全文获取类型
收费全文 | 1296篇 |
免费 | 55篇 |
国内免费 | 6篇 |
专业分类
耳鼻咽喉 | 8篇 |
儿科学 | 26篇 |
妇产科学 | 56篇 |
基础医学 | 94篇 |
口腔科学 | 63篇 |
临床医学 | 105篇 |
内科学 | 253篇 |
皮肤病学 | 16篇 |
神经病学 | 79篇 |
特种医学 | 32篇 |
外科学 | 422篇 |
综合类 | 7篇 |
预防医学 | 36篇 |
眼科学 | 27篇 |
药学 | 36篇 |
中国医学 | 1篇 |
肿瘤学 | 96篇 |
出版年
2023年 | 4篇 |
2022年 | 17篇 |
2021年 | 27篇 |
2020年 | 17篇 |
2019年 | 24篇 |
2018年 | 47篇 |
2017年 | 35篇 |
2016年 | 25篇 |
2015年 | 20篇 |
2014年 | 38篇 |
2013年 | 49篇 |
2012年 | 81篇 |
2011年 | 114篇 |
2010年 | 60篇 |
2009年 | 40篇 |
2008年 | 80篇 |
2007年 | 83篇 |
2006年 | 101篇 |
2005年 | 94篇 |
2004年 | 82篇 |
2003年 | 61篇 |
2002年 | 65篇 |
2001年 | 13篇 |
2000年 | 10篇 |
1999年 | 17篇 |
1998年 | 20篇 |
1997年 | 10篇 |
1996年 | 13篇 |
1995年 | 11篇 |
1994年 | 6篇 |
1993年 | 4篇 |
1992年 | 5篇 |
1991年 | 3篇 |
1990年 | 3篇 |
1989年 | 4篇 |
1988年 | 5篇 |
1987年 | 5篇 |
1986年 | 4篇 |
1985年 | 5篇 |
1984年 | 2篇 |
1983年 | 6篇 |
1982年 | 4篇 |
1981年 | 7篇 |
1980年 | 7篇 |
1978年 | 5篇 |
1977年 | 3篇 |
1974年 | 6篇 |
1972年 | 3篇 |
1965年 | 2篇 |
1961年 | 2篇 |
排序方式: 共有1357条查询结果,搜索用时 15 毫秒
41.
Mermigkis C Bouloukaki I Mermigkis D Kallergis E Mavroudi E Varouchakis G Tzortzaki E Siafakas N Schiza SE 《Sleep & breathing》2012,16(3):813-819
Background??aim
C-reactive protein (CRP) is directly implicated in atherogenesis and associated cardiovascular morbidity in patients with obstructive sleep apnea (OSA). Effective continuous positive airway pressure (CPAP) treatment has been shown to gradually decrease CRP levels and thus consequently improve disease-related cardiovascular morbidity. However, the influence of gender on the CRP evolution pattern has never been assessed before. The aim of our study was to investigate possible gender differences in CRP evolution in OSA patients 3 and 6?months after the start of effective CPAP treatment.Methods
The study population consisted of 436 patients (252 males/184 females) with newly diagnosed moderate to severe OSA and good CPAP compliance assessed by a thorough follow up. High-sensitivity C-reactive protein (hs-CRP) was assessed before CPAP initiation and at the third and sixth month of the follow-up period.Results
C-reactive protein values showed a statistically significant decrease at the third and sixth month of CPAP therapy [initial values 0.79?±?0.65?mg/dL versus 0.70?±?0.52?mg/dL (p?0.05) after 3?months and 0.30?±?0.33?mg/dL (p?0.001) after 6?months of CPAP therapy]. When patients were divided into males and females, the above evolution pattern was changed. At the third month time point, the CRP values showed a statistically significant decrease only in males (from 0.74?±?0.53?mg/dL to 0.61?±?0.5?mg/dL, p?0.01) while females showed only minimal and insignificant changes (from 0.87?±?0.79?mg/dL to 0.83?±?0.51?mg/dL, p?>?0.05). After 6?months?? treatment, CRP decreased significantly in both genders (males from 0.74?±?0.53?mg/dL to 0.28?±?0.32?mg/dL, p?0.001 and females from 0.87?±?0.79?mg/dL to 0.34?±?0.36?mg/dL, p?0.001).Conclusion
Our results suggest a delay in the normalization of CRP levels in females despite effective CPAP treatment. A time period of at least 6?months appeared to be required in women in order to reduce CRP levels and consequent cardiovascular risk. In contrast, CPAP??s protective role in males is achieved at an earlier time point. Gender-related hormonal and genetic factors may influence the above CRP evolution pattern. 相似文献42.
Efstathios Karamanos Emre Sivrikoz Elizabeth Beale Linda Chan Kenji Inaba Demetrios Demetriades 《World journal of surgery》2013,37(10):2257-2264
Background
The purpose of the present study was to determine the prevalence of diabetes and its effect on surgical outcomes in patients undergoing emergent, in-patient cholecystectomy for acute cholecystitis. Some 8.3 % of the U.S. population has diabetes and this number is projected to rise to 21–33 % by 2050. Diabetes is considered to be associated with a higher incidence of acute cholecystitis; however, its impact on outcomes is unknown.Methods
The American College of Surgeons National Surgical Quality Improvement Program database was queried to identify all patients with acute cholecystitis who underwent emergent in-patient cholecystectomy from 2004 to 2010. The study population was divided into two groups: diabetics and non-diabetics. Diabetics were further subdivided into those taking oral medication and those on insulin. Demographics, co-morbidities, and wound classification were compared with univariate analysis, and 30-day outcomes were compared with univariate and multivariate analyses.Results
A total of 5,460 patients met the inclusion criteria. Of these 770 (14.10 %) had a diagnosis of diabetes. Mortality was higher for diabetics than for non-diabetics [4.4 vs 1.4 %, adjusted odds ratio (AOR) (95 % CI): 1.79 (1.09, 2.94), adj-p = 0.022]. Preoperative perforation rates were 25.1 and 13.0 %, respectively [AOR (95 % CI): 1.34 (1.09, 1.65), adj-p = 0.005]. The adjusted risk of cardiovascular events and renal failure was significantly higher for diabetics. Insulin treatment, but not oral medication, was associated with a significant increase in mortality, preoperative perforation, superficial surgical site infection, septic shock, cardiovascular incidents, and renal insufficiency.Conclusions
In patients undergoing cholecystectomy for acute cholecystitis, diabetes increases the risk of mortality, cardiovascular events, and renal failure. Insulin-treated diabetics have more co-morbidities and poorer outcomes. 相似文献43.
Background
The effect of music in the operating room is not fully understood. Through a systematic review the authors aim to give a conceptual presentation of the effect that music has on the pre- and postoperative course of surgical patients and on the effectiveness of the surgical work performed by both physicians and staff.Methods
The search was conducted both on the basis of the Medical Subject Headings (MeSH) tree and as a text search using the Medline database (1946 to December 2011). The main search heading was “music in operating room” with the accessory keyword “surgery.” The selection criteria specified the English language and the availability of abstracts or full-text articles. From 85 articles listed with the corresponding search, 28 were relevant and enrolled for the review.Results
Patients exhibit lower anxiety levels before and during surgery when hearing music and a significant reduction in analgesia and sedation requirements has been observed. Music was found to reduce the heart rate, blood pressure, and muscle effort of surgeons while at the same time increasing the accuracy of surgical tasks. Surgeons who played a musical instrument were found to perform surgical tasks faster. On the other hand, anesthesiologists report that music is associated with difficulties communicating and offering a stable level of sedation. The most appropriate music in the operating room seems to be the classical type.Conclusions
Music in the operating room can have beneficial effects on patients by decreasing stress, anxiety, and the demand for analgesic and anesthetic drugs. For the surgical staff, music is considered to be distracting. For the surgeon, music can increase the speed and accuracy of task performance. 相似文献44.
Domínguez-González Cristina Fernández-Torrón Roberto Moore Ursula de Fuenmayor-Fernández de la Hoz Carlos Pablo Vélez-Gómez Beatriz Cabezas Juan Antonio Alonso-Pérez Jorge González-Mera Laura Olivé Montse García-García Jorge Moris Germán León Hernández Juan Carlos Muelas Nuria Servian-Morilla Emilia Martin Miguel A. Díaz-Manera Jordi Paradas Carmen 《Journal of neurology》2022,269(7):3550-3562
Journal of Neurology - TK2 deficiency (TK2d) is a rare mitochondrial disorder that manifests predominantly as a progressive myopathy with a broad spectrum of severity and age of onset. The rate of... 相似文献
45.
Efstathios Karamanos Scott Dulchavsky Elizabeth Beale Kenji Inaba Demetrios Demetriades 《World journal of surgery》2016,40(4):863-869
Introduction
The impact of diabetes mellitus (DM) on outcomes in patients undergoing emergency laparotomy for adhesive small bowel obstruction (ASBO) remains unknown.Methods
Low-risk (ASA class of I and II) patients requiring emergency operation for ASBO were identified using the ACS NSQIP database. Propensity score matching was used to match patients with DM to those without DM in a ratio of 1:3. Mortality, infectious complications, acute renal failure (ARF), and myocardial infarction (MI) were compared between the two groups. The impact of delaying OR ≥24 h was also analyzed in the two groups.Results
A total of 1,608 patients were matched, 402 with DM and 1,204 without DM. Overall, patients with DM were significantly more likely to develop infections, ARF and MI. Diabetes had no negative impact on outcomes if the operation was performed within 24 h of admission. However, delaying surgery >24, significantly increased infections, ARF and MI.Conclusions
DM in low-risk patients has no negative impact on outcomes in patients undergoing surgery for ASBO within 24 h. However, delaying surgery >24 h resulted in worse outcomes.46.
Pajot A Schnuriger A Moris A Rodallec A Ojcius DM Autran B Lemonnier FA Lone YC 《European journal of immunology》2007,37(9):2635-2644
Using HLA-DR1-transgenic H-2 class II knockout mice, we identified two new HLA-DR1-restricted HIV-1 Gag p24-derived epitopes (Gag(321-340 )and Gag(331-350)) and confirmed the immunogenicity of seven that have been previously described. The human relevance was confirmed for the two new ones (Gag(321-340 )and Gag(331-350)) assaying peripheral blood mononuclear cells from HLA-DR1(+) HIV-1-infected long-term asymptomatic subjects and showing that Gag(331-350) could prime CD4(+) T cells from two HLA-DR1(+) HIV-1 seronegative donors in vitro. Seven of these epitopes, structurally conserved among HIV-1 clade B isolates, were selected for a comparative evaluation of their Th1 helper potential by immunizing HLA-A02.01/HLA-DR1-transgenic, H-2 class I/class II knockout mice with recombinant mouse invariant chain constructs in which each helper epitope was inserted in association with two reporter HIV-1-derived HLA-A02.01-restricted CD8(+) T cell epitopes. A T helper effect was demonstrated in all cases, and was particularly strong with epitopes Gag(301-320),Gag(321-340 )and Gag(271-290), which should, therefore, be considered in the design of new vaccines. 相似文献
47.
D. I. Tsilimigras D. Moris J. M. Hyer F. Bagante K. Sahara A. Moro A. Z. Paredes R. Mehta F. Ratti H. P. Marques S. Silva O. Soubrane V. Lam G. A. Poultsides I. Popescu S. Alexandrescu G. Martel A. Workneh A. Guglielmi T. Hugh L. Aldrighetti I. Endo K. Sasaki A. I. Rodarte F. N. Aucejo T. M. Pawlik 《The British journal of surgery》2020,107(7):854-864
48.
Maggie Tillquist MD Demetrios J. Kutsogiannis MD MHS FRCPC Paul E. Wischmeyer MD Christine Kummerlen MD Roger Leung BSc Daniel Stollery MD FCCP FRCPC Constantine J. Karvellas MD FRCPC Jean‐Charles Preiser MD PhD Nora Bird VMD BS RDMS Rosemary Kozar MD PhD Daren K. Heyland MD FRCPC MSc 《JPEN. Journal of parenteral and enteral nutrition》2014,38(7):886-890
Background: Critically ill patients commonly experience skeletal muscle wasting that may predict clinical outcome. Ultrasound is a noninvasive method that can measure muscle quadriceps muscle layer thickness (QMLT) and subsequently lean body mass (LBM) at the bedside. However, currently the reliability of these measurements are unknown. The objectives of this study were to evaluate the intra‐ and interreliability of measuring QMLT using bedside ultrasound. Methods: Ultrasound measurements of QMLT were conducted at 7 centers on healthy volunteers. Trainers were instructed to perform measurements twice on each patient, and then a second trainee repeated the measurement. Intrarater reliability measured how consistently the same person measured the subject according to intraclass correlation (ICC). Interrater reliability measured how consistently trainer and trainee agreed when measuring the same subject according to the ICC. Results: We collected 42 pairs of within operator measurements with an ICC of .98 and 78 pairs of trainer‐to‐trainee measurements with an ICC of .95. There were no statistically significant differences between the trainer and trainee results (trainer and trainee mean = ?0.028 cm, 95% CI = ?0.067 to ?0.011, P = .1607). Conclusions: Excellent intra‐ and interrater reliability for ultrasound measurements of QMLT in healthy volunteers was observed when performed by a range of providers with no prior ultrasound experience, including dietitians, nurses, physicians, and research assistants. This technique shows promise as a method to evaluate LBM status in ICU or hospital settings and as a method to assess the effects of nutrition and exercise‐based interventions on muscle wasting. 相似文献
49.
Serafeim Chlapoutakis Vasiliki Epameinondas Georgakopoulou Nikolaos Trakas Georgios Kouvelos Petros Papalexis Christos Damaskos Pagona Sklapani Anastasios Grivas Panagiotis Gouveris Dimitrios Tryfonopoulos Alexandros Tzovaras Gerasimos Ardavanis-Loukeris Elissavet Grouzi Demetrios A. Spandidos Miltiadis Matsagkas 《Oncology Letters》2022,23(5)
Pulmonary embolism (PE), along with deep vein thrombosis, are collectively known as venous thromboembolism (VTE). Predisposing factors for PE include post-operative conditions, pregnancy, cancer and an advanced age; of note, a number of genetic mutations have been found to be associated with an increased risk of PE. The association between cancer and VTE is well-established, and cancer patients present a higher risk of a thrombotic event compared to the general population. In addition, PE is a significant cause of morbidity and mortality among cancer patients. The aim of the present study was to illustrate the clinical characteristics, laboratory findings, radiology features and outcomes of cancer patients who developed PE, collected from an anticancer hospital. For this purpose, adult cancer patients diagnosed with PE by imaging with computed tomography pulmonary angiography were enrolled. The following data were recorded: Demographics, comorbidities, type of cancer, time interval between cancer diagnosis and PE occurrence, the type of therapy received and the presence of metastases, clinical signs and symptoms, predisposing factors for PE development, laboratory data, radiological findings, electrocardiography findings, and the type of therapy received for PE and outcomes in a follow-up period of 6 months. In total, 60 cancer patients were enrolled. The majority of the cancer patients were males. The most common type of cancer observed was lung cancer. The majority of cases of PE occurred within the first year from the time of cancer diagnosis, while the majority of patients had already developed metastases. In addition, the majority of cancer patients had received chemotherapy over the past month, while they were not receiving anticoagulants and had central obstruction. A large proportion of patients had asymptomatic PE. The in-hospital mortality rate was 13.3% and no relapse or mortality were observed during the follow-up period. The present study demonstrates that elevated levels of lactic acid and an increased platelet count, as well as low serum levels of carcinoembryonic antigen, albumin and D-dimer, may be potential biomarkers for asymptomatic PE among cancer patients. 相似文献
50.
Antonios Athanasiou Eleftherios Spartalis Mairead Hennessy Michael Spartalis Demetrios Moris Christos Damaskos Emmanouil Pikoulis 《Hepatobiliary & pancreatic diseases international : HBPD INT》2018,17(1):91-92
正To the editor:We read with great interest the article entitled Comparative study of the effects of terlipressin versus splenectomy on liver regeneration after partial hepatectomy in rats by Ulmer et al.[1].The aim of this study was to analyse the impact of terlipressin ver- 相似文献