全文获取类型
收费全文 | 3781篇 |
免费 | 273篇 |
国内免费 | 71篇 |
专业分类
耳鼻咽喉 | 15篇 |
儿科学 | 117篇 |
妇产科学 | 49篇 |
基础医学 | 592篇 |
口腔科学 | 73篇 |
临床医学 | 469篇 |
内科学 | 884篇 |
皮肤病学 | 60篇 |
神经病学 | 263篇 |
特种医学 | 425篇 |
外科学 | 415篇 |
综合类 | 41篇 |
一般理论 | 1篇 |
预防医学 | 319篇 |
眼科学 | 62篇 |
药学 | 184篇 |
肿瘤学 | 156篇 |
出版年
2023年 | 12篇 |
2022年 | 9篇 |
2021年 | 56篇 |
2020年 | 29篇 |
2019年 | 46篇 |
2018年 | 59篇 |
2017年 | 54篇 |
2016年 | 50篇 |
2015年 | 75篇 |
2014年 | 128篇 |
2013年 | 141篇 |
2012年 | 198篇 |
2011年 | 172篇 |
2010年 | 123篇 |
2009年 | 127篇 |
2008年 | 148篇 |
2007年 | 227篇 |
2006年 | 174篇 |
2005年 | 169篇 |
2004年 | 153篇 |
2003年 | 140篇 |
2002年 | 122篇 |
2001年 | 116篇 |
2000年 | 124篇 |
1999年 | 112篇 |
1998年 | 97篇 |
1997年 | 102篇 |
1996年 | 119篇 |
1995年 | 93篇 |
1994年 | 67篇 |
1993年 | 84篇 |
1992年 | 66篇 |
1991年 | 75篇 |
1990年 | 57篇 |
1989年 | 78篇 |
1988年 | 59篇 |
1987年 | 66篇 |
1986年 | 44篇 |
1985年 | 52篇 |
1984年 | 32篇 |
1983年 | 38篇 |
1982年 | 34篇 |
1981年 | 29篇 |
1980年 | 25篇 |
1979年 | 18篇 |
1978年 | 18篇 |
1977年 | 18篇 |
1976年 | 12篇 |
1975年 | 16篇 |
1970年 | 10篇 |
排序方式: 共有4125条查询结果,搜索用时 15 毫秒
1.
Ellen Strijbos Martijn R. Tannemaat Iris Alleman Robert H.P. de Meel Jaap A. Bakker Ruud van Beek Frank P. Kroon Guus F. Rimmelzwaan Jan J.G.M. Verschuuren 《Vaccine》2019,37(7):919-925
Objective
To investigate the efficacy and safety of an influenza vaccination in patients with myasthenia gravis with acetylcholine receptor antibodies (AChR MG).Methods
An influenza vaccination or placebo was administered to 47 AChR MG patients. Before and 4?weeks after administration blood samples and clinical outcome scores were obtained. Antibodies to the vaccine strains A/California/7/2009 (H1N1)pdm09, A/Hong Kong/4801/14 (H3N2) and B/Brisbane/060/08 were measured using the hemagglutination-inhibition (HI) assay and disease-specific AChR antibody titers were measured with a radio-immunoprecipitation assay. Forty-seven healthy controls (HC) were vaccinated with the same influenza vaccine to compare antibody titers.Results
A post-vaccination, seroprotective titer (HI?≥?1:40) was achieved in 89.4% of MG patients vs. 93.6% in healthy controls for the H3N2 strain, 95.7% vs 97.9% for the H1N1 strain and 46.8 vs 51% for the B-strain. A seroprotective titer for all three strains of the seasonal influenza vaccine was reached in 40.4% (19/47) of the MG group and in 51% (24/47) of the HC group. Immunosuppressive medication did not significantly influence post geomean titers (GMT). The titers of disease-specific AChR antibodies were unchanged 4?weeks after vaccination. The clinical outcome scores showed no exacerbation of MG symptoms.Conclusion
The antibody response to an influenza vaccination in patients with AChR MG was not different from that in healthy subjects, even in AChR MG patients using immunosuppressive medication. Influenza vaccination does not induce an immunological or clinical exacerbation of AChR MG.Clinical trial registry
The influenza trial is listed on clinicaltrialsregister.eu under 2016-003138-26. 相似文献2.
Anne‐Grete Mrtson Anette Veringa Edwin R. van den Heuvel Martijn Bakker Daan J. Touw Tjip S. van der Werf Lambert F. R. Span Jan‐Willem C. Alffenaar 《Mycoses》2019,62(8):698-705
Posaconazole is indicated for prophylaxis and treatment of invasive aspergillosis. Therapeutic drug monitoring (TDM) of posaconazole is used to optimise drug exposure. The aim of this study was to analyse and describe the TDM practices and exposure of posaconazole tablets. Patients who received posaconazole for treatment or prophylaxis of fungal infections were included in the study. The following therapeutic window was defined: if concentration was low (<0.7 mg/L for prophylaxis or < 1.5 mg/L for treatment) or high (>3.75 mg/L), the hospital pharmacist provided the physician with dosage advice, which implementation to patient care was analysed. A longitudinal analysis was performed to analyse if different confounding variables had an effect on posaconazole concentrations. Forty‐seven patients were enrolled resulting in 217 posaconazole trough concentrations. A median of 3 (IQR 1‐7) samples was measured per patient. The median concentration was 1.7 mg/L (IQR 0.8‐2.7) for prophylaxis and 1.76 mg/L (IQR 1.3‐2.3) for treatment. Overall, 78 posaconazole concentrations were out of the therapeutic window. For 45 (54%) of these concentrations, a dosage change was recommended. In the longitudinal analysis, the laboratory markers and patient baseline variables did not have an effect on posaconazole concentrations. Adequate posaconazole exposure was shown in 64% (affected 28 patients) of the measured concentrations. TDM practice of posaconazole can be improved by increasing the implementation rate of dose recommendation by a multidisciplinary antifungal stewardship team. 相似文献
3.
Erik de Bakker Mirthe A. M. van der Putten Martijn W. Heymans Sander W. Spiekstra Taco Waaijman Liselotte Butzelaar Vera L. Negenborn Vivian K. Beekman Erman O. Akpinar Thomas Rustemeyer Frank B. Niessen Susan Gibbs 《Experimental dermatology》2021,30(1):169-178
Unpredictable hypertrophic scarring (HS) occurs after approximately 35% of all surgical procedures and causes significant physical and psychological complaints. Parallel to the need to understanding the mechanisms underlying HS formation, a prognostic tool is needed. The objective was to determine whether (systemic) immunological differences exist between patients who develop HS and those who develop normotrophic scars (NS) and to assess whether those differences can be used to identify patients prone to developing HS. A prospective cohort study with NS and HS groups in which (a) cytokine release by peripheral blood mononuclear cells (PBMC) and (b) the irritation threshold (IT) after an irritant (sodium lauryl sulphate) patch test was evaluated. Univariate regression analysis of PBMC cytokine secretion showed that low MCP‐1, IL‐8, IL‐18 and IL‐23 levels have a strong correlation with HS (P < .010‐0.004; AUC = 0.790‐0.883). Notably, combinations of two or three cytokines (TNF‐a, MCP‐1 and IL‐23; AUC: 0.942, Nagelkerke R2: 0.727) showed an improved AUC indicating a better correlation with HS than single cytokine analysis. These combination models produce good prognostic results over a broad probability range (sensitivity: 93.8%, specificity 86.7%, accuracy 90,25% between probability 0.3 and 0.7). Furthermore, the HS group had a lower IT than the NS group and an accuracy of 68%. In conclusion, very fundamental immunological differences exist between individuals who develop HS and those who do not, whereas the cytokine assay forms the basis of a predictive prognostic test for HS formation, the less invasive, easily performed irritant skin patch test is more accessible for daily practice. 相似文献
4.
5.
6.
7.
Aetiological factors for oral manifestations of HIV 总被引:2,自引:0,他引:2
GD Palmer PG Robinson SJ Challacombe W Birnbaum D Croser PL Erridge T Hodgson D Lewis A McLaren JM Zakrzewska 《Oral diseases》1996,2(3):193-197
OBJECTIVES: Describe the oral diseases in HIV-infected individuals in London, UK and identify social and medical factors related to the presence of specific oral diseases.
DESIGN: Cross-sectional analytic study.
SETTING: Dental clinics.
SUBJECTS: Consecutive sample of 456 patients with HIV infection.
METHODS: Social and medical history and clinical examinations. Univariate and logistic regression analysis.
OUTCOMES: Presence of HIV-associated oral disease.
RESULTS: 80% of patients with AIDS and 50% of patients with HIV had a specific oral disease. The most common diseases were hairy leukoplakia (30%), erythematous candidiasis (24%), pseudomembranous candidiasis (14%), angular chielitis (6%), necrotising periodontal disease (8%) and non-recurrent ulceration (6%).
CONCLUSIONS: The presence of erythematous candidiasis was not related to advanced HIV disease. Pseudomembranous candidiasis, hairy leukoplakia and mucosal ulceration were significantly associated with advanced HIV disease. Smoking was also identified as a strong aetiological factor in oral diseases. Longitudinal studies are required to further explore the prognostic significance of oral diseases in HIV infection. 相似文献
DESIGN: Cross-sectional analytic study.
SETTING: Dental clinics.
SUBJECTS: Consecutive sample of 456 patients with HIV infection.
METHODS: Social and medical history and clinical examinations. Univariate and logistic regression analysis.
OUTCOMES: Presence of HIV-associated oral disease.
RESULTS: 80% of patients with AIDS and 50% of patients with HIV had a specific oral disease. The most common diseases were hairy leukoplakia (30%), erythematous candidiasis (24%), pseudomembranous candidiasis (14%), angular chielitis (6%), necrotising periodontal disease (8%) and non-recurrent ulceration (6%).
CONCLUSIONS: The presence of erythematous candidiasis was not related to advanced HIV disease. Pseudomembranous candidiasis, hairy leukoplakia and mucosal ulceration were significantly associated with advanced HIV disease. Smoking was also identified as a strong aetiological factor in oral diseases. Longitudinal studies are required to further explore the prognostic significance of oral diseases in HIV infection. 相似文献
8.
9.
10.
Fewer intensive care unit refusals and a higher capacity utilization by using a cyclic surgical case schedule 总被引:1,自引:0,他引:1
Van Houdenhoven M van Oostrum JM Wullink G Hans E Hurink JL Bakker J Kazemier G 《Journal of critical care》2008,23(2):222-226
PURPOSE: Mounting health care costs force hospital managers to maximize utilization of scarce resources and simultaneously improve access to hospital services. This article assesses the benefits of a cyclic case scheduling approach that exploits a master surgical schedule (MSS). An MSS maximizes operating room (OR) capacity and simultaneously levels the outflow of patients toward the intensive care unit (ICU) to reduce surgery cancellation. MATERIALS AND METHODS: Relevant data for Erasmus MC have been electronically collected since 1994. These data are used to construct an MSS that consisted of a set of surgical case types scheduled for a period or cycle. This cycle was executed repetitively. During such a cycle, surgical cases for each surgical department were scheduled on a specific day and OR. The experiments were performed for the Erasmus University Medical Center and for a virtual hospital. RESULTS: Unused OR capacity can be reduced by up to 6.3% for a cycle length of 4 weeks, with simultaneous optimal leveling of the ICU workload. CONCLUSIONS: Our findings show that the proposed cyclic OR planning policy may benefit OR utilization and reduce surgical case cancellation and peak demands on the ICU. 相似文献