全文获取类型
收费全文 | 693篇 |
免费 | 48篇 |
专业分类
耳鼻咽喉 | 7篇 |
儿科学 | 10篇 |
妇产科学 | 9篇 |
基础医学 | 90篇 |
口腔科学 | 13篇 |
临床医学 | 113篇 |
内科学 | 83篇 |
皮肤病学 | 12篇 |
神经病学 | 35篇 |
特种医学 | 45篇 |
外科学 | 166篇 |
综合类 | 3篇 |
预防医学 | 43篇 |
眼科学 | 5篇 |
药学 | 28篇 |
肿瘤学 | 79篇 |
出版年
2021年 | 20篇 |
2020年 | 8篇 |
2019年 | 14篇 |
2018年 | 25篇 |
2017年 | 13篇 |
2016年 | 17篇 |
2015年 | 20篇 |
2014年 | 17篇 |
2013年 | 30篇 |
2012年 | 46篇 |
2011年 | 46篇 |
2010年 | 31篇 |
2009年 | 14篇 |
2008年 | 31篇 |
2007年 | 29篇 |
2006年 | 22篇 |
2005年 | 28篇 |
2004年 | 35篇 |
2003年 | 29篇 |
2002年 | 29篇 |
2001年 | 11篇 |
2000年 | 10篇 |
1999年 | 11篇 |
1997年 | 3篇 |
1995年 | 6篇 |
1994年 | 5篇 |
1993年 | 2篇 |
1992年 | 7篇 |
1991年 | 17篇 |
1990年 | 11篇 |
1989年 | 9篇 |
1988年 | 16篇 |
1987年 | 19篇 |
1986年 | 13篇 |
1985年 | 11篇 |
1984年 | 4篇 |
1983年 | 5篇 |
1980年 | 5篇 |
1979年 | 9篇 |
1978年 | 10篇 |
1977年 | 2篇 |
1976年 | 2篇 |
1975年 | 3篇 |
1974年 | 8篇 |
1973年 | 5篇 |
1972年 | 7篇 |
1971年 | 7篇 |
1970年 | 2篇 |
1969年 | 4篇 |
1968年 | 2篇 |
排序方式: 共有741条查询结果,搜索用时 250 毫秒
81.
Myburgh C Larsen AH Hartvigsen J 《Archives of physical medicine and rehabilitation》2008,89(6):1169-1176
Myburgh C, Larsen AH, Hartvigsen J. A systematic, critical review of manual palpation for identifying myofascial trigger points: evidence and clinical significance.
Objective
To determine the reproducibility of manual palpation in identifying trigger points based on a systematic review of available literature.Data Sources
Medline (1965-2007), CINHAL (1982-2007), ISI Web of Science (1945-2007), and MANTIS (1966-2007) databases and reference lists of articles.Study Selection
Reproducibility studies relating to identification and diagnosis of trigger points through palpation. Acceptable studies were required to specifically consider either inter- or intrarater reliability of trigger point identification through manual palpation and include κ statistics as part of their statistical assessment.Data Extraction
Three independent reviewers considered the studies for inclusion and rated their methodologic quality based on the Standards for Reporting of Diagnostic Accuracy guidelines for the reporting of diagnostic studies.Data Synthesis
Eleven studies were initially included; however, 5 were subsequently excluded based on the inclusion and exclusion criteria. Only 2 studies were judged to be of high quality, and the level of evidence criteria suggested that, at best, moderate evidence could be found from which to make pronouncements on the literature. Only local tenderness of the trapezius (κ range, .15-.62) and pain referral of the gluteus medius (κ range, .298-.487) and quadratus lumborum (κ range, .36-.501) were found to be reproducible.Conclusions
The methodologic quality of the majority of studies for the purpose of establishing trigger point reproducibility is generally poor. More high-quality studies are needed to comment on this procedure. Clinicians and scientists are urged to move toward simpler, global assessments of patient status. 相似文献82.
Myburgh JA 《Critical care (London, England)》2008,12(2):143
Small-volume resuscitation of critically ill patients with hyperoncotic albumin offers a number of theoretical advantages, such as increasing intravascular volume in excess of the volume of fluid administered and reducing interstitial edema. Whilst iso-oncotic albumin has been shown to be equi-effective to isotonic saline for the resuscitation of critically ill patients without associated traumatic brain injury, the efficacy of hyperoncotic albumin for resuscitation has not been evaluated in large-scale randomized-controlled trials. Overall, the evidence for resuscitation with hyper-oncotic albumin is limited by studies of poor methodological quality with heterogenous study populations and control regimens. There is marginal qualitative evidence of improvements in surrogate outcomes in disparate patient populations, but no evidence of any survival benefit associated with resuscitation with hyperoncotic albumin. Given the lack of evidence and clinical uncertainty about the efficacy of hyperoncotic albumin, a large-scale randomized-controlled trial is required to determine its role in the acute resuscitation of hypovolemic or hypoalbuminemic critically ill patients. 相似文献
83.
84.
Myburgh JA Higgins A Jovanovska A Lipman J Ramakrishnan N Santamaria J;CAT Study investigators 《Intensive care medicine》2008,34(12):2226-2234
Objective To determine whether there was a difference between epinephrine and norepinephrine in achieving a mean arterial pressure (MAP)
goal in intensive care (ICU) patients.
Design Prospective, double-blind, randomised-controlled trial.
Setting Four Australian university-affiliated multidisciplinary ICUs.
Patients and participants Patients who required vasopressors for any cause at randomisation. Patients with septic shock and acute circulatory failure
were analysed separately.
Interventions Blinded infusions of epinephrine or norepinephrine to achieve a MAP ≥70 mmHg for the duration of ICU admission.
Measurements Primary outcome was achievement of MAP goal >24 h without vasopressors. Secondary outcomes were 28 and 90-day mortality. Two
hundred and eighty patients were randomised to receive either epinephrine or norepinephrine. Median time to achieve the MAP
goal was 35.1 h (interquartile range (IQR) 13.8–70.4 h) with epinephrine compared to 40.0 h (IQR 14.5–120 h) with norepinephrine
(relative risk (RR) 0.88; 95% confidence interval (CI) 0.69–1.12; P = 0.26). There was no difference in the time to achieve MAP goals in the subgroups of patients with severe sepsis (n = 158; RR 0.81; 95% CI 0.59–1.12; P = 0.18) or those with acute circulatory failure (n = 192; RR 0.89; 95% CI 0.62–1.27; P = 0.49) between epinephrine and norepinephrine. Epinephrine was associated with the development of significant but transient
metabolic effects that prompted the withdrawal of 18/139 (12.9%) patients from the study by attending clinicians. There was
no difference in 28 and 90-day mortality.
Conclusions Despite the development of potential drug-related effects with epinephrine, there was no difference in the achievement of
a MAP goal between epinephrine and norepinephrine in a heterogenous population of ICU patients.
This study was presented at the Annual Congress of the European Society of Intensive Care Medicine in Berlin on October 10
2007. The presentation received the International Sepsis Forum prize for best abstract and paper. This study has been published
in abstract form: Myburgh J.A., Higgins A., Jovanovska A., Lipman J., Ramakrishnan N., Santamaria J and the CAT Study Investigators.
(2007). A comparison of epinephrine and norepinephrine on reversal of shock. Intensive Care Medicine 33 (Supplement 2): S197.
Trial registration: The study was registered with Current Controlled Studies: ISRCTN number 92846592. 相似文献
85.
Hospers GA Punt CJ Tesselaar ME Cats A Havenga K Leer JW Marijnen CA Jansen EP Van Krieken HH Wiggers T Van de Velde CJ Mulder NH 《Annals of surgical oncology》2007,14(10):2773-2779
Background We studied the maximum tolerated dose (MTD) and efficacy of oxaliplatin added to capecitabine and radiotherapy (Capox-RT)
as neoadjuvant therapy for rectal cancer.
Methods T3-4 rectal cancer patients received escalating doses of oxaliplatin (day 1 and 29) with a fixed dose of capecitabine of 1000
mg/m2 twice daily (days 1–14, 25–38) added to RT with 50.4 Gy and surgery after 6–8 weeks. The MTD, determined during phase I,
was used in the subsequent phase II, in which R0 resection rate (a negative circumferential resection margin) was the primary
end point.
Results Twenty-one patients were evaluable. In the phase I part, oxaliplatin at 85 mg/m2 was established as MTD. In phase II, the main toxicity was grade III diarrhea (18%). All patients underwent surgery, and
20 patients had a resectable tumor. An R0 was achieved in 17/21 patients, downstaging to T0-2 in 7/21 and a pCR in 2/21.
Conclusion Combination of Capox-RT has an acceptable acute toxicity profile and a high R0 resection rate of 81% in locally advanced rectal
cancer. However the pCR rate was low. 相似文献
86.
87.
An association between syringomyelia and spinal syphilis was described in the early literature but has not been the subject of reports subsequently. We give details of a contemporary case, affirmed by magnetic resonance imaging. The patient showed significant clinical recovery following penicillin treatment, while the imaging appearances became less pronounced. 相似文献
88.
89.
C Snow-Harter R Whalen K Myburgh S Arnaud R Marcus 《Journal of bone and mineral research》1992,7(11):1291-1296
Muscle strength has been shown to predict bone mineral density (BMD) in women. We examined this relationship in 50 healthy men who ranged in age from 28 to 51 years (average 38.3 years). BMD of the lumbar spine, proximal femur, whole body, and tibia were measured by dual-energy x-ray absorptiometry (Hologic QDR 1000W). Dynamic strength using one repetition maximum was assessed for the biceps, quadriceps, and back extensors and for the hip abductors, adductors, and flexors. Isometric grip strength was measured by dynamometry. Daily walking mileage was assessed by 9 week stepmeter records and kinematic analysis of video filming. Subjects were designated as exercisers and nonexercisers. Exercisers participated in recreational exercise at least two times each week. The results demonstrated that BMD at all sites correlated with back and biceps strength (p < 0.01 to p = 0.0001). Body weight correlated with tibia and whole-body BMD (p < 0.001); age negatively correlated with Ward's triangle BMD (p < 0.01). In stepwise multiple regressions, back strength was the only independent predictor of spine and femoral neck density (R2 = 0.27). Further, back strength was the most robust predictor of BMD at the trochanter, Ward's triangle, whole body, and tibia, although biceps strength, age, body weight, and leg strength contributed significantly to BMD at these skeletal sites, accounting for 35-52% of the variance in BMD. Exercisers and nonexercisers were similar for walking (3.97 versus 3.94 miles/day), age (37.8 versus 38.5) years, and weight (80.0 versus 77.7 kg). However, BMD and muscle strength were significantly greater in exercises than in nonexercisers.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
90.
Corrie E. Chumpitazi Chris A. Rees Elizabeth A. Camp Erin B. Henkel Karina L. Valdez Bruno P. Chumpitazi 《The American journal of emergency medicine》2017,35(10):1490-1493