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101.
Purpose: To evaluate treatment satisfaction and compliance with pharmacologic therapy in urinary incontinence patients.
Materials and Methods: An online survey was returned by 1447 individuals from a nationwide panel of adults who had previously reported treatment for incontinence symptoms and agreed to participate in survey research. Data on demographics, incontinence severity, treatment compliance, and satisfaction were obtained. Logistic regression was used to estimate crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for characteristics associated with pharmacologic treatment dissatisfaction and discontinuation.
Results: The sample was predominantly female (87%) and white (93%) with a mean age of 56 years. On average, patients urinated 10 times/day and experienced 16 wetting accidents in the week preceding survey. Overall, 25% reported being somewhat or very dissatisfied with treatment. Those who reported a severe effect of incontinence on their lives were most likely to be dissatisfied (OR = 2.82, 95% CI = 1.89–4.23). Discontinuation of drug treatment was reported by 45% of study subjects, with major reasons being poor efficacy (in 41.3% of discontinuations), side effects (22.4%), and cost (18.7%). Predictors for discontinuation included young age (OR = 1.8, 95% CI = 1.2–2.8), experiencing symptoms for 10 or more years (OR = 1.5, 95% CI = 1.1–2.0), and experiencing more than 16 wetting accidents in the last week (OR = 1.6, 95% CI = 1.3–2.1).
Conclusions: This online survey of self-selected incontinence patients indicated that almost half of those who have received drug treatment for incontinence had discontinued primarily because of lack of efficacy, side effects, and cost concerns. Our findings suggest a substantial degree of unmet need from current therapy among those with incontinence. 相似文献
Materials and Methods: An online survey was returned by 1447 individuals from a nationwide panel of adults who had previously reported treatment for incontinence symptoms and agreed to participate in survey research. Data on demographics, incontinence severity, treatment compliance, and satisfaction were obtained. Logistic regression was used to estimate crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for characteristics associated with pharmacologic treatment dissatisfaction and discontinuation.
Results: The sample was predominantly female (87%) and white (93%) with a mean age of 56 years. On average, patients urinated 10 times/day and experienced 16 wetting accidents in the week preceding survey. Overall, 25% reported being somewhat or very dissatisfied with treatment. Those who reported a severe effect of incontinence on their lives were most likely to be dissatisfied (OR = 2.82, 95% CI = 1.89–4.23). Discontinuation of drug treatment was reported by 45% of study subjects, with major reasons being poor efficacy (in 41.3% of discontinuations), side effects (22.4%), and cost (18.7%). Predictors for discontinuation included young age (OR = 1.8, 95% CI = 1.2–2.8), experiencing symptoms for 10 or more years (OR = 1.5, 95% CI = 1.1–2.0), and experiencing more than 16 wetting accidents in the last week (OR = 1.6, 95% CI = 1.3–2.1).
Conclusions: This online survey of self-selected incontinence patients indicated that almost half of those who have received drug treatment for incontinence had discontinued primarily because of lack of efficacy, side effects, and cost concerns. Our findings suggest a substantial degree of unmet need from current therapy among those with incontinence. 相似文献
102.
KP Morris JR Skinner C Wren S Hunter MG Coulthard 《Archives of disease in childhood》1993,68(5):637-643
Thirteen anaemic children on dialysis were assessed to determine the incidence of cardiac changes in end stage renal failure. Nine children had an increased cardiothoracic ratio on radiography. The electrocardiogram was abnormal in every case but no child had left ventricular hypertrophy as assessed by voltage criteria. However, left ventricular hypertrophy, often gross, was found on echocardiography in 12 children and affected the interventricular septum disproportionately. Cardiac index was increased in 10 patients as a result of an increased left ventricular stroke volume rather than heart rate. Left ventricular hypertrophy was significantly greater in those on treatment for hypertension and in those with the highest cardiac index. Abnormal diastolic ventricular function was found in 6/11 children. Children with end stage renal failure have significant cardiac abnormalities that are likely to contribute to the high cardiovascular mortality in this group. Anaemia and hypertension, or its treatment, probably contribute to these changes. Voltage criteria on electrocardiogram are of no value in detecting left ventricular hypertrophy. Echocardiography must be performed, with the results corrected for age and surface area, in order to detect and follow these abnormalities. 相似文献
103.
104.
Disappearance of phantom pain after focal brain infarction 总被引:4,自引:0,他引:4
A patient with hemiplegia and hemihypoesthesia is presented in whom preexisting phantom limb pain disappeared with the appearance of a stroke localized by CT scan to the posterior internal capsule. Differentiation between the cutaneous sensation and the sensation of phantom limb pain that appeared later seems to support the assumed existence of a polysynaptic sensory pathway that conveys the sensations of deafferentation. 相似文献
105.
Isradipine prevents global and regional cocaine-induced changes in brain blood flow: a preliminary study 总被引:1,自引:0,他引:1
B. Johnson Bruce Barron Bing Fang L. Lamki Louis Wagner Lynda Wells Paul Kenny Dennis Overton Sukhindar Dhother David Abramson Richard Chen Larry Kramer 《Psychopharmacology》1998,136(4):335-341
The L-type calcium channel antagonist, isradipine, reduces brain ischemia in animal models of ischemic stroke. These effects
of isradipine appear more pronounced in dopamine (DA) rich brain regions. These same DA-rich brain regions have also been
shown to be the areas most affected by cocaine-induced ischemic changes. Using a novel quantified approach to single photon
emission computerized tomography, we demonstrated that isradipine pre-treatment prevented cocaine-induced ischemic changes,
especially in these DA-rich brain regions. This is the first demonstration that any medication, including isradipine, can
prevent the ischemic effects of cocaine on brain blood flow. Isradipine may, therefore, be a useful therapeutic agent for
the prevention of brain ischemia in cocaine addicts.
Received: 4 June 1997/Final version: 3 November 1997 相似文献
106.
Between June 1986 and April 1988, 86 sonographic examinations of the shoulder were performed on patients suspected of having rotator cuff tears. Major sonographic diagnostic criteria included (a) a well-defined discontinuity usually visible as a hypoechoic focus within the cuff, (b) nonvisualization of the cuff and (c) an echogenic focus within the cuff. Seventy-five patients underwent both sonography and arthrography. Compared with arthrography alone, ultrasound examinations enabled detection of 92% of rotator cuff tears (24 of 26 tears), with a specificity of 84% and a negative predictive value of 95%. Correlation was obtained in 30 of these patients who underwent surgery for rotator cuff tear or other soft-tissue abnormality. In this group, the sensitivity of sonography for detection of a tear was 93%, with a specificity of 73%, while for arthrography sensitivity was 87% and specificity was 100%. These data indicate that sonography is a useful, noninvasive screening procedure for patients suspected of having rotator cuff injury. 相似文献
107.
108.
S. Murthy Tadavarthy M.D. Wilfrido Castaneda-Zuniga C. Zollikofer Frederic Nemer Jesse Barron Kurt Amplatz 《Cardiovascular and interventional radiology》1981,4(1):39-42
Angiodysplasia of the colon is being recognized with increasing frequency as a source of lower gastrointestinal bleeding in
the elderly. In one patient with colonic angiodysplasia, superselective segmental embolization of the ileo-colic artery with
Ivalon resulted in the cessation of bleeding without causing bowel infarction. However, because of the development of collateral
branches to the angiodysplastic malformation, bleeding recurred. While colectomy remains the treatment of choice in younger
patients, in high risk patients embolization with a permanent embolic material, such as Ivalon, is an attractive alternative. 相似文献
109.
Summary Following left lateral funiculotomy, axons of cat pericruciate cortex exhibited neurofilamentous hyperplasia and complex, adaxonal, oligodendrocytic invaginations into electron-lucent or (commonly) electron-dense, degenerating axoplasm. These changes were absent from sham-operated and unoperated animals. Neurofilamentous hyperplasia was exclusively right-sided and appeared in myelinated axons 5–49 days postoperatively and in nonmyelinated axons 14–153 days after surgery. Oligoglial invaginations were present 1–49 days after surgery and were predominantly right-sided.Intramyelinic, axo-dendritic synapses appeared in operated cats 5–10 days postoperatively. Intra-axonal accumulations of ribosomes were found also. These changes also occurred exclusively or predominantly contralateral to spinal surgery.Other ultrastructural abnormalities, e.g., amorphous transformation of axoplasm and accumulations of dense bodies in intra-myelinic, dark cytoplasm, had a less certain relationship to lateral funiculotomy.The axonal alterations that were limited to operated cats possibly represent a true retrograde axonal degeneration occurring at a distance from the site of axonic interruption and unaccompanied by evidence of nerve cell death.This work was supported by the Medical Research Service of the Veterans Administration and by the National Institutes of Health Research Grant NS-08735 相似文献
110.
The effects of light deprivation on the retina and visual cortex of albino dystrophic and pigmented dystrophic rats have been investigated. Light deprivation retarded retinal degeneration (as assessed histologically and by nucleic acid measurements) in the former but had no significant effect on the latter. Similarly the changes in visual cortex nucleic acid content accompanying retinal degeneration were reduced in the albino dystrophic strain but not in the pigmented dystrophic strain. 相似文献