收费全文 | 22615篇 |
免费 | 1298篇 |
国内免费 | 213篇 |
耳鼻咽喉 | 147篇 |
儿科学 | 1323篇 |
妇产科学 | 333篇 |
基础医学 | 2677篇 |
口腔科学 | 400篇 |
临床医学 | 1373篇 |
内科学 | 4092篇 |
皮肤病学 | 420篇 |
神经病学 | 1435篇 |
特种医学 | 747篇 |
外国民族医学 | 5篇 |
外科学 | 3356篇 |
综合类 | 834篇 |
一般理论 | 2篇 |
预防医学 | 1469篇 |
眼科学 | 1142篇 |
药学 | 2178篇 |
5篇 | |
中国医学 | 311篇 |
肿瘤学 | 1877篇 |
2023年 | 121篇 |
2022年 | 273篇 |
2021年 | 531篇 |
2020年 | 338篇 |
2019年 | 381篇 |
2018年 | 478篇 |
2017年 | 367篇 |
2016年 | 467篇 |
2015年 | 494篇 |
2014年 | 723篇 |
2013年 | 936篇 |
2012年 | 1330篇 |
2011年 | 1340篇 |
2010年 | 797篇 |
2009年 | 651篇 |
2008年 | 1096篇 |
2007年 | 1106篇 |
2006年 | 1025篇 |
2005年 | 995篇 |
2004年 | 845篇 |
2003年 | 863篇 |
2002年 | 769篇 |
2001年 | 623篇 |
2000年 | 643篇 |
1999年 | 576篇 |
1998年 | 256篇 |
1997年 | 224篇 |
1996年 | 199篇 |
1995年 | 190篇 |
1994年 | 152篇 |
1993年 | 155篇 |
1992年 | 364篇 |
1991年 | 392篇 |
1990年 | 348篇 |
1989年 | 390篇 |
1988年 | 296篇 |
1987年 | 306篇 |
1986年 | 246篇 |
1985年 | 270篇 |
1984年 | 233篇 |
1983年 | 206篇 |
1982年 | 128篇 |
1981年 | 115篇 |
1979年 | 188篇 |
1978年 | 124篇 |
1975年 | 134篇 |
1974年 | 143篇 |
1973年 | 136篇 |
1972年 | 123篇 |
1971年 | 142篇 |
Background
Multiple myeloma (MM) is a hematologic malignancy of plasma cell origin. MM primarily affects bone marrow, but extramedullary sites can also be involved. Myelomatous pleural effusion (MPE) is an atypical and rare complication of MM. We aimed to systematically study the incidence and clinicopathologic profile of patients with MPE in a real-world setting.Patients and Methods
In this retrospective study, 415 consecutive patients with MM managed at a tertiary care center in North India during a study period of January 1, 2010 to December 31, 2015 were evaluated for MPE. The patients with MPE were analyzed for their clinical profile, diagnosis, treatment, and outcomes.Results
Of these 415 patients, 11 (2.65%) patients had MPE. The median age of the study population was 50 years with male preponderance. The majority of these patients had immunoglobin (Ig)G Kappa disease. All patients had higher than International Staging System stage I disease. MPE was a presenting feature at MM diagnosis in 45.45% (n = 5) of the patients, whereas the rest developed MPE during follow-up. MPE presented predominantly (81.8%) as a unilateral effusion. Concurrent extramedullary involvement at other site was seen in 45.45% (n = 5), with 3 (27%) patients having concurrent myelomatous ascites. Six of these were managed aggressively, whereas 5 patients opted for palliation. The outcomes were dismal (90.9% mortality), with a median survival of 2.47 months.Conclusion
MPE is a rare entity, and positive outcomes of therapy remain low with dismal prognosis. 相似文献Objective
Hypertonic saline (HTS) has potent immune and vascular effects. We assessed recipient pretreatment with HTS on allograft function in a porcine model of heart transplantation and hypothesized that HTS infusion would limit endothelial and left ventricular (LV) dysfunction following transplantation.Methods
Heart transplants were performed after 6 hours of cold ischemic storage. Recipient pigs were randomized to treatment with or without HTS (7.5% NaCl) before cardiopulmonary bypass (CPB). Using a myograft apparatus, coronary artery endothelial-dependent (Edep) and -independent (Eind) relaxation was assessed. LV performance was determined using pressure-volume loop analysis. Pulmonary interleukin (IL)-2, IL-6, and tumor necrosis factor (TNF)-α expression was measured.Results
Weaning from CPB and LV performance after transplantation were improved in HTS-treated animals. Successful weaning from CPB was greater in the HTS-treated hearts (8 of 8 vs 2 of 8; P < .05). Mean LV functional recovery was improved in the HTS-treated animals, as assessed by preload recruitable stroke work (65 ± 10% vs 27 ± 10%; P < .001) and end-systolic elastance (55 ± 7% vs 37 ± 4%; P < .001). Treatment with HTS resulted in improved Edep (mean maximum elastance [Emax], 56 ± 5% vs 37 ± 7%; P < .001) and Eind (mean Emax%, 77 ± 6% vs 52 ± 4%; P < .001) vasorelaxation compared with control. Pulmonary expression of IL-2, IL-6, and TNF-α increased following transplantation, whereas HTS therapy attenuated IL production (P < .001). Transplantation increased plasma TNF-α levels and LV TNF-α expression, whereas HTS prevented this up-regulation (P < .001).Conclusions
Recipient HTS pretreatment preserves allograft vasomotor and LV function, and HTS therapy limits CPB-induced injury. HTS may be a novel recipient intervention to prevent graft dysfunction. 相似文献2. The CGA is administered intravenously (IV) and intranasally (IN) at the dose of 10?mg/kg. Further, its concentration in the plasma, cerebrospinal fluid (CSF) and the whole brain is analyzed by HPLC-UV method.
3. The study observes that CGA is rapidly absorbed in plasma with tmax of 1?min similar to IV route after IN administration. The peak plasma concentration and AUC0–24 are higher by 3.5 and 4.0 times respectively in IV administration, compared to IN delivery that represents the significant less systemic exposure of CGA in IN route.
4. However, the concentration of CGA in the brain is 4, 6.5, 5.3, 5.2 and 4.5 times higher at 30, 60, 120, 240 and 360?min, respectively in IN administration compared to IV administration. The exposure of CGA in the brain after IN administration (AUCbrain, IN) was significantly greater (4 times) as compared to the exposure of CGA in the brain (AUCbrain, IV) after IV administration reflecting significant brain uptake of CGA through nasal route. Therefore, IN delivery of CGA can be a promising approach for the treatment of stroke and neurodegenerative disorders. 相似文献