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101.
We assessed the influence of SODB, a melon superoxide dismutase (SOD), on left ventricular (LV) hypertrophy in SHR. SODB (4 or 40U SOD) was given orally for 4 or 28 days to SHR. For each treatment period, LV weight index (LVWI) and cardiomyocytes size were measured. SOD, glutathione peroxidase (GPx) and catalase expressions, and LV production and presence of superoxide anion were determined. Pro-inflammatory markers were also measured. SODB reduced LVWI and cardiomyocytes size after 4 or 28 days. Cardiac SOD and GPx increased by 30–40% with SODB. The presence but not production of superoxide anion was significantly reduced by SODB. No effect of SODB was detected on inflammatory status in any group. The beneficial effect of SODB on cardiac hypertrophy seems to be related to the stimulation of endogenous antioxidant defense, suggesting that SODB may be of interest as a dietary supplementation during conventional antihypertensive therapy.  相似文献   
102.
We describe an exceptional case of life-threatening group A Escherichia coli-induced purpura fulminans. Genotyping of common polymorphisms in genes involved in innate immunity or coagulation did not reveal known susceptibility to such a manifestation. Genetic analysis of the strain revealed an unusual conserved virulence plasmidic region, pointing out its potential virulence.  相似文献   
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Objectives

The studies of comorbidities, risk factors of organic pathologies, or declining life expectancy of patients with mental disorders, particularly psychotic disorders, are the subject of many publications. The cares, including palliative care, for these patients, but also the patients and caregivers experience in these situations are rarely described in the literature. From the story of Peter, we evoke the palliative support and the management of these patients in a psychiatric hospital.

Patient

Pierre was monitored for paranoid schizophrenia. He was hospitalized in a psychiatric hospital after a suicidal attempt. Before that event, he spent a large part of his life in the psychiatric hospital, with more than 50 hospitalisations. After 1 month of hospitalisation, a diagnosis of a lung cancer with lethal prognosis was done. Pierre was very anxious, especially about the medical exams, and also the chemotherapy. He did not eat and sleep anymore. He told every doctor and nurse that he did not want any treatment, especially not chemotherapy. After discussions with Pierre, his family, specialized doctors in pneumology and palliative care, we decided to respect his will, and Pierre was informed about that decision. After that, he felt relieved, ate and slept again, and kept his normal activities in the hospital. Pierre died 4 months after the diagnosis was done.

Results

We present a brief introduction on palliative care history in France, and discuss the specificities of this kind of monitoring, especially about the management of the medical teams, but also the assessments of the behavior or the pain. It is sometime really difficult to assess behavior and pain for patients suffering from schizophrenia. These patients cannot talk about their pain as well as other patients because of the language impairment and lack of capacity of expressing their feelings. Also, it seems, in recent research, that schizophrenic patients do not feel the pain as other patients. These specificities increasingly complex the evaluation, at the limit of normal and pathologic event. Beyond these practical aspects, we initiate a reflection on the challenges of this unusual support. In fact, we discuss the end of life and the specific follow-up of this patient, and the legal aspects in this situation of patients suffering from severe psychiatric illness. We also talk about the impact of this kind of management on the patient and the medical team. We question and discuss the possibility of patients suffering from severe schizophrenia to take some decisions about their health. Finally, we question ethical aspects in this specific context, dealing with unreasonable obstinacy, refusal of treatment. In fact, it is an ethical question to know if we have to consider the will of a patient suffering from judgment trouble because of his psychiatric disease if he do not want a medical treatment. Do we have to respect that choice? Do we have to try to convince him, even if he will have some psychotic anxiety?

Conclusions

We discuss in this publication the care for patient suffering from psychosis disorders, concerning the patient's right, but also our responsibility as doctors in medical decision. In the situation described, limiting curative care was adapted to the gravity of the disease, and did not compromised the patient's integrity. The patient's right and responsibility needs to be treated for each situation, without any theorical previous rules, except the Leonetti law. We argue that caregivers in psychiatric hospital have to accompany these patients, also at the end of their lives. Some teams in psychiatric hospital works for the prevention and treatment for the physical pain, and we probably need to extend their abilities to healthcare at the end of life, promoting medical education.  相似文献   
107.
Journal of NeuroVirology - Rapid maturation of major white matter pathways occurs in the first 2 years of life, indicating a critical neuronal developmental period. The impact of...  相似文献   
108.
Objective Analysis of risk factors associated with severity in patients with confirmed leptospirosis. Design and setting Retrospective study in 147 leptospirosis-confirmed patients at two tertiary nonteaching hospital in Reunion Island. Patients 138 men and 9 women, aged 36 ± 14 years, 80 in the ICU and 67 in medical wards. Measurements and results We collected demographic, clinical, biological, and radiographic data and performed univariate and multivariate analysis to examine risk factors associated with admission in ICU and mortality. Pulmonary forms were more frequent (85%) than in previous reports, with 85 cases (65.3%) on abnormal chest radiography. Among the 38 patients who underwent bronchoalveolar lavage at admission 31 (81.5%) had alveolar hemorrhage. Independent factors related to ICU admission were: age over 46 years (OR 3.02), creatinine higher than 200 μmol/l (6.69), shock (13.87), and acute respiratory failure (20.69). Mortality was 12.9%. The only factor independently related to mortality was need for mechanical ventilation (OR 20.94). Icterohemorrhagiae serogroup was found in 62 cases (42.8%) but was not related to death. Conclusions Pulmonary involvement is a major feature in leptospirosis disease but is not associated with poor outcome. Identification of clinical and laboratory findings on admission may help to better characterize severe cases. Mailing address: Arnaud Bourdin is currently at the Service de Pneumologie, CHU Montpellier, France.  相似文献   
109.
Despite good clinical results, the mechanisms of action of spinal cord stimulation (SCS) for the treatment of chronic refractory neuropathic pain have not yet been elucidated. In the present study, the effects of SCS were assessed on various neurophysiological parameters in a series of 20 patients, successfully treated by SCS for mostly unilateral, drug-resistant lower limb pain due to failed back surgery syndrome. Plantar sympathetic skin response (SSR), F-wave and somatosensory-evoked potentials (P40-SEP) to tibial nerve stimulation, H-reflex of soleus muscle, and nociceptive flexion (RIII) reflex to sural nerve stimulation were recorded at the painful lower limb. The study included two recording sets while SCS was switched ‘ON’ or ‘OFF’ for 1 h. Significant changes in ‘ON’ condition were as follows: SSR amplitude, H-reflex threshold, and RIII-reflex threshold and latency were increased, whereas SSR latency, F-wave latency, H-reflex amplitude, P40-SEP amplitude, and RIII-reflex area were reduced. Analgesia induced by SCS mainly correlated with RIII attenuation, supporting a real analgesic efficacy of the procedure. This study showed that SCS is able to inhibit both nociceptive (RIII-reflex) and non-nociceptive (P40-SEP, H-reflex) myelinated sensory afferents at segmental spinal or supraspinal level, and to increase cholinergic sympathetic skin activities (SSR facilitation). Complex modulating effects can be produced by SCS on various neural circuits, including a broad inhibition of both noxious and innocuous sensory information processing.  相似文献   
110.

Objectives

Analytical and clinical performances of the new standardized cystatin C particle-enhanced turbidimetric immunoassay (PETIA) using DiaSys reagents on Olympus AU2700® analyzer were evaluated.

Design and methods

We have studied imprecision, linearity, limit of detection and limit of quantification of this new immunoassay. Method comparison was assessed in relation to results generated by the standardized Siemens-particle-enhanced nephelometric immunoassay (PENIA). In order to evaluate the clinical relevance of this assay, estimated glomerular filtration rate (GFR) was calculated using MDRD, CKD-EPI creatinine, CKD-EPI cystatin C 2012 and CKD-EPI creatinine–cystatin C 2012 equations and compared to GFR measured using urinary clearance of 99mTc-DTPA in 100 hypertensive patients.

Results

Cystatin C measurements using DiaSys reagents have reliable analytical performances and are comparable to the standardized Siemens-PENIA method (bias of 0.01 mg/L). The mean measured GFR was 90.0 ± 29.7 mL/min/1.73 m2. Bias and accuracy of the three CKD-EPI equations were better than the MDRD. Both CKD-EPI creatinine-based and cystatin C-based formulae had similar bias, precision and accuracy. The combined creatinine–cystatin C equation was significantly more accurate and precise than the CKD-EPI creatinine equation in patients with GFR above 60 mL/min/1.73 m2.

Conclusions

The use of cystatin C in a combined equation with creatinine could improve the accuracy of eGFR in the reference interval.  相似文献   
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