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41.
《Expert review of cardiovascular therapy》2013,11(3):271-281
Angiotensin-converting enzyme inhibitors (ACEIs) are the first-line therapy for the treatment of hypertension. However, not all ACEIs are equal. Delapril is a nonsulfhydryl ACEI with unique properties. Delapril has a high lipophilicity and weak bradykinin potentiating action. As a result, delapril has a more potent inhibition capacity of vascular wall angiotensin-converting enzyme activity and a lower incidence of cough than enalapril or captopril. With regard to efficacy, delapril has a long-lasting antihypertensive effect with a trough/peak ratio that is in the upper range of different ACEIs and a positively high smoothness index. Thus, delapril effectively and smoothly reduces blood pressure over 24 h. Moreover, the benefits of delapril are not limited to hypertensive patients, but also in those with microalbuminuria, left ventricular hypertrophy, myocardial infarction or heart failure; delapril appears to be effective and well tolerated. 相似文献
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Cristina Lalmolda Hector Prados Georgina Mateu Mariona Noray Xavier Pomares Manel Luján 《Archivos de bronconeumologia》2019,55(5):246-251
IntroductionThe aim of this study was to assess several air-pressure settings for MI–E to determine their effect on peak cough flow (PCF), and to compare the best pressures with those are more common used in the literature (±40 cmH2O) in patients with neuromuscular disorders (NMD).MethodsAdults with NMD in whom MI–E was indicated were recruited. Assisted PCF was measured by an external pneumotachograph. The protocol included 9 PCF measures per patient: 1 baseline (non-assisted), 4 with increasing inspiratory pressures without negative pressure (10, 20, 30 and 40 cmH2O or maximum tolerated), and then 4 adding expiratory pressures (?10, ?20, ?30 and ?40 cmH2O or maximum tolerated) with maximum inspiratory pressure previously achieved.ResultsTwenty one patients were included, 61% with amyotrophic lateral sclerosis (ALS). Mean PCFs with recommended pressures (±40 cmH2O) were lower than the scored in the individualized steps of the titration protocol (197.7 ± 67 l/min vs 214.2 ± 60 l/min, p < 0.05). Regarding subgroups, mean PCFmax values in ALS patients with bulbar symptoms were significantly higher than those achieved with recommended pressures (163.6 ± 80 vs 189 ± 66 l/min, p < 0.05).ConclusionThe PCFmax obtained with the protocol did not always match the recommended settings. It may be advisable to perform MI–E titration assessed by non-invasive PCF monitoring in patients with NMD, especially in ALS with bulbar involvement to improve the therapy detecting airway collapse induced by high pressures. 相似文献
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目的比较不同细胞类型的咳嗽变异型哮喘患者的临床特征差别。方法选择2014年12月至2017年3月在本院咳嗽门诊就诊的慢性咳嗽患者,遵循中国慢性咳嗽指南(2015版)诊治流程,在询问病史、临床症状和获得体征的基础上,进行血常规、胸片、肺通气功能+气道反应性、诱导痰细胞学分类等相关检查,依据检查结果和治疗反应,确定病因诊断,筛选出咳嗽变异型哮喘,依据诱导痰细胞学分类计数检查结果进行分组,比较不同细胞类型的成人咳嗽变异型哮喘患者的临床特征差别。结果共收集诊断明确且病因单一的成人咳嗽变异型哮喘患者114例,占所有慢性咳嗽患者的32.95%,其中男性56例(48.7%),女性58例(51.3%)。按细胞类型分类:嗜酸性粒细胞增多型23例(20.2%),中性粒细胞增多型53例(46.5%),寡细胞型14例(12.3%),混合细胞型24例(21.1%);分组比较显示:中性粒细胞增多型年龄最长(P=0.042),而嗜酸性粒细胞增高型患者的FeNo值水平最高(P<0.001);混合细胞型患者咳嗽时间最长(P=0.012),与寡细胞型相比较,混合细胞型患者有明确体育锻炼史(P=0.007)。结论不同细胞类型的成人咳嗽变异型哮喘患者的临床特征存在较明显的差别,可以用于指导临床疾病管理。 相似文献
45.
《中国现代医生》2017,55(25):83-86
目的评价酮替芬治疗感冒后咳嗽临床疗效与安全性。方法检索主要中英文数据库从建库至2015年12月20日酮替芬治疗感冒后咳嗽随机对照试验研究,筛选合格研究。Cochrane评价员手册、Jadad评分法分别进行偏倚风险评价及质量评价。应用Rev Man5.3软件进行Meta分析。结果符合纳入标准的文献共3篇。Meta分析结果显示,酮替芬治疗感冒后咳嗽治疗组与对照组相比,临床疗效总有效率比值比(odds ratio,OR)为9.44,95%可信区间(confidence interval,CI)(2.81,31.70),差异有统计学意义(P=0.0003);不良反应OR为1.94,95%CI(0.40,9.54),差异无统计学意义(P=0.41)。结论酮替芬治疗感冒后咳嗽有显著临床疗效,但仍需更多高质量、大样本的临床研究来进一步验证。 相似文献
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董玉龙 《临床合理用药杂志》2012,5(19):37-38
目的探讨咳嗽变异性哮喘(CVA)临床特点和误诊原因,提高其诊断水平。方法对65例CVA患者的临床资料进行回顾性分析。结果 65例患者全部误诊,其中误诊为急性上呼吸道感染25例(38.5%),慢性支气管炎18例(27.7%),急性支气管炎13例(20.0%),慢性咽炎8例(12.3%),过敏性鼻炎1例(1.5%)。治疗1周后,咳嗽基本消失21例(32.3%),明显缓解31例(47.7%),部分缓解13例(20.0%)。结论医师对本病认识不足、基层医院缺少必要的辅助检查是导致误诊的主要原因。 相似文献
49.
《The Brazilian journal of infectious diseases》2014,18(2):177-180
In many parts of the world, numerous outbreaks of pertussis have been described despite high vaccination coverage. In this article we report the epidemiological characteristics of pertussis in Brazil using a Surveillance Worksheet. Secondary data of pertussis case investigations reported from January 1999 to December 2008 recorded in the Information System for Notifiable Diseases (SINAN) and the Central Laboratory for Public Health (LACEN-MS) were utilized. The total of 561 suspected cases were reported and 238 (42.4%) of these were confirmed, mainly in children under six months (61.8%) and with incomplete immunization (56.3%). Two outbreaks were detected. Mortality rate ranged from 2.56% to 11.11%. The occurrence of outbreaks and the poor performance of cultures for confirming diagnosis are problems which need to be addressed. High vaccination coverage is certainly a good strategy to reduce the number of cases and to reduce the impact of the disease in children younger than six months. 相似文献
50.
Ian M. Paul Kate M. Reynolds Ralph E. Kauffman William Banner G. Randall Bond Robert B. Palmer 《Clinical toxicology (Philadelphia, Pa.)》2017,55(1):25-32
Study objective: Dextromethorphan is the most common over-the-counter (OTC) antitussive medication. We sought to characterize adverse events associated with dextromethorphan in children <12 years old from a surveillance program of OTC cough/cold medication exposures.Methods: This is a retrospective case series of oral exposures to dextromethorphan with ≥1 adverse event from multiple U.S. sources (National Poison Data System, FDA Adverse Event Reporting System, manufacturer safety reports, news/media, medical literature) reported between 2008 and 2014. An expert panel determined the relationship between exposure and adverse events, estimated dose ingested, intent of exposure, and identified contributing factors to exposure.Results: 1716 cases contained ≥1 adverse event deemed at least potentially related to dextromethorphan; 1417 were single product exposures. 773/1417 (55%) involved only one single-ingredient dextromethorphan product (dextromethorphan-only). Among dextromethorphan-only cases, 3% followed ingestion of a therapeutic dose; 78% followed an overdose. 69% involved unsupervised self-administration and 60% occurred in children <4 years old. No deaths or pathologic dysrhythmias occurred. Central nervous system [e.g., ataxia (N?=?420)] and autonomic symptoms [e.g., tachycardia (N?=?224)] were the most common adverse events. Flushing and/or urticarial rash occurred in 18.1% of patients. Dystonia occurred in 5.4%.Conclusions: No fatalities were identified in this multifaceted surveillance program following a dextromethorphan-only ingestion. Adverse events were predominantly associated with overdose, most commonly affecting the central nervous and autonomic systems. 相似文献