收费全文 | 4315篇 |
免费 | 374篇 |
国内免费 | 11篇 |
耳鼻咽喉 | 15篇 |
儿科学 | 138篇 |
妇产科学 | 152篇 |
基础医学 | 583篇 |
口腔科学 | 52篇 |
临床医学 | 594篇 |
内科学 | 761篇 |
皮肤病学 | 73篇 |
神经病学 | 412篇 |
特种医学 | 102篇 |
外科学 | 360篇 |
综合类 | 55篇 |
一般理论 | 4篇 |
预防医学 | 633篇 |
眼科学 | 154篇 |
药学 | 280篇 |
中国医学 | 6篇 |
肿瘤学 | 326篇 |
2023年 | 60篇 |
2022年 | 91篇 |
2021年 | 162篇 |
2020年 | 102篇 |
2019年 | 176篇 |
2018年 | 164篇 |
2017年 | 109篇 |
2016年 | 119篇 |
2015年 | 135篇 |
2014年 | 163篇 |
2013年 | 226篇 |
2012年 | 346篇 |
2011年 | 314篇 |
2010年 | 175篇 |
2009年 | 162篇 |
2008年 | 231篇 |
2007年 | 239篇 |
2006年 | 245篇 |
2005年 | 238篇 |
2004年 | 240篇 |
2003年 | 224篇 |
2002年 | 216篇 |
2001年 | 33篇 |
2000年 | 25篇 |
1999年 | 25篇 |
1998年 | 40篇 |
1997年 | 36篇 |
1996年 | 34篇 |
1995年 | 29篇 |
1994年 | 29篇 |
1993年 | 24篇 |
1992年 | 19篇 |
1991年 | 14篇 |
1990年 | 9篇 |
1989年 | 14篇 |
1988年 | 13篇 |
1987年 | 6篇 |
1986年 | 15篇 |
1985年 | 6篇 |
1984年 | 18篇 |
1983年 | 17篇 |
1982年 | 15篇 |
1981年 | 16篇 |
1980年 | 15篇 |
1978年 | 12篇 |
1977年 | 8篇 |
1976年 | 11篇 |
1972年 | 7篇 |
1970年 | 6篇 |
1968年 | 5篇 |
Introduction
In emergency departments, focused assessment for sonographic examination of trauma patients (FAST) accurately detects hemoperitoneum in unstable patients. Currently, only an approximation of the volume of free intraperitoneal fluid (FIPF) can be done using ultrasound (US) and CT scans. We previously reported a new method developed on an experimental cadaveric model using US examination of the abdomen and applying a mathematic formula to effusion measurements to evaluate the exact volume of FIPF. The aim of this prospective study is to extrapolate this method in a clinical practice and apply it to CT measurements of the same area.Patients and methods
We included prospectively eleven patients admitted with acute intraperitoneal haemorrhage: 10 patients with post-traumatic hemoperitoneum and 1 patient with a ruptured extra-uterine pregnancy. The mean age was 43.2 years (extremes: 21–82). There were six males and five females. All of these patients had to undergo emergency surgery by laparotomy or laparoscopy. The amount of FIPF was assessed preoperatively on axial sections of CT scan, by measuring fluid thickness in millimetres in the hepatorenal pouch (Morrison’s pouch), between the inferior aspect of the liver and the anterior aspect of the right kidney. During the emergency surgical procedure, we collected and quantified FIPF volume by direct measure in all cases.Results
The correlation between fluid thickness x (mm) on the CT scan and the estimated amount of FIPF was established by the following linear function: volume (mL) = 81.068x + 263.2. The Spearman’s R obtained is 0.779 and the significance level is 0.005. We found a constant correlation between FIPF measured by radiologic procedure and direct per-operative measurement of FIPF.Conclusion
This new linear function can be used to measure the exact volume of FIPF. This evaluation can help surgical decisions, especially when abdominal trauma is associated with other haemorrhagic lesions. 相似文献Cardiomyopathies are an important cause of heart failure and sudden cardiac death. Little is known about the role of rare genetic variants in inflammatory cardiomyopathy. Chronic Chagas disease cardiomyopathy (CCC) is an inflammatory cardiomyopathy prevalent in Latin America, developing in 30% of the 6 million patients chronically infected by the protozoan Trypanosoma cruzi, while 60% remain free of heart disease (asymptomatic (ASY)). The cytokine interferon-γ and mitochondrial dysfunction are known to play a major pathogenetic role. Chagas disease provides a unique model to probe for genetic variants involved in inflammatory cardiomyopathy.
MethodsWe used whole exome sequencing to study nuclear families containing multiple cases of Chagas disease. We searched for rare pathogenic variants shared by all family members with CCC but absent in infected ASY siblings and in unrelated ASY.
ResultsWe identified heterozygous, pathogenic variants linked to CCC in all tested families on 22 distinct genes, from which 20 were mitochondrial or inflammation-related – most of the latter involved in proinflammatory cytokine production. Significantly, incubation with IFN-γ on a human cardiomyocyte line treated with an inhibitor of dihydroorotate dehydrogenase brequinar (enzyme showing a loss-of-function variant in one family) markedly reduced mitochondrial membrane potential (ΔψM), indicating mitochondrial dysfunction.
ConclusionMitochondrial dysfunction and inflammation may be genetically determined in CCC, driven by rare genetic variants. We hypothesize that CCC-linked genetic variants increase mitochondrial susceptibility to IFN-γ-induced damage in the myocardium, leading to the cardiomyopathy phenotype in Chagas disease. This mechanism may also be operative in other inflammatory cardiomyopathies.
相似文献