全文获取类型
收费全文 | 195638篇 |
免费 | 8936篇 |
国内免费 | 519篇 |
专业分类
耳鼻咽喉 | 2889篇 |
儿科学 | 6150篇 |
妇产科学 | 4806篇 |
基础医学 | 26892篇 |
口腔科学 | 6509篇 |
临床医学 | 12848篇 |
内科学 | 46873篇 |
皮肤病学 | 6400篇 |
神经病学 | 15945篇 |
特种医学 | 4587篇 |
外国民族医学 | 30篇 |
外科学 | 24499篇 |
综合类 | 1055篇 |
一般理论 | 49篇 |
预防医学 | 18642篇 |
眼科学 | 3962篇 |
药学 | 13460篇 |
中国医学 | 841篇 |
肿瘤学 | 8656篇 |
出版年
2023年 | 1139篇 |
2022年 | 1679篇 |
2021年 | 4412篇 |
2020年 | 2308篇 |
2019年 | 4421篇 |
2018年 | 6357篇 |
2017年 | 3932篇 |
2016年 | 3860篇 |
2015年 | 4183篇 |
2014年 | 5512篇 |
2013年 | 8013篇 |
2012年 | 12779篇 |
2011年 | 13431篇 |
2010年 | 7141篇 |
2009年 | 5839篇 |
2008年 | 10973篇 |
2007年 | 11580篇 |
2006年 | 10954篇 |
2005年 | 10883篇 |
2004年 | 9786篇 |
2003年 | 9277篇 |
2002年 | 8780篇 |
2001年 | 5968篇 |
2000年 | 6504篇 |
1999年 | 5170篇 |
1998年 | 1301篇 |
1997年 | 951篇 |
1996年 | 860篇 |
1995年 | 739篇 |
1994年 | 596篇 |
1993年 | 563篇 |
1992年 | 2280篇 |
1991年 | 2080篇 |
1990年 | 1875篇 |
1989年 | 1621篇 |
1988年 | 1438篇 |
1987年 | 1387篇 |
1986年 | 1315篇 |
1985年 | 1188篇 |
1984年 | 882篇 |
1983年 | 749篇 |
1979年 | 787篇 |
1975年 | 599篇 |
1974年 | 676篇 |
1973年 | 728篇 |
1972年 | 626篇 |
1971年 | 626篇 |
1970年 | 606篇 |
1969年 | 596篇 |
1968年 | 538篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
991.
Josefine Jnsson Kristina M. Renault Sonia García-Calzn Alexander Perfilyev Angela C. Estampador Kirsten Nrgaard Mads Vendelbo Lind Allan Vaag Line Hjort Kim F. Michaelsen Emma Malchau Carlsen Paul W. Franks Charlotte Ling 《Diabetes》2021,70(4):854
Maternal obesity may lead to epigenetic alterations in the offspring and might thereby contribute to disease later in life. We investigated whether a lifestyle intervention in pregnant women with obesity is associated with epigenetic variation in cord blood and body composition in the offspring. Genome-wide DNA methylation was analyzed in cord blood from 208 offspring from the Treatment of Obese Pregnant women (TOP)-study, which includes pregnant women with obesity randomized to lifestyle interventions comprised of physical activity with or without dietary advice versus control subjects (standard of care). DNA methylation was altered at 379 sites, annotated to 370 genes, in cord blood from offspring of mothers following a lifestyle intervention versus control subjects (false discovery rate [FDR] <5%) when using the Houseman reference-free method to correct for cell composition, and three of these sites were significant based on Bonferroni correction. These 370 genes are overrepresented in gene ontology terms, including response to fatty acids and adipose tissue development. Offspring of mothers included in a lifestyle intervention were born with more lean mass compared with control subjects. Methylation at 17 sites, annotated to, for example, DISC1, GBX2, HERC2, and HUWE1, partially mediates the effect of the lifestyle intervention on lean mass in the offspring (FDR <5%). Moreover, 22 methylation sites were associated with offspring BMI z scores during the first 3 years of life (P < 0.05). Overall, lifestyle interventions in pregnant women with obesity are associated with epigenetic changes in offspring, potentially influencing the offspring’s lean mass and early growth. 相似文献
992.
M. Taboada A. Baluja S.H. Park P. Otero C. Gude A. Bolón E. Ferreiroa A. Tubio A. Cariñena V. Caruezo J. Alvarez P.G. Atanassoff 《Revista espa?ola de anestesiología y reanimación》2021,68(7):384-391
Background of the studyThe goal of the study was to compare the incidence of complications, technical difficulty of intubation and physiologic pre-intubation status between the first intubation and reintubation performed on the same patient in an ICU.Materials and methodsThe study was approved by the ethics committee of Galicia (Santiago-Lugo, code No. 2015-012). Due to the observational, noninterventional, and noninvasive design of this study, the need for written consent was waived by the ethics committee of Galicia. Patients requiring tracheal intubation and reintubation in the ICU were included in this prospective observational study. Main endpoint was to compare the incidence of complications, physiologic pre-intubation status, and the rate of technical difficulty of intubation between the first intubation and reintubation performed on the same patient in an ICU.Results and discussion504 patients were intubated in our ICU during the study period, and 82 (16%) required reintubation. There was no difference between the first intubation and reintubation regarding number of total complication (35% vs 33%; P = .86), hypotension (24% vs 24%; P = 1), hypoxia (26% vs 26%; P = 1), esophageal intubation (1% vs 1%; P = 1), and bronchoaspiration (2% vs 1%; P = .86). Physiologic pre-intubation status and technical difficulty of intubation did not differ between the first intubation and reintubation.ConclusionsIn our ICU patients requiring tracheal reintubation, incidence of complications, physiologic pre-intubation status, and technical difficulty of intubation did not differ between the first intubation and reintubation. 相似文献
993.
M.A. Pajares J.A. Margarit C. García-Camacho J. García-Suarez E. Mateo M. Castaño C. López Forte J. López Menéndez M. Gómez M.J. Soto S. Veiras E. Martín B. Castaño S. López Palanca T. Gabaldón J. Acosta J. Fernández Cruz A.R. Fernández López R. Vicente 《Revista espa?ola de anestesiología y reanimación》2021,68(4):183-231
The ERAS guidelines are intended to identify, disseminate and promote the implementation of the best, scientific evidence-based actions to decrease variability in clinical practice. The implementation of these practices in the global clinical process will promote better outcomes and the shortening of hospital and critical care unit stays, thereby resulting in a reduction in costs and in greater efficiency. After completing a systematic review at each of the points of the perioperative process in cardiac surgery, recommendations have been developed based on the best scientific evidence currently available with the consensus of the scientific societies involved. 相似文献
994.
André Luís Conde Watanabe Mateus Silva Feijó Vinícius Paulo Lima de Menezes Mayara Regina Galdino-Vasconcelos Jorge Luis Salinas Caballero Gustavo Ferreira Fernando Jorge Natália Trevizoli Luiz Gustavo Diaz Priscila Brizolla de Campos Gabriel Cajá Raquel Ullmann Ana Virgínia Figueira Tiago Morato Adriano Moraes Juan Rafael Branez Pereira Marcelo Perosa 《Transplantation proceedings》2021,53(1):73-82
IntroductionLiver transplantation is the standard treatment for end-stage liver disease. Brazil holds the third highest number of liver transplants performed per year, but center maldistribution results in high discrepancies in accessing this treatment. In 2012, an interstate partnership successfully implemented a new liver transplantation program in the middle west of Brazil. Here, we report the results of the first 500 liver transplants performed in this new program and discuss the impacts of a new transplant center in regional transplantation dynamics.MethodsWe reviewed data from the first 500 consecutive deceased donor liver transplants performed in the new program during an 8-year period. We analyzed data on patients’ clinical and demographic profiles, postoperative outcomes, and graft and recipient survival rates. Univariate survival analysis was conducted using log-rank tests to compare the groups.ResultsAlmost half (48%) of the procured organs and 40% of the recipients transplanted in our center were from outside our state. Recipient 30-day mortality was 9%. Overall recipient survival at 1 year and 5 years was 85% and 80%, respectively. Mortality was significantly associated with higher Model for End-Stage Liver Disease (P < .001) but not with the presence of hepatocellular carcinoma (P = .795).DiscussionThe new transplantation program treated patients from different regions of Brazil and became the reference center in liver transplantation for the middle west region. Despite the recent implementation, our outcomes are comparable to experienced centers around the world. This model can inspire the creation of new transplantation programs aiming to democratize access to liver transplantation nationwide. 相似文献
995.
Gustavo Martinez-Mier Pedro I. Moreno-Ley Luis F. Budar-Fernández Marco T. Méndez-López Carlos A. Allende-Castellanos Luis A. Jiménez-López Daniel A. Barrera-Amoros Edgar Aguilar-Sandoval Maritza De la Paz-Román Ernesto Soto-Miranda Yamilli Rivera-Sanchez Mónica Martínez-Maldonado 《Transplantation proceedings》2021,53(3):1005-1009
ContextThymoglobulin is used effectively as induction agent in kidney transplantation but the optimal dose is not well established.ObjectiveDemonstrate that low-dose thymoglobulin (3 mg/kg) has similar efficacy and safety compared to basiliximab induction in low-risk kidney transplantation under standard maintenance immunosuppressionDesign, Setting, ParticipantsProspective randomized study in kidney transplant patients (12/2016-05/2018). Inclusion criteria: Recipients > 18 years, first living donor transplant. Exclusion criteria: Second and multiorgan transplant, ABO incompatibility, positive cross-match, panel reactive antibodies (PRA) > 30%, positive donor-specific antibody, human immunodeficiency virus, hepatitis B surface antigen, hepatitis C virus positive, white blood cells < 2000 cells/mm3, platelets < 75,000 cells/mm3 and malignancy.InterventionGroup A: basiliximab (20 mg D0 and D4). Group B: thymoglobulin (3 mg/kg total). Maintenance immunosuppression: tacrolimus, mycophenolate mofetil, and steroids.Main Outcome MeasuresBiopsy-proven acute rejection (BPAR), delayed graft function, slow graft function, leukopenia, infections, adverse events, graft loss, estimated glomerular filtration rate, and death within 12 months.Results100 patients (basiliximab, n = 53) (thymoglobulin, n = 47) were included. Donor and recipient characteristics were similar except for longer dialysis (basiliximab), PRA class I (1.2% basiliximab, 4.5% thymoglobulin), HLA match (basiliximab 2.8, thymoglobulin 2.2), and cytomegalovirus status. BPAR rate was basiliximab 3.8% and thymoglobulin 6.4% (P = ns). Delayed graft function (basiliximab 3.8%; thymoglobulin 4.3%), slow graft function, and 12-month leukopenia (basiliximab 11.3%, thymoglobulin 21.3%) were similar between groups (P = ns). There was no difference in infections and adverse events between groups. Patient and graft survival were as follows: basiliximab 98.1% and 92.5%, thymoglobulin 100% and 93.6% (P = ns).ConclusionLow-dose thymoglobulin induction (3 mg/kg) can be used effectively and safely in low-risk kidney transplantation with good results during the first year post-transplant. 相似文献
996.
M. Vives A. Hernández A.D. González J. Torres P. Cuesta T. Villen P. Carmona D. Nagore M. Serna U. Bengoetxea X. Borrat G. García de Casasola E. Sánchez R. Campo J. Mercadal 《Revista espa?ola de anestesiología y reanimación》2021,68(3):143-148
The use of ultrasound as a clinical diagnostic tool and guide of bedside procedures has become an indispensable examination in the acute critically ill patient. The training of professionals in minimum skills of knowledge, management and indications of use of ultrasound required to be defined by the Scientific Societies. The Intensive Care Ultrasound Working Group of the Spanish Society of Anesthesiology and Resuscitation (SEDAR), of the Spanish Society of Internal Medicine (SEMI) and the Spanish Society of Emergency Medicine (SEMES) has developed this consensus document in which the recommended training program and the minimum competencies to be achieved with regard to the use of Ultrasound in Intensive Care, Anesthesia and Emergency medicine are defined.This document defines the training program and the skills to acquire in order to achieve the diploma in lung, abdominal and vascular ultrasound. This document can serve as a guide to define the skills to be acquired in the training programs of residents (MIRs) of specialists working in intensive care, anesthesia, and emergency medicine. 相似文献
997.
Daniela de Queiroz Moura Ramon Rawache Marília Ferreira Gomes Garcia Nathalia Farias Vasconcelos Priscila Santos Gustavo Rego Coelho Thiago Luis da Paz Santos Duílio Reis da Rocha Filho Sonia Leite da Silva Eliana Regia Barbosa de Almeida Paula F.C.B.C. Fernandes João Batista Cerqueira José Huygens Parente Garcia Claudia Maria Costa de Oliveira 《Transplantation proceedings》2021,53(4):1345-1349
Transplantation of any organ has some inherent risk of disease transmission, such as infection and malignancy. The present study aims to describe 2 cases of choriocarcinoma transmission after kidney and liver transplantation originating from the same patient. The donor was a 17-year-old woman who died of cerebral hemorrhage. Both organ recipients died of metastatic choriocarcinoma few months after the transplantation, within days after starting chemotherapy. Retrospective hCG (human chorionic gonadotropin hormone) analysis in donor's blood stored at the time of donation had a result of 9324 mIU/mL. Despite its rarity, clinicians should be aware of the risk of transplant-related choriocarcinoma from female donors in childbearing age. In some cases, hCG dosage should be performed before donation. 相似文献
998.
Fausto Biancari Giovanni Mariscalco Magnus Dalén Nicla Settembre Henryk Welp Andrea Perrotti Karsten Wiebe Enrico Leo Antonio Loforte Sidney Chocron Davide Pacini Tatu Juvonen L. Mikael Broman Dario Di Perna Hakeem Yusuff Chris Harvey Nicolas Mongardon Juan P. Maureira Antonio Fiore 《Journal of cardiothoracic and vascular anesthesia》2021,35(7):1999-2006
999.
1000.
Sergio Agudiez-Calvo Jorge Ballesteros-Frutos Héctor Raúl Cabezas-García Daniel Pecos-Martin Tomás Gallego-Izquierdo 《The Journal of foot and ankle surgery》2021,60(2):247-251
The aim of this study was the validation and transcultural adaptation of the Pain Scale for Plantar Fasciitis to Spanish, following the steps defined by “Guidelines for the process of cross-cultural adaptation of self-report measures.” A cross-sectional study was driven in 153 patients with unilateral plantar fasciitis diagnosis. Statistical analysis measured the internal consistency, the test-retest reliability, the construct validity with the Spanish version of Foot and Function Index, and a factorial analysis. The questionnaire Pain Scale for Plantar Fasciitis was also given to a group of 10 people who received a physiotherapy treatment based on manual therapy, therapeutic exercise, and health education, which aim was to determine the questionnaire's sensitivity to changes. The questionnaire showed high internal consistency and test-retest reliability (Cronbach's α = 0.99, intraclass correlation coefficient = 0.98 [0.97-0.98]), good convergent validity with a moderate correlation with the Foot and Function Index (rho = 0.677, p < .0001) and no floor or ceiling effects were detected. The factorial analysis revealed that the first 3 factors showed 42.47% of variance, finding only 1 latent feature. Statistically significant differences were found in those patients who received physiotherapy treatment after 1 month, revealing that the questionnaire was sensitive to changes in the symptoms of subjects with plantar fasciitis. The Spanish version of Pain Scale for Plantar Fasciitis has proved to be a valid, reliable, and change-sensitive tool for patients with plantar fasciitis. 相似文献