全文获取类型
收费全文 | 784篇 |
免费 | 84篇 |
国内免费 | 4篇 |
专业分类
耳鼻咽喉 | 1篇 |
儿科学 | 10篇 |
妇产科学 | 10篇 |
基础医学 | 36篇 |
临床医学 | 85篇 |
内科学 | 431篇 |
皮肤病学 | 17篇 |
神经病学 | 101篇 |
特种医学 | 7篇 |
外科学 | 61篇 |
综合类 | 6篇 |
预防医学 | 24篇 |
眼科学 | 3篇 |
药学 | 50篇 |
肿瘤学 | 30篇 |
出版年
2024年 | 3篇 |
2023年 | 21篇 |
2022年 | 8篇 |
2021年 | 21篇 |
2020年 | 13篇 |
2019年 | 10篇 |
2018年 | 36篇 |
2017年 | 40篇 |
2016年 | 24篇 |
2015年 | 25篇 |
2014年 | 27篇 |
2013年 | 48篇 |
2012年 | 103篇 |
2011年 | 83篇 |
2010年 | 29篇 |
2009年 | 30篇 |
2008年 | 78篇 |
2007年 | 74篇 |
2006年 | 47篇 |
2005年 | 49篇 |
2004年 | 37篇 |
2003年 | 23篇 |
2002年 | 26篇 |
2001年 | 6篇 |
2000年 | 1篇 |
1999年 | 2篇 |
1997年 | 2篇 |
1995年 | 2篇 |
1983年 | 4篇 |
排序方式: 共有872条查询结果,搜索用时 31 毫秒
1.
Maria Gradin Mats Eriksson for the NeoOpioid investigators group 《Acta paediatrica (Oslo, Norway : 1992)》2011,100(2):204-208
Background: It has been proposed that a systematic pain assessment increases the awareness of the need to treat and prevent pain, and most international and national neonatal pain guidelines state that pain assessment should be performed in a systematic way. National surveys show a wide variation in compliance to these guidelines. Methods: A survey to all Swedish neonatal units was performed in 1993, 1998, 2003 and 2008, concerning the use of, and need for, pain assessment tools. Results: The number of units that tried to assess pain increased from 64% in 1993 to 83% in 2008. Forty‐four per cent of these used a structured method in 2003, compared to three per cent in 1998. The most common pain indicator was facial actions. Conclusion: The proportion of neonatal units that reported the use of a structured pain assessment tool has increased significantly from 1993 to 2008. There is a need for better evidence for the relation between the implementation of pain guidelines and the actual performance of pain assessment. 相似文献
2.
Leenhardt A Defaye P Mouton E Delay M Delarche N Dupuis JM Bizeau O Mabo P Cheggour S Babuty D;on behalf of the OPERA Registry investigators 《Europace : European pacing, arrhythmias, and cardiac electrophysiology》2012,14(10):1465-1474
AIMS: Inappropriate therapy delivered by implantable cardioverter defibrillators (ICDs) remains a challenge. The OPERA registry measured the times to, and studied the determinants of, first appropriate (FAT) and inappropriate (FIT) therapies delivered by single-, dual- and triple-chamber [cardiac resynchronization therapy defibrillator (CRT-D)] ICD. METHODS AND RESULTS: We entered 636 patients (mean age = 62.0 ± 13.5 years; 88% men) in the registry, of whom 251 received single-, 238 dual-, and 147 triple-chamber ICD, for primary (30.5%) or secondary (69.5%) indications. We measured times to FAT and FIT as a function of multiple clinical characteristics, examined the effects of various algorithm components on the likelihood of FAT and FIT delivery, and searched for predictors of FAT and FIT. Over 22.8 ± 8.8 months of observation, 184 patients (28.9%) received FAT and 70 (11.0%) received FIT. Ventricular tachycardia (VT) was the trigger of 88% of FAT, and supraventricular tachycardia was the trigger of 91% of FIT. The median times to FIT (90 days; range 49-258) and FAT (171 days; 50-363) were similar. The rate of FAT was higher (P <0.001) in patients treated for secondary than primary indications, while that of FIT were similar in both groups. Out of 57 analysable FIT, 27 (47.4%) could have been prevented by fine tuning the device programming like the sustained rate duration or the VT discrimination algorithm. CONCLUSIONS: First inappropriate therapy occurred in 11% of 636 ICD recipients followed for ~2 years. Nearly 50% of FIT could have been prevented by improving device programming. 相似文献
3.
Roalfe AK Bryant TL Davies MH Hackett TG Saba S Fletcher K Lip GY Hobbs FD Mant J;on behalf of the BAFTA investigators 《Europace : European pacing, arrhythmias, and cardiac electrophysiology》2012,14(10):1420-1427
AIMS: To compare the quality of life (QoL) of those in atrial fibrillation (AF) aged 75 years and over with that of the general population, to explore what factors affect the QoL of those with AF, and to assess the sensitivity of the EuroQol (EQ-5D) and Short-Form 12 (SF-12) generic health questionnaires in detecting differences in health status in those with AF in this age group. METHODS AND RESULTS: The study population was 1762 men and women aged 75 years and over with confirmed AF who attended a randomization clinic for the Birmingham Atrial Fibrillation Treatment of the Aged (BAFTA) study, a primary care based trial of stroke prevention. Patients self-completed the EQ-5D and SF-12 questionnaires, and a simple measure of disability (Rankin). Cardiovascular co-morbidities were collected and number of drugs used as an additional proxy for co-morbidity. Quality-of-life outcomes were compared with general population samples of the same age. On multiple regression, female gender, greater medication use, and disability were independently associated with lower QoL scores in AF. Those in AF with a Rankin score ≥2 had lower QoL scores, while those with a Rankin score <2 had higher scores than the general population. Increasing co-morbidity was associated with reduced QoL scores, with the EQ-5D and SF-12 Physical Component Score showing similar sensitivity to these associations, and the SF-12 Mental Component Score showing less sensitivity. CONCLUSION: In the absence of co-morbidity, chronic AF has little impact on generic QoL in an elderly non-acutely ill population. 相似文献
4.
5.
Mehta RH Harjai KJ Cox DA Stone GW Brodie BR Boura J Grines L O'Neill W Grines CL;Primary Angioplasty in Myocardial Infarction investigators 《The American journal of cardiology》2005,96(7):901-906
Little is known about the influence of stenting versus balloon angioplasty on long-term outcomes (particularly mortality) after primary percutaneous coronary intervention (PCI). We evaluated 2,087 patients with ST-elevation myocardial infarction enrolled in various Primary Angioplasty in Myocardial Infarction (PAMI) trials in the United States, who underwent primary PCI. The main outcome was all-cause mortality at 5 years, obtained through the National Death Index. Of the 2,087 patients, stenting was performed in 692 (33%). The absolute difference in the hospital (2.2% vs 3.3%), 1-year (3.3% vs 5.2%), and 5-year (10% vs 13%) mortality rates favored patients receiving a stent versus conventional balloon therapy, with the difference increasing with time. A multivariate Cox model identified stent use (vs balloon alone) as an independent correlate of lower 5-year mortality (hazard ratio 0.60, 95% confidence interval 0.42 to 0.85). The absolute reduction in mortality was greatest in the highest risk group. In conclusion, compared with balloon angioplasty, stenting during primary PCI not only resulted in better angiographic and short-term outcomes, but also in a sustained beneficial effect on mortality at 5 years. These data support the routine use of coronary stenting in most patients undergoing primary PCI, when feasible. 相似文献
6.
Armoundas AA Albert CM Cohen RJ Mela T;TOVA investigators 《Journal of cardiovascular electrophysiology》2004,15(5):594-597
Electrical alternans is a pattern of variation in the shape of the ECG waveform that appears on an every-other-beat basis. In humans, alternation in ventricular repolarization, namely, repolarization alternans, has been associated with increased vulnerability to ventricular tachycardia/ventricular fibrillation and sudden cardiac death. This study investigates the utility of implantable cardioverter defibrillator electrograms to estimate repolarization alternans preceding a tachyarrhythmic event. It is demonstrated that microvolt-level repolarization alternans is present prior to an arrhythmic event, and one can record low-amplitude-noise signals that can be used to obtain reliable estimates of repolarization alternans. This study eventually may lead to new methods that would prevent the onset of malignant tachyarrhythmias. 相似文献
7.
Holmberg SD Moorman AC Williamson JM Tong TC Ward DJ Wood KC Greenberg AE Janssen RS;HIV Outpatient Study 《Lancet》2002,360(9347):1747-1748
Protease inhibitors for treatment of HIV-1 have been linked with increased risk of hyperlipidaemia and hyperglycaemia. In a cohort of 5672 outpatients with HIV-1 seen at nine US HIV clinics between January, 1993, and January, 2002, the frequency of myocardial infarctions increased after the introduction of protease inhibitors in 1996 (test for trend, p=0.0125). We noted that 19 of 3247 patients taking, but only two of 2425 who did not take, protease inhibitors had a myocardial infarction (odds ratio 7.1, 95% CI 1.6-44.3; Cox proportional hazards model-adjusted for smoking, sex, age, diabetes, hyperlipidaemia, and hypertension-hazard ratio 6.5, 0.9-47.8). Our findings suggest that, although infrequent, use of protease inhibitors is associated with increased risk of myocardial infarction in patients with HIV-1. 相似文献
8.
Kayode O. Kuku Hector M. Garcia-Garcia Edward Koifman Alexandre H. Kajita Sameer Desale Viana Azizi Gebremedhin Melaku Anh Bui Yael F. Meirovich Solomon Beyene Aaphtaab Dheendsa Blaine Schneider Ron Waksman On behalf of the CELLO study investigators 《The international journal of cardiovascular imaging》2018,34(3):345-352
The CliRpath Excimer Laser System to Enlarge Lumen Openings (CELLO) registry included patients treated with modified excimer laser catheters for the endovascular treatment of peripheral artery disease affecting the superficial femoral artery (SFA) and proximal popliteal artery. The aim of this study was to assess, via intravascular ultrasound (IVUS) the dissections in the vessel wall following treatment with the laser catheters. IVUS grayscale images from the CELLO registry were systematically reviewed for dissections in the treated vessel segments by two investigators. Images from 33 patients; 66 pullbacks (1867 IVUS frames in 2 phases), were successfully matched frame-to-frame to evaluate identical segments of the treated vessels in the two phases; post-2 mm Turbo-Elite laser pilot channel creation and post Turbo-Booster laser atherectomy. Dissections were categorized as; (1) intimal, (2) medial, (3) intramural hematoma, and (4) adventitial according to the ACC Clinical Expert Consensus Document classification of dissections. An average of 57 frames was evaluated per pullback, giving a total of 3734 frames (1867 matched for pre-ablation (post channel creation) and post-ablation phases). Treatments with the modified Excimer laser catheters resulted in a significant increase in lumen area of 5.5?±?3.2-mm2 (95% CI 4.3–6.8, p?<?0.0001) and reduction in plaque plus media volume of ?10.6?±?36.0 mm3 (95% CI ?25.8 to 4.6, p?=?0.1619) whilst giving rise to mainly intramural hematoma formations post Turbo-Booster laser treatment in 55% of frames assessed and 24% medial dissections with less than 1% adventitial disruption. The Excimer laser based Turbo-Booster treatment of peripheral artery lesions resulted in significant plaque debulking and increased lumen diameter with negligible degree of adventitial layer injury. 相似文献
9.
Etienne Gayat Alexa Hollinger Alain Cariou Nicolas Deye Antoine Vieillard-Baron Samir Jaber Benjamin G. Chousterman Qin Lu Pierre François Laterre Xavier Monnet Michael Darmon Marc Leone Bertrand Guidet Romain Sonneville Jean-Yves Lefrant Marie-Céline Fournier Matthieu Resche-Rigon Alexandre Mebazaa Matthieu Legrand On behalf of FROG-ICU investigators 《Intensive care medicine》2018,44(5):598-605
10.
Zi-Meng Liu Juan Chen Qiuye Kou Qinhan Lin Xiaobo Huang Zhanhong Tang Yan Kang Ke Li Lixin Zhou Qing Song Tongwen Sun Ling Zhao Xue Wang Xiandi He Chunting Wang Benquan Wu Jiandong Lin Shiying Yuan Qin Gu Kejian Qian Xianqing Shi Yongwen Feng Aihua Lin Xiaoshun He Study Group of investigators Xiang-Dong Guan 《Intensive care medicine》2018,44(11):1816-1825