全文获取类型
收费全文 | 1866篇 |
免费 | 102篇 |
国内免费 | 49篇 |
专业分类
耳鼻咽喉 | 35篇 |
儿科学 | 22篇 |
妇产科学 | 5篇 |
基础医学 | 59篇 |
口腔科学 | 47篇 |
临床医学 | 223篇 |
内科学 | 325篇 |
皮肤病学 | 2篇 |
神经病学 | 397篇 |
特种医学 | 55篇 |
外科学 | 199篇 |
综合类 | 295篇 |
预防医学 | 30篇 |
眼科学 | 53篇 |
药学 | 104篇 |
1篇 | |
中国医学 | 162篇 |
肿瘤学 | 3篇 |
出版年
2024年 | 2篇 |
2023年 | 16篇 |
2022年 | 54篇 |
2021年 | 94篇 |
2020年 | 64篇 |
2019年 | 36篇 |
2018年 | 66篇 |
2017年 | 49篇 |
2016年 | 61篇 |
2015年 | 66篇 |
2014年 | 112篇 |
2013年 | 106篇 |
2012年 | 127篇 |
2011年 | 111篇 |
2010年 | 95篇 |
2009年 | 86篇 |
2008年 | 80篇 |
2007年 | 86篇 |
2006年 | 67篇 |
2005年 | 74篇 |
2004年 | 50篇 |
2003年 | 57篇 |
2002年 | 43篇 |
2001年 | 38篇 |
2000年 | 35篇 |
1999年 | 17篇 |
1998年 | 24篇 |
1997年 | 16篇 |
1996年 | 28篇 |
1995年 | 18篇 |
1994年 | 24篇 |
1993年 | 23篇 |
1992年 | 14篇 |
1991年 | 21篇 |
1990年 | 14篇 |
1989年 | 10篇 |
1988年 | 13篇 |
1987年 | 15篇 |
1986年 | 17篇 |
1985年 | 16篇 |
1984年 | 15篇 |
1983年 | 7篇 |
1982年 | 11篇 |
1981年 | 12篇 |
1980年 | 10篇 |
1979年 | 2篇 |
1978年 | 6篇 |
1977年 | 3篇 |
1976年 | 3篇 |
1973年 | 1篇 |
排序方式: 共有2017条查询结果,搜索用时 562 毫秒
61.
Peter Ong Giancarlo Pirozzolo Anastasios Athanasiadis Udo Sechtem 《Clinical therapeutics》2018,40(9):1584-1590
Purpose
Coronary spasm is frequently found in patients with angina and unobstructed coronaries. The pathophysiology is incompletely understood, although sex differences have been described. Often a positive family history (PFH) is encountered. We assessed the relationship between sex, coronary spasm, and a PFH for cardiovascular disease.Methods
This single-center observational study recruited 415 stable angina patients with unobstructed coronaries (no stenosis >50%) between 2008 and 2011 (mean [SD] age, 62 [10] years; 38% men). Patients were referred for angiography because of signs and symptoms of myocardial ischemia. Intracoronary acetylcholine (ACh) testing was performed in all patients according to a standardized protocol. Risk factor assessment included hypertension, hypercholesterolemia, diabetes, smoking, and a PFH. The latter was defined as a first-degree relative with myocardial infarction or stroke. Statistical analysis involved comparison of categorical and continuous variables. Multivariable analysis aimed at identifying predictors for a pathologic ACh testing, microvascular spasm, and a PFH.Findings
Epicardial spasm was found in 33% of patients and microvascular spasm in 30% of patients. A pathologic ACh test was more frequent in women than in men (72% vs 49%; P < 0.0005). A PFH was found in 55% of patients with significantly more women than men (61% vs 45%; P?=?0.001). Among patients with epicardial spasm, women had a PFH significantly more often than men (66% vs 43%; P?=?0.006). The latter difference was not found when comparing women and men with microvascular spasm.Implications
There is a female preponderance among patients with angina and unobstructed coronaries. ACh testing enables detection of coronary spasm. Epicardial spasm in women is associated with a PFH. 相似文献62.
Spontaneous left anterior descending coronary artery spasm occurred in two patients during coronary angiography. After intravenous injection of 0.75 mg of nitroglycerin, the narrowing was unchanged in one patient and only partially relieved in the other. The coronary narrowing completely disappeared after intracoronary injection of 1 mg of the active metabolite of molsidomine, linsidomine chlorhydrate (SIN-1). In the first patient, this injection was performed just prior to the initiation of coronary balloon dilatation, which was then cancelled. Although rare, these two observations demonstrate the limitations of the intravenous use of nitroglycerin during diagnostic coronary angiography and point out the efficacy of intracoronary administration of SIN-1. 相似文献
63.
《JACC: Cardiovascular Interventions》2020,13(16):1865-1876
ObjectivesThe aim of this study was to investigate the prognosis of a large cohort of patients with stable angina and unobstructed coronaries undergoing acetylcholine spasm testing.BackgroundCoronary artery spasm can be found in up to 60% of patients with symptoms of myocardial ischemia despite unobstructed coronary arteries.MethodsConsecutive symptomatic patients with unobstructed coronary arteries undergoing acetylcholine testing to detect epicardial or microvascular coronary spasm were prospectively enrolled. After a median follow-up period of 7.2 years (6.5 to 7.9 years), data regarding mortality, nonfatal myocardial infarction, stroke, repeat coronary angiography, recurrent symptoms, and quality of life were obtained in 736 patients (57% women, mean age 62 ± 12 years).ResultsIn total, 55 deaths (7.5%), 8 nonfatal myocardial infarctions (1.4%), and 12 strokes (2.2%) occurred during the follow-up period. Recurrent symptoms were reported by 64% of patients, and repeat coronary angiography was performed in 12% of cases. Multivariate analysis revealed epicardial spasm as a predictor of nonfatal myocardial infarction (hazard ratio: 14.469; 95% confidence interval: 1.735 to 120.646) and repeat angiography (hazard ratio: 1.703; 95% confidence interval: 1.062 to 2.732), whereas patients with microvascular spasm more often had recurrent angina at follow-up (hazard ratio: 1.311; 95% confidence interval: 1.013 to 1.697).ConclusionsIn this long-term follow-up study, the overall prognosis of patients with coronary spasm was favorable. Patients with epicardial spasm were at increased risk for myocardial infarction and repeat angiography, while microvascular spasm was associated with recurrent angina. Acetylcholine testing may help identify patients at increased risk for adverse cardiac events among this overall low-risk population. 相似文献
64.
Familial migraine and coronary artery spasm in two siblings 总被引:2,自引:0,他引:2
A common pathophysiology for the clinical association of variant angina and migraine has been suggested, but the pathogenesis of both illnesses is yet unknown. Our report presents two siblings with both illnesses and a familial history of migraine where coronary artery spasm was documented, spontaneously in one and after the administration of ergonovine maleate in the other one. Our study strongly supports the hypothesis that genetic factors possibly play a role in the etiology of variant angina and migraine at least in some patients. 相似文献
65.
The case of a young man with spontaneous vasospasm at two sites in his left anterior descending coronary artery is described. Intravascular ultrasound demonstrated mild eccentric atherosclerosis with smaller total artery cross-sectional area (defined as the external elastic membrane) compared with reference segments. Impaired compensatory enlargement (remodeling) in response to mild atherosclerosis may derive from one or more biologic mechanisms that are also responsible for vasospasm. This characteristic is easily identified by intravascular ultrasound. In this case, coronary stenting of the vasospastic sites led to excellent long-term control of symptoms more than 1 year after intervention. 相似文献
66.
67.
Anandita Pattnaik Alexandra Lim Sara Sabeti Ashley Kwon Katherine Hall Ira Lott Virginia Kimonis 《European journal of medical genetics》2021,64(9):104234
In this report, we describe an unusual case of progressive hemifacial atrophy or Parry-Romberg syndrome in a 10-year-old girl with progressive hemifacial microsomia and limb anomalies who had brain magnetic resonance imaging (MRI) findings of white matter hyper-intensities. Patients typically present with neurological manifestations such as epilepsy, facial pain, and migraines and ophthalmological symptoms in conjunction with white matter lesions. The patient demonstrated normal cognition and psychomotor development despite the presence of white matter lesions in her frontal lobe that is commonly associated with neurological symptoms. This report brings attention to the complicated relationship between facial, limb and brain imaging findings in Parry-Romberg syndrome and differentiates it from hemifacial microsomia syndrome. 相似文献
68.
《The British journal of oral & maxillofacial surgery》2020,58(5):590-596
The aim of this retrospective study was to use computer-aided design and manufacturing (CAD/CAM) patient-specific plates and cutting guides for the waferless positioning and fixation of the maxilla after bimaxillary osteotomies in cases of hemifacial microsomia with condylar dysplasia or absence of the temporomandibular joint (TMJ), and to compare the results with the CAD/CAM fabricated surgical wafer by 3-dimensional analysis. Eighteen patients were selected from the hospital database, preoperative surgical planning and simulation were done on 3-dimensional computed tomographic models for all patients, and they were divided into Group I – in which CAD/CAM patient-specific cutting guides and plates were used; and Group II – in which CAD/CAM fabricated surgical wafers were used. Finally, the outcome was evaluated by comparing planned with postoperative outcomes. The largest discrepancies of the Le Fort I segment were 0.50 (0.18) mm in the anteroposterior direction and 0.82 (0.60)° in the yaw orientation with Group I. The largest discrepancies of the Le Fort I segment were 1.32 (1.40) mm in superioinferior direction and 8.48 (7.73)° in the yaw orientation with Group II. The CAD/CAM patient-specific cutting guides and plates proved to be reliable and have great value in improving the accuracy in repositioning the Le Fort I segment and in the efficacy of orthognathic treatment of hemifacial microsomia with condylar dysplasia or no TMJ. The CAD/CAM patient-specific cutting guides and plates are therefore a useful alternative to the wafer technique. 相似文献
69.
目的:比较针刺夹脊穴结合温针灸与常规针刺治疗原发性面肌痉挛的疗效差异。方法:选择60例符合纳入标准的原发性面肌痉挛病人随机分成两组,每组各30例。对照组用常规针刺治疗,治疗组在对照组的针刺选穴基础上取颈部夹脊穴(C3-C6棘突下旁开0.5寸,左右各4穴)和温针灸养老穴。结果:两组患者的面肌痉挛强度和频率均降低(P<0.05)。总有效率比较,治疗组(90%)>对照组(63.3%),(Z=-2.815,P=0.005<0.01)。结论:针刺夹脊穴结合温针灸与常规针刺均可改善患者面肌痉挛症状,且夹脊穴结合温针灸治疗疗效更佳。 相似文献
70.
We studied 16 patients with small myocardial infarction who had further episodes of chest pain with ST-segment elevation, a sign of transmural myocardial ischemia and imminent infarction extension. Coronary angiography in 14 showed a critical lesion in 13. Intravenous verapamil abolished chest pain and ST-segment elevation. It caused a fall in right atrial and left ventricular end-diastolic pressures (LVEDP) and cardiac output, reflex systemic vasoconstriction, and a rise in systemic vascular resistance. There was no reflex tachycardia. Volume expansion raised LVEDP and restored a normal cardiac output. Accelerated junctional rhythm with isorhythmic A-V dissociation occurred in 5 patients. Two patients sustained a transmural infarction, 10 underwent coronary artery bypass grafting, and 4 are symptom-free with oral treatment. Intravenous treatment was an effective method of treating acute episodes of transmural myocardial ischemia and preventing their recurrence in patients with critical coronary artery narrowing. Continuous verapamil infusion stabilized the patients' condition and enabled smooth coronary angiography and induction of anesthesia for surgery. 相似文献