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81.
目的:应用彩色多普勒超声心动图指导经皮二尖瓣球囊成形术(PBMV)治疗风湿性二尖瓣狭窄的价值、方法:运用彩超对行PBMV的患进行术前术后检查,观察二尖瓣钙化程度及部位、开口形状、瓣口面积、二尖瓣返流(MR)程度、瓣下病变、左房左室大小、左房有无血栓.结果:91例PBMV术后患中,术后MR72例,其中MR新出现19例,MR加重8例、与术前对比,术后二尖瓣开放幅度、二尖瓣口面积、二尖瓣跨瓣压、二尖瓣压差半降时间较术前有明显改善趋势,左房内径、肺动脉内径较术前有缩小趋势.同时,术后左房压、右室压及肺动脉压也有下降趋势。结论:彩超能明确PBMV治疗二尖瓣狭窄的效果。影响:PBMV效果的因素较多,但二尖瓣钙化的程度、部位和瓣膜形态较为重要。 相似文献
82.
C Minneci G Casolo G Popoff A Sulla C E Comin E Pedemonti 《European journal of echocardiography》2004,5(1):72-75
We report a patient with a mass originating from the anterior mitral valve leaflet causing severe left ventricular outflow tract obstruction. Noninvasive imaging provided the best diagnostic tools for diagnosis. Histological findings showed a very rare giant blood cyst of the mitral valve. 相似文献
83.
PETER T. BUSER M.D. MICHEL ZUBER M.D. PETER RICKENBACHER M.D. PAUL ERNE M.D. HANS-RUDOLF JENZER M.D. DIETER BURCKHARDT M.D. 《Echocardiography (Mount Kisco, N.Y.)》1997,14(6):597-605
To define the prevalence of cardioembolic sources found by transesophageal echocardiography (TEE) in different age groups of patients with and without cryptogenic systemic embolism, TEE risk factors for cardiogenic embolism were identified from 341 consecutive patients referred for TEE. One hundred and thirty-five had cryptogenic cerebral or systemic peripheral embolic events (CEE) and 206 other indications for TEE (CTR). Cardioembolic sources were found in 40% of CEE and in 29% of CTR (P < 0.02). Specifically, left atrial (LA) thrombi (P < 0.0001), atrial septal aneurysm with right-to-left shunt (P < 0.002), and atherosclerotic aortic plaques (P < 0.02) were more frequent. The prevalence of potential cardioembolic sources was significantly higher in patients ≥ 70-years old than in younger patients (P < 0.03), specifically LA thrombi (P < 0.004) and atherosclerotic aortic plaques (P < 0.0001). In patients ≥ 70-years old, potential cardioembolic sources were found in 63% and in 40% in CEE and CTR (P = 0.073), respectively. However, LA thrombi were more frequent in CEE (P < 0.003). Thus, potential cardioembolic sources observed by TEE are found more frequently in patients ≥ 70-years old than in younger patients. LA thrombi were more frequent in CEE than in CTR patients ≥ 70-years old. In patients ≥ 70-years old with CEE who are eligible for an anticoagulant regimen, a search for potential cardioembolic sources by TEE should be considered. 相似文献
84.
TAKASHI OKI M.D. NOBUO FUKUDA M.D. TOMOTSUGU TABATA M.D. ARATA IUCHI M.D. MASATO TANIMOTO M.D. KAZUYO MANABE M.D. YOSHIMI KAGEJI M.D. MIWA SASAKI M.D. SUSUMU ITO M.D. 《Echocardiography (Mount Kisco, N.Y.)》1995,12(4):351-358
Transesophageal echocardiography was conducted to determine the systolic pattern of the anterior mitral leaflet in patients with flat chest, and to differentiate it from that associated with mitral valve prolapse. The fronto-sagittal index (an index of chest flattening) was determined in 50 subjects using chest radiographs, and was used to classify them into a flat chest group (index < 0.38, n = 28) and a normal chest group (index ≥ 0.38, n = 22). We then used transesophageal echocardiography to examine the anterior leaflet in these subjects. A significant positive correlation was observed between the fronto-sagittal index and the short-to long-axis diameter ratio of the left ventricle in all patients. These parameters, and the left atrial dimension were lower in the flat than the normal chest group. The clear zone area of the anterior leaflet during mid-to late-systole was significantly larger in the flat chest group. However, no intergroup differences existed in the rough zone area of the anterior leaflet or in the middle scallop area of the posterior leaflet. Mitral regurgitation was observed in 20 and 12 subjects in the flat and normal chest groups, respectively. The maximum mitral regurgitant area did not differ between the two groups. The clear zone area of the anterior leaflet increased significantly following inhalation of amyl nitrite in 22 subjects of both groups, but the other areas did not increase. The mitral regurgitant area decreased or disappeared after amyl nitrite at a similar rate in each group. Thus, the decrease in the antero-posterior dimension of the thorax in subjects with flat chest affects the systolic pattern of the clear zone of the anterior leaflet more than that of the rough zone of the anterior leaflet or the posterior leaflet. This systolic pattern in such patients differs from that associated with mitral valve prolapse. 相似文献
85.
目的:观察地尔硫Zhuo注射液静脉滴注治疗冠心病心绞痛的疗效。方法:86例心绞痛患者分为两组,其中治疗组46例,用地尔硫Zhuo50mg加入5%葡萄糖液250ml中静滴,1次/d,连续10d;对照组40例用丹参液16ml加入5%葡萄糖液250ml中静滴,1次/d,连续10d。结果:治疗组症状控制总有效率98%,患者心电图改善率61%,明显高于对照组的37%和28%,地尔硫Zhuo改善心功能效果明显 相似文献
86.
Abstract: The influence of endoscopic examination on the occurrence of arrhythmia was investigated electrocardiographically in 30 patients with cardiovascular disease who underwent transesophageal echocardiography (TEE) (group A) and 38 patients with digestive tract disease who underwent upper gastrointestinal endoscopy (UGIE) (group B). The mode and frequency of arrhythmia during the examination were compared between the two groups. (1) Arrhythmia was more frequently observed in group A (22 of 30, 73.3%) than in group B (9 of 38, 23.7%) patients (p<0.001). The common arrhythmias in both groups were supraventricular premature beat and ventricular premature beat. Serious arrhythmias, such as 2nd degree atrioventricular block and ventricular fibrillation were detected only in group A patients. (2) The region of the esophagus where the tip of the probe or scope was located was classified into three segments: upper (0–15 cm), middle (15–35 cm) and lower (35 cm<). Arrhythmias tended to be frequent when the tip of the probe or scope was located in the middle segment of the esophagus. These data indicate that arrhythmias observed during TEE or UGIE are related to the underlying heart disease. Furthermore, the middle segment of the esophagus appears to be particularly susceptible to the provocation of arrhythmia. 相似文献
87.
为了评价多平面经食道超声心动图(TEE)的临床应用价值,对36例临床经胸超声心动图(TTE)检查尚未完全明确诊断的心血管疾病患者进行了TEE检查。结果显示:①26例(72%)患者TEE补充或纠正了TTE诊断;②9例手术患者TEE诊断符合率100%;③对感染性心内膜炎小赘生物的检出、间隔缺损部位、数目、合并畸型、心腔内血栓、大动脉瘤等TEE的诊断价值明显高于TTE。 相似文献
88.
目的分析和评价超声心动图和下肢静脉超声联合血浆D-二聚体对孕产妇肺栓塞(pulmonary thromboembolism, PE)的临床诊断和预测价值。方法回顾性收集2019年5月—2021年5月同济大学附属第一妇婴保健院收治120例临床疑诊PE的孕产妇临床资料,按照肺动脉断层血管造影(computed tomographic pulmonary angiographic, CTPA)的结果分为阴性组和阳性组,比较和评价超声心动图、下肢静脉超声、血浆D-二聚体单独及联合诊断孕产妇PE的临床诊断和预测效能。结果临床特征比较: 两组间年龄、孕次、产次、受孕方式、受孕胎数、终止妊娠方式、是否早产、既往妇产科手术史、既往外科手术史、是否合并高血压、糖尿病、肥胖及BNP等指标比较差异均无统计学意义(均P>0.05)。两组间仅血浆D-二聚体比较差异有统计学意义(t=-3.598,P<0.001)。超声心动图、下肢静脉超声和血浆D-二聚体升高单独及联合诊断孕产妇PE的灵敏度分别为45.00%、53.33%、95.00%和85.00%,特异度分别为83.33%、91.67%、21.67%和81.67%,阳性预测值分别为72.97%、86.49%、54.81%和82.26%,阴性预测值分别为60.24%、66.27%、81.25%和84.48%。与单独诊断相比较,联合诊断显著提高灵敏度(χ2=49.669,P<0.001)、特异度(χ2=88.413,P<0.001)、阳性预测值(χ2=20.629,P<0.001)和阴性预测值(χ2=11.169,P=0.01)。多因素Logistic回归分析提示超声心动图阳性(OR=18.266,P<0.001)、下肢静脉血栓(OR=45.482,P<0.001)及D-二聚体升高(OR=6.595,P=0.019)与孕产妇PE发生显著相关,ROC曲线分析显示单独及联合诊断的曲线下面积(AUC)分别为0.642、0.725、0.583和0.833。结论超声心动图和下肢静脉超声联合血浆D-二聚体对孕产妇PE具有良好的诊断和预测价值,为临床早期预防、诊断和治疗提供可靠依据。 相似文献
89.
Transesophageal echocardiography greatly enhances the examination of patients difficult to image transthoracically. While of low patient risk, a potential for harm from human bites to the echocardiography staff and to the transesophageal probe remains, particularly when dealing with uncooperative patients. This risk potential prompted implementation of additional anti-bite protection in our universal precautions policy beyond use of a standard mouth guard. A mouth gag instrument was modified by placing latex rubber tubing over the instrument blades. This instrument was inserted into the mouth and set in an open position giving the operator safe access for probe and mouth bite guard insertion. This technique improved access to the patient's mouth and visualization of probe insertion without the mouth bite guard. The mouth gag instrument provided an insertion of the transesophageal probe in impaired or otherwise uncooperative patients, which was safer for the patient, laboratory staff, and the probe itself. 相似文献
90.
David J. Murray Robert B. Forbes Judith B. Dillman Larry T. Mahoney David L. Dull 《Journal canadien d'anesthésie》1989,36(3):295-300
In this study, two-dimensional and pulsed Doppler echocardiography were used to measure cardiovascular changes before and
after IV atropine in 31 infants and small children during halothane (n = 15) or isoflurane (n = 16) anaesthesia. Prior to
induction of anaesthesia heart rate (HR), mean blood pressure (MBP), and two0dimensional echocardiographic dimensions of the
left ventricle and pulmonary artery bloodflow velocity were measured by pulsed Doppler echocardiography. Cardiovascular measurements
were repeated while anaesthesia was maintained at 1.5 MAC halothane (n = 15) or isoflurane (n = 16). Atropine 0.02 mg·kg−1 IV was then administered and two minutes later, a third set of cardiovascular data was obtained. Heart rate decreased during
halothane anaesthesia but did not change significantly during isoflurane anaesthesia. Mean blood pressure, cardiac output
(CO) and stroke volume (SV) decreased similarly during 1.5 MAC halothane or isoflurane anaesthesia. Ejection fraction (EF)
decreased and left ventricular end-diastolic volume (LVEDV) increased significantly in bothgroups, but decreases in EF (32
± 5 percentvs18 ± 5 per cent) and increases in LVEDV (18 ± 7 per cent vs7 ± 5 per cent) were significantly greater during
halothane than during isoflurane anaesthesia. Following atropine, HR increased more in the patients maintained with halothane
(31 ± 6 per cent), than during isoflurane anaesthesia (18 ± 5 per cent). Atropine increased CO in both groups of patients,
but SV and EF remained unchanged. When compared with awake values, HR increased similarly and significantly (18 ± 4 per cent)
following atropine in both groups, and CO returned to control levels. Halothane decreased EF and increased LVEDV more than
isoflurane at 1.5 MAC end— expired anaesthetic levels. Atropine did not diminish the myocardial depression produced by halothane
or isoflurane. The increase in CO following atropine during halothane and isoflurane anaesthesia in infants and small children
is the result of increases in HR alone.
Nous avons utilisé un appareil à échocardiographie bi-dimensionnelle couplé à un Doppler pulsé chez des bébés et de jeunes
enfants pour évaluer l’impact hémodynamique de l’halothane (n = 15) et de l’isoflurane (n = 16) et la modification possible
de ces effets par l’atropine. Nous avons mesure la frequence cardiaque (FC), la pression artérielle moyenne (PAM), la dimension
de la cavité ventriculaire gauche (par écho bi-dimensionnelle) et la vélocité du flot sanguin pulmonaire (par Doppler) et
ce, en trois occasions soit avant l’induction, après l’instauration de 1.5 MAC d’halothane ou d’isoflurane et finalement,
deux minutes après l’injection IV de 0.02 mg·kg−1 d’atropine. On ne nota une baisse de la frequence cardiaque qu’avec l’halothane tandis que la PAM, le débit cardiaque (DC)
et le volume d’éjection (VE) diminuaient autant avec l’un ou l’autre anesthésique. La diminution de la fraction d’éjection
(FE) et l’augmentation du volume télédiastolique du ventricule gauche (VTDVG) significatives pour les deux groupes, étaienl
plus marqué avec l’halothane qu’avec l’isoflurane: FE 32 ± 5 pour cent vs18 ±5 pour cent; VTDVG 18 ± 7 pour cent vs 7 ± 5
pour cent. Avec l’atropine, la FC monta plus dans le groupe halothane (31 ± 6 pour cent) que dans le groupe isoflurane (18
± 5 pour cent), le DC augmentant dans les deux groupes, alors que le VE et la FE demeuraient inchangés. Comparée aux mesures
pré-induction, l’atropine amenait une hausse significative de la FC, semblable dans les deux groupes (18 ± 4 pour cent) et
restaurait le DC. Donc, chez les bebes et les jeunes enfants, a 1.5 MAC, l’halothane diminue la FE et augmente le VTDVG plus
que ne le fait l’isoflurane. L’atropine ne modifie pas la depression myocardique et elle ne restaure le DC que par une hausse
de la FC.
Supported by PHS Grant No. 8507300 from the College of Medicine, University of Iowa Hospital, Iowa City, IA. 相似文献
Supported by PHS Grant No. 8507300 from the College of Medicine, University of Iowa Hospital, Iowa City, IA. 相似文献