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排序方式: 共有1209条查询结果,搜索用时 15 毫秒
1.
Sameer Arora Kamal Shemisa Muthiah Vaduganathan Arman Qamar Ankur Gupta Sushil K. Garg Dharam J. Kumbhani Helen Mayo Houman Khalili Ambarish Pandey Sandeep R. Das 《Journal of the American College of Cardiology》2019,73(19):2454-2464
Ticagrelor is a cornerstone of modern antithrombotic therapy alongside aspirin in patients with acute coronary syndrome and after percutaneous coronary intervention. Adverse effects such as bleeding and dyspnea have been associated with premature ticagrelor discontinuation, which may limit any potential advantage of ticagrelor over clopidogrel. The randomized trials of ticagrelor captured adverse events, offering the opportunity to more precisely quantify these effects across studies. Therefore, a meta-analysis of 4 randomized clinical trials of ticagrelor conducted between January 2007 and June 2017 was performed to quantify the incidence and causes of premature ticagrelor discontinuation. Among 66,870 patients followed for a median 18 months, premature ticagrelor discontinuation was seen in 25%; bleeding was the most common cause of discontinuation followed by dyspnea. Versus the comparators, the relative risk of dyspnea-related discontinuation during follow-up was 6.4-fold higher, the relative risk of bleeding was 3.2-fold higher, and the relative risk of discontinuation due to any adverse event was 59% higher for patients receiving ticagrelor. Understanding these potential barriers to adherence to ticagrelor is crucial for informed patient-physician decision making and can inform future efforts to improve ticagrelor adherence. This review discusses the incidence, causes, and biological mechanisms of ticagrelor-related adverse effects and offers strategies to improve adherence to ticagrelor. 相似文献
2.
Urvashi Razdan R. M. Raizada V. N. Chaturvedi 《Indian journal of otolaryngology and head and neck surgery》2004,56(1):20-22
Objective To assess the efficacy of conservative modalities in the management of epistaxis.
Study design Prospective case studies.
Setting Rural medical college hospital.
Patients Indoor and outdoor patients with epistaxis.
lntervention Conservative(non surgical) management techniques in epistaxis.
Results Chemical cauterization was successful in 72.07% cases, anterior nasal packing in 84.5% and posterior nasal packing in 95.6%
cases.
Conclusion Out of 300 cases of epistaxis included in the study (except for one case that required internal maxillary artery ligation).
all cases were treated successfully with conservative treatment alongwith treating the underlying pathology causing epistaxis. 相似文献
3.
Bharti Razdan Peter J. Marro Outi Tammela Rajiv Goel Om Prakash Mishra Maria Delivoria-Papadopoulos 《Brain research》1993,600(2):308-314
The effect of hypoxia on the structure and function of the synaptosomal membranes and myelin fraction (glial cells, neuronal cell bodies and axonal membranes) was investigated by measuring Na+,K+-ATPase activity and levels of lipid peroxidation products in cerebral cortical synaptosomal membranes and myelin fractions obtained from newborn piglets. Hypoxic hypoxia was induced and cerebral hypoxia was documented as a decrease in the ratio of phosphocreatine to inorganic phosphate (PCr/Oi) using31P-NMR spectroscopy. PCr/Pi decreased from baseline of2.93 ± 0.76to0.61 ± 0.36 during hypoxia. The synaptosomal membrane Na+,K+-ATPase activity decreased from a control value of56.6 ± 3.7to40.4 ± 6.0 μgmol Pi/mg protein/h during hypoxia. The level of conjugated dienes increased from zero (reference value) to4.5 ± 2.7 nmol/mg lipid and the level of fluorescent compounds increased from23.5 ± 2.2to92.6 ± 46.4 ng quinine sulfate/mg lipid in the synaptosomal membranes during hypoxia. No change in myelin fraction Na+,K+-ATPase activity or levels of lipid peroxidation products were noted. These data indicate that sunaptosomal membranes, rich in polyunsaturated fatty acids, are more susceptible to oxygen free radical mediated lipid peroxidative damage during hypoxia. 相似文献
4.
Association of TNF-beta polymorphism with disease severity among patients infected with hepatitis C virus 总被引:2,自引:0,他引:2
Goyal A Kazim SN Sakhuja P Malhotra V Arora N Sarin SK 《Journal of medical virology》2004,72(1):60-65
The pathogenesis of chronic hepatitis C virus (HCV) infection remains unclear. Tumour necrosis factor alpha (TNF-alpha) is alleged to contribute in the pathogenesis of chronic HCV infection. Single nucleotide polymorphism in TNF-alpha and -beta genes could influence the outcome of HCV infection. The aim was to study single nucleotide polymorphism in TNF-alpha promoter region and Nco I polymorphisms in the TNF-beta gene in patients with chronic hepatitis C. Fifty-two patients with histologically proven chronic hepatitis, who had raised ALT levels (>1.5 x ULN) and were HCV RNA positive, were studied. Genotyping of -308 promoter variant of TNF-alpha was performed by PCR with primers that incorporated an Nco I restriction site. For PCR typing of the TNF-beta Nco I restriction fragment length polymorphism, sequence specific primers were used. Polymorphism in the TNF-alpha G/G, G/A and A/A allele was not different between HCV patients and healthy controls. TNF-beta A/A allele was significantly more common (P = 0.02) in patients (28.8%) as compared to controls (12.8%), whereas no significant difference was observed for TNF-beta G/A and G/G alleles [corrected]. Nco I TNF-beta A/A was strongly associated with -308 TNF-alpha G/G (RR of HCV persistence = 4.9), indicating possible linkage between TNF-beta A/A and TNF-alpha G/G allele. Patients with severe hepatic fibrosis more frequently had the TNF-beta A/A allele as compared to patients with mild disease (P = 0.04). Immunogenetic factors, such as single nucleotide polymorphisms in TNF-beta (A/A allele), may affect the natural course of HCV infection, in particular, the disease progression. Larger studies including cytokine expression profiles are needed to fully understand the contribution of the polymorphisms described in the pathogenesis of chronic hepatitis C. 相似文献
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7.
Prabhu Manivannan Ankur Ahuja Hara Prasad Pati 《Indian journal of hematology & blood transfusion》2017,33(4):453-462
Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired clonal hematopoietic stem cell disorder with its protean clinical manifestations. This is due to partial or complete absence of ‘glycophosphatidyl-inositol-anchor proteins’ (GPI-AP). The main aim of this review is to highlight various diagnostic modalities available, basic principle of each test and recent advances in the diagnosis of PNH. Recently among various tests available, the flow cytometry has become ‘the gold standard’ for PNH testing. In order to overcome the difficulties encountered by the testing and research laboratories throughout the world, International Clinical Cytometry Society has come up with guidelines regarding the indications for testing, protocol for sample collection, processing, panel of antibodies as well as gating strategies to be used, how to interpret the test and reporting format to be used. It is essential to test at least two GPI-linked markers on at least two different lineages particularly on red cells and granulocytes/monocytes. The fluorescent aerolysin combined with other monoclonal antibodies in multicolour flow cytometry offered an improved assay not only for diagnosis but also for monitoring of PNH clones. It is equally important to diagnose this rare entity with high index of suspicion. 相似文献
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10.
Priyadarshi Soumyaranjan Sahu Jyotsna Seepana Sudarsini Padela Abani Kanta Sahu Swarna Subbarayudu Ankur Barua 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(3):253-258
Neurocysticercosis (NCC) is one of the major causes of childhood seizures
in developing countries including India and Latin America. In this study neurological
pediatric cases presenting with afebrile seizures were screened for anti-Cysticercus
antibodies (IgG) in their sera in order to estimate the possible burden of
cysticercal etiology. The study included a total of 61 pediatric afebrile seizure
subjects (aged one to 15 years old); there was a male predominance. All the sera were
tested using a pre-evaluated commercially procured IgG-ELISA kit (UB-Magiwell
Cysticercosis Kit ™). Anti-Cysticercus antibody in serum was positive in 23 of 61 (37.7%)
cases. The majority of cases with a positive ELISA test presented with generalized
seizure (52.17%), followed by complex partial seizure (26.08%), and simple partial
seizure (21.73%). Headaches were the major complaint (73.91%). Other presentations
were vomiting (47.82%), pallor (34.78%), altered sensorium (26.08%), and muscle
weakness (13.04%). There was one hemiparesis case diagnosed to be NCC. In this study
one child without any significant findings on imaging was also found to be positive
by serology. There was a statistically significant association found between the
cases with multiple lesions on the brain and the ELISA-positivity (p
= 0.017). Overall positivity of the ELISA showed a potential cysticercal etiology.
Hence, neurocysticercosis should be suspected in every child presenting with afebrile
seizure especially with a radio-imaging supportive diagnosis in tropical developing
countries or areas endemic for taeniasis/cysticercosis. 相似文献