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71.
72.
EF Druyts B Yip VD Lima TA Burke D Lesovski KA Fernandes CW McInnes CA Rustad JSG Montaner RS Hogg 《HIV medicine》2009,10(2):88-93
Objective
The aim of the study was to determine rates of utilization of in‐patient, out‐patient and laboratory services stratified by virological and immunological markers of HIV disease among patients on antiretroviral treatment in British Columbia, Canada.Methods
We estimated resource utilization for in‐patient visits, out‐patient visits, and laboratory tests among patients initiating antiretroviral treatment between 1 April 1994 and 31 December 2000, with follow‐up to 31 March 2001. Resource use was stratified by CD4 cell count and plasma HIV viral load (pVL) at the time of utilization and rates per 100 patient‐years were calculated for each health care resource.Results
A total of 2718 patients were included in our analyses. The overall rates of in‐patient visits, out‐patient visits, and laboratory tests were 902, 3001 and 840 per 100 patient‐years, respectively. Utilization was higher for patients with low CD4 cell counts and high pVLs when compared with patients with high CD4 cell counts and low pVLs.Conclusions
Patients with low CD4 cell counts and high pVLs had the highest use of health care services. Regular follow‐up with health care providers in an out‐patient setting, allowing for proper monitoring and maintenance of HIV care, is important in minimizing unnecessary and potentially costly in‐patient care. 相似文献73.
EF Druyts BS Rachlis VD Lima SS Harvard W Zhang EK Brandson SA Strathdee JSG Montaner RS Hogg 《HIV medicine》2009,10(5):274-281
Objectives
The aim of the study was to compare the risks of death among HIV‐infected patients on highly active antiretroviral therapy (HAART) in two proximate, yet distinct neighbourhoods: a neighbourhood with a high concentration of gay men, and a neighbourhood with a high concentration of injecting drug users.Methods
We compared the clinical and socioeconomic characteristics of HIV‐infected patients from the two neighbourhoods entering the British Columbia Centre for Excellence in HIV/AIDS Drug Treatment Program from 1 September 1997 to 30 November 2005, using contingency table statistics. Cox survival models and Kaplan–Meier methods were used to estimate the cumulative mortality rates. Results We found significant differences between patients from the two neighbourhoods for all socioeconomic variables. Patients in the neighbourhood with a high concentration of injecting drug users were more likely to be female, have a history of injecting drug use, have a less HIV‐experienced physician and be less adherent. Patients in the neighbourhood with a high concentration of gay men were more likely to have AIDS. Mortality was significantly higher for patients in the neighbourhood with a high concentration of injecting drug users [hazard ratio (HR) 3.01; 95% confidence interval (CI) 1.73, 5.24].Conclusions
A threefold increase was observed in the risk of death among HIV‐infected individuals on HAART in the neighbourhood with a high concentration of injecting drug users relative to the neighbourhood with a high concentration of gay men. The implications of this study should be assessed in similar HIV/AIDS epicentres. 相似文献74.
Chin R McCain TW Lucia MA Cappellari JO Adair NE Lovato JF Dunagan DP Brooks MA Clark HP Haponik EF 《American journal of respiratory and critical care medicine》2002,166(3):377-381
Transbronchial needle aspiration has emerged as a key technique for sampling mediastinal adenopathy but variable yields are reported. To determine the number of aspirates needed to optimize yield, we prospectively studied transbronchial needle aspiration and the sequential effect of each successive specimen on diagnostic yield in 79 patients with known or suspected lung carcinoma and mediastinal adenopathy. A total of 451 aspirates were performed in 79 patients (mean, 5.7 aspirates per patient; range, 2-13) with 45 cases (57%) positive for malignancy. A cytologically positive transbronchial needle aspiration occurred with the first aspirate in 42% of patients in whom this procedure established mediastinal nodal involvement. All positive results were achieved with seven or fewer aspirates. Similar yields were obtained for small cell and non-small cell lung cancer after seven aspirates. Rapid on-site specimen cytologic evaluation was used in 55 of 79 cases (70%), with a positive diagnosis obtained in 39 of 55 cases (71%) with on-site evaluation compared with six of 24 cases (25%) performed without on-site evaluation. The data suggest there is a plateau in yield after seven transbronchial needle aspirates, which may be sufficient to obtain an optimal yield in assessing patients with lung cancer and mediastinal adenopathy. 相似文献
75.
76.
T and B lymphocyte markers in effusions of patients with non-Hodgkin's lymphoma 总被引:1,自引:0,他引:1 下载免费PDF全文
T and B cells were sought in effusion fluids of 13 patients with lymphoma. In T cell lymphomas (four cases) morphologically abnormal cells that formed E rosettes were present. In B cell lymphomas (nine cases) morphologically abnormal cells were present in only two cases, however immunological studies showed a reduction in T cells and monoclonal light chain immunoglobulin expression in six of nine cases. 相似文献
77.
Margolis RL; Stine OC; McInnis MG; Ranen NG; Rubinsztein DC; Leggo J; Brando LV; Kidwai AS; Loev SJ; Breschel TS; Callahan C; Simpson SG; DePaulo JR; McMahon FJ; Jain S; Paykel ES; Walsh C; DeLisi LE; Crow TJ; Torrey EF; Ashworth RG; Macke JP; Nathans J; Ross CA 《Human molecular genetics》1996,5(5):607-616
The two most consistent features of the diseases caused by trinucleotide
repeat expansion-neuropsychiatric symptoms and the phenomenon of genetic
anticipation-may be present in forms of dementia, hereditary ataxia,
Parkinsonism, bipolar affective disorder, schizophrenia and autism. To
identify candidate genes for these disorders, we have screened human brain
cDNA libraries for the presence of gene fragments containing polymorphic
trinucleotide repeats. Here we report the cDNA cloning of CAGR1, originally
detected in a retinal cDNA library. The 2743 bp cDNA contains a 1077 bp
open reading frame encoding 359 amino acids. This amino acid sequence is
homologous (56% amino acid identify and 81% amino acid conservation) to the
Caenorhabditis elegans cell fate-determining protein mab-21. CAGR1 is
expressed in several human tissues, most prominently in the cerebellum, as
a message of approximately 3.0 kb. The gene was mapped to 13q13, just
telomeric to D13S220. A 5'-untranslated CAG trinucleotide repeat is highly
polymorphic, with repeat length ranging from six to 31 triplets and a
heterozygosity of 87-88% in 684 chromosomes from several human populations.
One allele from an individual with an atypical movement disorder and
bipolar affective disorder type II contains 46 triplets, 15 triplets longer
than any other allele detected. Though insufficient data are available to
link the long repeat to this clinical phenotype, an expansion mutation of
the CAGR1 repeat can be considered a candidate for the etiology of
disorders with anticipation or developmental abnormalities, and
particularly any such disorders linked to chromosome 13.
相似文献
78.
Urine output following administration of a low-dose dopamine infusion was assessed in 20 very immature infants (median gestational age 27 weeks). Prior to the infusion, all infants had had a period of anuria. Urine output improved significantly during the second 24 h after commencing the infusion but, at that time period, urine output was greater than 2 ml/kg/h (designated a good response) in only 13 infants. There was no significant difference in gestational age, birth weight, period of anuria or fluid input of infants who had a good or a poor response to dopamine. Although the baseline blood pressure did not differ significantly between these two groups, the increase in blood pressure resulting from dopamine administration was significantly greater in those infants with a good response in urine output (p<0.02). We conclude that low-dose dopamine infusion can improve urine output in very immature infants. Our results suggest that there may be inter-individual variation in the sensitivity to dopamine. 相似文献
79.
Massive left diaphragmatic separation and rupture due to coughing during an asthma exacerbation 总被引:1,自引:0,他引:1
Kallay N Crim L Dunagan DP Kavanagh PV Meredith W Haponik EF 《Southern medical journal》2000,93(7):729-731
We report a case of herniation of abdominal contents into the left hemithorax in a patient hospitalized with an acute exacerbation of asthma accompanied by paroxysms of coughing. There was no history of trauma. We believe this is the first reported case of diaphragmatic rupture complicating an asthma exacerbation. We review clinical features, pathophysiology, diagnosis, and treatment of diaphragmatic rupture in its most common setting, trauma, and discuss its occasional "spontaneous" occurrence. 相似文献
80.