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51.
Cardiorespiratory fitness and body mass index as predictors of cardiovascular disease mortality among men with diabetes 总被引:4,自引:0,他引:4
BACKGROUND: Questions remain as to whether higher levels of cardiorespiratory fitness, a measure of regular physical activity, are associated with lower risk of cardiovascular disease (CVD) mortality in overweight and obese individuals with diabetes. Our objective was to quantify the independent and joint relations of cardiorespiratory fitness (hereafter, fitness) and body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) with CVD mortality in men with diabetes. METHODS: This study was conducted using prospective observational data from the Aerobics Center Longitudinal Study. Study participants comprised 2316 men with no history of stroke or myocardial infarction and who were diagnosed as having diabetes (mean [SD] age, 50 [10] years); had a medical examination, including a maximal exercise test during 1970 to 1997 with mortality surveillance to December 31, 1998; and had a BMI of 18.5 or greater and less than 35.0. The main outcome measure was CVD mortality across levels of fitness with stratification by BMI. RESULTS: We identified 179 CVD deaths during a mean (SD) follow-up of 15.9 (7.9) years and 36,710 man-years of exposure. In a model containing age, examination year, fasting glucose level, systolic blood pressure, parental history of premature CVD, total cholesterol level, cigarette smoking, abnormal resting, and exercise electrocardiograms, a significantly higher adjusted risk of mortality was observed in men with a low fitness level who were normal weight (hazard ratio, 2.7 [95% confidence interval, 1.3-5.7]), overweight (hazard ratio, 2.7 [95% confidence interval, 1.4-5.1]), and class 1 obese (hazard ratio, 2.8 [95% confidence interval, 1.4-5.1]) compared with normal weight men with a high fitness level. CONCLUSION: In this cohort of men with diabetes, low fitness level was associated with increased risk of CVD mortality within normal weight, overweight, and class 1 obese weight categories. 相似文献
52.
Computed tomography of abdominal fatty masses 总被引:2,自引:0,他引:2
53.
54.
OBJECTIVE:
Inflammation plays an important role in the development of chronic lung disease (CLD), which has become a major cause of morbidity in surviving infants less than 1250 g at birth. The authors hypothesized that the progression of this inflammation and, therefore, the establishment of CLD would be decreased with the use of early prophylactic inhaled corticosteroids. Short, and long term respiratory and neurodevelopmental outcomes were also examined.DESIGN:
A double-blind, randomized placebo controlled trial.SETTING:
Level-III neonatal intensive care unit.POPULATION STUDIED:
Sixty infants less than 1250 g at birth, diagnosed with respiratory distress syndrome and requiring ventilatory support at 72 h of age were enrolled in the study.INTERVENTION:
Infants enrolled received either placebo or beclomethasone diproprionate by a metered dose inhaler, which was used in-line with the ventilator circuit while the infant was ventilated and then via a spacer until 28 days of age.RESULTS:
Thirty infants were given beclomethasone and 30 were given placebo. There were two deaths in each group. Among the surviving infants, the frequency of moderate-to-severe CLD was 17% in each study group. Mean time to extubation was not different for beclomethasone compared with placebo at 16.4 and 12.5 days (P=0.12), respectively. The requirement for intravenous corticosteroids was lower in the beclomethasone-treated group (RR 0.67, 95% CI 0.43 to 1.04), although this difference was not statistically significant. The incidence of growth failure, infection and intraventricular hemmorhage did not differ between the two groups. Long term outcomes were not different with respect to the incidence of respiratory re-admissions, cerebral palsy, developmental delay, blindness or deafness.CONCLUSIONS:
Early treatment with inhaled beclomethasone diproprionate did not reduce the incidence of CLD or decrease the duration of mechanical ventilation. The decrease in intravenous corticosteroid use was not statistically significant. Long term outcome was not affected. 相似文献55.
LaMonte MP 《Pathophysiology of haemostasis and thrombosis》2002,32(Z3):39-45
Evidence for the potential use of direct thrombin inhibition in the treatment of acute stroke is reviewed. Reduction of secondary microthrombi and improved regional collateral cerebral blood flow is the proposed mechanism of action of thrombin inhibition for the treatment of cerebral ischemia. A clinical study in Japan found that argatroban administered within 48 h of stroke symptom onset is safe and effective in reducing neurological impairment due to ischemic stroke. The implications of further clinical studies are discussed. 相似文献
56.
Ventral hernia repair: a study of current practice 总被引:5,自引:5,他引:0
Ventral wall hernias are common; despite this, there are no guidelines on the best surgical management. The aim of this study
was to examine the types of repair in use for abdominal wall hernias in the West of Scotland over a 3-month period. Data were
gathered on 120 patients. There were 60 incisional, 32 umbilical, and 28 epigastric hernias. The main indication for repair
was pain (78%), while 12 patients (10%), presented acutely with incarceration or strangulation. The most common method of
repair was sutured (55%), followed by mesh (29%) and Mayo repair (16%). There was no correlation between use of mesh and hernia
size or whether repair was for a recurrent hernia. Surgical practice varies widely in the repair of ventral wall hernias.
Clinical trials are required to establish the best method of repair for this common condition.
Electronic Publication 相似文献
57.
Background
Low grade fibromyxoid sarcomas (LGFMS) are very rarely seen. They commonly arise from deep soft tissues of the lower extremities. Very few cases of intra-abdominal location have been reported. 相似文献58.
Mark?RoyEmail author Clemens?Kirschbaum Andrew?Steptoe 《Annals of behavioral medicine》2003,26(3):194-200
Intraindividual variation in recent stress exposure and its impact upon cortisol and testosterone was investigated. Over 1
year, 72 young male firefighters completed the Daily Stress Inventories, for 2 shift cycles (16 days), every 3 months. At
the end of each 16-day period each participant attended a 1-hr morning assessment session. Saliva samples and blood pressure
measurements were taken at 10-min intervals, and at 30 min, a blood sample was drawn. Across the year of assessment, there
were significant linear relationships in reported stress and in neuroendocrine activity. In contrast to expectations, as daily
stress decreased across the year (p < .008), salivary cortisol increased (p < .001) and testosterone levels decreased (p <
.001). Within-subjects comparisons of the sessions with the highest and lowest stress confirmed these linear relationships:
Lower stress prior to the assessment session was associated with higher cortisol levels (p < .01). These results, though in
contrast to the orthodoxy concerning the association between stress and cortisol, are supported by findings in a number of
other studies and may constitute down regulation of cortisol activity following an increment in stress exposure.
This research was supported by the Medical Research Council, United Kingdom. We are grateful to the London Fire & Civil Defence
Authority for their cooperation. 相似文献
59.
Intravenous thrombolytic therapy for stroke: a review of recent studies and controversies. 总被引:3,自引:0,他引:3
STUDY OBJECTIVES: To review the randomized, controlled, multicenter trials of intravenous thrombolytic therapy for ischemic stroke. METHODS: Studies of ischemic stroke confirmed by computed tomography (CT) and randomization of more than 100 patients are reviewed. Streptokinase studies are the MAST-I, the MAST-E, and the ASK Trial. Studies using tissue plasminogen activator (tPA) are the NINDS Stroke Study, ECASS I, ECASS II, and ATLANTIS. One study using ancrod is STAT. We discuss significant factors common to each study, including thrombolytic agent used, CT scan interpretation, time of therapy administration in relation to stroke onset, thrombolytic dose, ancillary medication administration, safety, and neurologic outcomes. RESULTS: All streptokinase studies were stopped early because of increased mortality in the treated groups. Initial results of the STAT study are promising; publication of full study details is awaited. The ATLANTIS study was terminated early because of nonstatistical efficacy at interim analysis. The NINDS and the ECASS trials were completed; only the NINDS study demonstrated significant increase in the percentage of patients with complete recovery or minimal deficit at 3 months, without significant difference in mortality in the treated group. CONCLUSION: This review supports the use of intravenous thrombolytic therapy for ischemic stroke using tPA at a dose of.9 mg/kg body weight and a "golden window" treatment time of 3 hours. Administration without strict adherence to protocol, even within this time frame, may shift the benefit/risk profile of tPA. We recommend the treating physician have rapid access to CT scanning and to collaboration with individuals experienced in the evaluation of stroke and CT interpretation. 相似文献
60.
NJ Hoogenraad JD Mitchell NA Don TM Sutherland AC Mc Leay 《Archives of disease in childhood》1980,55(4):292-295
The activity of urea cycle enzymes was assayed in duodenal biopsy specimens obtained from a female infant who presented with neonatal hyperammonaemia. All enzyme levels were normal except N-acetyl glutamate-dependent carbamyl phosphate synthetase 1 (CPS1) which was half the mean activity in normal control specimens. A similar deficiency of CPS1 was also shown in duodenal specimens from the patient's mother who became slightly symptomatic after relatively high protein meals and during pregnancy, and had spontaneously modified her diet to one with protein restriction. The patient is growing normally on a dietary regimen similar to that spontaneously adopted by her mother. Urea cycle enzyme activity in the duodenal biopsy material from the controls was similar to that found in the normal human liver and appears to have distinct advantages as a means of assaying for urea cycle defects in patients with hyperammonaemia and their relatives. 相似文献