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41.
目的 探讨家庭群居爆发型新型冠状病毒肺炎(简称"新冠肺炎")(novel coronavirus pneumonia,NCP)的临床与胸部HRCT表现特点。方法 收集2020年2月3所医院经核酸检测阳性确诊的新冠肺炎患者10例(4个家庭),其中男性6例(中位年龄60.5岁),女性4例(中位年龄59岁)。所有患者均接受胸部CT扫描并行薄层HRCT重建,由两名10年以上工作经验放射科医生共同阅片分析新冠肺炎HRCT病变发生部位、形态、分布、密度等特点,以及治疗前后HRCT征象变化。并收集临床和实验室指标进行分析和总结。结果 本组4个家庭中首例确诊病例均有武汉确诊病例或武汉疫区接触史,4例为输入型病例(占40%),平均潜伏期5 d。实验室检查中5例(50%)外周血白细胞总数降低,4例(40%)淋巴细胞明显降低;8例(80%)C-反应蛋白增高,10例(100%)乳酸脱氢酶增高。10例(100%)患者胸部CT均有阳性表现,其中7例(70%)表现为双肺散在分布磨玻璃密度影(ground glass opacity,GGO),病变界限大多清楚。8例(80%)累及多个肺叶,2例(20%)为单肺叶病变。绝大多数病灶位于胸膜下和肺外周处,以双肺下叶为著。5例患者(50%)病变内可见细支气管充气征,9例患者(90%)病变内可见增粗细小血管影。7例患者(70%)治疗后复查胸部CT,3例(30%)原肺内胸膜下病变出现不同程度实变及纤维化,2例(20%)实变影转变为GGO,1例(10%)原肺内GGO消失,又出现新发GGO,1例(10%)病变范围有增大。结论 新冠肺炎具有家庭群居爆发的特点,均可有输入性病例,潜伏期较短,其胸部HRCT表现具有一定特征性,且有助于治疗后患者病变动态观察;结合流行病学和实验室检查有助于对NCP做出临床诊断和提供疫情防控的可靠依据。 相似文献
42.
本文在文献回顾的基础上对目前成人动脉血气分析采血部位、采血用具、穿刺方法等情况进行归纳分析,旨在为临床护士采集血气分析标本提供参考。 相似文献
43.
O'Day SJ; Rabinowe SN; Neuberg D; Freedman AS; Soiffer RJ; Spector NA; Robertson MJ; Anderson K; Whelan M; Pesek K 《Blood》1994,83(9):2707-2714
Recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) clearly hastens myeloid recovery in patients with relapsed hematologic malignancies undergoing autologous bone marrow transplantation (ABMT). In efforts to further improve neutrophil engraftment and shorten hospital stay in ABMT patients, rhGM-CSF was administered by a potentially more potent route (continuous infusion) to non-Hodgkin's lymphoma (NHL) patients with better BM reserve (first remission). Time to myeloid engraftment was compared with that of NHL patients treated in first remission at our institution on a similar ABMT protocol but without growth factor support (controls). Median neutrophil engraftment (absolute neutrophil count, 500 cells/microL) in first remission patients treated with rhGM-CSF was 14 days, compared with 22 days in controls (P = .0001). Hospital stays were also significantly reduced for rhGM-CSF patients (P = .0003). Platelet engraftment did not differ between the two groups. Persistent fever and generalized serositis were the primary toxicities. rhGM-CSF, delivered by this route, was efficacious but more toxic than 2-hour rhGM-CSF infusions previously reported by other investigators. Future alterations in both dose and schedule may retain comparable efficacy yet diminish toxicity. 相似文献
44.
目的:测算分析北京市新农合大病保险对患者疾病经济负担的减轻作用,对制度实施效果进行评价。方法:按照经济发展水平和大病保险承办方式选取北京市三个区县,再从中选择大病患者较多的2~3个乡镇。通过与大病保险管理者进行访谈,了解其运行现状;对样本乡镇全部大病患者进行问卷调查了解患者主观感受,收到有效问卷497份。利用新农合管理中心信息平台测算患者疾病经济负担。对定量和定性资料分别采用统计分析与主题框架法进行分析。结果:经大病保险报销,三个区县大病患者平均自付费用明显减轻,实际补偿比均有不同程度的提高,但灾难性卫生支出情况无显著改善。结论:应通过提高大病保险起付线与报销比例,拓宽报销目录等举措提高其补偿水平,重点缓解极重患者疾病经济负担。 相似文献
45.
目的:探讨原发性高血压(EH)患者心脏变时性功能不良(CI)及其意义。方法:随机选择EH患者60例,行活动平板运动试验,记录心率、血压变化,运动时间(time)、代谢当量(METs);计算2级运动的心率变时性反应指数(CRI2)、最大心率收缩压二项乘积(RPP)和心肌耗氧量(MV.O2)并与正常对照组40例比较。结果:EH组峰值心率及心率上升幅度小于对照组(148.75±11.81):(154.27±12.05)次/min,(67.44±13.37):(74.12±14.43)次/min,P<0.05;CRI2低于对照组(0.94±0.22):(1.03±0.15),P<0.05;EH组CI的人数共29例(48.33%)明显多于对照组7例(17.5%),P<0.005,其中CRI2<0.8的人数20例(33.33%),CRI2>1.3的人数9例(15%),对照组为6例(15%)、1例(2.5%),两组间有显著性差异P<0.05;表明EH组存在CI;EH组运动时间(time)缩短(8.78±1.87):(9.77±1.88)min,P<0.05;运动贮量(METs)降低(9.21±1.39):(9.82±1.48),P<0.05;而RPP,MV.O2分别高于对照组[(26484.64±3573.49):(24118.39±3060.76),(30.78±5.0):(27.47±4.23)ml/kg.min,P<0.001]。结论:EH患者存在CI,提示有心脏自主神经损害,临床应引起重视。 相似文献
46.
NA Hanchard DR Murdock PL Magoulas M Bainbridge D Muzny YQ Wu M Wang AL McGuire JR Lupski RA Gibbs CW Brown 《Clinical genetics》2013,83(5):457-461
The advent of whole‐exome next‐generation sequencing (WES) has been pivotal for the molecular characterization of Mendelian disease; however, the clinical applicability of WES has remained relatively unexplored. We describe our exploration of WES as a diagnostic tool in a 3½‐year old female patient with a 2‐year history of episodic muscle weakness and paroxysmal dystonia who presented following a previous extensive but unrevealing diagnostic work‐up. WES was performed on the proband and her two parents. Parental exome data was used to filter potential de novo genomic events in the proband and suspected variants were confirmed using di‐deoxy sequencing. WES revealed a de novo non‐synonymous mutation in exon 21 of the calcium channel gene CACNA1S that has been previously reported in a single patient as a rare cause of atypical hypokalemic periodic paralysis. This was unexpected, as the proband's original differential diagnosis had included hypokalemic periodic paralysis, but clinical and laboratory features were equivocal, and standard clinical molecular testing for hypokalemic periodic paralysis and related disorders was negative. This report highlights the potential diagnostic utility of WES in clinical practice, with implications for the approach to similar diagnostic dilemmas in the future. 相似文献
47.
Chhaya V Verma Rachna D Arora Hetal M Mistry Swati V Kubal Nandini S Kolwankar Pranali C Patil Anushka A Dalvi Sonal A Vichare Akhila Natesan Anagha N Mangaonkar Dolly D Kanakia Gayatri S Jere Karan Y Bansode Madhura R Patil Rajvi D Sheth Sandhya D Dudhavade Sayali D Mhatre Suresh K Patel Akanksha G Mohite Ankita N Bhavsar Jessica E Alfonso Maryam NA Syed Nidhi P Savla Riya N Rajgond Rutuja A Bute Samiksha M Mane Shubham R Jaiswal Vibhawari A Parab Abhiram M Kasbe Mohan A Joshi Ramesh N Bharmal 《Indian Journal of Critical Care Medicine》2021,25(3):317
48.
Alessandro Conforti Ilenia Di Cola Viktoriya Pavlych Piero Ruscitti Onorina Berardicurti Francesco Ursini Roberto Giacomelli Paola Cipriani 《Autoimmunity reviews》2021,20(2):102735
Rheumatoid arthritis (RA) is an inflammatory disease typically affecting the joints, but the systemic inflammatory process may involve other tissues and organs. Many extra-articular manifestations are recognized, which are related to worse long outcomes. Rheumatoid nodules are the most common extra-articular feature, found in about 30% of patients. Secondary Sjögren's syndrome and pulmonary manifestations are observed in almost 10% of patients, also in the early disease. Active RA with high disease activity has been associated with an increased risk of such features. Male gender, smoking habit, severe joint disease, worse function, high pro-inflammatory markers levels, high titer of rheumatoid factor, and HLA-related shared epitope have been reported as clinical predictors of occurrence of these rheumatoid complications. In addition, there is a little evidence deriving from randomized controlled trials in this field, thus the therapeutic strategy is mainly empiric and based on small case series and retrospective studies. However, considering that these extra-articular manifestations are usually related to the more active and severe RA, an aggressive therapeutic strategy is usually employed in view of the poor outcomes of these patients.The extra-articular features of RA remain, despite the improvement of joint damage, a major diagnostic and therapeutic challenge, since these are associated with a poor prognosis and need to be early recognized and promptly managed. 相似文献
49.
目的 通过淫羊藿总黄酮(TFE)对去卵巢大鼠骨组织Wnt/β-catenin信号通路及腰椎骨和股骨生物力学性能影响研究,探讨TFE对去卵巢大鼠抗骨质疏松的可能机制.方法 选用40只90天龄的SPF级SD雌性大白鼠,随机分为4组:对照组、去卵巢组(OVX)组、去卵巢+己烯雌酚(DES)组、去卵巢+淫羊藿总黄酮(TFE)组.实验持续12周后处死全部大鼠,取腰椎骨、股骨分别测量生物力学参数及骨密度.免疫蛋白印迹法检测各组大鼠胫骨骨皮质区p-GSK3-β(thr9)、RANKL、OPG、β-catenin蛋白表达水平.结果 与对照组比较,OVX组大鼠股骨、腰椎骨的生物力学性能及骨密度下降(P<0.05);DES组、TFE组股骨和腰椎骨的生物力学性能和骨密度较去卵巢OVX组明显改善(P<0.05);两治疗组的组间差异无统计学意义(P>0.05).免疫蛋白印迹法提示去卵巢大鼠分别加用TFE、DES治疗后,胫骨蛋白β-catenin、OPG表达上调,p-GSK3-β(thr9)、RANKL表达下调.结论 淫羊藿总黄酮能够改善去卵巢大鼠的骨生物力学性能,上调Wnt/β-catenin信号通路,从而改善骨质疏松. 相似文献
50.