全文获取类型
收费全文 | 25419篇 |
免费 | 1832篇 |
国内免费 | 541篇 |
专业分类
耳鼻咽喉 | 8篇 |
儿科学 | 610篇 |
妇产科学 | 47篇 |
基础医学 | 1007篇 |
口腔科学 | 9篇 |
临床医学 | 5066篇 |
内科学 | 11906篇 |
皮肤病学 | 14篇 |
神经病学 | 342篇 |
特种医学 | 770篇 |
外科学 | 2216篇 |
综合类 | 3390篇 |
现状与发展 | 1篇 |
一般理论 | 1篇 |
预防医学 | 321篇 |
眼科学 | 4篇 |
药学 | 1522篇 |
10篇 | |
中国医学 | 495篇 |
肿瘤学 | 53篇 |
出版年
2024年 | 37篇 |
2023年 | 423篇 |
2022年 | 625篇 |
2021年 | 1012篇 |
2020年 | 982篇 |
2019年 | 1109篇 |
2018年 | 1006篇 |
2017年 | 623篇 |
2016年 | 546篇 |
2015年 | 718篇 |
2014年 | 1692篇 |
2013年 | 1414篇 |
2012年 | 1056篇 |
2011年 | 1300篇 |
2010年 | 1105篇 |
2009年 | 1055篇 |
2008年 | 1201篇 |
2007年 | 1259篇 |
2006年 | 1068篇 |
2005年 | 1009篇 |
2004年 | 803篇 |
2003年 | 744篇 |
2002年 | 658篇 |
2001年 | 647篇 |
2000年 | 533篇 |
1999年 | 549篇 |
1998年 | 493篇 |
1997年 | 515篇 |
1996年 | 408篇 |
1995年 | 363篇 |
1994年 | 349篇 |
1993年 | 282篇 |
1992年 | 293篇 |
1991年 | 256篇 |
1990年 | 224篇 |
1989年 | 173篇 |
1988年 | 170篇 |
1987年 | 164篇 |
1986年 | 151篇 |
1985年 | 137篇 |
1984年 | 147篇 |
1983年 | 108篇 |
1982年 | 99篇 |
1981年 | 66篇 |
1980年 | 60篇 |
1979年 | 53篇 |
1978年 | 39篇 |
1977年 | 18篇 |
1976年 | 17篇 |
1973年 | 13篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
41.
Characteristics of Bifocal Pacing: 总被引:1,自引:0,他引:1
JAN C.J. RES MARCEL J.J.A. BOKERN† DICK H.S. VOS‡ 《Pacing and clinical electrophysiology : PACE》2005,28(S1):S36-S38
Bifocal RIGHT ventricular stimulation (BRIGHT) is an ongoing, randomized, single-blind, crossover study of atrial synchronized bi-right ventricular (RV) pacing in patients in New York Heart Association heart failure functional class III, a left ventricular ejection fraction <35%, left bundle branch block and QRS complexes ≥120 ms. This analysis compared the electrical and handling characteristics, and the complications of pacing at the RV apex (Ap) with passive, versus RV outflow tract (OT) with active fixation leads. A mean of 1.6 ± 0.9 and 2.2 ± 2.0 attempts were needed to position the Ap and OT leads, respectively (ns). R-wave amplitudes at Ap versus OT were 23 ± 13 mV versus 14 ± 8 mV (n = 36, P < 0.001). R-wave amplitudes at the Ap remained stable between implant and M7. R-wave amplitudes at the OT could not be measured after implantation. In two patients, atrioventricular block occurred during active fixation at the OT. Conduction recovered spontaneously within 4 months. Ventricular fibrillation was induced in one patient during manipulation of an Ap lead in the RV. Marked differences were found between leads positioned in the OT versus Ap, partly related to the difference in lead design. Mean R-wave amplitude was higher at the Ap that at the OT. Ease and success rate of lead implant was similar in both positions. 相似文献
42.
BEATA WOAKOWSKA-KAPLON GRZEGORZ OPOLSKI† 《Pacing and clinical electrophysiology : PACE》2005,28(S1):S110-S114
Atrial fibrillation (AF) may be associated with activation of atrial natriuretic peptide (ANP). The exact trigger for the release of ANP is still being debated. Atrial volume, pressure, and wall stretch are considered to be the main determinants of ANP activation. The aim of the study was to evaluate plasma ANP concentrations in patients with persistent AF and to analyze the echocardiographic determinants of ANP concentration in this group. The study population included 67 patients, 59 ± 7 years of age, with a median AF duration of 5.5 months (range 0.1–12). The relationship between plasma ANP concentrations and echocardiographic left atrial (LA) diameter and volume, and left ventricular (LV) diameter and ejection fraction (EF) was analyzed by logistic regression analysis. The median baseline plasma ANP concentration was 63 pg/mL (range 21–126) in the study group versus 34 pg/mL (range 16–73) in a control group. The mean left antero-posterior atrial dimension, LA volume, LV enddiastolic diameter, and LVEF were 48 mm, 104 mL, 52 mm, and 54%, respectively. A significant linear positive correlation was found between plasma ANP concentration and maximal LA volume (r = 0.62, P < 0.01). A negative correlation was found between LVEF and plasma ANP concentration (r =−0.42, P = 0.01). However, by multivariate regression analysis, no echocardiographic parameter was an independent predictor of plasma ANP concentration. Plasma ANP concentrations were independent of echocardiographic measurements of LA size or LV size and function in patients with persistent AF. 相似文献
43.
Pleomorphic Ventricular Tachycardia: Demonstration of Conduction Reversal Within the Reentry Circuit
KARL-HEINZ KUCK MICHAEL SCHLÜTER KLAUS-PETER KUNZE MANFRED GEIGER 《Pacing and clinical electrophysiology : PACE》1989,12(7):1055-1064
A case is presented of a patient with incessant venfricular tacbycardia of left bundle branch block morphology. Endocardial mapping revealed the site of earliest activation during tachycardia to be the proximal right ventricular septum. Pacing at this site elicited the clinical tachycardia, whereas pacing at the proximal left ventricular septum induced a right bundle branch block morphology identical to that of a previously recorded spontaneous ventricuiar tachycardia. Electrophysiological evidence is given that both types of tachycardia originate from a single reentry circuit located in the proximal ventricular septum in which the reentrant wavefront may travel either orthodromically (during spontaneous tachycardia and right ventricular pacing) or antidromically (during left ventricular pacing). 相似文献
44.
Objective Based on the Helical Ventricular Myocardial Band (HVMB) theory proposed by Torrent-Guasp,the ventricular myocardial hand extends from the root of the pulmonary artery to the root of the aorta with two helical coils.This new theory is considered as a revolutionary concept for further understanding the global, three-dimensional and functional architecture of the ven- tricular myocardium. No repot had described techniques for disecting HVMB while keepin~ the integrity of the coronmy artery sys- tern. We explored techniques for dissecting HVMB in swine.Methads 33 fresh swine hearts were randomly divided intoll groups, 3 bearts in each. 160% barium sulfate (type I)suspmmion was injected into the coronary artery system. The coronary arteries were li- gated. The strial tissue was removed following puuing the hearts in boiling water then cooling for several hours. The superficial coro- nary vessels and fat tissue around the atrio-ventricular taxi inter-ventricular sulcus we~'e preserved. Some branches of the left anterior descending artery, distal segment, of posterior descending branch, and middle and distal segment of obtuse marginal branches were mu- tilated appropriately. HVMB dissection was completed with fingers in accordnce with Torrent Guasp' s technique. Results A contin- ued bundle of muscle, originated at the root of pulmonary artery and ended at the root of aorta, was unwrapped along the major dire- tion of the cardiac muscle fiber in all of the 33 hearts with spating of the coronary artery. The swine hearts' ventricular myocandium was cumosed of two loops, with basal loop firm the root of the pulmonart artery to the anterior papillary muscle and apical from the beginning of the anterior papillary muscle to the root tithe aorta. Each loop consisted of two segments: the right segment-coincid- ing with the right ventricular free wall and the left segment-coinciding with the basal d the left ventricular free wall. Posterior papillary muscle, which belongs to the descendant segment, denmrcated the border between the descendent and the ascendant of the HVMB's apical loop. Conclusion Although controversies about the theory of the HVMB remain, we have dissected the HVMB in the swine hearts' ventricular myocardium successfully with sparing of the coronary artery systems. This dissection procedure provides technical information for the studies of associated diseases based on the theory of HVMB. 相似文献
45.
目的我们应用平衡法门控心血池显像技术对不同Killip分级的前壁心肌梗死患者进行左室总体和局部收缩和舒张功能参数的对比分析。方法对照组15例(G0),前壁心肌梗死KillipⅠ级17例(G1),前壁心肌梗死KillipⅡⅢ级12例(G2)。利用平衡法门控心血池显像技术评价3组的左室总体和局部的收缩与舒张功能。结果①左室整体收缩功能,在LVEF,ESC 2个参数中,G1比G0有显著差异(P<0.05),G2分别比G1和G0有显著差异(P<0.05)。在PER、1/3EF、1/3ER 3个参数中,G2分别比G1和G0显著下降(P<0.05)。②左室总体舒张功能,在PFR、1/3FF、1/3FR、EDC中,G1比G0有显著差异(P<0.05),G2分别比G1和G0有显著差异(P<0.05)。③左室局部收缩功能,在以LVREF为参数时,G1在4个节段比G0显著差异(P<0.05),G2在所有6个节段中比G1和G0均显著下降(P<0.05)。④左室局部舒张功能,在以LVR1/3FF为参数时,G1在4个节段比G0显著下降(P<0.05),G2在所有6个节段比G0和G1均显著下降(P<0.05)。结论前壁心肌梗死后出现心功能受损或心力衰竭的主要原因为左室重构。 相似文献
46.
Min Zong Xinchun Yang Xiulan Liu Liang Shi Taifeng Liu 《岭南心血管病杂志(英文版)》2007,8(4):187-193
Objectives Recent studies have described regional differences in the electrophysiology and pharmacology of ventricular myocardium in canine, feline, rat, guinea pig, and human hearts. This has been shown to be due to a smaller IKs and a lager sodium-calcium exchange current (INa-Ca) and late INa in M region (deep subepicardial to midmyocardial). Studies from our laboratory have found a new repolarization current-nonselective cation current (NSCCs) existing in rabbit right ventricular myocytes. Methods We examined the characteristics of NSCCs in epicardial, M region, and endocardial cells isolated from the rabbit left ventricle with standard microelectrode and whole-cell patch-clamp techniques. The permeability to Na , K , Li , Cs but not to Cl- indicating that it was a nonselective cation current. Gd3 (0.1 mmol/l) and La3 (0.1 mmol/l) can block the current markedly. Results Further characterization of NSCCs was significantly smaller in M cells than in epicardial and endocardial cells. NSCCs current density was significantly smaller in M cells than in epicardial and endocardial cells. With repolarization to -80 mV, INs current density was (-0.44±0.05) PA/PF in endocardial cells, (-0.12±0.05) PA/PF in M cells and (-0.28±0.07) PA/PF in epicardial cells; and with repolarization to 30 mV, INs current density was (1.09±0.29) PA/PF in endocardial cells, (0.38±0.09) PA/PF in M cells and (0.91±0.32) PA/PF in epicardial cells. Conclusions Transmural dispersion of repolarization was due to the heterogeneity of NSCCs in rabbit left ventricle epicardial, endocardial myocytes and M cells. These findings may advance our understanding of the ionic basis for our understanding of factors contributing to the development of cardiac arrhythmias. 相似文献
47.
Anthony M Dart Jan Erik Otterstad Bridget-Anne Kirwan John D Parker Sophie de Brouwer Philip A Poole-Wilson Jacobus Lubsen 《European journal of echocardiography》2007,8(4):275-283
AIMS: To evaluate the relationship between echocardiographic cardiac function and outcome in patients with stable symptomatic angina. METHODS: Baseline echo left ventricular ejection fraction and volume data measured in a central laboratory was available for 7016 patients (92% of the total) participating in the ACTION trial (A Coronary disease Trial Investigating Outcome with Nifedipine GITS). Ejection fraction was also measured by investigators. Evaluation of the different echocardiographic variables was based on adjusted hazard ratios comparing the unfavourable limit of the 90% range of the variable concerned to the favourable limit. RESULTS: The centrally measured ejection fraction was the most powerful predictor of all-cause death (adjusted hazard ratio=2.5), myocardial infarction, any stroke or transient ischaemic attack and overt heart failure (adjusted hazard ratio=4.5). The addition of either end systolic volume or end diastolic volume to ejection fraction did not materially affect the power of prediction. Compared to the central ejection fraction measurement, the investigator-measured ejection fraction was a less powerful predictor for all outcomes considered. CONCLUSION: Routine echocardiography carefully analysed by standardised methods provides useful prognostic information in patients with stable angina, including for total mortality. 相似文献
48.
Ulrik Sartipy Anders Albåge Per Insulander Dan Lindblom 《Journal of interventional cardiac electrophysiology》2007,19(3):171-178
This article presents a review on the efficacy of surgical ventricular restoration and direct surgery for ventricular tachycardia
in patients with left ventricular aneurysm or dilated ischemic cardiomyopathy. The procedure includes a non-electrophysiologically
guided subtotal endocardiectomy and cryoablation in addition to endoventricular patch plasty of the left ventricle. Coronary
artery bypass surgery and mitral valve repair are performed concomitantly as needed. In our experience, this procedure yielded
a 90% success rate in terms of freedom from spontaneous ventricular tachycardia, with an early mortality rate of 3.8%. A practical
guide to the pre- and postoperative management of these patients is provided.
Electronic supplementary material The online version of this article (doi: ) contains supplementary material, which is available to authorized users. 相似文献
49.
门控心肌显像结合GS Quant软件评价左室功能 总被引:2,自引:2,他引:0
目的:评价GS Quant软件结合99mTc-甲氧基异TN(MtBI)门控心肌断层显像(G-SPECT)测定左室射血分数(LVEF)的价值。方法:选择24例于同期2周内完成G-SPECT、门控心血池显像(RNA)和超声心动图检查(UCG)的患者,比较3种方法所测定的LVEF值。结果:99mTc-MIBI G-SPECT所测得的LVEF值与RNA和UCG法所测得的LVEF值均有较好的相关性,相关系数r分别为0.81(P<0.05)和0.76(P<0.05)。结论:99mTc-MIBI G-SPECT所测定的LVEF值有很好的准确性和可重复性,具有较高的临床应用价值,可进一步推广应用门控核素心肌断层显像这一技术。 相似文献
50.
Takayuki Murakami Atsushi Komiya Kunihisa Mikata Shigeki Kaneko Ichiro Ikeda 《International journal of urology》2007,14(3):240-241
Abstract: A 66-year-old man was referred to our hospital with chest discomfort and shortness of breath. Seven months previously he had undergone a laparoscopic left nephroureterectomy for a left renal pelvic tumor and was given two cycles of adjuvant chemotherapy (methotrexate, epirubicin and cisplatin). Echocardiogram showed an 8-mm sized mass extending from the right atrium into the right ventricle. On computed tomography, multiple lung tumors, as well as the right atrial and ventricular mass, were seen. The patient died of acute heart failure caused by right ventricular outflow obstruction. On autopsy, a right atrial and ventricular metastasis of the initial transitional cell carcinoma was found. The patient's cause of death was acute heart failure as a result of cardiac metastasis of his initial renal pelvic carcinoma. 相似文献