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131.
Surface hardness development in light-cured composites 总被引:1,自引:0,他引:1
132.
Kathrin Krause Benjamin T. Kopp Mia F. Tazi Kyle Caution Kaitlin Hamilton Asmaa Badr Chandra Shrestha Dmitry Tumin Don Hayes Frank Robledo-Avila Luanne Hall-Stoodley Brett G. Klamer Xiaoli Zhang Santiago Partida-Sanchez Narasimham L. Parinandi Stephen E. Kirkby Duaa Dakhlallah Karen S. McCoy Amal O. Amer 《Journal of cystic fibrosis》2018,17(4):454-461
Introduction
Cystic fibrosis (CF) is a multi-organ disorder characterized by chronic sino-pulmonary infections and inflammation. Many patients with CF suffer from repeated pulmonary exacerbations that are predictors of worsened long-term morbidity and mortality. There are no reliable markers that associate with the onset or progression of an exacerbation or pulmonary deterioration. Previously, we found that the Mirc1/Mir17–92a cluster which is comprised of 6 microRNAs (Mirs) is highly expressed in CF mice and negatively regulates autophagy which in turn improves CF transmembrane conductance regulator (CFTR) function. Therefore, here we sought to examine the expression of individual Mirs within the Mirc1/Mir17–92 cluster in human cells and biological fluids and determine their role as biomarkers of pulmonary exacerbations and response to treatment.Methods
Mirc1/Mir17–92 cluster expression was measured in human CF and non-CF plasma, blood-derived neutrophils, and sputum samples. Values were correlated with pulmonary function, exacerbations and use of CFTR modulators.Results
Mirc1/Mir17–92 cluster expression was not significantly elevated in CF neutrophils nor plasma when compared to the non-CF cohort. Cluster expression in CF sputum was significantly higher than its expression in plasma. Elevated CF sputum Mirc1/Mir17–92 cluster expression positively correlated with pulmonary exacerbations and negatively correlated with lung function. Patients with CF undergoing treatment with the CFTR modulator Ivacaftor/Lumacaftor did not demonstrate significant change in the expression Mirc1/Mir17–92 cluster after six months of treatment.Conclusions
Mirc1/Mir17–92 cluster expression is a promising biomarker of respiratory status in patients with CF including pulmonary exacerbation. 相似文献133.
Should the mitral valve be repaired for moderate ischemic mitral regurgitation at the time of revascularization surgery?
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134.
Plasma cytokine measurements augment prognostic scores as indicators of outcome in patients with severe sepsis 总被引:9,自引:0,他引:9
Oberholzer A Souza SM Tschoeke SK Oberholzer C Abouhamze A Pribble JP Moldawer LL 《Shock (Augusta, Ga.)》2005,23(6):488-493
Despite recent advances in the prospective identification of the patient with sepsis who may benefit from anti-inflammatory or antithrombotic therapies, successful treatment regimens have been fairly modest. We have explored whether determination of several proinflammatory cytokine or mediator concentrations can complement physiologic scoring systems to identify patients with severe sepsis who will survive or expire within 28 days. The design of the study included an exploratory analysis performed in conjunction with a prospective, randomized, double-blind, placebo-controlled, multicenter, clinical trial and involved 33 academic institutions in the United States. One hundred twenty-four patients with severe sepsis with or without septic shock were included in this analysis. Blood samples were obtained at baseline and on days 1 through 4, and were evaluated for proinflammatory and anti-inflammatory cytokine concentrations, as well as for procalcitonin and total protein C levels. Baseline concentrations and changes in the concentrations of these mediators were evaluated in relationship to the Acute Physiology and Chronic Health Evaluation (APACHE) II and multiple organ dysfunction (MOD) scores, and 28-day all-cause mortality. Using univariate logistic regression analyses, APACHE II and MOD scores, age (but not gender), and baseline plasma interleukin (IL)-6 and soluble tumor necrosis factor receptor (sTNFR) 1 (log transformed) concentrations were all predictive of increased 28-day all-cause mortality (P < 0.01). Baseline total protein C, IL-8, IL-10, TNF-alpha, and procalcitonin concentrations, and the change in plasma cytokine concentrations from baseline over the initial 4 days were not useful in predicting outcome. Selected baseline proinflammatory cytokine concentrations and APACHE II score were correlated (P < 0.01). IL-6 concentration is a strong candidate for predicting clinical outcome in patients with severe sepsis alone, or when combined with the APACHE II or MOD scores. The potential usefulness of the combination of cytokine measurements and prognostic scores to identify patients who may benefit from treatment with anti-inflammatory or antithrombotic therapies should be further evaluated. 相似文献
135.
1 Versus 2-cm Excision Margins for pT2-pT4 Primary Cutaneous Melanoma (MelMarT): A Feasibility Study
Marc D. Moncrieff David Gyorki Robyn Saw Andrew J. Spillane Howard Peach Deemesh Oudit Jenny Geh Peter Dziewulski Ewan Wilson Paolo Matteucci Rowan Pritchard-Jones Roger Olofsson Bagge Frances C. Wright Nic Crampton Oliver Cassell Navid Jallali Adam Berger John Kelly Stephen Hamilton Amer Durrani Serigne Lo Elizabeth Paton Michael A. Henderson 《Annals of surgical oncology》2018,25(9):2541-2549
Background
There is a lack of consensus regarding optimal surgical excision margins for primary cutaneous melanoma?>?1 mm in Breslow thickness (BT). A narrower surgical margin is expected to be associated with lower morbidity, improved quality of life (QoL), and reduced cost. We report the results of a pilot international study (MelMarT) comparing a 1 versus 2-cm surgical margin for patients with primary melanoma?>?1 mm in BT.Methods
This phase III, multicentre trial [NCT02385214] administered by the Australia & New Zealand Medical Trials Group (ANZMTG 03.12) randomised patients with a primary cutaneous melanoma?>?1 mm in BT to a 1 versus 2-cm wide excision margin to be performed with sentinel lymph node biopsy. Surgical closure technique was at the discretion of the treating surgeon. Patients’ QoL was measured (FACT-M questionnaire) at baseline, 3, 6, and 12 months after randomisation.Results
Between January 2015 and June 2016, 400 patients were randomised from 17 centres in 5 countries. A total of 377 patients were available for analysis. Primary melanomas were located on the trunk (56.9%), extremities (35.6%), and head and neck (7.4%). More patients in the 2-cm margin group required reconstruction (34.9 vs. 13.6%; p?<?0.0001). There was an increased wound necrosis rate in the 2-cm arm (0.5 vs. 3.6%; p?=?0.036). After 12 months’ follow-up, no differences were noted in QoL between groups.Discussion
This pilot study demonstrates the feasibility of a large international RCT to provide a definitive answer to the optimal excision margin for patients with intermediate- to high-risk primary cutaneous melanoma.136.
Tianli Du Katherine A. Bill Jennifer Ford Mohammed Barawi Richard D. Hayward Amer Alame Richard N. Berri 《American journal of surgery》2018,215(3):472-475
Background
Pancreatic cancer is the fourth leading cause of cancer-related death in United States. We compared Computed Tomography (CT) with pancreas protocol and Endoscopic Ultrasound (EUS) in terms of mass detection, mass size, vascular involvement and lymph node involvement.Methods
We retrospectively evaluated 93 patients. Concordance between CT and EUS, and accuracy of CT and EUS were assessed using a retrospective chart review and statistical analysis.Results
CT and EUS agreed on mass detection in 88% of the cases and mass size in 67% of the cases. They agreed in 74% of cases about the presence or absence of vascular involvement and 82% in lymph node involvement. Cohen's kappa indicated that the concordance between two tests was moderately reliable.Conclusion
CT and EUS agree moderately well in identifying characteristics of pancreatic masses, but discrepancies between the two modalities are common, particularly with respect to involvement of specific blood vessels and lymph nodes. Clinicians should use caution in relying on a single modality to make decisions. 相似文献137.
David F. Stroncek Bronwen E. Shaw Brent R. Logan Deidre M. Kiefer Bipin N. Savani Paolo Anderlini Christopher N. Bredeson Peiman Hematti Siddhartha Ganguly Miguel Angel Diaz Hisham Abdel-Azim Ibrahim Ahmed Dipnarine Maharaj Matthew Seftel Amer Beitinjaneh Sachiko Seo Jean A. Yared Joerg Halter Michael A. Pulsipher 《Biology of blood and marrow transplantation》2018,24(1):175-184
Little is known about the experiences of individuals donating peripheral blood stem cells (PBSCs) or marrow for a second time. To study this, unrelated donors making a second donation through the National Marrow Donor Program between 2004 and 2013 were evaluated. Experiences of second-time donors giving marrow (n?=?118: first donation was PBSC in 76 and marrow in 42) were compared with those making only 1 marrow donation (n?=?5829). Experiences of second-time donors giving PBSCs (n?=?602) (first donation was PBSCs in 362; marrow in 240) were compared to first-time PBSC donors (n?=?16,095). For donors giving a second PBSC or marrow donation there were no significant differences in maximum skeletal pain, maximum symptoms measured by an established modified toxicity criteria, and recovery time compared with those who donated only once. Notably, the yield of marrow nucleated cells and PBSC CD34+ cells with second donations was less. As previously noted with single first-time donations, female (PBSCs and marrow) and obese donors (PBSCs) had higher skeletal pain and/or toxicity with a second donation. PBSC donors who experienced high levels of pain or toxicity with the first donation also experienced high levels of these symptoms with their second donation and slower recovery times. In conclusion, for most donors second donation experiences were similar to first donation experiences, but CD34+ yields were less. Knowledge of the donor's first experience and stem cell yields may help centers decide whether second donations are appropriate and institute measures to improve donor experiences. 相似文献
138.
Jose F. Camargo Erik Kimble Rossana Rosa Luis A. Shimose Maria X. Bueno Nikeshan Jeyakumar Michele I. Morris Lilian M. Abbo Jacques Simkins Maritza C. Alencar Cara Benjamin Eric Wieder Antonio Jimenez Amer Beitinjaneh Mark Goodman John J. Byrnes Lazaros J. Lekakis Denise Pereira Krishna V. Komanduri 《Biology of blood and marrow transplantation》2018,24(4):806-814
The optimal viral load threshold at which to initiate preemptive cytomegalovirus (CMV) therapy in hematopoietic cell transplantation (HCT) recipients remains to be defined. In an effort to address this question, we conducted a retrospective study of 174 allogeneic HCT recipients who underwent transplantation at a single center between August 2012 and April 2016. During this period, preemptive therapy was initiated at the discretion of the treating clinician. A total of 109 patients (63%) developed CMV viremia. The median time to reactivation was 17 days (interquartile range, IQR, 7-30 days) post-HCT. A peak viremia ≥150?IU/mL was strongly associated with a reduced probability of spontaneous clearance (relative risk, .16; 95% confidence interval, .1-.27), independent of established clinical risk factors, including CMV donor serostatus, exposure to antithymocyte globulin, and underlying lymphoid malignancy. The median time to clearance of viremia was significantly shorter in those who started therapy at CMV <350?IU/mL (19 days; IQR, 11-35 days) compared with those who started antiviral therapy at higher viremia thresholds (33 days; IQR, 21-42 days; P?=?.02). The occurrence of treatment-associated cytopenias was frequent but similar in patients who started preemptive therapy at CMV <350?IU/mL and those who started at CMV >350?IU/mL (44% versus 57%; P?=?.42). Unresolved CMV viremia by treatment day 35 was associated with increased risk of therapeutic failure (32% versus 0%; P?=?.001). Achieving eradication of CMV viremia by treatment day 35 was associated with a 74% reduction in 1-year nonrelapse mortality (NRM) (adjusted hazard ratio [HR], .26; 95% confidence interval [CI], .1-.8; P?=?.02), whereas therapeutic failure was associated with a significant increase in the probability of 1-year NRM (adjusted HR, 26; 95% CI, 8-87; P?<.0001). We conclude that among allogeneic HCT patients, a peak CMV viremia ≥150?IU/mL is associated with a >80% reduction in the probability of spontaneous clearance independent of ATG administration, CMV donor serostatus, and lymphoid malignancy, and is a reasonable cutoff for preemptive therapy. Delaying initiation of therapy until a CMV value ≥350?IU/mL is associated with more protracted CMV viremia, and unresolved viremia by treatment day 35 is associated with a significant increase in NRM. 相似文献
139.
140.