全文获取类型
收费全文 | 1679篇 |
免费 | 163篇 |
国内免费 | 8篇 |
专业分类
耳鼻咽喉 | 16篇 |
儿科学 | 74篇 |
妇产科学 | 27篇 |
基础医学 | 173篇 |
口腔科学 | 79篇 |
临床医学 | 150篇 |
内科学 | 356篇 |
皮肤病学 | 14篇 |
神经病学 | 130篇 |
特种医学 | 87篇 |
外科学 | 333篇 |
综合类 | 31篇 |
预防医学 | 176篇 |
眼科学 | 13篇 |
药学 | 84篇 |
肿瘤学 | 107篇 |
出版年
2023年 | 11篇 |
2021年 | 37篇 |
2020年 | 23篇 |
2019年 | 39篇 |
2018年 | 35篇 |
2017年 | 16篇 |
2016年 | 26篇 |
2015年 | 30篇 |
2014年 | 46篇 |
2013年 | 67篇 |
2012年 | 73篇 |
2011年 | 74篇 |
2010年 | 41篇 |
2009年 | 39篇 |
2008年 | 89篇 |
2007年 | 74篇 |
2006年 | 57篇 |
2005年 | 61篇 |
2004年 | 60篇 |
2003年 | 55篇 |
2002年 | 47篇 |
2001年 | 46篇 |
2000年 | 50篇 |
1999年 | 42篇 |
1998年 | 26篇 |
1997年 | 14篇 |
1996年 | 14篇 |
1995年 | 15篇 |
1993年 | 29篇 |
1992年 | 30篇 |
1991年 | 34篇 |
1990年 | 31篇 |
1989年 | 29篇 |
1988年 | 36篇 |
1987年 | 39篇 |
1986年 | 37篇 |
1985年 | 33篇 |
1984年 | 26篇 |
1983年 | 27篇 |
1982年 | 19篇 |
1980年 | 12篇 |
1979年 | 16篇 |
1978年 | 19篇 |
1977年 | 12篇 |
1976年 | 11篇 |
1974年 | 17篇 |
1971年 | 11篇 |
1970年 | 15篇 |
1969年 | 16篇 |
1966年 | 18篇 |
排序方式: 共有1850条查询结果,搜索用时 62 毫秒
1.
M. D. Wiles A. El-Nayal G. Elton M. Malaj J. Winterbottom C. Gillies I. K. Moppett K. Bauchmuller 《Anaesthesia》2022,77(2):143-152
Pulse oximetry is used widely to titrate oxygen therapy and for triage in patients who are critically ill. However, there are concerns regarding the accuracy of pulse oximetry in patients with COVID-19 pneumonitis and in patients who have a greater degree of skin pigmentation. We aimed to determine the impact of patient ethnicity on the accuracy of peripheral pulse oximetry in patients who were critically ill with COVID-19 pneumonitis by conducting a retrospective observational study comparing paired measurements of arterial oxygen saturation measured by co-oximetry on arterial blood gas analysis (SaO2) and the corresponding peripheral oxygenation saturation measured by pulse oximetry (SpO2). Bias was calculated as the mean difference between SaO2 and SpO2 measurements and limits of agreement were calculated as bias ±1.96 SD. Data from 194 patients (135 White ethnic origin, 34 Asian ethnic origin, 19 Black ethnic origin and 6 other ethnic origin) were analysed consisting of 6216 paired SaO2 and SpO2 measurements. Bias (limits of agreement) between SaO2 and SpO2 measurements was 0.05% (−2.21–2.30). Patient ethnicity did not alter this to a clinically significant degree: 0.28% (1.79–2.35), −0.33% (−2.47–2.35) and −0.75% (−3.47–1.97) for patients of White, Asian and Black ethnic origin, respectively. In patients with COVID-19 pneumonitis, SpO2 measurements showed a level of agreement with SaO2 values that was in line with previous work, and this was not affected by patient ethnicity. 相似文献
2.
Benjamin R. Griffin J. Pedro Teixeira Sophia Ambruso Michael Bronsert Jay D. Pal Joseph C. Cleveland T. Brett Reece David A. Fullerton Sarah Faubel Muhammad Aftab 《The Journal of thoracic and cardiovascular surgery》2021,161(4):1346-1355.e3
ObjectivesSevere acute kidney injury (AKI) is a known risk factor for infection and mortality. However, whether stage 1 AKI is a risk factor for infection has not been evaluated in adults. We hypothesized that stage 1 AKI following cardiac surgery would independently associate with infection and mortality.MethodsIn this retrospective propensity score–matched study, we evaluated 1620 adult patients who underwent nonemergent cardiac surgery at the University of Colorado Hospital from 2011 to 2017. Patients who developed stage 1 AKI by Kidney Disease Improving Global Outcomes creatinine criteria within 72 hours of surgery were matched to patients who did not develop AKI. The primary outcome was an infection, defined as a new surgical-site infection, positive blood or urine culture, or development of pneumonia. Secondary outcomes included in-hospital mortality, stroke, and intensive care unit (ICU) and hospital length of stay (LOS).ResultsStage 1 AKI occurred in 293 patients (18.3%). Infection occurred in 20.9% of patients with stage 1 AKI compared with 8.1% in the no-AKI group (P < .001). In propensity-score matched analysis, stage 1 AKI independently associated with increased infection (odds ratio [OR]; 2.24, 95% confidence interval [CI], 1.37-3.17), ICU LOS (OR, 2.38; 95% CI, 1.71–3.31), and hospital LOS (OR, 1.30; 95% CI, 1.17-1.45).ConclusionsStage 1 AKI is independently associated with postoperative infection, ICU LOS, and hospital LOS. Treatment strategies focused on prevention, early recognition, and optimal medical management of AKI may decrease significant postoperative morbidity. 相似文献
3.
Dr. Robert L. Geggel David R. Fulton Harvey L. Chernoff Richard Cleveland Thomas J. Hougen 《Pediatric cardiology》1987,8(4):279-283
Summary An infant girl is described who had cor triatriatum and partial anomalous pulmonary venous connection of the left pulmonary
veins to the coronary sinus, the first report of this combination of lesions. The infant also had a Dandy-Walker malformation
and multiple facial and intrathoracic hemangiomas. The cardiac diagnosis was made by two-dimensional echocardiography. Cardiac
catheterization and angiography confirmed the findings and also demonstrated a persistent left superior vena cava draining
to the coronary sinus. The infant underwent successful surgical repair. Partial anomalous pulmonary venous connection and
left superior vena cava not infrequently are associated with cor triatriatum. Although two-dimensional echocardiography is
sensitive for the detection of cor triatriatum, preoperative cardiac catheterization is necessary to identify unequivocally
systemic and pulmonary venous connections. 相似文献
4.
Relationships of plasma viscosity, coagulation and fibrinolysis to coronary risk factors and angina 总被引:1,自引:0,他引:1
G D Lowe D A Wood J T Douglas R A Riemersma C C Macintyre T Takase E G Tuddenham C D Forbes R A Elton M F Oliver 《Thrombosis and haemostasis》1991,65(4):339-343
Plasma viscosity, molecular markers of activated coagulation and fibrinolysis (fibrinopeptides A and B beta 15-42), coagulation factors (fibrinogen and factor VII) and antiplasmins were measured in 529 men aged 35-54 years and related to new angina pectoris (n = 117) and to coronary risk factors in controls without angina (n = 412). Five major risk factors (cigarette-smoking, blood pressure, cholesterol, triglyceride and body mass index) were each associated with increases in plasma viscosity, coagulation factors, and imbalance of coagulation over fibrinolysis (increased ratio of fibrinopeptide A/fibrinopeptide B beta 15-42). Increased viscosity and fibrinogen in smokers were partly reversed in ex-smokers, but the imbalance of coagulation and fibrinolysis persisted. Cholesterol and triglyceride were also associated with increased antiplasmin activity. In men with angina, only fibrinogen was elevated compared to controls. We suggest that increased plasma viscosity and an imbalance of coagulation over fibrinolysis may be mechanisms by which known risk factors promote arterial thrombosis, but are not present in stable angina. 相似文献
5.
J. E. Hammond R. G. Berger T. S. Carey R. Rutledge T. J. Cleveland J. P. Kichak C. F. Ayscue 《Journal of medical systems》1991,15(3):257-267
Many hospitals today have implemented widely disparate information systems on mainframe and mini-computer hardware. The advent of network technology in hospitals has made it possible to access information in these systems. Unfortunately, the user interfaces to applications on these systems are unique and difficult to learn, which makes them unsuitable for use by clinical services. In this paper we describe the development of a Physician's Workstation which integrates information from multiple existing information systems and discuss how the workstation makes it possible to move from the departmental systems of the present to the computer-based medical record system of the future. 相似文献
6.
Hysterosalpingography was performed in 31 patients by means of a low-dose scanning-beam digital radiographic system. The technique permits adequate evaluation of gynecologic abnormalities while allowing significant reduction in radiation: 2.4-mR (6.1 X 10(-7) C/kg) exposure to the skin and 0.7-mrad (7 X 10(-6) Gy) mean dose to the ovaries per image obtained. Sixteen patients demonstrated readily recognizable and documented abnormalities, corroborated by laparoscopy, laparotomy, or other supportive evidence. 相似文献
7.
Superficial bladder cancer: intravesical chemotherapy and tumour progression to muscle invasion or metastases 总被引:2,自引:0,他引:2
G Smith R A Elton G D Chisholm J E Newsam T B Hargreave 《British journal of urology》1986,58(6):659-663
Of 299 patients who presented with superficial bladder cancer (Ta, T1), 60 were treated by intravesical chemotherapy (Epodyl, methotrexate or mitomycin C). The rate of tumour progression to muscle invasion or metastases was identical for each intravesical regime. There was no evidence that mitomycin C promoted tumour progression. Carcinoma in situ in non-tumour-bearing urothelium was the most significant predictive factor for progression to muscle invasion or metastases. 相似文献
8.
S Prescott M A Hadi R A Elton A W Ritchie G C Foubister J C Gould T B Hargreave 《British journal of urology》1990,66(5):509-514
Two different regimens of cephalosporin antibiotic prophylaxis were compared with antiseptic lubricating jelly to try to prevent infection and complications in 196 men after prostatic surgery. Pre-operative urine was cultured and prostatic chips (170 cases) were also cultured to define the source of any infection. The use of antibiotics was associated with a reduced risk of postoperative bacteriuria. No serious complications occurred, although 1 patient in the antiseptic treated group developed rigors; 79 of 170 patients (46%) had positive prostatic chip cultures, of whom 74 had sterile pre-operative urine. There was no association between the result of chip culture and the presence of a pre-operative catheter. Culture positive patients had an increased risk of post-operative urine infection, although the same organism was found in the prostate and urine in only 36% of cases of post-operative bacteriuria and in 43 (54%) the organism cultured from the prostate was Staphylococcus albus. This study provides further evidence of the benefit of true prophylactic antibiotic therapy for transurethral prostatic surgery and the prostatic chip data suggest that some of the risk is due to pre-operative contamination of the prostate in the absence of per-operative urinary infection or catheterisation. 相似文献
9.
Dr. Caroline S. Zeind Pharm.D. Dr. Kerry O. Cleveland M.D. Dr. Madhavi Menon M.D. Dr. James R. Brown Pharm.D. Dr. David K. Solomon Pharm.D. 《Pharmacotherapy》1996,16(4):547-561
The optimum therapy for cryptococcal meningitis in patients with the acquired immunodeficiency syndrome (AIDS) remains unresolved. Traditional therapy consists of amphotericin B with or without flucytosine. Obstacles exist in administering these agents to patients with AIDS. Mortality rates during initial therapy are relatively high. Given the lack of proved benefit, we do not recommend adding flucytosine to amphotericin B routinely. The search for more efficacious and less toxic agents continues. The oral triazoles, especially fluconazole, have increased the options for treatment of this disease. New strategies and novel approaches in managing cryptococcal meningitis in patients with AIDS continue to be developed. 相似文献
10.
Percutaneous transluminal angioplasty has been shown to be both feasible and efficacious for the treatment of aortic coarctation. Recent reports, however, have indicated that the development of aortic aneurysms at or near the coarctation segment may complicate attempts to treat this lesion by catheter-based intervention. Accordingly, we examined the light microscopic features of coarctation segments excised at surgery (n = 31) or obtained at autopsy (n = 2) in 33 patients with coarctation of the aorta. Cystic medial necrosis, defined as depletion and disarray of elastic tissue, was observed in each of the 33 specimens. In the majority of coarctation specimens (22 of 33 or 67%) the extent of cystic medial necrosis, graded semiquantitatively on a scale of 0 (normal aorta) to 3+, was severe (3+). The finding that cystic medial necrosis represents a consistent histologic feature of coarctation of the aorta provides a pathologic basis for the formation of aneurysms observed after balloon angioplasty of coarctation sites. 相似文献