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排序方式: 共有1126条查询结果,搜索用时 15 毫秒
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Juhani Ojala Jukka Vanhanen Hanna Harno Pantelis Lioumis Selja Vaalto Mari A. Kaunisto Jukka Putaala Marko Kangasniemi Erika Kirveskari Jyrki P. Mäkelä Eija Kalso 《Neuromodulation》2022,25(4):538-548
ObjectivesCentral poststroke pain (CPSP), a neuropathic pain condition, is difficult to treat. Repetitive transcranial magnetic stimulation (rTMS) targeted to the primary motor cortex (M1) can alleviate the condition, but not all patients respond. We aimed to assess a promising alternative rTMS target, the secondary somatosensory cortex (S2), for CPSP treatment.Materials and MethodsThis prospective, randomized, double-blind, sham-controlled three-arm crossover trial assessed navigated rTMS (nrTMS) targeted to M1 and S2 (10 sessions, 5050 pulses per session at 10 Hz). Participants were evaluated for pain, depression, anxiety, health-related quality of life, upper limb function, and three plasticity-related gene polymorphisms including Dopamine D2 Receptor (DRD2). We monitored pain intensity and interference before and during stimulations and at one month. A conditioned pain modulation test was performed using the cold pressor test. This assessed the efficacy of the descending inhibitory system, which may transmit TMS effects in pain control.ResultsWe prescreened 73 patients, screened 29, and included 21, of whom 17 completed the trial. NrTMS targeted to S2 resulted in long-term (from baseline to one-month follow-up) pain intensity reduction of ≥30% in 18% (3/17) of participants. All stimulations showed a short-term effect on pain (17–20% pain relief), with no difference between M1, S2, or sham stimulations, indicating a strong placebo effect. Only nrTMS targeted to S2 resulted in a significant long-term pain intensity reduction (15% pain relief). The cold pressor test reduced CPSP pain intensity significantly (p = 0.001), indicating functioning descending inhibitory controls. The homozygous DRD2 T/T genotype is associated with the M1 stimulation response.ConclusionsS2 is a promising nrTMS target in the treatment of CPSP. The DRD2 T/T genotype might be a biomarker for M1 nrTMS response, but this needs confirmation from a larger study. 相似文献
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K. Heikkilä I. E. H. Madsen S. T. Nyberg E. I. Fransson H. Westerlund P. J. M. Westerholm M. Virtanen J. Vahtera A. Väänänen T. Theorell S. B. Suominen M. J. Shipley P. Salo R. Rugulies J. Pentti J. H. Pejtersen T. Oksanen M. Nordin M. L. Nielsen A. Kouvonen A. Koskinen M. Koskenvuo A. Knutsson J. E. Ferrie N. Dragano H. Burr M. Borritz J. B. Bjorner L. Alfredsson G. D. Batty A. Singh‐Manoux M. Kivimäki the IPD‐Work Consortium 《Allergy》2014,69(6):775-783
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Varenicline and Nicotine Patch Therapies in Young Adults Motivated to Quit Smoking: A Randomized,Placebo‐controlled,Prospective Study 下载免费PDF全文
Anna Tuisku Merita Salmela Pentti Nieminen Tuula Toljamo 《Basic & clinical pharmacology & toxicology》2016,119(1):78-84
This study compares the nicotine patch to placebo in young adult light smokers, and the nicotine patch to varenicline in heavy smokers. Volunteer daily smokers were recruited into a randomized, placebo‐controlled study via community media, colleges and the army (aged 18–26 years). Those subjects with light tobacco dependence were randomized to (i) placebo patch (n = 86) and (ii) nicotine patch 10 mg/16 hr for 8 weeks (n = 94), and those with stronger dependence to (iii) nicotine patch 15 mg/16 hr for 8 weeks (n = 51) and (iv) varenicline for 12 weeks (n = 60). The primary outcome variable was self‐reported smoking abstinence at week 12. Secondary outcome variables were self‐reported smoking abstinence at weeks 4 and 26, and self‐reported abstinence verified by saliva cotinine level at week 12. The prevalence of self‐reported smoking abstinence did not differ statistically significantly in light smokers during the follow‐up (week 4: 19.8% for placebo patch and 26.6% for nicotine patch 10 mg/16 hr; week 12: 17.4% versus 23.4%; week 26: 15.1% versus 20.2%), but the groups of heavy smokers differed significantly for 12 weeks (week 4: 19.6% for nicotine patch 15 mg/16 hr and 73.3% for varenicline, p < 0.001; week 12: 15.7% versus 36.7%, p = 0.018). This statistically significant difference did not endure for the entire follow‐up (week 26: 9.8% versus 18.3%, p = 0.280). However, saliva cotinine verified abstinence at week 12 did not support self‐reported abstinence. Varenicline may be more effective than the nicotine patch as a smoking cessation pharmacotherapy among young adult heavy smokers in the short‐term. 相似文献
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Raffaele Ferrari Mia Kero Kin Mok Anders Paetau Pentti J. Tienari Olli Tynninen John Hardy Parastoo Momeni Auli Verkkoniemi-Ahola Liisa Myllykangas 《Neurobiology of aging》2014
A hexanucleotide repeat expansion in the chromosome 9 open reading frame 72 gene (C9orf72) was recently identified as the most common genetic cause of frontotemporal dementia/amyotrophic lateral sclerosis. Here we describe the clinical, pathologic, and genetic features of a Finnish C9orf72 expansion carrier, who developed a dysplastic gangliocytoma (Lhermitte-Duclos disease), a rare hamartoma/overgrowth syndrome of cerebellar granule cells associated with mutations in the phosphatase and tensin homolog gene. In addition to the dysplastic gangliocytoma, the patient showed typical transactive response DNA-binding protein with Mr 43 kD (TDP-43) pathology mainly in the cortex and the substantia nigra and numerous p62-positive/TDP-43-negative inclusions in the cerebellar granule cells. His sister carried the same gene defect and showed a similar type of TDP-43/p62 pathology in her brain. Our findings confirm that the clinical and pathologic picture of C9orf72 mutation carriers is more heterogeneous than originally thought and warrants further studies on the possible involvement of phosphatase and tensin homolog gene pathway in the specific cerebellar granule cell pathology associated with C9orf72 expansion. 相似文献
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Patient participation in pro re nata medication in psychiatric inpatient settings: An integrative review 下载免费PDF全文
Kirsi Hipp MNSc RN Lauri Kuosmanen PhD RN FEANS Eila Repo‐Tiihonen MD PhD Minna Leinonen MSc Olavi Louheranta PhD ThM Mari Kangasniemi PhD RN 《International journal of mental health nursing》2018,27(2):536-554
Pro re nata (PRN) medication is widely used and studied in psychiatric care, but our knowledge about patient participation in its administration is fragmented. The aim of this integrative review was to describe and synthesize previous knowledge of patient participation in PRN in psychiatric inpatient settings. We conducted both electronic and manual searches, using the CINAHL, Scopus, PsycINFO, and PubMed databases, and eight scientific journals. Searches were limited to the English language, to the years 2006–2016, and to selected papers using inclusion, exclusion, and quality criteria. We identified 16 relevant papers, and these showed that patient participation included patient‐related starting points, including the patients’ willingness to participate and their knowledge of the medication. The patients’ participation in PRN practices was demonstrated by the opportunity to request PRN and to refuse any PRN that was offered. Patient participation was shown to be linked to certain situations where PRN was recommended. The role that the professionals played in patient participation included interacting with patients, providing counselling and alternatives for PRN. Our results also revealed that coercion was used administering PRN. The existing literature exposed challenges that need to be addressed if patient participation in the use of PRN medication is to be effectively achieved in psychiatric inpatient settings. Equal partnerships between patients, nurses, and physicians are an essential part of this process, and further research into PRN medication is urgently needed, particularly studies that focus on patients’ experiences. 相似文献
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Tianwei Xu Linda L. Magnusson Hanson Theis Lange Liis Starkopf Hugo Westerlund Ida E. H. Madsen Reiner Rugulies Jaana Pentti Sari Stenholm Jussi Vahtera Åse M. Hansen Mika Kivimäki Naja H. Rod 《Diabetologia》2018,61(1):75-83