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目的 了解神经外科护士对患者身体约束的知信行现状。方法 采用身体约束知信行问卷对180名神经外科护士进行调查,分析护士对患者身体约束的知识、态度、行为得分情况。结果 180名护士的患者身体约束知识问卷得分为(12.40±1.90)分,身体约束态度问卷得分为(34.53±3.22)分,身体约束行为问卷得分为(52.98±5.77)分,均处于中等水平。不同年龄、不同临床工作年限护士的患者身体约束态度问卷得分及不同学历护士的患者身体约束知识问卷得分比较,差异均有统计学意义(均P<0.05)。结论 神经外科护士对患者身体约束的知信行水平亟待提高,应加强对护士的患者身体约束的知识、行为培训,重视人文关怀理念的培养,以降低身体约束对患者造成身心伤害。 相似文献
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A 58-year-old female was referred to our department with intermittent suffocation for 1.5 years, aggravated for a month. 1.5 years before she developed oral ulcer, raynaud phenomenon, proteinuria, bilateral pleural effusion, ANA and anti-dsDNA positive. This patient was diagnosed with systemic lupus erythematosus (SLE). After given hormones, hydroxychloroquine sulfate (HCQ), her symptom relieved soon. The patient stopped her pills 1 year ago. One month ago, she had chest tightness, increased urine foam, and suffered from oliguria. Her admission medical examination: blood pressure (BP) 130/80 mmHg, conjunctiva pale, and lower lung breath sounds reduced. There was no tenderness, rebound pain and abdominal muscle tension in the abdomen. Liver and spleen rib inferior, mobile dullness negative, and lower extremity edema. Blood routine tests were performed with hemoglobin (HGB) 57 g/L. Urine routine: BLD (3+). 24-hour urinary protein 3.2 g. serum albumin 20.5 g/L, C-reactive protein (CRP) 12.85 mg/L, erythrocyte sedimentation rate (ESR) 140 mm/h. Antinuclear antibody (ANA) (H)1 ∶10 000;, anti-dsDNA antibody 1 ∶3 200;, anti-Smith antibody, anti-U1-snRNP / Sm antibody were positive, blood complement 3(C3) 0.43 g/L, complement 4(C4) 0.07 g /L. Anticardiolipin antibody (ACL), anti-β2-GP1;, lupus anticoagulant (LA) were negative, HRCT suggested bilateral medial pleural cavity product liquid. Admission diagnosis: SLE lupus nephritis, anemia, pleural effusion, and hypoproteinemia. We treated her with methylprednisolone 1 000 mg×3 d;, late to 48 mg/d and cyclophosphamide 1.0 g, HCQ 0.2 g bid, gamma globulin 10 g×5 d. Day 2 of treatment;, this patient developed acute right upper quadrant pain, not accompanied by nausea, vomiting, blood stool and diarrhea. Antipyretic antispasmodic treatment was invalid, after the morning to ease their own abdominal pain. Day 4 of treatment, daytime blood HGB 77 g/L. Bilateral renal vascular ultrasound: bilateral renal artery blood flow velocity was reduced. The abdominal pain of the above symptoms recurred at night, BP was 120/80 mmHg, and no positive signs were found on abdominal examination. No abnormality was found in the vertical abdominal plain film. Blood routine examination: HGB 53 g/L, Plasma D dimer 2 515 μg/L;, amylase in hematuria was normal, the stool occult blood was negative. Abdominal computed tomography (CT): normal structure of right adrenal gland disappeared, irregular mass shadow could be seen in adrenal region, CT value was about 50 HU. Morphological density of left adrenal gland was not abnormal. The retroperitoneum descended along the inferior vena cava to the right iliac blood vessel and showed a bolus shadow. The density of some segments increased. The lesion involved the right renal periphery and reached the left side of abdominal aorta. Most lesions surrounded the inferior vena cava, the right renal vein and part of the small intestine. The boundary between the upper lesion and the vena cava was unclear. Iodine-containing contrast agent was taken orally. No sign of contrast agent overflowing was found in the abdominal cavity. Hematoma and exudative changes were considered in retroperitoneum. Conclusion of contrast-enhanced ultrasound of blood vessels: The retroperitoneal inferior vena cava (volume 3.5 cm×3.5 cm×1.5 cm) was hypoechoic and had no blood flow lesion. The adrenal gland had a high possibility of origin. Left renal vein thrombosis extended to inferior vena cava. According to the above data;, it was analyzed that the cause of retroperitoneal hematoma of the patient was left adrenal vein thrombosis caused by hypercoagulable state, which led to vascular rupture and hemorrhage caused by increased vascular pressure in adrenal gland. Therefore, on the basis of continuing to actively treat the primary disease, and on the basis of dynamic observation of no active hemorrhage for 3 days, the anticoagulant therapy was continued with 10 mg/d of apixaban. Clinical symptoms were gradually eased, HGB did not decrease. Two weeks later, the ultrasonic examination showed that the irregular cluster hypoechoic range behind the inferior vena cava was significantly smaller than that before (1.8 cm×1.2 cm×0.7 cm). Abdominal CT examination after 1 month showed that there was no abnormal morphological density of bilateral adrenal glands and basic absorption of retroperitoneal exudation. Adrenal hemorrhage is uncommon. SLE with adrenal hemorrhage is rarer. In SLE patients;, especially those complicated with APS, if abdominal pain accompanied by HGB decrease occurs, except after gastrointestinal hemorrhage, the possibility of adrenal hemorrhage should be warned. 相似文献
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目的:研究骨形成蛋白(BMP)-2、4在人脑胶质瘤发生发展中所起的作用及其与临床病理分级的关系.方法:应用RT-PCR技术和免疫组织化学SABC法检测BMP-2、4mRNA和蛋白质在20例正常脑组织和40例不同级别人脑胶质瘤组织中的表达变化,并分析其与患者的年龄、性别、病理分级的相关性.结果:BMP-2和BMP-4在正常脑组织和人脑胶质瘤组织中均有表达,且在胶质瘤中的表达显著高于正常脑组织,即BMP-2、4 mRNA和蛋白质Ⅲ、Ⅳ级胶质瘤组织中的表达显著高于Ⅰ、Ⅱ级,且其与患者的年龄及性别无关.结论:BMP-2、4在人脑胶质瘤的发生发展过程中起一定作用. 相似文献
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住院医师规范化培训是我国临床医师培训的重要手段,重症医学在住院医师规培过程中具有重要地位,是保证住院医师规范化培训质量的重要环节。住院医师在ICU规培期间应该掌握危重患者的识别,早期发现,常见危重情况的基本处理、医患沟通等能力。采用制定详细的规培大纲,多种教学方法配合,重视临床工作能力培养等方法,从而探索制定出住院医师规范化培训在重症医学的培训模式。 相似文献
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目的探讨肺结核患者咯血的治疗效果及并发症。方法找出2例咯血患者,观察在抗痨、抗炎、止血、对症与支持疗法的基础上,给予中药治疗,3次/d,2个月为1个疗程。结果 2例患者都痰中无血,抗痨治疗方案不变,经7个月最终痊愈出院。结论中西结合用于肺结核咯血的治疗,方法简单,疗效肯定,可在临床中推广。 相似文献
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目的:观察妇科灌肠液保留灌肠结合双柏膏及抗生素治疗慢性盆腔炎的临床效果。方法:将220例慢性盆腔炎患者随机分为四组,对照组40例予五水头孢唑林钠、奥硝唑静滴治疗,治疗组各60例:在对照组治疗的基础上分别加用妇科灌肠液保留灌肠、自制双柏膏贴敷治疗。结果:4组治疗前的积分比较,差异无显著性意义(P〉0.05),治疗后治疗组1积分(2.56±2.01),治疗组2积分(3.56±4.01),治疗组3积分(2.01±2.04),对照组积分(7.98±4.02),四组比较,差异有显著性意义(P〈0.05),具可比性;总有效率治疗组92.5%,对照组77.5%,四组对比,差异有显著性意义(P〈0.05)。结论:采用妇科灌肠液保留灌肠结合双柏膏及抗生素治疗慢性盆腔炎,临床疗效较好,值得推广应用。 相似文献
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目的 研究分析献血者乙肝表面抗原(HBsAg)酶联免疫吸附测定(ELISA)筛查阴性血液中乙型肝炎病毒(HBV)DNA检出情况及HBV DNA阳性者基因序列,分析漏检与基因突变之间的关系,寻找漏检原因.方法 对31184例HBV HB-sAg ELISA检测为阴性的献血者血液进行HBV DNA基因扩增技术检测,对HBV DNA阳性样本进行测序分析.结果 31184份标本中,检测到HBV DNA 82例阳性,阳性率为0.26%(82/31184),对其使用测序方法检测,确认82例样本均存在HBV DNA片段,其中有27份[32.9%(27/82)]存在HBV DNA S区基因变异.结论 ELISA漏检的原因除去方法学灵敏度以及HBV感染"窗口期"等因素外,HBV S区基因变异引起免疫学检测靶标变化也是主要的原因. 相似文献