全文获取类型
收费全文 | 677篇 |
免费 | 33篇 |
国内免费 | 4篇 |
专业分类
耳鼻咽喉 | 2篇 |
儿科学 | 55篇 |
妇产科学 | 3篇 |
基础医学 | 65篇 |
口腔科学 | 15篇 |
临床医学 | 126篇 |
内科学 | 135篇 |
皮肤病学 | 21篇 |
神经病学 | 10篇 |
特种医学 | 140篇 |
外科学 | 47篇 |
综合类 | 9篇 |
预防医学 | 9篇 |
眼科学 | 5篇 |
药学 | 44篇 |
肿瘤学 | 28篇 |
出版年
2023年 | 1篇 |
2022年 | 4篇 |
2021年 | 7篇 |
2020年 | 2篇 |
2019年 | 3篇 |
2018年 | 11篇 |
2017年 | 2篇 |
2016年 | 5篇 |
2015年 | 13篇 |
2014年 | 11篇 |
2013年 | 17篇 |
2012年 | 11篇 |
2011年 | 16篇 |
2010年 | 26篇 |
2009年 | 24篇 |
2008年 | 17篇 |
2007年 | 11篇 |
2006年 | 20篇 |
2005年 | 15篇 |
2004年 | 14篇 |
2003年 | 13篇 |
2002年 | 7篇 |
2001年 | 9篇 |
2000年 | 9篇 |
1999年 | 13篇 |
1998年 | 37篇 |
1997年 | 48篇 |
1996年 | 47篇 |
1995年 | 42篇 |
1994年 | 19篇 |
1993年 | 22篇 |
1992年 | 13篇 |
1991年 | 18篇 |
1990年 | 8篇 |
1989年 | 17篇 |
1988年 | 28篇 |
1987年 | 22篇 |
1986年 | 23篇 |
1985年 | 14篇 |
1984年 | 5篇 |
1983年 | 7篇 |
1982年 | 6篇 |
1981年 | 14篇 |
1980年 | 6篇 |
1979年 | 5篇 |
1978年 | 8篇 |
1977年 | 9篇 |
1976年 | 5篇 |
1975年 | 9篇 |
1974年 | 1篇 |
排序方式: 共有714条查询结果,搜索用时 0 毫秒
51.
Myocardial tagging in polar coordinates with use of striped tags 总被引:1,自引:0,他引:1
Regional deformation abnormalities in the heart wall provide a good indicator of ischemia. Myocardial tagging with magnetic resonance imaging is a new method of assessing heart wall motion during contraction. Current methods of myocardial tagging either do not provide two-dimensional information or lack a coordinate system well adapted to the morphology of the heart. In this article, the authors describe a new tagging method that provides a true polar coordinate system, with both radial and angular dimensions. This is accomplished with use of a section-selective version of spatially modulated magnetization resulting in striped tags (STAGs). These STAG planes are placed in the myocardium in a star pattern so that they intersect on the long axis of the heart and stripes appear through the width of the heart wall. In the short-axis view during contraction, rotation around the long axis yields angular information such as shear and twist, while separation of the stripes within the myocardium permits measurement of radial thickening. Therefore, this method provides a coordinate system for calculating two-dimensional strain that is adapted to the morphology of the left ventricle. 相似文献
52.
The immediate-spin (IS) crossmatch is used to detect ABO incompatibility between donor red cells (RBCs) and the serum of the intended recipient. However, this test may be positive in the absence of ABO incompatibility (false positive) or it may be negative when ABO incompatibility exists (false negative). During a 25-month study, the rates of both false-positive and false-negative IS crossmatch results were evaluated, and the sensitivity and specificity of the IS crossmatch were determined. During the study period, 53,656 IS crossmatches were performed for patients without significant RBC antibodies. Fifty-five patients had positive IS crossmatches, and no false-negative reactions were found. In tests of 55 patients with positive IS crossmatches, 77 false-positive and 5 true-positive reactions were noted. The causes of the false-positive reactions were rouleaux (36 patients), cold-reactive antibodies (8 patients), a combination of rouleaux and cold-reactive antibodies (2 patients), fibrin clot (1 patient), and undetermined (3 patients). The sensitivity and specificity of the IS crossmatch were 100 and 99.86 percent, respectively. Laboratory personnel should be aware that the IS crossmatch may have false-positive or false-negative results, and they should develop written protocols to distinguish quickly between true-positive and false-positive reactions. 相似文献
53.
The interaction between FLFQPQRFamide and alpha 2-adrenergic spinal antinociception was examined in an electrophysiological study in the intact anaesthetised rat. The inhibition of C fibre-evoked neuronal responses by the selective alpha 2-adrenergic agonist dexmedetomidine was significantly reduced by intrathecal FLFQPQRFamide pretreatment. The results suggest a modulatory role of FLFQPQRFamide in spinal alpha 2-adrenergic antinociception. 相似文献
54.
55.
BACKGROUND: Hospitals and blood centers throughout the United States use a variety of reagents and methods to perform pretransfusion testing. A survey was developed to determine the reagents and methods in use and their relative prevalence in different work settings. STUDY DESIGN AND METHODS: A national survey on pretransfusion testing was conducted. Surveys were distributed to state and regional blood bank associations, which then distributed them to hospitals and blood centers within their region. In most instances, the blood centers distributed the survey to the local hospitals. Completed surveys were returned to the authors for review, and all information was entered into a database for analysis. RESULTS: Analysis of the data shows that the majority of blood banks use monoclonal reagents for ABO testing and monoclonal-polyclonal blended reagents for Rh testing. The data show that anti-IgG and polyclonal antihuman globulin reagents are used almost equally for antibody screening (detection) tests and that most blood banks use a three-cell antibody-screening test. Slightly more than 50 percent of hospitals use an immediate-spin crossmatch in the absence of unexpected antibodies. CONCLUSION: A number of approved reagents and methods are used by blood bank laboratories for pretransfusion testing. Facility size (number of beds) and type tend to influence the choice of methods and reagents employed. This survey provides an opportunity for blood bank laboratories to compare their current practices with those of their peers. 相似文献
56.
FAGAN EA; DAVISON FD; TROWBRIDGE R; CARMAN WF; SMITH HM; TEDDER R; WILLIAMS R 《QJM : monthly journal of the Association of Physicians》1991,78(2):123-134
Excluding studies from Brechot and co-workers, little supporthas been found for a role of the hepatitis B virus in the pathogenesisof HBsAg seronegative patients with predominantly chronic liverdiseases, including primary liver cancer. In this study liverDNA from 59 predominantly British patients (four cases withpaired biopsies, 612 months apart) with different, mostlychronic, liver diseases was analysed by molecular hybridization.All were seronegative for HBsAg and serum hepatitis B virusDNA (dot blot hybridization) and their liver diseases were believedto be unrelated to hepatitis B virus infection. Hepatitis Bvirus DNA was detected in liver of 11 (18.6 per cent) patients;nine had episomal(3.2 Kb) DNA and eight had higher molecularweight bands suggesting integrated forms. Six patients werealso seronegative for anti-HBc. Patients of UK and non-UK originwere equally represented. Hepatitis B virus DNA was detectedin serum of six of nine patients tested using the polymerasechain reaction. The detection of hepatitis B virus DNA in liverand in serum by this assay in a significant proportion of patientswith chronic liver disease, hitherto unsuspected of being hepatitisB virus-related, suggests a possible role for this virus inlow- as well as high-prevalence countries. 相似文献
57.
Discrepancies in reverse ABO typing due to prozone 总被引:5,自引:0,他引:5
Three group O sera manifesting prozone in reverse ABO tests are reported. All were implicated in erroneous blood typing results. One sample failed to react with A1 red cells (RBCs) in immediate-spin (IS) tests, had anti-A and -B titers of 8192 and 2048, respectively, by indirect antiglobulin technique (IAT), and was from a diabetic patient; the parenteral administration of A substance present in porcine insulin is a possible cause of hyperimmunity in this case. The second sample was from the recipient of a single unit of group B fresh-frozen plasma; the serum anti-A and -B titers were 10,240 by IAT, but only weak reactions with A1 and B RBCs were noted in routine IS reverse typing tests; the hyperimmunity in the patient concerned was likely due to crossreacting anti-A, B stimulated by B-active glycoproteins and/or glycolipids in the transfused plasma. The third serum also had anti-A and anti-B IAT titers of 10,240 but did not react with A1 and B RBCs by IS; the hyperimmunity in this case may be related to sepsis from intestinal flora carrying A- and/or B-like antigens. These antibodies lysed A1 and/or B RBCs in tests incubated at room temperature (RT) and strongly agglutinated those RBCs by IS when diluted 10-fold with saline. The absence of the prozone phenomenon in tests with RBCs suspended in diluents containing EDTA is consistent with the previously published mechanism for anti-A prozone: namely, the steric hindrance of agglutination by the C1 component of human complement.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
58.
Background: This article describes standard operating procedures (SOPs) for a computer crossmatch to replace the immediate-spin crossmatch for ABO incompatibility between patient blood samples submitted for pretransfusion testing and the blood component selected for transfusion. These SOPs were developed following recent changes to the Standards for Blood Banks and Transfusion Services of the American Association of Blood Banks (AABB). Study Design and Methods: SOPs were developed, utilizing currently available software, for pretransfusion testing. The SOP for donor unit processing entails bar code entry of the unit number, component name, and ABO/Rh type; computer entry and interpretation of serologic reactions; warning of discrepancies between bar code-entered blood type and result interpretation; and quarantine of the donor unit in such instances. The SOP for patient sample testing requires bar code entry of specimen accession number, which accesses patient demographics; computer entry and interpretation of ABO/Rh tests; repeat blood typing at the time of crossmatch if only one patient blood type is on record; and warning if there are nonconcordant current and historical blood types. The computer crossmatch SOP requires bar code entry of specimen accession and donor unit numbers; release of group O red cells pending resolution of discrepancies; and immediate-spin crossmatch during computer downtime. Tables validated on- site prompt warning messages and prevent both computer crossmatch and release if blood components of the wrong ABO type are selected. Results: These SOPs meet the requirements of the 15th edition of the AABB Standards. Projected annual time savings at this institution are > 100,000 workload recording units. Further benefits include reduced patient sample volume requirements, less handling of biohazardous material, and elimination of unwanted positive or negative reactions associated with the immediate-spin crossmatch. Release of incompatible blood components when the wrong patient blood type is on record is addressed by requiring the use of group O red cells in the absence of two concordant blood types, one of which must be from a current sample. Conclusion: A combination of existing computer programs and carefully developed SOPs can provide a safe and efficient means of detecting donor-recipient incompatibility without performance of serologic crossmatch. 相似文献
59.
The need to detect antibodies that agglutinate and/or hemolyze red cells (RBCs) directly at 37 degrees C, but do not react in subsequently performed indirect antiglobulin tests (IATs), is of concern relative to the streamlining and automation of antibody detection methods. To determine incidence and significance of such reactions, data from 87,480 tests, which used low-ionic-strength saline, 10-minute incubation at 37 degrees C, and anti-IgG, were analyzed for unexpected antibodies. There were 3590 positive tests, of which 475 showed reactions at 37 degrees C but not in subsequently performed IATs (37 + IAT-). Of these, 196 reactions were due to autoantibodies or other factors usually considered insignificant with respect to the survival of transfused incompatible RBCs, 176 were due to alloantibodies of questionable clinical significance (M, Lea, P1, etc.), and 103 were associated with alloantibodies of potential clinical significance (63 E, 27 K, 5 Jka, 4 D, 3 cE, and 1 C). This latter reaction was seen in 72 patients, with two 37 + IAT-antibodies occurring in each of 3 patients. Of the 75 potentially significant 37 + IAT-antibodies, 57 were seen in patients recently exposed to homologous RBCs, 13 in patients with a history of transfusion and/or pregnancy, and 5 in patients with no known exposure to homologous RBCs. IAT reactivity was observed in subsequent samples with 27 of these antibodies. The predictive value of a 37 + IAT-test was 21.7 percent for a potentially significant antibody. The incidence was 0.12 percent of all tests for unexpected antibodies.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
60.
Percutaneous umbilical blood samples (PUBS), obtained under ultrasound guidance, are used for prenatal diagnosis and management of hemolytic disease of the newborn (HDN) and other fetal disorders. Rapid testing at the time of sampling is vital to distinguish fetal from maternal blood. Blood typing was performed by slide technique in the treatment room during 38 procedures on 25 patients. Anti-I was used to test 50 presumed PUBS; venous I-positive maternal blood was tested in parallel. Because anti-I cannot detect fetal blood after umbilical vein transfusion (UVT) of I-positive donor blood, ABO and Rh blood typing reagents were used to test 29 samples when maternal and fetal or donor blood groups differed. Monoclonal reagents were used for optimal detection of weak AB antigens in fetal blood. Avid, chemically modified anti-D was used for Rh typing. Blood typing showed 27 (34%) of 79 samples to be maternal blood. Fetal blood was obtained in 8 of 10 cases investigated for fetal disorder and in 16 cases of potential HDN (anti-D, 5; -CD, 5; -cE, 2; -K, 2; -c; -E). The absence of HDN (antigen-negative fetus) was determined in 4 cases. UVT afforded live birth of 9 of 10 infants with HDN and was not indicated in two cases. 相似文献