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51.
We report our clinical experience with phototherapy in 3802 infants; 3629 were exposed to "standard" daylight phototherapy and 173 to "high-intensity" blue-light phototherapy. High-intensity blue-light phototherapy was twice as effective as standard daylight phototherapy in decreasing bilirubin concentrations. No failures occurred with high-intensity phototherapy compared with an overall failure rate of 1.84/1000 with daylight lamps; these cases were transferred to high-intensity phototherapy with prompt response. Rebound after cessation of phototherapy was greater in those exposed to high-intensity blue light with a significantly greater number requiring a second exposure. However, the incidence was still low. No third exposure was required in any infant. Nursing of infants under high-intensity blue light was more difficult and inconvenient as was clinical monitoring. The light also caused more stress on the nursing and medical personnel. However, the infants tolerated both types of phototherapy equally well. High-intensity blue-light phototherapy would seem to be the treatment of choice for infants with rapidly increasing or very high bilirubin levels, as well as in those not responding adequately to daylight phototherapy. 相似文献
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双能量X线骨质密度测量仪监测小儿下肢骨延长骨矿物质的变化 总被引:1,自引:0,他引:1
目的 在儿童骨延长的患儿中 ,为了能够有效地控制骨延长的速率 ,达到骨延长的目的 ,采用双能量X线骨质密度测量仪 (dualenergyX Rayabsorptiometry ,DEXA)监测延长断端骨矿含量 (bonemineralcontent,BMC)的变化。方法 30例患儿中有 5 0处下肢作了骨延长术 ,平均年龄10 .9岁 (5~ 17岁 ) ,引起短肢的病因不同。术后 7~ 10d开始行骨延长 ,每次延长 0 .2 5mm ,每天 4次。牵引延长期间每周扫描一次 ,拆除外固定器后每 2周扫描一次到术后 2年。DEXA扫描的分辨率是 1mm× 1mm ,扫描速度 30mm/s。比较不同延长时期中骨矿含量的变化。分析不同病因和不同外固定器之间骨矿含量变化的差别。结果 不同固定器之间骨矿含量的差别无著性意义。根据骨延长区BMC增加速率 ,将患儿分为快速组、一般组和慢速组。快速组每日BMC增加速率为 0 .3%~ 0 .6 % ,新骨生长快速 ;一般组每日BMC增加 0 .1%~ 0 .3% ,新骨中速生长 ;慢速组每日增加 <0 .1% ,新骨生成缓慢。骨矿化速率与原发病因相关。结论 DEXA能动态监测骨延长中新生骨的骨矿含量的变化 ,根据骨矿含量变化的程度 ,能够调整骨延长的速率 ,从而达到预期骨延长的目的。 相似文献
53.
PC NG KW SO TF FOK MC YAM MY WONG W WONG 《Journal of paediatrics and child health》1997,33(4):324-328
Objectives: A prospective study comparing the efficiacy and side-effects of oral sulindac with intravenous indomethacin in clinically stable preterm infants (<1750 g) requiring non-invasive closure of haemodynamically significant patent ductus arteriosus.
Methodology: As maturity and birthweight are the two major determinants of ductal closure, infants were matched as closely as possible for these parameters. An eligible patient was first assigned to the sulindac group and a subsequent patient with similar gestational age (± 1 week) and birthweight (±100 g) to the previously recruited infant would automatically receive indomethacin. A total of eight infants were enrolled in each group.
Results: The ductus arteriosus was successfully closed in all eight infants receiving indomethacin, and in seven of eight infants receiving sulindac. No significant differences were found with regards to the ductal size between the two groups at diagnosis or on each of the consecutive days of treatment ( P >0.25). More renal adverse effects were encountered in the indomethacin group. Significant differences in changes from baseline value for urine output, plasma sodium, urea and creatinine concentrations were noted at 24, 48 and 72 h after commencement of treatment between the two groups ( P <0.05). All the parameters returned to normal or pre-treatment levels 48 h after stopping therapy. Unexpectedly, severe gastrointestinal complications were encountered in the sulindac group.
Conclusions: Sulindac is capable of promoting ductal constriction in clinically stable preterm infants without compromising the renal function. The spectrum of gastrointestinal complications observed in sulindac treated infants were similar to those described for indomethacin. The use of sulindac for ductal closure in the preterm infant should remain experimental. 相似文献
Methodology: As maturity and birthweight are the two major determinants of ductal closure, infants were matched as closely as possible for these parameters. An eligible patient was first assigned to the sulindac group and a subsequent patient with similar gestational age (± 1 week) and birthweight (±100 g) to the previously recruited infant would automatically receive indomethacin. A total of eight infants were enrolled in each group.
Results: The ductus arteriosus was successfully closed in all eight infants receiving indomethacin, and in seven of eight infants receiving sulindac. No significant differences were found with regards to the ductal size between the two groups at diagnosis or on each of the consecutive days of treatment ( P >0.25). More renal adverse effects were encountered in the indomethacin group. Significant differences in changes from baseline value for urine output, plasma sodium, urea and creatinine concentrations were noted at 24, 48 and 72 h after commencement of treatment between the two groups ( P <0.05). All the parameters returned to normal or pre-treatment levels 48 h after stopping therapy. Unexpectedly, severe gastrointestinal complications were encountered in the sulindac group.
Conclusions: Sulindac is capable of promoting ductal constriction in clinically stable preterm infants without compromising the renal function. The spectrum of gastrointestinal complications observed in sulindac treated infants were similar to those described for indomethacin. The use of sulindac for ductal closure in the preterm infant should remain experimental. 相似文献
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In 2001, a publicly funded pneumococcal conjugate vaccine (7vPCV) program commenced for Aboriginal and Torres Strait Islander children aged under two years. At present, there is very little knowledge about the uptake of 7vPCV vaccine amongst Aboriginal and Torres Strait Islander children. This study examined the rollout and use of 7vPCV vaccine in Australia and estimated immunisation coverage for Indigenous children at the age of 12 months for 7vPCV vaccine. To calculate 7vPCV coverage we chose four consecutive 3-month birth cohorts born between 1 October 2001 and 30 September 2002. The immunisation status of children in each birth cohort was assessed at 12 months for the third dose of 7vPCV vaccine. The largest absolute number of 7vPCV doses was given in Queensland, the Northern Territory and New South Wales. As the 7vPCV program matured, a progressively higher proportion of total doses was administered to children under the age of 12 months consistent with the introduction of the program. For all jurisdictions except the Northern Territory and Western Australia, where it has remained reasonably constant, estimated coverage increased over the most recent birth cohorts but was still less than 50 per cent for all states except the Northern Territory, Queensland, and Western Australia. This study provides the first national measure of 7vPCV immunisation coverage among Indigenous children in Australia. With the likely improvement over time in the recording of 7vPCV vaccinations and Indigenous status on the Australian Childhood Immunisation Register, the validity of coverage estimates is likely to increase. 相似文献
57.
Patients with chronic kidney disease have abnormal upper gastro‐intestinal tract digestive function: A study of uremic enteropathy 下载免费PDF全文
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Elliptical localization with pulsed second‐order fields (ECLIPSE) for robust lipid suppression in proton MRSI 下载免费PDF全文
Robin A. de Graaf Peter B. Brown Henk M. De Feyter Scott McIntyre Terence W. Nixon 《NMR in biomedicine》2018,31(9)
Proton MRSI has great clinical potential for metabolic mapping of the healthy and pathological human brain. Unfortunately, the promise has not yet been fully achieved due to numerous technical challenges related to insufficient spectral quality caused by magnetic field inhomogeneity, insufficient RF transmit power and incomplete lipid suppression. Here a robust, novel method for lipid suppression in 1H MRSI is presented. The method is based on 2D spatial localization of an elliptical region of interest using pulsed second‐order spherical harmonic (SH) magnetic fields. A dedicated, high‐amplitude second‐order SH gradient setup was designed and constructed, containing coils to generate Z2, X2Y2 and XY magnetic fields. Simulations and phantom MRI results are used to demonstrate the principles of the method and illustrate the manifestation of chemical shift displacement. 1H MRSI on human brain in vivo demonstrates high quality, robust suppression of extracranial lipids. The method allows a wide range of inner or outer volume selection or suppression and should find application in MRSI, reduced‐field‐of‐view MRI and single‐volume MRS. 相似文献