titers were induced 7.83 (95 %CI 5.25–11.67) folds and 2.40 (95 %CI 1.90–3.03) folds compared to one month after the second, in the immunocompromised and immunocompetent groups, respectively. Of the 17 immunocompromised participants who were seronegative after the second dose, 4 (24%) became seropositive following the third. Comparing the titers prior to the third dose, an increase of 50.7 (95 %CI 32.5–79.1) fold in the immunocompromised group and 25.7 (95 %CI 19.1–34.7) fold in and immunocompetent group, was observed.ConclusionA third BNT162b2 vaccine elicited robust humoral response, superior to the response observed following the second, among immunocompetent and immunocompromised individuals. 相似文献
6.
7.
8.
Wan-Jun Zhang Li-Qiang Wu Jun Wang Sheng-Yun Lin Bo Wang 《World Journal of Clinical Cases》2022,10(23):8242-8248
ABSTRACT
BACKGROUND
Hepatitis-associated aplastic anemia (HAAA) is a rare condition. Patients with HAAA usually present with acute hepatitis, jaundice and significantly increased transaminase. After 1–2 mo, hepatitis gradually improves, but progressive hemocytopenia, bone marrow hematopoietic failure, and severe or extremely severe aplastic anemia are manifest. Most cases of HAAA are fulminant and usually lethal if left untreated. The literature on Epstein–Barr virus (EBV)-associated HAAA is sparse.
CASE SUMMARY
We report a 30-year-old man who was admitted to our hospital because of pale yellow urine and skin with a simultaneous decrease in peripheral blood ternary cells. We made a diagnosis of EBV-associated HAAA. The treatment strategy for this patient included eltrombopag, an immunosuppressive regimen of rabbit anti-human thymocyte immunoglobulin, cyclosporine, and supportive care. The patient was discharged in normal physical condition after five months. A hemogram performed on follow-up revealed that he had achieved a complete response.
CONCLUSION
Eltrombopag plus anti-thymocyte globubin and cyclosporine may be a therapeutic option for EBV-associated HAAA.Larger studies are warranted to confirm. 相似文献
9.
10.
Major depressive disorder is a serious and common neuropsychiatric disorder that affects more than 350 million people worldwide. Electroconvulsive therapy is the oldest and most effective treatment available for the treatment of severe major depressive disorder. Electroconvulsive therapy modifies structural network changes in patients with major depressive disorder and schizophrenia. And it can also affect neuroinflammatory responses and may have neuroprotective effects. Electroconvulsive therapy plays an irreplaceable role in the treatment of major depressive disorder. 相似文献