全文获取类型
收费全文 | 1566篇 |
免费 | 176篇 |
国内免费 | 5篇 |
专业分类
耳鼻咽喉 | 3篇 |
儿科学 | 46篇 |
妇产科学 | 28篇 |
基础医学 | 194篇 |
口腔科学 | 10篇 |
临床医学 | 207篇 |
内科学 | 370篇 |
皮肤病学 | 18篇 |
神经病学 | 56篇 |
特种医学 | 142篇 |
外科学 | 233篇 |
综合类 | 61篇 |
一般理论 | 1篇 |
预防医学 | 121篇 |
眼科学 | 17篇 |
药学 | 84篇 |
肿瘤学 | 156篇 |
出版年
2023年 | 4篇 |
2022年 | 22篇 |
2021年 | 40篇 |
2020年 | 22篇 |
2019年 | 28篇 |
2018年 | 39篇 |
2017年 | 43篇 |
2016年 | 27篇 |
2015年 | 29篇 |
2014年 | 41篇 |
2013年 | 71篇 |
2012年 | 87篇 |
2011年 | 86篇 |
2010年 | 70篇 |
2009年 | 65篇 |
2008年 | 56篇 |
2007年 | 62篇 |
2006年 | 75篇 |
2005年 | 67篇 |
2004年 | 77篇 |
2003年 | 58篇 |
2002年 | 49篇 |
2001年 | 29篇 |
2000年 | 44篇 |
1999年 | 25篇 |
1998年 | 41篇 |
1997年 | 33篇 |
1996年 | 38篇 |
1995年 | 43篇 |
1994年 | 30篇 |
1993年 | 21篇 |
1992年 | 22篇 |
1991年 | 27篇 |
1990年 | 19篇 |
1989年 | 31篇 |
1988年 | 23篇 |
1987年 | 22篇 |
1986年 | 42篇 |
1985年 | 17篇 |
1984年 | 20篇 |
1983年 | 13篇 |
1982年 | 7篇 |
1981年 | 10篇 |
1980年 | 12篇 |
1979年 | 8篇 |
1978年 | 21篇 |
1977年 | 8篇 |
1976年 | 8篇 |
1975年 | 5篇 |
1972年 | 2篇 |
排序方式: 共有1747条查询结果,搜索用时 31 毫秒
1.
Conan MacDougall Theora Canonica Chris Keh Binh An P. Phan Janice Louie 《Pharmacotherapy》2022,42(4):343-361
Rifamycins (rifampin, rifabutin, and rifapentine) play an essential role in the treatment of mycobacterial and some nonmycobacterial infections. They also induce the activity of various drug transporting and metabolizing enzymes, which can impact the concentrations and efficacy of substrates. Many anticoagulant and antiplatelet (AC/AP) agents are substrates of these enzymes and have narrow therapeutic indices, leading to risks of thrombosis or bleeding when coadministered with rifamycins. The objective of this systematic review was to evaluate the effects on AC/AP pharmacokinetics, laboratory markers, and clinical safety and efficacy of combined use with rifamycins. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidance was performed. The PubMed, Embase, and Web of Science databases were queried for English-language reports on combination use of rifamycins and AC/AP agents from database inception through August 2021. The 29 studies identified examined warfarin (n = 17), direct oral anticoagulants (DOACs) (n = 8), and antiplatelet agents (n = 4) combined with rifampin (n = 28) or rifabutin (n = 1). Eleven studies were case reports or small case series; 14 reported on pharmacokinetic or laboratory markers in healthy volunteers. Rifampin-warfarin combinations led to reductions in warfarin area under the curve (AUC) of 15%–74%, with variability by warfarin isomer and study. Warfarin dose increases of up to 3–5 times prerifampin doses were required to maintain coagulation parameters in the therapeutic range. DOAC AUCs were decreased by 20%–67%, with variability by individual agent and with rifampin versus rifabutin. The active metabolite of clopidogrel increased substantially with rifampin coadministration, whereas prasugrel was largely unaffected and ticagrelor saw decreases. Our review suggests most combinations of AC/AP agents and rifampin are problematic. Further studies are required to determine whether rifabutin or rifapentine could be safe alternatives for coadministration with AC/AP drugs. 相似文献
2.
Joseph F. Levy Rahul Khairnar Alexander V. Louie Timothy N. Showalter C. Daniel Mullins Mark V. Mishra 《Practical radiation oncology》2019,9(2):e172-e179
Purpose
A hydrogel rectal spacer (HRS) is a medical device that is approved by the U.S. Food and Drug Administration to increase the separation between the prostate and rectum. We conducted a cost-effectiveness analysis of HRS use for reduction in radiation therapy (RT) toxicities in patients with prostate cancer (PC) undergoing external beam RT (EBRT).Methods and Materials
A multistate Markov model was constructed from the U.S. payer perspective to examine the cost-effectiveness of HRS in men with localized PC receiving EBRT (EBRT alone vs EBRT + HRS). The subgroups analyzed included site of HRS placement (hospital outpatient, physician office, ambulatory surgery center) and proportion of patients with good baseline erectile function (EF). Data on EF, gastrointestinal and genitourinary toxicities incidence, and potential risks associated with HRS implantation were obtained from a recently published randomized clinical trial. Health utilities and costs were derived from the literature and the 2018 Physician Fee Schedule and were discounted 3% annually. Quality-adjusted life years (QALYs) and costs were modeled for a 5-year period from receipt of RT. Probabilistic sensitivity analysis and value-based threshold analyses were conducted.Results
The per-patient 5-year incremental cost for spacers administered in a hospital outpatient setting was $3578, and the incremental effectiveness was 0.0371 QALYs. The incremental cost-effectiveness ratio was $96,440/QALY for patients with PC undergoing HRS insertion in a hospital and $39,286/QALY for patients undergoing HRS insertion in an ambulatory facility. For men with good baseline EF, the incremental cost-effectiveness ratio was $35,548/QALY and $9627/QALY in hospital outpatient and ambulatory facility settings, respectively.Conclusions
Based on the current Medicare Physician Fee Schedule, HRS is cost-effective at a willingness to pay threshold of $100,000. These results contain substantial uncertainty, suggesting more evidence is needed to refine future decision-making. 相似文献3.
4.
5.
6.
The first 150 words of the full text of this article appear below. Key points Coronary artery disease accounts for >30% ofdeaths in Western society. The diagnosis of myocardial infarctionshould be qualified by size, causation and time from occurrence. Mortalityis reduced by immediate or primary percutaneouscoronary intervention or thrombolysis within the first 24 hof onset of ST-segment elevation myocardial infarction. Strategiesto reduce platelet activation (glycoprotein IIb/IIIa receptorantagonists, or clopidogrel) are now recommended in the treatmentof high-risk non-ST-segment myocardial infarction/unstable angina. Elevatedserum troponins may be the result of non-ischaemic myocardialdamage, especially in critical illness.
Pathophysiology
Changes in the definition of terms relating to the diagnosisof myocardial infarction (MI) have evolved by better understandingof the pathophysiology culminating in the new term of acutecoronary syndrome (ACS). Figure 1 illustrates the processesthat occur in the development of an acute coronary event. 相似文献
7.
Braffman BH; Coleman BG; Ramchandani P; Arger PH; Nodine CF; Dinsmore BJ; Louie A; Betsch SE 《Radiology》1994,190(3):797
8.
9.
Karen G. Louie Thomas C. Hamilton Robert H. Shoemaker Robert C. Young Robert F. Ozols 《Investigational new drugs》1992,10(2):73-78
Summary Five compounds which were identified as potential new anticancer drugs inin vitro screening with the human tumor colony forming assay were selected for further evaluation usingin vitro andin vivo models of human ovarian cancer. Three of five compounds were found to inhibitin vitro colony formation of ovarian cancer cell lines derived from both untreated and combination chemotherapy refractory patients. One compound was also found to prolong survival in a human ovarian carcinoma xenograft model system. This compound, chloroquinoxaline sulfonamide, was selected for development and has shown preliminary indication of activity in phase I clinical testing. 相似文献
10.
M. P. Muller S. E. Richardson A. McGeer L. Dresser J. Raboud T. Mazzulli M. Loeb M. Louie 《European journal of clinical microbiology & infectious diseases》2006,25(4):230-237
The clinical presentation of SARS is nonspecific and diagnostic tests do not provide accurate results early in the disease course. Initial diagnosis remains reliant on clinical assessment. To identify features of the clinical assessment that are useful in SARS diagnosis, the exposure status and the prevalence and timing of symptoms, signs, laboratory and radiographic findings were determined for all adult patients admitted with suspected SARS during the Toronto SARS outbreak. Findings were compared between patients with laboratory-confirmed SARS and those in whom SARS was excluded by laboratory or public health investigation. Of 364 cases, 273 (75%) had confirmed SARS, 30 (8%) were excluded, and 61 (17%) remained indeterminate. Among confirmed cases, exposure occurred in the healthcare environment (80%) or in the households of affected patients (17%); community or travel-related cases were rare (<3%). Fever occurred in 97% of patients by the time of admission. Respiratory findings including cough, dyspnea and pulmonary infiltrates evolved later and were present in only 59, 37 and 68% of patients, respectively, at admission. Direct exposure, fever on the first day of illness, and elevated temperature, pulmonary infiltrates, lymphopenia and thrombocytopenia at admission were associated with confirmed cases. Rhinorrhea, sore throat, and an elevated neutrophil count at admission were associated with excluded cases. In the absence of fever or significant exposure, SARS is unlikely. Other clinical, laboratory and radiographic findings further raise or lower the likelihood of SARS and provide a rational basis for estimating the likelihood of SARS and directing initial management. 相似文献