全文获取类型
收费全文 | 12383篇 |
免费 | 555篇 |
国内免费 | 86篇 |
专业分类
耳鼻咽喉 | 157篇 |
儿科学 | 242篇 |
妇产科学 | 95篇 |
基础医学 | 1615篇 |
口腔科学 | 266篇 |
临床医学 | 745篇 |
内科学 | 3272篇 |
皮肤病学 | 158篇 |
神经病学 | 750篇 |
特种医学 | 486篇 |
外科学 | 2228篇 |
综合类 | 73篇 |
一般理论 | 4篇 |
预防医学 | 318篇 |
眼科学 | 241篇 |
药学 | 746篇 |
中国医学 | 46篇 |
肿瘤学 | 1582篇 |
出版年
2023年 | 96篇 |
2022年 | 188篇 |
2021年 | 310篇 |
2020年 | 152篇 |
2019年 | 211篇 |
2018年 | 298篇 |
2017年 | 210篇 |
2016年 | 309篇 |
2015年 | 265篇 |
2014年 | 368篇 |
2013年 | 441篇 |
2012年 | 779篇 |
2011年 | 826篇 |
2010年 | 473篇 |
2009年 | 384篇 |
2008年 | 774篇 |
2007年 | 811篇 |
2006年 | 800篇 |
2005年 | 814篇 |
2004年 | 751篇 |
2003年 | 687篇 |
2002年 | 716篇 |
2001年 | 180篇 |
2000年 | 145篇 |
1999年 | 170篇 |
1998年 | 190篇 |
1997年 | 161篇 |
1996年 | 124篇 |
1995年 | 115篇 |
1994年 | 96篇 |
1993年 | 102篇 |
1992年 | 95篇 |
1991年 | 125篇 |
1990年 | 79篇 |
1989年 | 91篇 |
1988年 | 93篇 |
1987年 | 76篇 |
1986年 | 46篇 |
1985年 | 46篇 |
1984年 | 52篇 |
1983年 | 46篇 |
1982年 | 32篇 |
1981年 | 25篇 |
1980年 | 22篇 |
1979年 | 19篇 |
1978年 | 23篇 |
1977年 | 19篇 |
1976年 | 19篇 |
1974年 | 19篇 |
1969年 | 19篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
81.
J. Mark Ebertz Jeanne M. Hermens J. Clifford McMillan Hideo Uno Carol Hirshman Jon M. Hanifin 《Inflammation research》1986,18(5-6):455-462
Intravenous administration of morphine sulfate often produces urticarial and hypotensive reactions associated with elevations in plasma histamine. The source of this histamine and mechanisms controlling its release are poorly understood. Previous studies of morphine-induced histamine release compared human leukocytes to rat peritoneal mast cells. The effects of morphine on human cutaneous mast cells has not been examined. We studiedin vitro histamine release from human basophils and human skin preparations containing cutaneous mast cells to evaluate their relative, contribution to the pharmacologic effects of morphine.Human skin mast cell preparations showed dosedependent histamine release over a morphine concentration range of 1.5×10–5 to 4.5×10–3
M, with peak release occurring at 5×10–4
M, with peak release occurring at 5×10–4
M. Clinically, morphine sulfate is usually injected as a 1.5×10–2
M solution. Histamine release was calcium dependent and equivalent to that obtained with 3 and 10 mM strontium. Morphologic examination revealed degranulation and exocytosis occurring in morphine-stimulated tissue but not in specimens exposed to buffer alone. Lactate dehydrogenase levels did not increase following morphine incubation, thus supporting a noncytolytic mechanism of histamine release.Basophils, in contrast, showed no significant histamine release from exposure to morphine up to 10–2
M. Concanavalin A, as a positive control in these same preparations, produced a mean histamine release of 21.0%.Our studies indicate distinct functional differences between human skin mast cell and human blood basophil responses to morphine sulfate. We conclude that the cutaneous and systemic reactions to morphine sulfate probably result from the release of histamine from mast cells rather than from basophils.This study was supported by: National Institutes of Health Grants 2-T32 AMO7153, 5-RO1 AI18615, AI 15557, HL 25831, American Society of Anesthesiologists Starter Grant 1283, and a grant from the Bramble Foundation. 相似文献
82.
(1) The spread of epidural analgesia following injection of 15ml of 2% mepivacaine was 17.3 ± 0.6, 14.3 ± 0.4, and 13.3 ± 0.7 spinal segments in cervical, thoracic, and lumbar epidural analgesia, respectively. The patients age showed significant correlation with the spread of epidural analgesia in cervical (r = 0.5776, p < 0.001), thoracic (r = 0.3758, p < 0.01), and lumbar area (r = 0.8195, p < 0.001). The spread of cervical epidural analgesia was more caudad than cephalad (p < 0.05), but in lumbar epidural analgesia it was more cephalad than caudad (p < 0.05). There was no difference between the cephalad and caudad spread in thoracic epidural analgesia.(2) The epidural pressure immediately after injection of 15ml of 2% mepivacaine into the lumbar epidural space at a constant pressure (80mmHg) correlated to the patients age (r = –0.5714, p < 0.001) and the spread of analgesia (r = –0.3904, p < 0.05). The lower epidural pressure associated with higher age, the wider spread of analgesia. There was no significant correlation between the residual pressure at 60 seconds and the age or the spread of analgesia.(Hirabayashi Y et al.: Spread of epidural analgesia following a constant pressure injection: an investigation of relationships between locus of injection, epidural pressure and spread of analgesia. J Anesth 1: 44–50, 1987) 相似文献
83.
Goto Y Takahashi K Harada J Sugiura Y Aso K Takanami C Nakajima K Yagi Y Urano H 《Journal of anesthesia》1987,1(2):178-182
Concerning the classification of ventilators, Elam (1958), Faireley (1959), and Hunter (1961) reported some simple ones such as pressure limited, volume limited, pressure preset, or volume preset models. Mapleson (1969) also classified them by the generating force or cycling together with the above-mentioned types.The latest ventilators applicable to patients with respiratory failure usually have some cut-off function at high airway pressures as a safety measure. Therefore, all of them belong to the pressure limited type. Some ventilators are of two types such as the time cycled and pressure cycled type.Therefore, we attempted to classify ventilators into four groups, i.e. the time cycled, volume cycled, pressure cycled and selective time-pressure cycled types according to the fundamental mode of ventilator function, the so-called change of cycling from inspiration to expiration. Each group was further divided into subgroups according to preset dials such as respiratory rate, I/E ratio, inspiration time, expiration time, tidal volume, flow rate and airway pressure.By this method, fifty one ventilators on the market in Japan can be classified without overlapping. Although this classification seems complex, it will be of use in selecting ventilators by emphasizing preset dials according to the users needs, ability or both.(Goto Y, Takahashi K, Harada J et al.: A consideration on the new classification of latest lung ventilators. J Anesth 1: 178–182, 1987) 相似文献
84.
The relationships between the epidural pressures following the injection of local anesthetic solution and the spread of epidural analgesia were investigated. In 46 patients, 15ml of 2% mepivacaine was injected into the lumbar epidural space at a constant rate (1ml/sec) using an electropowered syringe pump. Injection pressures and residual pressures were recorded and the spread of analgesia to pinprick was assessed. The changes of the epidural pressures during and following the injection of a volume of local anesthetic solution in old subjects were significantly smaller than those in young subjects (P < 0.05). The spread of analgesia closely correlated with the epidural pressures during and following the injection of local anesthetic solution. The most close correlation was found between the epidural pressure immediately after the completion of injection and the spread of analgesia (r = –0.5659, P < 0.001). In conclusion, the lower the terminal injection pressure and the residual pressures associated with higher age, the wider the spread of epidural analgesia.(Hirabayashi Y, Matsuda I, Inoue S et al.: Epidural pressure and its relation to spread of epidural analgesia. J Anesth 1: 168–172, 1987) 相似文献
85.
Kenya Kusunose Yuichiro Okushi Yoshihiro Okayama Robert Zheng Miho Abe Michikazu Nakai Yoko Sumita Takayuki Ise Takeshi Tobiume Koji Yamaguchi Shusuke Yagi Daiju Fukuda Hirotsugu Yamada Takeshi Soeki Tetsuzo Wakatsuki Masataka Sata 《Nutrients》2021,13(2)
A broad range of chronic conditions, including heart failure (HF), have been associated with vitamin D deficiency. Existing clinical trials involving vitamin D supplementation in chronic HF patients have been inconclusive. We sought to evaluate the outcomes of patients with vitamin D supplementation, compared with a matched cohort using real-world big data of HF hospitalization. This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Datasets (JROAD-DPC). After exclusion criteria, we identified 93,692 patients who were first hospitalized with HF between April 2012 and March 2017 (mean age was 79 ± 12 years, and 52.2% were male). Propensity score (PS) was estimated with logistic regression model, with vitamin D supplementation as the dependent variable and clinically relevant covariates. On PS-matched analysis with 10,974 patients, patients with vitamin D supplementation had lower total in-hospital mortality (6.5 vs. 9.4%, odds ratio: 0.67, p < 0.001) and in-hospital mortality within 7 days and 30 days (0.9 vs. 2.5%, OR, 0.34, and 3.8 vs. 6.5%, OR: 0.56, both p < 0.001). In the sub-group analysis, mortalities in patients with age < 75, diabetes, dyslipidemia, atrial arrhythmia, cancer, renin-angiotensin system blocker, and β-blocker were not affected by vitamin D supplementation. Patients with vitamin D supplementation had a lower in-hospital mortality for HF than patients without vitamin D supplementation in the propensity matched cohort. The identification of specific clinical characteristics in patients benefitting from vitamin D may be useful for determining targets of future randomized control trials. 相似文献
86.
Junko Ueshima Ryo Momosaki Akio Shimizu Keiko Motokawa Mika Sonoi Yuka Shirai Chiharu Uno Yoji Kokura Midori Shimizu Ai Nishiyama Daisuke Moriyama Kaori Yamamoto Kotomi Sakai 《Nutrients》2021,13(3)
Malnutrition negatively affects the quality of life of patients with dysphagia. Despite the need for nutritional status assessment in patients with dysphagia, standard, effective nutritional assessments are not yet available, and the identification of optimal nutritional assessment items for patients with dysphagia is inadequate. We conducted a scoping review of the use of nutritional assessment items in adult patients with oropharyngeal and esophageal dysphagia. The MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials databases were searched to identify articles published in English within the last 30 years. Twenty-two studies met the inclusion criteria. Seven nutritional assessment categories were identified: body mass index (BMI), nutritional screening tool, anthropometric measurements, body composition, dietary assessment, blood biomarkers, and other. BMI and albumin were more commonly assessed in adults. The Global Leadership Initiative on Malnutrition (GLIM), defining new diagnostic criteria for malnutrition, includes the categories of BMI, nutritional screening tool, anthropometric measurements, body composition, and dietary assessment as its required components, but not the blood biomarkers and the “other” categories. We recommend assessing nutritional status, including GLIM criteria, in adult patients with dysphagia. This would standardize nutritional assessments in patients with dysphagia and allow future global comparisons of the prevalence and outcomes of malnutrition, as well as of appropriate interventions. 相似文献
87.
Takuya Sekiguchi Yoshihiro Hagiwara Akira Ando Kenji Kanazawa Kazuaki Suzuki Masashi Koide Yutaka Yabe Satsuki Onoda Eiji Itoi 《Journal of orthopaedic science》2021,26(4):595-598
BackgroundThe Shoulder Pain and Disability Index (SPADI) is a simple disease specific questionnaire that is used to evaluate the impact of shoulder disorders. The purpose of this study was to translate the SPADI into Japanese (SPADI-Jp) and evaluate its reliability and validity in Japanese patients with shoulder disorders.MethodsCross-cultural adaptation of the SPADI was performed according to international guidelines. A total of 100 patients with shoulder disorders participated in this study. Each participant was asked to finish the SPADI-Jp, Disability of Arm, Shoulder and Hand (DASH), and the Short-Form 36 (SF-36) at the initial visit. Thirty-four patients repeated the SPADI-Jp to assess the test–retest reliability. The test–retest reliability was quantified using the interclass correlation coefficient (ICC), while Cronbach's alpha was calculated to assess the internal consistency. The construct validity was assessed using Spearman's rank correlation coefficients.ResultsInternal consistency in the SPADI-Jp was very high (0.969), as measured by the Cronbach's alpha. The ICC of the SPADI-Jp was 0.930. There was a strong, positive correlation between the DASH and the SPADI-Jp (r = 0.837, p < 0.001). The SPADI-Jp was significantly correlated with most of the SF-36 subscales. The correlations of the SPADI-Jp with physical subscales of the SF-36 were stronger than those with the other subscales.ConclusionsWe demonstrated that the SPADI-Jp is a reliable and valid self-assessment tool. Because cross-cultural adaptation, validation, and reliability of the disease-specific questionnaire for shoulder pain and disability have not been evaluated in Japan, the SPADI-Jp can be useful for evaluating such patients in the Japanese population. 相似文献
88.
Hideyuki Arima Yu Yamato Kimihito Sato Yoshihiro Uchida Toshiyuki Tsuruta Kanehisa Hashiguchi Hajime Hamamoto Eiichiro Watanabe Kaoru Yamanaka Tomohiko Hasegawa Go Yoshida Tatsuya Yasuda Tomohiro Banno Shin Oe Hiroki Ushirozako Tomohiro Yamada Koichiro Ide Yuh Watanabe Yukihiro Matsuyama 《Journal of orthopaedic science》2021,26(4):577-583
BackgroundSagittal spino-pelvic malalignment in patients with chronic low back pain (CLBP) have been reported in the past, which may also affect cervical spine lesions. The purpose of this study is to investigate the cervical alignment in patients with CLBP.MethodOf the patients who visited an orthopedic specialist due to low back pain lasting more than three months, 121 cases (average 71.5-years-old, 46 male and 75 female) with whole standing spinal screening radiographs were reviewed (CLBP group). Cervical parameters included cervical lordosis (CL), C2–C7 sagittal vertical axis (C2-7 SVA), and the T1 slope minus CL (T1S-CL). Cervical spine deformity was defined as C2-7 SVA >4 cm, CL <0°, or T1S-CL ≧20°. We compared the cervical alignment of these patients with 121 age and gender matched volunteers (control group).ResultsThe prevalence of cervical spine deformity was significantly higher in the CLBP group than in the control group (20.7% vs. 10.7%, P = 0.034). The mean CL was smaller in the CLBP group than in the control group (16.1° vs. 21.4°, P = 0.002). The mean C2-7 SVA was 17.6 mm vs. 18.7 mm in the CLBP group and in the control group, respectively (P = 0.817). The mean T1S-CL was larger in the CLBP group than in the control group (9.1° vs. 3.5°, P < 0.001). Multivariate analysis showed that people with CLBP were more likely to have cervical deformities than people without CLBP (odds ratio 2.16, 95% confidence interval 1.006 to 4.637).ConclusionsThis study results suggest that people with CLBP present with worse cervical sagittal alignment and higher prevalence of cervical spine deformities than age and gender matched volunteers with no CLBP. This means CLBP impacts cervical spine lesions negatively.Level of evidenceⅣ 相似文献
89.
90.
S Minoshima T Shiina I Yamagami Y Kitakata K Isobe K Uno Y Anzai J Okada Y Uchida J Itami 《Kaku igaku. The Japanese journal of nuclear medicine》1990,27(7):749-756
SPECT with N-isopropyl-p-[I-123]iodoamphetamine were performed in a 81-year-old man with cerebral infarction. In the subacute phase, the radioactivity was increased in the infarct area where fogging effect and remarkable contrast enhancement was demonstrated in X-ray CT. The contralateral cerebellar hemisphere showed reduced activity due to crossed cerebellar diaschisis (CCD). In the chronic phase, the decrement of the activity in the infarct was observed. Increased activity in the subacute phase was thought to reflect the hyperemia in the infarct, while CCD suggested the decreased metabolic activity in the lesion. The coexistence of the hyperemia and the CCD indicates flow and metabolic uncoupling, which means "luxury perfusion". This case was also thought to demonstrate atypical findings of CCD in SPECT imaging. 相似文献