全文获取类型
收费全文 | 108942篇 |
免费 | 7453篇 |
国内免费 | 2053篇 |
专业分类
耳鼻咽喉 | 612篇 |
儿科学 | 1986篇 |
妇产科学 | 969篇 |
基础医学 | 9837篇 |
口腔科学 | 1302篇 |
临床医学 | 14236篇 |
内科学 | 17462篇 |
皮肤病学 | 534篇 |
神经病学 | 5993篇 |
特种医学 | 3233篇 |
外国民族医学 | 4篇 |
外科学 | 10476篇 |
综合类 | 15366篇 |
现状与发展 | 6篇 |
一般理论 | 1篇 |
预防医学 | 14336篇 |
眼科学 | 2971篇 |
药学 | 11358篇 |
95篇 | |
中国医学 | 5283篇 |
肿瘤学 | 2388篇 |
出版年
2024年 | 224篇 |
2023年 | 1584篇 |
2022年 | 2868篇 |
2021年 | 4322篇 |
2020年 | 4304篇 |
2019年 | 3299篇 |
2018年 | 3257篇 |
2017年 | 3331篇 |
2016年 | 3468篇 |
2015年 | 3476篇 |
2014年 | 7615篇 |
2013年 | 7954篇 |
2012年 | 6635篇 |
2011年 | 7210篇 |
2010年 | 5475篇 |
2009年 | 5310篇 |
2008年 | 5249篇 |
2007年 | 5101篇 |
2006年 | 4657篇 |
2005年 | 3793篇 |
2004年 | 3230篇 |
2003年 | 2830篇 |
2002年 | 2382篇 |
2001年 | 2095篇 |
2000年 | 1788篇 |
1999年 | 1540篇 |
1998年 | 1288篇 |
1997年 | 1322篇 |
1996年 | 1099篇 |
1995年 | 1130篇 |
1994年 | 976篇 |
1993年 | 863篇 |
1992年 | 819篇 |
1991年 | 716篇 |
1990年 | 704篇 |
1989年 | 602篇 |
1988年 | 632篇 |
1987年 | 566篇 |
1986年 | 515篇 |
1985年 | 611篇 |
1984年 | 612篇 |
1983年 | 369篇 |
1982年 | 479篇 |
1981年 | 392篇 |
1980年 | 359篇 |
1979年 | 279篇 |
1978年 | 252篇 |
1977年 | 174篇 |
1976年 | 160篇 |
1973年 | 120篇 |
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
81.
We investigated changes in brain function supporting inhibitory control under age-controlled incentivized conditions, separating age- and performance-related activation in an accelerated longitudinal design including 10- to 22-year-olds. Better inhibitory control correlated with striatal activation during neutral trials, while Age X Behavior interactions in the striatum indicated that in the absence of extrinsic incentives, younger subjects with greater reward circuitry activation successfully engage in greater inhibitory control. Age was negatively correlated with ventral amygdala activation during Loss trials, suggesting that amygdala function more strongly mediates bottom-up processing earlier in development when controlling the negative aspects of incentives to support inhibitory control. Together, these results indicate that with development, reward-modulated cognitive control may be supported by incentive processing transitions in the amygdala, and from facilitative to obstructive striatal function during inhibitory control. 相似文献
82.
Roberto V.P. Ribeiro Mitesh V. Badiwala Danny Ramzy Laura C. Tumiati Vivek Rao 《The Journal of thoracic and cardiovascular surgery》2019,157(2):615-625.e1
Objective
Hypertonic saline (HTS) has potent immune and vascular effects. We assessed recipient pretreatment with HTS on allograft function in a porcine model of heart transplantation and hypothesized that HTS infusion would limit endothelial and left ventricular (LV) dysfunction following transplantation.Methods
Heart transplants were performed after 6 hours of cold ischemic storage. Recipient pigs were randomized to treatment with or without HTS (7.5% NaCl) before cardiopulmonary bypass (CPB). Using a myograft apparatus, coronary artery endothelial-dependent (Edep) and -independent (Eind) relaxation was assessed. LV performance was determined using pressure-volume loop analysis. Pulmonary interleukin (IL)-2, IL-6, and tumor necrosis factor (TNF)-α expression was measured.Results
Weaning from CPB and LV performance after transplantation were improved in HTS-treated animals. Successful weaning from CPB was greater in the HTS-treated hearts (8 of 8 vs 2 of 8; P < .05). Mean LV functional recovery was improved in the HTS-treated animals, as assessed by preload recruitable stroke work (65 ± 10% vs 27 ± 10%; P < .001) and end-systolic elastance (55 ± 7% vs 37 ± 4%; P < .001). Treatment with HTS resulted in improved Edep (mean maximum elastance [Emax], 56 ± 5% vs 37 ± 7%; P < .001) and Eind (mean Emax%, 77 ± 6% vs 52 ± 4%; P < .001) vasorelaxation compared with control. Pulmonary expression of IL-2, IL-6, and TNF-α increased following transplantation, whereas HTS therapy attenuated IL production (P < .001). Transplantation increased plasma TNF-α levels and LV TNF-α expression, whereas HTS prevented this up-regulation (P < .001).Conclusions
Recipient HTS pretreatment preserves allograft vasomotor and LV function, and HTS therapy limits CPB-induced injury. HTS may be a novel recipient intervention to prevent graft dysfunction. 相似文献83.
Rotary ventricular assist devices (VADs) are less sensitive to preload than the healthy heart, resulting in inadequate flow regulation in response to changes in patient cardiac demand. Starling‐like physiological controllers (SLCs) have been developed to automatically regulate VAD flow based on ventricular preload. An SLC consists of a cardiac response curve (CRC) which imposes a nonlinear relationship between VAD flow and ventricular preload, and a venous return line (VRL) which determines the return path of the controller. This study investigates the importance of a physiological VRL in SLC of dual rotary blood pumps for biventricular support. Two experiments were conducted on a physical mock circulation loop (MCL); the first compared an SLC with an angled physiological VRL (SLC‐P) against an SLC with a vertical VRL (SLC‐V). The second experiment quantified the benefit of a dynamic VRL, represented by a series of specific VRLs, which could adapt to different circulatory states including changes in pulmonary (PVR) and systemic (SVR) vascular resistance versus a fixed physiological VRL which was calculated at rest. In both sets of experiments, the transient controller responses were evaluated through reductions in preload caused by the removal of fluid from the MCL. The SLC‐P produced no overshoot or oscillations following step changes in preload, whereas SLC‐V produced 0.4 L/min (12.5%) overshoot for both left and right VADs. Additionally, the SLC‐V had increased settling time and reduced controller stability as evidenced by transient controller oscillations. The transient results comparing the specific and standard VRLs demonstrated that specific VRL rise times were improved by between 1.2 and 4.7 s ( = 3.05 s), while specific VRL settling times were improved by between 2.8 and 16.1 seconds ( = 8.38 s) over the standard VRL. This suggests only a minor improvement in controller response time from a dynamic VRL compared to the fixed VRL. These results indicate that the use of a fixed physiologically representative VRL is adequate over a wide variety of physiological conditions. 相似文献
84.
目的 观察高通量血液透析(HFHD)与低通量血液透析(LFHD)的不同模式运用到老年患者维持性血液透析(MHD)中对其血压的影响。方法 选择2015年2月—2017年10月本院治疗的MHD老年患者74例,先为其施LFHD 3个月,再为其辅以3个月的HFHD,3次/周,4 h/次,对比不同透析模式对患者血压的影响。结果 实施HFHD后患者的平均动脉压(MAP)有所降低,在第3 h与第4 h透析后,血压把控优于LFHD(P<0.05)。结论 对于MHD老年患者来说,实施HFHD是优良的透析方法。 相似文献
85.
J.A. Hannam S.J. Mitchell D. Cumin C. Frampton A.F. Merry M.R. Moore C.J. Kruger 《British journal of anaesthesia》2019,122(2):198-205
Background
Etomidate is frequently selected over propofol for induction of anaesthesia because of a putatively favourable haemodynamic profile, but data confirming this perception are limited.Methods
Patients undergoing cardiac surgery were randomised to induction of anaesthesia with propofol or etomidate. Phase I (n=75) was conducted as open-label, whereas Phase II (n=75) was double blind. Mean arterial blood pressure (MAP) and boluses of vasopressor administered after induction were recorded. The primary endpoint was the area under the curve below baseline MAP (MAP-time integral) during the 10 min after induction. Secondary endpoints were the use of vasopressors over the same period, and the effect of blinding on the aforementioned endpoints. Groups were compared using regression models with phase and anaesthetist as factors.Results
The mean difference between etomidate and propofol in the MAP-time integral below baseline was 2244 mm Hg s (95% confidence interval, 581–3906; P=0.009), representing a 34% greater reduction with propofol. Overall, vasopressors were used in 10/75 patients in the etomidate group vs 21/75 in the propofol group (P=0.38), and in 20/74 patients during the blinded phase vs 11/76 during the open-label phase (P=0.31). The interaction between randomisation and phase (open-labelled or blinded) was not significant for either primary (P=0.73) or secondary endpoints (P=0.90).Conclusions
Propofol caused a 34% greater reduction in MAP-time integral from baseline after induction of anaesthesia than etomidate, despite more frequent use of vasopressors with propofol, confirming the superior haemodynamic profile of etomidate in this context. The proportion of patients receiving vasopressors increased slightly, albeit not significantly, in both groups in the blinded phase.Clinical trial registration
Australian and New Zealand Clinical Trials Registry, ACTRN12614000717651. 相似文献86.
目的分析真菌性血流感染的病原菌分布以及耐药特征,为真菌血流感染的早期合理用药提供理论依据。
方法回顾性分析武汉大学人民医院2016年1月至2018年12月收治的真菌性血流感染者的菌群、科室分布以及耐药性。
结果入组192例真菌血流感染者的血培养样本中共分离192株真菌,其中白色念珠菌检出率为31.77%(61/192),其次热带念珠菌检出率为18.75%(36/192);重症医学科检出率最高为33.85%(65/192)。所有菌株均对两性霉素B敏感,对其他抗菌药物耐药率分别为5-氟胞嘧啶4.49%(9/192)、伊曲康唑5.73%(11/192)、氟康唑10.94%(21/192)和伏立康唑11.46%(22/192);除两性霉素B外,2016至2018年真菌对其他抗菌药物的耐药率均逐年上升,其中2018年所分离192株光滑念珠菌对伊曲康唑耐药菌率达46.7%。
结论真菌血流感染病原菌以念珠菌属为主,对目前抗真菌药物具有较高敏感性,但耐药率逐年上升,加强监测血培养病原菌变化及耐药趋势对指导临床用药至关重要。 相似文献
87.
《Australian critical care》2020,33(5):436-440
IntroductionBrown or dark brown eyes make it difficult to distinguish the contrast between a black pupil and the surrounding iris, which may result in clinical assessment errors. The pupillometer can be used to derive an indexed value, the Neurological Pupil index™ (NPi) for pupillary light reflex. However, there are limited data associating the NPi and iris colour. We examine the NPi and eye colour association.MethodsData were pooled from the Establishing Normative Data for Pupillometer Assessments in Neuroscience Intensive Care (END-PANIC) Registry. The analysis includes 14,168 observations collected from 865 patients with neurological conditions who were admitted to the intensive care unit. Summary statistics and statistical models were developed to examine the association using Statistical Analysis Software (SAS) summary procedure.ResultsThe mean age of the cohort was 56 years (standard deviation = 17). Eye colour included dark brown (n = 339), blue (n = 234), brown (n = 173), green (n = 82), and other (n = 37). There was significant differences (p < 0.0001) between mean NPi values by eye colour [blue = 4.08 (0.92), brown = 3.34 (1.45), dark = 3.71 (1.33), green = 4.08 (0.67), other = 3.76 (1.25)]. However, a further random-effects mixed model after controlling for confounding variables revealed no significant difference in NPi values among different eye colour groups.ConclusionsThe pupillary light reflex, when assessed using the pupillometer, is not dependent on the eye colour. Practitioners are not required to consider eye colour as a confounder when they perform pupillary assessment for examining patients with neurological conditions. 相似文献
88.
[目的]探讨护理质量控制中心在提升基层医院护理质量和管理水平的作用。[方法]护理质量控制中心指导基层医院建立完善的质量控制标准、质量评价体系,协助制订护士培训、检查、考核计划,并行使护理质量控制中心的监督、管理职责,促使各项制度得到有效落实。[结果]在护理质量控制中心的指导下,基层医院的护理管理体系、管理制度、评价体系逐步完善,护理人员业务水平、病人满意度及健康知识知晓率得到提升(P<0.05)。[结论]护理质量控制中心能在基层医院的护理质量管理中发挥积极作用。 相似文献
89.
《Brain stimulation》2020,13(5):1159-1167
BackgroundInhibitory control refers to a central cognitive capacity involved in the interruption and correction of actions. Dysfunctions in these cognitive control processes have been identified as major maintaining mechanisms in a range of mental disorders such as ADHD, binge eating disorder, obesity, and addiction. Improving inhibitory control by transcranial direct current stimulation (tDCS) could ameliorate symptoms in a broad range of mental disorders.ObjectiveThe primary aim of this pre-registered meta-analysis was to investigate whether inhibitory control can be improved by tDCS in healthy and clinical samples. Additionally, several moderator variables were investigated.MethodsA comprehensive literature search was performed on PubMed/MEDLINE database, Web of Science, and Scopus. To achieve a homogenous sample, only studies that assessed inhibitory control in the go-/no-go (GNG) or stop-signal task (SST) were included, yielding a total of 75 effect sizes from 45 studies.ResultsResults of the meta-analysis indicate a small but significant overall effect of tDCS on inhibitory control (g = 0.21) which was moderated by target and return electrode placement as well as by the task. The small effect size was further reduced after correction for publication bias.ConclusionBased on the studies included, our meta-analytic approach substantiates previously observed differences between brain regions, i.e., involvement of the right inferior frontal gyrus (rIFG) vs. the right dorsolateral prefrontal cortex (rDLPFC) in inhibitory control. Results indicate a small moderating effect of tDCS on inhibitory control in single-session studies and highlight the relevance of technical and behavioral parameters. 相似文献
90.