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1.
Paul J. Devlin Brian W. McCrindle James K. Kirklin Eugene H. Blackstone William M. DeCampli Christopher A. Caldarone Ali Dodge-Khatami Pirooz Eghtesady James M. Meza Peter J. Gruber Kristine J. Guleserian Bahaaladin Alsoufi Linda M. Lambert James E. OBrien Erle H. Austin Jeffrey P. Jacobs Tara Karamlou 《The Journal of thoracic and cardiovascular surgery》2019,157(2):684-695.e8
Objective
Arch obstruction after the Norwood procedure is common and contributes to mortality. We determined the prevalence, associated factors, and practice variability of arch reintervention and assessed whether arch reintervention is associated with mortality.Methods
From 2005 to 2017, 593 neonates in the Congenital Heart Surgeons' Society Critical Left Heart Obstruction cohort underwent a Norwood procedure. Median follow-up was 3.7 years. Multivariable parametric models, including a modulated renewal analysis, were performed.Results
Of the 593 neonates, 146 (25%) underwent 218 reinterventions for arch obstruction after the Norwood procedure: catheter-based (n = 168) or surgical (n = 50) at a median age of 4.3 months (quartile 1-quartile 3, 2.6-5.7). Interdigitation of the distal aortic anastomosis was protective against arch reintervention. Development of ≥ moderate tricuspid valve regurgitation and right ventricular dysfunction at any point was associated with arch reintervention. Nonsignificant variables for arch reintervention included shunt type and preoperative aortic measurements. Surgical arch reintervention was protective against arch reintervention, but transcatheter reintervention was associated with increased reintervention. Arch reintervention was not associated with increased mortality. There was wide institutional variation in incidence of arch reintervention (range, 0-40 reinterventions per 100 years patient follow-up) and in preintervention gradient (range, 0-64 mm Hg).Conclusions
Interdigitation of the distal aortic anastomosis during the Norwood procedure decreased the risk of arch reintervention. Surgical arch reintervention is more definitive than transcatheter. Arch reintervention after the Norwood procedure is not associated with increased mortality. Serial surveillance for arch obstruction, integrated with changes in right ventricular function and tricuspid valve regurgitation, is recommended after the Norwood procedure to improve outcomes. 相似文献2.
Molly Orcutt Wendy C. King Melissa A. Kalarchian Michael J. Devlin Marsha D. Marcus Luis Garcia Kristine J. Steffen James E. Mitchell 《Surgery for obesity and related diseases》2019,15(2):295-303
Background
A history of childhood maltreatment and psychopathology are common in adults with obesity.Objectives
To report childhood maltreatment and to evaluate associations between severity and type of childhood maltreatment and lifetime history of psychopathology among adults with severe obesity awaiting bariatric surgery.Setting
Four clinical centers of the Longitudinal Assessment of Bariatric Surgery Research Consortium.Methods
The Childhood Trauma Questionnaire, which assesses presence/severity (i.e., none, mild, moderate, severe) of physical abuse, mental abuse, physical neglect, mental neglect, and sexual abuse, was completed by 302 female and 66 male bariatric surgery patients. Presurgery lifetime history of psychopathology and suicidal ideation/behavior were assessed with the Structured Clinical Interview for DSM-IV and the Suicidal Behavioral Questionnaire-Revised, respectively. Presurgery lifetime history of antidepressant use was self-reported.Results
Two thirds (66.6%) of females and 47.0% of males reported at least 1 form of childhood trauma; 42.4% and 24.2%, respectively, at greater than or equal to moderate severity. Among women, presence/greater severity of childhood mental or physical abuse or neglect was associated with a higher risk of history of psychopathology (i.e., major depressive disorder, posttraumatic stress disorder, other anxiety disorder, alcohol use disorder, binge eating disorder), suicidal ideation/behavior and antidepressant use (P for all ≤ .02). These associations were independent of age, race, education, body mass index, and childhood sexual abuse. Childhood sexual abuse was independently associated with a history of suicidal ideation/behavior and antidepressant use only (P for both ≤ .05). Statistical power was limited to evaluate these associations among men.Conclusion
Among women with obesity, presence/severity of childhood trauma was positively associated with relatively common psychiatric disorders. 相似文献3.
4.
H. B. Devlin 《Annals of the Royal College of Surgeons of England》1990,72(3):175-176
5.
6.
A sensitive assay for human plasma BzAO, involving the conversion of 14C-benzylamine to 14C-benzaldehyde, was developed. MPTP and several of its analogues were found to be competitive inhibitors of the enzyme. Ki values for the MPTP analogues in the presence of human plasma BzAO were determined. The analogues had a different rank order of inhibition of human plasma BzAO compared with the rank order of inhibition of bovine plasma BzAO found previously. MPTP and 1-methyl-4-(2-methylphenyl)-1,2,3,6-tetrahydropyridine (2'-CH3-MPTP), which are potent nigrostriatal toxins, were weak inhibitors of human plasma BzAO. 相似文献
7.
R D Devlin D H Gutteridge R L Prince R W Retallack G K Worth 《Journal of bone and mineral research》1990,5(11):1121-1126
We report serum 25-hydroxyvitamin D (25-OHD), 24,25-dihydroxyvitamin D [24,25-(OH)2D], and 1,25-dihydroxyvitamin D [1,25-(OH)2D] levels in untreated Paget's disease and the effect of treatment with either calcitonin (CT) or etidronate (EHDP) on these levels. In untreated Paget's patients serum 25-OHD (73 +/- 29 nmol/liter, n = 36, mean +/- SD) and 24,25-(OH)2D (0.3-12.9 nmol/liter, median 2.2, n = 36) levels were significantly lower than in age-matched controls (94 +/- 30 nmol/liter, n = 32, p less than 0.005, and 1.3-16.4 nmol/liter, median 5.3; n = 32, p less than 0.001, respectively). Also, the 24,25-(OH)2D levels correlated with the 25-OHD levels in the untreated Paget's patients (r = 0.56, p less than 0.01) and in the controls (r = 0.39, p less than 0.05). The percentage molar ratio of 24,25-(OH)2D to 25-OHD in Paget's patients had a median value of 3.7% (range 0.4-14.3%), which was not significantly different from controls, who had a median value of 5.6% (range 2.2-18%). There was no difference between the 1,25-(OH)2D, and immunoreactive PTH (iPTH) levels of Paget's patients and control subjects. The percentage molar ratio of 1,25-(OH)2D to 25-OHD in untreated Paget's patients (0.157 +/- 0.09%) was not significantly different from controls (0.124 +/- 0.05%) despite lower 25-OHD levels in Paget's patients. There was a significant inverse correlation between the severity of Paget's disease as measured by plasma alkaline phosphatase (AP) levels and 25-OHD levels (r = 0.392, p less than 0.02); however, 24,25-(OH)2D and 1,25-(OH)2D levels were not correlated with AP.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
8.
9.
Philip M. Zeman Bernie C. Till Nigel J. Livingston James W. Tanaka Peter F. Driessen 《Clinical neurophysiology》2007,118(12):2591-2604
OBJECTIVE: To evaluate the effectiveness of a new method of using Independent Component Analysis (ICA) and k-means clustering to increase the signal-to-noise ratio of Event-Related Potential (ERP) measurements while permitting standard statistical comparisons to be made despite the inter-subject variations characteristic of ICA. METHODS: Per-subject ICA results were used to create a channel pool, with unequal weights, that could be applied consistently across subjects. Signals derived from this and other pooling schemes, and from unpooled electrodes, were subjected to identical statistical analysis of the N170 own-face effect in a Joe/No Joe face recognition paradigm wherein participants monitored for a target face (Joe) presented amongst other unfamiliar faces and their own face. Results between the Joe, unfamiliar face and own face conditions were compared using Cohen's d statistic (square root of signal-to-noise ratio) to measure effect size. RESULTS: When the own-face condition was compared to the Joe and unfamiliar-face conditions, the channel map method increased effect size by a factor ranging from 1.2 to 2.2. These results stand in contrast to previous findings, where conventional pooling schemes failed to reveal an N170 effect to the own-face stimulus (Tanaka JW, Curran T, Porterfield A, Collins D. The activation of pre-existing and acquired face representations: the N250 ERP as an index of face familiarity. J Cogn Neurosci 2006;18:1488-97). Consistent with conventional pooling schemes, the channel map approach showed no reliable differences between the Joe and Unfamiliar face conditions, yielding a decrease in effect size ranging from 0.13 to 0.75. CONCLUSIONS: By increasing the signal-to-noise ratio in the measured waveforms, the channel pool method demonstrated an enhanced sensitivity to the neurophysiological response to own-face relative to other faces. SIGNIFICANCE: By overcoming the characteristic inter-subject variations of ICA, this work allows classic ERP analysis methods to exploit the improved signal-to-noise ratio obtainable with ICA. 相似文献
10.
Hugh Devlin Kety Karayianni Anastasia Mitsea Reinhilde Jacobs Christina Lindh Paul van der Stelt Elizabeth Marjanovic Judith Adams Susan Pavitt Keith Horner 《Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics》2007,104(6):821-828
OBJECTIVES: Measurement of cortical thickness and subjective assessment of cortical porosity on panoramic radiographs are methods previously reported for diagnosing osteoporosis. The aims of this study were to determine the relative efficacy of the mandibular cortical index and cortical width in detecting osteoporosis, both alone and in combination, and to determine the optimal cortical width threshold for referral for additional osteoporosis investigation. STUDY DESIGN: Six hundred seventy-one postmenopausal women 45 to 70 years of age were recruited for this study. They received dual energy x-ray absorptiometry (DXA) scans of the left hip and lumbar spine (L1 to L4), and dental panoramic radiographic examinations of the teeth and jaws. Three observers separately assessed the mandibular cortical width and porosity in the mental foramen region of the mandible. Cortical width was corrected for magnification errors. Chi-squared automatic interaction detection analysis (CHAID) software was used (SPSS AnswerTree, version 3.1, SPSS Inc., Chicago, IL). RESULTS: Chi-squared automatic interaction detection analysis showed that the cortical porosity was a poorer predictor of osteoporosis than mandibular cortical width. For the 3 observers, a mandibular cortical width of <3 mm provided diagnostic odds ratios of 6.51, 6.09, and 8.04. The test is therefore only recommended in triage screening of individuals by using radiographs made for purposes other than osteoporosis. CONCLUSION: When evaluating panoramic radiographs, only those patients with the thinnest mandibular cortices (i.e., <3 mm) should be referred for further osteoporosis investigation. 相似文献