全文获取类型
收费全文 | 6847篇 |
免费 | 212篇 |
国内免费 | 38篇 |
专业分类
耳鼻咽喉 | 240篇 |
儿科学 | 137篇 |
妇产科学 | 294篇 |
基础医学 | 836篇 |
口腔科学 | 49篇 |
临床医学 | 445篇 |
内科学 | 1838篇 |
皮肤病学 | 128篇 |
神经病学 | 606篇 |
特种医学 | 113篇 |
外科学 | 739篇 |
综合类 | 59篇 |
一般理论 | 10篇 |
预防医学 | 327篇 |
眼科学 | 203篇 |
药学 | 675篇 |
中国医学 | 4篇 |
肿瘤学 | 394篇 |
出版年
2023年 | 27篇 |
2022年 | 176篇 |
2021年 | 260篇 |
2020年 | 73篇 |
2019年 | 135篇 |
2018年 | 151篇 |
2017年 | 113篇 |
2016年 | 124篇 |
2015年 | 164篇 |
2014年 | 210篇 |
2013年 | 323篇 |
2012年 | 446篇 |
2011年 | 567篇 |
2010年 | 277篇 |
2009年 | 185篇 |
2008年 | 447篇 |
2007年 | 540篇 |
2006年 | 495篇 |
2005年 | 533篇 |
2004年 | 521篇 |
2003年 | 452篇 |
2002年 | 395篇 |
2001年 | 19篇 |
2000年 | 23篇 |
1999年 | 31篇 |
1998年 | 29篇 |
1997年 | 18篇 |
1996年 | 24篇 |
1995年 | 33篇 |
1994年 | 21篇 |
1993年 | 18篇 |
1992年 | 14篇 |
1991年 | 21篇 |
1990年 | 9篇 |
1989年 | 12篇 |
1988年 | 7篇 |
1987年 | 16篇 |
1986年 | 9篇 |
1985年 | 14篇 |
1984年 | 22篇 |
1983年 | 16篇 |
1982年 | 22篇 |
1981年 | 12篇 |
1980年 | 10篇 |
1979年 | 15篇 |
1978年 | 12篇 |
1977年 | 7篇 |
1976年 | 5篇 |
1974年 | 7篇 |
1973年 | 6篇 |
排序方式: 共有7097条查询结果,搜索用时 0 毫秒
101.
Przybylski A Sterliński M Lewandowski M Srzednicki M Wolski P Maciag A Pytkowski M Kowalik I Szwed H 《Kardiologia polska》2002,57(10):306-312
BACKGROUND: Cardioversion of atrial fibrillation (AF) carries the risk of thromboembolic complications and, therefore, anticoagulation therapy is routinely administered before and after this procedure. In patients with permanent AF who undergo implantation of cardioverter-defibrillator (ICD), anticoagulants are usually withdrawn during the perioperative period. However, in some patients sinus rhythm may be restored during defibrillation threshold (DFT) testing which potentially may increase the risk of thromboembolic complications. AIM: To assess the frequency of sinus rhythm restoration during ICD implantation in patients with permanent AF and the rate of both thromboembolic events and local bleeding complications which may occur due to temporary withdrawal of anticoagulation therapy and its re-initiation early after the procedure. METHODS: Permanent AF was present in 23 (12%) of 193 patients selected for ICD implantation. All patients received prolonged oral anticoagulation according to the generally accepted standards. Anticoagulation therapy was stopped few days before the procedure and replaced by low molecular weight heparin which was administered up to 24 hours before ICD implantation and re-initiated 12-24 hours afterwards. RESULTS: During DFT testing sinus rhythm was restored in 5 (21.7%) patients with AF. Clinical and DFT characteristics were similar in those who were converted to sinus rhythm and those who remained in AF. No thromboembolic events were noted in either group. Local haematoma at the site of ICD implantation occurred in two (8%) patients. CONCLUSIONS: Sinus rhythm was restored in 21.7% of patients with permanent AF who underwent ICD implantation. Temporary withdrawal of anticoagulation therapy did not increase the risk of thromboembolic complications, however, its early re-initiation after implantation resulted in an increase in local bleeding complication rate. 相似文献
102.
Effect of nifedipine on interdigestive gallbladder volume and postprandial gallbladder emptying in man 总被引:3,自引:0,他引:3
Dr Krzysztof Jonderko Andrzej Nowak Anna Kasicka-Jonderko Zbigniew Śliwiński Cezary Kucio 《Digestive diseases and sciences》1991,36(10):1434-1440
The effect of two oral doses (10 and 20 mg) of nifedipine versus placebo on the fasted gallbladder volume and on the meal-induced gallbladder emptying was assessed according to a double-blind study protocol in 12 healthy volunteers. Eight subjects underwent three studies (with placebo and with both nifedipine doses), whereas in two subjects the effect of a 10-mg nifedipine dose, vs placebo and in two others the effect of a 20-mg nifedipine dose vs placebo was examined. The studies were performed on separate days, and the gallbladder volume was measured by means of real-time ultrasonography. Neither placebo nor 20 mg nifedipine per os elicited any significant change in the fasted gallbladder vlume. With 10 mg nifedipine per os a significant increase in the interdigestive gallbladder volume was observed: 22.9±2.9 cm3 before and 26.2±3.2 cm3 after the drug receipt (P<0.005). A trend towards an inhibition of the postprandial gallbladder emptying was observed with 10 mg nifedipineper os without, however, reaching the level of statistical significance. Following 20 mg nifedipineper os, a marked delay in the meal-stimulated gallbladder emptying occurred as reflected by a decrease in the gallbladder ejection fraction from 48.1±4.5% (placebo) to 26.4±5.0% (nifedipine) (P<0.02) at 30 min and from 54.0±3.6% (placebo) to 33.2±4.6% (nifedipine) (P<0.02) at 40 min after the test meal. We conclude that a therapeutic oral dosage of nifedipine has a significant relaxing effect on the human gallbladder. 相似文献
103.
Ioanna Kosmidou Shmuel Chen A. Pieter Kappetein Patrick W. Serruys Bernard J. Gersh John D. Puskas David E. Kandzari David P. Taggart Marie-Claude Morice Paweł E. Buszman Andrzej Bochenek Erick Schampaert Pierre Pagé Joseph F. Sabik Thomas McAndrew Björn Redfors Ori Ben-Yehuda Gregg W. Stone 《Journal of the American College of Cardiology》2018,71(7):739-748
Background
There is limited information on the incidence and prognostic impact of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD).Objectives
This study sought to determine the incidence of NOAF following PCI and CABG for LMCAD and its effect on 3-year cardiovascular outcomes.Methods
In the EXCEL (Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial, 1,905 patients with LMCAD and low or intermediate SYNTAX scores were randomized to PCI with everolimus-eluting stents versus CABG. Outcomes were analyzed according to the development of NOAF during the initial hospitalization following revascularization.Results
Among 1,812 patients without atrial fibrillation on presentation, NOAF developed at a mean of 2.7 ± 2.5 days after revascularization in 162 patients (8.9%), including 161 of 893 (18.0%) CABG-treated patients and 1 of 919 (0.1%) PCI-treated patients (p < 0.0001). Older age, greater body mass index, and reduced left ventricular ejection fraction were independent predictors of NOAF in patients undergoing CABG. Patients with versus without NOAF had a significantly longer duration of hospitalization, were more likely to be discharged on anticoagulant therapy, and had an increased 30-day rate of Thrombolysis In Myocardial Infarction major or minor bleeding (14.2% vs. 5.5%; p < 0.0001). By multivariable analysis, NOAF after CABG was an independent predictor of 3-year stroke (6.6% vs. 2.4%; adjusted hazard ratio [HR]: 4.19; 95% confidence interval [CI]: 1.74 to 10.11; p = 0.001), death (11.4% vs. 4.3%; adjusted HR: 3.02; 95% CI: 1.60 to 5.70; p = 0.0006), and the primary composite endpoint of death, MI, or stroke (22.6% vs. 12.8%; adjusted HR: 2.13; 95% CI: 1.39 to 3.25; p = 0.0004).Conclusions
In patients with LMCAD undergoing revascularization in the EXCEL trial, NOAF was common after CABG but extremely rare after PCI. The development of NOAF was strongly associated with subsequent death and stroke in CABG-treated patients. Further studies are warranted to determine whether prophylactic strategies to prevent or treat atrial fibrillation may improve prognosis in patients with LMCAD who are undergoing CABG. (Evaluation of XIENCE Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization [EXCEL]; NCT01205776) 相似文献104.
105.
Marek Strzala Arkadiusz Stanula Grzegorz G?ab Jacek Glodzik Andrzej Ostrowski Marcin Kaca Leszek Nosiadek 《Journal of Sports Science and Medicine》2015,14(1):110-117
The aim of this study was to investigate somatic properties and physiological capacity, and analyze kinematic parameters in the 200 m breaststroke swimming race. Twenty-seven male swimmers participated in the study. They were 15.7±1.98 years old. Their average height was 1.80 ± 0.02 m and lean body mass (LBM) was 62.45 ± 8.29 kg. Physiological exercise capacity was measured in two separate 90 sec. all-out tests, one for the arms and second for legs. During the tests total work of arm cranking (TWAR) and cycling (TWLG) as well as peak of VO2 for arm (VO2peakAR) and leg (VO2peakLG) were measured. The underwater swimmers body movements were recorded during the all-out swimming 200m breaststroke speed test using an underwater camera installed on a portable trolley. The swimming kinematic parameters and propulsive or non-propulsive movement phases of the arms and legs as well as average speed (V200), surface speed (V200surface) and swimming speed in turn zones (V200turns) were extracted. V200surface was significantly related to the percentage of leg propulsion and was shown to have large effect on VO2peakLG in the Cohen analysis. V200turns depended significantly on the indicators of physiological performance and body structure: TWAR, VO2peak LG and LBM, LBM, which in turn strongly determined the measured results of TWAR, TWLG, VO2peakAR and VO2peakLG. The V200turns and V200surface were strongly associated with V200, 0.92, p < 0.001 and 0.91, p < 0.001 respectively. In each lap of the 200m swimming there was an increased percentage of propulsion of limb movement observed simultaneously with a reduction in the gliding phase in the breaststroke cycles.
Key points
- This study investigated the influence of the selected indicators of somatic properties and physiological capacity as well kinematic and coordination parameters on breaststroke swimming.
- In this observations the body’s functional capacity have an important impact on achieving good breaststroke swimming results, the V200 was moderately associated on VO2peakLG, moreover, separate V200turns depended with VO2peakLG and on LBM and TWAR.
- The speed of surface breaststroke swimming - V200surface similarly as V200turns had a very strong influence on the end result of V200 , 0.91, p<0.001 and 0.92, p<0.001 respectively.
- The ability to swim fast on the surface (V200surface) was positively and significantly associated with the percentage time of propulsion generation -LP in the breaststroke cycle.
106.
The Importance of Interleukin 18, Glutathione Peroxidase, and Selenium Concentration Changes in Acute Pancreatitis 总被引:6,自引:0,他引:6
Wereszczynska-Siemiatkowska U Mroczko B Siemiatkowski A Szmitkowski M Borawska M Kosel J 《Digestive diseases and sciences》2004,49(4):642-650
Cytokinemia and oxidative stress are important factors responsible for an inadequate immune response in the early course of acute pancreatitis (AP). The aim of the study was to evaluate the profiles of interleukin 18 (IL-18), glutathione peroxidase (GPx), and selenium concentrations in serum with respect to AP severity and to study the relationships between these parameters and recognized prognostic indicators of AP severity. Prospective clinical analyses were performed on 61 patients with mild and severe forms of AP and for 15 healthy volunteers. In both forms of AP severity, the IL-18 concentration in the serum was significantly higher than in healthy controls. In the severe form of AP, the IL-18 concentration was the highest and exceeded significantly the values recorded on the 1st, 2nd, 3rd, 5th, and 10th days of mild AP. A significantly lower GPx concentration in the serum was recorded in severe AP compared to the mild form and in the control group. There was a significantly lower selenium concentration in the severe form of AP. Significant correlations between GPx and selenium, between IL-18 and GPx, and between IL-18 and selenium were recorded. The ROC analysis shows a high prognostic accuracy of IL-18 and GPx concentrations in the determination of AP severity. IL-18 is released early in the course of AP and may be a key immunomodulator of the inflammatory response in the severe form of this disease. Low GPx and selenium concentrations in severe AP reflect the lower antioxidative ability in this form of AP. IL-18 and GPx may represent new indicators of AP severity. 相似文献
107.
Tomasz Zdrojewski Bogdan Wyrzykowski Lukasz Wierucki Tomasz Grodzicki Andrzej Januszewicz Krzysztof Narkiewicz Marzena Zarzeczna-Baran Jerzy Gluszek Grzegorz Opolski Witold Zatonski Andrzej Tykarski Wojciech Drygas 《European journal of cardiovascular prevention and rehabilitation》2006,13(5):832-838
AIM: Epidemiological data show that citizens of small towns and villages have presented worse trends in cardiovascular mortality during the political, social and economic transformation in Poland during past 15 years than citizens of large towns. To try to eliminate these inequalities the Polish 400 Cities Project (P400CP), a large educational and interventional project, was prepared. The project consists of two arms: medical and social interventions. MATERIAL AND METHODS: The main aim of the medical screening intervention in P400CP is to increase detection and control of cardiovascular risk factors in inhabitants of 418 small cities (<8000 inhabitants) and surrounding villages, particularly in men and people of lower education. In 2003 and 2004 the P400CP covered 123 cities. All together, 36 696 subjects aged between 18 and 98 years were examined. In all participants, blood pressure (BP), anthropometric measurements, laboratory tests and questionnaire interviews were performed. The social arm of P400CP is one of multi-level educational intervention. Modern techniques of social psychology and marketing were involved to increase participation in interventions. RESULTS: Only 12.5% of all subjects had normal BP, cholesterol (<190 mg/dl) and glucose (<100 mg/dl in whole capillary blood) levels. During the first screening visit 65.5% of all examined subjects had BP>/=140 mmHg or >/=90 mmHg. The fasting glucose level was increased in 19% of women and 26% of men. Almost two-third of all subjects had a total cholesterol level above the norm. CONCLUSIONS: The prevalence of cardiovascular risk factors in participants of the screening programme P400CP in small towns in Poland was very high. High prevalence and low control of risk factors in participants of the P400CP confirm the decision to target this programme at citizens of small towns and villages. 相似文献
108.
Gruchala M Ciećwierz D Wasag B Targoński R Dubaniewicz W Nowak A Sobiczewski W Ochman K Romanowski P Limon J Rynkiewicz A 《American heart journal》2003,145(1):125-131
Background There is growing evidence from recent studies that atrial natriuretic peptide (ANP) plays an important part in coronary blood flow regulation and in atherosclerosis. Transition T2238→C in the atrial natriuretic peptide (ANP) precursor gene, which leads potentially to the translation of ANP with 2 additional arginines, has been suggested to be associated with salt-sensitive hypertension. According to our knowledge, this study is the first to look for the potential association of the ScaI ANP gene polymorphism with the history of nonfatal myocardial infarction and the extent of coronary artery disease (CAD).Methods The study was performed in 847 consecutive, white patients (719 men and 128 women) with significant coronary artery stenosis confirmed by means of elective coronary angiography (at least 1 coronary artery with ≥50% lumen narrowing). Screening for the T2238→C substitution was performed by means of polymerase chain reaction of genomic DNA, followed by ScaI digestion and agarose gel electrophoresis.Results We found a significant association of the A2A2 ScaI ANP genotype with a higher incidence of positive history of nonfatal myocardial infarction (odds ratio 1.85, 95% CI 1.33-2.58) and multiple-vessel CAD (odds ratio 1.45, 95% CI 1.02-2.06). The ScaI ANP genotype distribution did not differ with age, sex, body mass index, plasma lipids, hypertension, diabetes mellitus, and family history of CAD in studied groups.Conclusions Our results suggest that the ScaI ANP polymorphism may be associated with nonfatal myocardial infarction and the extent of CAD. However, the precise mechanism of this association remains to be determined. (Am Heart J 2003;145:125-31.) 相似文献
109.
Grabczak EM Zielonka TM Wiwała J Bareła AD Opuchlik A Potulska A Ambroziak U Chazan R 《Polskie Archiwum Medycyny Wewn?trznej》2008,118(9):524-529
Amiodarone is a highly effective antiarrhythmic agent used in life-threatening ventricular and supraventricular arrhythmias. Its long-term use may however lead to several adverse effects, including corneal deposits, liver and thyroid gland dysfunction, lung lesions, bone marrow injury, skin lesions, or neurological abnormalities. The article presents the case of a 56-year-old man with a history of a stroke, who after a few days of amiodarone therapy for an episode of atrial fibrillation was diagnosed with amiodarone-induced hyperthyroidism and interstitial pulmonary lesions. Clinical and laboratory symptoms of hyperthyroidism and radiographic signs of pulmonary involvement did not occur until several weeks after discontinuation of amiodarone therapy. Differential diagnosis of causes of hyperthyroidism and diseases causing nodular pulmonary lesions did not demonstrate any other pathologies. Empirical antibiotic therapy and administration of thiamazole and high doses of propranolol failed to improve the patient's clinical status. It was not until thiamazole was given in combination with glucocorticosteroids, when a slow relief of hyperthyroidism symptoms and resolution of radiographic pulmonary signs were observed. Based on the presented case, the risk of appearance of 2 serious concomitant adverse effects was demonstrated, even following a short-term amiodarone therapy. This paper also contains an overview of adverse effects which may be encountered during or after therapy with this effective antiarrhythmic agent. It was emphasized how important it is to select patients appropriately, and to monitor potential adverse effects during amiodarone therapy. 相似文献
110.
Jan Rykala Karolina Przybylowska Ireneusz Majsterek Grazyna Pasz-Walczak Andrzej Sygut Adam Dziki Piotr Kuna 《Archives of Medical Science》2015,11(3):619-627