全文获取类型
收费全文 | 38474篇 |
免费 | 2032篇 |
国内免费 | 147篇 |
专业分类
耳鼻咽喉 | 518篇 |
儿科学 | 914篇 |
妇产科学 | 744篇 |
基础医学 | 4905篇 |
口腔科学 | 2201篇 |
临床医学 | 2745篇 |
内科学 | 9930篇 |
皮肤病学 | 939篇 |
神经病学 | 3119篇 |
特种医学 | 797篇 |
外科学 | 5709篇 |
综合类 | 236篇 |
一般理论 | 13篇 |
预防医学 | 2836篇 |
眼科学 | 692篇 |
药学 | 2120篇 |
中国医学 | 135篇 |
肿瘤学 | 2100篇 |
出版年
2024年 | 30篇 |
2023年 | 265篇 |
2022年 | 622篇 |
2021年 | 1401篇 |
2020年 | 741篇 |
2019年 | 1093篇 |
2018年 | 1277篇 |
2017年 | 837篇 |
2016年 | 933篇 |
2015年 | 1063篇 |
2014年 | 1585篇 |
2013年 | 1921篇 |
2012年 | 3156篇 |
2011年 | 3277篇 |
2010年 | 1875篇 |
2009年 | 1570篇 |
2008年 | 2648篇 |
2007年 | 2666篇 |
2006年 | 2588篇 |
2005年 | 2506篇 |
2004年 | 2132篇 |
2003年 | 1922篇 |
2002年 | 1711篇 |
2001年 | 192篇 |
2000年 | 141篇 |
1999年 | 221篇 |
1998年 | 291篇 |
1997年 | 226篇 |
1996年 | 201篇 |
1995年 | 196篇 |
1994年 | 148篇 |
1993年 | 112篇 |
1992年 | 104篇 |
1991年 | 88篇 |
1990年 | 52篇 |
1989年 | 39篇 |
1988年 | 47篇 |
1987年 | 42篇 |
1986年 | 44篇 |
1985年 | 53篇 |
1984年 | 55篇 |
1983年 | 54篇 |
1982年 | 43篇 |
1981年 | 50篇 |
1980年 | 62篇 |
1979年 | 32篇 |
1978年 | 36篇 |
1977年 | 45篇 |
1976年 | 28篇 |
1974年 | 20篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
61.
James Edward Paul Elizabeth Ling Carlos Lalonde Lehana Thabane 《Journal canadien d'anesthésie》2007,54(10):799-810
PURPOSE: To determine if deliberate hypotension decreases blood loss and transfusion requirements in patients undergoing orthopedic surgery, a systematic review of all randomized trials addressing this issue was undertaken. METHODS: Electronic databases, citations lists and review articles were searched for potential articles. Relevant articles met the following inclusion criteria: English language, humans undergoing orthopedic surgery, deliberate hypotension used by any method, intraoperative blood loss measured as an outcome, and the trial methodology being randomized and controlled. Four outcomes were analyzed, including estimated blood loss, blood transfused, surgery duration, and quality of the surgical field. For all analyses, the random-effects model was used. RESULTS: Seventeen articles met the inclusion criteria. The surgeries studied included total hip arthroplasty (seven), orthognathic surgery (eight), total knee arthroplasty (one) and spinal fusion (one). A total of 636 patients were randomized across all studies. For blood loss, the overall weighted mean difference favoured treatment, with a savings of about 287 mL of blood [95% confidence interval (CI): -447, -127]. The mean differences also showed a statistically significant benefit for deliberate hypotension in reducing transfusion requirements (-667 mL of blood transfused; 95% CI: -963, -370). Deliberate hypotension was not shown to reduce the duration of surgery (-1.9 min of surgery; 95% CI: -7.2, 3.5) or improve surgical conditions (surgical field quality rating -0.5; 95% CI: -1.1, 0.2). CONCLUSION: This review provides some support for the use of deliberate hypotension in reducing blood loss and transfusion requirements in orthopedic surgery, but these results are tempered by the small sample sizes and poor methodological quality of published studies. 相似文献
62.
Israel Lerman Liliana Lozano Antonio
R. Villa Sergio Hernndez-Jimnez Katie Weinger A. Enrique
Caballero Carlos Aguilar Salinas Maria Luisa Velasco Francisco Javier Gmez-Prez Juan
A. Rull 《Biomedicine & Pharmacotherapy》2004,58(10):566-570
To examine the relationship between demographic, clinical and psychosocial variables and diabetes self-care management in Mexican type 2 diabetic patients. Cross-sectional study of 176 consecutive patients with type 2 diabetes aged 30-75 years, attending a tertiary health-care center in Mexico City. A brief medical history and previously validated questionnaires were completed. The study group consisted of 64 males/112 females, aged 55 +/- 11 years, mean diabetes duration of 12 +/- 8 years and HbA1c of 9.0 +/- 2.0%, 78.4% reported following the correct dose of diabetes pills or insulin, 58% ate the recommended food portions, and 44.3% did exercise three or more times per week. A good adherence to these three recommendations was observed in only 26.1% of the patients. These patients considered as a group were characterized by a greater knowledge about the disease (P < 0.00001), regular home blood glucose monitoring (P < 0.01), an inner perception of better diabetes control (P = 0.007), good health (P = 0.004) and better communication with their physician (P < 0.02). A poor adherence to two or the three main diabetes care recommendations was associated with a depressive state (OR 2.38, 95% CI 1.1-4.9, P < 0.01) and a history of excessive alcohol intake (OR 4.03, 95% CI 1.1-21.0, P = 0.03). Poor adherence to standard diabetes care recommendations is frequently observed in patients with type 2 diabetes attending a specialized health care center in Mexico City. Depression must be identified and treated effectively. 相似文献
63.
Carlos Estrela Cyntia Rodrigues de Araújo Estrela Augusto César Braz Hollanda Daniel de Almeida Decurcio Jesus Djalma Pécora 《Journal of applied oral science : revista FOB》2006,14(1):33-37
The purpose of this research was to verify the influence of Iodoform on antimicrobial potential of calcium hydroxide. S. aureus, E. faecalis, P. aeruginosa, B. subtilis, C. albicans were the biological indicators. The substances tested were: calcium hydroxide + saline; calcium hydroxide + Iodoform + saline; Iodoform + saline. For the agar diffusion test, 18 Petri plates with 20 ml of BHI agar were inoculated with the microbial suspensions. Fifty-four cavities were made and filled with the substances tested. The diameters of microbial inhibition were then measured. In direct exposure test, 162 #50 sterile absorbent paper points were immersed in the experimental suspensions for 5 min, and covered with the pastes. At intervals of 24, 48 and 72 hours, the paper points were immersed in 10 ml of Letheen Broth, followed by incubation at 37°°C for 48h. Microbial growth was evaluated by turbidity of the culture medium. A 0.1 ml inoculum obtained from the Letheen Broth was transferred to 7 ml of BHI, and incubated at 37°°C for 48h. Bacterial growth was again evaluated by turbidity of the culture medium. The calcium hydroxide associated with the saline or the iodoform plus saline showed antimicrobial effectiveness in both experimental methods. The iodoform paste presented antimicrobial ineffectiveness for the agar diffusion test on all biological microorganisms and for the direct exposure test on B. subtilis and on the mixture. 相似文献
64.
65.
Carlos Cotrim Otília Sim?es M J Loureiro Pedro Cordeiro Rita Miranda Cecília Silva Teresa Avillez Manuel Carrageta 《Revista portuguesa de cardiologia》2006,25(5):529-533
We describe the case of a pregnant woman with idiopathic pulmonary arterial hypertension, a responder in right heart catheterization, followed since the first trimester in outpatient consultations, admitted to hospital at 23 weeks gestation. She was treated with inhaled iloprost until delivery (at 34 weeks gestation) and continuous infusion of iloprost throughout the perioperative period and following days. This line of therapy has proved efficacious in previous cases. The authors present echocardiographic images that document acute changes in ventricular synchrony during inhalation of iloprost. 相似文献
66.
Laboratory investigation: Effects of propofol on the systemic inflammatory response during aortic surgery 总被引:2,自引:0,他引:2
José M. Rodríguez-López Pilar Sánchez-Conde Francisco S. Lozano Juan L. Nicolás Francisco J. García-Criado Carlos Cascajo Clemente Muriel 《Journal canadien d'anesthésie》2006,53(7):701-710
PURPOSE: A laboratory investigation was undertaken to assess the effects of propofol on renal function, through modulation of the systemic inflammatory response, in an in vivo experimental model of aortic surgery in comparison with sevoflurane. METHODS: Twenty young male piglets were anesthetized with either propofol 4 mg.kg(-1).hr(-1) (n = 10) or sevoflurane 1.5% end-tidal concentration (n = 10). Animals were subjected to aorta-aortic bypass with suprarenal aortic clamping for 30 min. At specific intervals (basal -before the start of surgery; reperfusion 15 min after unclamping the aorta; at 24, 48 and 72 hr after surgery, and on the seventh day after surgery) the levels of the following were determined: plasma creatinine, renal myeloperoxidase, tumour necrosis factor-alpha, interleukin 1-ss, and interferon-gamma; kidney superoxide anion and its detoxifying enzyme superoxidase dismutase, kidney malondialdehyde and the activity of inducible nitric oxide synthase. Seven days after surgery, the animals were anesthetized using the described techniques, and after blood withdrawal and kidney sampling they were sacrificed. RESULTS: In comparison with sevoflurane, propofol was associated with a lower concentration of plasma creatinine (P < 0.05) together with lower concentrations of myeloperoxidase, tumour necrosis factor-alpha, interleukin 1-ss, interferon-gamma, superoxide anion and superoxidase dismutase, malondialdehyde and inducible nitric oxide synthase (P < 0.05). CONCLUSION: In an experimental model of aortic reconstructive surgery, and compared with sevoflurane, propofol anesthesia is associated with less neutrophil infiltration, lower plasma proinflammatory cytokine levels, lower production of oxygen free radicals, less lipid peroxidation, and reduced inducible nitric oxide synthase activity. These observations suggest a possible renal protective effect of propofol in this surgical setting. 相似文献
67.
Andreas Nikolis Apostolos Christopoulos Michel Saint-Cyr Carlos Cordoba Louis Guertin Patrick G Harris 《CANADIAN JOURNAL OF PLASTIC SURGERY》2003,11(1):37-40
Complications following free tissue transfer have been well established in the literature. Common and rare causes of free flap failure must be addressed by the treating surgeon when microvascular patency is threatened. With the evolution and prevalence of microsurgery, ‘rare’ causes of free flap failure will become increasingly frequent. A high index of suspicion must be established in patients with multiple failed operative interventions. A case of recurrent free flap failure secondary to heparin-induced thrombocytopenia is presented in a patient with a history of squamous cell carcinoma of the floor of the mouth, and a long-standing history of alcohol and tobacco consumption. 相似文献
68.
Francisco J. Romero Juan Segura-Aguilar Elena Monsalve Carlos Hermenegildo Eberhard Nies Francisco J. Puertas Joaquí n Rom 《Neurotoxicology and teratology》1990,12(6):603-605
The present work tries to establish the antioxidant capacity of the peripheral nervous tissue of the rat, in terms of the enzymatic activities present in this tissue that either prevent the formation of activated species as the semiquinone radical (DT-diaphorase), protect against activated oxygen species (superoxide dismutase, glutathione peroxidase), conjugate natural toxic products or xenobiotics (glutathione S-transferases, especially the activity conjugating 4-hydroxy-nonenal), or complete the glutathione system metabolism (glutathione disulfide reductase, γ-glutamyl transpeptidase). All the activities studied are lower in this tissue than they are in liver, except for γ-glutamyl transpeptidase. The relevance of the results obtained and its possible relationship with different neuropathies is discussed. It is concluded that the peripheral nervous tissue is by far less protected than the liver against oxidative damage. 相似文献
69.
Tim Elliott Marc Bonneville Juan Carlos Zúiga-Pflücker Paul R. Walker David Essayan Nicolas Glaichenhaus Anna Vyakarnam Jean-Laurent Casanova Yang Liu Hugh Auchincloss Jr Gerry Waneck Christian LeGuern Cezmi Akdis Allison Green 《Current opinion in immunology》2002,14(6):673
A selection of interesting papers that were published in the two months before our press date in major journals most likely to report significant results in immunology. 相似文献
70.
Simon Vinitski Carlos Gonzalez Feroze Mohamed Tad Iwanaga Robert L. Knobler Kamil Khalili John Mack 《Magnetic resonance in medicine》1997,37(3):457-469
Our aim was to develop an accurate multispectral tissue segmentation method based on 3D feature maps. We utilized proton density (PD), T2-weighted fast spin-echo (FSE), and T1-weighted spin-echo images as inputs for segmentation. Phantom constructs, cadaver brains, an animal brain tumor model and both normal human brains and those from patients with either multiple sclerosis (MS) or primary brain tumors were analyzed with this technique. Initially, misregistration, RF inhomogeneity and image noise problems were addressed. Next, a qualified observer identified samples representing the tissues of interest. Finally, k-nearest neighbor algorithm (k-NN) was utilized to create a stack of color-coded segmented images. The inclusion of T1 based images, as a third input, produced significant improvement in the delineation of tissues. In MS, our 3D technique was found to be far superior to that based on any combination of 2D feature maps (P < 0.001). We identified at least two distinctly different classes of lesions within the same MS plaque, representing different stages of the disease process. Further, we obtained the regional distribution of MS lesion burden and followed its changes over time. Neuropsychological aberrations were the clinical counterpart of the structural changes detected in segmentation. We could also delineate the margins of benign brain tumors. In malignant tumors, up to four abnormal tissues were identified: 1) a solid tumor core, 2) a cystic component, 3) edema in the white matter, and 4) areas of necrosis and hemorrhage. Subsequent neurosurgical exploration confirmed the distribution of tissues as predicted by this analysis. 相似文献