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1.
EEG in Creutzfeldt-Jakob disease. 总被引:2,自引:0,他引:2
Electroecenphalography (EEG) is an integral part of the diagnostic process in patients with Creutzfeldt-Jakob disease (CJD). The EEG has therefore been included in the World Health Organisation diagnostic classification criteria of CJD. In sporadic CJD (sCJD), the EEG exhibits characteristic changes depending on the stage of the disease, ranging from nonspecific findings such as diffuse slowing and frontal rhythmic delta activity (FIRDA) in early stages to disease-typical periodic sharp wave complexes (PSWC) in middle and late stages to areactive coma traces or even alpha coma in preterminal EEG recordings. PSWC, either lateralized (in earlier stages) or generalized, occur in about two-thirds of patients with sCJD, with a positive predictive value of 95%. PSWC occur in patients with methionine homozygosity and methionine/valine heterozygosity but only rarely in patients with valine homozygosity at codon 129 of the prion protein gene. PSWC tend to disappear during sleep and may be attenuated by sedative medication and external stimulation. Seizures are an uncommon finding, occurring in less than 15% of patients with sCJD. In patients with iatrogenic CJD, PSWC usually present with more regional EEG findings corresponding to the site of inoculation of the transmissible agent. In genetic CJD, PSWC in its typical form are uncommon, occurring in about 10%. No PSWC occur in EEG recordings of patients with variant CJD. 相似文献
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Dietmar Winkler Matth?us Willeit Rainer Wolf Mara Stamenkovic Johannes Tauscher Edda Pjrek Anastasios Konstantinidis Shird Schindler Christian Barnas Siegfried Kasper 《European neuropsychopharmacology》2003,13(2):129-134
The value of a long-term treatment with clonazepam in the prophylaxis of affective disorder is discussed controversially in the scientific literature. Altogether there are only a few reports on the use of this compound as a mood stabilizer, most of them describing patients suffering from bipolar affective disorder. The aim of this investigation was to evaluate clonazepam as a phase prophylactic medication in affective disorder. We conducted a retrospective chart review in 34 out-patients of our lithium clinic (15 suffering from unipolar depression, 15 from bipolar disorder, four from schizoaffective disorder), who had been treated with clonazepam as a long-term medication. Clonazepam was either given as monotherapy, or as in the case of lithium non-responders, as adjunctive therapy. Patients with unipolar depression had significantly (P=0.026) less depressive episodes after initiation of treatment with clonazepam. Patients with bipolar disorder did not benefit from this therapy. Neither manic/hypomanic phases nor depressive episodes were reduced in this group of patients. Interestingly, clonazepam also reduced affective phases in our four schizoaffective patients on a trend level. Our results indicate that patients with unipolar depression may benefit from a maintenance treatment with clonazepam. Due to methodological limitations our results need to be replicated in controlled double-blind randomized clinical trials. 相似文献
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TF Leung WC Tsoi CK Li KW Chik MMK Shing PMP Yuen 《Acta paediatrica (Oslo, Norway : 1992)》1998,87(6):705-777
We describe a 15-y-old girl with Fechtner-like syndrome, who is the first Chinese reported to have this rare syndrome. She presented with left homonymous hemianopia and neuroimaging revealed haemorrhage in both parietal and occipital lobes. Peripheral blood smear showed macrothrombocytopenia and intracytoplasmic inclusion bodies inside leucocytes. Thrombocytopenia and proteinuria responded to intravenous immunoglobulin and pulsed methylprednisolone. This case illustrates that life-threatening haemorrhage can occur in patients with Fechtner syndrome. Although there was no effective treatment reported in the literature, high dose steroid and immunoglobulin seemed to be useful in our patient. Our patient also had nephritic-nephrotic syndrome with renal insufficiency, which is unusual in adolescent female patients. 相似文献
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Scott W. Powers Kelly C. Byars Monica J. Mitchell Susana R. Patton Teresa Schindler Margaret H. Zeller 《Children's Health Care》2003,32(4):297-311
This pilot study examined a behavioral treatment to increase calorie intake in toddlers with cystic fibrosis. Eight toddlers were randomly assigned to behavioral plus nutrition (BEH) or nutrition intervention (NTR) conditions. Calorie intake and weight were measured at pre- and posttreatment. The BEH group showed a trend for changes in calorie intake pre- to posttreatment (p = .07; 40% increase). Results for the BEH and NTR groups did not differ significantly. Most participants achieved weight gains consistent with normal growth. Seventy-five percent had not shown this pattern during the year prior to intervention. These results support the feasibility and potential for behavioral interventions in this age group. 相似文献
6.
S Neubauer G Ertl T Krahe R Schindler H Hillenbrand K Lackner K Kochsiek 《Zeitschrift für Kardiologie》1991,80(1):25-36
MR-spectroscopy of the heart is a relatively new technique for the study of various aspects of cardiac metabolism. The majority of results has so far been obtained with the isolated perfused heart. Here, 31P-MR spectroscopy can be employed to measure high-energy phosphate metabolism and intracellular pH repeatedly and non-invasively. Using a technique called saturation transfer, velocities of enzymatic reactions, such as the creatine kinase reaction, can be measured. Intra- and extracellular Na+ and K+ concentrations can be registered with 23Na- and 39K-MR in conjunction with shift reagent. 13C-MR can be used to tackle carbohydrate metabolism. In-situ-R-spectroscopy allows determination of high-energy phosphates in intact large mammals. Clinical applications of MR-spectroscopy remain to be defined; preliminary results indicate high diagnostic and prognostic potential for patients with coronary artery disease and congestive heart failure. 相似文献
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V J Schindler 《The American journal of occupational therapy》1988,42(8):507-512
The role of psychosocial occupational therapy with AIDS patients is explored. The clinical picture is defined, information regarding the transmission, incidence, diagnosis, and treatment is presented, and the impact of the illness on the developmental life cycle is described. The occupational behavior framework is used to guide evaluation and intervention and case examples are provided. Finally, fears and issues affecting therapists working with these patients are explored. 相似文献
10.
Haemodynamic and metabolic effects of glucose-potassium-insulin (GKI) were studied in 14 patients with peritonitis. Study entry criteria were: hypodynamic septic shock (mean arterial pressure less than 50 mmHg and cardiac index less than 3.5 l/min) despite a highly positive fluid balance (greater than +2,000 ml during the last 12 h) and use of catecholamines (greater than 15 mcg/kg/min Dobutamine). GKI (glucose 70% 1 g/kg + potassium 10 mval + insulin 1.5 U/kg) was infused within 15 min via a central venous catheter. Before and 10 min after GKI haemodynamic and metabolic measurements were performed. GKI led to significant increases in systolic (+53%) and mean (+61%) arterial pressures, cardiac index (+50%), right (+60%) and left (+109%) ventricular stroke work indices, and oxygen consumption index (+18%). Heart rate remained unchanged, pulmonary shunt fraction increased slightly, systemic and pulmonary vascular resistances showed an insignificant decline. Serum glucose (p less than 0.01) and pCO2 (p less than 0.1) increased. The haemodynamic improvement lasted from 30 min or less (n = 3; 21%) to several hours. Nine patients (64%) survived more than 2 days, and two patients (14%) were eventually discharged from the hospital. We conclude, that in hypodynamic septic shock refractory to volume loading and catecholamine treatment GKI may be beneficial, although the mechanism of action remains unclear. 相似文献