全文获取类型
收费全文 | 3045篇 |
免费 | 192篇 |
国内免费 | 10篇 |
专业分类
耳鼻咽喉 | 16篇 |
儿科学 | 81篇 |
妇产科学 | 57篇 |
基础医学 | 327篇 |
口腔科学 | 31篇 |
临床医学 | 393篇 |
内科学 | 465篇 |
皮肤病学 | 40篇 |
神经病学 | 367篇 |
特种医学 | 119篇 |
外科学 | 448篇 |
综合类 | 22篇 |
一般理论 | 1篇 |
预防医学 | 305篇 |
眼科学 | 118篇 |
药学 | 242篇 |
1篇 | |
肿瘤学 | 214篇 |
出版年
2023年 | 10篇 |
2022年 | 55篇 |
2021年 | 102篇 |
2020年 | 57篇 |
2019年 | 97篇 |
2018年 | 125篇 |
2017年 | 78篇 |
2016年 | 76篇 |
2015年 | 78篇 |
2014年 | 120篇 |
2013年 | 201篇 |
2012年 | 241篇 |
2011年 | 263篇 |
2010年 | 164篇 |
2009年 | 139篇 |
2008年 | 210篇 |
2007年 | 197篇 |
2006年 | 192篇 |
2005年 | 160篇 |
2004年 | 156篇 |
2003年 | 149篇 |
2002年 | 127篇 |
2001年 | 26篇 |
2000年 | 14篇 |
1999年 | 16篇 |
1998年 | 14篇 |
1997年 | 13篇 |
1996年 | 10篇 |
1995年 | 12篇 |
1994年 | 20篇 |
1993年 | 7篇 |
1992年 | 11篇 |
1991年 | 8篇 |
1990年 | 8篇 |
1989年 | 6篇 |
1988年 | 6篇 |
1987年 | 7篇 |
1986年 | 9篇 |
1985年 | 4篇 |
1984年 | 6篇 |
1983年 | 4篇 |
1980年 | 3篇 |
1979年 | 3篇 |
1977年 | 3篇 |
1973年 | 3篇 |
1969年 | 4篇 |
1967年 | 5篇 |
1966年 | 3篇 |
1934年 | 2篇 |
1932年 | 2篇 |
排序方式: 共有3247条查询结果,搜索用时 15 毫秒
51.
52.
Purpose of Review
Recurrent painful ophthalmoplegic neuropathy (RPON), formerly known as ophthalmoplegic migraine, is an uncommon disorder with repeated episodes of ocular cranial nerve neuropathy associated with ipsilateral headache. This review discusses the clinical presentation, current understanding of the pathophysiology, key differential diagnoses, and evaluation and treatment of RPON.Recent Findings
The literature is limited due to the rarity of the disorder. Recent case reports and series continue to suggest the age of first attack is most often during childhood or adolescence as well as a female predominance. Multiple recent case reports and series demonstrate focal enhancement of the affected cranial nerve, as the nerve root exits the brainstem. This finding contributed to the current classification of the disorder as a neuropathy, with the present understanding that it is due to a relapsing-remitting inflammatory or demyelinating process. The link to migraine remains a cause of disagreement in the literature.Summary
RPON is a complex disorder with features of inflammatory neuropathy and an unclear association with migraine. Regardless, the overall prognosis is good for individual episodes, but permanent nerve damage may accumulate with repeated attacks. A better understanding of the pathogenesis is needed to clarify whether it truly represents a single disorder and to guide its treatment. Until that time, a combined approach with acute and preventive therapies can mitigate acute symptoms as well as attempt to limit recurrence of this disabling syndrome.53.
Cairo MS Davenport V Bessmertny O Goldman SC Berg SL Kreissman SG Laver J Shen V Secola R van de Ven C Reaman GH 《British journal of haematology》2005,128(1):49-58
Thrombocytopenia remains the major dose-limiting toxicity of myelosuppressive chemotherapy in children with solid tumours. Recombinant human interleukin-11 (rhIL-11) has been approved by the Food and Drug Administration as treatment for adults with solid tumours and lymphomas with severe chemotherapy-induced thrombocytopenia. We conducted a phase I/II trial of rhIL-11 following ifosfamide, carboplatin and etoposide (ICE) chemotherapy in children with solid tumours or lymphomas. Patients received ifosfamide 1800 mg/m(2)/d for 5 d, carboplatin 400 mg/m(2)/d for 2 d and etoposide 100 mg/m(2)/d for 5 d with rhIL-11 subcutaneous (s.c.) at 25-125 microg/kg/d on days 6-33. Forty-seven patients with median age 10.5 years (range, 0.7-26 years) were studied. Median days to absolute neutrophil count >/=0.5 x 10(9)/l, platelet count >/=50 x 10(9)/l and platelet transfusions were 23, 18, 18, 16.5 and 18.5, 21, 20, 18 and 3, 3, 4, and 2 d at doses 25, 50, 75 and 100 Schulteg/kg respectively. There was a dose-dependent increase in C(max) (7.6-25.5 ng/ml), AUC(0-rho) (57-209 ng.h/ml) and T(1/2) (4-8.2 h) respectively. There was a 4% incidence of anti-IL-11 antibody formation. Clinically important adverse events to rhIL-11 were papilloedema and periosteal bone formation. In summary, rhIL-11 was well tolerated at doses of =50 microg/kg (maximal tolerated dose) and associated with improved haematological recovery and reduced platelet transfusion requirements compared with historical controls receiving similar ICE chemotherapy without rhIL-11. 相似文献
54.
Sharma TS Messiah S Fisher S Miller TL Lipshultz SE 《Journal of the CardioMetabolic Syndrome》2008,3(2):93-97
Highly active antiretroviral therapy has greatly reduced mortality among human immunodeficiency virus (HIV)-infected patients by delaying, and possibly preventing, progression to AIDS. The risk of cardiovascular disease (CVD) is now an important consideration in these patients and may increase as they live longer. Risk factors for CVD, the inflammatory effects of HIV, and the metabolic complications of antiretroviral therapy may accelerate the onset of CVD. Death from myocardial infarction, however, is still rare compared with death from progression of HIV disease, and the benefits of antiretroviral therapy clearly outweigh any associated risk of CVD. In this review, the authors describe the risk of accelerated CVD in HIV-infected individuals, the proposed viral and therapy-related mechanisms of CVD, the clinical features of CVD in these patients, and monitoring and management guidelines to reduce CVD risk. Identifying, monitoring, and treating CVD risk factors in HIV-positive patients is vital to improving their lives and should become standard practice. 相似文献
55.
Ghrelin secretion in humans is sexually dimorphic,suppressed by somatostatin,and not affected by the ambient growth hormone levels 总被引:11,自引:0,他引:11
Barkan AL Dimaraki EV Jessup SK Symons KV Ermolenko M Jaffe CA 《The Journal of clinical endocrinology and metabolism》2003,88(5):2180-2184
We studied plasma ghrelin and GH concentrations over a 24-h period in young healthy men and women and in patients with acromegaly. Healthy subjects were restudied after administration of GH-lowering agents, octreotide or GHRH antagonist. Ghrelin concentrations in women studied during the late follicular stage of the cycle were about 3-fold higher than in men. Suppression of GH secretion by GHRH antagonist did not alter ghrelin concentration profiles. In the presence of high GH levels (acromegaly), ghrelin levels were similar to those found in healthy men. Administration of somatostatin analog octreotide suppressed both GH and ghrelin concentration profiles. We conclude that: 1) ghrelin secretion is sexually dimorphic in humans, with women in the late follicular stage having higher levels than men; 2) ghrelin secretion is suppressed by somatostatin; and 3) GH has no influence over ghrelin secretion. 相似文献
56.
Greene CM Van Beneden CA Javadi M Skoff TH Beall B Facklam R Abercrombie DR Kramer SL Arnold KE 《American journal of infection control》2005,33(2):108-113
BACKGROUND: Invasive group A streptococcus (GAS) affects approximately 10,500 persons annually; 1 in 5 patients >/=65 years die. In August 2001, CDC investigated a cluster of GAS deaths in a Georgia long-term care facility (LTCF). METHODS: We screened LTCF residents and staff for GAS carriage and conducted a retrospective cohort study among residents. We defined a case as GAS isolation associated with clinical infection. RESULTS: Eight cases were identified (median age: 79 years); 6 (75%) patients died. Carriage was similar in residents (10%) and staff (9%). All isolates among residents and 63% among staff were type emm 77. Risk factors for GAS disease or carriage among residents were receiving skin treatment (relative risk [RR] = 4.0, 95% confidence interval [CI] = 1.9-11.0) and having an infected or colonized roommate (RR = 2.0, 95% CI = 1.10-5.0). No wound care nurse carried GAS. Interventions included education about standardized infection control guidelines and appropriate hand hygiene; carriers were treated with antibiotics. No subsequent GAS cases were identified in the following year. CONCLUSIONS: Transmission of GAS in this outbreak likely occurred during wound care and ended with improved hand hygiene. This investigation highlights additional research and policy needs for control of severe GAS infections among the high-risk LTCF population. 相似文献
57.
Stacy A. Shackelford Jennifer M. Gurney Audra L. Taylor Sean Keenan Jason B. Corley Cord W. Cunningham Brendon G. Drew Shane D. Jensen Russ S. Kotwal Harold R. Montgomery Erika T. Nance Michael A. Remley Andrew P. Cap the Joint Trauma System Defense Committee on Trauma the Armed Services Blood Program 《Transfusion》2021,61(Z1):S333-S335
Hemorrhage is the most common mechanism of death in battlefield casualties with potentially survivable injuries. There is evidence that early blood product transfusion saves lives among combat casualties. When compared to component therapy, fresh whole blood transfusion improves outcomes in military settings. Cold-stored whole blood also improves outcomes in trauma patients. Whole blood has the advantage of providing red cells, plasma, and platelets together in a single unit, which simplifies and speeds the process of resuscitation, particularly in austere environments. The Joint Trauma System, the Defense Committee on Trauma, and the Armed Services Blood Program endorse the following: (1) whole blood should be used to treat hemorrhagic shock; (2) low-titer group O whole blood is the resuscitation product of choice for the treatment of hemorrhagic shock for all casualties at all roles of care; (3) whole blood should be available within 30 min of casualty wounding, on all medical evacuation platforms, and at all resuscitation and surgical team locations; (4) when whole blood is not available, component therapy should be available within 30 min of casualty wounding; (5) all prehospital medical providers should be trained and logistically supported to screen donors, collect fresh whole blood from designated donors, transfuse blood products, recognize and treat transfusion reactions, and complete the minimum documentation requirements; (6) all deploying military personnel should undergo walking blood bank prescreen laboratory testing for transfusion transmitted disease immediately prior to deployment. Those who are blood group O should undergo anti-A/anti-B antibody titer testing. 相似文献
58.
Andrew D. Redd Aleisha Collinson-Streng Craig Martens Stacy Ricklefs Caroline E. Mullis Jordyn Manucci Aaron A. R. Tobian Ethan J. Selig Oliver Laeyendecker Nelson Sewankambo Ronald H. Gray David Serwadda Maria J. Wawer Stephen F. Porcella Thomas C. Quinn 《Journal of clinical microbiology》2013,51(8):2805
59.
Elvis Cami Travis Tagami Gilbert Raff Michael J. Gallagher Austin Fan Adam Hafeez Stacy J. Willner Priscilla Sigua Arce Julie George Abhay Bilolikar Kavitha Chinnaiyan Robert D. Safian 《Journal of Cardiovascular Computed Tomography》2021,15(2):114-120
BackgroundValues of fractional flow reserve (FFRCT) by coronary computed tomography angiography (CTA) decline from the ostium to the terminal vessel, irrespective of stenosis severity. The purpose of this study is to determine if the site of measurement of FFRCT impacts assessment of ischemia and its diagnostic performance relative to invasive FFR (FFRINV).Methods1484 patients underwent FFRCT; 1910 vessels were stratified by stenosis severity (normal; <25%, 25–50%, 50–70%, and >70% stenosis). The rates of positive FFRCT (≤0.8) were determined by measuring FFRCT from the terminal vessel and from distal-to-the-lesion. Reclassification rates from positive to negative FFRCT were calculated. Diagnostic performance of FFRCT relative to FFRINV was evaluated in 182 vessels using linear regression, Bland Altman analysis, and receiver operating characteristic (ROC) curves.ResultsPositive FFRCT was identified in 24.9% of vessels using terminal vessel FFRCT and 10.1% using FFRCT distal-to-the-lesion (p ?< ?0.001). FFRCT obtained distal-to-the-lesion resulted in reclassification of 59.6% of positive terminal FFRCT to negative FFRCT. Relative to FFRINV, there were improvements in specificity (50% to 86%, p ?< ?0.001), diagnostic accuracy (65% to 88%, p ?< ?0.001), positive predictive value (50% to 78%, p ?< ?0.001), and area-under-the-curve (AUC, 0.83 to 0.91, p ?< ?0.001) when FFRCT was measured distal-to-the-lesion.ConclusionFFRCT values from the terminal vessel should not be used to assess lesion-specific ischemia due to high rates of false positive results. FFRCT measured distal-to-the-lesion improves the diagnostic performance of FFRCT relative to FFRINV, ensures that FFRCT values are due to lesion-specific ischemia, and could reduce the rate of unnecessary invasive procedures. 相似文献
60.
James W. Snyder Gina K. Thomson Stacy Heckman Kira Jamros Sameh AbdelGhani Kenneth S. Thomson 《Clinical microbiology and infection》2021,27(5):783.e1-783.e5
ObjectiveThe current BD Kiestra? total laboratory automation (TLA) system automates specimen inoculation, incubation, and digital visualization of cultures prior to initiation of manual or semi-automated identification (ID) and antimicrobial susceptibility testing (AST). The current study aimed to compare the performance, in a clinical setting, of a fully automated research-use-only prototype, BD Kiestra? IdentifA/SusceptA (automated system), to our current BD Kiestra? TLA which utilizes manual or semi-automated IDs and ASTs (current system).MethodsClinical samples yielding significant growth after processing by the BD Kiestra? TLA were tested in parallel for ID and AST by both systems. IDs and ASTs were determined by Bruker matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry and BD Phoenix, respectively, with data stored and managed in the BD EpiCenter?. The automated system used a common inoculum preparation for both tests, whereas the current system used separate inocula. Results were compared to assess agreement between the systems.ResultsOn initial testing, 89% of IDs (466/523) and 92.4% of IDs (484/523) for the automated and current ID systems, respectively, yielded acceptable MALDI-TOF log scores of ≥1.7. On repeat testing, the respective acceptable scores were 97.1% (508/523) and 98.1% (513/523). For initial ASTs, the automated and current systems yielded 97.5% categorical agreement for 7325 drug–organism tests. After omitting discrepant MICs that differed by only one dilution and categorical discrepancies that were not reproducible, 0.2% unresolved discrepancies remained thus (99.8% categorical agreement).ConclusionsThe automated prototype is suitable for development into technology that will provide clinical microbiology laboratories with significant advantages such as improved efficiency, standardization, reproducibility, reduced technical error and greater safety. 相似文献