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91.
R. LA TOUCHE C. FERNÁNDEZ-DE-LAS-PEÑAS J. FERNÁNDEZ-CARNERO K. ESCALANTE S. ANGULO-DÍAZ-PARREÑO A. PARIS-ALEMANY & J. A. CLELAND 《Journal of oral rehabilitation》2009,36(9):644-652
Summary No studies have investigated the effects of the treatments directed at the cervical spine in patients with temporomandibular disorders (TMD). Our aim was to investigate the effects of joint mobilization and exercise directed at the cervical spine on pain intensity and pressure pain sensitivity in the muscles of mastication in patients with TMD. Nineteen patients (14 females), aged 19–57 years, with myofascial TMD were included. All patients received a total of 10 treatment session over a 5‐week period (twice per week). Treatment included manual therapy techniques and exercise directed at the cervical spine. Outcome measures included bilateral pressure pain threshold (PPT) levels over the masseter and temporalis muscles, active pain‐free mouth opening (mm) and pain (Visual Analogue Scale) and were all assessed pre‐intervention, 48 h after the last treatment (post‐intervention) and at 12‐week follow‐up period. Mixed‐model anovas were used to examine the effects of the intervention on each outcome measure. Within‐group effect sizes were calculated in order to assess clinical effect. The 2 × 3 mixed model anova revealed significant effect for time (F = 77·8; P < 0·001) but not for side (F = 0·2; P = 0·7) for changes in PPT over the masseter muscle and over the temporalis muscle (time: F = 66·8; P < 0·001; side: F = 0·07; P = 0·8). Post hoc revealed significant differences between pre‐intervention and both post‐intervention and follow‐up periods (P < 0·001) but not between post‐intervention and follow‐up period (P = 0·9) for both muscles. Within‐group effect sizes were large (d > 1·0) for both follow‐up periods in both muscles. The anova found a significant effect for time (F = 78·6; P < 0·001) for changes in pain intensity and active pain‐free mouth opening (F = 17·1; P < 0·001). Significant differences were found between pre‐intervention and both post‐intervention and follow‐up periods (P < 0·001) but not between the post‐intervention and follow‐up period (P > 0·7). Within‐group effect sizes were large (d > 0·8) for both post‐intervention and follow‐up periods. The application of treatment directed at the cervical spine may be beneficial in decreasing pain intensity, increasing PPTs over the masticatory muscles and an increasing pain‐free mouth opening in patients with myofascial TMD. 相似文献
92.
To assess the safety of magnetic resonance (MR) imaging in women who have an intrauterine contraceptive device (IUD) in place, in vitro and in vivo studies were performed at both 0.35 and 1.5 T. Two commonly used IUDs were tested, one all of plastic, the other with a coil of copper wire on it. Specifically, the study assessed possible motion of the IUD in the magnetic field, potential of the IUD to heat up during two spin-echo imaging sequences commonly used in MR imaging of the pelvis (2,000/30 and 60 [repetition time, msec/echo time, msec], and 500/30), and the appearance on MR images of the IUD devices. A retrospective review of MR images of the pelvis in six women who had an IUD in place was also performed. Results show that an IUD does not move under the influence of the magnetic field, does not heat during spin-echo sequences commonly used for pelvic imaging, and does not produce artifacts in vitro or in vivo. Patients with either type of IUD can be safely imaged with MR, and MR images of the pelvis are not degraded by the presence of an IUD. 相似文献
93.
Lymphoceles: imaging characteristics and percutaneous management 总被引:3,自引:0,他引:3
vanSonnenberg E; Wittich GR; Casola G; Wing VW; Halasz NA; Lee AS; Withers C 《Radiology》1986,161(3):593-596
Twenty-five patients who had lymphoceles underwent sectional imaging and interventional radiologic procedures. Viewed using sonography, lymphoceles were hypoechoic to anechoic, occasionally with internal septa and debris. Low numbers (occasionally negative values) were observed using computed tomography (CT); these numbers strongly suggest the diagnosis of lymphocele. Calcification was observed on CT images of one patient. Diagnostic aspiration revealed tan to yellow fluid containing many lymphocytes; pathognomonic fat globules were observed in four cases. Malignant cells were found in two collections, an unusual occurrence. Therapeutic needle aspiration and short-term catheter drainage were usually unsuccessful (only one of five patients [20%] was cured). Long-term (1-5-week) catheter drainage cured 11 of 14 patients (78.6%). Sclerosing agents may have been beneficial for lymphocele obliteration in three of four patients. For most patients, lymphoceles may be diagnosed and treated successfully using radiologic means. 相似文献
94.
Karakas S Karadag F Karul AB Gurgey O Gurel S Guney E Cildag O 《International journal of clinical practice》2005,59(10):1167-1170
Nutritional depletion and weight loss are two features of chronic obstructive pulmonary disease (COPD), and the association between low body mass index (BMI) and poor prognosis in patients with COPD is a common clinical observation. Mechanisms of weight loss are still unclear in COPD. Excessive energy expenditure partly due to increased work of breathing was shown, but other mechanisms have been searched for. Leptin is a hormone secreted by adipocytes that plays an important role in energy homeostasis and regulates body weight through control of appetite and energy expenditure. The aim of this study was to evaluate the association of circulating leptin levels and measures of body composition in COPD patients. Thirty male COPD outpatients (mean age 66.3 +/- 8.4) and 20 controls (mean age 65.9 +/- 10.8) were included in the study. After standard spirometry and body composition measurements, serum leptin concentration was measured by ELISA assay. COPD patients were grouped according to BMI. Mean BMI was 19.01 +/- 2.26 kg/m2 in group 1 (COPD patients with low BMI), 26.85 +/- 4.51 in group 2 COPD (COPD patients with normal/high BMI) and 27.64 +/- 2.75 kg/m2 in healthy controls (group 3). Mean serum leptin concentration was 1.41 +/- 1.86 ng/ml in group 1, 2.60 +/- 1.38 ng/ml in group 2 and 2.82 +/- 1.46 ng/ml in group 3 (p = 0.002). Leptin correlated to not only BMI but also body weight, waist circumference, triceps and biceps skinfold thickness and body fat percent (p < 0.05 for all). Results of this study suggest that the cause of weight loss is not increased circulating leptin in COPD. Instead, leptin remains regulated in COPD and further decreased in patients with low BMI, probably as a compensatory mechanism to preserve body fat content, which should be evaluated in further studies. 相似文献
95.
96.
Walker AS; Peto TE; Babiker AG; Darbyshire JH 《QJM : monthly journal of the Association of Physicians》1998,91(6):423-438
The Concorde trial compared immediate (Imm) with deferred (Def) AZT
monotherapy in asymptomatic HIV-positive participants. Haematological and
immunological markers and weight were measured throughout, and correlated
with clinical endpoints. Markers associated with disease progression (CD4
lymphocyte count and percentage, platelets, p24 antigen and beta 2
microglobulin favoured Imm: those associated with toxicity (haemoglobin,
neutrophils and white cell count) favoured Def. CD8 and total lymphocyte
count did not differ significantly between groups. In multivariate
analysis, the combination of baseline CD4, p24 antigen and beta 2m was the
best baseline predictor of disease. Including change in CD4 and beta 2m at
12 weeks, or changes over follow- up in these markers significantly
improved the fit. Markers were also incorporated into the definition of
'clinical' endpoints. Hazard ratio estimates from end-points that included
CD4 < 50 and CD4 < 25 were closest to those for AIDS or death alone,
but added very few extra events. Use of other landmark CD4 counts (100 or
greater) or relative decreases in counts (25% or more) increased the number
of events, but overestimated the effect of immediate AZT. Although AZT had
a beneficial effect on the surrogate markers of efficacy evaluated, these
changes did not predict clinical outcome, nor could the markers be usefully
incorporated into an endpoint definition.
相似文献
97.
98.
99.
Wierzbicki AS; Lumb PJ; Semra YK; Crook MA 《QJM : monthly journal of the Association of Physicians》1998,91(4):291-294
Lipid targets can be difficult to attain in familial hypercholesterolaemia.
To compare atorvastatin with simvastatin- fenofibrate and
simvastatin-cholestyramine therapy, we studied 54 patients with familial
hypercholesterolaemia over periods of 2-6 months on each therapeutic
regimen. The atorvastatin regimen reduced total cholesterol by 41.2 +/-
11.2%, LDL by 45.6 +/- 15.5%, triglycerides by 33.8 +/- 24.8%, and
increased HDL by 2.3 +/- 37.0%. Simvastatin- fenofibrate therapy achieved
reductions of 33.9 +/- 8.5% in cholesterol, 42.0 +/- 12.2% in LDL, 34.7 +/-
38.3% for triglycerides, and a 25.4 +/- 55.1% increase in HDL.
Simvastatin-cholestyramine gave a reduction of 31.3 +/- 11.8% in
cholesterol, 36.0 +/- 14.4% in LDL, 13.7 +/- 36.3% in triglycerides, and a
1.1 +/- 30.3% rise in HDL. The atorvastatin regimen was marginally but not
significantly better than simvastatin-fenofibrate in improving the LDL:HDL
ratio, LDL:apoB and and apolipoprotein B:A1 ratios. Eleven patients (20.4%)
had side- effects: two discontinued atorvastatin due to side-effects; two
patients had rashes; six had myalgia and two had diarrhoea.
Gastrointestinal side-effects were described in 16 (30.1%) patients on
simvastatin-cholestyramine therapy and four cases of myalgia (11.2%) were
seen with simvastatin-fenofibrate. In nine patients on atorvastatin (20.4%)
a 30% or greater fall in HDL was observed, compared to five patients with
resin therapy (9.2%) and two with fibrate therapy (5.5%). There were no
significant differences in liver or muscle biochemistry between the
regimens, but atorvastatin did raise transaminase and creatine kinase
concentrations significantly compared to pre-treatment values (p = 0.001).
Atorvastatin significantly improves the lipid profile in most patients
compared with other regimens. It has a comparable incidence of side-effects
to combination therapy regimens.
相似文献
100.
The mouse monoclonal antibody M2A1 of IgG1 class, which is highly specific for blood group M antigen, was obtained and characterized by means of hemagglutination, enzyme-linked immunosorbent assay, immunoblotting, and inhibition assays. The use of modified M glycoprotein preparations for inhibition tests and of variant McN and Henshaw red cell membranes for immunoblotting showed that M2A1 recognized an epitope including the NH2-terminal serine and sialic acid residues of glycophorin A, whereas the fifth glycine residue was not involved. The reactivity of the antibody with M antigen was distinctly dependent on ionic strength and pH; the optimum was at pH 8 to 9. The alpha-amino group of terminal serine residue was not necessary for the reaction with M2A1 antibody, and the results obtained suggested that the positive charge of this group contributed to decreasing antigen-antibody reactions at pH below 8. The reaction of the antibody with blood group N antigen was not detectable in any of the assays used. 相似文献