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71.
These days, working people are finding it difficult to manage their time, get more done at work, and find some balance in their work and personal lives. Successful time management is often suggested to be a product of organizing skills, however, what works for one person may not work for others. Context current competence assessment formats for physicians, health professionals, and managers during their training years reliably test core knowledge and basic skills. However, they may underemphasize some important domains of professional medical practice. Thus, in addition to assessments of basic skills, new formats that assess clinical reasoning, expert judgment, management of ambiguity, professionalism, time management, learning strategies, and teamwork to promise a multidimensional assessment while maintaining adequate reliability and validity in classic health education and health care institutional settings are needed to be worked on. It should be kept in mind that institutional support, reflection, and mentoring must accompany the development of assessment programs. This study was designed to describe the main factors that consume time, effective hours of work, time management opportunities, and attitudes and behaviors of health professionals and managers on time management concept through assessment by the assessment tool Time Management Inquiry Form (TMIQ-F). The study was conducted at the State Hospital, Social Security Hospital, and University Hospital at Kirikkale, Turkey between October 1999 and January 2000, including 143 subjects defined as medical managers and medical specialists. According to the results, a manager should give priority to the concept of planning, which may be counted among the efficient time management techniques, and educate him/herself on time management. 相似文献
72.
N Col-Araz S Oguzkan-Balci O Baspinar T Sever A Balat S Pehlivan 《International journal of medical sciences》2012,9(6):506-512
Myocardial inflammation is one of the commonest mechanisms in cardiomyopathy (CMP). Mannose binding lectin (MBL) is a key molecule in innate immunity, while macrophage migration inhibitory factor (MIF) is a constitutive element of the host defenses. We investigated the possible association between polymorphisms of MBL2 and MIF genes and CMP in Turkish children. Twenty-children with CMP and 30 healthy controls were analyzed for codon 54 A/B polymorphism in MBL, and -173 G/C polymorphism in MIF genes by using PCR-RFLP methods. No significant difference was found between genotypes and alleles of MBL2 gene codon 54 A/B polymorphism in patients and controls (p>0.05). However, serum uric acid levels was found higher in dilated CMP patients with AA genotype. Frequency of MIF -173 CC genotype was significantly higher in patients (p<0.05), and sodium levels were higher in patients with MIF -173 CC genotype. This study is the first to investigate the MBL and MIF gene polymorphisms in Turkish children with CMP. We conclude that CC genotype of MIF (-173) polymorphism may be a risk factor for CMP patients. However, further studies with larger samples are needed to address the exact role of this polymorphism in CMP. 相似文献
73.
Papeta N Kiryluk K Patel A Sterken R Kacak N Snyder HJ Imus PH Mhatre AN Lawani AK Julian BA Wyatt RJ Novak J Wyatt CM Ross MJ Winston JA Klotman ME Cohen DJ Appel GB D'Agati VD Klotman PE Gharavi AG 《Journal of the American Society of Nephrology : JASN》2011,22(11):1991-1996
A chromosome 22q13 locus strongly associates with increased risk for idiopathic focal segmental glomerulosclerosis (FSGS), HIV-1-associated nephropathy (HIVAN), and hypertensive ESRD among individuals of African descent. Although initial studies implicated MYH9, more recent analyses localized the strongest association within the neighboring APOL1 gene. In this replication study, we examined the six top-most associated variants in APOL1 and MYH9 in an independent cohort of African Americans with various nephropathies (44 with FSGS, 21 with HIVAN, 32 with IgA nephropathy, and 74 healthy controls). All six variants associated with FSGS and HIVAN (additive ORs, 1.8 to 3.0; P values 3 × 10(-2) to 5 × 10(-5)) but not with IgA nephropathy. In conditional and haplotype analyses, two APOL1 haplotypes accounted for virtually all of the association with FSGS and HIVAN on chromosome 22q13 (haplotype P value = 5.6 × 10(-8)). To assess the role of MYH9 deficiency in nephropathy, we crossbred Myh9-haploinsufficient mice (Myh9(+/-)) with HIV-1 transgenic mice. Myh9(+/-) mice were healthy and did not demonstrate overt proteinuria or nephropathy, irrespective of the presence of the HIV-1 transgene. These data further support the strong association of genetic variants in APOL1 with susceptibility to FSGS and HIVAN among African Americans. 相似文献
74.
Keskin N Civilibal M Elevli M Koldas M Duru NS Ozturk H 《Pediatric nephrology (Berlin, Germany)》2011,26(11):1989-1993
Henoch–Schonlein purpura (HSP) is a systemic vasculitis characterized by involvement of skin, joints, gastrointestinal tract
(GIT), and kidney; its pathogenesis is still controversial. The aim of our study was to investigate the role of oxidative
stress in the pathogenesis of HSP. Plasma advanced oxidation protein products (AOPP) level was measured in 29 children with
HSP at the onset of the disease and during remission in comparison with 30 healthy subjects. Patients at the active stage
had significantly higher AOPP levels than those at the remission stage of HSP and the controls (42.9 ± 25.7, 30.6 ± 11.8,
27.9 ± 11.2 mmol/l; P = 0.027 and P = 0.023 respectively). The mean AOPP levels of the patients with arthritis and/or arthralgia were significantly higher those
than without joint involvement (48.3 ± 26.0 and 22.3 ± 9.3, P = 0.036 respectively). However, AOPP levels were similar in patients with and without gastrointestinal involvement. Plasma
AOPP levels were positively correlated with leukocyte and thrombocyte count at disease onset, whereas they were found to be
negatively correlated with serum glucose and sodium levels. The mean thrombocyte count was the only independent predictor
of increased level of AOPP in regression analysis (β = 0.407; P = 0.029). In conclusion, this study showed that increased oxidative stress may play an important role in the pathogenesis
of HSP. Also, we suggest that higher platelet count might be an indirect indicator of oxidative stress in these patients.
Further research is required to identify the potential association between oxidative stress and increased thrombocyte count
in children with HSP. 相似文献
75.
Saliha Senel Gulay Ceylaner Deniz Yuksel Nilgun Erkek Candemir Karacan 《European journal of pediatrics》2010,169(4):453-455
Carpal tunnel syndrome, an entrapment neuropathy of the median nerve, is rarely seen in childhood. Familial carpal tunnel
syndrome, an even more exceptional entity, is frequently associated with inherited systemic disorders. Rarely it can be presented
as a primary familial form with Mendelian autosomal dominant inheritance. We report the occurrence of carpal tunnel syndrome
in two generations of a family in which the index case was a 6-year-old boy with bilateral hand pain and paresthesias. Our
report demonstrates an interesting inheritance pattern of carpal tunnel syndrome in a family transmitted by an autosomal dominant
gene with variable expressivity and reduced penetrance. To our knowledge, it is the first report of familial bilateral carpal
tunnel syndrome in a family with possible skipped generation. 相似文献
76.
77.
78.
Bakiler AR Yavascan O Harputluoglu N Kara OD Aksu N 《Pediatric nephrology (Berlin, Germany)》2007,22(11):1911-1919
The measurement of aortic stiffness (As) [aortic strain (S), pressure strain elastic modulus (Ep) and pressure strain normalized
by diastolic pressure (Ep*)] is suggested as an excellent marker of subclinical arterial sclerosis. We aimed to investigate
the presence of As and to determine the relationship between As and some risk factors in children with chronic renal failure
(CRF). Twenty-six pre-dialysis (PreD) [female/male (F/M) 7/19] patients and 23 chronic peritoneal dialysis (CPD) (F/M 13/10)
patients were assessed. Twenty-nine healthy children were selected as a control group (F/M 14/15). We determined anemia, abnormal
calcium/phosphate metabolism, hypertension, diastolic dysfunction, increased left ventricular mass (LVM), hypertriglyceridemia,
increased stiffness (Ep, Ep*), and decreased strain (S) in the CRF (PreD and CPD) group compared with the controls (P < 0.05). Presence of renal disease, LVM and usage of angiotensin-converting enzyme inhibitor (ACE-I) in all groups; female
gender, duration of disease and the usage of anti-hypertensive drug therapy in CRF patients; and LVM and LVM index in healthy
children were found to be independent predictors for aortic stiffness and/or strain. In conclusion, CRF is associated with
significant arterial functional abnormalities in uremic children and not controlled by dialysis treatment. These results suggest
that, even in young children, uremia has a profound impact on arterial function. 相似文献
79.
Bayazit AK Yalcinkaya F Cakar N Duzova A Bircan Z Bakkaloglu A Canpolat N Kara N Sirin A Ekim M Oner A Akman S Mir S Baskin E Poyrazoglu HM Noyan A Akil I Bakkaloglu S Soylu A 《Pediatric nephrology (Berlin, Germany)》2007,22(9):1327-1333
Renovascular disease accounts for 8–10% of all cases of paediatric hypertension, whereas, in adults, its incidence is approximately
1%. The Turkish Paediatric Hypertension Group aimed to create the first registry database for childhood renovascular hypertension
in Turkey. Twenty of the 28 paediatric nephrology centres in Turkey responded to the survey and reported 45 patients (27 girls,
18 boys) with renovascular hypertension between 1990 and 2005. The age at presentation ranged from 20 days to 17 years. The
mean blood pressure at the diagnosis was 169/110 mmHg. Chief complaints of symptomatic patients were headache (38%), seizure
(18%), epistaxis (4%), growth retardation (4%), cognitive dysfunction (4%), polyuria (2%), palpitation (2%), and hemiplegia
(2%). Renovascular hypertension was found incidentally in 11 children. The diagnosis of renovascular hypertension was established
with conventional angiography in 39 patients, MR angiography in three, CT angiography in two, and captopril diethylene triamine
penta-acetic acid (DTPA) scintigraphy in one patient. Twenty-one children had bilateral renal artery stenosis and 24 had unilateral
renal artery stenosis. Of these, 14 (31%) had fibromuscular dysplasia; 12 (27%) Takayasu’s arteritis; six (13%) neurofibromatosis;
two (5%) Williams syndrome; one (2%) Kawasaki disease; one (2%) mid-aortic syndrome; one (2%) extrinsic compression to the
renal artery, and eight (18%) unspecified bilateral renal artery stenosis. Hypertension was controlled with antihypertensive
drugs in 17 patients. Percutaneous transluminal angioplasty (PTRA) or surgery had to be performed in 28 patients: PTRA in
16 patients, PTRA + surgery in one patient and surgery in 11 patients (four nephrectomies). The importance of vasculitic disease,
especially Takayasu’s arteritis, should not be underestimated in children with renovascular hypertension. 相似文献
80.
Berdeli A Mir S Yavascan O Serdaroglu E Bak M Aksu N Oner A Anarat A Donmez O Yildiz N Sever L Tabel Y Dusunsel R Sonmez F Cakar N 《Pediatric nephrology (Berlin, Germany)》2007,22(12):2031-2040
The podocin (NPHS2) gene encodes podocin protein, which has an important role in glomerular ultrafiltration and controlling slit membrane permeability.
The detection of an NPHS2 mutation affects the treatment plan for children with nephritic syndrome (NS). The frequency and spectrum of podocin mutations
in the Turkish population have remained largely unknown. The aim of this study was to screen for podocin mutations in Turkish
patients with steroid-resistant NS (SRNS) and to compare it with other published series. There were 295 children with SRNS,
originating from Turkey, included in this study. Forty-one patients (13.8%) had familial NS and 254 patients (86.2%) had sporadic
NS. Mutation analysis was performed in all eight exons of the NPHS2 gene with the direct DNA sequencing method. There were 53 different pathogenetic NPHS2 mutations detected, including 37 novel mutations. The mutation detection rate was 24.7% for all patients, 29.2% for familial,
and 24% for sporadic SRNS. The most common mutated exon was exon 5 (52 allele). The presence of mutations in exon 4 was found
to increase the risk of end-stage renal disease (ESRD). Among patients with mutations, the rates of renal failure and/or ESRD
(26%) were significantly higher than in those without mutations (12.6%). The mean time of progression to renal failure and
ESRD in patients with mutations (1.8 ± 2.5 years) was significantly shorter than in patients without mutations (3.7 ± 4.0 years).
Additionally, in patients with heterozygote mutations, fewer cases (13.6%) progressed to renal failure and/or ESRD than in
with patients who had homozygote/compound heterozygote mutations (31.3%). In conclusion, podocin mutations are responsible
for some of both familial and sporadic SRNS cases in Turkey. The mutations in this gene should be searched for in every child
after presentation with the first episode of NS. 相似文献