全文获取类型
收费全文 | 1697篇 |
免费 | 103篇 |
国内免费 | 14篇 |
专业分类
耳鼻咽喉 | 8篇 |
儿科学 | 46篇 |
妇产科学 | 55篇 |
基础医学 | 177篇 |
口腔科学 | 33篇 |
临床医学 | 171篇 |
内科学 | 487篇 |
皮肤病学 | 18篇 |
神经病学 | 81篇 |
特种医学 | 46篇 |
外科学 | 301篇 |
综合类 | 26篇 |
预防医学 | 126篇 |
眼科学 | 37篇 |
药学 | 94篇 |
中国医学 | 1篇 |
肿瘤学 | 107篇 |
出版年
2023年 | 20篇 |
2022年 | 45篇 |
2021年 | 75篇 |
2020年 | 58篇 |
2019年 | 53篇 |
2018年 | 68篇 |
2017年 | 49篇 |
2016年 | 50篇 |
2015年 | 53篇 |
2014年 | 62篇 |
2013年 | 66篇 |
2012年 | 131篇 |
2011年 | 127篇 |
2010年 | 95篇 |
2009年 | 97篇 |
2008年 | 119篇 |
2007年 | 123篇 |
2006年 | 100篇 |
2005年 | 102篇 |
2004年 | 95篇 |
2003年 | 69篇 |
2002年 | 71篇 |
2001年 | 9篇 |
2000年 | 4篇 |
1999年 | 7篇 |
1998年 | 12篇 |
1997年 | 8篇 |
1996年 | 4篇 |
1995年 | 12篇 |
1994年 | 3篇 |
1993年 | 3篇 |
1992年 | 2篇 |
1991年 | 3篇 |
1990年 | 2篇 |
1989年 | 1篇 |
1988年 | 2篇 |
1987年 | 5篇 |
1983年 | 1篇 |
1982年 | 2篇 |
1981年 | 1篇 |
1980年 | 2篇 |
1972年 | 1篇 |
1967年 | 2篇 |
排序方式: 共有1814条查询结果,搜索用时 296 毫秒
91.
92.
Five community partnerships (CP) were initiated in South Africa as demonstration projects aimed at the re-orientation of health professionals' education (HPE) to be more community responsive and interprofessional. A cluster evaluation of these partnerships has demonstrated that, in addition to motivating all stakeholders to forge closer working relationships, it is necessary for partnerships to pay close attention to a variety of structural and operational dimensions, the lack of which could prove to be major constraints to effective partnership functioning. This study critically reviews the challenges to collaborative working as experienced by the South African cluster. Within the context of the post-apartheid restructuring and development, the discussion highlights the insights that partnerships offer to clarify the extent to which potential barriers could affect the stakeholder groups. The paper identifies potential impediments, and makes explicit how they impact on partnership fostering. Evidence is also presented for their early detection and possible solutions are identified. The lessons learnt from these South African cases are that wide representation, commitment and a sense of ownership, sound leadership skills, regular and effective communication, reliable member expertise and capabilities and attention to power issues are crucial elements in the partnership equation. The paper concludes with an invitation to health administrators and partnership executives to devote attention to the array of interacting components that, collectively, could impinge on the effectiveness of the multifaceted nature of interprofessional joint working arrangements. 相似文献
93.
Walid H. El-Tantawy Heba F. Salem Nirmeen A. S. Mohammed Safwat 《Pharmacy World & Science》2007,29(3):190-198
Objectives To study the clinical efficacy of Triclabendazole (TCBZ) on Egyptian patients infected with Fasciola and understand the effect
of Fascioliasis on the pharmacokinetics of TCBZ.
Methods The pharmacokinetics of TCBZ administered as a single oral dose (10 mg/kg) was investigated in both infected and parasite––free
Egyptian subjects. After oral administration, TCBZ is metabolized to a sulphone and sulfoxide derivatives. The latter is responsible
for the fasciolicidal activity of TCBZ, and it could be used as a marker of drug bioavailability. Blood samples were collected
following the oral administration, and TCBZ sulfoxide plasma concentrations were determined by a sensitive and specific HPLC
method.
Results Pharmacokinetic parameters (C
max, AUC0–48,
t
1/2 and t
max) for TCBZ sulfoxide were calculated. In patients; the mean C
max was 9.11 ± 1.3 μg/ml, the mean AUC (0–48) was 91 ± 10.5 μg h ml−1, the mean t
1/2 was 7.4 ± 0.6 h, and the t
max was 3.0 ± 0.4 h. In normal subjects, the mean C
max was 8.48 ± 0.92 μg/ml, the mean AUC(0–48) was 85 ± 6.55 μg h ml−1, the mean t
1/2 was 6.2 ± 0.357 h, and the t
max was 3 ± 0.4 h. No significant difference could be detected in the patients as compared to normal subjects, which would suggest
that Fascioliasis does not affect any of the studied parameters.
No eggs in faeces could be detected following TCBZ treatment. Also, most of the clinical investigations showed significant
decline back to the normal ranges post-treatment which indicates complete curing and high TCBZ efficacy.
Conclusion Fasioliasis as an infective condition widely spread in Egypt has no significant effect on the pharmacokinetic parameters of
the orally administered TCBZ and at the same time it is very effective against the parasite which strongly and safely suggests
the use of this medication for the treatment of this infection. 相似文献
94.
Takrouri MS Seraj MA Channa AB el-Dawlatly AA Thallage A Riad W Khalaf M 《Middle East journal of anesthesiology》2002,16(6):587-595
BACKGROUND: Dexmedetomidine is a potent new alpha-2 adrenoceptor agonist with an alpha-2 to alpha- ratio more than 7 times that of clonidine. Its potent sedative, analgesic and sympatholytic effects blunt the cardiovascular responses (hypertension, tachycardia) without unexpected toxicity. Many reports confirmed its pharmacological properties if given by infusion. Recent report confirmed favorable non-depressant effect on respiration and blood gases. SETTING: ICU patients at King Khalid University Hospital. PATIENTS AND METHOD: Open label clinical evaluation on ten surgical patient ASA I class received dexmeditomidine infusion to the sedative effect level of Ramsy scale of 3 for ventilated patients and 2 for spontaneously breathing patient. The clinical observation and analgesic requirement as well as the hemodynamic parameters and hemoglobin oxygen saturation were observed for the period of ventilation and weaning till discharge from the ICU. These records were subjected to paired t test for values measured at preinfusion period compared to 10 minutes and 6 hours measurement after infusion. RESULTS: The study confirmed the previous findings of previous reports regarding the cardiovascular stability and non depressive effect on respiration. It also confirmed the sparing effect on the use of analgesics which indicates its analgesic effect. The sedation quality is unique in that the patient is easily arousable. This was reported favorably by the nursing staff. Bradycardia was observed in one patient who was treated effectively by stopping the infusion. CONCLUSION: We concluded that dexmedetomidine is useful sedative agent with analgesic properties which reduce the analgesic requirement of the patient. The patient were ventilated, weaned, then breathed spontaneously in a satisfactory manner. 相似文献
95.
Novick RJ Fox SA Stitt LW Kiaii BB Abu-Khudair W Lee A Benmusa A Swinamer SA Rayman R Menkis AH McKenzie FN Quantz MA Boyd WD 《Journal of cardiac surgery》2002,17(6):520-528
BACKGROUND AND AIM: We have shown that cumulative sum (CUSUM) failure analysis may be more sensitive than standard statistical methods in detecting a cluster of adverse patient outcomes after cardiac surgical procedures. We therefore applied CUSUM, as well as standard statistical techniques, to analyze a surgeon's experience with off-pump coronary artery bypass grafting (OPCAB) and on-pump procedures to determine whether the two techniques have similar or different outcomes. METHODS: In 320 patients undergoing nonemergent, first time coronary artery bypass grafting, preoperative patient characteristics, rates of mortality and major complications, and ICU and hospital lengths of stay were compared between the on-pump and OPCAB cohorts using Fisher's exact tests and Wilcoxon two sample tests. Predicted mortality and length of stay were determined using previously validated models of the Cardiac Care Network of Ontario. Observed versus expected ratios of both variables were calculated for the two types of procedures. Furthermore, CUSUM curves were constructed for the on-pump and OPCAB cohorts. A multivariable analysis of the predictors of hospital length of stay was also performed to determine whether the type of coronary artery bypass procedure had an independent impact on this variable. RESULTS: The predicted mortality risk and predicted hospital length of stay were almost identical in the 208 on-pump patients (2.2 +/- 3.9%; 8.2 +/- 2.5 days) and the 112 OPCAB patients (2.0 +/- 2.2%; 7.8 +/- 2.1 days). The incidence of hospital mortality and postoperative stroke were 2.9% and 2.4% in on-pump patients versus zero in OPCAB patients (p = 0.09 and 0.17, respectively). Mechanical ventilation for greater than 48 hours was significantly less common in OPCAB (1.8%) than in on-pump patients (7.7%, p = 0.04). The rate of 10 major complications was 14.9% in on-pump versus 8.0% in OPCAB patients (p = 0.08). OPCAB patients experienced a hospital length of stay that was a median of 1.0 day shorter than on-pump patients (p = 0.01). The observed versus expected ratio for length of stay was 0.78 in OPCAB patients versus 0.95 in on-pump patients. On CUSUM analysis, the failure curve in OPCAB patients was negative and was flatter than that of on-pump patients throughout the duration of the study. Furthermore, OPCAB was an independent predictor of a reduced hospital length of stay on multivariable analysis. CONCLUSIONS: OPCAB was associated with better outcomes than on-pump coronary artery bypass despite a similar predicted risk. This robust finding was documented on sensitive CUSUM analysis, using standard statistical techniques and on a multivariable analysis of the independent predictors of hospital length of stay. 相似文献
96.
Thoracoscopic sympathectomy: endobronchial anesthesia vs endotracheal anesthesia with intrathoracic CO2 insufflation 总被引:1,自引:0,他引:1
El-Dawlatly A Al-Dohayan A Riyad W Thalaj A Delvi B Al-Saud S 《Journal of anesthesia》2002,16(1):13-16
Purpose. To compare clinical advantages and hemodynamic and respiratory changes during one lung-collapsed ventilation (OLCV) using
a double-lumen tube (DLT) or a single-lumen tube (SLT) with intrathoracic CO2 insufflation, in patients undergoing thoracic sympathectomy (TS) under general anesthesia.
Methods. One hundred and twenty-five patients (94 men and 31 women) undergoing TS for the treatment of palmar hyperhidrosis (PH)
were randomly allocated to two groups: group A (68 patients; age, 29 ± 6 years) in whom DLT was used, and group B (57 patients;
age, 32 ± 3 years) in whom SLT with intrathoracic CO2 insufflation at a rate of 0.5–1 l·min−1 and sustained intrathoracic pressure at 6 mmHg insufflation were used. Anesthesia was maintained with 1 minimum alveolar
concentration (MAC) isoflurane in 50% nitrous oxide in oxygen with incremental doses of sufentanil and atracurium when required.
Arterial blood gases were measured in 10 patients in group B. Hemodynamic and respiratory parameters were obtained perioperatively.
Results. There were no significant differences in hemodynamic and respiratory parameters between the two groups during the study
phases, except for the arterial oxygen saturation (SpO2). The times required for anesthesia and surgery were significantly shorter in the SLT group than in the DLT group. SpO2 during OLCV was 95 ± 1% with DLT and 98 ± 1% with SLT, with a significant difference. Three patients had an SpO2 of less than 90% in the recovery room, where the chest tube position was readjusted, with no further sequelae.
Conclusion. General anesthesia with SLT and intrathoracic CO2 insufflation provides optimal operating conditions, adequate oxygenation, and perfect hemodynamic stability during TS.
Received: November 28, 2000 / Accepted: August 8, 2001 相似文献
97.
98.
Trigui W Le Pimpec-Barthes F Shaker W Lang-Lazdunski L Riquet M 《The Annals of thoracic surgery》2002,74(3):923-924
The simultaneous occurrence of bronchopleural fistula (BPF) and esophagopleural fistula (EPF) after pneumonectomy is very rare. We describe a 60-year-old man who developed empyema associated with bronchopleural fistula as a complication of a right pneumonectomy. Initial chest tube drainage and antibiotic therapy were ineffective. Five months later ingested food particles appeared in the drainage fluid. Esophagoscopy revealed an esophageal fistula of 10 mm in diameter. After nutritional support by feeding jejunostomy both BPF and EPF were repaired by subscapular muscle myoplasty and extensive thoracoplasty through a right thoracotomy. Endoscopic examination performed 1 month after surgery showed complete closure of both fistulas and 9 months after surgery the patient was eating and gaining weight. The patient's death was due to aspiration pneumonia of another origin. 相似文献
99.
100.
BACKGROUND: Invasive ductal carcinoma of the breast is a heterogeneous collection of divergent types of carcinomas. Some subtypes have been characterized by histologic observations. This study describes a distinctive subset recognized through cytomorphologic examination of breast carcinoma specimens obtained by fine-needle aspiration biopsies (FNAB). Identification of this subset is established further by analyses of its clinical and immunologic characteristics. METHODS: One hundred patients underwent FNAB and were diagnosed with breast ductal carcinoma. These diagnoses were followed by surgical resections and histologic evaluation of tumors. Immunohistochemical analyses of estrogen receptor, progesterone receptor, Her2/neu, p53 protein, and Ki-67 were performed. Patient's age, race, and family history of breast carcinoma were obtained. The objective of the study is to identify a cytomorphologically distinctive, clinically relevant, subset of breast carcinomas. RESULTS: A subset carcinoma was recognized by cytomorphologic examination of Pap-stained FNAB slides. This subset consisted of seven patients with a median age of 37 years. At the time of surgical resection, all patients had axillary lymph node metastases. Six of seven patients had distant metastases. Immunohistochemical studies revealed that all tumors are positive for p53 protein and negative for estrogen and progesterone receptors. CONCLUSION: This study presented a unique subset of breast ductal carcinomas that involved young patients and had aggressive growth behavior. These tumors expressed p53 protein but not estrogen and progesterone receptors. 相似文献