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Risks of red blood cell alloimmunization in transfusion‐dependent β‐thalassemia in Oman: a 25‐year experience of a university tertiary care reference center and a literature review 下载免费PDF全文
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Joanna E. Long Saif Khairat Elizabeth Chmelo Mary H. Palmer 《Geriatric nursing (New York, N.Y.)》2018,39(2):230-237
The purpose of this study was to explore the efficacy and acceptability of an innovative, electronically delivered self-management intervention for urinary incontinence (UI) that included daily mindfulness practice, completion of sequential bladder diaries, and bladder health education to improve UI in older women living independently in a retirement community. A mixed methods pilot study was conducted over ten weeks using a custom website or CD. Ten women were recruited and 8 completed the study; 5 of those (71%) experienced fewer daily UI episodes post intervention (p = 0.055). The women also reported a statistically significant decrease in the impact UI had on their everyday life (p = 0.04). Seventy-one percent (N = 5) reported subjective improvement in UI, and high acceptability scores also were achieved. The intervention was both effective in helping older women self-manage UI and acceptable to the population group. Further research is needed with a larger and diverse population of older women. 相似文献
24.
BACKGROUND: We sought to evaluate the prognostic value of the 6-minute walk test in stable outpatients with heart failure. METHODS AND RESULTS: We examined the association of 6-minute walk test distance and outcomes among 541 patients enrolled in the Digitalis Investigation Group trial. Patients were grouped by total distance (< or =200 m, 201 m-300 m, 301 m-400 m, and >400 m) with median follow-up of 32 months. All-cause mortality for patients who walked < or =200 m was significantly higher than patients who walked >200 m (43.9% versus 23.3%, P<0.001), but mortality was comparable among patients who walked >200 m (201 m-300 m: 23.7%, 301 m-400 m: 25.2%, >400 m 19.8%, P for trend 0.45). Results were similar for death due to worsening heart failure (< or =200 m: 29.3%, 201 m-300 m: 7.6%, 301 m-400 m: 6.7%, >400 m: 6.1%, P for trend <0.001). In multivariable analysis, distance < or =200 m remained associated with increased mortality (< or =200 m: hazard ratio (HR) 1.47, 95% CI 0.96-2.27; >200 m: HR 1.00, Referent; P=0.07) and death due to worsening heart failure (< or =200 m: HR 2.89, 95% CI 1.54-5.41; >200 m: 1.00, Referent; P=0.001). CONCLUSIONS: The 6-minute walk test identifies patients who walk less than 200 m as being at markedly increased risk of death. Changing the 6-minute walk test to a time- and distance-based standard would improve the efficiency of the test while retaining the bulk of the prognostic information. 相似文献
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Background Amiodarone has been shown to be safe in patients with acute myocardial infarction (AMI) who are at risk for sudden cardiac death. However, there is limited data concerning the safety of amiodarone in patients who experience AMI complicated by atrial fibrillation. Methods To determine the safety of amiodarone therapy, we conducted a retrospective analysis of elderly patients hospitalized with AMI who experienced atrial fibrillation and had survived to hospital discharge (n = 17,597). Amiodarone prescribed at discharge was evaluated for its association with short-term and long-term mortality in crude and adjusted analyses employing propensity score methods. Results Of the 17,597 patients, 550 patients (3.1%) were prescribed amiodarone, 2317 patients (13.2%) were prescribed other antiarrhythmic agents (excluded from analysis), and 14,730 (83.7%) were prescribed no antiarrhythmic medication at discharge. Thirty-day mortality rates were similar for patients prescribed amiodarone and those not prescribed amiodarone (6.8% amiodarone vs 5.4% no amiodarone, P = .21), but mortality at 1 year was higher among patients prescribed amiodarone (35.6% vs 31.6%, P = .001). However, amiodarone was not associated with mortality at 30 days (odds ratio 0.80, 95% CI 0.53-1.20) or at long-term follow-up (mean duration 612 days, hazard ratio 1.04, 95% CI 0.92-1.18) after multivariable modeling. Conclusions Amiodarone was not independently associated with short-term or long-term mortality in elderly patients discharged after a hospitalization for AMI complicated by atrial fibrillation. Although our data suggest that amiodarone may be safe to use in this population, randomized controlled trial data are needed to confirm this finding. (Am Heart J 2002;144:1095-101.) 相似文献
26.
Foody JM Rathore SS Wang Y Herrin J Masoudi FA Havranek EP Radford MJ Krumholz HM 《American heart journal》2004,147(1):66-73
Background
Studies have suggested that cardiologists may provide higher quality heart failure care than generalists. However, national rates of specialty care during hospitalization for heart failure and factors associated with care by a cardiologist are unknown.Methods
We assessed specialty care in a sample of Medicare patients hospitalized nationwide with heart failure between 1998 and 1999 (n = 25,869). Multivariable hierarchical logistic regression models were used to identify factors independently associated with treatment by a cardiologist.Results
One-quarter (25.5%) of patients had a cardiologist as their attending physician, 31.3% of patients received a cardiology consult, and 43.2% of patients were not treated by a cardiologist during hospitalization. Older patients (age <75 years: referent; age 75-84 years: risk ratio [RR], 0.92; 95% CI, 0.86-0.98; age ≥85 years: RR, 0.81; 95% CI, 0.74-0.88) and women (RR, 0.87; 95% CI, 0.83-0.93) were less likely to have an attending cardiologist. Patients with a history of heart failure (RR, 1.13; 95% CI, 1.06-1.20), coronary disease (RR, 1.23; 95% CI, 1.14-1.32), coronary artery bypass grafting (RR, 1.42; 95% CI, 1.32-1.42), or percutaneous transluminal coronary angioplasty (RR, 1.30; 95% CI, 1.19-1.42) were more likely to be treated by a cardiologist, whereas patients with chronic obstructive pulmonary disease (RR, 0.74; 95% CI, 0.70-0.79) and dementia (RR, 0.61; 95% CI, 0.54-0.70) were less likely to be treated by a cardiologist. Patient race was not associated with treatment by a cardiologist. The strongest predictors of attending cardiology care were hospital factors, including large volume (>300 beds; RR, 1.45; 95% CI, 1.32-1.42) and geographic location (RR, 1.00 Northeast (referent) vs RR, 0.55; 95% CI 0.46-0.65 Midwest).Conclusions
Slightly more than half of older patients with heart failure received care from a cardiologist. Several patient characteristics, including age and sex, were associated with the use of specialty care, suggesting that factors other than clinical presentation may independently influence the use of specialty care. 相似文献27.
Chamberlain Jayne L. Huda Saif Whittam Daniel H. Matiello Marcelo Morgan B. Paul Jacob Anu 《Journal of neurology》2021,268(5):1665-1665
Journal of Neurology - The original version of this article unfortunately contained a mistake. Fifth sentence of the fourth paragraph in the section “Non-nAChR autoantibody targets in... 相似文献
28.
Ranawaka A. P. M. Perera Ronald Ko Owen T. Y. Tsang David S. C. Hui Mike Y. M. Kwan Christopher J. Brackman Esther M. W. To Hui-ling Yen Kathy Leung Samuel M. S. Cheng Kin Ho Chan Karl C. K. Chan Ka-Chi Li Linda Saif Vanessa R. Barrs Joseph T. Wu Thomas H. C. Sit Leo L. M. Poon Malik Peiris 《Journal of clinical microbiology》2021,59(2)
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[Purpose] Obesity is a global health problem and is associated with a multitude of
complications. This study was designed to determine changes in cardiopulmonary functions
after aerobic and anaerobic exercise training in obese subjects. [Subjects and Methods]
Forty obese subjects, whose ages ranged between 18 and 25 years, were divided into 2 equal
groups: group A received aerobic exercise training in addition to dietary measures, and
group B received anaerobic exercise training for 3 months in addition to dietary measures.
Measurements of systolic blood pressure, diastolic blood pressure, heart rate, maximum
voluntary ventilation, maximal oxygen consumption, and body mass index were obtained for
both groups before and after the exercise program. [Results] The mean body mass index,
systolic blood pressure, diastolic blood pressure, heart rate, and maximal oxygen
consumption decreased significantly, whereas the mean maximum voluntary ventilation
increased significantly after treatment in group A. The mean maximum voluntary ventilation
also increased significantly after treatment in group B. There were significant
differences between the mean levels of the investigated parameters in groups A and B after
treatment. [Conclusion] Aerobic exercise reduces weight and improves cardiopulmonary
fitness in obese subjects better than anaerobic exercise.Key words: Obesity, Aerobic, Anaerobic 相似文献