全文获取类型
收费全文 | 48927篇 |
免费 | 2585篇 |
国内免费 | 1169篇 |
专业分类
耳鼻咽喉 | 263篇 |
儿科学 | 1520篇 |
妇产科学 | 232篇 |
基础医学 | 2584篇 |
口腔科学 | 91篇 |
临床医学 | 7299篇 |
内科学 | 9613篇 |
皮肤病学 | 253篇 |
神经病学 | 2214篇 |
特种医学 | 1398篇 |
外科学 | 4476篇 |
综合类 | 10011篇 |
预防医学 | 2918篇 |
眼科学 | 234篇 |
药学 | 5608篇 |
51篇 | |
中国医学 | 2432篇 |
肿瘤学 | 1484篇 |
出版年
2024年 | 66篇 |
2023年 | 584篇 |
2022年 | 1479篇 |
2021年 | 2006篇 |
2020年 | 1768篇 |
2019年 | 1361篇 |
2018年 | 1426篇 |
2017年 | 1562篇 |
2016年 | 1837篇 |
2015年 | 1719篇 |
2014年 | 4202篇 |
2013年 | 3897篇 |
2012年 | 3540篇 |
2011年 | 3638篇 |
2010年 | 2831篇 |
2009年 | 2460篇 |
2008年 | 2346篇 |
2007年 | 2388篇 |
2006年 | 2122篇 |
2005年 | 1768篇 |
2004年 | 1413篇 |
2003年 | 1162篇 |
2002年 | 886篇 |
2001年 | 857篇 |
2000年 | 718篇 |
1999年 | 629篇 |
1998年 | 495篇 |
1997年 | 461篇 |
1996年 | 383篇 |
1995年 | 330篇 |
1994年 | 327篇 |
1993年 | 228篇 |
1992年 | 206篇 |
1991年 | 204篇 |
1990年 | 188篇 |
1989年 | 146篇 |
1988年 | 142篇 |
1987年 | 99篇 |
1986年 | 89篇 |
1985年 | 131篇 |
1984年 | 112篇 |
1983年 | 55篇 |
1982年 | 78篇 |
1981年 | 66篇 |
1980年 | 64篇 |
1979年 | 50篇 |
1978年 | 38篇 |
1977年 | 34篇 |
1976年 | 24篇 |
1975年 | 17篇 |
排序方式: 共有10000条查询结果,搜索用时 93 毫秒
991.
The aim of the present review is to summarize the current knowledge regarding pharmacological prevention and treatment of acute pancreatitis (AP) based on experimental animal models and clinical trials. Somatostatin (SS) and octreotide inhibit the exocrine production of pancreatic enzymes and may be useful as prophylaxis against Post Endoscopic retrograde cholangiopancreatography Pancreatitis (PEP). The protease inhibitor Gabexate mesilate (GM) is used routinely as treatment to AP in some countries, but randomized clinical trials and a meta-analysis do not support this practice. Nitroglycerin (NGL) is a nitrogen oxide (NO) donor, which relaxes the sphincter of Oddi. Studies show conflicting results when applied prior to ERCP and a large multicenter randomized study is warranted. Steroids administered as prophylaxis against PEP has been validated without effect in several randomized trials. The non-steroidal anti-inflammatory drugs (NSAID) indomethacin and diclofenac have in randomized studies showed potential as prophylaxis against PEP. Interleukin 10 (IL-10) is a cytokine with anti-inflammatory properties but two trials testing IL-10 as prophylaxis to PEP have returned conflicting results. Antibodies against tumor necrosis factor-alpha (TNF-α) have a potential as rescue therapy but no clinical trials are currently being conducted. The antibiotics beta- lactams and quinolones reduce mortality when necrosis is present in pancreas and may also reduce incidence of infected necrosis. Evidence based pharmacological treatment of AP is limited and studies on the effect of potent anti-inflammatory drugs are warranted. 相似文献
992.
Jérôme Fichet Axel de Labriolle Bruno Giraudeau Philippe Arbeille Bernard Charbonnier 《Heart and vessels》2008,23(6):397-402
Stroke is a rare but severe event after acute coronary syndrome. Relations between both arterial territories are still discussed
but prevalence of asymptomatic carotid stenosis potentially implicated in the mechanism of stroke is under-investigated. This
study aimed to determine the prevalence of asymptomatic carotid stenosis in that population and review the value of screening
in a view to potential surgical correction or other preventive therapies. Systematic carotid Doppler ultrasound screening
was implemented on 152 consecutive patients admitted to the intensive care unit due to acute coronary syndrome. Fifty-two
percent of patients had at least one carotid artery stenosis determined using the NASCET method. Forty-three percent had at
least one carotid stenosis <30%, 6% had mild (30–60%) stenosis, and 2.6% had high-grade (>60%) stenosis. Existence of carotid
stenosis was associated with age, diabetes mellitus, hypertension, and with the extent of the coronary atherosclerosis (left
main artery stenosis). In multivariate analysis, age and diabetes were independently associated with existence of a carotid
stenosis. When ultrasound screening was restricted to patients identified by multivariate analysis, the prevalence of carotid
stenosis potentially requiring surgical treatment rose to 4.6%. The frequency of asymptomatic carotid atherosclerosis was
high in this population but lesions were mild. While the small number of high-grade lesions indicates that systematic screening
is not to be recommended, screening of patients aged >65 years or with diabetes, or both, with a view to surgery may be envisaged,
since the role of mild stenosis in the occurrence of stroke remains debatable. 相似文献
993.
Sarah Morton Alexander Isted Pascale Avery Joe Wang 《The American journal of medicine》2018,131(10):1251-1256.e2
Background
Frailty and acute kidney injury are independently associated with an increased risk of morbidity and mortality. The degree of frailty can be assessed by the Clinical Frailty Score (CFS). This study assessed whether an individual's CFS was associated with acute kidney injury in acute elderly medical admissions and recorded the short-term outcomes.Methods
This was a single-center prospective observational cohort study. All patients aged ≥65 years admitted under an acute medical take over 12 nonconsecutive days were included. Patient demographics, comorbidities, baseline CFS, and renal status on admission were recorded. Outcomes of death, length of stay, and hospital re-attendance were assessed 2 weeks following admission.Results
Of 164 patients (77 males), 19% had acute kidney injury on admission and 22% were considered severely frail. Severe frailty was associated with acute kidney injury (P = .01) and death within 2 weeks (P = .01). Two-week mortality was highest among patients with both (36%).Conclusion
The incidence of acute kidney injury in “severely frail” acutely unwell elderly patients is significantly higher and associated with an increased short-term mortality. The CFS may be useful in acute illness to guide clinical decisions in elderly patients. 相似文献994.
Naoko Ito Masatoki Sato Nobuo Momoi Yoshimichi Aoyagi Kisei Endo Mina Chishiki Yukihiko Kawasaki Mitsuaki Hosoya 《Pediatrics international》2015,57(6):1172-1174
A 9‐year‐old girl developed influenza A H1N1 pdm09‐associated myocarditis and pericarditis 2 days after starting zanamivir therapy. The virus was detected in the respiratory tract but not in the serum or pericardial effusion. The virus sampled from the respiratory tract had normal susceptibility to neuraminidase inhibitors. Although no differences in interferon‐γ, interleukin (IL)‐1β, and tumor necrosis factor‐α were observed between the plasma and pericardial effusion, some inflammatory cytokines or chemokines (IL‐6 and IL‐8) and vascular endothelial growth factor were remarkably elevated in the pericardial effusion compared with the plasma. This suggested that the influenza virus, after infecting the respiratory tract, affected the myocardium, causing myocarditis to gradually develop, which might have been followed by an autoreactive pericarditis causing increased pericardial effusion. Therefore, influenza‐associated myocarditis should be considered when influenza patients have respiratory and cardiac involvement, even during treatment with a neuraminidase inhibitor. 相似文献
995.
Alterations of intestinal immune function and regulatory effects of L-arginine in experimental severe acute pancreatitis rats 总被引:13,自引:1,他引:13
ABM: To discuss the changes of intestinal mucosal immune function in rats with experimental severe acute pancreatitis (SAP) and the regulatory effect of L-arginine. METHODS: Male adult Wistar rats were randomly divided into pancreatitis group, sham-operation group, and L-arginine treatment group. Animals were killed at 24, 48, and 72 h after SAP models were developed and specimens were harvested. Endotoxin concentration in portal vein was determined by limulus endotoxin analysis kit. CD3+, CD4+, CD8+ T lymphocytes in intestinal mucosal lamina propria were examined by immunohistochemistry. Secretory immunoglobulin A (SIgA) in cecum feces was examined by radioimmunoassay. RESULTS: Compared to the control group, plasma endotoxin concentration in the portal vein increased, percentage of CD3+ and CD4+ T lymphocyte subsets in the end of intestinal mucosal lamina propria reduced significantly, CD4+/CD8+ ratio decreased, and SIgA concentrations in cecum feces reduced at 24, 48, and 72 h after SAP developed. Compared to SAP group, the L-arginine treatment group had a lower level of plasma endotoxin concentration in the portal vein, a higher CD3+ and CD4+ T lymphocyte percentage in the end of intestinal mucosal lamina propria, an increased ratio of CD4+/CD8+ and a higher SIgA concentration in cecum feces. CONCLUSION: Intestinal immune suppression occurs in the early stage of SAP rats, which may be the main reason for bacterial and endotoxin translocation. L-arginine can improve the intestinal immunity and reduce bacterial and endotoxin translocation in SAP rats. 相似文献
996.
Erythema nodosum associated with all-trans-retinoic acid (ATRA) for acute promyelocytic leukemia (APL) is very rare. We describe four patients with classic APL who developed erythema nodosum during ATRA therapy. Fever and subsequent multiple painful erythematous nodules over extremities developed on D11, D16, D17, and D19, respectively, after ATRA therapy. The skin biopsy taken from each patient was consistent with erythema nodosum. All patients received short course of steroids. Fever subsided rapidly and the skin lesions regressed completely. All patients achieved complete remission without withdrawal of ATRA. ATRA seemed to be the most possible etiology of erythema nodosum in our patients. Short-term use of steroid is very effective in ATRA-induced erythema nodosum. 相似文献
997.
Ekstrand K.; Bostrom P. A; Lilja B.; Hansen O.; Arborelius M. Jr 《European heart journal》1997,18(5):822-834
Clinical and ergometric data were derived from 1098 consecutiveexercise tests in patients with a first acute myocardial infarctionbetween 19741983. In 1992 a follow-up was performed inorder to analyse the importance of a submaximal early exercisetest, in combination with clinical data, for the predictionof short- and long-term prognosis of cardiovascular death. The relative value of 20 clinical variables, including medicalhistory, markers of infarction size, medication etc., and 28variables at exercise test were studied. Univariate, multivariateand survival analysis, for estimation of prognosis and independentprediction of cardiovascular death was used. Independent clinical risk factors for cardiovascular death were(1) Within 1 year: relative heart volume (ml.m2 bodysurface area) on chest X-ray. (2) Long-term mortality: maximumheart rate and relative heart volume, diabetes, age and digitalismedication. Independent exercise risk factors were: (1) Within1 year: heart rate, ventricular arrhythmia and ST depression 1 mm before exercise, diastolic blood pressure at maximum exerciseand target heart rate. (2) Long-term mortality: angina pectorisand/or ST depression 1 mm at maximum exercise. In subgroupsof patients with clinical risk factors, mortality risk increasedif there were signs of angina pectoris and/or ST depression 1 mm during exercise. The risk increased 100% in diabetics,91% with age >70 years, 58% with relative heart volume 500ml.m2 body surface area, 42% with heart rate 100 atadmission, and 34% with digitalis medication. No increase wasfound in the subgroup of patients without clinical risk factors. Thus, submaximal early exercise stress testing provides importantinformation for short- and long-term prognosis in patients afterthe first acute myocardial infarction compared to clinical evaluationalone. 相似文献
998.
目的 评估肾脏替代治疗对心脏术后急性肾功能衰竭的效果。方法 1995年 1月至 2 0 0 3年 7月 ,5 4例心脏术后因急性肾功能衰竭接受了肾脏替代治疗 ,其中腹膜透析 2 0例 ,血液透析 15例 ,连续性肾脏替代治疗 19例。结果 14例患者肾功能恢复出院 ,6例病情好转后自动出院 ,34例死亡。结论 肾脏替代治疗是心脏术后急性肾功能衰竭的一种有效治疗手段 ,应尽早实施。 相似文献
999.
严重急性呼吸综合征所致呼吸衰竭及无创通气治疗 总被引:13,自引:0,他引:13
目的 回顾性总结严重急性呼吸综合征 (SARS)并发呼吸衰竭患者的血气特点 ,探讨应用无创正压通气 (NPPV)治疗的策略。方法 2 0 0 3年 4月 2 2日~ 5月 1日 ,12 0例临床符合SARS诊断标准的患者入住北京地坛医院 (SARS专科医院 )的 4个病区 ,30例患者 (占 2 5 % )在病程中出现呼吸衰竭 ,达到急性肺损伤 (ALI)和 (或 )急性呼吸窘迫综合征 (ARDS)的诊断标准。 2 8例应用双水平气道正压通气 (BiPAP)。主要观察指标 :(1)住院期间的血气分析、脉搏容积血氧饱和度 (SpO2 )及呼吸频率 ,特别是上机前、上机后 1h及撤机后的结果 ;(2 )放射学检查或临床提示住院后新出现的气胸、纵隔气肿、心包积气及皮下气肿 ;(3)应用无创通气的天数 ;(4 )需气管插管行有创通气的患者数 ;(5 )患者的病死率 ;(6 )一线医务人员因护理治疗无创通气SARS患者而感染SARS的情况。结果统计 30例患者在整个病程中的动脉血二氧化碳分压 (PaCO2 )变化情况 ,16例 (5 3% )患者出现CO2 潴留 ,PaCO2为 4 5~ 5 6mmHg ,平均 (4 8± 4 )mmHg。NPPV治疗后动脉血氧分压 (PaO2 )、SpO2 、氧合指数及呼吸频率均显著改善 (P均 <0 0 1) ,但pH及PaCO2 的变化并不明显。 18例患者成功撤机 ,应用NPPV的时间为5~ 30d ,平均 (10± 6 )d。除 1例不能耐受BiPAP 相似文献
1000.
Sergio Raposeiras-Roubín Berenice Caneiro Queija Fabrizio D’Ascenzo Tim Kinnaird Albert Ariza-Solé Sergio Manzano-Fernández Christian Templin Lazar Velicki Ioanna Xanthopoulou Enrico Cerrato Giorgio Quadri Andrea Rognoni Giacome Boccuzzi Andrea Montabone Salma Taha Alessandro Durante Sebastiano Gili Giulia Magnani Emad Abu-Assi 《Revista espa?ola de cardiología》2019,72(3):215-223