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31.
Paul K. L. Chin Daniel F. B. Wright Mei Zhang Mary C. Wallace Rebecca L. Roberts David M. Patterson Berit P. Jensen Murray L. Barclay Evan J. Begg 《Drugs in R&D》2014,14(2):113-123
Aims
Dabigatran is largely cleared by renal excretion. Renal function is thus a major determinant of trough dabigatran concentrations, which correlate with the risk of thromboembolic and haemorrhagic outcomes. Current dabigatran dosing guidelines use the Cockcroft–Gault (CG) equation to gauge renal function, instead of contemporary equations including the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations employing creatinine (CKD-EPI_Cr), cystatin C (CKD-EPI_Cys) and both renal biomarkers (CKD-EPI_CrCys).Methods
A linear regression model including the dabigatran etexilate maintenance dose rate, relevant interacting drugs and genetic polymorphisms (including CES1), was used to analyse the relationship between the values from each renal function equation and trough steady-state plasma dabigatran concentrations.Results
The median dose-corrected trough steady-state plasma dabigatran concentration in 52 patients (38–94 years) taking dabigatran etexilate was 60 µg/L (range 9–279). The dose-corrected trough concentration in a patient on phenytoin and phenobarbitone was >3 standard deviations below the cohort mean. The CG, CKD-EPI_Cr, CKD-EPI_Cys and CKD-EPI_CrCys equations explained (R2, 95 % CI) 32 % (9–55), 37 % (12–60), 41 % (16–64) and 47 % (20–69) of the variability in dabigatran concentrations between patients, respectively. One-way analysis of variance (ANOVA) comparing the R2 values for each equation was not statistically significant (p = 0.74).Discussion
Estimates of renal function using the four equations accounted for 32–47 % of the variability in dabigatran concentrations between patients. We are the first to provide evidence that co-administration of phenytoin/phenobarbitone with dabigatran etexilate is associated with significantly reduced dabigatran exposure.Electronic supplementary material
The online version of this article (doi:10.1007/s40268-014-0045-9) contains supplementary material, which is available to authorized users. 相似文献32.
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Assessment of Microvascular Abnormalities by Nailfold Capillaroscopy in Juvenile Dermatomyositis After Medium‐ to Long‐Term Followup 下载免费PDF全文
Zoltan Barth Birgit N. Witczak Berit Flatø Akos Koller Ivar Sjaastad Helga Sanner 《Arthritis care & research》2018,70(5):768-776
Objective
In juvenile dermatomyositis (DM), microvascular abnormalities, measured by nailfold capillaroscopy (NFC), are common early in the disease course. We aimed to compare the presence of NFC abnormalities in patients with medium‐ to long‐term juvenile DM with that of controls, and to explore associations between NFC abnormalities and disease activity and other disease characteristics.Methods
Fifty‐eight juvenile DM patients with a median disease duration of 16.8 (range 2–38) years were clinically examined and compared with matched controls. By NFC, we assessed nailfold capillary density (NCD), giant capillaries, scleroderma, and neovascular pattern (defined as scleroderma active or late pattern). NFC was analyzed with researchers blinded to patient/control identity and disease characteristics. We measured disease activity and damage by validated tools, and patients were categorized as having active or inactive disease according to the Paediatric Rheumatology International Trials Organisation criteria.Results
Compared to controls, patients had decreased NCD (mean ± SD 6.4 ± 2.1/mm versus 7.6 ± 0.8/mm; P = 0.001) and showed more abnormality in all other NFC parameters; 36% of patients versus 4% of controls had NCD <6/mm (P < 0.001). Giant capillaries, scleroderma, and neovascular pattern were found in 9%, 84%, and 41% of patients, respectively. Patients with active disease (n = 30) presented more frequently with neovascular pattern than patients with inactive disease (n = 28) (P = 0.041). Decreased NCD and neovascular pattern were associated with higher levels of disease activity and impaired muscle function.Conclusion
After medium‐ to long‐term followup, juvenile DM patients had decreased NCD and, often, neovascular pattern; both were associated with higher levels of disease activity and impaired muscle function. This suggests that NFC can be a biomarker for disease activity in longstanding juvenile DM too.35.
Dietary fiber and risk of coronary heart disease: a pooled analysis of cohort studies 总被引:17,自引:0,他引:17
Pereira MA O'Reilly E Augustsson K Fraser GE Goldbourt U Heitmann BL Hallmans G Knekt P Liu S Pietinen P Spiegelman D Stevens J Virtamo J Willett WC Ascherio A 《Archives of internal medicine》2004,164(4):370-376
BACKGROUND: Few epidemiologic studies of dietary fiber intake and risk of coronary heart disease have compared fiber types (cereal, fruit, and vegetable) or included sex-specific results. The purpose of this study was to conduct a pooled analysis of dietary fiber and its subtypes and risk of coronary heart disease. METHODS: We analyzed the original data from 10 prospective cohort studies from the United States and Europe to estimate the association between dietary fiber intake and the risk of coronary heart disease. RESULTS: Over 6 to 10 years of follow-up, 5249 incident total coronary cases and 2011 coronary deaths occurred among 91058 men and 245186 women. After adjustment for demographics, body mass index, and lifestyle factors, each 10-g/d increment of energy-adjusted and measurement error-corrected total dietary fiber was associated with a 14% (relative risk [RR], 0.86; 95% confidence interval [CI], 0.78-0.96) decrease in risk of all coronary events and a 27% (RR, 0.73; 95% CI, 0.61-0.87) decrease in risk of coronary death. For cereal, fruit, and vegetable fiber intake (not error corrected), RRs corresponding to 10-g/d increments were 0.90 (95% CI, 0.77-1.07), 0.84 (95% CI, 0.70-0.99), and 1.00 (95% CI, 0.88-1.13), respectively, for all coronary events and 0.75 (95% CI, 0.63-0.91), 0.70 (95% CI, 0.55-0.89), and 1.00 (95% CI, 0.82-1.23), respectively, for deaths. Results were similar for men and women. CONCLUSION: Consumption of dietary fiber from cereals and fruits is inversely associated with risk of coronary heart disease. 相似文献
36.
Live S. Nordhagen Ina Kreyberg Karen Eline S. Bains Kai-Håkon Carlsen Kari Glavin Håvard O. Skjerven Milada C. Småstuen Katarina Hilde Björn Nordlund Riyas Vettukattil Gunilla Hedlin Berit Granum Christine M. Jonassen Hrefna K. Gudmundsdóttir Guttorm Haugen Eva Maria Rehbinder Cilla Söderhäll Anne Cathrine Staff Karin C. Lødrup Carlsen PreventADALL study group 《Acta paediatrica (Oslo, Norway : 1992)》2020,109(12):2594-2603
37.
Hagell Peter Höglund Arja Hellqvist Carina Johansson Eva-Lena Löwed Berit Sjöström Anne-Christine Karlberg Carina Lundgren Margareth Dizdar Nil Johansson Anders Willows Thomas Rådberg Johan Bergquist Filip 《Journal of neurology》2020,267(11):3411-3417
Journal of Neurology - Continuous subcutaneous (s.c.) apomorphine infusion is an effective therapy for Parkinson’s disease (PD), but a limitation is the formation of troublesome s.c. nodules.... 相似文献
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Aim:To gain knowledge of how adult students experienced the first year of a blended learning master programme to better understand their learning process.Method... 相似文献
40.
Marianne Torp Stensvehagen Berit Arnesveen Bronken Lars Lien Gerry Larsson 《Scandinavian journal of caring sciences》2019,33(2):487-497
The impact of stress on health can depend on factors such as frequency, heightening of stress during a given period or the presence of one or a few repeated hassles of psychological importance. The aim of this study was to gain a deeper understanding of how adult women experience and cope with daily hassles after sexual abuse. Ten interviews were analysed using the grounded theory method. The theoretical model of ‘protecting armor in daily life’ emerged. The aftermath of sexual abuse related coping with daily stress can be understood as a three‐phase process: (1) avoiding and escaping—coping after experiencing sexual abuse; (2) accepting and disclosing—starting a process of recovery; and (3) reconciling and repossessing—living with the experience in the present. The model contributes to a deeper understanding of the everyday life of women who have experienced sexual abuse. Increased knowledge of coping behaviours that can be used to deal with daily hassles may also serve as a tool for health professionals, other helpers and family to help these women rebuild a good life. 相似文献