全文获取类型
收费全文 | 575篇 |
免费 | 47篇 |
国内免费 | 5篇 |
专业分类
儿科学 | 2篇 |
妇产科学 | 3篇 |
基础医学 | 36篇 |
临床医学 | 77篇 |
内科学 | 229篇 |
特种医学 | 5篇 |
外科学 | 13篇 |
综合类 | 47篇 |
预防医学 | 141篇 |
药学 | 58篇 |
1篇 | |
中国医学 | 10篇 |
肿瘤学 | 5篇 |
出版年
2024年 | 9篇 |
2023年 | 22篇 |
2022年 | 47篇 |
2021年 | 53篇 |
2020年 | 68篇 |
2019年 | 52篇 |
2018年 | 50篇 |
2017年 | 20篇 |
2016年 | 22篇 |
2015年 | 24篇 |
2014年 | 40篇 |
2013年 | 57篇 |
2012年 | 37篇 |
2011年 | 37篇 |
2010年 | 11篇 |
2009年 | 17篇 |
2008年 | 16篇 |
2007年 | 8篇 |
2006年 | 7篇 |
2005年 | 8篇 |
2004年 | 4篇 |
2003年 | 4篇 |
2002年 | 2篇 |
2000年 | 1篇 |
1999年 | 7篇 |
1997年 | 2篇 |
1995年 | 1篇 |
1993年 | 1篇 |
排序方式: 共有627条查询结果,搜索用时 744 毫秒
1.
含左氧氟沙星及卷曲霉素方案治疗耐多药肺结核近期疗效分析 总被引:21,自引:0,他引:21
目的 观察和评价含左氧氟沙星和卷曲霉素联合化疗方案在耐多药肺结核 (MDR PTB)治疗中的疗效。方法 将 177例MDR PTB患者分为治疗组 88例和对照组 89例。化疗方案 :治疗组以左氧氟沙星和卷曲霉素为主 ,联合利福喷汀、异烟肼、对氨基水杨酸钠、吡嗪酰胺 ;对照组用链霉素、乙胺丁醇 ,联用药物同治疗组 ,疗程均为 2 1个月。结果 共有 16 1例患者完成化疗疗程 ,治疗组 82例 ,痰菌阴转率 83% ;对照组 79例 ,痰菌阴转率 5 8% ;痰菌阴转率治疗组明显高于对照组 (P <0 0 1) ;治疗组病灶显效率 5 0 % ,空洞闭合率 6 3% ,治疗组优于对照组 (P <0 0 1) ;治疗组的药物不良反应率为 31% ,对照组为 35 % ,两组比较差异无显著性 (P >0 0 5 )。结论 含左氧氟沙星和卷曲霉素的方案治疗MDR PTB ,有助于痰菌阴转和病变吸收好转 ,药物不良反应低 ,值得在临床上推广应用 相似文献
2.
3.
��һ���������ֵ��ȣ��⡡�����ڣ������� 《中国实用儿科杂志》2019,34(5):414-418
??Objective??To investigate the clinical features and risk factors of multidrug-resistant bloodstream infection in children with acute leukemia. Methods??The clinical data of 121 blood culture-positive patients with acute leukemia admitted from January 1??2013 to September 30??2018 to Department of Pediatrics??Zhujiang Hospital of Southern Medical University were analyzed retrospectively. Results??Of the 121 patients with acute leukemia infected with bacterial bloodstream??55 were in the multidrug-resistant??MDR?? group and 66 in the non-multidrug-resistant??non-MDR?? group. There were 31 gram-positive bacteria in the MDR group. The top three strains were coagulase-negative Staphylococci??Staphylococcus aureus and Streptococcus mutans. Escherichia coli was the main strain of gram-negative bacteria. Logistic analysis suggested that MDR bloodstream infection was more likely to occur in the patiens with AML??P??0.038??OR 2.505??95%CI 1.036—6.058?? and at induction chemotherapy stage??P??0.038??OR 2.226??95%CI 1.045—4.774??. Other high-risk factors included neutropenic dysplasia ??7 d before fever??P??0.003??OR 3.36??95%CI 1.520—7.428????hemoglobin ??70 g/L??P??0.122??OR 1.897??95%CI 0.842—4.274????and platelet??20 g/L??P??0.005??OR 2.995??95%CI 1.388—6.464??. The fever duration and antibiotic course in the MDR group were longer than those in the non-MDR group??and the procalcitoni and C-reactive protein were higher in the MDR group. The empirical treatment of the MDR group was less effective??and the transfer rate for ICU and mortality rate were higher. Conclusion??AML??induction chemotherapy??neutrophil deficiency time before fever ??7 days ??hemoglobin??70 g/L and platelet??20×109/L are risk factors for MDR bloodstream infection. The inflammation response is severe MDR bloodstream infections??which may result in longer anti-infective treatments and a worse prognosis. 相似文献
4.
Julia V. Ershova Grigory V. Volchenkov Dorothy A. Kaminski Tatiana R. Somova Tatiana A. Kuznetsova Natalia V. Kaunetis J. Peter Cegielski Ekaterina V. Kurbatova 《Emerging infectious diseases》2015,21(11):2048-2051
We studied the epidemiology of drug-resistant tuberculosis (TB) in Vladimir Region, Russia, in 2012. Most cases of multidrug-resistant TB (MDR TB) were caused by transmission of drug-resistant strains, and >33% were in patients referred for testing after mass radiographic screening. Early diagnosis of drug resistance is essential for preventing transmission of MDR TB. 相似文献
5.
目的:比较分析耐多药结核病(MDR-TB)临床治疗药物和潜在药物结构与性质差异,为开发新药提供参考。方法:运用密度泛函理论M06-2X/6-311+G(2d,p)方法,对噁唑烷酮类MDR-TB治疗药物利奈唑胺(Lin),临床试验药物舒特唑胺(Sut)、德帕唑胺(Del)、TBI-223(223)及新近合成化合物19c的药效构象、几何和电子结构、红外(IR)、紫外-可见(UV-Vis)、电子圆二色(ECD)谱进行计算比较,并借助概念密度泛函理论进行分子全局反应指数分析,使用药物代谢动力学平台开展成药性和ADME/Tox评估。结果:计算显示19c增加一个手性中心明显减少了药效构象,在不同溶剂环境中,五种化合物药效结构几何参数值相近,计算值与晶体参数吻合较好。极性环境使Del极性改变最大。计算红外光谱特征与实验吻合。Lin计算的紫外最大吸收波数与实验完全一致,Del紫外吸收光谱以HOMO电子向LUMO跃迁为主,其他均以HOMO向LUMO+2跃迁为主,都具有双峰曲线。Sut计算ECD峰与实验相吻合。19c、Sut和Lin静电势分布主要集中在噁唑烷酮端,而Del和223则另一端呈电势负性。五种化合物反应指数彼此数值接近。类药性评价显示Del分布系数与其他差别大,整体彼此相近。动力学参数五种化合物比较一致,但临床用药Lin的参数更优。结论:新化合物19c较MDR-TB临床治疗药物及临床试验药物具有优势,存在进一步开发的价值。 相似文献
6.
7.
8.
9.
Svetlana Zhdanova Scott K. Heysell Oleg Ogarkov Galina Boyarinova Galina Alexeeva Suporn Pholwat Elena Zorkaltseva Eric R. Houpt Eugeniy Savilov 《Emerging infectious diseases》2013,19(10):1649-1652
Of 235 Mycobacterium tuberculosis isolates from patients who had not received tuberculosis treatment in the Irkutsk oblast and the Sakha Republic (Yakutia), eastern Siberia, 61 (26%) were multidrug resistant. A novel strain, S 256, clustered among these isolates and carried eis-related kanamycin resistance, indicating a need for locally informed diagnosis and treatment strategies. 相似文献
10.
Improving treatment outcomes in multidrug-resistant tuberculosis (MDR-TB) is partly hampered by inadequate effective antitubercular agents. Development of bedaquiline and delamanid has potentially changed the treatment landscape for MDR-TB. This review provides an update on the progress of these novel antitubercular agents. We review published studies aimed at evaluating clinical efficacy and effectiveness of bedaquiline and delamanid. Five prospective clinical studies and seven retrospective studies on bedaquiline showed that patients treated with a bedaquiline-containing regimen had a high culture conversion rate ranging from 65 to 100% and a satisfactory treatment outcome. The combined use with linezolid might add to the effectiveness of bedaquiline. Controversies about bedaquiline resistance are discussed. Three clinical trials have reported outcomes on delamanid and showed that introducing delamanid to a background regimen improved culture conversion rate at 2 months from 29.6% to more than 40%. A higher favorable treatment rate was also observed among patients who received delamanid for more than 6 months, but about a quarter of patients defaulted in the control group. Seven retrospective studies were summarized and found a treatment benefit as well. More reliable evidence from randomized clinical trials reporting on the treatment outcomes is needed urgently to support a strong recommendation for the use of delamanid. Advances in the combined use of bedaquiline and delamanid are also reviewed, and the combination may be well tolerated but requires electrocardiograph monitoring. 相似文献