全文获取类型
收费全文 | 125743篇 |
免费 | 10523篇 |
国内免费 | 3464篇 |
专业分类
耳鼻咽喉 | 636篇 |
儿科学 | 3504篇 |
妇产科学 | 3178篇 |
基础医学 | 12237篇 |
口腔科学 | 2410篇 |
临床医学 | 12675篇 |
内科学 | 29042篇 |
皮肤病学 | 1291篇 |
神经病学 | 7038篇 |
特种医学 | 2346篇 |
外国民族医学 | 8篇 |
外科学 | 7688篇 |
综合类 | 18630篇 |
现状与发展 | 14篇 |
一般理论 | 11篇 |
预防医学 | 11575篇 |
眼科学 | 2938篇 |
药学 | 13576篇 |
111篇 | |
中国医学 | 7466篇 |
肿瘤学 | 3356篇 |
出版年
2024年 | 494篇 |
2023年 | 2583篇 |
2022年 | 4188篇 |
2021年 | 5813篇 |
2020年 | 5243篇 |
2019年 | 4998篇 |
2018年 | 4775篇 |
2017年 | 4670篇 |
2016年 | 4772篇 |
2015年 | 4512篇 |
2014年 | 7767篇 |
2013年 | 10001篇 |
2012年 | 7134篇 |
2011年 | 7759篇 |
2010年 | 6206篇 |
2009年 | 5820篇 |
2008年 | 5636篇 |
2007年 | 5494篇 |
2006年 | 4819篇 |
2005年 | 4314篇 |
2004年 | 3643篇 |
2003年 | 3223篇 |
2002年 | 2602篇 |
2001年 | 2449篇 |
2000年 | 1982篇 |
1999年 | 1787篇 |
1998年 | 1566篇 |
1997年 | 1494篇 |
1996年 | 1357篇 |
1995年 | 1256篇 |
1994年 | 1109篇 |
1993年 | 993篇 |
1992年 | 912篇 |
1991年 | 784篇 |
1990年 | 762篇 |
1989年 | 687篇 |
1988年 | 552篇 |
1987年 | 463篇 |
1986年 | 506篇 |
1985年 | 636篇 |
1984年 | 631篇 |
1983年 | 347篇 |
1982年 | 508篇 |
1981年 | 388篇 |
1980年 | 416篇 |
1979年 | 286篇 |
1978年 | 249篇 |
1977年 | 223篇 |
1976年 | 197篇 |
1975年 | 130篇 |
排序方式: 共有10000条查询结果,搜索用时 0 毫秒
21.
《The Journal of thoracic and cardiovascular surgery》2023,165(1):149-158.e4
BackgroundCoronary artery bypass grafting (CABG) improves survival in patients with heart failure and severely reduced left ventricular systolic function (LVEF). Limited data exist regarding adverse cardiovascular event rates after CABG in patients with heart failure with midrange ejection fraction (HFmrEF; LVEF > 40% and < 55%).MethodsWe analyzed data on isolated CABG patients from the Veterans Affairs national database (2010-2019). We stratified patients into control (normal LVEF and no heart failure), HFmrEF, and heart failure with reduced LVEF (HFrEF) groups. We compared all-cause mortality and heart failure hospitalization rates between groups with a Cox model and recurrent events analysis, respectively.ResultsIn 6533 veterans, HFmrEF and HFrEF was present in 1715 (26.3%) and 566 (8.6%) respectively; the control group had 4252 (65.1%) patients. HFrEF patients were more likely to have diabetes mellitus (59%), insulin therapy (36%), and previous myocardial infarction (31%). Anemia was more prevalent in patients with HFrEF (49%) as was a lower serum albumin (mean, 3.6 mg/dL). Compared with the control group, a higher risk of death was observed in the HFmrEF (hazard ratio [HR], 1.3 [1.2-1.5)] and HFrEF (HR, 1.5 [1.2-1.7]) groups. HFmrEF patients had the higher risk of myocardial infarction (subdistribution HR, 1.2 [1-1.6]; P = .04). Risk of heart failure hospitalization was higher in patients with HFmrEF (HR, 4.1 [3.5-4.7]) and patients with HFrEF (HR, 7.2 [6.2-8.5]).ConclusionsHeart failure with midrange ejection fraction negatively affects survival after CABG. These patients also experience higher rates myocardial infarction and heart failure hospitalization. 相似文献
22.
23.
Stress Testing Versus CT Angiography in Patients With Diabetes and Suspected Coronary Artery Disease
Abhinav Sharma Adrian Coles Nishant K. Sekaran Neha J. Pagidipati Michael T. Lu Daniel B. Mark Kerry L. Lee Hussein R. Al-Khalidi Udo Hoffmann Pamela S. Douglas 《Journal of the American College of Cardiology》2019,73(8):893-902
Background
The optimal noninvasive test (NIT) for patients with diabetes and stable symptoms of coronary artery disease (CAD) is unknown.Objectives
The purpose of this study was to assess whether a diagnostic strategy based on coronary computed tomographic angiography (CTA) is superior to functional stress testing in reducing adverse cardiovascular (CV) outcomes (CV death or myocardial infarction [MI]) among symptomatic patients with diabetes.Methods
PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) was a randomized trial evaluating an initial strategy of CTA versus functional testing in stable outpatients with symptoms suggestive of CAD. The study compared CV outcomes in patients with diabetes (n = 1,908 [21%]) and without diabetes (n = 7,058 [79%]) based on their randomization to CTA or functional testing.Results
Patients with diabetes (vs. without) were similar in age (median 61 years vs. 60 years) and sex (female 54% vs. 52%) but had a greater burden of CV comorbidities. Patients with diabetes who underwent CTA had a lower risk of CV death/MI compared with functional stress testing (CTA: 1.1% [10 of 936] vs. stress testing: 2.6% [25 of 972]; adjusted hazard ratio: 0.38; 95% confidence interval: 0.18 to 0.79; p = 0.01). There was no significant difference in nondiabetic patients (CTA: 1.4% [50 of 3,564] vs. stress testing: 1.3% [45 of 3,494]; adjusted hazard ratio: 1.03; 95% confidence interval: 0.69 to 1.54; p = 0.887; interaction term for diabetes p value = 0.02).Conclusions
In diabetic patients presenting with stable chest pain, a CTA strategy resulted in fewer adverse CV outcomes than a functional testing strategy. CTA may be considered as the initial diagnostic strategy in this subgroup. (PROspective Multicenter Imaging Study for Evaluation of Chest Pain [PROMISE]; NCT01174550) 相似文献24.
《Gait & posture》2019
BackgroundStanding on textured materials can improve static balance, potentially by modulating somatosensory inputs from the soles of the feet.Research questionTo synthesise and quantify the immediate effects of textured materials on static balance in healthy young and older adults.MethodsPrimary outcomes were the centre of pressure (COP) displacement and velocity, during eyes open and eyes closed conditions. Ten crossover studies (n = 318, 58% female) met the inclusion criteria. A random effects meta-analysis model derived pooled standardised mean differences (SMD; Hedges g) to quantify the effects of textured materials. Heterogeneity was quantified with the tau-statistic (τ). A 95% prediction interval quantified the likely range of true effects on COP outcomes in similar future studies.ResultsThere was a small to moderate beneficial effect for textured materials vs control conditions in: COP displacement during both eyes open (SMD: 0.29; 95% CI -0.06 to 0.64; τ = 0.32) and eyes closed (SMD: 0.75; 95% CI 0.18 to 1.33; τ = 0.55). A trivial to small beneficial effect was observed in COP velocity during eyes open (SMD: 0.14; 95% CI -0.14 to 0.43; τ = 0.18) and eyes closed (SMD: 0.20; 95% CI 0.01 to 0.40; τ = 0.18) for textured materials. The 95% prediction intervals showed texture may not consistently provide beneficial results across studies for all outcomes: COP displacement EC (-0.61 to 2.12), EO (-0.54 to 1.12), COP velocity EC (-0.27 to 0.68) and EO (-0.44 to 0.73).SignificanceOverall, textured materials improved balance, but these effects were heterogeneous. This research may therefore inform applied investigations into balance improvements for healthy populations, for example, in functional movements and sports. 相似文献
25.
Marta López-Fauqued Laura Campora Frédérique Delannois Mohamed El Idrissi Lidia Oostvogels Ferdinandus J. De Looze Javier Diez-Domingo Thomas C. Heineman Himal Lal Janet E. McElhaney Shelly A. McNeil Wilfred Yeo Fernanda Tavares-Da-Silva 《Vaccine》2019,37(18):2482-2493
Background
The ZOE-50 (NCT01165177) and ZOE-70 (NCT01165229) phase 3 clinical trials showed that the adjuvanted recombinant zoster vaccine (RZV) was ≥90% efficacious in preventing herpes zoster in adults. Here we present a comprehensive overview of the safety data from these studies.Methods
Adults aged ≥50 (ZOE-50) and ≥70 (ZOE-70) years were randomly vaccinated with RZV or placebo. Safety analyses were performed on the pooled total vaccinated cohort, consisting of participants receiving at least one dose of RZV or placebo. Solicited and unsolicited adverse events (AEs) were collected for 7 and 30?days after each vaccination, respectively. Serious AEs (SAEs) were collected from the first vaccination until 12?months post-last dose. Fatal AEs, vaccination-related SAEs, and potential immune-mediated diseases (pIMDs) were collected during the entire study period.Results
Safety was evaluated in 14,645 RZV and 14,660 placebo recipients. More RZV than placebo recipients reported unsolicited AEs (50.5% versus 32.0%); the difference was driven by transient injection site and solicited systemic reactions that were generally seen in the first week post-vaccination. The occurrence of overall SAEs (RZV: 10.1%; Placebo: 10.4%), fatal AEs (RZV: 4.3%; Placebo: 4.6%), and pIMDs (RZV: 1.2%; Placebo: 1.4%) was balanced between groups. The occurrence of possible exacerbations of pIMDs was rare and similar between groups. Overall, except for the expected local and systemic symptoms, the safety results were comparable between the RZV and Placebo groups irrespective of participant age, gender, or race.Conclusions
No safety concerns arose, supporting the favorable benefit-risk profile of RZV. 相似文献26.
27.
28.
目的 探讨血清谷丙转氨酶(ALT)与新诊2型糖尿病(T2DM)患病风险之间的关联,为T2DM的防治提供科学依据。方法 采用4阶段分层随机抽样的方法选取2006年和2009年参与青岛糖尿病预防项目的研究对象男性3 012例、女性4 422例,采用Pearson相关检验分析不同性别ALT与FPG、2 h PG的相关性,并利用多因素logistic回归分析ALT与新诊T2DM患病的关系。结果 男性中,ALT与空腹血浆血糖(FPG)、餐后2 h血浆血糖(2 h PG)的Pearson相关系数分别为0.088、0.080(均P<0.01);多因素logistic回归显示,在调整了年龄、BMI、糖尿病家族史、城乡、教育、婚姻、收入、吸烟及饮酒状况等混杂因素后,ALT的第4分位(Q4)组新诊T2DM患病风险是第1分位(Q1)组的1.832倍(OR = 1.832,95% CI:1.324~2.534,P<0.01)。女性中,ALT与FPG、2h PG的Pearson相关系数分别为0.065、0.108(均P<0.01);多因素logistic回归显示,在调整了年龄、BMI、糖尿病家族史、城乡、教育、婚姻、收入、吸烟及饮酒状况等混杂因素后,ALT的第4分位(Q4)组新诊T2DM患病风险是第1分位(Q1)组的1.445倍(OR = 1.445,95% CI:1.087~1.919,P<0.05)。结论 在男、女性人群中,ALT水平升高与T2DM患病相关,且这种相关性不受年龄、BMI、糖尿病家族史等的影响。 相似文献
29.
30.
A. Guerrero Gómez N. González Jaramillo J.A. Castro Pérez 《Revista espa?ola de anestesiología y reanimación》2019,66(1):10-17