收费全文 | 1448810篇 |
免费 | 120744篇 |
国内免费 | 6448篇 |
耳鼻咽喉 | 18710篇 |
儿科学 | 47012篇 |
妇产科学 | 39333篇 |
基础医学 | 200378篇 |
口腔科学 | 40265篇 |
临床医学 | 130280篇 |
内科学 | 297411篇 |
皮肤病学 | 35356篇 |
神经病学 | 122042篇 |
特种医学 | 60521篇 |
外国民族医学 | 274篇 |
外科学 | 227844篇 |
综合类 | 32037篇 |
现状与发展 | 2篇 |
一般理论 | 451篇 |
预防医学 | 112661篇 |
眼科学 | 30787篇 |
药学 | 101869篇 |
5篇 | |
中国医学 | 2321篇 |
肿瘤学 | 76443篇 |
2018年 | 16008篇 |
2017年 | 12866篇 |
2016年 | 15627篇 |
2015年 | 16692篇 |
2014年 | 22608篇 |
2013年 | 34593篇 |
2012年 | 42435篇 |
2011年 | 45916篇 |
2010年 | 28310篇 |
2009年 | 26523篇 |
2008年 | 43525篇 |
2007年 | 46329篇 |
2006年 | 47166篇 |
2005年 | 45667篇 |
2004年 | 43480篇 |
2003年 | 42599篇 |
2002年 | 40474篇 |
2001年 | 70225篇 |
2000年 | 73165篇 |
1999年 | 59318篇 |
1998年 | 17194篇 |
1997年 | 15205篇 |
1996年 | 15979篇 |
1995年 | 16804篇 |
1994年 | 15678篇 |
1993年 | 14681篇 |
1992年 | 47622篇 |
1991年 | 46221篇 |
1990年 | 44409篇 |
1989年 | 42280篇 |
1988年 | 39103篇 |
1987年 | 38521篇 |
1986年 | 36222篇 |
1985年 | 35199篇 |
1984年 | 26888篇 |
1983年 | 22528篇 |
1982年 | 14316篇 |
1981年 | 12874篇 |
1980年 | 12113篇 |
1979年 | 23902篇 |
1978年 | 17413篇 |
1977年 | 14738篇 |
1976年 | 13490篇 |
1975年 | 14035篇 |
1974年 | 16409篇 |
1973年 | 15662篇 |
1972年 | 14385篇 |
1971年 | 13259篇 |
1970年 | 12081篇 |
1969年 | 11285篇 |
Introduction
Left ventricular (LV) dysfunction is estimated to occur in 10%–25% of the general intensive care unit (ICU) population and is frequently seen as regional wall motion abnormalities (RWMAs). Although RWMA is mostly attributed to myocardial ischemia or infarction, some studies have suggested that nonischemic RWMA might also be prevalent. We sought to establish that RWMA can be seen in critically ill patients with normal coronary arteries and to explore reasons for RWMA in this population.Methods
In this retrospective study, data from the hospital angiography register and the ICU register were collated between 2012 and 2019. Patients were identified who underwent angiography in conjunction with their ICU stay and had RWMA on echocardiography. Patients were divided into either those with non-obstructed or those with obstructed coronary arteries. Cardiac magnetic resonance imaging (cMRI) examinations were reviewed if they had been performed on patients with non-obstructed coronaries.Results
We identified 53 patients with RWMA and non-obstructed coronary arteries and 204 patients with RWMA and obstructed coronary arteries. Patients with non-obstructed coronary arteries were more often female, younger, and had fewer cardiovascular risk factors. They less commonly had ST elevation, but more frequently had T-wave inversion or serious arrhythmias. Troponin levels were higher in patients with obstructed coronary arteries, but NT-proBNP was similar between the groups. There were no differences in risk-adjusted 90-day mortality between patients with non-obstructed versus obstructed coronary arteries (OR 1.21, [95% CI 0.56–2.64], p = .628). In those with non-obstructed coronary arteries, follow-up echocardiography was available for 38 patients, of whom 30 showed normalization of cardiac function. Of the 14 patients with non-obstructed coronary arteries on whom cMRI was performed, 7 had a tentative diagnosis of Takotsubo syndrome or myocardial stunning; 4 had a myocardial infarction (preexisting in 3 cases); 1 patient had acute myocarditis; 1 patient had post-myocarditis; and 1 patient was diagnosed with dilated cardiomyopathy.Conclusion
RWMA can be seen to occur in critically ill patients in the absence of coronary artery obstruction. Several conditions can cause regional hypokinesia, and cMRI is useful to evaluate the underlying etiology. 相似文献This paper describes the design of a theory-informed pragmatic intervention for adolescent perinatal depression in primary care in Nigeria.
MethodsWe conducted Focus Group Discussions (FGDs) among 17 adolescent mothers and 25 maternal health care providers with experience in the receipt and provision of care for perinatal depression. The Consolidated Framework for Implementation Research (CFIR) was used to systematically examine the barriers and facilitators affecting adolescent mothers' use of an existing intervention package for depression. The Theoretical Domain Framework (TDF) and the Capability, Opportunity, Motivation, Behaviour (COM-B) model were used to analyze the results of the data across the five CFIR domains.
ResultsFGD analysis revealed that care providers lacked knowledge on approaches to engage young mothers in treatment. Young mothers had poor treatment engagement, low social support, and little interest in parenting. A main characteristic of the newly designed intervention is the inclusion of age-appropriate psychoeducation supported with weekly mobile phone calls, to address treatment engagement and parenting behaviours of young mothers. Also in the outer setting, low social support from relatives was addressed with education, “as need arises” phone calls, and the involvement of "neighborhood mothers”. In the inner settings, care providers’ behaviour is addressed with training to increase their capacity to engage young mothers in treatment.
ConclusionA theory-based approach helped develop an age-appropriate intervention package targeting depression and parenting skills deficit among perinatal adolescents in primary maternal care and in which a pragmatic use of mobile phone was key.
相似文献