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排序方式: 共有893条查询结果,搜索用时 31 毫秒
881.
Alaaeldin Dawood Nabil Alkafrawy Said Saleh Rasha Noreldin Shimaa Zewain 《Gynecological endocrinology》2018,34(4):294-297
Background: Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. The evidence in support of low-grade inflammation in PCOS as an etiology is emerging. Inflammation is likely to be associated with other prominent aspects of PCOS including insulin resistance (IR) and cardiovascular disease (CVD) risk. Interleukin-18 (IL-18) is considered as a strong marker of inflammation.Objectives: Evaluation of the relation between serum IL-18 and atherosclerotic CVD (ASCVD) risk in Egyptian lean females with PCO.Methods: This study included control group of healthy lean normally menstruating females, lean PCOS group (BMI?25?kg/m2), and obese PCOS group (BMI?>?25?kg/m2) presented with infertility and diagnosed according to Rotterdam criteria. Measurements of serum lipid profile, IR, and IL-18 were done.Results: Lipid accumulation product (LAP), IR and ASCVD risk were significantly higher in PCOS patients (lean and obese) compared to controls and in obese compared to lean. Serum IL-18 was significantly higher in the PCOV groups compared to the controls and correlated directly with LAP, IR and ASCVD risk.Conclusion: IL-18 is elevated in PCOS patients even in lean ones and is correlated with IR and ASCVD risk. 相似文献
882.
Mohamed Rezk Alaa Masood Ragab Dawood Mahmoud Emara Hanan El-Sayed 《The journal of maternal-fetal & neonatal medicine》2018,31(18):2436-2440
Objective: To assess prospectively the maternal and fetal outcome in women with immune thrombocytopenic purpura (ITP) who undergone earlier splenectomy compared to women on medical therapy.Methods: A 5-year observational study included pregnant women in the first trimester previously diagnosed with primary ITP with 74 patients underwent splenectomy before pregnancy and 86 patients on medical therapy. Patients were followed throughout pregnancy and labour to record their obstetric outcome. Data were collected and tabulated.Results: There was a higher platelet count in the splenectomy group at enrollment (p?.05) and at delivery (p?.001). Higher number of patients in the medical group experienced bleeding episodes (p?.001), severe thrombocytopenia (p?.001), need for therapy (p?.001), complications of steroid therapy (p?.05), postpartum hemorrhage (p?.05), and defective lactation (p?.001) compared to patients in the splenectomy group. Higher rates of small for gestational age, preterm labour, and admission to neonatal intensive care unit (NICU) were observed in patients in the medical group (p?.05) compared to patients in the splenectomy group.Conclusion: Earlier splenectomy in patients with ITP may have a beneficial impact on obstetric outcome and should be explained to patients wishing to get pregnant. Further larger multicenter studies are warranted to confirm or refute our findings. 相似文献
883.
Hodgson-Zingman DM Karst ML Zingman LV Heublein DM Darbar D Herron KJ Ballew JD de Andrade M Burnett JC Olson TM 《The New England journal of medicine》2008,359(2):158-165
Atrial fibrillation is a common arrhythmia that is hereditary in a small subgroup of patients. In a family with 11 clinically affected members, we mapped an atrial fibrillation locus to chromosome 1p36-p35 and identified a heterozygous frameshift mutation in the gene encoding atrial natriuretic peptide. Circulating chimeric atrial natriuretic peptide (ANP) was detected in high concentration in subjects with the mutation, and shortened atrial action potentials were seen in an isolated heart model, creating a possible substrate for atrial fibrillation. This report implicates perturbation of the atrial natriuretic peptide-cyclic guanosine monophosphate (cGMP) pathway in cardiac electrical instability. 相似文献
884.
Way-Seah Lee Chun-Wei Tee Zhong-Lin Koay Tat-Seng Wong Fatimah Zahraq Hee-Wei Foo Sik-Yong Ong Shin-Yee Wong Ruey-Terng Ng 《World journal of gastroenterology : WJG》2018,24(9):1013-1021
AIM To study implications of measuring quality indicators on training and trainees' performance in pediatric colonoscopy in a low-volume training center.METHODS We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years(January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks.RESULTS Median(± SD) age of 121 children [males = 74(61.2%)] who had 177 colonoscopies was 7.0(± 4.6) years. On average, 30 colonoscopies were performed each year(range: 19-58). Except for investigations of abdominal pain(21/177, 17%), indications for colonoscopies were appropriate in the remaining 83%. Bowel preparation was good in 87%. One patient(0.6%) with severe Crohn's disease had bowel perforation. Cecum examination and ileal intubation rate was 95% and 68.1%. Ileal intubation rate was significantly higher in diagnosing or assessing inflammatory bowel disease(IBD) than non-IBD(72.9% vs 50.0%; P = 0.016). Performance of four trainees was consistent throughout the study period. Average cecum and ileal examination rate among trainees were 97% and 77%.CONCLUSION Benchmarking against established guidelines helps units with a low-volume of colonoscopies to identify area for further improvement. 相似文献
885.
Aaron D. Boes Brandt D. Uitermarkt Fatimah M. Albazron Martin J. Lan Conor Liston Alvaro Pascual-Leone Marc J. Dubin Michael D. Fox 《Brain stimulation》2018,11(3):575-581
Background
Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for medication-refractory major depression, yet the mechanisms of action for this intervention are poorly understood. Here we investigate cerebral cortex thickness as a possible biomarker of rTMS treatment response.Methods
Longitudinal change in cortical thickness is evaluated relative to clinical outcomes across 48 participants in 2 cohorts undergoing left dorsolateral prefrontal cortex rTMS as a treatment for depression.Results
Our results reveal changes in thickness in a region of the left rostral anterior cingulate cortex that correlate with clinical response, with this region becoming thicker in patients who respond favorably to rTMS and thinner in patients with a less favorable response. Moreover, the baseline cortical thickness in this region correlates with rTMS treatment response – those patients with thinner cortex before treatment tended to have the most clinical improvement.Conclusions
This study is the first analysis of longitudinal cortical thickness change with rTMS as a treatment for depression with similar results across two cohorts. These results support further investigation into the use of structural MRI as a possible biomarker of rTMS treatment response. 相似文献886.
Thanaa El A Helal Hoda E El Abdel Wahab Sally M Saber Waleed H Abdelaaty Mohamed M Eltabbakh Ahmed M Aref Mohamed H Dawood 《African health sciences》2022,22(1):602
Background/AimUlcerative Colitis (UC) is an inflammatory bowel disease which is common in many areas of the world including Egypt. A lot of controversy regarding the pathogenesis of UC exist. The current study is an attempt to detect some pathogenic bacteria in UC patients.Materials and methodsEndoscopic colonic biopsies obtained from 40 patients with ulcerative colitis and 20 controls were analyzed by means of real-time PCR technique for the presence of Clostridium difficile, Helicobacter Pylori (H. pylori) and pathogenic Escherichia Coli (E. coli) which are positive for KPC and/or OXA-48.ResultsAll patients and control samples were negative for Clostridium difficile. Three of the 40 patient samples (7.5%) and none of the 20 controls were positive for H. pylori with no significant difference between the two groups. KPC-positive E. coli were detected in 11 of the 40 patients (27.5%) and in none of the controls with a significant difference between the two groups (P=0.01). All patients and control samples were negative for OXA-48 positive E. coli.ConclusionAlthough this study does not support the claim that Clostridium difficile and/or H. pylori have a role in UC, it greatly suggests that pathogenic E. coli may be involved in one way or another in the course of UC. 相似文献
887.
Fatimah Alsaad Norah Alkeneetir Moath Almatroudi Alhanouf Alatawi Abeer Alotaibi Omar Aldibasi Ismail A. Khatri 《Neurosciences (Riyadh, Saudi Arabia)》2022,27(2):104
Objectives:To determine the frequency, risk factors, and outcomes of Early seizure (ES) after stroke in a Saudi cohort.Methods:A retrospective study was conducted in King Abdulaziz Medical City, Riyadh, KSA. All stroke patients whether they had first or recurrent stroke were included from February 2016 to December 2017. Data were analyzed using the SAS software version 9.4.Results:Out of 665 patients, 456 (68.6%) were males and 564 (85.2%) were Saudis; the cohort’s mean age was 60.6±12.6 years. Fifty-one (7.7%) patients had ES, which were more common in women (p=0.0123). Loss of consciousness (p=0.0402) and confusion (<0.0007) were associated with ES, whereas unilateral weakness (p=0.001) and unilateral numbness (p=0.0317) at presentation decreased the risk of ES. Vascular risk factors did not differ between patients with and without ES. Hemorrhagic stroke was associated with ES (p=0.0054), whereas patients with small vessel disease were less likely to develop ES (p=0.0013). Patients with ES had more severe stroke (NIHSS >5) (p=0.0139), more ICU admissions (49% vs. 26.2%; p=0.0005), longer length of hospital stay (44.9 days vs. 24.9 days; p=0.0018), higher rates of stroke-related complications (e.g. recurrent stroke, pulmonary embolism, hospital acquired infections, and need for tracheostomy and gastrostomy tube placement) (p≤0.0001), and were likely to be more severely disabled defined as mRS 3–5 at discharge (47.7% vs. 40.8%; p=0.0055) or to die in hospital (11.8% vs. 4.6%; p≤0.0001).Conclusion:The ES after stroke were common in our cohort. Increased stroke severity and confusion were independent predictors of ES. The ES were associated with higher rates of in-hospital complications, longer length of hospital stay, and worse outcomes at discharge. Stroke is one of the common causes of symptomatic seizures in the elderly. Post-stroke seizures (PSS) are commonly classified into early seizures (ES) and late seizures (LS). 1 No specific cut-off point that delineates ES has been agreed upon, but most studies arbitrarily define ES as those that occur within 7–14 days of incident stroke. 1-2 The PSS occurring beyond this period are considered LS. The incidence rate for ES after stroke is not well established, although it has been reported to be 2%–33%. 2,3 A recent meta-analysis has found that ES incidence after ischemic stroke is 3.3%, whereas the LS incidence rate was found to be 18 per 1000 person-years. 1 A study investigating seizures that occurred within 24 h of stroke onset has found an incidence of 3.1% in more than 6,000 stroke patients. 3 Not all patients with PSS develop epilepsy. Approximately 2-4% of patients develop epilepsy after stroke. 4 Data on the risk factors for ES after stroke are inconsistent. In some studies, cardioembolic stroke, cortical location of stroke, hemorrhagic transformation of ischemic stroke, increased severity of stroke, and history of coronary artery disease or atrial fibrillation were found to be the predictors of ES after stroke. 2,4-5 The ES after stroke are associated with increased morbidity and mortality, and can affect the functional independence of stroke patients, resulting in poorer quality of life, as well as in increased resource utilization. 3-6 However, evidence-based data on PSS and guidelines on PSS management remain lacking. 6 The PSS are not uncommon and are broadly classified into ES and LS. Not all patients with ES develop post-stroke epilepsy. 6 The pathophysiological mechanisms underlying ES and LS are widely different. Having a specific time window to define ES from LS is crucial, as this may help in predicting post-stroke epilepsy. In the acute phase of stroke, ionic shifts, excitotoxicity neurotransmitters, metabolic dysfunction, and changes in coagulation cascade can all contribute to the early onset of seizure after an ischemic event. 7-8 By contrast, LS results from persistent structural changes and gliosis that occur in the late phase of stroke, causing disruption in neuronal firing, circuit dysfunction, and eventually epileptogenic changes. 7-8 The PSS has been studied in different populations; considering the observed variations in incidence, risk factors, and outcomes of PSS, we find it important to investigate this condition in the Saudi population. Our study aimed to determine the frequency of post stroke seizures in our population, and to identify the predictors of ES. It also looked at the outcome of these patients. To the best of our knowledge, this is the earliest study to report data on ES after stroke in a Saudi cohort, and it may be useful in planning future large-scale studies on ES prevention and management. 相似文献
888.
Ahmad Alamer Abdulaali R. Almutairi Shiraz Halloush Ahmed Al-jedai Ahmed Alrashed Mashael AlFaifi Yahya Mohzari Malak Almutairi Fatimah AlHassar Jude Howaidi Wedad Almutairi Ivo Abraham Nimer Alkhatib 《Saudi Pharmaceutical Journal》2023,31(4):510
PurposeWe aimed to evaluate the cost effectiveness of Favipiravir treatment versus standard of care (SC) in moderately to severely ill COVID-19 patients from the Saudi healthcare payer perspective.MethodsWe used the patient-level simulation method to simulate a cohort of 415 patients with moderate to severe COVID-19 disease who were admitted to two Saudi COVID-19 referral hospitals: 220 patients on Favipiravir and 195 patients on SC. We estimated the incremental cost-effectiveness ratio (ICER) of Favipiravir versus SC in terms of the probability to be discharged alive from hospital and the mean time in days to discharge one patient alive. The model was performed twice: first, using unweighted, and second, using weighted clinical and economic data. Weighting using the inverse weight probability method was performed to achieve balance in baseline characteristics.ResultsIn the unweighted model, base case (probabilistic) ICER estimates favored Favipiravir at savings of Saudi Riyal (SAR)1,611,511 (SAR1,998,948) per 1% increase in the probability of being discharged alive. As to mean time to discharging one patient alive, ICERs favored Favipiravir at savings of SAR11,498 (SAR11,125). Similar results were observed in the weighted model with savings using Favipiravir of SAR1,514,893 (SAR2,453,551) per 1% increase in the probability of being discharged alive, and savings of SAR11,989 (SAR11,277) for each day a patient is discharged alive.ConclusionFrom the payer perspective, the addition of Favipiravir in moderately to severely ill COVID-19 patients was cost-savings over SC. Favipiravir was associated with a higher probability of discharging patients alive and lower daily spending on hospitalization than SC. 相似文献
889.
890.
Ricardo J. Garcia Lisa Francis Maha Dawood Zhi‐Wei Lai Stephen V. Faraone Andras Perl 《Arthritis \u0026amp; Rheumatology》2013,65(5):1313-1318