全文获取类型
收费全文 | 3146篇 |
免费 | 107篇 |
国内免费 | 20篇 |
专业分类
耳鼻咽喉 | 24篇 |
儿科学 | 38篇 |
妇产科学 | 49篇 |
基础医学 | 427篇 |
口腔科学 | 42篇 |
临床医学 | 330篇 |
内科学 | 675篇 |
皮肤病学 | 16篇 |
神经病学 | 354篇 |
特种医学 | 89篇 |
外科学 | 542篇 |
综合类 | 5篇 |
一般理论 | 1篇 |
预防医学 | 175篇 |
眼科学 | 23篇 |
药学 | 253篇 |
中国医学 | 2篇 |
肿瘤学 | 228篇 |
出版年
2023年 | 13篇 |
2022年 | 21篇 |
2021年 | 60篇 |
2020年 | 26篇 |
2019年 | 39篇 |
2018年 | 71篇 |
2017年 | 26篇 |
2016年 | 48篇 |
2015年 | 64篇 |
2014年 | 99篇 |
2013年 | 164篇 |
2012年 | 217篇 |
2011年 | 251篇 |
2010年 | 113篇 |
2009年 | 122篇 |
2008年 | 239篇 |
2007年 | 237篇 |
2006年 | 237篇 |
2005年 | 215篇 |
2004年 | 220篇 |
2003年 | 204篇 |
2002年 | 222篇 |
2001年 | 32篇 |
2000年 | 38篇 |
1999年 | 36篇 |
1998年 | 51篇 |
1997年 | 46篇 |
1996年 | 22篇 |
1995年 | 20篇 |
1994年 | 21篇 |
1993年 | 12篇 |
1992年 | 13篇 |
1991年 | 3篇 |
1990年 | 9篇 |
1989年 | 7篇 |
1988年 | 6篇 |
1987年 | 6篇 |
1986年 | 6篇 |
1985年 | 2篇 |
1984年 | 7篇 |
1983年 | 7篇 |
1981年 | 3篇 |
1980年 | 5篇 |
1979年 | 4篇 |
1976年 | 1篇 |
1970年 | 1篇 |
1964年 | 1篇 |
1963年 | 1篇 |
1961年 | 1篇 |
1959年 | 2篇 |
排序方式: 共有3273条查询结果,搜索用时 15 毫秒
61.
Deutsch David Bouchoucha Michel Uzan Julien Raynaud Jean-Jacques Sabate Jean-Marc Benamouzig Robert 《Digestive diseases and sciences》2022,67(7):3026-3035
Digestive Diseases and Sciences - Abdominal pain is a cardinal sign of functional bowel disorders (FBD), in favor of irritable bowel syndrome (IBS). However, the determinants of abdominal pain... 相似文献
62.
63.
Pierre Savi Josette Bornia Veronique Salel Marianne Delfaud & Jean-Marc Herbert 《British journal of haematology》1997,98(4):880-886
This study aimed to determine the binding characteristics of [3 H]α,β-Me-ATP, a specific ligand of the P2x1 receptors to rat platelets, and to investigate the effect of clopidogrel, a thienopyridine compound which has been found to selectively inhibit ADP-induced platelet aggregation and adenylyl cyclase ex vivo . Binding of [3 H]α,β-Me-ATP to rat platelets was time-dependent and saturable. Scatchard analysis of the saturation binding data indicated that [3 H]α,β-Me-ATP bound to one population of specific binding sites with high affinity ( K D = 23.6 ± 1.6 n m ; B max = 690 ± 24 fmole/108 cells) ( n= 3). Unlabelled α,β-Me-ATP as well as 2-MeS-ADP and ADP competitively inhibited the specific binding of [3 H]α,β-Me-ATP with IC50 values of 19.0 ± 6.6, 103 ± 20 and 1120 ± 80 n m respectively ( n= 3). Other nucleotide analogues such as ATP, ATP-γS, UTP and GTP also antagonized [3 H]α,β-Me-ATP binding. When administered orally (10 mg/kg, p.o.), clopidogrel inhibited ADP- or 2-MeS-ADP-induced platelet aggregation but did not affect the binding of [3 H]α,β-Me-ATP to rat platelets ex vivo. In vitro , α,β-Me-ATP did not induce the aggregation or shape change of rat platelets and did not interfere with ADP-induced platelet aggregation. 相似文献
64.
Franqois P. Sarasin MD Jean-Marc Reymond MD John L Griffith PhD Joni R. Beshansky RN MPH Jurg A. Schifferli MD Pierre-Francois Unger MD Jean-Raoul Scherrer MD Dr. Harry P. Selker MD MSPH 《Journal of general internal medicine》1994,9(4):187-194
Objective: Emergency department (ED) triage for acute cardiac ischemia in the primary teaching hospital in Geneva, Switzerland, is very accurate, but at the cost of very long ED stays. Thus, the authors sought: 1) to determine the impact of the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI), incorporated into a computerized electrocardiograph, on length of stay and speed of triage decision making for ED patients presenting with symptoms suggesting acute cardiac ischemia, and 2) to study the ACI-TIPI’s impact on physicians of different training levels. Design: A seven-month prospective clinical trial with alternating-month experimental and control periods. Setting: An urban major teaching hospital in Geneva, Switzerland. Participants: Patients over the age of 18 years presenting to the ED with chest pain or other symptoms suggesting acute cardiac ischemia (acute myocardial infarction or unstable angina pectoris). Emergency department physicians, classified as novice (those in their first ED rotations) and experienced (those in their second or later ED rotations). Patients staying overnight in the ED (n=111) were excluded from the analysis. Intervention: During the experimental months, the computerized electrocardiograph printed the ACI-TIPI probability of acute cardiac ischemia at the top of each subject’s electrocardiogram. During control months, the probability was not provided. Measurements and main results: Among the 418 study subjects, for patients with acute ischemia seen by novice clinicians, the use of the ACI-TIPI decreased ED time from presentation to triage decision and ED release by 0.7 hour (19%) (p=0.007). Subgroup analyses for patients with acute myocardial infarction, patients with unstable angina pectoris, and patients given thrombolytic therapy also showed analogous decreases in ED time consistent with this finding. Other key determinants of ED length of stay included: age, whether the coronary care unit was full, whether patients received thrombolytic therapy, and whether admission was during the night shift. The experimental and control groups did not differ in triage disposition appropriateness or mortality. Conclusions: For ED patients with acute cardiac ischemia evaluated by novice clinicians, the ACI-TIPI substantially speeded ED decision making and triage. The suggestion of an impact on different cardiac ischemia subgroups and mortality deserves further larger clinical trials. 相似文献
65.
Canard JM Debette-Gratien M Dumas R Escourrou J Gay G Giovannini M Greff M Grimaud JC Helbert T Marchetti B Lapuelle J Napoleon B Palazzo L Ponchon T Rey JF Sautereau D;la Société Française d'Endoscopie Digestive 《Gastroentérologie clinique et biologique》2005,29(1):17-22
AIM: The aim of this study was to evaluate the practice of colonoscopy and sigmoidoscopy in France in 2000. METHODS: A prospective study was conducted in November 2000 using questionnaires sent to all gastroenterologists practicing in France (N=2858) who were asked to reply to items concerning colonoscopies and sigmoidoscopies performed on two workdays chosen in advance. The response rate was 32.8%. Data were extrapolated to establish estimates for the entire year. RESULTS: An estimated 894000 colonoscopies and 115320 sigmoidoscopies were performed in 2000. Single-use material was used in 22.1% of the procedures. Indications for endoscopy were mainly hematochezia (21.6%), gastrointestinal symptoms (35%) and surveillance of patients with a history of previous polypectomy (15%). Colorectal cancer screening was the indication for 20% of colonoscopies. Abnormal findings were reported for 54.8% of the endoscopies (polyps for 287218 procedures and cancer for 32799). Failure was noted in 4.9% of colonoscopies. The complication rate was 0.48%. Most polyps were adenomas (64.4%) or hyperplasic polyps (28.1%). The overall estimated number of colonoscopies with polypectomy was 224133. CONCLUSION: In 2000 there was an increased rate of colonoscopy for colorectal cancer screening (20%) but an overall decrease (2.5%) in the total number of colonoscopies compared to 1999. Abnormal findings were disclosed by 54.8% of the procedures. Extrapolation from these data indicates that colonoscopic screening enabled the diagnosis of 32799 colorectal cancers. 相似文献
66.
67.
Jean Bousquet Toni Dedeu Eve Dupas Jean-Louis Pépin Landry Stephane Zeng Eyindanga Sylvie Arnavielhe Julia Ayache Xavier Basagana Samuel Benveniste Nuria Calves Venturos Hing Kin Chan Mehdi Cheraitia Yves Dauvilliers Judith Garcia-Aymerich Ingrid Jullian-Desayes Chitra Dinesh Daniel Laune Jade Lu Dac Ismael Nujurally Giovanni Pau Robert Picard Xavier Rodo Renaud Tamisier Michael Bewick Nils E. Billo Wienczyslawa Czarlewski Joao Fonseca Ludger Klimek Oliver Pfaar Jean-Marc Bourez 《Clinical and translational allergy》2018,8(1):36
Allergic rhinitis (AR) is impacted by allergens and air pollution but interactions between air pollution, sleep and allergic diseases are insufficiently understood. POLLAR (Impact of air POLLution on sleep, Asthma and Rhinitis) is a project of the European Institute of Innovation and Technology (EIT Health). It will use a freely-existing application for AR monitoring that has been tested in 23 countries (the Allergy Diary, iOS and Android, 17,000 users, TLR8). The Allergy Diary will be combined with a new tool allowing queries on allergen, pollen (TLR2), sleep quality and disorders (TRL2) as well as existing longitudinal and geolocalized pollution data. Machine learning will be used to assess the relationship between air pollution, sleep and AR comparing polluted and non-polluted areas in 6 EU countries. Data generated in 2018 will be confirmed in 2019 and extended by the individual prospective assessment of pollution (portable sensor, TLR7) in AR. Sleep apnea patients will be used as a demonstrator of sleep disorder that can be modulated in terms of symptoms and severity by air pollution and AR. The geographic information system GIS will map the results. Consequences on quality of life (EQ-5D), asthma, school, work and sleep will be monitored and disseminated towards the population. The impacts of POLLAR will be (1) to propose novel care pathways integrating pollution, sleep and patients’ literacy, (2) to study sleep consequences of pollution and its impact on frequent chronic diseases, (3) to improve work productivity, (4) to propose the basis for a sentinel network at the EU level for pollution and allergy, (5) to assess the societal implications of the interaction. MASK paper N°32. 相似文献
68.
Jean-Marc?Le?Goff Claire?Roger Benjamin?Louart Pierre?Géraud?Claret Aurélien?Daurat Stéphanie?Bulyez Jean-Yves?LefrantEmail author Xavier?Bobbia Laurent?Muller 《Journal of clinical monitoring and computing》2018,32(3):513-518
Lung ultrasound (LUS) increases clinical diagnosis performance in intensive care unit (ICU). Real-time three-dimensional (3-D) imaging was compared with two-dimensional (2-D) LUS by assessing the global diagnosis concordance. In this single center, prospective, observational, pilot study, one trained operator performed a 3-D LUS immediately after a 2-D LUS in eight areas of interest on the same areas in 16 ventilated critically ill patients. All cine loops were recorded on a computer without visible link between 2-D and 3-D exams. Two experts blindly reviewed cine loops. Four main diagnoses were proposed: normal lung, consolidation, pleural effusion and interstitial syndrome. Fleiss κ and Cohen’s κ values were calculated. In 252 LUS cine loops, the concordance between 2-D and 3-D exams was 83.3% (105/126), 77.6% (99/126) and 80.2% (101/126) for the trained operator and the experts respectively. The Cohen’s κ coefficient value was 0.69 [95% Confidence Interval (CI) 0.58–0.80] for expert 1 meaning a substantial agreement. The inter-rater reliability was very good (Fleiss’ κ value?=?0.94 [95% CI 0.87–1.0]) for 3-D exams. The Cohen’s κ was excellent for pleural effusion (κ=?0.93 [95% CI 0.76–1.0]), substantial for normal lung diagnosis (κ?=?0.68 [95% CI 0.51–0.86]) and interstitial syndrome (κ?=?0.62 [95% CI 0.45–0.80]) and fair for consolidation diagnoses (κ?=?0.47 [95% CI 0.30–0.64]). In ICU ventilated patients, there was a substantial concordance between 2-D and 3-D LUS with a good inter-rater reliability. However, the diagnosis concordance for lung consolidation is poor. 相似文献
69.
Damien Contou Romain Sonneville Florence Canoui-Poitrine Gwenhaël Colin Rémi Coudroy Frédéric Pène Jean-Marc Tadié Martin Cour Gaëtan Béduneau Antoine Marchalot Laurent Guérin Sébastien Jochmans Stephan Ehrmann Nicolas Terzi Sébastien Préau François Barbier Guillaume Schnell Damien Roux Olivier Leroy Claire Pichereau Elodie Gélisse Lara Zafrani Richard Layese Christian Brun-Buisson Armand Mekontso Dessap Nicolas de Prost For the Hopeful Study Group 《Intensive care medicine》2018,44(9):1502-1511
Purpose
Data on purpura fulminans (PF) in adult patients are scarce and mainly limited to meningococcal infections. Our aim has been to report the clinical features and outcomes of adult patients admitted in the intensive care unit (ICU) for an infectious PF, as well as the predictive factors for limb amputation and mortality.Methods
A 17-year national multicenter retrospective cohort study in 55 ICUs in France from 2000 to 2016, including adult patients admitted for an infectious PF defined by a sudden and extensive purpura, together with the need for vasopressor support. Primary outcome variables included hospital mortality and amputation during the follow-up period (time between ICU admission and amputation, death or end of follow-up).Results
Among the 306 included patients, 126 (41.2%; 95% CI 35.6–46.9) died and 180 (58.8%; 95% CI 53.3–64.3) survived during the follow-up period [13 (3–24) days], including 51/180 patients (28.3%, 95% CI 21.9–35.5) who eventually required limb amputations, with a median number of 3 (1–4) limbs amputated. The two predominantly identified microorganisms were Neisseria meningitidis (63.7%) and Streptococcus pneumoniae (21.9%). By multivariable Cox model, SAPS II [hazard-ratio (HR)?=?1.03 (1.02–1.04); p?<?0.001], lower leucocytes [HR 0.83 (0.69–0.99); p?=?0.034] and platelet counts [HR 0.77 (0.60–0.91); p?=?0.007], and arterial blood lactate levels [HR 2.71 (1.68–4.38); p?<?0.001] were independently associated with hospital death, while a neck stiffness [HR?0.51 (0.28–0.92); p?=?0.026] was a protective factor. Infection with Streptococcus pneumoniae [sub-hazard ratio 1.89 (1.06–3.38); p?=?0.032], together with arterial lactate levels and ICU admission temperature, was independently associated with amputation by a competing risks analysis.Conclusion
Purpura fulminans carries a high mortality and morbidity. Pneumococcal PF leads to a higher risk of amputation.Trials registration
NCT03216577.70.