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101.
Gastrocolic fistula as a complication of benign gastric ulcer 总被引:1,自引:0,他引:1
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Neonatal sepsis of nosocomial origin: an epidemiological study from the "Grupo de Hospitales Castrillo" 总被引:2,自引:0,他引:2
López Sastre JB Coto Cotallo D Fernández Colomer B;Grupo de Hospitales Castrillo 《Journal of perinatal medicine》2002,30(2):149-157
A prospective multicenter study was designed to assess the frequency, etiology, and mortality of nosocomial neonatal sepsis diagnosed between 1996 and 1997 in the neonatology services of 27 acute-care hospitals in Spain ("Grupo de Hospitales Castrillo"). Nosocomial sepsis is defined in the literature using chronological criteria (> 3-7 days of life at the onset of symptoms); accordingly, there is the possibility of including late-onset maternally acquired sepsis or of excluding early-onset nosocomial sepsis (< 3-7 days of life). For these reasons, in this study, cases of nosocomial sepsis that developed at < or = 3-7 days after birth (early onset) were also recorded and maternally acquired sepsis diagnosed beyond 3-7 days of life were excluded. Using these criteria in a total of 30,993 admissions to the neonatal units of the participating hospitals, the nosocomial sepsis rate was 2.1% with an incidence density of 0.89 per 1000 patient days. Sepsis rate was significantly more frequent among very low birth weight (VLBW) infants (15.6%) than among those weighing > or = 1500 g (1.16%) (P < 0.001). Fifty-eight percent of all isolates were Gram-positive organisms, mainly Staphylococcus epidermidis (42%). Gram-negative organisms were isolated in 29.5% of cases (Escherichia coli and Klebsiella spp. were the most commonly isolated pathogens) and fungal infections in 12%, with absolute predominance of Candida spp. The overall mortality rate was 11.8% and the following subgroups had significantly higher (P < 0.001) mortality rates: sepsis caused by Gram-negative organisms (19% vs. 5.1% in Gram-positive pathogens) and sepsis caused by Pseudomonas aeruginosa (33.3% vs. 9.4% for the total number of sepsis caused by the remaining causative pathogens). Sepsis caused by S. epidermidis showed a significantly lower mortality rate (5.5%) compared with overall sepsis for the remaining etiologies (14.2%) (P < 0.001). In VLBW infants, the mortality rate was significantly higher than in infants weighing > 1500 g (17.3% vs. 6.5%, P < 0.001). 相似文献
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TR Puoane GD Hughes J Uwimana Q Johnson WR Folk 《African journal of traditional, complementary, and alternative medicines》2012,9(4):495-502
The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART). The study explored the perceptions, knowledge and attitudes of patients, health workers and traditional healers about the use of traditional medicine and Anti Retroviral Therapy (ART), using an exploratory qualitative design in two provinces of South Africa: an urban township health facility in the Western Cape, and a rural district hospital in KwaZulu-Natal (KZN) with antennal HIV rate of 32% and 28%''respectively. In-depth interviews were conducted with 14 participants: six HIV patients on ART and using Traditional Medicine(TM), two doctors, two nurses and four traditional healers. Two focus group discussions -one at each site - were held with community health workers who work with HIV-positive patients (Western Cape [5] and in KZN [4]). Patient said to have used Traditional Healing Practices (THP) before they were diagnosed with HIV, and some who have been diagnosed with HIV continue using TM in conjunction with ART and/or Cotrimoxazole prophylaxis. Patients preferred not to disclose THP to health professionals because of lack of support and understanding. Patients utilize THP because of family expectations, privacy and confidentiality, especially when they have not disclosed their HIV status. Healthcare professionals had strong negative opinions about THP, especially for HIV-positive patients. Traditional healers supported the patient''s rationale for THP use. This study revealed a need to better understand factors involved in patients'' choosing to use THP concurrently with ART. 相似文献
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Snyder DS; Chao NJ; Amylon MD; Taguchi J; Long GD; Negrin RS; Nademanee AP; O'Donnell MR; Schmidt GM; Stein AS 《Blood》1993,82(9):2920-2928
Ninety-nine consecutive patients with acute leukemia in first complete remission under age 50 (median age 27 years; age range 1 to 47 years) with a histocompatible sibling donor were treated with fractionated total body irradiation (1,320 cGy) and high-dose etoposide (60 mg/kg) followed by allogeneic bone marrow transplantation. Sixty-one patients were diagnosed with acute myelogenous leukemia (AML), 34 patients with acute lymphoblastic leukemia (ALL), 3 patients with biphenotypic acute leukemia, and 1 patient with acute undifferentiated leukemia. Thirty of the 34 patients with ALL had at least one of the following high-risk factors: age greater than 30, white blood cell count at presentation > 25,000/microL, extramedullary disease, certain chromosomal translocations, or the need for greater than 4 weeks of induction chemotherapy to achieve first complete remission. Cumulative probabilities of disease-free survival and relapse at 3 years were 61% and 12%, respectively, for the 61 patients with AML and 64% and 12%, respectively, for the 34 patients with ALL. By stepwise Cox regression analysis, significant prognostic variables for patients with acute myelogenous leukemia were the presence of acute graft-versus-host disease and increasing age, whereas for patients with acute lymphoblastic leukemia, significant variables were age and the development of cytomegalovirus-associated interstitial pneumonia. Complications related to graft-versus-host disease and relapse of leukemia were the major causes of death. 相似文献
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Background : Why oral health status outside capital cities is poorer than that in capital cities has not been satisfactorily explained. The aim of this study was to determine if the reason was poorer access to dental care. Methods : Data were obtained from the Australian National Survey of Adult Oral Health (2004–06). Oral health status was measured by DMFT Index, and numbers of decayed, missing and filled teeth. A two‐step analysis was undertaken: comparing the dependent variables by location, socio‐demographic confounders and preventive dental behaviours, and then including six access to dental care variables. Results : Of the 14 123 people interviewed, 5505 were examined, and 4170 completed the questionnaire. With socio‐economic parameters in the first regression model, non‐capital city people had higher DMFT (regression coefficient = 1.15, p < 0.01), more decayed (0.42, p < 0.01) and missing teeth (0.85, p < 0.01), but not filled teeth (?0.11, p = 0.71), than capital city based people. In the second step analysis, non‐capital city people still had a greater DMFT (1.01, p < 0.01), more decayed (0.27, p = 0.03) and missing teeth (0.74, p < 0.01), but not filled teeth (0.00, p = 0.99) than capital city based people. Conclusions : Access to dental care was not the only reason why people outside capital cities have poorer oral health than people living in capital cities. 相似文献
109.
Goto Y O'Malley C Fanning NF Wang J Redmond HP Shorten GD 《Irish journal of medical science》2003,172(4):191-194
Background Benzodiazepines, which are commonly administered perioperatively, can depress immune function. Neutrophil apoptosis plays
a central role in the regulation of inflammation. This is particularly important during and after surgery.
Aim To examine the effects of benzodiazepines (midazolam and diazepam) on neutrophil apoptosis.
Methods Venous blood samples were withdrawn from patients scheduled to undergo elective surgery, (a) immediately prior to, and 10
minutes after administration of midazolam 0.2mg/kg intravenously (n=11) and (b) immediately prior to, and 60 minutes after
administration of diazepam 10mg po (n=10). Neutrophil apoptosis was measured by Annexin VFITC after 1 and 12 hours in culture.
Results The percentage of apoptotic cells was significantly less after midazolam at 12% (11.9) hours in culture compared to pre-midazolam
29.7% (13.3) (p<0.05). After diazepam, the rates of neutrophil apoptosis were also significantly less after 12 hours in culture
(p<0.05).
Conclusion Administration of benzodiazepines in clinically relevant doses inhibits neutrophil apoptosis. In the perioperative period,
this may influence the inflammatory response to surgery. 相似文献
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