全文获取类型
收费全文 | 3680篇 |
免费 | 276篇 |
国内免费 | 27篇 |
专业分类
耳鼻咽喉 | 51篇 |
儿科学 | 146篇 |
妇产科学 | 95篇 |
基础医学 | 554篇 |
口腔科学 | 136篇 |
临床医学 | 324篇 |
内科学 | 860篇 |
皮肤病学 | 67篇 |
神经病学 | 422篇 |
特种医学 | 77篇 |
外科学 | 280篇 |
综合类 | 11篇 |
预防医学 | 392篇 |
眼科学 | 45篇 |
药学 | 225篇 |
中国医学 | 4篇 |
肿瘤学 | 294篇 |
出版年
2024年 | 6篇 |
2023年 | 50篇 |
2022年 | 85篇 |
2021年 | 160篇 |
2020年 | 78篇 |
2019年 | 107篇 |
2018年 | 127篇 |
2017年 | 106篇 |
2016年 | 112篇 |
2015年 | 137篇 |
2014年 | 150篇 |
2013年 | 166篇 |
2012年 | 290篇 |
2011年 | 282篇 |
2010年 | 127篇 |
2009年 | 134篇 |
2008年 | 231篇 |
2007年 | 226篇 |
2006年 | 197篇 |
2005年 | 183篇 |
2004年 | 138篇 |
2003年 | 154篇 |
2002年 | 123篇 |
2001年 | 56篇 |
2000年 | 36篇 |
1999年 | 48篇 |
1998年 | 32篇 |
1997年 | 22篇 |
1996年 | 25篇 |
1995年 | 23篇 |
1994年 | 14篇 |
1993年 | 12篇 |
1992年 | 38篇 |
1991年 | 31篇 |
1990年 | 23篇 |
1989年 | 29篇 |
1988年 | 22篇 |
1987年 | 15篇 |
1986年 | 23篇 |
1985年 | 33篇 |
1984年 | 26篇 |
1983年 | 28篇 |
1982年 | 17篇 |
1980年 | 6篇 |
1979年 | 10篇 |
1978年 | 4篇 |
1977年 | 5篇 |
1974年 | 4篇 |
1973年 | 6篇 |
1972年 | 5篇 |
排序方式: 共有3983条查询结果,搜索用时 250 毫秒
71.
72.
Melissa Alves Cirelli Marianna Sobral Lacerda Camila Takao Lopes Juliana de Lima Lopes Alba Lucia Bottura Leite de Barros 《Archives of Psychiatric Nursing》2018,32(2):235-241
AimTo describe and investigate correlations among anxiety, stress and depression and identify their relationship with sociodemographic and clinical characteristics of patients with heart failure.
Methods
This is an analytical cross-sectional study. Sociodemographic and clinical characteristics were collected, along with levels of anxiety, stress and depression from 309 outpatients.Results
The mean levels of stress, anxiety and depression were correlated but low. Time since diagnosis, the disease's functional class, family income, and smoking influenced stress. Functional class and Chagas disease influenced anxiety and depression. Being unemployed and smoking influenced anxiety, while being a homeowner influenced depression.Conclusion
These findings should be considered when planning nursing interventions. 相似文献73.
Fabi Marianna Andreozzi Laura Frabboni Ilaria Dormi Ada Corinaldesi Elena Lami Francesca Cicero Cristina Tchana Bertrand Francavilla Rosa Sprocati Monica Bigucci Barbara Balsamo Claudia Valin Paola Sogno Di Fazzio Giorgia Iughetti Lorenzo Valletta Enrico Marchetti Federico Donti Andrea Lanari Marcello 《Clinical rheumatology》2021,40(4):1507-1514
Clinical Rheumatology - Kawasaki disease (KD) is the most frequent cause of acquired heart disease in children in high-income countries because of coronary artery involvement. Risk factors for... 相似文献
74.
Noriaki Moriyama Teemu Laakso Peter Raivio Sebastian Dahlbacka Eeva-Maija Kinnunen Tatu Juvonen Antti Valtola Annastiina Husso Maina P. Jalava Tuomas Ahvenvaara Tuomas Tauriainen Jarkko Piuhola Asta Lahtinen Matti Niemelä Timo Mäkikallio Marko Virtanen Pasi Maaranen Markku Eskola Mika Laine 《The Canadian journal of cardiology》2021,37(1):37-46
BackgroundThe data on acute kidney injury (AKI) in patients without chronic kidney disease (CKD) after transcatheter aortic valve replacement (TAVR) are limited. The study sought to compare the incidence of AKI and its impact on 5-year mortality after TAVR and surgical aortic valve replacement (SAVR) in patients without CKD.MethodsThis registry included data from 6463 consecutive patients who underwent TAVR or SAVR. CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m2. AKI was defined according to the Kidney Disease Improving Global Outcomes criteria. For sensitivity analysis, propensity-score matching between TAVR and SAVR was performed.ResultsThe study included 4555 consecutive patients (TAVR, n = 1215 and SAVR, n = 3340) without CKD. Propensity-score matching identified 542 pairs. Patients who underwent TAVR had a significantly lower incidence of AKI in comparison to those who underwent SAVR (unmatched 4.7% vs 16.4%, P < 0.001, multivariable analysis: odds ratio, 0.29, 95% confidence interval [CI], 0.20-0.41; matched 5.9% vs 19.0%, P < 0.001). Patients with AKI had significantly increased 5-year mortality compared with those without AKI (unmatched 36.0% vs 19.1%, log-rank P < 0.001; matched 36.3% vs 24.0%, log-rank P < 0.001). The adjusted hazard ratios for 5-year mortality were 1.58 (95% CI, 1.20-2.08) for AKI grade 1, 3.27 (95% CI, 2.09-5.06) for grade 2, and 4.82 (95% CI, 2.93-8.04) for grade 3.ConclusionsTAVR in patients without CKD was associated with a significantly less frequent incidence of AKI compared with SAVR. AKI significantly increased the risk of 5-year mortality after either TAVR or SAVR, and increasing severity of AKI was incrementally associated with 5-year mortality. 相似文献
75.
Virtanen MP Nieminen T Kähönen MA Majahalme SK Tuomisto MT Turjanmaa VM Kööbi T 《Journal of human hypertension》2008,22(2):126-128
We evaluated the relationship between the variability in the left ventricular mass index (LVMI) and different hemodynamic factors. LVMI was associated with blood pressure and, in one subgroup, strongly to arterial pulse wave velocity (PWV). High physical activity was connected to increased LVMI, and a combination of low stroke index (SI) and high heart rate (HR) to decreased LVMI. 相似文献
76.
We have assessed the angiographic features of a group of 37 patients given oral dipyridamole and 37 patients given matching placebo. Both groups represented severe coronary arterial disease and were studied prior to bypass surgery. Six patients (16%) had angina and 13 patients (35%) had electrocardiographic changes after dipyridamole. All the patients in the control group were nonresponders. In the group given dipyridamole the patients responding with angina had significantly more compromised collaterals than the patients without chest pain (P = 0.021). The same applied to the patients with electrocardiographic changes versus those with no electrocardiographic changes (P = 0.034). No differences between responders and nonresponders could be found in terms of the severity of coronary arterial disease, severity of anginal symptoms, exercise tolerance, antianginal medication, number of past myocardial infarctions, and left ventricular ejection fraction. In conclusion, the data strongly suggest that ischaemic responses to dipyridamole originate from myocardial steal accentuated by compromised flow in collateral vessels. 相似文献
77.
Carola?BardageEmail author Saskia?M.?F.?Pluijm Nancy?L.?Pedersen Dorly?J.?H.?Deeg Marja?Jylh? Marianna?Noale Tzvia?Blumstein ángel?Otero 《European journal of ageing》2005,2(2):149-158
Self-rated health (SRH) may have different implications in various social and cultural settings. However, few studies are available concerning SRH among older persons across countries. The aim of this study was to analyse whether there are cross-national differences in the association between status characteristics, several diseases common among older persons, activities of daily living (ADL), and SRH. The study base was the Comparison of Longitudinal European Studies on Aging (CLESA), which includes data from six population-based studies on aging conducted in Finland, Israel, Italy, The Netherlands, Spain and Sweden. The study population comprised 5,629 persons, with participants from all countries except Italy. Logistic regression analyses were used to assess the relationship between status characteristics, health conditions, ADL and SRH. To examine whether the association among status characteristics, health conditions, ADL and outcome differed across the CLESA countries, interaction terms defined as variable*country were considered separately for each variable. Regression analyses revealed that sex, education, lifetime occupation, heart disease and respiratory disease were differently distributed across countries. Among homogeneous factors, marital status (OR=1.21), hypertension (OR=1.41), stroke (OR=1.67), diabetes (OR=2.15), cancer (OR=1.47), musculoskeletal diseases (OR=2.44), and ADL (OR=2.72) turned out to be significantly associated with fair or poor SRH. The results indicate that there are differences in self-ratings of health across countries. These differences cannot be explained entirely by status characteristics, self-reported diseases or functional ability. However, an important finding was that in all countries most of the indicators of medical and functional health were homogeneously associated with SRH. 相似文献
78.
Politou M Terpos E Anagnostopoulos A Szydlo R Laffan M Layton M Apperley JF Dimopoulos MA Rahemtulla A 《British journal of haematology》2004,126(5):686-689
The aim of this study was to evaluate the role of markers of bone remodelling, and osteoclast activation/function in patients with monoclonal gammopathy of undetermined significance (MGUS). We have measured serum levels of soluble RANKL (sRANKL), osteoprotegerin (OPG), macrophage inflammatory protein-1alpha (MIP-1alpha), markers of bone resorption [N-telopeptide of collagen type-I (NTX), and tartrate-resistant acid phosphatase isoform-5b (TRACP-5b)] and bone formation [bone-alkaline phosphatase (bALP)] in 40 MGUS patients. These parameters were compared with those of 42 newly diagnosed myeloma patients, and 45 healthy, gender- and age-matched controls. MGUS patients had elevated levels of NTX, sRANKL, and sRANKL/OPG ratio compared with controls (P < 0.0001). Furthermore, TRACP-5b, MIP-1alpha and NTX were decreased in patients with MGUS compared with myeloma patients (P < 0.001), while OPG and bALP were increased (P < 0.001). Serum levels of MIP-1alpha, as well as TRACP-5b, and sRANKL/OPG ratio were reduced, while bALP was increased in MGUS patients, even when compared with myeloma patients who had stage I/II disease. These results demonstrate that increased osteoclastogenesis leading to increased bone resorption is present in MGUS but seems to be compensated for by normal bone formation, which is absent in MM. Furthermore MIP-1alpha, bALP, and sRANKL/OPG may be useful tools for distinguishing between cases of MGUS and early myeloma. 相似文献
79.
Pier Pasquale Leone Damiano Regazzoli Matteo Pagnesi Jorge Sanz-Sanchez Mauro Chiarito Francesco Cannata Nicolas M. Van Mieghem Marco Barbanti Corrado Tamburino Rui Teles Marianna Adamo Mizuki Miura Francesco Maisano Won-Keun Kim Francesco Bedogni Giulio Stefanini Antonio Mangieri Francesco Giannini Azeem Latib 《JACC: Cardiovascular Interventions》2021,14(11):1218-1228
ObjectivesThe aim of this study was to define predictors of prosthesis-patient mismatch (PPM) and its impact on mortality after transcatheter aortic valve replacement (TAVR) with self-expandable valves (SEVs) in patients with small annuli.BackgroundTAVR seems to reduce the risk for PPM compared with surgical aortic valve replacement, especially in patients with small aortic annuli. Nevertheless, predictors and impact of PPM in this population have not been clarified yet.MethodsPredictors of PPM and all-cause mortality were investigated using multivariable logistic regression analysis from the cohort of the TAVI-SMALL (International Multicenter Registry to Evaluate the Performance of Self-Expandable Valves in Small Aortic Annuli) registry, which included patients with severe aortic stenosis and small annuli (annular perimeter <72 mm or area <400 mm2 on computed tomography) treated with transcatheter SEVs: 445 patients with (n = 129) and without (n = 316) PPM were enrolled.ResultsIntra-annular valves conferred increased risk for PPM (odds ratio [OR]: 2.36; 95% confidence interval [CI]: 1.16 to 4.81), while post-dilation (OR: 0.46; 95% CI: 0.25–0.84) and valve oversizing (OR: 0.53; 95% CI: 0.28–1.00) seemed to protect against PPM occurrence. At a median follow-up of 354 days, patients with severe PPM, but not those with moderate PPM, had a higher all-cause mortality rate compared with those without PPM (log-rank p = 0.008). Multivariable Cox regression confirmed severe PPM as an independent predictor of all-cause mortality (hazard ratio: 4.27; 95% CI: 1.34 to 13.6).ConclusionsAmong patients with aortic stenosis and small aortic annuli undergoing transcatheter SEV implantation, use of intra-annular valves yielded higher risk for PPM; conversely, post-dilation and valve oversizing protected against PPM occurrence. Severe PPM was independently associated with all-cause mortality. 相似文献
80.
Virtanen I Korhonen M Petäjäniemi N Karhunen T Thornell LE Sorokin LM Konttinen YT 《The Journal of clinical endocrinology and metabolism》2003,88(10):4960-4966
Laminin has been proposed to influence the function of human adrenal cortex. We have studied the distribution of laminin (Ln) chains using immunofluorescence in human fetal and adult adrenal cortex. In the fetal gland Ln alpha2- and alpha5-chains were weakly expressed in the definitive zone, whereas Ln alpha4-, beta1-, and gamma1-chains occurred around vessels. In the adult gland, Ln alpha2-, alpha5-, and gamma1-chains were found in epithelial basement membranes (BM) in all cortical zones, Ln alpha4-chain in vessels, Ln beta1-chain in outer zone, and Ln beta2-chain in the two inner zones of the cortex, respectively. Among the integrins in adult gland, integrin alpha(3)-subunit was confined to basal surfaces of cortical cells, alpha(6) to vessels, alpha(1) to the stroma, and alpha(2) diffusely to epithelial cells. Lutheran glycoprotein and dystroglycan occurred in the fetal gland diffusely in the definitive zone and throughout the epithelium in the adult. The isoform composition of BM of the adult adrenal gland is distinct, with Ln-2 and -10 in BM of the outer zone and Ln-4 and -11 in BM of the two inner zones. The results suggest that integrin alpha(3)beta(1) and Lutheran are candidate receptors for Ln-10 and -11, whereas dystroglycan probably binds Ln-2 and -4. 相似文献