全文获取类型
收费全文 | 1720篇 |
免费 | 166篇 |
国内免费 | 11篇 |
专业分类
耳鼻咽喉 | 15篇 |
儿科学 | 102篇 |
妇产科学 | 24篇 |
基础医学 | 124篇 |
口腔科学 | 39篇 |
临床医学 | 214篇 |
内科学 | 410篇 |
皮肤病学 | 9篇 |
神经病学 | 215篇 |
特种医学 | 163篇 |
外科学 | 249篇 |
综合类 | 39篇 |
预防医学 | 77篇 |
眼科学 | 6篇 |
药学 | 132篇 |
中国医学 | 5篇 |
肿瘤学 | 74篇 |
出版年
2023年 | 5篇 |
2022年 | 5篇 |
2021年 | 22篇 |
2020年 | 9篇 |
2019年 | 14篇 |
2018年 | 47篇 |
2017年 | 48篇 |
2016年 | 45篇 |
2015年 | 40篇 |
2014年 | 57篇 |
2013年 | 73篇 |
2012年 | 65篇 |
2011年 | 65篇 |
2010年 | 80篇 |
2009年 | 73篇 |
2008年 | 77篇 |
2007年 | 61篇 |
2006年 | 65篇 |
2005年 | 69篇 |
2004年 | 55篇 |
2003年 | 51篇 |
2002年 | 40篇 |
2001年 | 63篇 |
2000年 | 44篇 |
1999年 | 26篇 |
1998年 | 62篇 |
1997年 | 56篇 |
1996年 | 58篇 |
1995年 | 55篇 |
1994年 | 38篇 |
1993年 | 43篇 |
1992年 | 30篇 |
1991年 | 33篇 |
1990年 | 34篇 |
1989年 | 28篇 |
1988年 | 28篇 |
1987年 | 26篇 |
1986年 | 27篇 |
1985年 | 16篇 |
1984年 | 16篇 |
1983年 | 24篇 |
1982年 | 7篇 |
1981年 | 33篇 |
1980年 | 15篇 |
1979年 | 6篇 |
1978年 | 6篇 |
1977年 | 11篇 |
1976年 | 15篇 |
1975年 | 9篇 |
1973年 | 10篇 |
排序方式: 共有1897条查询结果,搜索用时 15 毫秒
41.
Hyperthyroidism due to inappropriate secretion of thyroid-stimulating hormone: diagnosis and management 总被引:2,自引:0,他引:2
A Hermus H Ross P van Liessum A Naber A Smals P Kloppenborg 《The Netherlands journal of medicine》1991,38(5-6):193-198
The case histories of three patients with hyperthyroidism due to overproduction of thyroid-stimulating hormone (TSH) by the pituitary gland are described. In the first patient treatment with the T3-metabolite 3,5,3'-triiodothyroacetic acid (TRIAC) led to complete clinical and biochemical normalization. In the second patient treatment with the dopaminergic agonist bromocriptine led to a temporal amelioration of hyperthyroidism. In the third patient, who was the only one with a proven pituitary adenoma, hypersecretion of TSH could be controlled by administration of the somatostatin analogue octreotide. It is emphasized that patients with this disorder should preferably not be treated with thyrostatic drugs, radioactive iodine or thyroid surgery. The success rate of these treatment modalities is lower than normal, they may lead to an increase of goiter size, and they potentially may promote growth or development of a TSH-producing adenoma. Treatment should be aimed at diminishing TSH hypersecretion. 相似文献
42.
Successful hematopoietic cell transplantation in a patient with X‐linked agammaglobulinemia and acute myeloid leukemia 下载免费PDF全文
43.
Morgan R. Bobb Azeemuddin Ahmed MD MBA Paul Van Heukelom MD Rachel Tranter MPAS PA‐C Karisa K. Harland PhD MPH Brady M. Firth PhD MA Randy Fry MBA Katherine Schneider MSN RN CEN Kathryn K. Dierks DO Sarah L. Miller MD Nicholas M. Mohr MD MS 《Academic emergency medicine》2018,25(7):795-803
Objective
The objective of this study was to determine specific provider practices associated with high provider efficiency in community emergency departments (EDs).Methods
A mixed‐methods study design was utilized to identify key behaviors associated with efficiency. Stage 1 was a convenience sample of 16 participants (ED medical directors, nurses, advanced practice providers, and physicians) identified provider efficiency behaviors during semistructured interviews. Ninety‐nine behaviors were identified and distilled by a group of three ED clinicians into 18 themes. Stage 2 was an observational study of 35 providers was performed in four (30,000‐ to 55,000‐visit) community EDs during two 4‐hour periods and recorded in minute‐by‐minute observation logs. In Stage 3, each behavior or practice from Stage 1 was assigned a score within each observation period. Behaviors were tested for association with provider efficiency (relative value units/hour) using linear univariate generalized estimating equations with an identity link, clustered on ED site.Results
Five ED provider practices were found to be positively associated with efficiency: average patient load, using name of team member, conversations with health care team, visits to patient rooms, and running the board. Two behaviors, “inefficiency practices,” demonstrated significant negative correlations: non–work‐related tasks and documentation on patients no longer in the ED.Conclusions
Average patient load, running the board, conversations with team member, and using names of team members are associated with enhanced provider productivity. Identification of behaviors associated with efficiency can be utilized by medical directors, clinicians, and trainees to improve personal efficiency or counsel team members.44.
Chao Gao Piotr Buszman Paweł Buszman Ply Chichareon Rodrigo Modolo Scot Garg Kuniaki Takahashi Hideyuki Kawashima Rutao Wang Chun Chin Chang Norihiro Kogame Mariusz Tomaniak Masafumi Ono Hironori Hara Ton Slagboom Adel Aminian Christoph Kurt Naber Didier Carrie Aleksander Zurakowski 《The Canadian journal of cardiology》2021,37(1):122-130
BackgroundRadial artery access has been shown to reduce mortality and bleeding events, especially in patients with acute coronary syndromes. Despite this, interventional cardiologists experienced in femoral artery access still prefer that route for percutaneous coronary intervention. Little is known regarding the merits of each vascular access in patients stratified by their risk of bleeding.MethodsPatients from the Global Leaders trial were dichotomized into low or high risk of bleeding by the median of the PRECISE-DAPT score. Clinical outcomes were compared at 30 days.ResultsIn the overall population, there were no statistical differences between radial and femoral access in the rate of the primary end point, a composite of all-cause mortality, or new Q-wave myocardial infarction (MI) (hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.42-1.15). Radial access was associated with a significantly lower rate of the secondary safety end point, Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding (HR 0.55, 95% CI 0.36-0.84). Compared by bleeding risk strata, in the high bleeding score population, the primary (HR 0.47, 95% CI 0.26-0.85; P = 0.012; Pinteraction = 0.019) and secondary safety (HR 0.57, 95% CI 0.35-0.95; P = 0.030; Pinteraction = 0.631) end points favoured radial access. In the low bleeding score population, however, the differences in the primary and secondary safety end points between radial and femoral artery access were no longer statistically significant.ConclusionsOur findings suggest that the outcomes of mortality or new Q-wave MI and BARC 3 or 5 bleeding favour radial access in patients with a high, but not those with a low, risk of bleeding. Because this was not a primary analysis, it should be considered hypothesis generating. 相似文献
45.
46.
Early changes in phosphatidylcholine metabolism in human acute promyelocytic leukemia cells stimulated to differentiate by phorbol ester 总被引:7,自引:0,他引:7
The HL-60 leukemia cell line derived from a human acute promyelocytic leukemia is stimulated to differentiate into macrophages within 24-28 hr after exposure to the phorbol ester, 12-O-tetradecanoylphorbol-13- acetate (TPA). We studied early alterations (within 90 min of exposure to TPA) in phosphatidylcholine metabolism in HL-60 cells and found that phosphatidylcholine synthesis by methylation is phosphatidylethanolamine was inhibited in a dose-dependent fashion. In contrast, synthesis of phosphatidylcholine from endogenous choline was enhanced and correlated inversely with the degree of inhibition of the methylation pathway. Phorbol ester congeners of TPA caused similar alterations in phosphatidylcholine metabolism in direct relationship to their capacity to induce differentiation in HL-60 cells. Perturbation of phosphatidylcholine metabolism is an early membrane even in TPA- induced HL-60 cell differentiation. 相似文献
47.
H Eggebrecht C K Naber O Oldenburg J Herrmann M Haude R Erbel D Baumgart 《Catheterization and cardiovascular interventions》2000,51(4):500-504
Treatment of subclavian artery stenosis by percutaneous balloon angioplasty and adjunctive stent placement was shown to be safe and efficacious, but it may be limited in tight stenoses and long occlusions. We describe the case of a patient who experienced progressive angina pectoris associated with signs of cerebrovertebral insufficiency 9 yr after bypass surgery, including left internal mammary artery (LIMA) grafting to the left anterior descending coronary artery. Angiography showed reversed flow through the LIMA graft into the subclavian artery and a 4-cm occlusion beginning at the origin of the left subclavian artery, representing a rare coronary-subclavian steal syndrome. After a conventional approach failed, recanalization was performed successfully using laser guide wire angioplasty with adjunctive stent placement in a combined radial and femoral approach. 相似文献
48.
DZ Loesch F Tassone J Lo HR Slater LV Hills MQ Bui PA Silburn GD Mellick 《Clinical genetics》2013,84(4):382-385
We recently reported a significant increase in the frequency of carriers of grey zone (GZ) alleles of FMR1 gene in Australian males with Parkinson's disease (PD) from Victoria and Tasmania. Here, we report data comparing an independent sample of 817 PD patients from Queensland to 1078 consecutive Australian male newborns from Victoria. We confirmed the earlier finding by observing a significant excess of GZ alleles in PD (4.8%) compared to controls (1.5%). Although both studies provided evidence in support of an association between GZ‐carrier status and increased risk for parkinsonism, the existing evidence in the literature from screening studies remains equivocal and we discuss the need for alternative approaches to resolve the issue. 相似文献
49.
Rashid Ghaznawi Maarten HT Zwartbol Nicolaas PA Zuithoff Jeroen de Bresser Jeroen Hendrikse Mirjam I Geerlings 《Journal of cerebral blood flow and metabolism》2021,41(6):1229
Global cerebral hypoperfusion may be involved in the aetiology of brain atrophy; however, long-term longitudinal studies on this relationship are lacking. We examined whether reduced cerebral blood flow was associated with greater progression of brain atrophy. Data of 1165 patients (61 ± 10 years) from the SMART-MR study, a prospective cohort study of patients with arterial disease, were used of whom 689 participated after 4 years and 297 again after 12 years. Attrition was substantial. Total brain volume and total cerebral blood flow were obtained from magnetic resonance imaging scans and expressed as brain parenchymal fraction (BPF) and parenchymal cerebral blood flow (pCBF). Mean decrease in BPF per year was 0.22% total intracranial volume (95% CI: –0.23 to –0.21). Mean decrease in pCBF per year was 0.24 ml/min per 100 ml brain volume (95% CI: –0.29 to –0.20). Using linear mixed models, lower pCBF at baseline was associated with a greater decrease in BPF over time (p = 0.01). Lower baseline BPF, however, was not associated with a greater decrease in pCBF (p = 0.43). These findings indicate that reduced cerebral blood flow is associated with greater progression of brain atrophy and provide further support for a role of cerebral blood flow in the process of neurodegeneration. 相似文献
50.
Fc gamma receptor II (CD32) on malignant B cells influences modulation induced by anti-CD19 monoclonal antibody 总被引:1,自引:1,他引:1
Vervoordeldonk SF; Merle PA; van Leeuwen EF; van der Schoot CE; von dem Borne AE; Slaper-Cortenbach IC 《Blood》1994,83(6):1632-1639
Antigenic modulation is one of many factors determining the effectiveness of monoclonal antibody (MoAb)-mediated therapy. To select the isotype of a CD19 MoAb most suitable for radioimmunotherapy of patients with B-cell malignancies, we studied the influence of MoAb isotype on modulation, after binding of the MoAb to different cell-line cells. The CD19-IgG1 MoAb was found to induce modulation of CD19 antigens on Daudi cell line cells more rapidly than did its IgG2a switch variant. We provide evidence that this difference in modulation rate is caused by the expression of Fc gamma receptor II (Fc gamma RII) on these cells. Experiments aimed at elucidating the mechanism of Fc gamma RII involvement in modulation induction by CD19-IgG1 showed that Fc gamma RII did not comodulate with CD19 MoAbs. However, cocrosslinking of CD19 and Fc gamma RII with CD19-IgG1 MoAb resulted in enhanced calcium mobilization in Daudi cells. This increased signal induction accompanies the enhanced capping and subsequent modulation of CD19 antigens. Because Fc gamma RII is expressed in varying densities on malignant B cells in all differentiation stages, our results have implications for the MoAb isotype most suitable for use in MoAb-based therapy of patients with B-cell malignancies. 相似文献