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281.
目的系统评价格列美脲与格列本脲治疗T2DM的疗效。方法计算机检索PubMed、万方等数据库从建库至2010年12月间的有关文献。按Cochrane系统评价的方法评价纳入研究的质量,使用Review Manager4.2软件进行荟萃分析。结果共纳入9个随机对照试验。结果显示:格列美脲在降低HbA1c[P=0.08,加权均数差(WMD)=-0.18,95%CI(-0.39,0.02)]、FPG[P=0.06,WM=-0.46,95%CI(-0.94,0.01)]、餐后血糖[P=O.73,WMD=-0.16,95%CI(-1.08,0.76)]、TC[P=0.22,WMD=-0.2,95%CI(-0.51,0.12)]和TG[P=0.06,WMD=-0.30,95%CI(-0.61,0.01)]方面与格列本脲无差异;在相同血糖水平下,格列美脲组FIns[P〈0.05,WMD=-0.83,95%CI(-1.21,0.45)]及餐后胰岛素[P〈0.05,WMD=-5.94,95%CI(-8.79,-3.10)]升高程度低于格列本脲组;低血糖发生率格列美脲组低于格列本脲组[P〈0.05,RR=0.66,95%CI(0.53,0.81)];在降低BMI方面格列美脲优于格列本脲[P=0.02,WMD=-1.49,95%CI(-2.7,-0.27)]。结论与格列本脲相比,格列美脲在降低血糖的同时,还能改善胰岛素抵抗及减轻体重,且低血糖发生率低,是安全有效的治疗T2DM的药物。 相似文献
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283.
Rudofsky G Tsioga M Reismann P Leowardi C Kopf S Grafe IA Nawroth PP Isermann B 《European journal of medical research》2011,16(8):375-380
Background
Postoperative hyperthyroidism occurs in approximately one third of patients following parathyroidectomy due to primary hyperparathyroidism (PHP), but has only rarely been described in secondary hyperparathyroidism (SHP). The frequency, course, and laboratory markers of postoperative hyperthyroidism in SHP remain unknown. Our purpose was to evaluate the frequency and the clinical course of postoperative hypcrthyroidism following surgery of SHP and to determine the diagnostic value of thyroglobulin in this setting.Material and Methods
A total of 40 patients undergoing parathyroidectomy because of SHP were included in this study. Thyroid stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fl4), and thyroglobulin (Tg) were determined one day before and on day 1, 3, 5, 10, and 40 after surgery. At each of these visits patients were clinically evaluated for signs or symptoms of hyperthyroidism.Results
Biochemical evidence of hyperthyroidism was evident in 77% of patients postoperatively despite of preoperatively normal serum levels. TSH dropped from 1.18 ± 0.06mU/L to 0.15 ± 0.07mU/L (p = 0.0015). Free triiodothyronine (fT3) and fT4 levels increased from 2.86 ± 0.02ng/L and 10.32 ± 0.13ng/L, respectively, to their maximum of 4.83 ± 0.17ng/L and 19.35 ± 0.58ng/L, respectively. Thyroglobulin levels rose from 3.8 ± 0.8ng/mL to 111.8 ± 45.3ng/mL (p < 0.001). At day 40 all thyroid related laboratory values were within normal range. Correlation analysis of postoperative values revealed significant correlations for lowest TSH (r = -0.32; p = 0.038), and highest fT3 (r = 0.55; p < 0.001) and fT4 levels (r = 0.67; p < 0.001) with Tg.Conclusion
Transient hyperthyroidism is frequent after parathyroidectomy for SHP with Tg being a suitable marker. Awareness of this self-limiting disorder is important to avoid inappropriate and potentially harmful treatment. 相似文献284.
285.
IA Kelmanson 《Acta paediatrica (Oslo, Norway : 1992)》1995,84(1):75-78
The aim of this study was to create a scoring method to distinguish between sudden infant death syndrome (SIDS) and cases of sudden death resulting from life-threatening conditions (LTC). Four hundred infants less than one year old who died suddenly out of hospital in St Petersburg between 1983 and 1990 and who underwent a complete autopsy, were entered into the study. In 200 cases, the main diagnosis was SIDS, while in the remaining 200 cases, death was interpreted as resulting from LTC; 115 clinical and 240 morphological signs and symptoms were evaluated in each case. The statistical approach was based on the method of stepwise logistic regression analysis and it helped to identify 6 clinical and 12 morphological signs which, combined, made it possible to distinguish between SIDS and non-SIDS (LTC) cases most accurately. 相似文献
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AA Hogewoning IA Larbi HA Addo AS Amoah D Boakye F Hartgers M Yazdanbakhsh R Van Ree JN Bouwes Bavinck APM Lavrijsen 《Journal of the European Academy of Dermatology and Venereology》2010,24(12):1406-1412
Background Atopic eczema is an increasing clinical problem in Africa. Objective To determine allergic characteristics and to identify possible risk factors for eczema among schoolchildren in an urbanized area in Ghana. Patients and methods Schoolchildren aged 3–16 years with eczema were recruited. For each patient, one to three age‐ and sex‐matched controls were selected. All children completed a questionnaire and were skin prick tested with a panel of allergens. Blood was drawn to determine the total and allergen‐specific IgE. Conditional logistic regression models with the matching factors included in the model were used to calculate the odds ratios and to adjust for possible confounders. Results A total of 52 children with eczema (27 boys and 25 girls) and 99 controls were included. Levels of total IgE were found to be 9.1 (1.1; 78.4) times more often elevated in children with eczema. This association was mainly driven by elevated IgE levels against cockroach antigen. Children with eczema were found to have 2.0 (0.87; 4.7) times more often positive skin prick tests (SPT), but this association diminished to 1.2 (0.40; 3.6) after adjustment for total IgE levels. Frequent washing with soap was identified as a risk factor for the development of eczema among these children. Conclusion Schoolchildren with eczema in Ghana were characterized by elevated IgE levels especially against cockroach antigen. The association between eczema and positive SPT was much weaker suggesting immune hyporesponsiveness of the skin. After adjustment for IgE level, SPT were less suitable to distinguish children with and without eczema. 相似文献