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51.
Effects of Procainamide and Lidocaine on Defibrillation Energy Requirements in Patients Receiving Implantable Cardioverter Defibrillator Devices 总被引:1,自引:0,他引:1
DEBRA S. ECHT M.D. STEVEN T. GREMILLION M.D. JOHN T. LEE M.D. DAN M. RODEN M.D. KATHERINE T. MURRAY M.D. MARK BORGANELLI M.D. DIANE M. CRAWFORD R.N. JAMES R. STEWART M.D. JOHN W. HAMMON M.D. 《Journal of cardiovascular electrophysiology》1994,5(9):752-760
Effects of Procainamide and Lidocaine on Defibrillation. intntduction: In acute canine studies, lidocaine. but not prucainamidc, increases defibrillation energy requirements. We evaluated the effects of lidocaine or procainamide on defihrillation energy requirements in 27 patients undergoing intraoperative testing fur implantable cardioverter dcfibrillator device placement.
Methods and Results: Patients were tested off antiarrhythmic drugs and again following either lidocaine (200 to 250 mg loading and 3 mg/min maintenance infusions) or procainamide (1 gm loading and 3 to 4 mg/min maintenance infusions). The defibrillation testing protocol consisted of initial testing at 15 J, followed by higher or lower energies to determine the lowest energy producing three consecutive successful defibrillations. Overall, the mean defibrillation energy increased from 14 ± 5 J to 18 ± 7 J during lidocaine (plasma concentration 5.1 ± 1.6 μ/mL; P < 0.02) but were similar at baseline (12 ± 5 J) and during procainamide infusion (13 ± 6 J) (plasma concentration: procainamide 10.7 ± 7.2 μ/rnl.; N-acetyl procainamide 1.0 ± 0.4 μ/niL). A positive linear correlation was found between lidocaine plasma concentration and percent change in defibrillation energy (lidocaine: r = 0.61; P = 0.01). Procainamide raised the defibrillation energy in three patients, two with supra therapeutic plasma concentrations. The increase in defibrillation energy equaled or exceeded 25 J in four patients after lidocaine and in one patient after procainamide.
Conclusion: The data suggest that at high plasma concentrations, lidocaine and procainamide adversely affect defibrillation energy requirements consistent with an adverse, concentration-dependent effect of sodium channel blockade on defibrillation energy requirements in patients. 相似文献
Methods and Results: Patients were tested off antiarrhythmic drugs and again following either lidocaine (200 to 250 mg loading and 3 mg/min maintenance infusions) or procainamide (1 gm loading and 3 to 4 mg/min maintenance infusions). The defibrillation testing protocol consisted of initial testing at 15 J, followed by higher or lower energies to determine the lowest energy producing three consecutive successful defibrillations. Overall, the mean defibrillation energy increased from 14 ± 5 J to 18 ± 7 J during lidocaine (plasma concentration 5.1 ± 1.6 μ/mL; P < 0.02) but were similar at baseline (12 ± 5 J) and during procainamide infusion (13 ± 6 J) (plasma concentration: procainamide 10.7 ± 7.2 μ/rnl.; N-acetyl procainamide 1.0 ± 0.4 μ/niL). A positive linear correlation was found between lidocaine plasma concentration and percent change in defibrillation energy (lidocaine: r = 0.61; P = 0.01). Procainamide raised the defibrillation energy in three patients, two with supra therapeutic plasma concentrations. The increase in defibrillation energy equaled or exceeded 25 J in four patients after lidocaine and in one patient after procainamide.
Conclusion: The data suggest that at high plasma concentrations, lidocaine and procainamide adversely affect defibrillation energy requirements consistent with an adverse, concentration-dependent effect of sodium channel blockade on defibrillation energy requirements in patients. 相似文献
52.
Ho F.-M.; HUANG P.-J.; LIAU C.-S.; LEE F.-K.; CHIENG P.-U.; SU C.-T.; LEE Y.-T. 《European heart journal》1995,16(4):570-575
To compare the diagnostic value of dobutamine stress echocardiographywith dipyridamole thallium-201 single-photon emission computedtomography (SPECT) in detecting coronary artery disease (CAD),we performed both tests on 54 patients who also underwent coronaryarteriography. Dobutamine was infused at an incremental regimenof 5,10,20,30 and 40 µg. kg-1. min-1. Dipyridamole wasinfused at a rate of 0.14 mg. kg-1. min-1 over 4 min. Dobutaminestress echocardiography detected 40 (93%) and SPECT 42 (98%,P=ns) of the 43 patients with significant CAD, defined as (greaterthan or equal) 50% diameter stenosis. The specificity was 73%(8 of 11) for both tests. The sensitivity for detecting individualcoronary artery stenosis with dobutamine stress echocardiographywas 81% (30 of 37) for the left anterior descending artery,75% (24 of 32) for the right coronary artery, and 61% (17 of28) for the left circumflex artery. For SPECT it was 89%, 97%(P>0.05 vs dobutamine stress echocardiography) and 75%, respectively. Among the 97 stenotic coronary arteries, 17 had mild to moderatestenosis (50%-69% diameter stenosis) and 80 had severe stenosis($$70% diameter stenosis). With dobutamine stress echocardiography,53% of the arteries with mild to moderate stenosis were identifiedvs 78% of those with severe stenosis (P<0.05). With SPECT,the sensitivity was 82% (14 of 17) in mild to moderate stenosisand 89% (71 of 80) in severe stenosis (P=ns). No major sideeffects occurred during either test. Thus, both dobutamine stressand SPECT are highly sensitive for detection and localizationof CAD. However, the sensitivity of dobutamine stress is affectedby the level of stenosis severity. 相似文献
53.
MARTIN G. WERTKIN M.D. BERNARD B. WETCHLER M.D. F.A.C.G. JEROME D. WAYE M.D. F.A.C.G. LEE K. BROWN B.S. 《The American journal of gastroenterology》1976,65(3):209-214
A case of interstitial emphysema involving the mesentery and serosa of the sigmoid colon after volvulus reduced by colonoscopy is presented. The case is reported as a form of pneumatosis intestinalis although it does not conform to the classical clinicopathologic picture of pneumatosis cystoides intestinalis. The infrequent occurrence of this condition in association with volvulus and/or colonoscopy is discussed. 相似文献
54.
NAMITA ROY-CHOWDHURY YANG LU JINLAN JIANG SUNG W LEE CHANDAN GUHA JAYANTA ROY-CHOWDHURY 《Journal of gastroenterology and hepatology》2004,19(S7):S295-S301
Abstract Liver-directed gene therapy can be aimed at replacing a missing gene product, overexpressing or ectopically expressing a gene product in the liver, generating proteins that are normally not produced in the liver (e.g. hormones, vaccines), down-regulating specific gene expression and targeted repair of genetic mutations. A common critical requirement for achieving these goals is the availability of efficient methods for transferring DNA and RNA into target organ in vivo . Both recombinant viruses and non-viral vectors are being explored for transferring nucleic acids to cells in vitro and in vivo . This review compares the characteristics of these vectors in the context of their potential application in liver-directed gene therapy for various inherited or acquired disorders. 相似文献
55.
56.
Summary. Peripheral blood stem cell autografts for the treatment of chronic myeloid leukaemia (CML) are currently under evaluation. A patient with CML received intensive chemotherapy followed by granulocyte colony-stimulating factor prior to the collection of peripheral blood derived stem cells. He developed unusually severe, and fatal, hypophosphataemia and this coincided with the rapid rise of his peripheral blood white cell count. The hypophosphataemia was considered to be due to a combination of severe anorexia, sepsis and the rapid growth factor-stimulated myeloid regeneration in CML. 相似文献
57.
58.
Association of BNP and Troponin Levels with Outcome among Cardiac Resynchronization Therapy Recipients 下载免费PDF全文
ALAA A. SHALABY M.D. M.Sc. WILLIAM T. ABRAHAM M.D. GREGG C. FONAROW M.D. MALCOLM M. BERSOHN M.D. Ph.D. JOHN GORCSAN M.D. III LI‐YIN LEE Ph.D. JASMINA HALILOVIC M.D. SAMIR SABA M.D. ALAN MAISEL M.D. JAGMEET P. SINGH M.D. Ph.D. ALI SONEL M.D. ALAN KADISH M.D. 《Pacing and clinical electrophysiology : PACE》2015,38(5):581-590
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60.
Ji Suk SHIM LEE Jin Sook LEE Jeong Yol Yeon Jo CHOI Sang Wan SHIN RYU Jae Jun 《Journal of applied oral science : revista FOB》2015,23(5):515-522