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151.
Newborn hearing screening is an effective strategy for early identification of hearing loss in the newborn which result in early intervention and best outcome. However implementing universal screening strategy is a challenge in many resource constrained settings. There are various limitations towards successful implementation of hearing screening program in the developing countries. The cost effectiveness of the screening program also needs to be considered in a resource constrained settings. We attempt to provide a viewpoint that can be potentially helpful for the successful implementation of hearing screening in a resource constrained settings of the developing countries. 相似文献
152.
Winnie N. Ye Madhura Thipse Maleka Ben Mahdi Sharlin Azad Ross Davies Marc Ruel Marc A. Silver Lale Hakami Thierry Mesana Frans Leenen Tofy Mussivand 《Artificial organs》2020,44(7):680-692
To review and analyze the clinical outcomes of thermal therapy (≤1.4°C increase in core body temperature) in patients with heart failure (HF). A systematic review and meta-analysis regarding the effects of thermal therapy on HF was done by searching PubMed, Ovid Medline, Ovid Embase, Scopus, and internal databases up to date (2019).
- Improvement in the New York Heart Association (NYHA) class : Ten studies with 310 patients showed significant improvement in NYHA class. Only 7 among 40 patients remained in Class IV and 99 patients in Class III from 155 patients. Increased patients in lower classes indicate that more patients showed improvement. Sixteen studies on 506 patients showed an overall improvement of 4.4% of left ventricular ejection fraction (LVEF). Four studies reported improved endothelial dysfunction by 1.7% increase in flow-mediated dilation (FMD) on 130 patients.
- Reduction in blood pressure: Thermal therapy reduced both systolic blood pressure (SBP) and diastolic blood pressure by 3.1% and 5.31%, respectively, in 431 patients of 15 studies.
- Decrease in cardiothoracic ratio (CTR): Eight studies reported an average of 5.55% reduction of CTR in a total of 347 patients.
- Improvement in oxidative stress markers: Plasma brain natriuretic peptide (BNP) levels significantly decreased (mean difference of 14.8 pg/dL) in 303 patients of 9 studies.
- Improvement of quality of life: Among 65 patients, thermal therapy reduced cardiac death and rehospitalization by 31.3%.
153.
Steven G. Pavlakis MD Dongfeng Lu PhD Yitzchak Frank MD Saroj Bakshi MD Savita Pahwa MD Tracey A. Barnett FNP Maura E. Porricolo PNP Robert J. Gould MD Molly L. Nozyce PhD Roger A. Hyman MD 《Pediatric neurology》1995,12(4):277-282
Twenty-five children with acquired immunodeficiency syndrome (AIDS) underwent cranial magnetic resonance imaging and proton magnetic resonance spectroscopy. Patients were divided into 2 groups based on clinical parameters: encephalopathy and nonencephalopathy. N-acetyl aspartate/creatine ratios were compared between the 2 groups and to control data. Spectra were obtained for 2 volumes of interest: the basal ganglia region and the white matter. The mean basal ganglia region ratio for the AIDS encephalopathy patients (n = 8) was 1.12 and the ratio for the AIDS nonencephalopathy patients (n = 17) was 1.48. The ratio for the 9 controls was 1.57. The encephalopathy group had a significantly lower ratio than both the control (P < .001) and the AIDS nonencephalopathy group (P < .002). The mean white matter ratio for the encephalopathy group (n = 8) was 1.47 and for the AIDS nonencephalopathy group (n = 13) was 1.82 with a control (n = 6) ratio of 1.82. The encephalopathy patients had a lower white matter ratio than the nonencephalopathy (P < .05) patients but the ratio was not different than controls (P < .11). It is concluded that N-acetyl aspartate/creatine ratios are reduced in childhood AIDS encephalopathy and proton magnetic resonance spectroscopy may be helpful in defining brain human immunodeficiency virus-1 infection. However, further longitudinal studies are necessary to determine the sensitivity and specificity of this technique. 相似文献
154.
Rohit Bakshi Vernice E. Bates Laszlo L. Mechtler Peter R. Kinkel William R. Kinkel 《Epilepsia》1998,39(3):295-299
Summary: Purpose: Reversible posterior leukoencephalopathy syndrome (RPLS) is an increasingly recognized brain disorder most commonly associated with malignant hypertension, toxemia of pregnancy, or the use of immunosuppressive agents. When associated with acute hypertension, RPLS typically occurs concurrently with the fulminant clinical syndrome of hypertensive encephalopathy. We describe occipital lobe seizures, in the setting of only moderate elevations of blood pressure, as the major clinical manifestation of RPLS.
Methods: Two patients from the Dent Neurologic Institute are presented with clinical and magnetic resonance imaging(MRI) correlation.
Results: New onset secondarily generalized occipital seizures were noted, with MRI findings consistent with RPLS. Both of the patients had chronic renal failure and a moderate acute exacerbation of chronic hypertension. Other features of hypertensive encephalopathy were lacking, such as headache, nausea, papilledema, and an altered sensorium. Magnetic resonance imaging (MRI) showed edematous lesions primarily involving the posterior supratentorial white matter and corticomedullary junction, consistent with RPLS. With lowered blood pressure, the MRI lesions resolved and the patients became seizure-free without requiring chronic anticonvulsant therapy.
Conclusions: Occipital seizures may represent the only major neurologic manifestation of RPLS due to acute hypertension, especially in patients with renal failure. Other evidence of hypertensive encephalopathy, such as cerebral signs and symptoms, need not be present. Blood pressure elevations may be only moderate. Early recognition of this readily treatable cause of occipital seizures may obviate the need for extensive, invasive investigations. Despite the impressive lesions on MRI, prompt treatment of this disorder carries a favorable prognosis. 相似文献
Methods: Two patients from the Dent Neurologic Institute are presented with clinical and magnetic resonance imaging(MRI) correlation.
Results: New onset secondarily generalized occipital seizures were noted, with MRI findings consistent with RPLS. Both of the patients had chronic renal failure and a moderate acute exacerbation of chronic hypertension. Other features of hypertensive encephalopathy were lacking, such as headache, nausea, papilledema, and an altered sensorium. Magnetic resonance imaging (MRI) showed edematous lesions primarily involving the posterior supratentorial white matter and corticomedullary junction, consistent with RPLS. With lowered blood pressure, the MRI lesions resolved and the patients became seizure-free without requiring chronic anticonvulsant therapy.
Conclusions: Occipital seizures may represent the only major neurologic manifestation of RPLS due to acute hypertension, especially in patients with renal failure. Other evidence of hypertensive encephalopathy, such as cerebral signs and symptoms, need not be present. Blood pressure elevations may be only moderate. Early recognition of this readily treatable cause of occipital seizures may obviate the need for extensive, invasive investigations. Despite the impressive lesions on MRI, prompt treatment of this disorder carries a favorable prognosis. 相似文献
155.
156.
This study examined the number of repetitions, increase in heart rate, increase in blood pressure, and rating of perceived exertion of subjects performing the most-preferred and least-preferred tasks from a predetermined list under purposeful and nonpurposeful conditions. Twenty healthy women completed the four experimental tests in random order for a period of 10 min each. The results indicated that there was no significant interaction (p greater than .05) between task choice and condition, thus implying that the subjects' performance was not influenced by task preference regardless of whether the activity was purposeful or nonpurposeful. Comparisons between the purposeful and nonpurposeful conditions revealed that the increase in heart rate and rating of perceived exertion were significantly higher (p less than .05) during nonpurposeful activity for both the most-preferred and the least-preferred tasks. On the basis of these results, it is recommended that therapists use purposeful, or goal-directed, activities in their practice, even if they are unable to provide their patients with a choice of therapeutic tasks. 相似文献
157.
Giant splenic artery aneurysm 总被引:1,自引:0,他引:1
Charles D. Long MD Kalind R. Bakshi MD Mark B. Kahn MD Andrew B. Roberts MD 《Annals of vascular surgery》1993,7(5):474-478
Giant aneurysms of the splenic artery are uncommon. The mean size of splenic artery aneurysms is reported to be 2.1 cm; they are rarely larger than 3 cm. We present two cases in which the splenic artery aneurysm was larger than 8 cm, discuss the management and operative approach to these infrequently encountered entities, and provide a brief review of the relevant literature. 相似文献
158.
M S Piver S B Lele S Bakshi K L Parthasarathy L J Emrich 《American journal of clinical oncology》1988,11(5):515-519
From 1975 to 1982, 25 evaluable patients with FIGO Stage I ovarian cancer were treated with intraperitoneal chromic phosphate (32P). All patients underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy with (28%) or without (72%) omentectomy, with no other surgical staging procedures prior to referral. Patients were restaged by laparoscopy (inspection of diaphragms, abdomen, and pelvis), biopsy of suspicious lesions, and peritoneal cytologic washings prior to intraperitoneal chromic phosphate therapy. For the 25 patients, the estimated 5- and 10-year recurrence-free rates and the 5- and 10-year survival rates are 84% and 75%, respectively. Excellent 10-year recurrence-free rates were achieved for Stages IA and IC, nonruptured cysts, and Grade I and II tumors. In contrast, very low 10-year survival rates were achieved for patients with Stage IB, ruptured cysts, or Grade III tumors. 相似文献
159.
Roshan K. Verma Niveditha Damodharan Archana Angrup Jaimanti Bakshi Naresh K. Panda 《中华耳科学杂志(英文版)》2018,13(2):68-74
Objective
To study the bacteriological profile in a healing mastoid cavity.Methods
This study was a single centre prospective study. Culture swabs from granulations in the mastoid cavity were sent in 40 consecutive patients with squamosal chronic otitis media undergoing mastoidectomy. Cultures were processed for both aerobic and anaerobic bacteria.Results
Preoperatively: specimens from 26 out of 40 (60.5%) had growth on culture, with 22 (55%) showing only one organism while 4 showing multiple organisms. The commonest organism isolated was pseudomonas aeruginosa (n?=?15).At 1 month after mastoidctomy, 11 patients had sterile culture while 29 had growth, of which 26 had aerobic growth and 3 had anaerobic growth. Pseudomonas was seen in 22 patients and staphylococcus aureus in 2 patients. The mean Merchant score was 2.At 3 months: 29 patients (72.5%) had sterile culture from mastoid cavity while 11 patients (27.5%) had growth on culture. All positive cultures were aerobic, including pseudomonas (n?=?9) and proteus (n?=?2). The mean Merchant score was 1.03. Of the 40 patients, 16 (40%) had a different organism cultured postoperatively compared to preoperative swabs.Conclusion
Pseudomonas and proteus seem to be the most common organisms responsible for persistent otorrhea after mastoidectomy. Persistent sterile otorrhea was seen in 4 patients (10%) in this group at the end of 3 months. Sterile cultures of preoperative swab are more likely to remain sterile in the postoperative period. 相似文献160.