全文获取类型
收费全文 | 1444篇 |
免费 | 59篇 |
国内免费 | 31篇 |
专业分类
耳鼻咽喉 | 26篇 |
儿科学 | 62篇 |
妇产科学 | 19篇 |
基础医学 | 118篇 |
口腔科学 | 27篇 |
临床医学 | 125篇 |
内科学 | 368篇 |
皮肤病学 | 108篇 |
神经病学 | 36篇 |
特种医学 | 207篇 |
外科学 | 233篇 |
综合类 | 29篇 |
预防医学 | 77篇 |
眼科学 | 7篇 |
药学 | 37篇 |
中国医学 | 3篇 |
肿瘤学 | 52篇 |
出版年
2019年 | 10篇 |
2017年 | 13篇 |
2016年 | 15篇 |
2015年 | 23篇 |
2014年 | 29篇 |
2013年 | 71篇 |
2012年 | 21篇 |
2011年 | 19篇 |
2010年 | 49篇 |
2009年 | 58篇 |
2008年 | 26篇 |
2007年 | 32篇 |
2006年 | 39篇 |
2005年 | 34篇 |
2004年 | 17篇 |
2003年 | 17篇 |
2002年 | 28篇 |
2001年 | 25篇 |
2000年 | 28篇 |
1999年 | 24篇 |
1998年 | 87篇 |
1997年 | 74篇 |
1996年 | 83篇 |
1995年 | 52篇 |
1994年 | 64篇 |
1993年 | 54篇 |
1992年 | 16篇 |
1991年 | 16篇 |
1990年 | 24篇 |
1989年 | 41篇 |
1988年 | 44篇 |
1987年 | 34篇 |
1986年 | 27篇 |
1985年 | 26篇 |
1984年 | 23篇 |
1983年 | 15篇 |
1982年 | 21篇 |
1981年 | 18篇 |
1980年 | 13篇 |
1979年 | 18篇 |
1978年 | 16篇 |
1977年 | 17篇 |
1976年 | 17篇 |
1975年 | 12篇 |
1974年 | 9篇 |
1973年 | 17篇 |
1972年 | 8篇 |
1971年 | 10篇 |
1965年 | 7篇 |
1957年 | 7篇 |
排序方式: 共有1534条查询结果,搜索用时 15 毫秒
1.
2.
3.
Muckle — Wells syndrome (MWS) is a rare autosomal dominant disease that belongs to a group of hereditary periodic fever syndromes. It is part of the wider spectrum of the cryopyrin-associated periodic syndrome (CAPS) which has only rarely been described in non-Caucasian individuals. It is characterized by recurrent self-limiting episodes of fever, urticaria, arthralgia, myalgia and conjunctivitis from childhood. Progressive sensorineural hearing loss and amyloidosis are two late complications. MWS is caused by gain of function mutations in the NLRP3 gene, which encodes cryopyrin, a protein involved in regulating the production of proinflammatory cytokines. We report two patients with MWS in an Indian family associated with the p.D303N mutation in the NLRP3 gene. These findings promote awareness of these hereditary periodic fever syndromes as a cause for recurrent fevers from childhood in the Indian population.KEY WORDS: Hereditary periodic fever, D303N mutation, Indian family, Muckle—Wells syndrome, p.D303N mutation 相似文献
4.
Karl Pillemer Emily K. Chen Catherine Riffin Holly Prigerson MC Reid Leslie Schultz 《American journal of public health》2015,105(11):2237-2244
We employed the research-to-practice consensus workshop (RTP; workshops held in
New York City and Tompkins County, New York, in 2013) model to merge researcher
and practitioner views of translational research priorities in palliative care.
In the RTP approach, a diverse group of frontline providers generates a research
agenda for palliative care in collaboration with researchers. We have presented
the major workshop recommendations and contrasted the practice-based research
priorities with those of previous consensus efforts. We uncovered notable
differences and found that the RTP model can produce unique insights into
research priorities. Integrating practitioner-identified needs into research
priorities for palliative care can contribute to addressing palliative care more
effectively as a public health issue.Over the past 2 decades, palliative care has become established as a promising approach
for addressing the needs of individuals with life-threatening illnesses from a holistic,
interdisciplinary perspective. For this project, we defined palliative care as an
approach that improves the quality of life of patients and families facing the problems
encountered in life-threatening illness by preventing and relieving suffering. Core
components of palliative care include providing relief from pain and other distressing
symptoms, affirming dying as a normal process, integrating psychological and spiritual
aspects of care, enhancing the quality of life of patients, and offering support systems
to patients and their families to help them live as fully as possible until death
occurs.Research suggests that palliative care results in positive patient outcomes, greater
patient and family satisfaction, and significant cost savings.1,2 The American Public Health Association, the
World Health Organization, and the Institute of Medicine3–6 have identified the
development of a robust palliative care delivery system as a key public health issue
because of the documented ability of palliative care to deliver effective and efficient
patient- and symptom-focused care to a growing population in need.In its 2013 report the American Public Health Association specifically detailed the
public health implications of palliative care, acknowledged the growing burden of
advanced chronic illness and disease in older adults, and recommended key steps to
address the problem. This policy statement called for federal, state, and local efforts
to promote effective symptom management in populations with serious illness or at the
end of life. Other recommended initiatives included the development of a palliative care
workforce, educational programs to improve uptake and use of palliative and hospice
care, and research funding to support the expansion of palliative care initiatives.
Achieving these goals will require moving beyond traditional medical practices to
include both policies and initiatives at the public health level.Despite the potential of palliative care to address the mental and physical health needs
of individuals with advanced illness, significant knowledge gaps impede its reach and
effectiveness. Reports from scientific bodies and consensus workshops have highlighted
weaknesses in the literature and called for more research on palliative care and
improved research methods.7–10 Thus, although both interest in and demand for
palliative care are increasing, reviews of the knowledge base continue to lament the
lack of research on many key issues.11,12Especially urgent is a research agenda that fits most closely with the needs of providers
who deliver palliative care. The systematic engagement of community practitioners in a
consensus process can lead to particularly useful and actionable recommendations for
research,13–15 which are greatly needed at this stage in the
development of the field. Therefore, to shed new light on research priorities in
palliative care, we used a structured, participatory method designed to solicit
practitioner input on research priorities: the research-to-practice consensus workshop
(RTP) model.16We employed the RTP approach to identify knowledge gaps and types of studies that should
be conducted to improve providers’ ability to deliver palliative care most
effectively. This model harnesses practice wisdom by engaging clinicians, agency staff,
and other practitioners with researchers in a process of articulating and refining
research questions and research priorities that honors scientific expertise and practice
wisdom. 相似文献
5.
AMJ van Wegberg RAF Evers JGM Burgerhof E van Dam M.R. Heiner-Fokkema MCH Janssen MC de Vries FJ van Spronsen 《Molecular genetics and metabolism》2021,132(1):49-55
BackgroundIn patients with phenylketonuria, stability of blood phenylalanine and tyrosine concentrations might influence brain chemistry and therefore patient outcome. This study prospectively investigated the effects of tetrahydrobiopterin (BH4), as a chaperone of phenylalanine hydroxylase on diurnal and day-to-day variations of blood phenylalanine and tyrosine concentrations.MethodsBlood phenylalanine and tyrosine were measured in dried blood spots (DBS) four times daily for 2 days (fasting, before lunch, before dinner, evening) and once daily (fasting) for 6 days in a randomized cross-over design with a period with BH4 and a period without BH4. The sequence was randomized. Eleven proven BH4 responsive PKU patients participated, 5 of them used protein substitutes during BH4 treatment. Natural protein intake and protein substitute dosing was adjusted during the period without BH4 in order to keep DBS phenylalanine levels within target range. Patients filled out a 3-day food diary during both study periods. Variations of DBS phenylalanine and Tyr were expressed in standard deviations (SD) and coefficient of variation (CV).ResultsBH4 treatment did not significantly influence day-to-day phenylalanine and tyrosine variations nor diurnal phenylalanine variations, but decreased diurnal tyrosine variations (median SD 17.6 μmol/l, median CV 21.3%, p = 0.01) compared to diet only (median SD 34.2 μmol/l, median CV 43.2%). Consequently, during BH4 treatment diurnal phenylalanine/tyrosine ratio variation was smaller, while fasting tyrosine levels tended to be higher.ConclusionBH4 did not impact phenylalanine variation but decreased diurnal tyrosine and phenylalanine/tyrosine ratio variations, possibly explained by less use of protein substitute and increased tyrosine synthesis. 相似文献
6.
Evolution of transmitted HIV‐1 drug resistance and viral subtypes circulation in Italy from 2006 to 2016 下载免费PDF全文
7.
Matthias May Atiqullah Aziz Richard Zigeuner Thomas Chromecki Luca Cindolo Luigi Schips Ottavio De Cobelli Bernardo Rocco Cosimo De Nunzio Andrea Tubaro Ioman Coman Michael Truss Orietta Dalpiaz Bernd Hoschke Christian Gilfrich Bogdan Feciche Anette Stoltze Fabian Fenske Hans-Martin Fritsche Robert S. Figenshau Kerry Madison Manuel Sánchez-Chapado Maria del Carmen Santiago Martin Luigi Salzano Giuseppe Lotrecchiano Steven Joniau Raphaela Waidelich Christian Stief Sabine Brookman-May 《World journal of urology》2013,31(5):1073-1080
Purpose
To investigate gender differences in clinicopathological features and to analyze the prognostic impact of gender in renal cell carcinoma (RCC) patients undergoing surgery.Methods
A total of 6,234 patients (eleven centers; Europe and USA) treated by radical or partial nephrectomy were included in this retrospective study (median follow-up 59 months; IQR 30–106). Gender differences in clinicopathological parameters were assessed. Multivariable Cox regression models were applied to determine the influence of parameters on disease-specific survival (DSS) and overall survival (OS).Results
A total of 3,751 patients of the study group were male patients (60.2 %), who were significantly younger at diagnosis and received more frequently NSS than women. Significantly, more often high-grade tumors and simultaneous metastasis were present in men. Whereas tumor size and pTN stages did not differ between genders, clear-cell and chromophobe RCC was diagnosed less frequently, but papillary RCC more often in men. Gender also independently influenced DSS (HR 0.75, p < 0.001) and OS (HR 0.80, p < 0.001) with a benefit for women. However, inclusion of gender in multivariable models did not significantly gain predictive accuracies (PA) for DSS (0.868–0.870, p = 0.628) and OS (0.775–0.777, p = 0.522). Furthermore, no significantly different DSS and OS rates were found in patients undergoing NSS.Conclusions
This study demonstrates important gender differences in clinicopathological features and outcome of RCC patients with improved DSS and OS for women compared to men, even if solely patients with clear-cell RCC or M0-stage are taken into evaluation. However, inclusion of gender in multivariable models does not significantly gain PA of multivariable models. 相似文献8.
9.
10.
MC Bush S Patel RH Lapinski JL Stone 《The journal of maternal-fetal & neonatal medicine》2013,26(4):237-241
Objective: To determine whether inflammatory bowel disease (IBD) is associated with increased risk for adverse perinatal outcome.Methods: A case–control study of 116 singleton pregnancies with IBD compared to 56?398 singleton controls delivered between 1986 and 2001.Results: Patients with IBD were slightly older (32.8 vs. 30.6 years, p <?0.001), more likely to be Caucasian or Asian than Black or Latino (92% vs. 57%, p <?0.001) and have private health insurance (33% vs. 3%, p <?0.001). IBD was associated with an increased risk for labor induction (32% vs. 24%, p?=?0.002), chorioamnionitis (7% vs. 3%, p?=?0.04) and Cesarean section (32% vs. 22%, p?=?0.007), but there were no differences in neonatal outcomes. Subgroup analysis demonstrated an increased risk for low birth weight (LBW) in the ulcerative colitis group vs. the Crohn's disease group (19% vs. 0%, p?=?0.002). Patients with prior surgery for IBD had a lower incidence of LBW (0% vs. 12%, p?=?0.03). Flares during pregnancy were associated with an increased risk for preterm delivery (27% vs. 8%, p?=?0.02) and LBW (32% vs. 3%, p?=?0.003).Conclusion: IBD was an independent risk factor for Cesarean section but there was no increase in adverse perinatal outcome. Crohn's disease, prior IBD surgery and quiescent disease were associated with a lower risk for LBW. 相似文献