全文获取类型
收费全文 | 58647篇 |
免费 | 6261篇 |
国内免费 | 858篇 |
专业分类
耳鼻咽喉 | 578篇 |
儿科学 | 1381篇 |
妇产科学 | 1157篇 |
基础医学 | 7609篇 |
口腔科学 | 1565篇 |
临床医学 | 7229篇 |
内科学 | 9699篇 |
皮肤病学 | 628篇 |
神经病学 | 4627篇 |
特种医学 | 2440篇 |
外国民族医学 | 57篇 |
外科学 | 7117篇 |
综合类 | 4491篇 |
现状与发展 | 5篇 |
一般理论 | 43篇 |
预防医学 | 6466篇 |
眼科学 | 1293篇 |
药学 | 5050篇 |
23篇 | |
中国医学 | 1188篇 |
肿瘤学 | 3120篇 |
出版年
2023年 | 364篇 |
2022年 | 654篇 |
2021年 | 1199篇 |
2020年 | 847篇 |
2019年 | 888篇 |
2018年 | 944篇 |
2017年 | 895篇 |
2016年 | 823篇 |
2015年 | 1141篇 |
2014年 | 1610篇 |
2013年 | 2299篇 |
2012年 | 3127篇 |
2011年 | 3302篇 |
2010年 | 2375篇 |
2009年 | 2095篇 |
2008年 | 3040篇 |
2007年 | 2953篇 |
2006年 | 2880篇 |
2005年 | 2615篇 |
2004年 | 2426篇 |
2003年 | 2187篇 |
2002年 | 2005篇 |
2001年 | 1739篇 |
2000年 | 1847篇 |
1999年 | 1441篇 |
1998年 | 612篇 |
1997年 | 542篇 |
1996年 | 497篇 |
1995年 | 508篇 |
1994年 | 460篇 |
1993年 | 413篇 |
1992年 | 1081篇 |
1991年 | 1124篇 |
1990年 | 1028篇 |
1989年 | 1017篇 |
1988年 | 1022篇 |
1987年 | 893篇 |
1986年 | 879篇 |
1985年 | 851篇 |
1984年 | 706篇 |
1983年 | 591篇 |
1982年 | 390篇 |
1979年 | 662篇 |
1978年 | 517篇 |
1977年 | 437篇 |
1976年 | 418篇 |
1975年 | 384篇 |
1974年 | 438篇 |
1973年 | 437篇 |
1972年 | 377篇 |
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
1.
Heather L. Brown 《Journal of emergency nursing》2021,47(2):321-325
The coronavirus 2019 pandemic has affected almost every aspect of health care delivery in the United States, and the emergency medicine system has been hit particularly hard while dealing with this public health crisis. In an unprecedented time in our history, medical systems and clinicians have been asked to be creative, flexible, and innovative, all while continuing to uphold the important standards in the US health care system. To continue providing quality services to patients during this extraordinary time, care providers, organizations, administrators, and insurers have needed to alter longstanding models and procedures to respond to the dynamics of a pandemic. The Emergency Medicine Treatment and Active Labor Act of 1986, or EMTALA, is 1 example of where these alterations have allowed health care facilities and clinicians to continue their work of caring for patients while protecting both the patients and the clinicians themselves from infectious exposures at the same time. 相似文献
2.
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3.
4.
5.
毛细胞白血病(HCL)是一种以脾大、全血细胞减少、骨髓组织增生等为临床表现的罕见慢性B淋巴细胞增殖性疾病。克拉屈滨作为其一线药物,对HCL的完全缓解率很高。本文报道了2017-09-04绍兴市人民医院收治的1例经典型HCL患者在克拉屈滨治疗期间,出现严重粒细胞缺乏伴高热,合并全身皮疹及间质性肺炎,经大剂量激素等治疗后好转的诊疗过程。并结合文献回顾了HCL的诊断及治疗方法,简述了克拉屈滨治疗HCL致间质性肺炎这一少见并发症的诊疗思路,以提高临床医师对该毒副作用的认识,为临床工作提供帮助。 相似文献
6.
Characteristics of hyperparathyroid states in the Canadian multicentre osteoporosis study (CaMos) and relationship to skeletal markers 下载免费PDF全文
7.
Josh Greenstein Devjani Das Josie Acuna Monica Kapoor Cara Brown Abbas Husain Brendan Lally Barry Hahn 《The American journal of emergency medicine》2019,37(2):313-316
Background
In the emergency department, rib fractures are a common finding in patients who sustain chest trauma. Rib fractures may be a sign of significant, underlying pathology, especially in the elderly patients where rib fractures are associated with significant morbidity and mortality. To date, no studies have evaluated the ability of ultrasound to detect rib fractures using cadaver models and subsequently use this model as a teaching tool.Objectives
The purpose of this study was to determine if it is possible to generate rib fractures on cadaver models which could be accurately identified using ultrasound.Methods
This was a cross-sectional study performed during one session at a cadaver lab. A single hemithorax from four adult cadavers were used as models. Single rib fractures on each of rib five through eight were created. Four subjects, blinded to the normal versus fractured ribs, were asked to identify the presence of a fracture on each rib.Results
A total of 8 of 16 potential ribs had fractured induced by study staff. Mean accuracy was 55% for all subjects. The overall sensitivity and specificity for detecting rib fractures was 50% (CI: 31.89–68.11) and 59.38% (CI: 35.69–73.55) respectively. The overall PPV and NPV was 55.17% and 54.29% respectively.Conclusions
In this pilot study, subjects were not able to detect induced rib fractures using ultrasound on cadaver models. The use of this model as a teaching tool in the detection of rib fractures requires further investigation. 相似文献8.
目的:探讨轴向载荷分担比用于胫腓骨骨干骨折术后指导外固定器轴向动力化促进骨折愈合的有效性。方法:选取外固定器治疗的胫腓骨骨干骨折患者100例,随机分为观察组50例,对照组50例。观察组在轴向载荷分担比指导下行外固定器轴向动力化治疗,对照组未行动力化,随访比较两组的治疗效果。结果:所有患者均获随访,随访时间4~12个月,平均6.5个月,治疗期间所有患者均未出现外固定针断裂、松动及再骨折等并发症,观察组1例骨搬移患者轴向载荷分担比5%,X线片显示骨折断端有连续性骨痂通过,拆除外固定器连接杆后发生移位,恢复原数值行轴向加压再动力化,现已愈合。观察组除外1例骨搬移患者,其余49例患者外固定器固定时间为[(24.4±4.7)周],骨折临床愈合时间为[(22.4±4.7)周],与对照组50例患者外固定器固定时间[(29.3±5.6)周],骨折临床愈合时间[(27.3±5.6)周]比较,显著减少(P0.05)。结论:外固定器轴向载荷分担比指导胫腓骨骨干骨折外固定术后轴向动力化可以加速骨折愈合,但不适合骨搬移截骨端已硬化患者。 相似文献
9.
目的探讨不同剂量骨水泥PKP联合雌激素对绝经后女性骨质疏松性腰椎体压缩性骨折患者的影响。方法选取2015年1月至2018年6月我院收治的120例老年女性骨质疏松性腰椎体压缩性骨折患者为研究对象,按行PKP手术治疗时骨水泥注入的剂量不同分为三组(A组2-4 mL、B组4-5 mL、C组5-6 mL),所有患者均随访1年,比较术后三组患者VAS评分、ODI评分、伤椎椎体前缘高度、椎体中部高度及并发症的发生率。结果三组患者相比,治疗前VAS评分、ODI评分组间比较差异无显著性(P0.05);术后3天及1年后随访时,三组患者各项指标均较治疗前显著改善,组内比较差异具有显著性(P0.05),组间比较差异无显著性(P0.05);治疗前伤椎椎体前缘高度及椎体中部高度组间比较差异无显著性(P0.05);术后3天及1年后随访时,三组患者治疗后椎体前缘、中间高度均较术前明显增加(P0.05),组间比较椎体前缘高度:C组B组A组,椎体中间高度:C组B组A组,且组间比较有统计学差异(P0.05); A组患者并发症的发生率(12.5%)明显低于B组(30.0%)、C组(41.0%),有统计学差异(P0.05)。结论 PKP术中注入小剂量骨水泥(2-4 mL)对于治疗老年女性OVCFs具有良好的治疗效果及较高的安全性。 相似文献
10.
Gregory S. Orgel Robert A. Weston Christopher Ziebell Lawrence H. Brown 《The American journal of emergency medicine》2019,37(9):1729-1733
ObjectiveTo evaluate changes in insurance status among emergency department (ED) patients presenting in the two years immediately before and after full implementation of the Affordable Care Act (ACA).MethodsWe evaluated National Hospital Ambulatory Medical Care Survey (NHAMCS) Emergency Department public use data for 2012–2015, categorizing patients as having any insurance (private; Medicare; Medicaid; workers' compensation) or no insurance. We compared the pre- and post-ACA frequency of insurance coverage—overall and within the older (≥65), working-age (18–64) and pediatric (<18) subpopulations—using unadjusted odds ratios with 95% confidence intervals. We also conducted a difference-in-differences analysis comparing the change in insurance coverage among working-age patients with that observed for older Medicare-eligible patients, while controlling for sex, race and underlying temporal trends.ResultsOverall, the proportion of ED patients with any insurance did not significantly change from 2012 to 2013 to 2014–2015 (74.2% vs 77.7%) but the proportion of working-age adult patients with at least one form of insurance increased significantly, from 66.0% to 71.8% (OR 1.31, CI: 1.13–1.52). The difference-in-differences analysis confirmed the change in insurance coverage among working-age adults was greater than that seen in the reference population of Medicare-eligible adults (AOR 1.70, CI: 1.29–2.23). The increase was almost entirely attributable to increased Medicaid coverage.ConclusionIn the first two years following full implementation of the ACA, there was a significant increase in the proportion of working-age adult ED patients who had at least one form of health insurance. The increase appeared primarily associated with expansion of Medicaid. 相似文献