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51.
Aim
To investigate whether participation in a clinical audit and education session would improve GP management of patients who smoke.Methods
GPs who participated in an associated smoking cessation research program were invited to complete a three-stage clinical audit. This process included a retrospective self-audit of smoking cessation management practices over the 6 months prior to commencing the study, attending a 2.5 hour education session about GP management of smoking cessation, and completion of a second retrospective self-audit 6 months later. Twenty-eight GPs completed the full audit and education process, providing information about their smoking cessation management with 1114 patients. The main outcome measure was changes in GP management of smoking cessation with patients across the audit period, as measured by the clinical audit tool.Results
The majority of GPs (57%) indicated that as a result of the audit process they had altered their approach to the management of patients who smoke. Quantitative analyses confirmed significant increases in various forms of evidence-based smoking cessation management practices to assist patients to quit, or maintain quitting across the audit period. However comparative analyses of patient data challenged these findings, suggesting that the clinical audit process had less impact on GP practice than suggested in GP's self-reported audit data.Conclusion
This study provides some support for the combined use of self-auditing, feedback and education to improve GP management of smoking cessation. However further research is warranted to examine GP- and patient-based reports of outcomes from clinical audit and other educational interventions. 相似文献52.
为探讨体外循环(CPB)导致心脏植物神经系统(CAS)损伤的机理,了解温血心停跳液能否防止CPB后心率变异性(HRV)的降低,采用对照方法观察了温血心停跳液与冷晶体心停跳液对狗HRV的影响。结果显示:CPB后温血心停跳液组(WB组)和冷晶体心停跳液组(CC组)的全频谱(TP)、低频(LF)和高频(HF)均较术前明显降低(P<0.05),而且CC组比WB组降低更明显(P<0.05),但LF/HF在组内及组间均无明显变化(P>0.05)。CPB后24小时平均心率(MHR)明显增加(P<0.05),且CC组高于WB组(P<0.05)。本研究表明:采用温血心停跳液或冷晶体心停跳液的CPB不会干扰CAS平衡,但均能使HRV降低,温血心停跳液不能防止HRV损害。 相似文献
53.
54.
D Arora TK Bhattacharyya SK Kathpalia SPS Kochar GS Sandhu VSM BK Goyal 《Medical Journal Armed Forces India》2007,63(1):7-11
Background
The aim of this study was to assess the role of middle cerebral artery peak systolic velocity (MCA-PSV), as measured by doppler ultrasound, in detecting foetal anaemia in Rh- isoimmunised pregnancies. Intra-uterine foetal blood transfusion was performed in such anaemic foetuses to tide over the crisis of foetal immaturity till considered fit for extra-uterine survival.Methods
Rh-isoimmunised pregnancies reporting to a tertiary institute from 2003 to 2005, were screened by doppler ultrasound to estimate MCA-PSV to detect foetal anaemia. If the foetus developed MCA-PSV of more than 1.5 multiple of median (MoM) for the gestational age, foetal blood sampling through cordocentesis was performed to confirm foetal anaemia, followed by intrauterine foetal blood transfusion to all anaemic foetuses at the same sitting. Neonatal outcome was evaluated by recording gestational age at the time of delivery, duration of gestational time gained and need for blood transfusion in the neonatal period.Results
A total of thirteen isoimmunised pregnancies were evaluated. Three pregnancies did not require in-utero foetal blood transfusion. Twenty-one intrauterine foetal blood transfusions were performed in the remaining ten patients. Five received blood transfusion in the neonatal period. Intra uterine foetal death occurred in one grossly hydropic foetus and favourable neonatal outcome was recorded in the rest.Conclusion
The clinical outcome of these pregnancies justifies the use of doppler studies of MCA-PSV in detecting foetal anaemia and intra uterine foetal blood transfusion is the only hope of prolonging pregnancy and salvaging such foetuses.Key Words: Rh-isoimmunisation, Middle cerebral artery peak systolic velocity, Foetal anaemia, Foetal blood transfusion 相似文献55.
56.
SK Bhattacharya MK Bhattacharya B Manna D Dutta A Deb P Dutta AG Goswami A Dutta S Sarkar A Mukhopadhaya T Krishnan TN Naik GB Nair 《Acta paediatrica (Oslo, Norway : 1992)》1995,84(2):160-164
In a case-control study to understand the risk factors for development of life-threatening dehydration, a total of 379 children comprising 243 cases (moderate or severe dehydration) and 136 controls (non or mild dehydration) up to 2 years of age suffering from acute watery diarrhoea were studied. By univariate analysis, the presence of vibrios in stool, withdrawal of breast feeding during diarrhoea, not giving fluids, including oral rehydration solution (ORS), during diarrhoea, frequent purging (> 8/ day), vomiting (> 2/day) and undernutrition were identified as risk factors. However, by multivariate analysis after controlling for confounders, withdrawal of breast feeding during diarrhoea (odds ratio (OR) = 6.8, p < 0.00001) and not giving ORS during diarrhoea (OR = 2.1, p < 0.006) were identified as significant risk factors. The confounding variables which also contributed significantly to increasing the risk were age (≤ 12 months; OR = 2.7, p = 0.001), frequent purging (> 8/day; OR = 4.1, p < 0.00001), vomiting (> 2/day; OR = 2.4, p = 0.001) and severe undernutrition (%median <60 weight-for-age of Indian Academy of Paediatrics classification; OR = 3.1, p = 0.001). We feel that these findings will be useful for Global and National Diarrhoeal Diseases Control Programmes for formulating intervention strategies for preventing death due to diarrhoeal dehydration. 相似文献
57.
58.
S Majewski FX Bosch J. Dillner O-E Iversen SK Kjaer N Muñoz S-E Olsson J Paavonen K Sigurdsson J Bryan MT Esser K Giacoletti M James F Taddeo S Vuocolo E Barr 《Journal of the European Academy of Dermatology and Venereology》2009,23(10):1147-1155
Background Quadrivalent human papillomavirus (HPV types 6/11/16/18) L1 VLP vaccine is highly effective in preventing HPV 6/11/16/18-related cervical and external genital disease. Herein, we evaluated the impact of the quadrivalent HPV 6/11/16/18 L1 VLP vaccine on prevention of HPV-associated cervico-genital lesions in a broad population of sexually active European women.
Methods Female subjects ( N = 9265) aged 16–24 with four or fewer lifetime sexual partners were enrolled and randomized to quadrivalent HPV vaccine or placebo. Subjects underwent cervicovaginal sampling for HPV DNA detection. Papanicolaou testing and anti-HPV 6/11/16/18 serology testing was also performed.
Results Vaccine efficacy against lesions representing immediate cervical cancer precursors (cervical intraepithelial neoplasia grade 2/3 or adenocarcinoma in situ ) related to HPV 6/11/16/18 in the per-protocol population was 100.0%[95% confidence interval (95% CI), 89.8–100.0]. Efficacy against external genital lesions (vulvar or vaginal intraepithelial neoplasia, condyloma, vulvar or vaginal cancer) related to vaccine HPV types in the per-protocol European population was 99.0% (95% CI, 94.4–100.0).
Conclusion These data demonstrate that quadrivalent HPV 6/11/16/18 vaccination programs in 16- to 24-year-old European women can be beneficial.
NCT0009252, NCT00092534, NCT00092495 相似文献
Methods Female subjects ( N = 9265) aged 16–24 with four or fewer lifetime sexual partners were enrolled and randomized to quadrivalent HPV vaccine or placebo. Subjects underwent cervicovaginal sampling for HPV DNA detection. Papanicolaou testing and anti-HPV 6/11/16/18 serology testing was also performed.
Results Vaccine efficacy against lesions representing immediate cervical cancer precursors (cervical intraepithelial neoplasia grade 2/3 or adenocarcinoma in situ ) related to HPV 6/11/16/18 in the per-protocol population was 100.0%[95% confidence interval (95% CI), 89.8–100.0]. Efficacy against external genital lesions (vulvar or vaginal intraepithelial neoplasia, condyloma, vulvar or vaginal cancer) related to vaccine HPV types in the per-protocol European population was 99.0% (95% CI, 94.4–100.0).
Conclusion These data demonstrate that quadrivalent HPV 6/11/16/18 vaccination programs in 16- to 24-year-old European women can be beneficial.
NCT0009252, NCT00092534, NCT00092495 相似文献
59.
生理模型同时预报普鲁卡因胺及其代谢物乙酰普鲁卡因胺在大鼠体内处置动力学 总被引:3,自引:0,他引:3
用生理模型同时对iv普鲁卡因胺(PA)后,PA及其代谢产物乙酰普鲁卡因胺(NAPA)在大鼠体内处置动力学进行预报。测定了所需的有关PA参数.结果PA在大鼠血液、肝和肾脏清除率分别为47.28,13.56和33.71 ml·kg-1·min-1。估算的组织/血液药物浓度比表明,心、肝、肾、肌肉和小畅对PA的亲和力大于血液成分。对大鼠iv PA后,PA及其NAPA在组织中浓度进行预报,并与实验结果比较。结果大多数组织中浓度预报值与观察值基本—致。同时对PA及其NAPA在人血浆中浓度进行了预报。 相似文献
60.