全文获取类型
收费全文 | 450篇 |
免费 | 19篇 |
国内免费 | 3篇 |
专业分类
耳鼻咽喉 | 1篇 |
儿科学 | 39篇 |
基础医学 | 65篇 |
临床医学 | 25篇 |
内科学 | 158篇 |
皮肤病学 | 1篇 |
神经病学 | 11篇 |
特种医学 | 9篇 |
外科学 | 40篇 |
综合类 | 27篇 |
预防医学 | 23篇 |
药学 | 58篇 |
1篇 | |
中国医学 | 12篇 |
肿瘤学 | 2篇 |
出版年
2024年 | 4篇 |
2023年 | 8篇 |
2022年 | 8篇 |
2021年 | 22篇 |
2020年 | 23篇 |
2019年 | 46篇 |
2018年 | 64篇 |
2017年 | 33篇 |
2016年 | 21篇 |
2015年 | 13篇 |
2014年 | 54篇 |
2013年 | 33篇 |
2012年 | 14篇 |
2011年 | 27篇 |
2010年 | 9篇 |
2009年 | 6篇 |
2008年 | 17篇 |
2007年 | 11篇 |
2006年 | 13篇 |
2005年 | 7篇 |
2004年 | 6篇 |
2003年 | 1篇 |
1999年 | 1篇 |
1997年 | 2篇 |
1995年 | 1篇 |
1992年 | 1篇 |
1991年 | 1篇 |
1990年 | 1篇 |
1989年 | 1篇 |
1988年 | 1篇 |
1986年 | 1篇 |
1985年 | 2篇 |
1984年 | 2篇 |
1983年 | 7篇 |
1982年 | 6篇 |
1981年 | 2篇 |
1979年 | 1篇 |
1978年 | 1篇 |
1974年 | 1篇 |
排序方式: 共有472条查询结果,搜索用时 15 毫秒
41.
目的:观察定喘汤加减辅助治疗老年急性发作期哮喘的临床疗效。方法:90例老年急性发作期哮喘患者按随机数字表法平均分为对照组和观察组。对照组45例予以常规疗法治疗,观察组45例在对照组治疗基础上予以定喘汤加减治疗。比较两组临床症状,肺功能变化,炎症介质,血清Ig E、NO及超氧化物歧化酶(superoxide dismutase,SOD)水平,临床疗效及并发症状况。结果:对照组有效率75.56%低于观察组有效率91.11%,差异具有统计学意义(P0.05)。与对照组比较,观察组治疗后喘憋、咳嗽、肺部湿啰音及哮鸣音缓解时间缩短,治疗后第1秒用力呼气量(forced expiratory volume in 1 second,FEV1)、用力肺活量(forced vital capacity,FVC)、FEV1%和FEV1/FVC显著升高,差异均有具有统计学意义(P0.05);治疗后血清白细胞介素-4(interleukin 4,IL-4)、IL-8、IL-9水平降低,IL-10水平升高,差异均有具有统计学意义(P0.05);治疗后血清Ig E及NO水平降低,SOD水平升高,差异均有具有统计学意义(P0.05)。结论:定喘汤加减辅助治疗老年急性发作期哮喘临床疗效显著,同时能改善肺功能及缓解炎症反应。 相似文献
42.
Objective
To assess pulmonary abnormalities detected by high-resolution computed tomography (HRCT) in young children with cystic fibrosis (CF) and mild to moderate lung disease.Study design
High-resolution computed tomography was performed in 60 children, 6 to 10 years old, with mild to moderate lung disease (forced expiratory volume in 1 minute [FEV1], 52-137; mean, 102; SD, 15% predicted). HRCTs were scored by using a system that evaluates each lobe for severity and extent of CF lung disease. Findings of CF lung disease were tabulated in all subjects and in a subgroup with normal pulmonary function tests. HRCT scores were correlated with FEV1, forced vital capacity (FVC), and forced expiratory flow between 25% and 75% of expired vital capacity (FEF25-75) in 57 patients.Results
Bronchiectasis was present in 35% of subjects, mucous plugging in 15%, and air trapping in 63%. No abnormality was detected in 25%. In 37 subjects with FEV1, FVC, and FEF25-75 >85% predicted, bronchiectasis was present in 30%. In 17% of these subjects, bronchiectasis was seen in ≥4 lobes. Correlations between HRCT scores and FEV1 were significant and showed fair to moderate correlation (r = 0.36-0.46).Conclusions
High-resolution computed tomography demonstrated a broad range of pulmonary abnormalities in young patients with CF with mild to moderate lung disease. In this study, abnormalities, including bronchiectasis, were common in young children with CF and normal pulmonary function tests. 相似文献43.
10名慢性阻塞性肺疾病(COPD)患者口服两个不同剂量的茶碱,分别达到两个稳态,测定谷浓度值,同时测定最大肺活量(FVC),一秒钟用力呼气量(FEV1)。提高茶碱稳态浓度前后的FVC值无显著差异,揭示在常规剂量下茶碱对COPD病人通气功能的改善是有限的。引用公式:FVC=Css×m+i,预测病人FVC值与实测值差异无显著性(P>0.05)。不同稳态浓度的FVC值可用此公式预测。 相似文献
44.
Denis Libeert Dimitri Declercq Simeon Wanyama Muriel Thomas Sabine Van daele Frans De Baets Stephanie Van Biervliet 《Journal of cystic fibrosis》2018,17(2):264-270
Background
Long-term effect of enteral tube feeding (ETF) in cystic fibrosis (CF) remains equivocal.Methods
A Belgian CF registry based, retrospective, longitudinal study, evaluated the pre- and post- ETF (n?=?113) clinical evolution and compared each patient with 2 age, gender, pancreatic status and genotype class-matched controls.Results
At baseline ETF had a worse BMI z-score (p?<?0.0001) and FEV1% (p?<?0.0001) compared to controls. Patients eventually receiving ETF, had already a significant worse nutritional status and pulmonary function at first entry in the registry. Both parameters displayed a significant decline before ETF-introduction. ETF had more hospitalization and intravenous antibiotic (IVAB) treatment days (p?<?0.0001). After ETF introduction hospitalizations and IVAB decreased significantly. After ETF-introduction BMI z-score recuperated towards the original curve before the decline, but remained below the controls. Starting ETF had no effect on rate of height gain in children. The pre-index FEV1 decline (?1.52%/year (p?=?0.002)) stabilized to +0.39%/year afterwards. Controls displayed decline of ?0.48%/year (p?<?0.0001).Conclusion
ETF introduction improved BMI z-score and stabilized FEV1, associated with less hospitalizations and IVAB treatments. Higher mortality and transplantation in the ETF cases, leading to drop-outs, made determination of the effect size difficult. 相似文献45.
46.
47.
Kentaro Wakamatsu Nobuhiko Nagata Hiroyuki Kumazoe Keishi Oda Hiroshi Ishimoto Michihiro Yoshimi Shohei Takata Minako Hamada Yoshifusa Koreeda Kouji Takakura Miwa Ishizu Makiko Hara Shinji Ise Miiru Izumi Takashi Akasaki Sanae Maki Masaharu Kawabata Hiroshi Mukae Masayuki Kawasaki 《Respiratory investigation》2017,55(1):16-23
Background
The prognostic significance of serial measurements of serum KL-6 levels in patients with idiopathic pulmonary fibrosis (IPF) is unclear; hence, it was assessed in this study.Methods
Medical records of 66 patients with IPF, who were not treated with pirfenidone prior to enrollment, were retrospectively reviewed for information on clinical progress, forced vital capacity (FVC), survival, and serum KL-6 levels. We assessed initial serum levels of KL-6, serial changes in serum KL-6 levels, yearly decline in FVC (ΔFVC), and the rate of decline (%ΔFVC).Results
Patients with increased serum KL-6 levels during follow-up had a significantly steeper decline in ΔFVC than those with no KL-6 increase (?201 vs. ?50.7 ml/year; p=0.0001). Patients with both initial serum KL-6 ≥1000 U/ml and serial increases in serum KL-6 had the steepest decline, while those with both initial serum KL-6 <1000 ml and no serial increases in KL-6 had the least decline in ΔFVC and %ΔFVC. Relative to the non-increased KL-6 group, survival in the increased KL-6 group tended to be poorer (p=0.0530). Patients with both initial serum KL-6 values <1000 U/ml and no serial increase in KL-6 had more favorable prognoses than those with serial increases in KL-6 or initial serum KL-6 values ≥1000 U/ml (p<0.0044). Prognosis was significantly poorer in patients with serial KL-6 changes >51.8 U/ml/year than in those with serial KL-6 changes <51.8 U/ml/year (p=0.0009).Conclusion
Thus, serial serum KL-6 measurements can be useful for assessing prognosis in patients with IPF. 相似文献48.
Atsushi Miyamoto Atsuko Kurosaki Shuhei Moriguchi Yui Takahashi Kazumasa Ogawa Kyoko Murase Shigeo Hanada Hironori Uruga Hisashi Takaya Nasa Morokawa Takeshi Fujii Junichi Hoshino Kazuma Kishi 《Respiratory investigation》2019,57(2):140-149
Background
This study aimed to determine the radiologic predictors and clarify the clinical features related to survival in patients with combined pulmonary fibrosis and emphysema (CPFE) and lung cancer.Methods
We retrospectively reviewed the medical chart data and high-resolution computed tomography (HRCT) findings for 81 consecutive patients with CPFE and 92 primary lung cancers (70 men, 11 women; mean age, 70.9 years). We selected 8 axial HRCT images per patient, and visually determined the normal lung, modified Goddard, and fibrosis scores. Multivariate analysis was performed using the Cox proportional hazards regression model.Results
The major clinical features were a high smoking index of 54.8 pack-years and idiopathic pulmonary fibrosis (n = 44). The major lung cancer profile was a peripherally located squamous cell carcinoma (n = 40) or adenocarcinoma (n = 31) adjacent to emphysema in the upper/middle lobe (n = 27) or fibrosis in the lower lobe (n = 26). The median total normal lung, modified Goddard, and fibrosis scores were 10, 8, and 8, respectively. TNM Classification of malignant tumors (TNM) stage I, II, III, and IV was noted in 37, 7, 26, and 22 patients, respectively. Acute exacerbation occurred in 20 patients. Multivariate analysis showed that a higher normal lung score and TNM stage were independent radiologic and clinical predictors of poor survival at the time of diagnosis of lung cancer.Conclusions
A markedly reduced area of normal lung on HRCT was a relevant radiologic predictor of survival. 相似文献49.
目的探讨支气管哮喘-慢性阻塞性肺疾病重叠综合征(ACO)患者血清中纤维蛋白原(Fbg)、呼出气一氧化氮(FeNO)、免疫球蛋白E(IgE)的变化水平与肺功能的相关性。 方法选择2016年1月至2018年5月期间在我院接受治疗的支气管哮喘急性发作期患者56例,慢阻肺急性加重期患者51例,ACO急性加重期患者45例,同时选取50例健康者作为对照。检测受试对象的外周血嗜酸性粒细胞数量、Fbg和IgE水平、FeNO以及肺功能指标。采用Pearson相关性分析Fbg、FeNO、IgE与1 s用力呼气容积(FEV1),FEV1改善值,用力肺活量(FVC)的关系。绘制受试者工作特征(ROC)曲线,并计算Fbg、FeNO、IgE指标曲线下面积(AUC)。 结果①三组患者嗜酸性粒细胞数量和血浆IgE水平明显高于对照组(P<0.05);但是三组患者之间比较,未见统计学差异(P>0.05)。ACO患者血清Fbg水平高于哮喘组患者(P<0.05),FeNO检测值高于慢阻肺患者(P<0.05);②ACO患者FEV1、FEV1改善值和FVC值明显高于对照组和慢阻肺组受试者,但是FEV1值高于哮喘组患者,而FEV1改善值和FVC值低于哮喘组患者(P<0.05);③ACO患者血浆Fbg水平与FEV1、FEV1改善值和FVC值均呈负相关性(P<0.05),而FeNO值仅与FEV1值呈负相关性(P<0.05)。而血浆IgE水平与FEV1改善值呈正负关性(P<0.05);④经ROC曲线分析,Fbg、FeNO、IgE联合检测ROC曲线的AUC为0.892(95%CI:0.773-0.948),敏感性和特异性分别为89%和78%。 结论Fbg、FeNO和IgE与ACO患者肺功能指标密切相关,有助于临床鉴别ACO、支气管哮喘以及慢性阻塞性肺疾病。 相似文献
50.
中西医结合治疗支气管哮喘的临床观察 总被引:7,自引:0,他引:7
为了探讨支气管哮喘的治疗方法,将本病患者87例随机分为中西医结合治疗组46例和西药对照组41例,治疗组用中西医结合方法治疗,对照组单纯用西医方法治疗;观察两组症状、体征治疗前后的变化.治疗组总有效率86.96%,对照组总有效率73.81%,两组疗效有显著性差异(P<0.05);肺功能改善治疗组明显优于对照组.应用中西医结合方法治疗支气管哮喘的疗效明显优于单用西医治疗. 相似文献