全文获取类型
收费全文 | 2213篇 |
免费 | 177篇 |
国内免费 | 2篇 |
专业分类
耳鼻咽喉 | 27篇 |
儿科学 | 91篇 |
妇产科学 | 58篇 |
基础医学 | 282篇 |
口腔科学 | 75篇 |
临床医学 | 201篇 |
内科学 | 610篇 |
皮肤病学 | 26篇 |
神经病学 | 211篇 |
特种医学 | 39篇 |
外科学 | 248篇 |
综合类 | 20篇 |
一般理论 | 2篇 |
预防医学 | 191篇 |
眼科学 | 17篇 |
药学 | 147篇 |
中国医学 | 7篇 |
肿瘤学 | 140篇 |
出版年
2023年 | 9篇 |
2022年 | 19篇 |
2021年 | 74篇 |
2020年 | 30篇 |
2019年 | 72篇 |
2018年 | 66篇 |
2017年 | 48篇 |
2016年 | 52篇 |
2015年 | 59篇 |
2014年 | 78篇 |
2013年 | 87篇 |
2012年 | 125篇 |
2011年 | 127篇 |
2010年 | 70篇 |
2009年 | 64篇 |
2008年 | 128篇 |
2007年 | 119篇 |
2006年 | 105篇 |
2005年 | 120篇 |
2004年 | 113篇 |
2003年 | 99篇 |
2002年 | 82篇 |
2001年 | 74篇 |
2000年 | 93篇 |
1999年 | 86篇 |
1998年 | 30篇 |
1997年 | 18篇 |
1996年 | 18篇 |
1995年 | 15篇 |
1994年 | 11篇 |
1993年 | 10篇 |
1992年 | 35篇 |
1991年 | 25篇 |
1990年 | 24篇 |
1989年 | 15篇 |
1988年 | 15篇 |
1987年 | 12篇 |
1986年 | 17篇 |
1985年 | 22篇 |
1984年 | 12篇 |
1983年 | 8篇 |
1982年 | 6篇 |
1981年 | 7篇 |
1979年 | 18篇 |
1976年 | 6篇 |
1975年 | 10篇 |
1974年 | 8篇 |
1973年 | 7篇 |
1970年 | 11篇 |
1968年 | 7篇 |
排序方式: 共有2392条查询结果,搜索用时 15 毫秒
101.
Kenzo Uchida Hideaki Nakajima Naoto Takeura Takafumi Yayama Alexander Rodriguez Guerrero Ai Yoshida Takumi Sakamoto Kazuya Honjoh Hisatoshi Baba 《The spine journal》2014,14(8):1601-1610
Background contextSignal intensity on preoperative cervical magnetic resonance imaging (MRI) of the spinal cord has been shown to be a potential predictor of outcome of surgery for cervical compressive myelopathy. However, the prognostic value of such signal remains controversial. One reason for the controversy is the lack of proper quantitative methods to assess MRI signal intensity.PurposeTo quantify signal intensity and to correlate intramedullary signal changes on MRI T1- and T2-weighted images (WIs) with clinical outcome and prognosis.Study designRetrospective case study.Patient samplePatients (n=148; cervical spondylotic myelopathy, n=102 and ossified posterior longitudinal ligament, n=46) who underwent surgery for cervical compressive myelopathy and had high signal intensity change on sagittal T2-WI MRI before surgery between 2006 and 2010.Outcome measureNeurologic assessment was conducted with the Japanese Orthopedic Association (JOA) scoring system for cervical myelopathy. The rate of neurologic improvement was calculated with the use of preoperative and postoperative JOA scores.MethodsQuantitative analysis of MRI signal on both T1- and T2-WIs via use of the signal intensity ratio (SIR; signal intensity of lesion relative to that at C7-T1 disc level) was performed. Correlations between SIR on T1- and T2-WIs and preoperative JOA score, JOA improvement rate, disease duration, and MRI morphologic classification (cystic or diffuse type) were analyzed. Multivariate regression analysis for JOA improvement rate was also analyzed. In a substudy, 25 patients underwent follow-up MRI starting from 6 months after surgery to analyze the relationship between changes in SIR on follow-up MRI and clinical outcome.ResultsSIR on T1-WIs, but not SIR on T2-WIs, correlated with postoperative neurologic improvement. The disease duration correlated negatively with SIR on T1-WIs and JOA improvement rate but not with SIR on T2-WIs. SIR on T2-WIs of “cystic type” was significantly greater than of “diffuse type,” but SIR on T1-WI and JOA improvement rate were not different in the two types. Stepwise multivariate regression analysis indicated that SIR on T1-WIs and long disease duration were significant predictors of postoperative neurologic outcome. SIR on follow-up T1-WI and changes in SIR on T1-WI after surgery correlated positively with postoperative improvement rate. SIR on follow-up T2-WI and changes on T2-WI correlated negatively with postoperative neurologic improvement.ConclusionsOur results suggest that low intensity signal on preoperative T1-WIs but not T2-WIs correlated with poor postoperative neurologic outcome. Furthermore, decreased signal intensity on postoperative T1-WIs and increased signal intensity on postoperative T2-WIs are predictors of poor neurologic outcome. 相似文献
102.
D. Scott Lim MD Robert L. Smith MD Firas Zahr MD Abhijeet Dhoble MD Roger Laham MD Mohamad Lazkani MD Susheel Kodali MD Chad Kliger MD James Hermiller MD Amit Vora MD Ian J. Sarembock MB ChB MD William Gray MD Samir Kapadia MD Adam Greenbaum MD Andrew Rassi MD David Lee MD Adnan Chhatriwalla MD Pinak Shah MD Josep Rodés-Cabau MD Homam Ibrahim MD Lowell Satler MD Howard C. Herrmann MD Paul Mahoney MD Charles Davidson MD George Petrossian MD Mayra Guerrero MD Konstantinos Koulogiannis MD Leo Marcoff MD Linda Gillam MD The CLASP IID Pivotal Trial Investigators 《Catheterization and cardiovascular interventions》2021,98(4):E637-E646
103.
J Cobo A Asensio S Moreno E Navas V Pintado J Oliva E Gómez-Mampaso A Guerrero 《The international journal of tuberculosis and lung disease》2001,5(5):413-418
OBJECTIVE: To identify risk factors for transmission of multidrug-resistant tuberculosis (MDR-TB) among hospitalized human immunodeficiency virus (HIV) infected patients exposed during a nosocomial outbreak. DESIGN: Case control study. Cases were HIV-infected patients with MDR-TB due to Mycobacterium bovis (MDR-TBMb) who acquired the disease after exposure to an MDR-TBMb patient in an hospital ward. Controls were HIV-infected patients exposed to a case of MDR-TBMb in an hospital ward but who did not develop MDR-TBMb during the follow-up. RESULTS: Nineteen cases and 31 controls were included. CD4 cell counts were significantly lower among cases. Exposure in the infectious diseases ward or exposure to the index patient were associated with development of MDR-TBMb, while exposure during a single-room hospital stay and exposure in the respiratory isolation ward were associated with non-development of MDR-TBMb. A multiple regression logistic model showed that only a CD4 cell count below 50/microL and exposure to the index patient increased the risk of developing MDR-TBMb (P < 0.05). Hospitalization in a single room seemed to protect HIV-infected patients from developing nosocomial MDR-TBMb (P = 0.052). CONCLUSIONS: Over classic risk factors, such as length of exposure or sharing a room with a case, severe immunosuppression independently increases the risk of MDR-TB transmission in the context of a nosocomial MDR-TB outbreak among HIV-infected patients. This information must be considered in the management of tuberculosis outbreaks. Patients with CD4 cell counts below 50/microL should be the principal group targeted for prevention strategies in nosocomial outbreaks. 相似文献
104.
Quality of Life in Functional Dyspepsia 总被引:1,自引:0,他引:1
Monés J Adan A Segú JL López JS Artés M Guerrero T 《Digestive diseases and sciences》2002,47(1):20-26
Our purpose was to assess the quality of life of functional dyspepsia patients using the SF-36 generic scale and the Gastrointestinal Symptoms Rating Scale (GSRS). In all, 328 dyspeptic patients were included in a multicenter, prospective, observational study. Both scales were filled out at baseline and one and three months after a prokinetic agent was given as a single-drug therapy. A total of 250 patients completed the study. An improvement in all SF-36 dimensions was observed, although the final scores were lower than the population reference values. Physical role (27% change), emotional role (20%), and physical pain (16%) dimensions showed the greater change. The GSRS total and domain scores also showed significant decreases. The best predictors of quality of life improvement were certain basal symptoms, drug compliance, and the absence of idiopathic dyspepsia. In conclusion, both the generic and the specific scales provide useful and sensitive measures of quality of life in functional dyspepsia patients on single-drug treatment. 相似文献
105.
M Puig-Domingo J M Guerrero R J Reiter M J Tannenbaum E C Hurlbut A Gonzalez-Brito C Santana 《Endocrinology》1988,123(2):677-680
T4 type II 5'-deiodinase (5'-D II) activity was studied in wild-captured Richardson's ground squirrels. As previously reported for other species, 5'-D II activity was detected in frontal cortex, cerebellum, pineal gland, and brown adipose tissue (BAT); in the median eminence the levels of 5'-D II activity were undetectable with our methodology. When pineal gland, frontal cortex, and cerebellum nyctohemeral profiles were studied, none of them showed variations. Cold exposure for 4 h led to an increase in the enzymatic activity 10-fold above the basal values for BAT, while in the pineal gland the values were doubled; cold exposure failed to change the 5'-D II activity in the frontal cortex. Acute melatonin treatment caused a 7-fold increase in 5'-D II activity in BAT, but did not affect enzyme activity in either the pineal gland or frontal cortex. The data indicate that 5'-D II in Richardson's ground squirrel shows classical localizations. Additionally, two new regulatory factors of 5'-D II are reported, i.e. melatonin for BAT and cold for the pineal gland. 相似文献
106.
Background
The changing paradigm of surgical residency training has raised concerns about the effects on the quality of training. The purpose of this study is to identify if resident participation in laparoscopic adrenalectomy (LA) and open adrenalectomy (OA) cases is associated with deleterious outcomes.Materials and methods
This is a retrospective study using the American College of Surgeons National Surgical Quality Improvement Program database. Data from patients undergoing LA and OA from 2005 to 2010 were queried. Preoperative variables as well as intra- and post-operative outcomes for each procedure were evaluated. Multivariate logistic regression was used to analyze if resident participation was associated with significant differences in outcomes, compared with no resident participation. Subset analysis was done to determine possible differences in outcomes based on the level of resident participating, divided into junior (Post Graduate Year [PGY]1–3), senior (PGY4–5), or fellow (≥PGY6) levels.Results
A total of 3219 adrenalectomies were performed. Of these, 735 (22.8%) were OAs and 2484 (77.2%) were LAs. Residents were involved in 2582 (80.2%) surgeries, which comprised 1985 (76.9%) LAs and 597 (23.1%) OAs. Senior residents or fellows performed majority of the cases (85.2%). Mean operative time was significantly higher with resident participation in LA (P < 0.0001) and OA group (P < 0.0001). On multivariate analysis, resident participation was not associated with significant differences in the operative outcomes of 30-d mortality or postoperative complications after laparoscopic or OA.Conclusions
Although resident participation does increase operative time in LA and OA, this does not appear to be clinically significant and does not result in adverse patient outcomes. 相似文献107.
Sol Fernández de Mosteyrín María del Val AcebrónTeresa Fernández de Mosteyrín Manuel L. Fernández Guerrero 《Enfermedades infecciosas y microbiología clínica》2014
Introduction
The incidence of human immunodeficiency virus (HIV) and other sexually transmitted diseases increases in males who have sex with males (MSM), despite the knowledge on how to prevent them. To determine the mechanisms that are driving this lack of prevention is important to reverse the trend.Patients and methods
An anonymous, voluntary and self-reporting questionnaire was completed by HIV+ MSM patients who were seen in a hospital clinic, with the aim of finding out the sexual risk practices and behaviour, as well as their perceptions and assessment as regards this risk. The questionnaire included 58 questions, divided into 10 sections, to explore the knowledge, attitudes, and behaviour as regards HIV. The questionnaires were also given to the physicians, with the aim of exploring their perceptions, attitudes and opinions as regards the situation of the epidemic, prevention, perception of the diseases and the patient, and values in clinical practice.Results
A total of 495 questionnaires from the patients were analysed. Most of them (87%) said they knew how HIV was acquired, and 97% knew how to prevent it, but 69% knew they were in a risk situation, and 43% had little concern of contracting HIV. Almost two-thirds (65%) had sex with ≥ 2 persons on the same day, 47% met on the Internet and 26% had group sex. The same percentage of those surveyed considered that they acted impulsively. They highlighted a lack of information (33%), bad luck (32%), assumed excessive risk (36%), and lake of concern (25%), as the main reasons for acquiring the infection. When confronted with diagnosis 41% of patients answered «I never thought that it would happen to me», and 32% said «I had bad luck». Of the 121 physicians who completed the questionnaire, 24% considered that infection due to HIV/AIDS was out of control in Spain, and 65% responded that there was an image that HIV/AIDS was a controlled disease and of little concern. A large majority (71%) of those surveyed, considered that the increase in new infections showed that there was no suitable preventive plan.Conclusions
The management of the risk of acquiring HIV maintains a low level of concern, due to the optimism produced by the advances in the fight against the disease and the current toning down of the discussion. The trivialisation of the risk, on distorting the idea of risky behaviour, is a determining factor of attitudes that makes it impossible to adopt effective preventive behaviour and to take sensible and anticipated decisions. 相似文献108.
Nayu Ikeda David Sapienza Ramiro Guerrero Wichai Aekplakorn Mohsen Naghavi Ali H Mokdad Rafael Lozano Christopher JL Murray Stephen S Lim 《Bulletin of the World Health Organization》2014,92(1):10-19C
Objective
To examine hypertension management across countries and over time using consistent and comparable methods.Methods
A systematic search identified nationally representative health examination surveys from 20 countries containing data from 1980 to 2011 on blood pressure measurements, the diagnosis and treatment of hypertension and its control with antihypertensive drugs. For each country, the prevalence of hypertension (i.e. systolic blood pressure ≥ 140 mmHg or antihypertensive use) and the proportion of hypertensive individuals whose condition was diagnosed, treated or controlled with medications (i.e. systolic pressure < 140 mmHg) were estimated.Findings
The age-standardized prevalence of hypertension varied between countries: for individuals aged 35 to 49 years, it ranged from around 12% in Bangladesh, Egypt and Thailand to around 30% in Armenia, Lesotho and Ukraine; for those aged 35 to 84 years, it ranged from 20% in Bangladesh to more than 40% in Germany, the Russian Federation and Turkey. The age-standardized percentage of hypertensive individuals whose condition was diagnosed, treated or controlled was highest in the United States of America: for those aged 35 to 49 years, it was 84%, 77% and 56%, respectively. Percentages were especially low in Albania, Armenia, the Islamic Republic of Iran and Turkey. Although recent trends in prevalence differed in England, Japan and the United States, treatment coverage and hypertension control improved over time, particularly in England.Conclusion
Globally the proportion of hypertensive individuals whose condition is treated or controlled with medication remains low. Greater efforts are needed to improve hypertension control, which would reduce the burden of noncommunicable diseases. 相似文献109.
Alireza Kashani Isabelle Thiffault Marie-Emmanuelle Dilenge Christine Saint-Martin Kether Guerrero Luan T. Tran Eric Shoubridge Marjo S. van der Knaap Nancy Braverman Geneviève Bernard 《Neurogenetics》2014,15(3):161-164
We report a case of mild cavitating leukoencephalopathy associated with a homozygous c.755A > G (p.Asp252Gly) NDUFS1 mutation in a 7-year old boy. Biochemical analysis confirmed an isolated reduction in complex I activity. Magnetic resonance imaging of the brain showed a diffuse cystic leukoencephalopathy with the involvement of the corpus callosum and sparing of the gray matter. The clinical course was marked by an acute presentation of neurological deficits at 24 months followed by recurrent episodes of mild neurological deterioration, subsequent remissions, and prolonged periods of stability. This is one of the mildest known clinical presentations of complex I deficiency secondary to mutations in NDUFS1, expanding the clinical spectrum and natural history of this disorder. Consideration of clinical variability needs to be taken into account in patient management and family counseling. 相似文献
110.