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541.
Sultzer DL Gray KF Gunay I Wheatley MV Mahler ME 《Journal of the American Geriatrics Society》2001,49(10):1294-1300
OBJECTIVES: Several previous studies have examined the effects of pharmacological interventions for agitated behavior in patients with dementia. However, the choice of medication in clinical practice continues to be directed largely by local pharmacotherapy culture rather than empirical treatment guidelines. We examined the relationship between behavioral improvement and co-occurring delusions and mood symptoms in patients with dementia who were treated with haloperidol, an antipsychotic medication, or trazodone, a serotonergic antidepressant. DESIGN: Randomized, double-blind, parallel-group, 9-week treatment trial. SETTING: Inpatient geropsychiatry unit. PARTICIPANTS: Twenty-eight patients with dementia and agitated or aggressive behaviors. INTERVENTION: Haloperidol 1 to 5 mg/day or trazodone 50 to 250 mg/day. MEASUREMENTS: Cohen-Mansfield Agitation Inventory (CMAI), Hamilton Depression Rating Scale (Ham-D), and delusional thoughts subscale and hallucinations subscale of the Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD). RESULTS: CMAI scores improved in each treatment group over the 9 weeks of treatment (P < .001 in each group). Within the haloperidol treatment group, CMAI improvement was not associated with baseline delusional thoughts score or with change in delusional thoughts score over the course of treatment. Within the trazodone treatment group, CMAI improvement was associated with baseline score on total Ham-D (r = -0.60, P = .02), Ham-D items measuring subjective mood symptoms (r = -0.50, P = .07), and Ham-D items measuring neurovegetative signs (r = -0.49, P = .08). CMAI improvement was also associated with improvement in Ham-D total score over the course of treatment (r = 0.62, P = .02). CONCLUSIONS: Mild depressive symptoms in patients with dementia and agitated behavior are associated with greater behavioral improvement by trazodone-treated patients. In contrast, the presence of delusions in concert with behavioral disturbance does not necessarily predict greater behavioral improvement with haloperidol treatment than in subjects without signs of psychosis. 相似文献
542.
Onalan O Balta G Oto A Kabakci G Tokgozoglu L Aytemir K Altay C Gurgey A Nazli N 《Journal of thrombosis and thrombolysis》2008,26(3):211-217
Background A case control study was conducted to test the hypothesis that plasminogen activator inhibitor type-1 (PAI-1) 4G/5G gene polymorphism
confers an increased risk for myocardial infarction (MI) in patients with known coronary atherosclerosis.
Methods One hundred fifty-six consecutive patients who presented with acute MI and 111 stable coronary artery disease (SCAD) patients
with documented critical coronary artery stenoses were prospectively enrolled. PAI-1 4G/5G gene polymorphism and conventional
atherosclerotic risk factors were studied in all patients. PAI-1 4G/5G gene polymorphism was studied in another 281 healthy
blood bank donors.
Results The frequency 4G4G genotype was significantly higher in the MI group as compared to SCAD group (32.7% vs. 15.3%, P = 0.001) while it was not statistically significant between MI and healthy control groups (32.7% vs. 26.0%, P = 0.136). Comparing with healthy controls SCAD group had significantly lower frequency of 4G4G genotype (P = 0.024). In comparison with SCAD group PAI-1 4G/4G genotype, male sex and smoking habits favored to MI in univariate analysis
with a P value of less than 0.2. These variables were included in multivariate regression model to estimate the associated risk for
MI. PAI-1 4G/4G genotype was the only independent variable (OR 2.67, 95%CI 1.43–4.96, P = 0.002) associated with MI in this regression model. Comparing with healthy control group 4G4G genotype was not associated
with MI (OR 1.38, 95%CI 0.90–2.12). However, presence of 4G4G genotype had a protective effect against development of SCAD
(OR 0.52, 96%CI 0.29–0.92).
Conclusion Compared to patients with critical coronary stenoses, PAI-1 4G/4G genotype was found to be an independent predictor for development
of MI in this population. PAİ-1 4G4G genotype have a protective effect against development of high grade stable coronary stenoses. 相似文献
543.
Demirkilic U Ozal E Bingol H Cingoz F Gunay C Doganci S Kuralay E Tatar H 《Asian cardiovascular & thoracic annals》2004,12(2):133-138
We report our experience of surgical treatment of coronary artery fistula and focus on the electrocardiographic changes that may be seen postoperatively. Between 1988 and 2003, cardiac operations were carried out on 9,487 patients, of whom 21 had a coronary artery fistula. The mean age of these 21 patients was 36.8 +/- 4.9 years. The fistula originated from the right coronary artery in 9 cases and from the left side in 12. The fistulous connection was to the right ventricle in 5 patients, to the right atrium in 6, to the pulmonary artery in 8, and to the coronary sinus in 2. There was no operative mortality. Two patients (10%) had nonspecific electrocardiographic changes during the postoperative period. Repeat coronary angiography revealed normal coronary anatomy in both, and their electrocardiograms normalized within 2 months. Patients suspected to have myocardial ischemia related to the surgical procedure, with ST segment depression or T wave abnormalities on the electrocardiogram, should undergo repeat angiography to eliminate the possibility of coronary artery damage. 相似文献
544.
María Elena Abad Benítez Angelita Serrano AguiarAlberto Martínez González Ramón Iranzo Balta 《Progresos de Obstetricia y Ginecología》2011,54(2):76-79
Proximal femoral focal deficiency is a rare skeletal anomaly with an estimated incidence of 1:50.000 live between 50.000 and births. We report a case of proximal femoral focal deficiency diagnosed by ultrasound at 28 weeks gestation. Differential diagnosis, prognosis and management are discussed. 相似文献
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548.
Serhan Sakarya Necati Gunay 《APMIS : acta pathologica, microbiologica, et immunologica Scandinavica》2014,122(10):941-950
Helicobacter pylori is a major causative agent of gastritis and peptic ulcer disease and is an established risk factor for gastric malignancy. Antibiotic combination therapy can eradicate H. pylori. As these same regimens can evoke adverse effects and resistance, new alternative therapies or adjunctive treatments are needed. A probiotic approach may provide a novel strategy for H. pylori treatment. In the current study, two probiotic bacteria, Lactobacillus acidophilus and Lactobacillus reuteri, and a probiotic yeast, Saccharomyces boulardii, were evaluated for their ability to influence H. pylori viability, adherence to gastric and duodenal cells, as well as the effect of S. boulardii on cell surface expression of sialic acid. Our results indicate that S. boulardii contains neuraminidase activity selective for α(2‐3)‐linked sialic acid. This neuraminidase activity removes surface α(2‐3)‐linked sialic acid, the ligand for the sialic acid‐binding H. pylori adhesin, which in turn, inhibits H. pylori adherence to duodenal epithelial cells. 相似文献
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