全文获取类型
收费全文 | 453篇 |
免费 | 29篇 |
国内免费 | 7篇 |
专业分类
耳鼻咽喉 | 1篇 |
儿科学 | 30篇 |
妇产科学 | 8篇 |
基础医学 | 41篇 |
口腔科学 | 16篇 |
临床医学 | 55篇 |
内科学 | 105篇 |
皮肤病学 | 8篇 |
神经病学 | 16篇 |
特种医学 | 42篇 |
外科学 | 91篇 |
综合类 | 9篇 |
预防医学 | 18篇 |
眼科学 | 12篇 |
药学 | 17篇 |
肿瘤学 | 20篇 |
出版年
2023年 | 4篇 |
2022年 | 1篇 |
2021年 | 8篇 |
2020年 | 5篇 |
2019年 | 7篇 |
2018年 | 13篇 |
2017年 | 7篇 |
2016年 | 7篇 |
2015年 | 14篇 |
2014年 | 17篇 |
2013年 | 14篇 |
2012年 | 19篇 |
2011年 | 18篇 |
2010年 | 23篇 |
2009年 | 22篇 |
2008年 | 12篇 |
2007年 | 31篇 |
2006年 | 45篇 |
2005年 | 13篇 |
2004年 | 14篇 |
2003年 | 13篇 |
2002年 | 17篇 |
2001年 | 19篇 |
2000年 | 10篇 |
1999年 | 8篇 |
1998年 | 18篇 |
1997年 | 18篇 |
1996年 | 13篇 |
1995年 | 7篇 |
1994年 | 14篇 |
1993年 | 12篇 |
1992年 | 6篇 |
1991年 | 3篇 |
1989年 | 4篇 |
1988年 | 6篇 |
1987年 | 2篇 |
1986年 | 4篇 |
1985年 | 8篇 |
1984年 | 3篇 |
1982年 | 3篇 |
1981年 | 4篇 |
1978年 | 1篇 |
1976年 | 1篇 |
1975年 | 1篇 |
排序方式: 共有489条查询结果,搜索用时 0 毫秒
41.
Winning the battle but losing the war: methicillin-resistant Staphylococcus aureus (MRSA) infection at a teaching hospital 总被引:2,自引:0,他引:2
Farrington M; Redpath C; Trundle C; Coomber S; Brown NM 《QJM : monthly journal of the Association of Physicians》1998,91(8):539-548
A methicillin-resistant Staphylococcus aureus (MRSA) control policy, aimed
at eradication, was established at a 1000-bed hospital in 1985, applied
consistently for 10.5 years, and then relaxed. Its components included
screening of high-risk patients, transfer of carriers to exhaust-ventilated
isolation rooms, closure of wards to new admissions when local transmission
was detected, MRSA screening during outbreaks, and prospective collection
of clinical and epidemiological information. During the eradication policy
period, every 6 months, a mean of 5.1 patients (range 1-12) already
carrying MRSA were admitted, and a mean of 3.6 (range 0-16) acquired
carriage in the hospital. The largest outbreak comprised 11 patients
despite epidemic MRSA strain EMRSA-16 being introduced six times, and MRSA
did not become endemic. MRSA- positive admissions increased progressively
from 1993; nursing staff workload increased, areas available for
alternative patient accommodation were reduced, the resulting ward closures
interfered with clinical services, and hence the control policy was relaxed
in mid- 1995. Isolation facilities were overwhelmed with 622 new patient-
isolates in the next 18 months, and there were 67 clinical infections in
1996. The proportion of blood cultures positive for MRSA rose nearly
sevenfold by 1996 and 27-fold by 1997. Thus, repeated eradication of MRSA,
even epidemic strains, by use of a stringent policy, is possible given
sufficient resources, whereas flexible national guidelines designed to
control, but not eradicate, epidemic staphylococci, are currently unlikely
to be successful. The costs of eradication policies need to be weighed
against those of endemicity.
相似文献
42.
JM Ranson NM Pantelides D Gharpuray Pandit JKG Laitung 《Journal of plastic, reconstructive & aesthetic surgery》2018,71(9):1269-1273
Objectives
The ‘10% rule’ has become widely accepted by surgeons performing sentinel lymph node biopsy (SLNB) for melanoma. The purpose of this study was to compare the ‘10% rule’ with alternative node harvesting criteria. In particular, we were interested to see whether the use of blue dye had any impact on the sensitivity of the test and whether it is necessary to remove all hot nodes.Methods
We reviewed 537 SLNBs performed for primary melanoma from 2009–2015. SLNB was offered to all patients with 1–4?mm Breslow thickness melanoma and sentinel nodes were harvested according to the ‘10% rule’.Results
One hundred sixteen patients (22%) had at least one positive sentinel node and there were 45 positive nodal basins from which more than one sentinel node had been harvested. Excluding blue dye and sampling only hot nodes would have enabled a 5% reduction in nodes harvested, without any compromise in the sensitivity of the test. However, applying harvesting criteria whereby not all hot nodes are taken was associated with a loss of sensitivity, with positive sentinel nodes being missed and patients understaged.Conclusions
Our data do not support the continued use of blue dye in SLNB for melanoma, as it does not improve the sensitivity of the test. This series adds to growing evidence, suggesting that the ‘10% rule’ with the inclusion of blue nodes should be reconsidered and that radiocolloid tracer alone is sufficient for sentinel node localisation. 相似文献43.
Polycystins are a family of novel transmembrane proteins with at least six members already identified in humans. Defects in polycystins-1 and -2 are responsible for nearly all cases of autosomal-dominant polycystic kidney disease (ADPKD), a major cause of end-stage renal failure. With the progress made in elucidating the genetic basis of ADPKD, the challenges are to understand the functions of polycystins and to delineate the biochemical and cellular mechanisms of cyst development and progression. In this review, we summarize the recent advances in our knowledge of the functions of polycystins with emphasis on the molecular composition of polycystin protein complexes in the kidney. 相似文献
44.
D. J. Van Der Windt R. Bottino A. Casu N. Campanile C. Smetanka J. He N. Murase H. Hara S. Ball B. E Loveland D. Ayares F. G. Lakkis D. K. C. Cooper M. Trucco 《American journal of transplantation》2009,9(12):2716-2726
Xenotransplantation of porcine islets into diabetic non‐human primates is characterized by (i) an initial massive graft loss possibly due to the instant blood‐mediated inflammatory reaction and (ii) the requirement of intensive, clinically unfriendly immunosuppressive therapy. We investigated whether the transgenic expression of a human complement‐regulatory protein (hCD46) on porcine islets would improve the outcome of islet xenotransplantation in streptozotocin‐induced diabetic Cynomolgus monkeys. Immunosuppression consisted of thymoglobulin, anti‐CD154 mAb for costimulation blockade, and mycophenolate mofetil. Following the transplantation of islets from wild‐type pigs (n = 2) or from 1,3‐galactosyltransferase gene‐knockout pigs (n = 2), islets survived for a maximum of only 46 days, as evidenced by return to hyperglycemia and the need for exogenous insulin therapy. The transplantation of islets from hCD46 pigs resulted in graft survival and insulin‐independent normoglycemia in four of five monkeys for the 3 months follow‐up of the experiment. One normalized recipient, selected at random, was followed for >12 months. Inhibition of complement activation by the expression of hCD46 on the pig islets did not substantially reduce the initial loss of islet mass, rather was effective in limiting antibody‐mediated rejection. This resulted in a reduced need for immunosuppression to preserve a sufficient islet mass to maintain normoglycemia long‐term. 相似文献
45.
INTRODUCTION: The International Civil Aviation Organization requires that pilots be able to distinguish the colors used in air navigation and in particular be able to identify the colors of signal lights. Most national aviation authorities use a lantern test to assess the ability of applicants for a pilot's license who have abnormal color vision to recognize the colors of signal lights. However, color-coding is now widely used in aviation systems other than signal lights. Color is used in tarmac markings, maps, manuals, and electronic flight instrument displays. These color codes can use 10 or more colors, many more than the 3 to 5 used for signal lights. This study investigated whether people with defective color vision (DCV) who pass the Farnsworth lantern test can recognize the main colors used for surface color codes. METHODS: There were 99 subjects with DCV who were tested using the Optec 900 version of the Farnsworth lantern test and also named the colors of a set of 10 surface colors that varied in shape (dots and lines) and size (3 sizes; angular diameters 0.27, 1.0, and 2.4 degrees; angular widths 0.14, 0.27, and 0.50 degrees). A control group of 20 subjects with normal color vision also named the surface colors. RESULTS: Of the DCV subjects, 19% passed the Farnsworth lantern test, of whom 74% made no errors with the surface colors. The other 26% made few errors (up to 5 errors in 120 presentations) and those errors were mostly to confuse red, orange, and brown. The subjects with normal color vision made no errors naming the surface colors. CONCLUSION: Those who pass the Farnsworth lantern test can recognize the colors of a 10-color surface color code with few or no errors. This is because the small (2.9-min arc) stimulus of the lantern test presents a more difficult task than the larger surface colors. 相似文献
46.
It is unknown whether right ventricular (RV) tissue Doppler (TD) predicts outcome in patients with left ventricular (LV) heart failure (HF) independently of contemporary echocardiographic Doppler variables of LV diastolic function. Comprehensive echocardiographic Doppler examination was performed before discharge in 107 patients hospitalized with LV HF. The primary end point was cardiac death or rehospitalization for HF. Follow-up was complete for 100 of 107 patients a mean of 527 days after hospital discharge. There were no significant differences in baseline clinical variables (mean age 58+/-12 years, 46% women, 77% hypertensive, 48% diabetic, 41% current smokers, and 23% known coronary artery disease) in prediction of the primary end point. Compared with patients without an event, patients with an event had a larger left atrial volume index (42+/-16 vs 33+/-13 ml/m2, p=0.001), lower LV ejection fraction (35+/-19% vs 46+/-22%, p=0.01), higher mitral peak early diastolic flow velocity/TD early diastolic velocity (19+/-7 vs 14+/-7, p=0.001), lower RV fractional area change (39+/-11% vs 43+/-10%, p=0.04), and lower RV TD systolic velocity (8+/-2 vs 10+/-3 cm/s, p=0.005). On Cox proportional hazards multivariate analysis, left atrial volume index (p=0.01), mitral peak early diastolic flow velocity/TD early diastolic velocity (p=0.03), and RV TD systolic velocity (p=0.04) were independent predictors of outcome. Even when contemporary echocardiographic Doppler measures of LV diastolic function are considered, RV TD systolic velocity is an independent predictor of cardiac death or rehospitalization for HF in patients hospitalized with HF and appears to be superior to conventional 2-dimensional parameters of RV function. 相似文献
47.
Michal Liebergall‐Wischnitzer CNM PhD Ora Paltiel MD MSc Drorit Hochner‐Celnikier MD Yuval Lavy MD Orly Manor PhD Anna Carol Woloski Wruble NM EdD 《Journal of Midwifery & Women's Health》2011,56(5):461-467
Introduction: Sexual function is affected by stress urinary incontinence with or without pelvic organ prolapse. The aim of the study was to describe the sexual function of women with mild‐to‐moderate stress urinary incontinence, with or without pelvic organ prolapse (up to stage 2) and examine correlations with symptoms and quality of life. This investigation was part of a large, randomized, clinical trial of women with stress urinary incontinence who participated in an exercise intervention. Methods: Women included in the study suffered from stress urinary incontinence as measured by a pad test and were interested in an exercise intervention. All participants underwent assessment for prolapse staging. Instruments included: the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ‐12), Incontinence Quality of Life Questionnaire (I‐QOL), and a health and urinary leakage questionnaire. Results: One hundred and eighty‐seven ambulatory women, aged 20 to 65 years, had a mean sexual function score of 36.9 (standard deviation [SD] 5.9). No significant correlation was found between the sexual function scores and quantity of urinary leakage. A significant correlation existed between the sexual function and I‐QOL scores (P < .001). An additional finding was that women with urgency symptoms were older (P= .04) and had significantly lower sexual function scores (mean 35.7; SD 6.4) than those who did not report urgency (mean 38.7; SD 4.6; P < .001). Discussion: Women with mild‐to‐moderate stress urinary incontinence, without or with lower stages of pelvic organ prolapse, demonstrated good sexual function, which correlated with physical and psychosocial factors. Health professionals need to perform multifaceted intake assessments on women with urinary leakage to customize their health promotion regimen. 相似文献
48.
Pregnancy augments nitric oxide-dependent dilator response to acetylcholine in the human uterine artery 总被引:4,自引:1,他引:3
Nelson SH; Steinsland OS; Suresh MS; Lee NM 《Human reproduction (Oxford, England)》1998,13(5):1361-1367
The influence of pregnancy on the dilator effects of acetylcholine in the
isolated human uterine artery was investigated. Acetylcholine (0.1 nM to
0.1 microM) produced concentration- and endothelium-dependent relaxation of
norepinephrine (3 microM)-induced contraction. The relaxation was greater
in arteries from pregnant patients (P arteries) than from non-pregnant
patients (NP arteries). The maximal relaxation was 53.5+/-3.4% (n=21) in P
arteries and 23.5+/-2.5% (n=35) in NP arteries. In both P and NP arteries
the cholinergic relaxation was increased in the presence of superoxide
dismutase and greatly reduced in the presence of the nitric oxide synthase
inhibitors, NG-mono-methyl L-arginine (L-NMMA) and
L-nitro-arginine-methylester (L-NAME). The effect of these nitric oxide
synthase inhibitors was reversed by L- arginine. We conclude that pregnancy
enhances acetylcholine-induced nitric oxide synthesis and release in the
human uterine artery.
相似文献
49.
Dendritic cells (DC) are rare, bone marrow (BM)-derived innate immune cells that critically maintain self-tolerance in the healthy steady-state. Regulatory DC (DCreg) with capacity to suppress allograft rejection and promote transplant tolerance in pre-clinical models can readily be generated from BM precursors or circulating blood monocytes. These DCreg enhance allograft survival via various mechanisms, including promotion of regulatory T cells. In non-human primates receiving minimal immunosuppressive drug therapy (IS), infusion of DCreg of donor origin, one week before transplant, safely prolongs renal allograft survival and selectively attenuates anti-donor CD8+ memory T cell responses in the early post-transplant period. Based on these observations, and in view of the critical need to reduce patient dependence on non-specific IS agents that predispose to cardiometabolic side effects and renal insufficiency, we will conduct a first-in-human safety and preliminary efficacy study of donor-derived DCreg infusion to achieve early (18?months post-transplant) complete IS withdrawal in low-risk, living donor liver transplant recipients receiving standard-of-care IS (mycophenolate mofetil, tacrolimus and steroids). We will test the hypothesis that, although donor-derived DCreg are short-lived, they will induce robust donor-specific T cell hyporesponsiveness. We will examine immunological mechanisms by sequential analysis of blood and tissue samples, incorporating cutting-edge technologies. 相似文献
50.
Dengue is a mosquito transmitted flaviviral infection which can give rise to severe haemorrhage (dengue haemorrhagic fever) and with capillary leakage induces hypovolaemic shock (dengue shock syndrome). Although dengue symptoms and complications have been known for many decades, there has only been one documented case of osteonecrosis of the maxilla which was treated by excision of the necrotic bone. In this case of dengue infection, extensive maxillary osteonecrosis and minimal root resorption appeared to follow factitious injury with a toothpick but resolved with non‐surgical management. 相似文献