全文获取类型
收费全文 | 566篇 |
免费 | 24篇 |
国内免费 | 2篇 |
专业分类
耳鼻咽喉 | 3篇 |
儿科学 | 56篇 |
妇产科学 | 3篇 |
基础医学 | 63篇 |
口腔科学 | 11篇 |
临床医学 | 76篇 |
内科学 | 139篇 |
皮肤病学 | 21篇 |
神经病学 | 3篇 |
特种医学 | 139篇 |
外科学 | 24篇 |
综合类 | 9篇 |
预防医学 | 8篇 |
眼科学 | 4篇 |
药学 | 13篇 |
肿瘤学 | 20篇 |
出版年
2022年 | 2篇 |
2021年 | 5篇 |
2018年 | 6篇 |
2016年 | 4篇 |
2015年 | 9篇 |
2014年 | 9篇 |
2013年 | 14篇 |
2012年 | 6篇 |
2011年 | 10篇 |
2010年 | 23篇 |
2009年 | 20篇 |
2008年 | 8篇 |
2007年 | 6篇 |
2006年 | 11篇 |
2005年 | 7篇 |
2004年 | 4篇 |
2003年 | 8篇 |
2002年 | 3篇 |
2001年 | 6篇 |
2000年 | 4篇 |
1999年 | 8篇 |
1998年 | 35篇 |
1997年 | 48篇 |
1996年 | 45篇 |
1995年 | 36篇 |
1994年 | 19篇 |
1993年 | 22篇 |
1992年 | 6篇 |
1991年 | 12篇 |
1990年 | 8篇 |
1989年 | 17篇 |
1988年 | 28篇 |
1987年 | 21篇 |
1986年 | 23篇 |
1985年 | 13篇 |
1984年 | 5篇 |
1983年 | 5篇 |
1982年 | 6篇 |
1981年 | 14篇 |
1980年 | 7篇 |
1979年 | 5篇 |
1978年 | 9篇 |
1977年 | 10篇 |
1976年 | 6篇 |
1975年 | 9篇 |
1972年 | 2篇 |
1971年 | 1篇 |
1970年 | 1篇 |
1966年 | 1篇 |
1965年 | 1篇 |
排序方式: 共有592条查询结果,搜索用时 15 毫秒
581.
582.
Systemic non‐biological agents (NBAs) have been extensively used for immunosuppression in clinical medicine, often with considerable efficacy, although sometimes accompanied with adverse effects as with all medicines. With the advent of biological agents, all of which currently are restricted to systemic use, there is a rising need to identify which agents have the better therapeutic ratio. The NBAs include a range of agents, most especially the corticosteroids (corticosteroids). This article reviews the purine synthesis inhibitors (azathioprine and mycophenolate), which are currently the most commonly used systemically immunosuppressive agents in the management of orofacial mucocutaneous diseases. Subsequent articles discuss other corticosteroid‐sparing agents used in the management of orofacial disease, such as calcineurin inhibitors, and the cytotoxic and other immunomodulatory agents. 相似文献
583.
Sabina AR. Barbur Christopher M. Jordan Morgan EA. Bailey Christopher M. Jack 《Orthopaedics and Trauma》2018,32(2):66-70
Pelvic ring injuries are a major cause of morbidity and mortality in the polytrauma patient. Mortality rates from pelvic ring injuries have declined, unrelated to injury severity. This is due to an improved understanding of trauma as a disease, initial and subsequent management options. There are a number of guidelines pertaining to these injuries. These have been brought together to provide an overview of the current guidance on the emergent management of these complex injuries. The foundations of treatment for these injuries includes the following: recognition of the high energy involved, rapid assessment, resuscitation and temporary stabilization of bony and soft tissue injuries. It is important to involve a multidisciplinary team prior to definitive management. By following the guidance set out by this article, the orthopaedic trauma team in the receiving hospital can optimize the patient and prepare them for transfer to the regional major trauma centre. This will improve patient morbidity and mortality and ensure standardization of pelvic trauma management in the first 24 hours. 相似文献
584.
JL Steiner JM Davis JL McClellan RT Enos JA Carson R Fayad M Nagarkatti PS Nagarkatti D Altomare KE Creek EA Murphy 《Cancer biology & therapy》2014,15(11):1456-1467
Breast cancer is the leading cause of cancer related death in women. Quercetin is a flavonol shown to have anti-carcinogenic actions. However, few studies have investigated the dose-dependent effects of quercetin on tumorigenesis and none have used the C3(1)/SV40 Tag breast cancer mouse model. At 4 weeks of age female C3(1)/SV40 Tag mice were randomized to one of four dietary treatments (n = 15–16/group): control (no quercetin), low-dose quercetin (0.02% diet), moderate-dose quercetin (0.2% diet), or high-dose quercetin (2% diet). Tumor number and volume was assessed twice a week and at sacrifice (20 wks). Results showed an inverted ‘U’ dose-dependent effect of dietary quercetin on tumor number and volume; at sacrifice the moderate dose was most efficacious and reduced tumor number 20% and tumor volume 78% compared to control mice (C3-Con: 9.0 ± 0.9; C3-0.2%: 7.3 ± 0.9) and (C3-Con: 2061.8 ± 977.0 mm3; and C3-0.2%: 462.9 ± 75.9 mm3). Tumor volume at sacrifice was also reduced by the moderate dose compared to the high and low doses (C3-2%: 1163.2 ± 305.9 mm3; C3-0.02%: 1401.5 ± 555.6 mm3), as was tumor number (C3-2%: 10.7 ± 1.3 mm3; C3-0.02%: 8.1 ± 1.1 mm3). Gene expression microarray analysis performed on mammary glands from C3-Con and C3-0.2% mice determined that 31 genes were down-regulated and 9 genes were up-regulated more than 2-fold (P < 0.05) by quercetin treatment. We report the novel finding that there is a distinct dose-dependent effect of quercetin on tumor number and volume in a transgenic mouse model of human breast cancer, which is associated with a specific gene expression signature related to quercetin treatment. 相似文献
585.
586.
Francisco Leyva Paul WX Foley Shajil Chalil Karim Ratib Russell EA Smith Frits Prinzen Angelo Auricchio 《Journal of cardiovascular magnetic resonance》2011,13(1):29
Background
Myocardial scarring at the LV pacing site leads to incomplete resynchronization and a suboptimal symptomatic response to CRT. We sought to determine whether the use of late gadolinium cardiovascular magnetic resonance (LGE-CMR) to guide left ventricular (LV) lead deployment influences the long-term outcome of cardiac resynchronization therapy (CRT).Methods
559 patients with heart failure (age 70.4 ± 10.7 yrs [mean ± SD]) due to ischemic or non-ischemic cardiomyopathy underwent CRT. Implantations were either guided (+CMR) or not guided (-CMR) by LGE-CMR prior to implantation. Fluoroscopy and LGE-CMR were used to localize the LV lead tip and and myocardial scarring retrospectively. Clinical events were assessed in three groups: +CMR and pacing scar (+CMR+S); CMR and not pacing scar (+CMR-S), and; LV pacing not guided by CMR (-CMR).Results
Over a maximum follow-up of 9.1 yrs, +CMR+S had the highest risk of cardiovascular death (HR: 6.34), cardiovascular death or hospitalizations for heart failure (HR: 5.57) and death from any cause or hospitalizations for major adverse cardiovascular events (HR: 4.74) (all P < 0.0001), compared with +CMR-S. An intermediate risk of meeting these endpoints was observed for -CMR, with HRs of 1.51 (P = 0.0726), 1.61 (P = 0.0169) and 1.87 (p = 0.0005), respectively. The +CMR+S group had the highest risk of death from pump failure (HR: 5.40, p < 0.0001) and sudden cardiac death (HR: 4.40, p = 0.0218), in relation to the +CMR-S group.Conclusions
Compared with a conventional implantation approach, the use of LGE-CMR to guide LV lead deployment away from scarred myocardium results in a better clinical outcome after CRT. Pacing scarred myocardium was associated with the worst outcome, in terms of both pump failure and sudden cardiac death. 相似文献587.
588.
Hemofiltration compared to hemodialysis for acute kidney injury: systematic review and meta-analysis
JO Friedrich R Wald SM Bagshaw KE Burns NK Adhikari 《Critical care (London, England)》2012,16(4):R146-16
ABSTRACT: INTRODUCTION: The objective of this systematic review and meta-analysis was to determine the effect of renal replacement therapy (RRT), delivered as hemofiltration vs. hemodialysis, on clinical outcomes in patients with acute kidney injury (AKI). METHODS: MEDLINE, EMBASE, and CENTRAL databases and conference abstracts were searched to June 2012 for parallel-group or crossover randomized and quasi-randomized controlled trials (RCTs) evaluating hemofiltration vs. hemodialysis in patients with AKI. Two authors independently selected studies and abstracted data on study quality and outcomes. Additional information was obtained from trial authors. We pooled data using random-effects models. RESULTS: Of 6657 citations, 19 RCTs (10 parallel-group and 9 crossover) met inclusion criteria. Sixteen trials used continuous RRT. Study quality was variable. The primary analysis included 3 parallel-group trials comparing similar doses of hemofiltration and hemodialysis; sensitivity analyses included trials comparing combined hemofiltration-hemodialysis or dissimilar doses. We found no effect of hemofiltration on mortality (risk ratio [RR] 0.96, 95% confidence interval [CI] 0.73-1.25, p=0.76; 3 trials, n=121 [primary analysis]; RR 1.10, 95%CI 0.88-1.38, p=0.38; 8 trials, n=540 [sensitivity analysis]) or other clinical outcomes (RRT dependence in survivors, vasopressor use, organ dysfunction) compared to hemodialysis. Hemofiltration appeared to shorten time to filter failure (mean difference [MD] -7 hours, 95%CI[-19,+5], p=0.24; 2 trials, n=50 [primary analysis]; MD -5 hours, 95%CI[-10, -1], p=0.01; 3 trials, n=113 [including combined hemofiltration-hemodialysis trials comparing similar doses]; MD -6 hours, 95% CI[-10, -1], p=0.02; 5 trials, n=383 [sensitivity analysis]). Data primarily from crossover RCTs suggested that hemofiltration increased clearance of medium to larger molecules, including inflammatory cytokines, compared to hemodialysis, although almost no studies measured changes in serum concentrations. Meta-analyses were based on very limited data. CONCLUSIONS: Data from small RCTs do not suggest beneficial clinical outcomes from hemofiltration, but confidence intervals were wide. Hemofiltration may increase clearance of medium to larger molecules. Larger trials are required to evaluate effects on clinical outcomes. 相似文献
589.
Ron Wald Jan O Friedrich Sean M Bagshaw Karen EA Burns Amit X Garg Michelle A Hladunewich Andrew A House Stephen Lapinsky David Klein Neesh I Pannu Karen Pope Robert M Richardson Kevin Thorpe Neill KJ Adhikari 《Critical care (London, England)》2012,16(5):R205
Introduction
Among critically ill patients with acute kidney injury (AKI) needing continuous renal replacement therapy (CRRT), the effect of convective (via continuous venovenous hemofiltration [CVVH]) versus diffusive (via continuous venovenous hemodialysis [CVVHD]) solute clearance on clinical outcomes is unclear. Our objective was to evaluate the feasibility of comparing these two modes in a randomized trial.Methods
This was a multicenter open-label parallel-group pilot randomized trial of CVVH versus CVVHD. Using concealed allocation, we randomized critically ill adults with AKI and hemodynamic instability to CVVH or CVVHD, with a prescribed small solute clearance of 35 mL/kg/hour in both arms. The primary outcome was trial feasibility, defined by randomization of >25% of eligible patients, delivery of >75% of the prescribed CRRT dose, and follow-up of >95% of patients to 60 days. A secondary analysis using a mixed-effects model examined the impact of therapy on illness severity, defined by sequential organ failure assessment (SOFA) score, over the first week.Results
We randomized 78 patients (mean age 61.5 years; 39% women; 23% with chronic kidney disease; 82% with sepsis). Baseline SOFA scores (mean 15.9, SD 3.2) were similar between groups. We recruited 55% of eligible patients, delivered >80% of the prescribed dose in each arm, and achieved 100% follow-up. SOFA tended to decline more over the first week in CVVH recipients (-0.8, 95% CI -2.1, +0.5) driven by a reduction in vasopressor requirements. Mortality (54% CVVH; 55% CVVHD) and dialysis dependence in survivors (24% CVVH; 19% CVVHD) at 60 days were similar.Conclusions
Our results suggest that a large trial comparing CVVH to CVVHD would be feasible. There is a trend toward improved vasopressor requirements among CVVH-treated patients over the first week of treatment.Trial Registration
ClinicalTrials.gov: NCT00675818相似文献590.
John M Finney A Sarah Walker Tim EA Peto David H Wyllie 《BMC medical informatics and decision making》2011,11(1):7