全文获取类型
收费全文 | 3801篇 |
免费 | 196篇 |
国内免费 | 43篇 |
专业分类
耳鼻咽喉 | 301篇 |
儿科学 | 170篇 |
妇产科学 | 8篇 |
基础医学 | 486篇 |
口腔科学 | 105篇 |
临床医学 | 477篇 |
内科学 | 788篇 |
皮肤病学 | 6篇 |
神经病学 | 28篇 |
特种医学 | 69篇 |
外科学 | 592篇 |
综合类 | 492篇 |
预防医学 | 94篇 |
眼科学 | 2篇 |
药学 | 317篇 |
中国医学 | 83篇 |
肿瘤学 | 22篇 |
出版年
2024年 | 9篇 |
2023年 | 66篇 |
2022年 | 108篇 |
2021年 | 146篇 |
2020年 | 127篇 |
2019年 | 129篇 |
2018年 | 155篇 |
2017年 | 124篇 |
2016年 | 135篇 |
2015年 | 144篇 |
2014年 | 291篇 |
2013年 | 256篇 |
2012年 | 213篇 |
2011年 | 283篇 |
2010年 | 212篇 |
2009年 | 201篇 |
2008年 | 185篇 |
2007年 | 231篇 |
2006年 | 153篇 |
2005年 | 109篇 |
2004年 | 95篇 |
2003年 | 95篇 |
2002年 | 65篇 |
2001年 | 48篇 |
2000年 | 42篇 |
1999年 | 51篇 |
1998年 | 41篇 |
1997年 | 43篇 |
1996年 | 34篇 |
1995年 | 35篇 |
1994年 | 18篇 |
1993年 | 17篇 |
1992年 | 23篇 |
1991年 | 20篇 |
1990年 | 16篇 |
1989年 | 20篇 |
1988年 | 12篇 |
1987年 | 11篇 |
1986年 | 14篇 |
1985年 | 11篇 |
1984年 | 17篇 |
1983年 | 8篇 |
1982年 | 10篇 |
1981年 | 5篇 |
1980年 | 2篇 |
1977年 | 1篇 |
1976年 | 3篇 |
1975年 | 2篇 |
1974年 | 1篇 |
1971年 | 1篇 |
排序方式: 共有4040条查询结果,搜索用时 31 毫秒
61.
Julio E. González-Aguirre Claudia Paola Rivera-Uribe Erick Joel Rendón-Ramírez Rogelio Cañamar-Lomas Juan Antonio Serna-Rodríguez Roberto Mercado-Longoría 《Archivos de bronconeumologia》2019,55(4):195-200
Introduction
Invasive respiratory support is a cornerstone of Critical Care Medicine, however, protocols for withdrawal of mechanical ventilation are still far from perfect. Failure to extubation occurs in up to 20% of patients, despite a successful spontaneous breathing trial (SBT).Methods
We prospectively included ventilated patients admitted to medical and surgical intensive care unit in a university hospital in northern Mexico. At the end of a successful SBT, we measured diaphragmatic shortening fraction (DSF) by the formula: diaphragmatic thickness at the end of inspiration – diaphragmatic thickness at the end of expiration/diaphragmatic thickness at the end of expiration × 100, and the presence of B-lines in five regions of the right and left lung. The primary objective was to determine whether analysis of DSF combined with pulmonary ultrasound improves prediction of extubation failure.Results
Eighty-two patients were included, 24 (29.2%) failed to extubation. At univariate analysis, DSF (Youden's J: >30% [sensibility and specificity 62 and 50%, respectively]) and number of B-lines regions (Youden's J: >1 zone [sensibility and specificity 66 and 92%, respectively]) were significant related to extubation failure (area under the curve 0.66 [0.52–0.80] and 0.81 [0.70–0.93], respectively). At the binomial logistic regression, only the number of B-lines regions remains significantly related to extubation failure (OR 5.91 [2.33–14.98], P < .001).Conclusion
In patients with a successfully SBT, the absence of B-lines significantly decreases the probability of extubation failure. Diaphragmatic shortening fraction analysis does not add predictive power over the use of pulmonary ultrasound. 相似文献62.
63.
64.
65.
目的 观察let-7家族微RNA抑制剂(anti-let-7)对支气管哮喘(简称哮喘)小鼠气道炎性反应的影响,并探讨let-7参与哮喘形成的机制.方法 32只小鼠按随机数字法分为4组(n=8),即正常对照组(A组)、哮喘组(B组)、干预对照组(C组)和干预组(D组).其中B、C和D组用鸡卵蛋白(OVA)免疫,建立哮喘模型,A组以生理盐水替代OVA处理.D组小鼠激发前注射anti-let-7以抑制内源性let-7表达,C组小鼠注射乱序siRNA对照.比较各组小鼠支气管肺泡灌洗液(BALF)的细胞计数,肺组织中let-7e以及BALF中白细胞介素-10(IL-10)含量;体外用anti-let-7转染肺癌细胞A549,并检测细胞中let-7e表达和细胞培养上清中IL-10的含量;荧光素酶报告法检测let-7e是否直接靶向IL-10.结果 与A组相比,B组和C组小鼠BALF中细胞总数和嗜酸粒细胞数显著增加[(20.32±5.33)×109/L和(24.74±6.69)×109/L比(7.12± 1.88)×109/L,(6.45±2.5)×109/L和(7.12±2.66)×109/L比(0.04±0.01)×109/L,均P<0.01];肺组织中let-7e水平明显升高(分别为3.83倍和3.27倍,均P<0.01).与C组比较,D组BALF中细胞总数和嗜酸粒细胞数明显减少[(13.85±3.74)× 109/L比(24.74±6.69)×109/L,(2.15±1.13)×109/L比(7.12±2.66)×109/L,均P<0.05];肺组织中let-7e显著降低[(0.45±0.22)比(3.28±0.45),P<0.01],同时BALF中IL-10水平明显升高[(4.68±0.85)比(1.70±0.29),P<0.01].此外,在肺癌细胞A549 中转染anti-let-7,let-7e表达显著下降[(0.22±0.03)比(1.00±0.11),P<0.01],同时培养上清中IL-10明显上升[(2.58±0.35)比(1.00±0.15),P<0.01].体外let-7e过表达显著降低IL-10报告载体的荧光素酶活性[(0.59±0.06)比(1.00±0.03),P<0.01],而对突变的IL-10报告载体没有抑制作用.结论 anti-let-7对哮喘小鼠气道炎性反应具有明显的抑制作用,其作用机制可能与let-7直接靶向并抑制IL-10有关. 相似文献
66.
67.
68.
69.
《Brazilian Journal of Anesthesiology》2019,69(4):358-368
Background and objectivesProcedural simulation training for difficult airway management offers acquisition opportunities. The hypothesis was that 3 hours of procedural simulation training for difficult airway management improves: acquisition, behavior, and patient outcomes as reported 6 months later.MethodsThis prospective comparative study took place in two medical universities. Second‐year residents of anesthesiology and intensive care from one region participated in 3 h procedural simulation (intervention group). No intervention was scheduled for their peers from the other region (control). Prior to simulation and 6 months later, residents filled‐out the same self‐assessment form collecting experience with different devices. The control group filled‐out the same forms simultaneously. The primary endpoint was the frequency of use of each difficult airway management device within groups at 6 months. Secondary endpoints included modifications of knowledge, skills, and patient outcomes with each device at 6 months. Intervention cost assessment was provided.Results44 residents were included in the intervention group and 16 in the control group. No significant difference was observed for the primary endpoint. In the intervention group, improvement of knowledge and skills was observed at 6 months for each device, and improvement of patient outcomes was observed with the use of malleable intubation stylet and Eschmann introducer. No such improvement was observed in the control group. Estimated intervention cost was 406€ per resident.ConclusionsA 3 h procedural simulation training for difficult airway management did not improve the frequency of use of devices at 6 months by residents. However, other positive effects suggest exploring the best ratio of time/acquisition efficiency with difficult airway management simulation.ClinicalTrials.gov IdentifierNCT02470195. 相似文献
70.
《世界耳鼻咽喉头颈外科杂志(英文)》2018,4(2):140-144
ObjectiveTo develop an animal model for teaching open laryngotracheal surgical procedures.MethodsThe heads and necks from 5 pre-pubescent sheep were harvested after humane anesthesia. After 2–5 days to allow for rigor mortis to resolve, a specimen was supported with sandbags on an operating table. Operative procedures including tracheotomy, medialization laryngoplasty, anterior cartilage grafting, tracheal resection with primary anastomosis, and laryngectomy with closure of the pharynx were attempted.ResultsThe ovine head and neck provided an accurate model for simulation of all attempted procedures. Ovine tissue resembled that of humans in mechanical properties and handling. Postsurgical endoscopy confirmed graft alignment.ConclusionsThe sheep head and neck provides an inexpensive, realistic, and safe model for surgical training for a variety of open laryngotracheal procedures. This is particularly relevant given the recent emphasis on surgical simulation and the relative rarity of some of these procedures in residency training. 相似文献