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61.

Background Context

Metastatic spine tumor surgery (MSTS) is associated with substantial blood loss, therefore leading to high morbidity and mortality. Although intraoperative cell salvage with leukocyte depletion filter (IOCS-LDF) has been studied as an effective means of reducing blood loss in other surgical settings, including the spine, no study has yet analyzed the efficacy of reinfusion of salvaged blood in reducing the need for allogenic blood transfusion in patients who have had surgery for MSTS.

Purpose

This study aimed to analyze the efficacy, safety, and cost-effectiveness of using IOCS-LDF in MSTS.

Study Design

This is a retrospective controlled study.

Patient Sample

A total of 176 patients undergoing MSTS were included in the study.

Methods

All patients undergoing MSTS at a single center between February 2010 and December 2014 were included in the study. The primary outcome measure was the use of autologous blood transfusion. Secondary outcome measures included hospital stay, survival time, complications, and procedural costs. The key predictor variable was whether IOCS-LDF was used during surgery. Logistic and linear regression analyses were conducted by controlling variables such as tumor type, number of diseased vertebrae, approach, number and site of stabilized segments, operation time, preoperative anemia, American Society of Anesthesiologists (ASA) grade, age, gender, and body mass index (BMI). No funding was obtained and there are no conflicts of interest to be declared.

Results

Data included 63 cases (IOCS-LDF) and 113 controls (non–IOCS-LDF). Intraoperative cell salvage with LDF utilization was substantively and significantly associated with a lower likelihood of allogenic blood transfusion (OR=0.407, p=.03). Intraoperative cell salvage with LDF was cost neutral (p=.88). Average hospital stay was 3.76 days shorter among IOCS-LDF patients (p=.03). Patient survival and complication rates were comparable in both groups.

Conclusions

We have demonstrated that the use of IOCS-LDF in MSTS reduces the need for postoperative allogenic blood transfusion while maintaining satisfactory postoperative hemoglobin. We recommend routine use of IOCS-LDF in MSTS for its safety, efficacy, and potential cost benefit.  相似文献   
62.
Neurological Sciences - Studies have suggested a possible association of migraine and increased risk of ischemic stroke in young adults, particularly in smokers and in women who use oral...  相似文献   
63.
Diabetes may modify central nervous system functions and is associated with moderate cognitive deficits and changes in the brain, a condition that may be referred to as diabetic encephalopathy. The prevalence of depression in diabetic patients is higher than in the general population, and clonazepam is being used to treat this complication. Oxidative stress may play a role in the development of diabetes complications. We investigated oxidative stress parameters in streptozotocin-induced diabetic rats submitted to forced swimming test (STZ) and evaluated the effect of insulin (STZ-INS) and/or clonazepam (STZ-CNZ and STZ-INS-CNZ) acute treatment on these animal model. Oxidative damage to proteins measured as carbonyl content in plasma was significantly increased in STZ group compared to STZ treated groups. Malondialdehyde plasma levels were significantly reduced in STZ-INS and STZ-INS-CNZ groups when compared to STZ rats, being significantly reduced in STZ-INS-CNZ than STZ-INS rats. The activities of the antioxidant enzymes catalase, superoxide dismutase and glutathione peroxidase showed no significant differences among all groups of animals. These findings showed that protein and lipid damage occurs in this diabetes/depression animal model and that the associated treatment of insulin and clonazepam is capable to protect against oxidative damage in this experimental model.  相似文献   
64.
Lithium causes erectile dysfunction in patients but its mechanism is yet unknown. The aim of our study was to verify the effect of acute lithium administration on the nonadrenergic noncholinergic (NANC)‐ and endothelium‐mediated relaxation of guinea pig isolated corpus cavernosum. Although lithium (0.5, 1, and 5 mm ) had no effect on the neurogenic relaxations, it significantly (P < 0.001) attenuated the relaxant responses to acetylcholine in a concentration‐dependent manner. Combination of low concentration of lithium (0.5 mm ) with either 0.1 or 1 μm l ‐NAME significantly (P < 0.001) reduced the endothelium‐mediated relaxation. Although the Nitric oxide (NO) precursor l ‐arginine at 1 mm did not alter the relaxant responses to acetylcholine in control strips, it improved the inhibition by lithium (1 mm ) of relaxant responses to acetylcholine. Sodium nitroprusside (SNP; 10 nm –1 mm ) produced similar concentration‐dependent relaxations in both groups. Our experiments indicated that lithium can result in impairment of the NO‐mediated endothelium‐dependent but not NANC relaxation of guinea pig corpus cavernosum.  相似文献   
65.
Chromodomain, helicase, DNA binding 5 (CHD5) is a member of a subclass of the chromatin remodeling Swi/Snf proteins and has recently been proposed as a tumor suppressor in a diverse range of human cancers. We analyzed all 41 coding exons of CHD5 for somatic mutations in 123 primary ovarian cancers as well as 60 primary breast cancers using high-resolution melt analysis. We also examined methylation of the CHD5 promoter in 48 ovarian cancer samples by methylation-specific single-stranded conformation polymorphism and bisulfite sequencing. In contrast to previous studies, no mutations were identified in the breast cancers, but somatic heterozygous missense mutations were identified in 3 of 123 ovarian cancers. We identified promoter methylation in 3 of 45 samples with normal CHD5 and in 2 of 3 samples with CHD5 mutation, suggesting these tumors may have biallelic inactivation of CHD5. Hemizygous copy number loss at CHD5 occurred in 6 of 85 samples as assessed by single nucleotide polymorphism array. Tumors with CHD5 mutation or methylation were more likely to have mutation of KRAS or BRAF (P = .04). The aggregate frequency of CHD5 haploinsufficiency or inactivation is 16.2% in ovarian cancer. Thus, CHD5 may play a role as a tumor suppressor gene in ovarian cancer; however, it is likely that there is another target of the frequent copy number neutral loss of heterozygosity observed at 1p36.  相似文献   
66.
Persistent perfluorinated organic compounds, such as perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA) are used in a variety of industrial applications. They are very stable in the environment, distribute widely in the global environment and in wild life, and are detected in human sera.  相似文献   
67.
Two new sulfated steroidal pentaglycosides(asterosaponins),novaeguinosides Ⅰ(2) and (Ⅱ)2,along with the known regularoside B(1)were isolated from the starfish Culcita novaeguineae.Their structures were elucidated by extensive NMR techniques as well as chemical evidence.  相似文献   
68.
Ethmomaxillary sinus is a variation of the posterior ethmoid cells. It is formed by the extension of the posterior ethmoid cells into the maxillary sinus and drains into superior nasal meatus. It is incidentally seen on paranasal sinus computerized tomography (CT) scans. Its prevalence has been reported as 0.7 and 2% in two studies. In this study, paranasal CT scans of 466 patients were investigated for the presence of ethmomaxillary sinus. The patients had paranasal CT with the preliminary diagnoses of septal deviation, chronic inflammatory paranasal sinus disease and nasal turbinate disorders. The ethmomaxillary sinus was present in nine of those patients (1.93%). It was septated in one of them. The CTs were further investigated for other anatomical variations and co-existent mucosal disease of the paranasal sinuses.  相似文献   
69.
古宏标  汤聿海  徐毅 《药学学报》1996,31(10):732-736
以培养血管平滑肌细胞(vascularsmcothmusclecell,VSMC)为模型,观察了间硝苯地平(m-nifedipine,m-Nif)对血管紧张素Ⅱ(angiotensinⅡ,ANGⅡ)促进VSMC增殖和蛋白质合成的影响。结果表明,m-Nif抑制ANGⅡ(100nmol·L-1)引起VSMC[3H]thymidine和[3H]leucine参入,并呈剂量依赖性。m-Nif(2×10-6mol·L-1)可抑制ANGⅡ对VSMC的刺激、DNA及蛋白质合成速率,分别降低了46%,58%,53%。提示m-Nif可抑制ANGⅡ对VSMC增殖和蛋白合成的促进作用。  相似文献   
70.
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