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Rammurti T Kamble George B Selby Martha Mims Mohamed A Kharfan-Dabaja Howard Ozer James N George 《Biology of blood and marrow transplantation》2006,12(5):506-510
Iron overload presenting as exacerbation of hepatic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation has not been previously described. We report 6 patients with established hepatic GVHD in whom iron overload (median serum ferritin, 7231 mug/dL; median transferrin saturation, 77%) resulting from a lifetime median of 20 units of packed red blood cell transfusions was manifested by worsening of liver function. Liver biopsies performed in 4 patients confirmed severe iron overload and also hepatic GVHD. Analysis for the C282Y and H63D hemochromatosis gene mutation was negative for the homozygous state in all 6 patients. Erythropoietin-assisted phlebotomy resulted in normalization of liver function at a median of 7 months and of serum ferritin at a median of 11 months. Immunosuppressive therapy was successfully tapered in all 4 patients who completed the phlebotomy program, and this supported the impression that iron overload, rather than GVHD, was the principal cause of liver dysfunction. At a median follow-up of 50 months (range, 18-76 months) from the transplantation and 25 months (range, 5-36 months) from ferritin normalization, all 4 patients require maintenance phlebotomy. We conclude that iron overload can mimic GVHD exacerbation, thus resulting in unnecessary continuation or intensification of immunosuppressive therapy for GVHD, and that maintenance phlebotomy is necessary after successful iron-reduction therapy. 相似文献
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Cengiz Yak?nc? Bülent Müngen Sabit ?ah?n Hamza Karab?ber Ya?ar Durmaz 《Brain & development》1997,19(8):571-572
Midazolam is a recently developed water-soluble benzodiazepine that shares anxiolytic, muscle relaxant, hypnotic and anticonvulsant actions with other members of this class. There are limited studies that midazolam can be used successfully to treat seizures in adults and children. In this study, 0.2 mg/kg intramuscular (IM) midazolam was administered to 11 children (eight boys and three girls), aged 3 days to 4 years (mean age 1.8±1.4 years), with seizures of various types. In all but one child, seizures stopped in 15 s–5 min after injection. No side effects were observed. These results suggest that IM administration of midazolam may be useful in a variety of seizures during childhood, especially in case of intravenous (IV) line problem. 相似文献
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Okan Bilge Yelda Pinar Mehmet Asim Ozer Figen Govsa 《Journal of plastic, reconstructive & aesthetic surgery》2007,60(10):1120-1126
The lumbrical muscles are located in the midpalm, dorsal to the palmar aponeurosis. The main function of these muscles is an indirect contribution to interphalangeal joint extension by decreasing the flexor effect of the flexor digitorum profundus muscle. Due to their minor biomechanical functions and suitable constructions, these muscles have been preferred in reconstructive surgery as local transposition flaps or pedicled flaps. Despite the surgical and clinical importance, vascular anatomical studies of these muscles are not well represented in the current literature. This study was performed in the Department of Anatomy of the Faculty of Medicine of the Ege University. Thirty-four cadaver hands, injected with red-coloured latex were used, and we aimed to describe the morphometry and vascular anatomy of the lumbrical muscles. We measured the length and width of the muscles, after removing their epimisium, and the diameter and length of the arteries to the muscles. The outcomes of our study determined that the length and width of the lumbrical muscles were reduced significantly from radial towards ulnar sides. The lumbrical muscles were supplied from both their palmar and dorsal surfaces by both superficial and deep palmar arches and/or their branches. We also described the level of entry of the dominant arteries for each lumbrical muscle and measured the size of the vessels and muscles to guide some surgical approaches. This anatomical study could guide for some surgical approaches and reduce the deficiency about the vascular anatomical patterns of the lumbrical muscles in the literature. 相似文献
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Erythraea centaurium is a plant which is used in the treatment of various inflammatory conditions in popular medicine. The aqueous extract of the plant has been examined for its antiinflammatory, analgesic, and antipyretic effects in several animal models. The extract exhibited antiinflammatory and antipyretic activity although no analgesic activity was observed. 相似文献
9.
Lumbar intraradicular disc herniation: report of a rare and preoperatively unpredictable case and review of the literature. 总被引:1,自引:0,他引:1
BACKGROUND CONTEXT: Intraradicular lumbar disc herniation is rare, having been reported to date in only three postoperative patients. The diagnosis is typically made intraoperatively. PURPOSE: To report a fourth case of intraradicular disc herniation, to emphasize its radiological characteristics and operative findings. STUDY DESIGN: Case report. PATIENT SAMPLE: A 41-year-old female. METHODS: Retrospective case review. RESULTS: The patient underwent a second operation and intraradicular disc fragment was removed. She was completely well at her 9-month check up. CONCLUSIONS: The diagnosis, mechanism, and surgical treatment of intraradicular lumbar disc herniation are reviewed. The round shape of the sequestrated fragment, as seen on magnetic resonance imaging, may help to establish the correct diagnosis. 相似文献
10.
Burcin Ozer Muserref Tatman-Otkun Dilek Memis Metin Otkun 《Central European Journal of Medicine》2010,5(2):203-208
The aim of this study was to determine the types nosocomial infections (NIs) and the risk factors for NIs in the central intensive
care unit (ICU) of Trakya University Hospital. The patients admitted to the ICU were observed prospectively by the unit-directed
active surveillance method based on patient and the laboratory over a 9-month-period. The samples of urine, blood, sputum
or tracheal aspirate were taken from the patients on the first and the third days of their hospitalization in ICU; the patients
were cultured routinely. Other samples were taken and cultured if there was suspicion of an infection. Infections were considered
as ICU-associated if they developed after 48 hours of hospitalization in the unit and 5 days after discharge from the unit
if the patients had been sent to a different ward in the hospital. The rate of NIs in 135 patients assigned was found to be
68%. The most common infection sites were lower respiratory tract, urinary tract, bloodstream, catheter site and surgical
wound. Hospitalization in ICU for more than 6 days and colonization was found to be the main risk factor for NIs. Prolonged
mechanical ventilation and tracheostomy, as well as frequently changed nasogastric catheterization, were found to be risk
factors for lower respiratory tract infections. For bloodstream infections, both prolonged insertion of and frequent change
of arterial catheters, and for urinary tract infections, female gender, period and repeating of urinary catheterization were
risk factors. A high prevalence rate of nosocomial infections was found in this study. Invasive device use and duration of
use continue to greatly influence the development of nosocomial infection in ICU. Important factors to prevent nosocomial
infections are to avoid long hospitalization and unnecessary device application. Control and prevention strategies based on
continuing education of healthcare workers will decrease the nosocomial infections in the intensive care unit. 相似文献