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2.
Radiofrequency-ablation of unresectable primary and secondary liver tumors: results in 88 patients 总被引:5,自引:0,他引:5
Philipp Hildebrand Markus Kleemann Uwe J. Roblick Lutz Mirow Matthias Birth Thorsten Leibecke Hans-Peter Bruch 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2006,391(2):118-123
Background and aims Radiofrequency-ablation (RFA) is increasingly used for destruction of unresectable primary and secondary liver tumors. We
report our experience in the use of RFA for the management of unresectable hepatic malignancies.
Patients and methods Between February 2000 and December 2004 we have undertaken 120 RFA procedures to ablate 426 unresectable primary or metastatic
liver tumors in 88 patients. RFA was performed via laparotomy (n=68), laparoscopy (n=9) or a percutaneous approach (n=43). Primary liver cancer was treated in seven patients (8%) and metastatic liver tumors were treated in 81 patients (92%).
All patients were followed to assess complications, treatment response and recurrence of malignant disease.
Results Procedure-related complication rate was low (3.4%). During a mean follow-up of 21.2 months, 15 patients had local tumor progression
(17%), 21 patients (23,9%) had new malignant disease and 27 patients (30.7%) died from intervention-unrelated complications
of their malignant disease. Additional liver lesions were identified in 27 (35%) of 77 cases by intraoperative ultrasound.
Thirty-six patients received simultaneous resection and RFA.
Conclusion RFA is a safe, well-tolerated and effective treatment for patients with unresectable primary and secondary liver malignancies. 相似文献
3.
Thorsten Grund Konrad Lehmann Nathalie Bock Aribert Rothenberger Gertraud Teuchert-Noodt 《Behavioral and brain functions : BBF》2006,2(1):2-14
Methylphenidate (MPH) is the most commonly used drug to treat attention deficit/hyperactivity disorder (ADHD) in children
effectively and safely. In spite of its widespread application throughout one of the most plastic and sensitive phases of
brain development, very little is known to date about its long-term effects on brain structure and function. Hence, this short
review updates the influence of MPH on brain development, since recent human and animal studies suggest that MPH alters the
dopaminergic system with long-term effects beyond the termination of treatment. 相似文献
4.
Dr. med. Thorsten Schäfer Heike Vogelsang 《Somnologie - Schlafforschung und Schlafmedizin》2002,6(2):79-84
Summary Question of the study Nasal continuous positive airway pressure (CPAP) prevents collapse of the upper airway during sleep in patients with obstructive sleep apnea provided that a positive transmural pressure can be maintained during inspiration. We examined pressure-flow characteristics in seven CPAP and bilevel devices during spontaneous breathing.
Methods The CPAP devices were set to a pressure level of 9.8 hPa (10 cm H2 O) and adapted to a pneumotachograph using a standard CPAP hose and an outlet valve. We continuously measured flow, volume and pressure during resting ventilation and increasing voluntary hyperventilation and analysed the dependence of the variables on a breath-to-breath basis.
Results Mean CPAP pressures differed between the devices (9.9 – 10.6 hPa) despite the same settings. In all machines pressure fell during inspiration to 8.4 – 9.8 hPa and increased during expiration to 11.1 – 11.7 hPa. This effect increased with higher flow rates. Maximum expiratory pressures rose to 12 – 19 hPa at peak flow rates of 2 l/s, mean expiratory pressures to 9.5 – 16 hPa. Inspiratory pressures dropped to 8.5 – 4.5 hPa (minimum) and 10.5 – 6.0 (mean). Bilevel devices showed a higher stability than CPAP devices. Pressure swings during the respiratory cycle increased the additional work of breathing.
Conclusions Due to differences in mean and effective CPAP levels CPAP devices are not simply exchangeable but should be individually adapted. Patients with higher minute ventilation might benefit from more stable CPAP machines. The impact on patients' compliance remains to be evaluated. 相似文献
Methods The CPAP devices were set to a pressure level of 9.8 hPa (10 cm H
Results Mean CPAP pressures differed between the devices (9.9 – 10.6 hPa) despite the same settings. In all machines pressure fell during inspiration to 8.4 – 9.8 hPa and increased during expiration to 11.1 – 11.7 hPa. This effect increased with higher flow rates. Maximum expiratory pressures rose to 12 – 19 hPa at peak flow rates of 2 l/s, mean expiratory pressures to 9.5 – 16 hPa. Inspiratory pressures dropped to 8.5 – 4.5 hPa (minimum) and 10.5 – 6.0 (mean). Bilevel devices showed a higher stability than CPAP devices. Pressure swings during the respiratory cycle increased the additional work of breathing.
Conclusions Due to differences in mean and effective CPAP levels CPAP devices are not simply exchangeable but should be individually adapted. Patients with higher minute ventilation might benefit from more stable CPAP machines. The impact on patients' compliance remains to be evaluated. 相似文献
5.
S P Schinke M A Orlandi R F Schilling C Parms 《Public health reports (Washington, D.C. : 1974)》1992,107(3):323-330
Hispanic and African American adolescents are more likely than white Anglo youth to harbor misconceptions about acquired immunodeficiency syndrome (AIDS) and are also more likely to engage in intravenous drug use and sexual intercourse. This paper describes the development of an AIDS prevention curriculum that uses an interactive videodisc program to teach skills for interventions. Focus group and expert panel studies yielded suggests for intervention vignettes and scenes relevant to Hispanic and African American adolescents. The authors then developed and produced a sample curriculum, specifically designed for Hispanic youth. Content was designed to build knowledge, attitudes, and skills in handling situations where young persons are at risk for human immunodeficiency virus (HIV) infection. The feasibility of the finished pilot product was tested with adolescents and with professionals who serve ethnic and racial minority youth. Adults and Hispanic adolescent viewers rated the videodisc as enjoyable, interesting, and likely to achieve positive effects with the intended target population. Findings suggest that the interactive videodisc is a useful way to interest and help Hispanic adolescents learn ways of reducing their risk of contracting and spreading HIV infection through lifestyle practices. This developmental research in the use of interactive videodisc also provides a basis for further investigation. 相似文献
6.
Thorsten Gerstner Deike Buesing Elke Longin Claudia Bendl Dieter Wenzel Brigitte Scheid Gisela Goetze Alfons Macke Gerhard Lippert Wolfgang Klostermann Geert Mayer Regine Augspach-Hofmann Sabine Fitzek Carl-Albrecht Haensch Markus Reuland Stephan A Koenig 《Seizure》2006,15(6):443-448
Valproic acid (VPA) is a broad-spectrum antiepileptic drug and is usually well-tolerated. Rare serious complications may occur in some patients, including haemorrhagic pancreatitis, bone marrow suppression, VPA-induced hepatotoxicity and VPA-induced encephalopathy. The typical signs of VPA-induced encephalopathy are impaired consciousness, sometimes marked EEG background slowing, increased seizure frequency, with or without hyperammonemia. There is still no proof of causative effect of VPA in patients with encephalopathy, but only of an association with an assumed causal relation. We report 19 patients with VPA-associated encephalopathy in Germany from the years 1994 to 2003, none of whom had been published previously. 相似文献
7.
Inhaled iloprost to control residual pulmonary hypertension following pulmonary endarterectomy 总被引:4,自引:0,他引:4
Thorsten Kramm Balthasar Eberle Stefan Guth Eckhard Mayer 《European journal of cardio-thoracic surgery》2005,28(6):882-888
Objective: Pulmonary endarterectomy (PEA) is the standard therapy for patients with chronic thromboembolic pulmonary hypertension (CTEPH). In the immediate postoperative period, persistent pulmonary hypertension increases the risk of acute respiratory or right heart failure. In pulmonary arterial hypertension, prostanoid inhalation has been found to improve pulmonary hemodynamics, right ventricular function, gas exchange, and clinical outcome. We report the results of a double-blinded randomized trial with the aerosolized prostacyclin analogue iloprost in patients with residual pulmonary hypertension after PEA. Methods: Twenty-two patients (age, 55 ± 13 years; 8 females; propofol- and sufentanil-based anesthesia; pressure-controlled mechanical ventilation) were randomized to receive either a single dose of 25 μg aerosolized iloprost (iloprost group; n = 11) or normal saline (placebo group; n = 11) immediately after postoperative ICU admission. Primary endpoints were changes in gas exchange, pulmonary and systemic hemodynamics, and clinical outcome. Results: Iloprost significantly enhanced cardiac index (CI) and reduced mean pulmonary arterial pressure (mPAP) and pulmonary vascular resistance [PVR (dyn s cm−5)] in contrast to placebo. Placebo: pre-inhalation 413 ± 195 versus post-inhalation 404 ± 196 at 30 min (p = 0.051), 415 ± 189 at 90 min (p = 0.929). Iloprost: pre-inhalation 503 ± 238 versus post-inhalation 328 ± 215 at 30 min (p = 0.001), 353 ± 156 at 90 min (p = 0.003). Blood oxygenation remained unchanged. Conclusion: In addition to the effect of PEA, iloprost reduces residual postoperative pulmonary hypertension, decreases right ventricular afterload and may facilitate the early postoperative management after PEA. 相似文献
8.
9.
Thorsten Sch?fer 《Infection》1992,20(6):312-312
Information
1992 science award of the Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. 相似文献10.
Gropp E Shanabrough M Borok E Xu AW Janoschek R Buch T Plum L Balthasar N Hampel B Waisman A Barsh GS Horvath TL Brüning JC 《Nature neuroscience》2005,8(10):1289-1291
Multiple hormones controlling energy homeostasis regulate the expression of neuropeptide Y (NPY) and agouti-related peptide (AgRP) in the arcuate nucleus of the hypothalamus. Nevertheless, inactivation of the genes encoding NPY and/or AgRP has no impact on food intake in mice. Here we demonstrate that induced selective ablation of AgRP-expressing neurons in adult mice results in acute reduction of feeding, demonstrating direct evidence for a critical role of these neurons in the regulation of energy homeostasis. 相似文献