全文获取类型
收费全文 | 31423篇 |
免费 | 2552篇 |
国内免费 | 694篇 |
专业分类
耳鼻咽喉 | 238篇 |
儿科学 | 1280篇 |
妇产科学 | 778篇 |
基础医学 | 1767篇 |
口腔科学 | 908篇 |
临床医学 | 3654篇 |
内科学 | 6503篇 |
皮肤病学 | 405篇 |
神经病学 | 1328篇 |
特种医学 | 786篇 |
外国民族医学 | 1篇 |
外科学 | 2936篇 |
综合类 | 4207篇 |
现状与发展 | 1篇 |
预防医学 | 4850篇 |
眼科学 | 334篇 |
药学 | 2258篇 |
36篇 | |
中国医学 | 1145篇 |
肿瘤学 | 1254篇 |
出版年
2024年 | 157篇 |
2023年 | 887篇 |
2022年 | 1712篇 |
2021年 | 2195篇 |
2020年 | 1872篇 |
2019年 | 1720篇 |
2018年 | 1697篇 |
2017年 | 1262篇 |
2016年 | 1169篇 |
2015年 | 1104篇 |
2014年 | 2324篇 |
2013年 | 2183篇 |
2012年 | 1826篇 |
2011年 | 1975篇 |
2010年 | 1594篇 |
2009年 | 1520篇 |
2008年 | 1402篇 |
2007年 | 1436篇 |
2006年 | 1031篇 |
2005年 | 938篇 |
2004年 | 726篇 |
2003年 | 609篇 |
2002年 | 419篇 |
2001年 | 399篇 |
2000年 | 277篇 |
1999年 | 269篇 |
1998年 | 213篇 |
1997年 | 202篇 |
1996年 | 173篇 |
1995年 | 169篇 |
1994年 | 158篇 |
1993年 | 122篇 |
1992年 | 133篇 |
1991年 | 116篇 |
1990年 | 89篇 |
1989年 | 80篇 |
1988年 | 55篇 |
1987年 | 63篇 |
1986年 | 47篇 |
1985年 | 58篇 |
1984年 | 57篇 |
1983年 | 42篇 |
1982年 | 39篇 |
1981年 | 33篇 |
1980年 | 28篇 |
1979年 | 17篇 |
1978年 | 22篇 |
1977年 | 14篇 |
1976年 | 15篇 |
1975年 | 6篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
991.
The toxicity profile of medicinal plants is an important preclinical requirement in the development of phytomedicines. The cytotoxic and genotoxic effects of the leaf of Uvaria chamae P. Beauv (Annonaceae) and stem bark of Morinda lucida Benth (Rubiaceae) were investigated in order to provide information on their safety as antimalarial plants. The methanol extract of U. chamae and ethanol (70%) extract of M. lucida were separately orally administered (125, 250, and 750?mg/kg/day) to mice for 10 consecutive days. Cyclophosphamide (50?mg/kg, single dose) and distilled water were used as positive and negative controls, respectively. The mice were injected with colchicine (0.04%) intra-peritoneally 24?h after the last administration of the extracts and the bone marrows harvested. Giemsa-stained slides of bone marrow cells were microscopically assessed for dividing cells to determine the mitotic index (MI) and scored for chromosomal aberrations (CA) according to standard methods. chamae exhibited dose-dependent cytotoxicity. At 750?mg/kg, the MI was significantly (p?0.05) lower (1.81?±?0.04) than that of cyclophosphamide (5.83?±?0.04). The lower the MI, the higher the cytotoxicity. The activity of M. lucida was not significantly different (p?>?0.05) from that of the negative control. The total CA observed from treatment with both plants at all doses were significantly (p?0.05) greater than that of control. This study concluded that U. chamae showed both cytotoxicity and genotoxicity while M. lucida exerted only genotoxic effect. Nevertheless, the two plants should be used with caution in antimalarial therapy. 相似文献
992.
Verônica M. Couto Maria J. Prieto Daniela E. Igartúa Daniela A. Feas Lígia N.M. Ribeiro Camila M.G. Silva Simone R. Castro Viviane A. Guilherme Darlene D. Dantzger Daisy Machado Silvia del V. Alonso Eneida de Paula 《Journal of pharmaceutical sciences》2018,107(9):2411-2419
Administration of local anesthetics is one of the most effective pain control techniques for postoperative analgesia. However, anesthetic agents easily diffuse into the injection site, limiting the time of anesthesia. One approach to prolong analgesia is to entrap local anesthetic agents in nanostructured carriers (e.g., liposomes). Here, we report that using an ammonium sulphate gradient was the best strategy to improve the encapsulation (62.6%) of dibucaine (DBC) into liposomes. Light scattering and nanotracking analyses were used to characterize vesicle properties, such as, size, polydispersity, zeta potentials, and number. In vitro kinetic experiments revealed the sustained release of DBC (50% in 7 h) from the liposomes. In addition, in vitro (3T3 cells in culture) and in vivo (zebrafish) toxicity assays revealed that ionic-gradient liposomes were able to reduce DBC cyto/cardiotoxicity and morphological changes in zebrafish larvae. Moreover, the anesthesia time attained after infiltrative administration in mice was longer with encapsulated DBC (27 h) than that with free DBC (11 h), at 320 μM (0.012%), confirming it as a promising long-acting liposome formulation for parenteral drug administration of DBC. 相似文献
993.
Sebastiano Mercadante Francesco Masedu Marco Maltoni Daniela De Giovanni Luigi Montanari Cristina Pittureri 《Current medical research and opinion》2018,34(7):1187-1192
Aim: To assess the prevalence and intensity of constipation in advanced-cancer patients referred to palliative care, and to assess changes after 1 week of specialist palliative care.Methods: This was a prospective multi-center study in advanced patients for a period of 1 year. At admission (T0), age, gender, primary tumor, concomitant diseases, Karnofsky status, Palliative prognostic score (PaP), Edmonton Symptom Assessment scale (ESAS), Memorial Delirium Assessment Scale (MDAS), and bowel function index (BFI) were collected. In BFI, high values represent severe constipation. The use of medication was also recorded, as well as possible causes of constipation. The same parameters were recorded 1 week after admission for palliative care (T7).Results: A total of 246 patients were screened for constipation. The mean BFI at T0 was 42.4 (SD?=?26.92). One hundred and sixty-three patients (66.3%) had a BFI >28. The mean BFI at T7 was 35.7 (SD?=?28.8), with a significant decrease from T0 to T7 (p?=?.000). A significant decrease of BFI in patients with a BFI >28 was reported (p?=?.000). In patients with a BFI ≤28 there was a significant worsening of constipation (p?=?.000). In patients with a BFI >28 at T0 there was a significant increase in the use of laxatives at T7 in comparison with patients having a BFI ≤28 (p?=?.002). In patients with a BFI ≤28 at T0, who had a significant worsening of BFI (Δ?>?12), the use of laxatives was significantly lower in comparison to patients who had a BFI >28 (p?=?.000). In the multivariate analysis, dehydration and the use of benzodiazepines were independently associated with higher BFI scores.Conclusion: Constipation is present in approximately two-thirds of patients, and is principally associated with dehydration and the use of benzodiazepines. Patients with normal bowel function at initial assessment may see a worsening in their condition a week later due to lack of prevention or subsequent under-treatment. 相似文献
994.
目的:构造基本医疗保险参保人欺诈风险预测模型,发现欺诈行为的主要特征,进而建立风险评估指标体系,以期为医保基金智能监管提供决策支持。方法:利用183万多条我国基本医疗保险诊疗历史记录的大规模真实数据,应用XGBoost算法和EasyEnsemble方法构造基本医疗保险参保人欺诈风险评估集成模型。在此基础上,利用特征重要度计算进一步识别和量化欺诈行为人的潜在特征以构造欺诈风险评估指标体系。结果:模型预测结果的准确性为83%;阳性与阴性预测值的加权平均值为95%;参保人欺诈的可能性能够被正确评估的概率为85%;其中,实际产生欺诈行为的所有参保人中,有82%的人员能通过本模型正确识别;各项费用发生金额、各阶段费用发生金额以及各类项目的数量等是区分欺诈与正常参保人的重要指标。结论:基于XGBoost集成模型构建的基本医疗保险参保人欺作风险评估指标体系能够有效地用于识别潜在欺诈人员。建立健全的风险评估指标体系并开发基于医保大数据的智能化监控系统,对于提高医保管理服务水平,保障医保基金安全以及维护社会医保的公平性有重要作用。 相似文献
995.
摘要:目的 探讨 2 型糖尿病(T2DM)患者体质量指数(BMI)与甲状旁腺素(PTH)、25 羟维生素 D[25(OH)D]的
相关性。方法 收集首都医科大学附属北京朝阳医院内分泌科住院治疗的 2 型糖尿病患者 110 例,BMI 在 18.5~
23.9 kg/m2患者作为正常体质量组(n=24),BMI 在 24.0~27.9 kg/m2患者作为超重组(n=47),BMI≥28.0 kg/m2患者作为
肥胖组(n=39)。记录患者年龄、性别、吸烟史、BMI、腹围和臀围。采集清晨空腹外周血,通过全自动生物化学分析仪
检测总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)、血清白蛋白
(ALB)、尿素氮(BUN)、血肌酐(Cr)、血清钙(Ca2+)、血清磷(P)、游离脂肪酸(FFA)、空腹血糖(FPG)和空腹胰岛素
(FINS)。高效液相色谱法测定糖化血红蛋白(HbA1c)。采用乳胶增强免疫透射比浊法测定超敏 C 反应蛋白(hs
CRP)。采用免疫化学发光法测定 PTH、25(OH)D。计算稳态模型胰岛素抵抗指数(HOMA-IR)。利用简化肾脏病膳
食改善公式(MDRD)估算肾小球滤过率(eGFR)。比较 3 组间 PTH、25(OH)D 及各指标的差异,多重线性逐步回归
分析 BMI 与 PTH、25(OH)D 等指标的相关性。结果 与正常体质量组比较,超重组的腹围、臀围、FINS 明显升高
(P<0.05);肥胖组的腹围、臀围、PTH、FINS、HOMA-IR 明显升高(P<0.05)。与超重组比较,肥胖组的腹围、臀围、
hs-CRP、PTH 明显升高(P<0.05)。多元线性逐步回归分析结果提示,BMI 与臀围(β=0.293)、腹围(β=0.060)、FINS
(β=0.026)、PTH(β=0.019)呈正相关(P<0.05)。结论 T2DM 患者 BMI 与 PTH 密切相关,与 25(OH)D 无关。 相似文献
996.
Yue-Bin Lv Simin Liu Zhao-Xue Yin Xiang Gao Virginia Byers Kraus Chen Mao Jin-Qiu Yuan Juan Zhang Jie-Si Luo Hua-Shuai Chen Yi Zeng Xiao-Ming Shi 《Journal of the American Medical Directors Association》2018,19(8):672-678.e4
Objective
Current international and national guidelines for body mass index (BMI) and waist circumference (WC) have been recommended to all adults. However, whether recommendations applied to the oldest old (aged 80+) is poorly known. The study objective was to investigate the relation of BMI and WC with 3-year all-cause mortality among the oldest old.Design, Setting, and Participants
A total of 4361 Chinese oldest old (mean age 91.8) participated in this community-based prospective cohort study.Measurements
BMI and WC were measured at baseline in 2011 and were used as continuous variables and as categorized variables by recommendations or by tertiles. Adjusted, sex-stratified Cox models with penalized splines and Cox models were constructed to explore the association.Results
Greater BMI and WC were linearly associated with lower mortality risk in both genders. The mortality risk was the lowest in overweight or obese participants (BMI ≥ 24.0) and was lower in participants with abdominal obesity. Compared to the upper tertile, those in the middle and lower tertile of BMI had a higher risk of mortality for men [hazard ratio (HR): 1.23 (1.02-1.48) and 1.53 (1.28-1.82)] and for women [HR: 1.21 (1.03-1.41) and 1.35 (1.15-1.58)]; it was also found in participants in the middle and lower tertile of WC for men [HR: 1.21 (1.01-1.46) and 1.41 (1.18-1.69)] and for women [HR: 1.35 (1.15-1.58) and 1.55 (1.32-1.81)] (all the P values for trend <.001). These findings were robust in further sensitivity analyses or when using propensity score matching, in subgroup analyses, or in octogenarians, nonagenarians, and centenarians.Conclusions
In Chinese oldest old, both higher BMI and higher WC predict better survival in both genders. The finding suggests optimal BMI and WC may be sensitive to age, thus, the current recommendations for the oldest old may need to be revisited. 相似文献997.
Vincenzo Carnevale Valeria Castriotta Pamela Angela Piscitelli Luciano Nieddu Maria Mattera Giuseppe Guglielmi Alfredo Scillitani 《Journal of the American Medical Directors Association》2018,19(9):793-796
Objectives
Sarcopenia is a common geriatric syndrome, whose diagnosis implies the assessment of muscle mass. Dual-energy x-ray absorptiometry (DXA) is the reference method for clinical practice, but it is not universally available. We compared DXA with 2 anthropometry-based methods to assess muscle mass in older adults.Design
Cross-sectional.Setting
Ambulatory patients.Participants
148 (87 female and 61 male) white older adults.Measurements
Mid-arm muscle circumference (MAMC), whole skeletal muscle mass estimated by the Lee's formula (eTSMM), and relative skeletal muscle index (RSMI).Results
Men and women did not differ for MAMC and RSMI, whereas eTSMM was higher (P < .001) in men. MAMC and eTSMM correlated with RSMI, in the whole sample as in men and women separately (P < .001). According to the McNemar test, the frequencies of older men and women with low muscle mass identified by eTSMM did not differ from those detected by RSMI (P = .066) at variance with MAMC. Using EWGSOP (European Working Group on Sarcopenia in Older People) criteria for RSMI as standard reference, the receiver operating characteristic (ROC) curves provided redefined cut-offs of reduced muscle mass: 18.6 cm in women and 22.3 cm in men for MAMC, and 17.7 kg in women and 28.3 kg in men for eTSMM. The areas under the ROC curves (AUCs) for MAMC were 0.882 in women (sensitivity 89%, specificity 84%) and 0.826 in men (sensitivity 94%, specificity 67%). The AUCs for eTSMM were 0.8913 in women (sensitivity 95%, specificity 81%) and 0.878 in men (sensitivity 97%, specificity 67%). No significant difference was found between the ROC curves of MAMC and eTSMM in both sexes.Conclusion
Two simple anthropometric methods, possibly used in every clinical setting, could be valuable screening tools for low muscle mass in older subjects. 相似文献998.
Being overweight or obese as a risk factor for acute liver injury secondary to acute acetaminophen overdose 下载免费PDF全文
Purpose
Increased incidences of hepatotoxicity have been observed in obese patients with acute acetaminophen overdose. We evaluate whether the status of being overweight or obese is associated with increase in the development of hepatotoxicity and acute liver injury (ALI) in patients with acute acetaminophen overdose.Methods
This was a retrospective cohort study comparing the risk of hepatotoxicity and ALI between overweight or obese patients (body mass index [BMI] ≥ 25) and normal BMI patients (BMI ≤ 24.9) presenting with acute acetaminophen overdose at Siriraj Hospital during January 2004 to June 2012. All patients were treated with intravenous N‐acetylcysteine. Psi parameters were calculated. High psi was defined as psi of ≥5.0 mM‐hour. Data were analyzed using multinomial logistic regressions, odds ratio (OR), stratified OR, and 95% confidence interval (CI).Results
There were 197 patients who fulfilled the criteria for analysis, 35 (17.8%) were obese, 24 (12.2%) were overweight, and 138 (70%) were normal BMI cases. Hepatotoxicity and ALI developed in 25 (12.7%) and 40 (20.3%) cases, respectively. Multinomial logistic regression revealed that the overweight‐obesity status and log10(psi value) were significant risk factors of ALI, with OR (95% CI) of 2.68 (1.21‐5.95) and 1.74 (1.27‐2.38), respectively, while only log10(psi) was a significant risk factor of hepatotoxicity with OR (95% CI) 378.51 (39.49‐3627.99). From stratification, overweight‐obesity had significant odds ratios for ALI in strata with low acetaminophen concentration, early initiation of N‐acetylcysteine and low psi.Conclusion
We conclude that being overweight or obese is an independent risk factor of ALI in acute acetaminophen overdoses. 相似文献999.
Victoria Landsman Mark Fillery Howard Vernon 《Journal of biopharmaceutical statistics》2018,28(5):857-869
Blinding is a critical component in randomized clinical trials along with treatment effect estimation and comparisons between the treatments. Various methods have been proposed for the statistical analyses of blinding-related data, but there is little guidance for determining the sample size for this type of data, especially if blinding assessment is done in pilot studies. In this paper, we try to fill this gap and provide simple methods to address sample size calculations for a “new” study with different research questions and scenarios. The proposed methods are framed in terms of estimation/precision or statistical testing to allow investigators to choose the best suited method for their goals. We illustrate the methods using worked examples with real data. 相似文献
1000.
Lisa Ying Fuyu Song Shein-Chung Chow Xiaodong Li 《Journal of biopharmaceutical statistics》2018,28(5):840-856
In recent years, multi-regional clinical trials (MRCT) that conduct clinical trials simultaneously in Asian Pacific region, Europe, and the United States have become very popular for global pharmaceutical development. The main purpose of multi-regional clinical trials is to shorten the time for pharmaceutical development and regulatory submission, and approval around the world. In practice, however, clinical results observed from some regions (sub-population) may not be consistent with the results from other regions and/or all regions combined (entire population). The inconsistency observed may be due to ethnic differences in different regions, differences in medical practice, time points of assessment, or by random chance due to small sample size for the region. Some regional regulatory agencies require consistency evaluation between local country results and overall results. However, the challenge is there is no detailed guidance on the definition of ‘consistency’ and methodology to evaluate it. Therefore, the questions are: how to evaluate consistency and what statistical methods are appropriate to be used for consistency evaluation? In this article, several statistical tests for consistency (similarity) between clinical results observed from a specific sub-population and the entire population are proposed. These methods are compared through extensive simulation. As most published articles discussed consistency evaluation for superiority situations, we have discussed consistency evaluation for non-inferiority situation in this article through a simulated example concerning consistency in some countries. Recommendations of the statistical methods to be used for consistency evaluation are given. Other aspects that should be considered for consistency evaluation are also provided. 相似文献