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91.
《Journal of cardiology》2014,63(6):438-443
BackgroundCatheter ablation is now an alternative approach to antiarrhythmic drug therapy for patients with symptomatic atrial fibrillation (AF). We focused on younger patients in whom the prevalence of AF is low, and we sought clinical factors associated with unsuccessful ablation outcomes.Methods and resultsAmong 1983 consecutive symptomatic patients who underwent AF ablation procedures, 95 patients (4.8%), age ≤ 40 years, were prospectively included. Of them, 64 had paroxysmal AF, and the remaining 31 had persistent AF. All patients underwent pulmonary vein isolation and cavotricuspid isthmus ablation. When AF recurred, redo ablations were performed if the patients desired. The mean number of ablation procedures was 1.3 ± 0.6 times per patient. During the follow-up of 40 [27.8–49.6] months, sinus rhythm was maintained in 86 patients (90.5%) without any antiarrhythmic drugs, but not in the remaining 9 patients (9.5%). Low body mass index (BMI) and persistent AF were associated with unsuccessful ablation procedures. In multivariate logistic regression analysis, a low BMI had the most significant value, with an odds ratio of 7.33 (p = 0.022). The receiver operating characteristic curve demonstrated a BMI cut point of 22.1 kg/m2, with an area under the curve of 0.773.ConclusionIn symptomatic younger AF patients, a low BMI was an independent clinical factor for unsuccessful AF ablation outcomes. 相似文献
92.
93.
Hideto?KamedaEmail author Koichi?Amano Naoya?Sekiguchi Hirofumi?Takei Hiroe?Ogawa Hayato?Nagasawa Tsutomu?Takeuchi 《Modern rheumatology / the Japan Rheumatism Association》2004,14(6):442-446
Methotrexate (MTX) is the most commonly used disease-modifying antirheumatic drug (DMARD) throughout the world. In Japan,
MTX is recommended by the Japanese Ministry of Health, Labour, and Welfare to be given as the second or third DMARD and at
a dosage of no more than 8 mg/week. We analyzed the efficacy of MTX in Japanese patients with RA in order to determine whether
it is comparable to that in Western countries, where 15–20 mg/week of MTX is used, as well as to elucidate the factors associated
with the favorable response to MTX. Around 8 mg/week of MTX was effective in half of the RA patients in the current study,
and male sex was the only factor associated with a good response to MTX from a multivariate regression model analysis. Some
of the patients who had a poor response to MTX showed an improvement with the addition of bucillamine or prednisolone. For
the remaining patients, an increase in the MTX dosage to more than 8 mg/week or the use of biologics such as the anti-tumor
necrosis factor (TNF)-α monoclonal antibody may be required. 相似文献
94.
Reactive arthritis (ReA) is sterile arthritis occurring after extra articular bacterial infection. The aim of this study was to analyze, over 30 years, clinical, biological and imaging characteristics as well as therapeutic management of new cases of ReA, comparing two periods.
Methods
retrospective monocentric study, data of all the patients followed in our unit between January 1st 1984 and April 2014 with the diagnosis or ReA were analyzed (clinical and biological features, management and outcome), and compared between two periods: from January 1984 to December 1993, and from January 2004 to December 2013.Results
Sixty two patients fulfilling international diagnosis criteria were analyzed. There was no significant difference between the two periods in number of new cases, clinical presentation, biological data or outcome. Changes in therapeutic management were obvious with occurrence of anti TNF in the recent period.Conclusion
Reactive arthritis is still a current rheumatologic problem in a developed country, with a need of early and tailored rheumatologic management. 相似文献95.
96.
Luna Gargani Cosimo Bruni Tatiana Barskova Valentina Hartwig Martina Marinelli Maria Giovanna Trivella Marco Matucci-Cerinic Antonio LAbbate 《Seminars in arthritis and rheumatism》2019,48(5):867-873
Objectives
Systemic sclerosis (SSc) causes functional and structural microcirculatory dysfunction, affecting also distal extremities. Optical Near-InfraRed Spectroscopy (NIRS) of blood HbO2 saturation (stO2) is able to evaluate O2 delivery/consumption balance in the explored tissue. The NIRS-sensitive camera non-invasively detects stO2 values in superficial tissues, automatically generating 2D-imaging maps in real time. We aimed at testing whether NIRS hand imaging may evaluate peripheral microcirculatory dysfunction and its spatial heterogeneity in SSc patients compared to controls.Methods
Forty SSc patients (aged 55.1?±?15.6 years) and twenty-one healthy controls (aged 54.3?±?14.5years, p?=?0.89) were studied by palmar hand NIRS-2D imaging. A blood pressure cuff was applied to the forearm and 3 min ischemia was induced. Images were acquired at basal conditions and every 10 seconds during 3 minutes of ischemia and 5 minutes of reperfusion. Five regions of interest were positioned on each fingertip, from the second to the fifth finger and one on the thenar eminence.Results
A significant difference was found between controls and SSc patients in basal stO2 (84.3?±?7.5?vs. 75.4?±?10.9%, p?<?0.001), minimum stO2 (65.2?±?8.0?vs. 53.4?±?10.1%, p?<?0.001) and time to maximum stO2 during hyperemia (63?±?38?vs. 85?±?49?s, p?<?0.05). Among clinical characteristics, anti-Scl70 antibody positivity, digital ulcers history and smoke exposure affected NIRS parameters, as well as sildenafil and statins therapy. Conversely, no significant differences were found in NIRS-2D values between different nailfold-videocapillaroscopy patterns.Conclusion
NIRS-2D imaging is a simple, automated tool to non-invasively detect regional microcirculatory impairment in SSc, which seems to add significant functional information to the morphological picture of nailfold-videocapillaroscopy. 相似文献97.
Anna Viola Daniela Pugliese Sara Renna Federica Furfaro Flavio Caprioli Renata D’Incà Fabrizio Bossa Stefano Mazza Giuseppe Costantino Massimo Claudio Fantini Gionata Fiorino Angela Alibrandi Ambrogio Orlando Alessandro Armuzzi Walter Fries 《Digestive and liver disease》2019,51(4):510-515
Background
Anti-TNF therapies infliximab (IFX), adalimumab (ADA), and golimumab (GOL) are approved for treating moderate to severe ulcerative colitis (UC). In UC, only the switch from IFX to ADA has been investigated, reaching no more than 10–43% remission rates at 12 months.Aim
Of the present study was to investigate disease outcome after a switch from subcutaneous (SC) agents to the intravenous (IV) agent (IFX).Methods
In this retrospective multicentre study, we analysed the charts of UC patients unresponsive/intolerant or with secondary loss of response (LOR) to ADA or GOL who were switched to IFX. We evaluated clinical response and remission together with adverse events at 3, 6, and 12 months follow-up.Results
Seventy-six patients were included; 38 patients started ADA and 38 started GOL for a mean therapy duration of 6?±?6 months. Indications for switch were adverse events in 3%, primary failure in 79%, and LOR in 18% of patients. Clinical remission was reached by 47%, 50%, and 77% of patients, respectively. Patients that switched for LOR did numerically, but not statistically, better than patients who switched for primary failure.Conclusions
Our data show a superior remission rate in SC to IV anti-TNF switch in UC compared to the IV to SC switch reported in literature. 相似文献98.
99.
《Enfermedades infecciosas y microbiología clínica》2021,39(7):330-334
IntroductionThere are not data on blood B-cell lymphoma 2 (Bcl-2) concentrations (one of the antiapoptotic molecules of the Bcl-2 family in the intrinsic apoptosis pathway) in septic patients. Therefore, this study was carried with the aims to explore whether blood Bcl-2 concentrations at diagnosis of sepsis are different in survivor and non-survivor septic patients, are associated with mortality, and are useful for the mortality prediction.MethodsIntensive Care Units from 3 Spanish hospitals participated in this observational and prospective study with septic patients and serum Bcl-2 concentrations at diagnosis of sepsis were determined. Mortality at 30 days was as outcome variable.ResultsWe found that 30-day non-surviving patients (n = 81) showed lower serum Bcl-2 levels (p = 0.003) than surviving patients (n = 140). We found that serum concentrations of Bcl-2 < 4.4 ng/mL were associated with mortality (OR = 3.228; 95% CI = 1.406–7.415; p = 0.006) in the multiple logistic regression analysis, and that showed an area under the curve for mortality prediction of 62% (95% CI = 55–68%; p = 0.003).ConclusionsIn our study appears novel findings such as higher blood Bcl-2 concentrations in survivor than in non-survivor septic patients, the association between low blood Bcl-2 concentrations and mortality of septic patients, and the ability of blood Bcl-2 concentrations for the prediction of septic patient mortality. 相似文献
100.
Kyung-Lim Joa Tai-Ryoon Han Sung-Bom Pyun Ueon-Woo Rah Joo-Hyun Park Yun-Hee Kim Min-Ho Chun Nam-Jong Paik Seung-Don Yoo Sam-Gyu Lee Si-Woon Park Sung-Hun Im Han-Young Jung 《Journal of Korean medical science》2015,30(5):644-650
The purpose of this report was to provide information for patients receiving inpatient rehabilitation after stroke and to identify the possible factors influencing functional outcome after inpatient rehabilitation. Stroke patients (n = 5,212) who were discharged from the Departments of Rehabilitation Medicine (RM) of university hospitals and rehabilitation hospitals from 2007 through 2011 were participants. Prevalence, age, transfer time after onset, length of stay (LOS), functional status at admission and discharge were analyzed. In all stroke subjects, cerebral infarctions (67%) were more common than hemorrhages. Cerebral infarctions in the middle cerebral artery territory were most common, while the basal ganglia and cerebral cortex were the most common areas for hemorrhagic stroke. The LOS decreased from 45 to 28 days. Transfer time after onset decreased from 44 to 30 days. Shorter transfer time after onset was correlated with better discharge functional status and shorter LOS. Initial functional status was correlated with discharge functional status. In ischemic stroke subtypes, cerebellar and brainstem strokes predicted better outcomes, while strokes with more than one territory predicted poorer outcomes with more disabilities. In hemorrhagic stroke subtypes, initial and discharge functional status was the lowest for cortical hemorrhages and highest for brainstem hemorrhages. This report shows that LOS and transfer time after onset has been decreased over time and initial functional status and shorter transfer after onset are predictors of better functional outcome at discharge. 相似文献