全文获取类型
收费全文 | 4248篇 |
免费 | 260篇 |
国内免费 | 23篇 |
专业分类
耳鼻咽喉 | 18篇 |
儿科学 | 122篇 |
妇产科学 | 116篇 |
基础医学 | 573篇 |
口腔科学 | 66篇 |
临床医学 | 383篇 |
内科学 | 1017篇 |
皮肤病学 | 115篇 |
神经病学 | 396篇 |
特种医学 | 66篇 |
外科学 | 436篇 |
综合类 | 21篇 |
一般理论 | 3篇 |
预防医学 | 517篇 |
眼科学 | 87篇 |
药学 | 258篇 |
中国医学 | 11篇 |
肿瘤学 | 326篇 |
出版年
2023年 | 29篇 |
2022年 | 61篇 |
2021年 | 131篇 |
2020年 | 77篇 |
2019年 | 133篇 |
2018年 | 142篇 |
2017年 | 81篇 |
2016年 | 74篇 |
2015年 | 102篇 |
2014年 | 153篇 |
2013年 | 242篇 |
2012年 | 326篇 |
2011年 | 340篇 |
2010年 | 231篇 |
2009年 | 155篇 |
2008年 | 322篇 |
2007年 | 302篇 |
2006年 | 287篇 |
2005年 | 263篇 |
2004年 | 228篇 |
2003年 | 227篇 |
2002年 | 206篇 |
2001年 | 28篇 |
2000年 | 14篇 |
1999年 | 28篇 |
1998年 | 32篇 |
1997年 | 31篇 |
1996年 | 23篇 |
1995年 | 23篇 |
1994年 | 19篇 |
1993年 | 25篇 |
1992年 | 16篇 |
1991年 | 21篇 |
1990年 | 10篇 |
1989年 | 10篇 |
1988年 | 9篇 |
1986年 | 9篇 |
1985年 | 10篇 |
1984年 | 10篇 |
1983年 | 11篇 |
1982年 | 14篇 |
1981年 | 10篇 |
1980年 | 13篇 |
1979年 | 5篇 |
1978年 | 11篇 |
1977年 | 5篇 |
1975年 | 4篇 |
1974年 | 3篇 |
1973年 | 6篇 |
1966年 | 3篇 |
排序方式: 共有4531条查询结果,搜索用时 31 毫秒
91.
Otto G. Thilenius MD PhD FACC Dolores Vitullo MD Saroja Bharati MD FACC Julia Luken MD John J. Lamberti MD FACC Constantine Tatooles MD FACC Maurice Lev MD FACC Ian Carr MD Rene A. Arcilla MD FACC 《The American journal of cardiology》1979,44(7):1339-1343
Clinical and angiographic or autopsy data, or both, on three children with a subdivided left atrium (cor triatriatum) and an associated endocardial cushion defect are reviewed. (One child had ostium primum defect, and two had complete atrioventricular [A-V] canal.) A fourth patient demonstrates the difficulties in differentiating subdivided left atrium from supravalve mitral stenosis in the presence of an endocardial cushion defect. The clinical findings are greatly influenced by the endocardial cushion defect. A pressure gradient between the pulmonary wedge and (left or right) ventricular end-diastolic pressures in patients with an endocardial cushion defect indicates pulmonary venous obstruction and should alert one to the possibility of these combined lesions. The exact diagnosis is made with injections of angiographic contrast medium into the proximal and distal left atrial chambers, to document the respective relations of the pulmonary veins, left atrial appendage and A-V valves to these atrial chambers. All three patients with an endocardial cushion defect and a subdivided left atrium had an associated patent ductus arteriosus. The common association of subdivided left atrium with intracardiac, pulmonary venous and aortic anomalies is again demonstrated. 相似文献
92.
93.
Javier Lucas Ramos Cristina Suárez Ferrer Joaquín Poza Cordón María Sánchez Azofra Jose Luis Rueda García Eduardo Martin Arranz Jorge Yebra Carmona Irene Andaluz García Maria Dolores Martín Arranz 《Gastroenterologia y hepatologia》2021,44(5):337-345
IntroductionThe dose of thiopurine drugs in combined treatments with anti-TNF in inflammatory bowel disease (IBD) has not been clearly established. The purpose of this study is to assess whether the dose of azathioprine influences clinical and biochemical response/remission rates, and anti-TNF drug levels/antibody formation.Material and methodsPatients with IBD on combined maintenance treatment with azathioprine and infliximab or adalimumab were selected. Based on the dose of azathioprine, two groups were defined (standard: 2–2.5 mg/kg/day; and decreased: less than 2 mg/kg/day).ResultsIn the IFX group, there were no statistically significant differences (p = 0.204) in the rates of remission (39% vs 41.3%), response (10% vs 21.7%) or failure (51.5% vs 37%) depending on the dose of thiopurine drugs. No differences were found between AZA-dose dependent IFX levels (2.46 vs 3.21 μg/mL; p = 0.211). In the adalimumab group, there were no statistically significant differences (p = 0.83) in the rates of remission (66% vs 56%), response without remission (15.38% vs 25%) or failure (18% vs 18%) depending on the dose of thiopurines. With respect to ADA-levels, no differences were found in both groups (7.69 vs 8.23 μg/mL; p = 0.37).ConclusionIn our experience, no statistically significant differences were found in either anti-TNF levels or clinical-biological response/remission rates based on doses of azathioprine. 相似文献
94.
95.
Joaquín Palma Humberto Reyes José Ribalta Ismael Hernández Lorena Sandoval Ramón Almuna Juris Liepins Fernando Lira Manuel Sedano Octavio Silva Dolores Tohá Juan Jorge Silva 《Journal of hepatology》1997,27(6):1022-1028
Backgrounds/Aims: Intense pruritus and the risk of stillbirths and premature deliveries justify the search for an effective pharmacologic treatment of intrahepatic cholestasis of pregnancy. This study was designed to test the efficacy of ursodeoxycholic acid in maternal pruritus, the biochemical abnormalities and the outcome of pregnancy, in patients with intrahepatic cholestasis of pregnancy of early onset.Methods: Pregnant patients hospitalized in a secondary case-referral center with intense pruritus and abnormal serum levels of bile salts and aminotransferases, detected before week 33 of pregnancy, were randomly assigned to receive ursodeoxycholic acid, 1 g per day orally, or an identical placebo, until delivery, in a double-blind study. A 3-week trial period was chosen to compare drug and placebo effects. The follow-up was extended for 3 months after delivery.Results: Twenty-four patients entered the trial; eight had deliveries before 2 weeks of treatment and one dropped out. The study was then completed in 15 patients: eight received ursodeoxycholic acid and seven placebo. No adverse effects were detected in the mother or in their babies. After 3 week of treatment, patients receiving ursodeoxycholic acid (mean daily) dose 16 mg/kg body weight) had a significant improvement in pruritus (p<0.02), In serum bilirubin (0.36±0.19 mg/dl (mean±SD) versus 0.95±0.48 in patients receiving placebo, p<0.01), in aspartate aminostransferase (52±42 IU/l vs 98±44, p<0.05) and in alanine aminotransferase (54±50 IU/l vs 229±154, p<0.01); serum total bile salts also tended to be lower in patients receiving ursodeoxycholic acid (26.3±33.7 μmol/l vs 55.0±44.8, p N.S.). Deliveries occurred at or near term in all mothers who received ursodeoxycholic acid (mean week of pregnancy: 38), while they occurred before week 36 of pregnancy in five patients who received placebo, including one stillbirth. All babies born alive had birth weights adequate for gestational age and they were thriving normally 3 months after delivery.Conclusions: Ursodeoxycholic acid is effective and safe in patients with intrahepatic cholestasis of pregnancy of early onset, attenuating pruritus and correcting some biochemical abnormalities in the mothers. Relevant aspects of fetal outcome were also improved in patients receiving ursodeoxycholic acid compared to placebo. 相似文献
96.
Carmona L Gómez-Reino JJ Rodríguez-Valverde V Montero D Pascual-Gómez E Mola EM Carreño L Figueroa M;BIOBADASER Group 《Arthritis and rheumatism》2005,52(6):1766-1772
OBJECTIVE: To investigate the impact of official recommendations regarding the management of latent tuberculosis (TB) infection on the rate of active TB in patients receiving treatment with tumor necrosis factor (TNF) antagonists. METHODS: Data on active TB rates and on screening and treatment of latent TB infection were extracted from the BIOBADASER (Spanish Society of Rheumatology Database on Biologic Products), a registry of patients with rheumatic conditions treated with TNF antagonists. The rates of active TB among the BIOBADASER patients were compared with those in the background Spanish population, and BIOBADASER patients with rheumatoid arthritis (RA) were compared with a cohort of RA patients from the EMECAR (Morbidity and Clinical Expression of Rheumatoid Arthritis) study who were not treated with TNF antagonists and were followed up for 5 years. RESULTS: Active TB developed in 34 patients, of whom 32 started taking TNF antagonists prior to the official recommendations on latent TB infection (pre-OR) and 2 began treatment after the recommendations were issued (post-OR). All cases of TB occurred during treatment with infliximab, and 28 of these patients had RA. Pre-OR, the active TB rate in BIOBADASER patients was 20.9-fold higher than in the background Spanish population, while RA patients in the BIOBADASER had rates 22.6- and 6.2-fold higher than the background and EMECAR populations, respectively. Post-OR, 324 patients with a tuberculin skin test result > or =5 mm and/or chest radiograph findings suggestive of past TB were treated for 9 months with isoniazid (INH). Post-OR, active TB rates among the BIOBADASER patients decreased by 78% (incidence risk ratio [IRR] 0.22, 95% confidence interval [95% CI] 0.03-0.88; P = 0.008), while among RA patients in the BIOBADASER, the rate dropped by 83% and reached the EMECAR rate (IRR 1.0, 95% CI 0.02-8.2). There were no INH treatment-related hospitalizations or deaths. CONCLUSION: Strategies to treat latent TB infection that are tailored to the at-risk population can effectively and safely lessen the likelihood of active TB in patients treated with TNF antagonists. 相似文献
97.
Solal-Céligny P Roy P Colombat P White J Armitage JO Arranz-Saez R Au WY Bellei M Brice P Caballero D Coiffier B Conde-Garcia E Doyen C Federico M Fisher RI Garcia-Conde JF Guglielmi C Hagenbeek A Haïoun C LeBlanc M Lister AT Lopez-Guillermo A McLaughlin P Milpied N Morel P Mounier N Proctor SJ Rohatiner A Smith P Soubeyran P Tilly H Vitolo U Zinzani PL Zucca E Montserrat E 《Blood》2004,104(5):1258-1265
The prognosis of follicular lymphomas (FL) is heterogeneous and numerous treatments may be proposed. A validated prognostic index (PI) would help in evaluating and choosing these treatments. Characteristics at diagnosis were collected from 4167 patients with FL diagnosed between 1985 and 1992. Univariate and multivariate analyses were used to propose a PI. This index was then tested on 919 patients. Five adverse prognostic factors were selected: age (> 60 years vs 60 years), Ann Arbor stage (III-IV vs I-II), hemoglobin level (< 120 g/L vs 120 g/L), number of nodal areas (> 4 vs 4), and serum LDH level (above normal vs normal or below). Three risk groups were defined: low risk (0-1 adverse factor, 36% of patients), intermediate risk (2 factors, 37% of patients, hazard ratio [HR] of 2.3), and poor risk ( 3 adverse factors, 27% of patients, HR = 4.3). This Follicular Lymphoma International Prognostic Index (FLIPI) appeared more discriminant than the International Prognostic Index proposed for aggressive non-Hodgkin lymphomas. Results were very similar in the confirmation group. The FLIPI may be used for improving treatment choices, comparing clinical trials, and designing studies to evaluate new treatments. 相似文献
98.
99.
Antonio Ramos-Martínez Alejandro Muñoz Serrano Arístides de Alarcón González Patricia Muñoz Ana Fernández-Cruz Maricela Valerio María Carmen Fariñas Manuel Gutiérrez-Cuadra José Ma Miró Josefa Ruiz-Morales Dolores Sousa-Regueiro José Miguel Montejo Juan Gálvez-Acebal Carmen HidalgoTenorio Fernando Domínguez 《Journal of infection and chemotherapy》2018,24(7):555-562
Purpose
To analyze the influence of adding gentamicin to a regimen consisting of β-lactam or vancomycin plus rifampicin on survival in patients suffering from Staphylococcal prosthetic valve endocarditis (SPVE).Methods
From January 2008 to September 2016, 334 patients with definite SPVE were attended in the participating hospitals. Ninety-four patients (28.1%) received treatment based on β-lactam or vancomycin plus rifampicin and were included in the study. Variables were analyzed which related to patient survival during admission, including having received treatment with gentamicin.Results
Seventy-seven (81.9%) were treated with cloxacillin (or vancomycin) plus rifampicin plus gentamicin, and 17 patients (18.1%) received the same regimen without gentamicin. The causative microorganism was Staphylococcus aureus in 40 cases (42.6%) and coagulase-negative staphylococci in 54 cases (57.4%). Overall, 40 patients (42.6%) died during hospital admission, 33 patients (42.9%) in the group receiving gentamicin and 7 patients in the group that did not (41.2%, P = 0.899). Worsening renal function was observed in 42 patients (54.5%) who received gentamicin and in 9 patients (52.9%) who did not (p = 0.904). Heart failure as a complication of endocarditis (OR: 4.58; CI 95%: 1.84–11.42) and not performing surgery when indicated (OR: 2.68; CI 95%: 1.03–6.94) increased mortality. Gentamicin administration remained unrelated to mortality (OR: 1.001; CI 95%: 0.29–3.38) in the multivariable analysis.Conclusions
The addition of gentamicin to a regimen containing vancomycin or cloxacillin plus rifampicin in SPVE was not associated to better outcome. 相似文献100.