全文获取类型
收费全文 | 12911篇 |
免费 | 857篇 |
国内免费 | 50篇 |
专业分类
耳鼻咽喉 | 102篇 |
儿科学 | 260篇 |
妇产科学 | 297篇 |
基础医学 | 1846篇 |
口腔科学 | 412篇 |
临床医学 | 1463篇 |
内科学 | 2874篇 |
皮肤病学 | 318篇 |
神经病学 | 1347篇 |
特种医学 | 430篇 |
外国民族医学 | 1篇 |
外科学 | 1517篇 |
综合类 | 42篇 |
一般理论 | 12篇 |
预防医学 | 1063篇 |
眼科学 | 148篇 |
药学 | 866篇 |
中国医学 | 30篇 |
肿瘤学 | 790篇 |
出版年
2024年 | 11篇 |
2023年 | 179篇 |
2022年 | 337篇 |
2021年 | 688篇 |
2020年 | 394篇 |
2019年 | 536篇 |
2018年 | 605篇 |
2017年 | 415篇 |
2016年 | 460篇 |
2015年 | 550篇 |
2014年 | 725篇 |
2013年 | 829篇 |
2012年 | 1264篇 |
2011年 | 1181篇 |
2010年 | 665篇 |
2009年 | 526篇 |
2008年 | 775篇 |
2007年 | 741篇 |
2006年 | 636篇 |
2005年 | 573篇 |
2004年 | 447篇 |
2003年 | 371篇 |
2002年 | 346篇 |
2001年 | 61篇 |
2000年 | 45篇 |
1999年 | 69篇 |
1998年 | 38篇 |
1997年 | 32篇 |
1996年 | 21篇 |
1995年 | 20篇 |
1994年 | 10篇 |
1993年 | 22篇 |
1992年 | 26篇 |
1991年 | 27篇 |
1990年 | 38篇 |
1989年 | 23篇 |
1988年 | 16篇 |
1987年 | 20篇 |
1986年 | 20篇 |
1985年 | 23篇 |
1984年 | 13篇 |
1983年 | 7篇 |
1982年 | 3篇 |
1981年 | 3篇 |
1979年 | 5篇 |
1978年 | 3篇 |
1976年 | 3篇 |
1975年 | 3篇 |
1971年 | 2篇 |
1970年 | 2篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
51.
52.
53.
Julie A. Hides Gunda Lambrecht Christopher T. Sexton Casey Pruett Nora Petersen Patrick Jaekel André Rosenberger Guillaume Weerts 《The spine journal》2021,21(3):477-491
BACKGROUND CONTEXTOne of the primary changes in the neuromuscular system in response to microgravity is skeletal muscle atrophy, which occurs especially in muscles that maintain posture while being upright on Earth. Reduced size of paraspinal and abdominal muscles has been documented after spaceflight. Exercises are undertaken on the International Space Station (ISS) during and following space flight to remediate these effects. Understanding the adaptations which occur in trunk muscles in response to microgravity could inform the development of specific countermeasures, which may have applications for people with conditions on Earth such as low back pain (LBP).PURPOSEThe aim of this study was to examine the changes in muscle size and function of the lumbar multifidus (MF) and anterolateral abdominal muscles (1) in response to exposure to 6 months of microgravity on the ISS and (2) in response to a 15-day reconditioning program on Earth.DESIGNProspective longitudinal series.PATIENT SAMPLEData were collected from five astronauts who undertook seven long-duration missions on the ISS.OUTCOME MEASURESFor the MF muscle, measures included cross-sectional area (CSA) and linear measures to assess voluntary isometric contractions at vertebral levels L2 to L5. For the abdominal muscles, the thickness of the transversus abdominis (TrA), obliquus internus abdominis (IO) and obliquus externus abdominis (EO) muscles at rest and on contraction were measured.METHODSUltrasound imaging of trunk muscles was conducted at four timepoints (preflight, postflight, mid-reconditioning, and post reconditioning). Data were analyzed using multilevel linear models to estimate the change in muscle parameters of interest across three time periods.RESULTSBeta-coefficients (estimates of the expected change in the measure across the specified time period, adjusted for the baseline measurement) indicated that the CSA of the MF muscles decreased significantly at all lumbar vertebral levels (except L2) in response to exposure to microgravity (L3=12.6%; L4=6.1%, L5=10.3%; p<.001), and CSAs at L3-L5 vertebral levels increased in the reconditioning period (p<.001). The thickness of the TrA decreased by 34.1% (p<.017), IO decreased by 15.4% (p=.04), and the combination of anterolateral abdominal muscles decreased by 16.2% (p<.001) between pre- and postflight assessment and increased (TrA<0.008; combined p=.035) during the postreconditioning period. Results showed decreased contraction of the MF muscles at the L2 (from 12.8% to 3.4%; p=.007) and L3 (from 12.2% to 5%; p=.032) vertebral levels following exposure to microgravity which increased (L2, p=.046) after the postreconditioning period. Comparison with preflight measures indicated that there were no residual changes in muscle size and function after the postreconditioning period, apart from CSA of MF at L2, which remained 15.3% larger than preflight values (p<.001).CONCLUSIONSIn-flight exercise countermeasures mitigated, but did not completely prevent, changes in the size and function of the lumbar MF and anterolateral abdominal muscles. Many of the observed changes in size and control of the MF and abdominal muscles that occurred in response to prolonged exposure to microgravity paralleled those seen in people with LBP or exposed to prolonged bed rest on Earth. Daily individualized postflight reconditioning, which included both motor control training and weight-bearing exercises with an emphasis on retraining strength and endurance to re-establish normal postural alignment with respect to gravity, restored the decreased size and control of the MF (at the L3-L5 vertebral levels) and anterolateral abdominal muscles. Drawing parallels between changes which occur to the neuromuscular system in microgravity and which exercises best recover muscle size and function could help health professionals tailor improved interventions for terrestrial populations. Results suggested that the principles underpinning the exercises developed for astronauts following prolonged exposure to microgravity (emphasizing strength and endurance training to re-establish normal postural alignment and distribution of load with respect to gravity) can also be applied for people with chronic LBP, as the MF and anterolateral abdominal muscles were affected in similar ways in both populations. The results may also inform the development of new astronaut countermeasures targeting the MF and abdominal muscles. 相似文献
54.
Gianfranco Donatelli Andrea Spota Fabrizio Cereatti Stefano Granieri Ibrahim Dagher Renaud Chiche Jean-Marc Catheline Guillaume Pourcher Lionel Rebibo Daniela Calabrese Simon Msika Carmelisa Dammaro Hadrien Tranchart Panagiotis Lainas Thierry Tuszynski Filippo Pacini Roberto Arienzo Jean-Marc Chevallier Jean-Loup Dumont 《Surgery for obesity and related diseases》2021,17(8):1432-1439
BackgroundEndoscopy plays a pivotal role in the management of adverse events (AE) following bariatric surgery. Leaks, fistulae, and post-operative collection after sleeve gastrectomy (SG) may occur in up to 10% of cases.ObjectivesTo evaluate the efficacy and safety of endoscopic internal drainage (EID) for the management of leak, fistula, and collection following SG.SettingRetrospective, observational, single center study on patients referred from several bariatric surgery departments to an endoscopic referral center.MethodsEID was used as first-line treatment for the management of leaks, fistulae, and collections. Leaks and fistulae were treated with double pigtail stent (DPS) deployment in order to guarantee internal drainage and second intention cavity obliteration. Collections were treated with endoscropic ultrasound (EUS)–guided deployment of DPS or lumen apposing metal stents.ResultsA total of 617 patients (83.3% female; mean age, 43.1 yr) were enrolled in the study for leak (n = 300, 48.6%), fistula (n = 285, 46.2%), and collection (n = 32, 5.2%). Median follow-up was 19.5 months. Overall clinical success was 84.7% whereas 15.3% of cases required revisional surgery after EID failure. Clinical success according to type of AE was 89.5%, 78.5%, and 90% for leak, fistula, and collection, respectively. A total of 10 of 547 (1.8%) presented a recurrence during follow-up. A total of 28 (4.5%) AE related to the endoscopic treatment occurred. At univariate logistic regression predictors of failure were: fistula (OR 2.012), combined endoscopic approach (OR 2.319), need for emergency surgery (OR 1.755), and previous endoscopic treatment (OR 4.818).ConclusionEarly EID for the management of leak, fistula, and post-operative collection after SG seems a safe and effective first-line approach with good long-term results. 相似文献
55.
Jignesh K. Patel Guillaume Coutance Alexandre Loupy Deanna Dilibero Michele Hamilton Michelle Kittleson Evan Kransdorf Babak Azarbal Osamu Seguchi Xiaohai Zhang David Chang Dael Geft Lawrence Czer Shaida Varnous Jon A. Kobashigawa 《American journal of transplantation》2021,21(7):2479-2488
Allosensitization represents a major barrier to heart transplantation (HTx). We assessed the efficacy and safety of complement inhibition at transplant in highly sensitized heart transplant recipients. We performed a single-center, single-arm, open-label trial (NCT02013037). Patients with panel reactive antibodies (PRA) ≥70% and pre–formed donor-specific antibodies (DSA) were eligible. In addition to standard of care, patients received nine infusions of eculizumab during the first 2 months posttransplant. The primary composite endpoint was antibody-mediated rejection (AMR) ≥pAMR2 and/or left ventricular dysfunction during the first year. Secondary endpoints included hemodynamic compromise, allograft rejection, and patient survival. Twenty patients were included. Median cPRA and mean fluorescence intensity of immunodominant DSA were 95% (90%–97%) and 6250 (5000–10 000), respectively. Retrospective B cell and T cell flow crossmatches were positive in 14 and 11 patients, respectively. The primary endpoint occurred in four patients (20%). Survival at 1 year was 90% with no deaths resulting from AMR. In a prespecified analysis comparing treated patients to matched control patients, we observed a dramatic reduction in the risk of biopsy-proven AMR in patients treated with eculizumab (HR = 0.36, 95% CI = 0.14–0.95, p = .032). Our findings support the prophylactic use of complement inhibition for heart transplantation at high immunological risk. ClinincalTrials.gov, NCT02013037. 相似文献
56.
57.
Mouillet Guillaume Falcoz Antoine Fritzsch Joëlle Almotlak Hamadi Jacoulet Pascale Pivot Xavier Villanueva Cristian Mansi Laura Kim Stefano Curtit Elsa Meneveau Nathalie Adotevi Olivier Jary Marine Eberst Guillaume Vienot Angelique Calcagno Fabien Pozet Astrid Djoumakh Oumelkheir Borg Christophe Westeel Virginie Anota Amélie Paget-Bailly Sophie 《Quality of life research》2021,30(11):3255-3266
Quality of Life Research - Routine Electronic Monitoring of Health-Related Quality of Life (HRQoL) (REMOQOL) in clinical care with real-time feedback to physicians could help to enhance... 相似文献
58.
Impact of variation in ADRB2, ADRB3, and GNB3 genes on body mass index and waist circumference in a Brazilian population. 总被引:2,自引:0,他引:2
Vanessa S. Mattevi Vernica M. Zembrzuski Mara H. Hutz 《American journal of human biology》2006,18(2):182-186
The potential effect of variants in three catecholaminergic pathway genes (ADRB2, ADRB3, and GNB3) on obesity-related traits was investigated in an European-derived Brazilian population. Three-hundred and thirty-five individuals were screened for the ADRB2 Arg16Gly and Gln27Glu, ADRB3 Trp64Arg, and GNB3 814G-->A and 825C-->T polymorphisms using PCR-based methods. The association of the polymorphisms with quantitative variables was tested separately in each sex by analysis of covariance using general linear models, including age as a covariate. Only the ADRB2 Arg16Gly polymorphism was associated with higher body mass index and waist circumference. This association was restricted to the male sample. As the number of studies increases, it becomes clear that the genetic bases of obesity are complex, with sex-specific effects a playing an important role in its etiology. In the context of this European-derived population, the ADRB2 gene accounts for a significant part of obesity-related phenotypes in males. 相似文献
59.
Guillaume André Durand Abdennour Amroun Gilda Grard Cyril Badaut 《Journal of medical virology》2023,95(1):e28165
We tested the use of nasal swabs spotted onto filter paper (Whatman 3M) for the molecular diagnosis of SARS-CoV-2 infection. Spots of a positive nasal swab in conservation medium (B.1.177 strain, 21Ct) were still positive (duo E-gene/IP4) after 10, 20, and 30 days of conservation at room temperature, with Ct values of 28, 27, and 26, respectively. Direct spotting of the swab at bedside (omicron strain) still gave a positive result after 10 days in two RT-qPCR systems: 33.7 Ct using duo E-gene/IP4, and 34.8 using a specific Omicron system. Spotting of a dilution range of media spiked with the Delta (strain 2021/FR/0610, lineage B 1.617.2) and Omicron strains (strain UVE/SARS-CoV-2/2021/FR/1514) showed a threshold of 0.04 TCID50 after 10 days of conservation. We show, for the first time, that this simple and low-cost conservation method can be used to store samples for RT-qPCR against SARS-CoV-2 for up to at least 1 month. 相似文献
60.
Clémence Jacquin Emilie Landais Céline Poirsier Alexandra Afenjar Ahmad Akhavi Nathalie Bednarek Caroline Bénech Adeline Bonnard Damien Bosquet Lydie Burglen Patrick Callier Sandra Chantot-Bastaraud Christine Coubes Charles Coutton Bruno Delobel Margaux Descharmes Jean-Michel Dupont Vincent Gatinois Nicolas Gruchy Sarah Guterman Abdelkader Heddar Lucas Herissant Delphine Heron Bertrand Isidor Pauline Jaeger Guillaume Jouret Boris Keren Paul Kuentz Cedric Le Caignec Jonathan Levy Nathalie Lopez Zoe Manssens Dominique Martin-Coignard Isabelle Marey Cyril Mignot Chantal Missirian Céline Pebrel-Richard Lucile Pinson Jacques Puechberty Sylvia Redon Damien Sanlaville Marta Spodenkiewicz Anne-Claude Tabet Alain Verloes Gaelle Vieville Catherine Yardin François Vialard Martine Doco-Fenzy 《American journal of medical genetics. Part A》2023,191(2):445-458
Chromosome 1p36 deletion syndrome (1p36DS) is one of the most common terminal deletion syndromes (incidence between 1/5000 and 1/10,000 live births in the American population), due to a heterozygous deletion of part of the short arm of chromosome 1. The 1p36DS is characterized by typical craniofacial features, developmental delay/intellectual disability, hypotonia, epilepsy, cardiomyopathy/congenital heart defect, brain abnormalities, hearing loss, eyes/vision problem, and short stature. The aim of our study was to (1) evaluate the incidence of the 1p36DS in the French population compared to 22q11.2 deletion syndrome and trisomy 21; (2) review the postnatal phenotype related to microarray data, compared to previously publish prenatal data. Thanks to a collaboration with the ACLF (Association des Cytogénéticiens de Langue Française), we have collected data of 86 patients constituting, to the best of our knowledge, the second-largest cohort of 1p36DS patients in the literature. We estimated an average of at least 10 cases per year in France. 1p36DS seems to be much less frequent than 22q11.2 deletion syndrome and trisomy 21. Patients presented mainly dysmorphism, microcephaly, developmental delay/intellectual disability, hypotonia, epilepsy, brain malformations, behavioral disorders, cardiomyopathy, or cardiovascular malformations and, pre and/or postnatal growth retardation. Cardiac abnormalities, brain malformations, and epilepsy were more frequent in distal deletions, whereas microcephaly was more common in proximal deletions. Mapping and genotype–phenotype correlation allowed us to identify four critical regions responsible for intellectual disability. This study highlights some phenotypic variability, according to the deletion position, and helps to refine the phenotype of 1p36DS, allowing improved management and follow-up of patients. 相似文献