全文获取类型
| 收费全文 | 132741篇 |
| 免费 | 9355篇 |
| 国内免费 | 454篇 |
专业分类
| 耳鼻咽喉 | 1698篇 |
| 儿科学 | 3462篇 |
| 妇产科学 | 2356篇 |
| 基础医学 | 17234篇 |
| 口腔科学 | 2596篇 |
| 临床医学 | 13315篇 |
| 内科学 | 27682篇 |
| 皮肤病学 | 2102篇 |
| 神经病学 | 12570篇 |
| 特种医学 | 4787篇 |
| 外国民族医学 | 4篇 |
| 外科学 | 19447篇 |
| 综合类 | 2106篇 |
| 现状与发展 | 1篇 |
| 一般理论 | 174篇 |
| 预防医学 | 12006篇 |
| 眼科学 | 3111篇 |
| 药学 | 9219篇 |
| 2篇 | |
| 中国医学 | 174篇 |
| 肿瘤学 | 8504篇 |
出版年
| 2023年 | 500篇 |
| 2022年 | 712篇 |
| 2021年 | 2185篇 |
| 2020年 | 1297篇 |
| 2019年 | 2158篇 |
| 2018年 | 2464篇 |
| 2017年 | 1899篇 |
| 2016年 | 2072篇 |
| 2015年 | 2542篇 |
| 2014年 | 3609篇 |
| 2013年 | 5588篇 |
| 2012年 | 8111篇 |
| 2011年 | 8660篇 |
| 2010年 | 4905篇 |
| 2009年 | 4755篇 |
| 2008年 | 8363篇 |
| 2007年 | 8887篇 |
| 2006年 | 8754篇 |
| 2005年 | 9013篇 |
| 2004年 | 8502篇 |
| 2003年 | 8311篇 |
| 2002年 | 7876篇 |
| 2001年 | 1470篇 |
| 2000年 | 1219篇 |
| 1999年 | 1474篇 |
| 1998年 | 1814篇 |
| 1997年 | 1532篇 |
| 1996年 | 1276篇 |
| 1995年 | 1270篇 |
| 1994年 | 1040篇 |
| 1993年 | 1051篇 |
| 1992年 | 975篇 |
| 1991年 | 901篇 |
| 1990年 | 853篇 |
| 1989年 | 831篇 |
| 1988年 | 722篇 |
| 1987年 | 727篇 |
| 1986年 | 708篇 |
| 1985年 | 838篇 |
| 1984年 | 970篇 |
| 1983年 | 945篇 |
| 1982年 | 1256篇 |
| 1981年 | 1109篇 |
| 1980年 | 1014篇 |
| 1979年 | 578篇 |
| 1978年 | 643篇 |
| 1977年 | 617篇 |
| 1976年 | 509篇 |
| 1975年 | 462篇 |
| 1974年 | 437篇 |
排序方式： 共有10000条查询结果，搜索用时 15 毫秒
1.
2.
Kara S. Tanaka MD Veronica R. Andaya BA Steven W. Thorpe MD Kenneth R. Gundle MD James B. Hayden MD Yee-Cheen Duong MD Raffi S. Avedian MD David G. Mohler MD Lee J. Morse MD Melissa N. Zimel MD Richard J. O'Donnell MD Andrew Fang MD Robert Lor Randall MD Tina H. Tran BS Christin New BA Rosanna L. Wustrack MD other members of Study Group FORCE 《Journal of surgical oncology》2023,127(1):148-158
3.
4.
Elizabeth D. Krebs Robert B. Hawkins J. Hunter Mehaffey Clifford E. Fonner Alan M. Speir Mohammed A. Quader Jeffrey B. Rich Leora T. Yarboro Nicholas R. Teman Gorav Ailawadi 《The Journal of thoracic and cardiovascular surgery》2019,157(4):1533-1542.e2
Objectives
Expedient extubation after cardiac surgery has been associated with improved outcomes, leading to postoperative extubation frequently during overnight hours. However, recent evidence in a mixed medical-surgical intensive care unit population demonstrated worse outcomes with overnight extubation. This study investigated the impact of overnight extubation in a statewide, multicenter Society of Thoracic Surgeons database.Methods
Records from 39,812 patients undergoing coronary artery bypass grafting or valve operations (2008-2016) and extubated within 24 hours were stratified according to extubation time between 06:00 and 18:00 (day) or between 18:00 and 6:00 (overnight). Outcomes including reintubation, mortality, and composite morbidity-mortality were evaluated using hierarchical regression models adjusted for Society of Thoracic Surgeons predictive risk scores. To further analyze extubation during the night, a subanalysis stratified patients into 3 groups: 06:00 to 18:00, 18:00 to 24:00, and 24:00 to 06:00.Results
A total of 20,758 patients were extubated overnight (52.1%) and were slightly older (median age 66 vs 65 years, P < .001) with a longer duration of ventilation (4 vs 7 hours, P < .001). Day and overnight extubation were associated with equivalent operative mortality (1.7% vs 1.7%, P = .880), reintubation (3.7% vs 3.4%, P = .141), and composite morbidity-mortality (8.2% vs 8.0%, P = .314). After risk adjustment, overnight extubation was not associated with any difference in reintubation, mortality, or composite morbidity-mortality. On subanalysis, those extubated between 24:00 and 06:00 exhibited increased composite morbidity-mortality (odds ratio, 1.18; P = .001) but no difference in reintubation or mortality.Conclusions
Extubation overnight was not associated with increased mortality or reintubation. These results suggest that in the appropriate clinical setting, it is safe to routinely extubate cardiac surgery patients overnight. 相似文献5.
6.
7.
8.
Osric A. Forrest Daniel M. Chopyk Yael Gernez Milton R. Brown Carol K. Conrad Richard B. Moss Vin Tangpricha Limin Peng Rabindra Tirouvanziam 《Journal of cystic fibrosis》2019,18(1):64-70
Background
Resistin is an immunometabolic mediator that is elevated in several inflammatory disorders. A ligand for Toll-like receptor 4, resistin modulates the recruitment and activation of myeloid cells, notably neutrophils. Neutrophils are major drivers of cystic fibrosis (CF) lung disease, in part due to the release of human neutrophil elastase- and myeloperoxidase-rich primary granules, leading to tissue damage. Here we assessed the relationship of resistin to CF lung disease.Methods
Resistin levels were measured in plasma and sputum from three retrospective CF cohorts spanning a wide range of disease. We also assessed the ability of neutrophils to secrete resistin upon activation in vitro. Finally, we constructed a multivariate model assessing the relationship between resistin levels and lung function.Results
Plasma resistin levels were only marginally higher in CF than in healthy control subjects. By contrast, sputum resistin levels were very high in CF, reaching 50–100 fold higher levels than in plasma. Among CF patients, higher plasma resistin levels were associated with allergic bronchopulmonary aspergillosis, and higher sputum resistin levels were associated with CF-related diabetes. Mechanistically, in vitro release of neutrophil primary granules was concomitant with resistin secretion. Overall, sputum resistin levels were negatively correlated with CF lung function, independently of other variables (age, sex, and genotype).Conclusions
Our data establish relationships between resistin levels in the plasma and sputum of CF patients that correlate with disease status, and identify resistin as a novel mechanistic link between neutrophilic inflammation and lung disease in CF. 相似文献9.