全文获取类型
收费全文 | 929篇 |
免费 | 54篇 |
国内免费 | 8篇 |
专业分类
耳鼻咽喉 | 18篇 |
儿科学 | 26篇 |
妇产科学 | 33篇 |
基础医学 | 85篇 |
口腔科学 | 20篇 |
临床医学 | 73篇 |
内科学 | 252篇 |
皮肤病学 | 33篇 |
神经病学 | 36篇 |
特种医学 | 13篇 |
外科学 | 167篇 |
综合类 | 17篇 |
预防医学 | 41篇 |
眼科学 | 6篇 |
药学 | 77篇 |
中国医学 | 1篇 |
肿瘤学 | 93篇 |
出版年
2023年 | 8篇 |
2022年 | 18篇 |
2021年 | 19篇 |
2020年 | 14篇 |
2019年 | 21篇 |
2018年 | 32篇 |
2017年 | 17篇 |
2016年 | 29篇 |
2015年 | 16篇 |
2014年 | 36篇 |
2013年 | 49篇 |
2012年 | 66篇 |
2011年 | 58篇 |
2010年 | 27篇 |
2009年 | 29篇 |
2008年 | 37篇 |
2007年 | 62篇 |
2006年 | 65篇 |
2005年 | 59篇 |
2004年 | 61篇 |
2003年 | 44篇 |
2002年 | 45篇 |
2001年 | 21篇 |
2000年 | 18篇 |
1999年 | 12篇 |
1998年 | 10篇 |
1997年 | 4篇 |
1996年 | 3篇 |
1995年 | 5篇 |
1994年 | 7篇 |
1993年 | 6篇 |
1992年 | 11篇 |
1991年 | 8篇 |
1990年 | 7篇 |
1989年 | 8篇 |
1988年 | 5篇 |
1987年 | 2篇 |
1986年 | 3篇 |
1985年 | 2篇 |
1982年 | 4篇 |
1981年 | 3篇 |
1979年 | 4篇 |
1976年 | 6篇 |
1974年 | 7篇 |
1973年 | 6篇 |
1972年 | 2篇 |
1970年 | 2篇 |
1969年 | 2篇 |
1966年 | 5篇 |
1929年 | 1篇 |
排序方式: 共有991条查询结果,搜索用时 31 毫秒
81.
Olfat Zekry Stephen B. Gibson Arun Aggarwal 《Journal of pain & palliative care pharmacotherapy》2016,30(2):91-98
This study was designed to describe the efficacy and toxicity of subcutaneous ketamine infusions and sublingual ketamine lozenges for the treatment of chronic nonmalignant pain. Data were collected prospectively on 70 subjects managed in an academic, tertiary care hospital between 2007 and 2012 who received between 3 and 7 days of subanesthetic, subcutaneous ketamine infusion. Data were analyzed for efficacy, adverse effects, and reduction in use of opioid medication. We also analyzed whether subsequent treatment with sublingual ketamine lozenges resulted in longer-term efficacy of the beneficial effects of the initial ketamine infusion. There was a significant reduction in pain intensity measured by numerical rating scale (NRS) from mean of 6.38 before ketamine to 4.60 after ketamine (P < .005) that was sustained for between 3 months and 6 years. In subjects on opioids, there was a significant reduction in opioid use at the end of the ketamine infusion from a mean morphine equivalent dose (MMED) of 216 mg/day before ketamine to 89 mg/day after ketamine (P < .005). The overall reduction in opioid use after ketamine infusion was 59%. No subjects increased their use of opioids during their hospitalization for the ketamine infusion. A small proportion of subjects who responded to the infusion were continued on ketamine lozenges. This group was followed for between 3 months and 2 years. The use of ketamine lozenges after the infusion resulted in 31% of these subjects being able to cease their use of opioids compared with only 6% who did not receive ketamine lozenges. Eleven percent of subjects who received lozenges subsequently increased their opioid usage. Adverse effects were fairly common, but only mild, with 46% of patients experiencing light-headedness and dizziness, 25% tiredness and sedation, 12% headaches, 12% hallucinations, and 8% vivid dreams. Adverse effects were easily managed by reducing the rate of the ketamine infusion. The administration of subanesthetic, subcutaneous ketamine infusion was well tolerated, with mostly mild adverse effects and no serious adverse effects. The infusion provided significant pain relief in subjects who had failed a wide range of pharmacological and cognitive behavioral therapies. In addition, the results indicate that sublingual ketamine lozenges offer a promising therapeutic option for longer-term relief of chronic nonmalignant pain. The ketamine lozenges have been shown to have acceptable storage stability, and the sublingual bioavailability is sufficiently high and reproducible to support its use in this context. 相似文献
82.
OBJECTIVE: To identify the influence of walking velocity and footwear condition on plantar pressure variables in healthy older adults. DESIGN: Single session data collection during varying speed and footwear conditions. BACKGROUND: Elevated plantar pressures are concerning due to the risk of tissue injury, ulceration, and pain. In young adults, increases in plantar pressure have been documented with faster walking speeds and when walking barefoot compared to wearing shoes. These relationships have not been systematically explored in older adults. METHODS: Key plantar pressure factors were recorded as subjects walked barefoot and in comfortable walking shoes across a 10 m walkway at three predetermined velocities (57, 80, 97 m/min). Separate 3x2 analyses of variance with repeated measures identified significant differences in pressure, force, and contact area in eight anatomically defined foot regions across walking speeds and between footwear conditions. RESULTS: Faster walking resulted in higher pressures under all foot regions except for the arch and lateral metatarsal (P=0.001), due primarily to greater forces under the heel, medial metatarsal and toes (P=0.001). Compared to wearing shoes, barefoot heel pressure was elevated (P=0.001) due to reduced heel contact area (P<0.001); pressure under the central metatarsals was higher (P=0.001) owing to greater central metatarsals force (P<0.001). CONCLUSIONS: Two conditions were associated with higher plantar pressures in the older adults studied: faster speeds and barefoot walking. 相似文献
83.
Collin Zimmerman Pamela J. Atherton Deirdre Pachman Drew Seisler Nina Wagner-Johnston Shaker Dakhil Jacqueline M. Lafky Rui Qin Axel Grothey Charles L. Loprinzi 《Supportive care in cancer》2016,24(3):1071-1078
Purpose
Previous pilot data suggested that venlafaxine could prevent acute and chronic oxaliplatin-related neuropathy. The purpose of this randomized, placebo-controlled, double-blinded pilot study was to obtain additional data to support conducting a phase III trial to test the use of venlafaxine to prevent oxaliplatin neurotoxicity.Methods
Fifty patients, scheduled to undergo oxaliplatin-based therapy (FOLFOX) for stages II–III (67 %) or stage IV (33 %) colon cancer, were randomized to receive venlafaxine extended release (37.5 mg) or placebo, twice daily, through their last dose of oxaliplatin and then titrated off. Neurotoxicity was evaluated via several patient- and physician-reported measures, including the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (EORTC QLQ-CIPN20) instrument.Results
Baseline patient characteristics were equivalent for the two arms, with a median age of 60 years. There was a trend toward benefit for the venlafaxine arm, when evaluated by the oxaliplatin-specific neuropathy scale and by acute neuropathy measures of throat discomfort and discomfort swallowing cold liquids, the latter only for the first two oxaliplatin doses. These trends were outweighed by a lack of any such trends in all other measurements including the following: (1) the CIPN20 sensory subscale (P?=?0.55, primary endpoint), physician-completed NCI CTCAE assessment, or cumulative administered oxaliplatin doses (median 716 vs 631 mg for placebo and venlafaxine, respectively, P?=?0.34).Conclusions
The present study neither supports the use of venlafaxine for preventing oxaliplatin-induced neuropathy in clinical practice nor the initiation of a phase III trial to investigate venlafaxine in this setting.84.
Excessive coupling of the salience network with intrinsic neurocognitive brain networks during rectal distension in adolescents with irritable bowel syndrome: a preliminary report
下载免费PDF全文
![点击此处可从《Neurogastroenterology and motility》网站下载免费的PDF全文](/ch/ext_images/free.gif)
85.
Evaluation of a new radioimmunoassay for urinary albumin 总被引:1,自引:0,他引:1
We have evaluated a new commercially available radioimmunoassay kit for albumin determination in urine. The assay is precise; within-run precision (CV) in the clinically significant ranges is 1.8-3.5%, between-run, 1.2-8.5%. The minimum detection limit was 0.6 micrograms/ml. Analytic recovery of different concentrations of albumin added to urine ranged from 98% to 103%. Samples, stored in plastic containers, were stable at room temperature for periods up to 7 days. Mean albumin excretion rates, measured in 20 normal volunteers for 3-h and 24-h periods during the same day were similar (7.1 +/- 4.6 [SD] versus 6.5 +/- 5.0 micrograms/min). In 8 normal subjects, 3-h excretion rates measured daily for 5 days showed no significant variability. In eight insulin-dependent diabetic subjects, albumin excretion measured in short periods of urine collection (3 h) were also in close agreement with 24-h collections (24.7 +/- 28.9 versus 17.6 +/- 18 micrograms/min). From these results it appears that this commercially available kit is suitable for conveniently monitoring microalbuminuria in large numbers of patients in research studies as well as for office practice. Such widespread use should make it possible to better determine the clinical usefulness of this test in the management of diabetic patients. 相似文献
86.
Shafik A Shafik IA El Sibai O Shafik AA 《World journal of gastroenterology : WJG》2007,13(30):4112-4116
AIM: To investigate the hypothesis that duodeno-jejunal dyssynergia existed at the duodeno-jejunal junction.
METHODS: Of 112 patients who complained of epigastric distension and discomfort after meals, we encountered nine patients in whom the duodeno-jejunal junction did not open on duodenal contraction. Seven healthy volunteers were included in the study. A condom which was inserted into the ist duodenum was filled up to 10 mL with saline in increments of 2 mL and pressure response to duodenal distension was recorded from the duodenum, duodeno-jejunal junction and the jejunum.
RESULTS: In healthy volunteers, duodenal distension with 2 and 4 mL did not produce pressure changes, while 6 and up to 10 mL distension effected significant duodenal pressure increase, duodeno-jejunal junction pressure decrease but no jejunal pressure change. In patients, resting pressure and duodeno-jejunal junction and jejunal pressure response to 2 and 4 mL duodenal distension were similar to those of healthy volunteers. Six and up to 10 mL 1^st duodenal distension produced significant duodenal and duodeno-jejunal junction pressure increase and no jejunal pressure change.
CONCLUSION: Duodeno-jejunal junction failed to open on duodenal contraction, a condition we call 'duodenojejunal junction dyssynergia syndrome' which probably leads to stagnation of chyme in the duodenum and explains patients' manifestations. 相似文献
METHODS: Of 112 patients who complained of epigastric distension and discomfort after meals, we encountered nine patients in whom the duodeno-jejunal junction did not open on duodenal contraction. Seven healthy volunteers were included in the study. A condom which was inserted into the ist duodenum was filled up to 10 mL with saline in increments of 2 mL and pressure response to duodenal distension was recorded from the duodenum, duodeno-jejunal junction and the jejunum.
RESULTS: In healthy volunteers, duodenal distension with 2 and 4 mL did not produce pressure changes, while 6 and up to 10 mL distension effected significant duodenal pressure increase, duodeno-jejunal junction pressure decrease but no jejunal pressure change. In patients, resting pressure and duodeno-jejunal junction and jejunal pressure response to 2 and 4 mL duodenal distension were similar to those of healthy volunteers. Six and up to 10 mL 1^st duodenal distension produced significant duodenal and duodeno-jejunal junction pressure increase and no jejunal pressure change.
CONCLUSION: Duodeno-jejunal junction failed to open on duodenal contraction, a condition we call 'duodenojejunal junction dyssynergia syndrome' which probably leads to stagnation of chyme in the duodenum and explains patients' manifestations. 相似文献
87.
Petersdorf SH Rankin C Head DR Terebelo HR Willman CL Balcerzak SP Karnad AB Dakhil SR Appelbaum FR 《American journal of hematology》2007,82(12):1056-1062
Induction therapy for acute myeloid leukemia (AML) usually consists of 7 days of cytarabine at 100-200 mg/m(2)/day and an anthracycline. Such combinations produce complete response (CR) rates of 60-80% in patients with de novo AML. On the basis of a previous report, suggesting a higher CR rate using a regimen of standard daunomycin and cytarabine followed by 3 days of high-dose cytarabine (HDAC), 101 eligible patients received this regimen in a phase II trial. Sixty patients [59%, 95% confidence interval (CI) 49-69%] achieved a CR, and 10 patients died of infection during induction. Although cytogenetic risk group affected overall survival (P = 0.0016) and relapse-free survival (P = 0.0043), it had no impact on CR rate (P = 0.63). Patients received postremission therapy with repetitive courses of alternate day high-dose cytarabine; this was associated with considerable toxicity and the majority of patients could not receive all of the scheduled postremission therapy. The estimated median survival was 23 months (95% CI 15-34 months), and the estimated probability of surviving 5 years was 34% (95% CI 24-43%). The results of this intensive induction regimen were similar to that seen in previous trials and were not as promising as reported in the previous pilot study. 相似文献
88.
89.
A. Miranda A. Mickle B. Medda Z. Zhang R.J. Phillips N. Tipnis T.L. Powley R. Shaker J.N. Sengupta 《Neuroscience》2009
Background and aims: Several types of gastric surgeries have been associated with early satiety, dyspepsia and food intolerances. We aimed to examine alterations in gastric vagal afferents following gastric surgery–fundus ligation. 相似文献
90.
Jadcherla SR Gupta A Coley BD Fernandez S Shaker R 《The American journal of gastroenterology》2007,102(10):2286-2293
BACKGROUND AND AIMS: Our aims were to identify and characterize the glottal response to esophageal mechanostimulation in human infants. We tested the hypotheses that glottal response is related to the type of esophageal peristaltic response, stimulus volume, and respiratory phase. METHODS: Ten infants (2.8 kg, SD 0.5) were studied at 39.2 wk (SD 2.4). Esophageal manometry concurrent with ultrasonography of the glottis (USG) was performed. The sensory-motor characteristics of mechanostimulation-induced esophago-glottal closure reflex (EGCR, adduction of glottal folds upon esophageal provocation) were identified. Mid-esophageal infusions of air (N = 41) were given and the temporal relationships of glottal response with deglutition, secondary peristalsis (SP), and the respiratory phase were analyzed using multinomial logistic regression models. RESULTS: The frequency occurrence of EGCR (83%) was compared (P < 0.001) with deglutition (44%), SP (34%), and no esophageal responses (22%). The odds ratios (OR, 95% CI) for the coexistence of EGCR with SP (0.4, 0.06-2.2), deglutition (1.9, 0.1-26), and no response (1.9, 0.4-9.0) were similar. The response time for esophageal reflexes was 3.8 (SD 1.8) s, and for EGCR was 0.4 (SD 0.3) s (P < 0.001). Volume-response relationship was noted (1 mL vs 2 mL, P < 0.05). EGCR was noted in both respiratory phases; however, EGCR response time was faster during expiration (P < 0.05). CONCLUSION: The occurrence of EGCR is independent of the peristaltic reflexes or the respiratory phase of infusion. The independent existence of EGCR suggests a hypervigilant state of the glottis to prevent retrograde aspiration during GER events. 相似文献