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91.
气管插管术在238例患者中的应用及护理干预 总被引:1,自引:0,他引:1
目的分析紧急气管插管术成功的方式方法。方法对我院2007年8月至2008年8月实施238例紧急气管插管术的回顾分析。结果238例中无需药物诱导直接气管插管54例,快速静推地西泮诱导后气管插管184例。经口气管插管195例,经鼻气管插管43例。总插管成功236例,成功率99.4%。一次插管成功220例,成功率94.5%。插管失败2例,失败率0.6%。并发症发生率6.2%。结论提高紧急气管插管成功的关键是:制定明确的急诊插管适应证,做好各项术前准备工作,精练插管方法;选择合适的插管方式;评估气管插管困难程度,掌握气管插管的技巧,熟悉气管插管失败后的挽救措施;预防气管插管术的并发症。 相似文献
92.
目的:研究植入125I粒子后家兔气管组织结构的辐射损伤,探讨临床应用安全性.方法:采用2x2析因设计方法,将实验组和空白对照组动物在不同时间点(第14天,第30天)的损伤程度进行组合交叉分组,研究辐射和时间两种因素各自损伤水平,以及两者间有无交互作用.具体分组方法如下:健康雄性普通级新两兰家兔16只(体重2.5~3.0 kg)按照体重与窝别配为8对,再随机分为2个亚组(第14天组,第30天组),每组4对;每对动物各自分为实验组1只,对照组1只.实验组(8只)采取气管外膜缝扎3颗0.5 mCi125I粒子,粒子互相间隔10 mm排列的布源方法,对照组(8只)采用3颗空白粒子,按相同方法布源.第14天与第30天分别取相应亚组动物气管进行肉眼观察、HE染色病理与透射电镜检查,观察炎症损伤程度,进行统计分析.结果:第14天和第30天,实验组和对照组兔左侧气管均无穿孔、血栓形成等严重并发症;两组HE染色对比炎症损伤程度计分无显著性差异(P>0.05);实验组电镜观察到辐射敏感细胞器损伤,但第14天与第30天无明显程度差异,对照组电镜检查正常.结论:间隔10 mm连续排列的3颗0.5 mCi125I粒子对家兔气管的辐射损伤小,临床应用安全. 相似文献
93.
Umezu H Tamura M Kobayashi S Sawabata N Honma K Miyoshi S 《General thoracic and cardiovascular surgery》2008,56(4):199-202
Tracheal chondrosarcomas are rare, with only 14 cases previously documented. We report a case of chondrosarcoma of the trachea
and review other published cases. Our patient was a 34-year-old man who began to feel shortness of breath 8 months after initial
hemoptysis. Transverse and coronal computed tomography demonstrated a tumor that was obstructing nearly 80% of the tracheal
lumen at the thoracic inlet. A bronchoscopic biopsy specimen led to an initial diagnosis of chondroma. Five tracheal rings
from the third to the seventh including the tumor were completely resected, and an end-to-end anastomosis was performed. The
histological diagnosis of the surgical specimen showed it to be a chondrosarcoma. The patient was alive without recurrence
at 6 years 4 months after surgery. Because recurrence after incomplete resection and malignant transformation can occur with
chondromas, radical resection of the trachea is recommended for all cartilaginous tumors of the trachea. 相似文献
94.
Duracher C Schmautz E Martinon C Faivre J Carli P Orliaguet G 《Paediatric anaesthesia》2008,18(2):113-118
BACKGROUND: The correct size of cuffed endotracheal tube (CET) limits the risk of postintubation tracheal damage. The aim of this study was to compare the size of the CET used in children with the size predicted by the Khine formula [age (years)/4 + 3]. METHODS: After ethical committee approval, 204 children aged 1 day-15 years were included prospectively in the study. The choice of the size of the CET was made at the discretion of the attending anesthesiologist. The main criterion of judgment was the comparison of the leak before and after inflating the cuff at a pressure of 20 cm.H(2)O. Demographic data, tracheal tube size used and that predicted by Khine's formulae and side-effects were recorded. RESULTS: Overall, 21% of the CET were in accordance with the size predicted by the Khine formula. In the remaining patients, 72% were oversized and 7% undersized. In 12 cases, the size of CET chosen initially was modified: for a larger size in eight children and for a smaller size in four others. Six children (2.9%) presented with minor postoperative complications. CONCLUSIONS: Our data suggest that Khine's formula for predicting the appropriate tracheal tube size underestimates optimal size by 0.5 mm. We therefore recommend the use of the following formula: internal diameter of the CET = [age/4 + 3.5] in children >1 year of age which may be applied without increased risk of complications. The rate of tracheal reintubation as well as the detected leaks supports these recommendations. 相似文献
95.
Dellabianca A Sacchi M Anselmi L De Amici E Cervio E Agazzi A Tonini S Sternini C Tonini M Candura SM 《British journal of pharmacology》2007,150(2):220-226
BACKGROUND AND PURPOSE: Nitric oxide (NO) and vasoactive intestinal peptide (VIP) are considered transmitters of non-adrenergic, non-cholinergic (NANC) relaxations in guinea-pig trachea, whereas the role of carbon monoxide (CO) is unknown. This study was designed to assess the participation of CO, and to investigate the localization of haem oxygenase-2 (HO-2), the CO-producing enzyme, in tracheal neurons. EXPERIMENTAL APPROACH: NANC responses to electrical field stimulation (EFS) at 3 and 10 Hz were evaluated in epithelium-free whole tracheal segments as intraluminal pressure changes. Drugs used were: L-nitroarginine methyl ester (L-NAME, 100 microM) to inhibit NO synthase (NOS), alpha-chymotrypsin (2 U ml(-1)) to inactivate VIP, zinc protoporphyrin-IX (ZnPP-IX, 10 microM) to inhibit HO-2, and 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (ODQ, 10 microM), a soluble guanylyl cyclase inhibitor. For immunohistochemistry, tissues were exposed to antibodies to PGP 9.5, a general neuronal marker, HO-2 and NOS, and processed with an indirect immunofluorescence method.Key results:alpha-Chymotrypsin did not affect NANC relaxations. ODQ inhibited NANC responses by about 60%, a value similar to that obtained by combining L-NAME and ZnPP-IX. The combination of ODQ, L-NAME and ZnPP-IX reduced the responses by 90%. Subpopulations of HO-2 positive neurons containing NOS were detected in tracheal sections. CONCLUSIONS AND IMPLICATIONS: In the guinea-pig trachea, NANC inhibitory responses at 3 and 10 Hz use NO and CO as main transmitters. Their participation is revealed following inhibition of NOS, HO-2 and soluble guanylyl cyclase. The involvement of CO as a relaxing transmitter paves the way for novel therapeutic approaches in the treatment of airway obstruction. 相似文献
96.
Ahmed Sayed Alaa Farok Hosam El-Sayed Said A. Soliman 《Methodist DeBakey Cardiovascular Journal》2013,9(4):233-234
We report a 70-year-old female who complained of shortness of breath and a pulsating suprasternal lump. CT scan showed innominate artery dilatation. In addition, operative exposure showed tortuous arteries and a common origin of the left common carotid and innominate arteries. Surgical correction by innominate artery division and reimplantation at the ascending aorta was performed, and the patient’s symptoms completely disappeared after the procedure. 相似文献
97.
98.
人工气管重建气道的进展 总被引:1,自引:0,他引:1
气管病变行手术切除治疗存在超限切除后直接吻合困难等问题,人工气管作为替代物以重建气道是解决这一问题的有效方法。寻求理想的人工气管则成了国内外研究的重点,近年来的实验研究在人工气管的材料选用,吻合技术等方面取得了很大进展,为临床应用提供了广阔前景。 相似文献
99.
肺不张是婴幼儿心脏术常见的并发症,婴幼儿不能有效的咳嗽及排痰,使痰液积聚在气管及支气管内,造成呼吸道阻塞,形成肺不张。应用直接气管内吸痰可有效清除痰液,保持呼吸道通畅,预防肺不张的发生。我科在临床通过对35例术后婴幼儿实施此项护理并配以拍背、雾化吸氧等均得到满意疗效。本文主要介绍了直接气管内吸痰的方法、适应症及护理要点。 相似文献
100.