全文获取类型
收费全文 | 27069篇 |
免费 | 1329篇 |
国内免费 | 70篇 |
专业分类
耳鼻咽喉 | 649篇 |
儿科学 | 1138篇 |
妇产科学 | 399篇 |
基础医学 | 2963篇 |
口腔科学 | 551篇 |
临床医学 | 1642篇 |
内科学 | 7255篇 |
皮肤病学 | 1081篇 |
神经病学 | 1845篇 |
特种医学 | 700篇 |
外科学 | 4124篇 |
综合类 | 113篇 |
一般理论 | 6篇 |
预防医学 | 2231篇 |
眼科学 | 753篇 |
药学 | 1540篇 |
中国医学 | 68篇 |
肿瘤学 | 1410篇 |
出版年
2023年 | 129篇 |
2022年 | 79篇 |
2021年 | 575篇 |
2020年 | 242篇 |
2019年 | 664篇 |
2018年 | 1044篇 |
2017年 | 621篇 |
2016年 | 531篇 |
2015年 | 572篇 |
2014年 | 609篇 |
2013年 | 978篇 |
2012年 | 1753篇 |
2011年 | 1921篇 |
2010年 | 1023篇 |
2009年 | 743篇 |
2008年 | 1587篇 |
2007年 | 1765篇 |
2006年 | 1608篇 |
2005年 | 1647篇 |
2004年 | 1490篇 |
2003年 | 1462篇 |
2002年 | 1421篇 |
2001年 | 1084篇 |
2000年 | 1355篇 |
1999年 | 995篇 |
1998年 | 138篇 |
1997年 | 91篇 |
1996年 | 105篇 |
1995年 | 67篇 |
1994年 | 48篇 |
1993年 | 48篇 |
1992年 | 330篇 |
1991年 | 245篇 |
1990年 | 200篇 |
1989年 | 151篇 |
1988年 | 154篇 |
1987年 | 155篇 |
1986年 | 119篇 |
1985年 | 110篇 |
1984年 | 83篇 |
1983年 | 61篇 |
1981年 | 31篇 |
1979年 | 54篇 |
1976年 | 31篇 |
1974年 | 31篇 |
1973年 | 34篇 |
1972年 | 29篇 |
1971年 | 27篇 |
1970年 | 25篇 |
1968年 | 28篇 |
排序方式: 共有10000条查询结果,搜索用时 39 毫秒
991.
G La Villa J M Salmerón V Arroyo J Bosch P Ginés J C García-Pagán A Ginés M Asbert W Jiménez F Rivera 《Gastroenterology》1992,102(6):2114-2119
Failure to escape from mineralocorticoids in compensated cirrhosis is considered a major argument supporting the overflow theory of ascites. To assess the frequency and mechanism of mineralocorticoid escape in cirrhosis, 9-alpha-fluorohydrocortisone (0.6 mg/day) was administered to 19 patients with compensated cirrhosis, portal hypertension, and no history of ascites who were able to maintain sodium balance on a 250 mmol Na+ diet. Fifteen patients (78.9%) escaped from mineralocorticoids, while 4 patients (21.1%) did not escape and developed ascites. Patients who did not escape had significantly higher cardiac index (4.97 +/- 0.42 vs 3.46 +/- 0.21 L.min-1.m-2) and lower peripheral vascular resistance (485.9 +/- 37.5 vs. 665.8 +/- 32.9 dyne.s.cm-5/m2) than those who escaped. Hepatic venous pressure gradient was not significantly different. The escape phenomenon was associated with a significant increase in mean arterial pressure, creatinine clearance, and atrial natriuretic factor and suppression of plasma renin activity. All of these parameters showed minimal or no changes in patients who did not escape. These results indicate that failure to escape from mineralocorticoids is uncommon in patients with compensated cirrhosis, is related to an inadequate expansion of effective plasma volume due to the accumulation of ascites, and occurs in patients with marked peripheral arteriolar vasodilation. 相似文献
992.
Gisbert JP Arata IG Boixeda D Barba M Cantón R Plaza AG Pajares JM 《European journal of gastroenterology & hepatology》2002,14(8):865-871
AIM: To evaluate whether the Helicobacter pylori status of the patient's spouse plays a role in reinfection after eradication success, and to assess the possibility of transmission of H. pylori among partners by using molecular methods. METHODS: We studied prospectively 120 patients in whom H. pylori had been eradicated. Endoscopy with biopsies and a 13C-urea breath test were performed 1 month after completing therapy. The breath test was repeated in all patients at 6 and 12 months. At the 1-year follow-up visit (or before if reinfection occurred), a breath test was also performed on the patient's partner. Samples for the molecular study included gastric biopsies from patients and gastric content obtained by the string test from partners. The heterogeneity of ureC was studied by enzymatic digestion with MseI and HhaI enzymes of a polymerase chain reaction (PCR) product of 1179 bp belonging to the ureC gene, and different band patterns were generated after electrophoresis. RESULTS: Four reinfections were diagnosed at 6 months, and four were diagnosed from 6 to 12 months (incidence 6.8% per patient-year). Seven of eight (87%) of the reinfected patients' spouses were infected, but H. pylori infection of spouses was also frequent (76%) among non-reinfected patients. In the multivariate analysis, age of the patient (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.87 to 0.99, P < 0.05), delta(13)CO(2) value after therapy (OR 2.51, 95% CI 1.14 to 5, P < 0.05), and therapy regimen (OR 6.23, 95% CI 1.25 to 31, P < 0.05) were the only variables that correlated with H. pylori recurrence. However, family variables (H. pylori status of spouse, breath test value of spouse, length of time couple had lived together, number of children living at home, household density) did not correlate with recurrences. Thus, the OR for the H. pylori status of spouse (adjusted by age, delta(13)CO(2) and therapy) was 2.93 (95% CI 0.29 to 29, P > 0.05). H. pylori recurrence occurred in seven of 92 (7.6%) patients when the spouse was infected (95% CI 3.7% to 15%), and in one of 28 (3.6%) patients when the spouse was H. pylori-negative (95% CI 0.6% to 18%) (P > 0.05; however, the power of this comparison was < 20%). Therefore, even if the spouse was infected, 92.4% of patients will remain uninfected 1 year after H. pylori eradication. Three reinfected patients (at 1 year) and their partners (also infected) agreed to have the endoscopy and string test performed, respectively. The molecular study revealed that H. pylori strains involved were different in all cases. CONCLUSION: Recurrence of H. pylori infection seems to be relatively infrequent, even if the patient's spouse is H. pylori-positive. The molecular study demonstrated that the strains in reinfected patients and their partners are different, suggesting that the patient's partner does not act as a reservoir for H. pylori reinfection. 相似文献
993.
J Maté Jiménez R Casta?os Mollor-Penalva J García-Samaniego Rey P Robledo Andrés P Sánchez Risco R Mu?oz Gómez J M Pajares García 《Revista española de enfermedades digestivas》1992,81(3):175-179
Lower gastrointestinal bleeding (LGB) is more frequent than upper gastrointestinal bleeding (UGB) with a better course and a more difficult diagnosis. We reviewed retrospectively 8544 cases from patients who were admitted at the Coloproctology Unit of Hospital de la Princesa. Those with the diagnosis of LGB with visible blood in stools (2646-31%) were outpatients, with a mean age of 43 years (range 9-91). Males represented 56.4% and females 43.6. All of them underwent at least sigmoidoscopic examination. The more frequent disorder was hemorrhoids (48.5%) and the bleeding source was found in the anus in 61%. Most of lesions (86%) could be reached with the short colonoscope and 92.7% of the bleeding sources were found with total colonoscopy. In 7.3% colonoscopy was not diagnostic and fiber gastroscopy identified the bleeding spot in 1.5% of the total. Barium studies were diagnostic in 0.5%, arteriography in 0.25% and radionuclide bleeding scan in 0.1%. Finally in 130 patients the bleeding source could not be found. We conclude that most of hemorrhagic lesions occur in the descending colon and that total colonoscopy can localize more than 92%. When total colonoscopy fails only 33% of the lesions can be found (2.35% from total) and 19% (1.5% from the total number) with UGB are identified with the fiber gastroscopic examination. 相似文献
994.
Videla S Vilaseca J Antolín M García-Lafuente A Guarner F Crespo E Casalots J Salas A Malagelada JR 《The American journal of gastroenterology》2001,96(5):1486-1493
OBJECTIVES: Inulin stimulates intracolonic generation of butyrate and growth of lactic acid bacteria. This study investigated whether inulin protects against colitis. METHODS: Rats with dextran sodium sulfate colitis received inulin either orally (1% in drinking water, or 400 mg/day) or by enema. Matched groups received vehicle. In addition, fecal water obtained from inulin-fed rats was administered by enema to rats with colitis and compared with fecal water from control rats. Finally, rats with colitis received daily enemas of either butyrate (at 40 or 80 mmol/L) or vehicle. Inflammation was assessed by eicosanoid asssay in rectal dialysates and MPO activity in colonic tissue. Mucosal lesions were blindly scored by microscopic examination. Luminal pH was measured from cecum to rectum by a surface microelectrode. RESULTS: Oral inulin prevented inflammation, as evidenced by lower lesion scores (p < 0.05), decreased release of mediators (p < 0.05), and lower tissue MPO (p < 0.05) as compared with controls. Inulin induced acidic environment (pH <7.0) from cecum to left colon and increased counts of lactobacilli. Fecal water from inulin-fed rats also reduced scores (p < 0.05) and inflammation (p < 0.05). However, inulin or butyrate enemas had no effect. CONCLUSIONS: Oral inulin reduces the severity of dextran sodium sulfate colitis. The effect seems to be mediated by modification of the intracolonic milieu. 相似文献
995.
Lahuerta JJ Martinez-Lopez J Grande C Bladé J de la Serna J Alegre A García-Laraña J Caballero D Sureda A de la Rubia J Alvarez AM Marín J Escudero A Conde E Perez-Equiza K García Ruiz JC Moraleda JM León A Bargay J Cabrera R Hernandez-García MT Diaz-Mediavilla J Miguel JS 《British journal of haematology》2000,109(1):138-147
High-dose chemoradiotherapy conditioning regimens for autologous stem cell transplantation (ASCT) are generally held to give similar results in multiple myeloma (MM), but no specific comparative study has been published. We addressed this issue by comparing the main high-dose chemoradiotherapy regimens used in the Spanish Registry. Patient cohorts included 315 cases treated with 200 mg/m2 melphalan (MEL200), 127 patients with 140 mg/m2 melphalan plus total body irradiation (MEL140 + TBI) and 121 cases with 12 mg/kg busulphan plus 140 mg/m2 melphalan (BUMEL). After ASCT, granulocyte and platelet recovery time was similar in all conditioning groups. There were no differences in transplant-related mortality. All regimens yielded a similar response in reference to pre-ASCT MM status, although BUMEL produced a slightly better overall response when compared with the other regimens (97% vs. 89% and 92%, P = 0.003). The 5-year overall survival (OS) with BUMEL was 47% [95% confidence interval (CI) 26-68] compared with 43% (CI 31-54) for MEL140 + TBI and 37% (CI: 18-56) for MEL200. The median survival for the BUMEL group was 64 months compared with 45 and 37 months for the MEL200 and MEL140 + TBI groups respectively. These differences were non-significant (P = 0.2). The median event-free survival (EFS) was better for BUMEL (32 months) than for MEL200 (22 months) or for MEL140 + TBI (20 months). The differences in EFS between BUMEL and the other conditioning regimens reached statistical significance (P = 0.01). Nevertheless, the adjusted multivariate analysis for OS and EFS revealed that the conditioning regimens had no independent prognostic value. We concluded that three different conditioning regimens, commonly used for ASCT in MM, have a similar antimyeloma effect. However, the trend for better results observed in our series with BUMEL requires a prospective trial. 相似文献
996.
José S. Merino Liliana Araneda Paulina Lincoñir-Campos Cristian Parra Katia Sáez Apolinaria García 《Enfermedades infecciosas y microbiología clínica》2019,37(2):109-111
Introduction
Mainly due to the high percentage of infection and the ineffectiveness of treatments, Helicobacter pylori is a global health problem. Knowing the age at acquisition is key to preventing the infection.Patients
Sixty-seven mothers and their respective children participated. To evaluate the presence of H. pylori, the faeces of the mother and her child were analysed using the HpSA antigen test.Results
71.6% (48/67) of pregnant mothers were positive for H. pylori at the term of their pregnancy. In newborns, 8.96% (6/67) of them showed H. pylori colonisation/persistent infection. During the first month of life, a prevalence and incidence of infection of 23.9% and 13%, respectively, was observed.Conclusion
Overall, the results suggest that there is a high risk of H. pylori infection during the first month of life, even of the persistent type. 相似文献997.
José Alberto de Agustín José Juan Gómez de Diego Pedro Marcos-Alberca Patricia Mahía José Luis Rodrigo María Luaces Iván Javier Núñez-Gil Joaquín Ferreiros Ana Bustos Beatriz Cabeza Miguel Ángel García-Fernández Carlos Macaya Leopoldo Pérez de Isla 《Revista espa?ola de cardiología》2018,71(2):105-109
Introduction and objectives
Multidetector computed tomography (MDCT) has been demonstrated as a feasible alternative to invasive coronary angiography (ICA). However, contradictory results have been reported regarding the effect of coronary artery calcium score (CS) on the diagnostic accuracy of MDCT. Our aim was to assess the agreement of MDCT and ICA and to evaluate the influence of CS on this agreement.Methods
We enrolled 266 consecutive patients who underwent evaluation with 64-slice MDCT and ICA. Standard CS software tools were used to calculate the Agatston score. Stenosis was qualitatively classified as mild, moderate, or severe by 1 blinded observer and the results were compared with those of ICA, which was used as the gold standard.Results
The mean age of the patients was 65.4 ± 11.2 years, and 188 patients (70.3%) were men. A total of 484 segments with coronary stenosis ≥ mild were qualitatively evaluated and quantified with MDCT. Noninvasive measurements were concordant with ICA in 402 stenoses (83.05%; Kappa, 0.684), with no significant differences between vessels and with no statistically significant influence of CS on this agreement (OR, 0.93; 95%CI, 0.76-1.09; P = .21). Multidetector computed tomography had high sensitivity, specificity, positive predictive value, and negative predictive value on a per-segment, per-vessel, and per-patient basis.Conclusions
Non-ICA using MDCT showed good agreement with ICA in the qualitative quantification coronary stenosis and CS had no significant impact on this agreement.Full English text available from: www.revespcardiol.org/en 相似文献998.
999.
M. Inmaculada Poveda García M. Dolores del Pino y Pino Raquel Alarcón Rodriguez Cristian Rodelo-Haad Tesifón Parrón Carreño 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2019,39(1):67-72
Introduction
We aimed to assess the effectiveness of ambulatory blood pressure monitoring (ABPM) and subclinical target organ damage parameters for diagnosis of resistant hypertension (RH).Methods
We assessed demographic and anthropometric variables, the incidence of cardiovascular events and subclinical target organ damage (n = 112). We also studied the relationship between these variables and the ABPM results.Results
Of the 112 patients referred from primary care with a diagnosis of RH, 69 (61.6%) were confirmed by ABPM. We found statistically significant differences (P < .001) between patients with RH and pseudo-resistant hypertension in the appearance of subclinical target organ damage. A percentage of 84 of the patients had microalbuminuria: 66.25 ± 30.7 mg/dl); 44.9% had stage 3 chronic kidney disease: the average glomerular filtration was 59 ml/min/1.73 m2; and 56.5% had left ventricular hypertrophy on echocardiography. Fundoscopy revealed that 64% of the patients had hypertensive retinopathy. Three variables were associated with an increased HR risk: microalbuminuria, hypertensive retinopathy and left ventricular hypertrophy (OR 5.7, 6.2 and 11.2, respectively).Conclusions
This study shows that the systematic testing for target organ damage, particularly in terms of albuminuria, is a simple and inexpensive tool, with a high predictive value for RH (85%), which could be useful for prioritising patients who need ABPM. 相似文献1000.
Nicolás Macías Soraya Abad Almudena Vega Santiago Cedeño Alba Santos Úrsula Verdalles Tania Linares Inés Aragoncillo Isabel Galán Ana García-Prieto José Luño Juan Manuel López Gómez 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2019,39(2):168-176