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1.

Background

Total knee arthroplasty is a treatment option for debilitating arthritis. In the postoperative period, patients experience moderate to severe pain affecting the rehabilitation, hospital stay, and patient satisfaction. This study aims at utilizing current best evidence to determine whether adductor canal block (ACB) or periarticular injection (PAI) is a better modality for managing short-term postoperative pain and opioid consumption.

Methods

Embase, MEDLINE, HealthStar, Emcare, and PubMed were searched for randomized controlled trials from 1946 to August 2018, for literature addressing the comparison of ACB and PAI for pain management in the setting of total knee arthroplasty. A systematic review and meta-analysis were performed.

Results

Six studies were included in our meta-analysis. When examining the combined visual analog scale (VAS) pain values for each group, analysis demonstrated greater reduction in scores for the PAI group, and the difference was statistically significant (P = .001). When comparing the VAS scores of subgroups analyzed at specific periods in time, there was a trend toward lower VAS scores in subgroups analyzed at 24 hours and 48 hours postoperatively (at rest and at movement) in the PAI group. Overall opioid consumption was lower in the PAI group, with demonstrated statistical significance (P = .03). When comparing the postoperative subgroups, there was a trend toward decreased opioid use in the PAI group, with 13.25% less opioid use at 48 hours and 9.5% less opioid use at 24 hours.

Conclusion

PAI could significantly improve postoperative pain and opioid consumption when compared with ACB. Additional, high-quality studies are required to further address this topic.  相似文献   
2.
A case of insulinoma is reported in a patient in whom selective arterial calcium injection (SACI) tests were performed both to confirm tumor localization before surgery and to confirm complete tumor removal during surgery. An 18-year-old woman with hypoglycemic episodes was diagnosed with an insulinoma in the pancreatic body demonstrated by celiac arteriography. In a preoperative SACI test, calcium was injected into the splenic artery (SpA), gastroduodenal artery (GDA), and superior mesenteric artery (SMA). Serum immunoreactive insulin (IRI) and proinsulin levels were measured in hepatic venous samples. IRI was markedly increased after the injection of calcium into the GDA and SMA, while there was no response in IRI levels when calcium was injected into the SpA. Therefore, no occult insulinoma was revealed in the distal area fed by the SpA, although the presence of insulinoma was uncertain in the proximal pancreas. In the intraoperative SACI test, calcium was injected into the celiac artery. Insulin (determined by enzyme immunoassay) and proinsulin levels were measured in portal venous samples before and after resection of the tumor. After resection, these levels decreased in response to the calcium stimuli, confirming complete removal of the insulinoma. The SACI test was helpful to localize the insulinoma and was useful to confirm the complete removal of the tumor.  相似文献   
3.
An automated measurement of total and free hydroxyproline in serum or urine is presented that uses flow injection analysis. After exclusion of nonspecific substances, hydroxyproline was oxidized by chloramine- T and L-cysteine with Ehrlich's reagent. The linearity obtained was from 3.8μmole/ L to 1.22 mmole/L with good precision (CV <3%). Comparison of the proposed method with HPLC yielded r = 0.939 as the correlation coefficient. Reference intervals of free and total hydroxyproline are 1.4–9.7 μmole/L, 3.8–27.2 μmole/L for serum, and 10.0–72.5 μmole/L, 25.2–303.6 μmole/L for urine, respectively. Serum free and total hydroxyproline levels in renal osteodystrophy patients on maintenance hemodialysis (N = 71) were significantly higher than in controls (P<0.0001). This method is superior to the use of HPLC with regard to stability of the color reaction. The measurement of serum free and total hydroxyproline is a useful marker for therapeutic observation of renal osteodystrophy patients. © 1994 Wiley-Liss, Inc.  相似文献   
4.
水蛭注射液对大白鼠血小板粘附和血小板聚集功能的影响   总被引:6,自引:1,他引:5  
目的 探讨水蛭注射液对大白鼠血小板粘附性和聚集性的影响。方法 采用大白鼠 2 4只 ,随机分成两组 ,实验组给药 ,对照组以实验组同样的方法和剂量给予生理盐水 ,5d后由颈总动脉取血 ,做血小板粘附性和聚集性试验。结果 水蛭注射液对大鼠血小板粘附性和聚集性具有显著的抑制作用 ,实验组与对照组抑制率有显著的统计学意义 (P <0 0 0 1)。结论 水蛭注射液能够抑制大白鼠血小板的粘附和聚集。  相似文献   
5.
6.
小鼠卵细胞质内显微注入单精子受精的实验研究   总被引:8,自引:0,他引:8  
杨益寿  熊素芳  龙文  李鸣  夏明珠  汪昌介 《解剖学报》1998,29(4):441-445,I011
为了探讨提高小鼠卵细胞质内单精子注入受精率的方法,选取鼠龄12-14周的健康昆明白小鼠作为精子和卵子的供体,受用ICSI技术,以受精后二细胞卵裂的形成率为指标,了解不同采卵时间,不同微注射针参数及不同培养液对细胞质单精子注入的影响。结果表明,hCG注射后18-19h采卵,用针尖内径为4-5μm,斜面角度为35-40度的微注射针进行ICSI操作受精后卵子置CZB中培养可获得较多的2细胞胚,卵裂率明显  相似文献   
7.
中药蝶脉灵注射液在心肺复苏中脑保护作用的实验研究   总被引:1,自引:0,他引:1  
目的 探讨中药蝶脉灵注射在心脏骤停时对脑复苏的作用。方法 用电刺激导致室颤制备家兔心脏骤停模型,在光镜和电镜下观察大剂量肾上腺素治疗时,蝶脉灵注射液对脑组织的影响。结果 蝶脉灵注射液对脑细胞有明显的保护作用。结论 蝶脉灵注射液能明显改善心脏骤停时脑缺血性损害,因而有利于脑复苏。  相似文献   
8.
Combined direct injection venography (DIV) and equilibrium angiography (EA) were performed in 13 patients, by injecting in vitro labeled 99mTc autologous RBC, via pedal veins, and imaging the first pass and the equilibrium phase. This paired comparative study of DIV with EA shows that DIV has advantages over EA because it provides selective information on the deep venous system from the calves to the inferior vena cava. DIV provides information on the flow dynamics and the high contrast first pass images provide better definition of non filling venous segments as well as visualization of collaterals. When using 99mTc-MAA, lung perfusion can also be imaged. DIV is recommended as the procedure of choice for the diagnosis of DVT and EA should be employed only when pedal vein injection is not possible.  相似文献   
9.
In the present study we investigated the relevance of spermimmobilization prior to intracytoplasmic sperm injection (ICSI)in the fertilization process. Using supravital staining of thespermatozoa with eosin and studying sperm decondensation with2 mM dithiothreitol (DTT) in conditions imitating sperm handlingduring ICSI, we demonstrated that immobilization of the spermatozoonby squeezing its tail between the glass pipette and the bottomof the dish damages the sperm plasma membrane. Polyvinylpyrrolidone(PVP), which is usually present in the drop with the spermatozoonto facilitate its handling, was found to impede the access ofboth eosin and DTT to the sperm nucleus. We conclude that (i)sperm immobilization prior to ICSI damages the sperm plasmamembrane, that (ii) this damage is sufficient for thiol-reducingagents to gain access to the sperm nucleus, and finally that(iii) PVP possibly interferes with sperm nucleus decondensation.  相似文献   
10.
The possibility of giving thrombin by intraperitoneal injection as a test of the function of the blood clotting system (the in vivo thrombin test) was demonstrated in experiments on noninbred albino rats.Department of Biochemistry, Tyumen' Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR N. A. Fedorov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 86, No. 12, pp. 675–677, December, 1978.  相似文献   
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