全文获取类型
收费全文 | 680篇 |
免费 | 25篇 |
国内免费 | 12篇 |
专业分类
耳鼻咽喉 | 1篇 |
儿科学 | 15篇 |
妇产科学 | 26篇 |
基础医学 | 58篇 |
临床医学 | 51篇 |
内科学 | 215篇 |
皮肤病学 | 9篇 |
神经病学 | 40篇 |
特种医学 | 12篇 |
外科学 | 34篇 |
综合类 | 134篇 |
预防医学 | 66篇 |
眼科学 | 7篇 |
药学 | 33篇 |
1篇 | |
中国医学 | 6篇 |
肿瘤学 | 9篇 |
出版年
2024年 | 1篇 |
2023年 | 6篇 |
2022年 | 32篇 |
2021年 | 35篇 |
2020年 | 31篇 |
2019年 | 28篇 |
2018年 | 32篇 |
2017年 | 21篇 |
2016年 | 33篇 |
2015年 | 37篇 |
2014年 | 54篇 |
2013年 | 53篇 |
2012年 | 31篇 |
2011年 | 52篇 |
2010年 | 36篇 |
2009年 | 34篇 |
2008年 | 26篇 |
2007年 | 30篇 |
2006年 | 22篇 |
2005年 | 19篇 |
2004年 | 12篇 |
2003年 | 14篇 |
2002年 | 11篇 |
2001年 | 11篇 |
2000年 | 8篇 |
1999年 | 7篇 |
1998年 | 7篇 |
1997年 | 5篇 |
1996年 | 9篇 |
1994年 | 1篇 |
1993年 | 2篇 |
1992年 | 1篇 |
1991年 | 2篇 |
1990年 | 5篇 |
1988年 | 1篇 |
1985年 | 1篇 |
1984年 | 2篇 |
1982年 | 1篇 |
1980年 | 1篇 |
1978年 | 1篇 |
1977年 | 1篇 |
1976年 | 1篇 |
排序方式: 共有717条查询结果,搜索用时 15 毫秒
1.
J. Rodríguez-Carrio A. Martínez-Zapico I. Cabezas-Rodríguez L. Benavente Á.I. Pérez-Álvarez P. López J.B. Cannata-Andía M. Naves-Díaz A. Suárez 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2019,29(2):135-143
Background and aims
Since accelerated atherosclerosis has been reported in systemic lupus erythematosus (SLE), predictive biomarkers of cardiovascular disease (CVD) are needed. Among non-traditional risk factors, bone mineral density (BMD) has been related to CVD. However, its role in SLE remains controversial. This study aims to analyze the associations of subclinical atherosclerosis with traditional and non-traditional CV risk factors.Methods and results
In a cross-sectional study, atherosclerosis burden was compared between 112 female SLE patients and 31 controls. Plaque number and carotid intima-media wall thickness (cIMT) were assessed by ultrasonography. In a retrospective study, BMD determinations obtained 5-years before the ultrasonography assessment were analyzed in a subgroup of 62 patients. Plaque frequency was increased in SLE, even in patients without CV events or carotid wall thickening. cIMT was increased in patients with CVD, positively correlated with body mass index (BMI). Interestingly, a paradoxical effect of BMI on carotid parameters was observed. Whereas underweight patients (BMI < 20) showed increased prevalence of carotid plaques with low cIMT, those with BMI > 30 showed higher cIMT and plaque burden. Overweight patients (25 < BMI<30) exhibited both elevated cIMT and plaque number. BMI was an independent predictor of BMD. In our retrospective study, patients with either clinical or subclinical CVD exhibited lower BMD levels than their CV-free counterparts. A low lumbar spine BMD independently predicted CVD development after adjusting for confounders.Conclusion
SLE was associated with a higher subclinical atherosclerosis burden, a bimodal effect being observed for BMI. Decreased BMD can be a CV risk biomarker in SLE. 相似文献2.
Nine sawmill workers were divided into two groups according to their exposure to 2-ethylhexanoic acid, (EHA), a pesticide which has replaced the older pentochlorophenol. The men with lower exposure excreted 30±10 nmol EHA/mmol creatinine (mean ±SD,n=4) in urine samples taken after the workshift, whereas men with higher exposure excreted 1.8±1.6 mol EHA/mmol creatinine (mean±SD,n=5,p<0.01). The urinary ornithine and arginine concentrations were at the lower exposure 1.4±0.4 and 1.5±0.8 mol/mmol creatinine, respectively (mean±SD,n=4), and they increased significantly (p<0.01) to 4.5±2.5 and 3.2±1.5mol/mmol (mean±SD,n=5), respectively, at the higher exposure. This might have been caused by the inhibitory effect of EHA on urea synthesis which was partially compensated for by elevated arginine and ornithine concentrations to drive the urea cycle more efficiently. 相似文献
3.
《Annales d'endocrinologie》2018,79(3):149-152
Patients with adrenal incidentaloma (AI) and subclinical hypercortisolism (SH) show a high prevalence of cardiovascular risk factors and an increased prevalence and incidence of cardiovascular events. Furthermore, some recent data suggest that in these patients, the cardiovascular mortality is also increased. Unfortunately, to date, the diagnosis of SH is still a matter of debate, and, therefore, it is still not possible to address the treatment of choice (i.e. surgical or conservative approach) in many AI patients. Overall, the available data show that in AI patients with established SH the surgical removal of the adrenal mass causing SH can lead to the improvement of hypertension and diabetes, but in many patients with possible SH the effect of surgery is still largely unknown. Finally, no data are available on the effect of the recovery from SH on the cardiovascular events. Therefore, randomized studies are needed to investigate the possibility of predicting the usefulness of surgery by using the available indexes of cortisol secretion in the individual AI patient. Finally, the development of safe and well-tolerated drugs aimed to control cortisol secretion will be among the goals of the future research. 相似文献
4.
IntroductionBehçet’s disease (BD) is an idiopathic multisystem disorder. Cardiac involvement[cardio-BD] occurs in 7–60% of BD patients. Technetium 99m-Methoxyisobutyl isonitrile (Tc-99m sestamibi) is a myocardial perfusion imaging agent that is used for evaluation of the coronary flow.Aim of the workTo evaluate the usefulness of Dipyridamole pharmacological stress test in conjunction with Tc-99m sestamibi cardiac gated single photon emission computed tomography (GSPECT) to investigate the prevalence of subclinical coronary endothelial dysfunction[SCED] in asymptomatic Egyptian BD patients; also to assess possibly associated clinical predictive variables.Patients and MethodsTwenty-five BD patients without overt cardiac involvement and fifteen healthy controls matched for age, BMI and sex were included. Database included full history, clinical examination, relevant laboratory tests, and Tc-99m sestamibi myocardial GSPECT with coronary angiography[CAG] in GSPECT positive cases. Disease activity was assessed using Behçet’s Disease Current Activity Form (BDCAF).ResultsSCED detected by reduced flow or left ventricular dysfunction (LVD) or both was found in 13/25[52%] of BD-patients[12 males and 1 female] vs. 1/15[6.7%] of controls[P < 0.0001] with normal CAG. Subjects with positive GSPECT had significantly older age[P = 0.01] and longer disease duration (P = 0.02) and were more frequently males (P < 0.0001) than those with negative GSPECT. No statistically significant differences between cases with negative and positive GSPECT were found regarding other clinical or laboratory parameters.ConclusionTc-99m sestamibi GSPECT could be a useful screening tool for detection of SCED in BD patients, so early prophylactic measures and therapy modifications could be considered. 相似文献
5.
6.
The aim of this study was to determine the clinical importance and predictors of SCSs in a large population of patients with temporal epilepsy (TLE) undergoing video electroencephalographic (VEEG) monitoring. We reviewed the VEEG data of 327 consecutive patients with TLE admitted to our epilepsy center between August 2012 and January 2017. Demographic, electro-clinical, and neuroimaging data were recorded and re-analyzed. To our knowledge, this is the first study assessing SCSs recorded by long-term VEEG monitoring in patients with TLE. Twenty-seven of 327 (8.3%) patients exhibited SCSs during VEEG monitoring. Of these patients, 24 had both SCSs and clinical seizures. The mean duration of the SCSs was 23.18 s (range: 5–1307 s). Of the 27 patients with SCSs, 24 (88.9%) showed localizing value during the diagnostic process. Seventeen patients exhibited colocalization with clinical seizures, 4 showed useless localization related to clinical seizures, and 3 did not have clinical seizures. Sixteen patients (59.3%) experienced their first SCSs within the first 24 h of monitoring and one had the first SCSs within 20 min. Multivariate logistic regression analysis showed that age <18 years at VEEG monitoring (OR = 3.272, 95% CI = 1.283–8.343, p = 0.013) and bilateral IEDs (OR = 4.558, 95% CI = 1.982–10.477, p < 0.001) were independently associated with the presence of SCSs. Thus, SCSs are not uncommon in patients with TLE, particularly those with age <18 years or bilateral IEDs, and should be considered of significant clinical relevance during the diagnostic process. 相似文献
7.
8.
B. Kowall N. Lehmann A.A. Mahabadi S. Moebus R. Erbel K.H. Jöckel A. Stang 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2019,29(3):228-235
Background and aims
There is controversy on the potentially benign nature of metabolically healthy obesity (MHO), i.e., obese persons with few or no metabolic abnormalities. So far, associations between MHO and coronary artery calcification (CAC), a measure of subclinical atherosclerosis, have mainly been studied cross-sectionally in Asian populations. We assessed cross-sectional and longitudinal MHO CAC associations in a Caucasian population.Methods and results
In the Heinz Nixdorf Recall Study, a population-based cohort study in Germany, CAC was assessed by electron-beam tomography at baseline and at 5-year follow-up. For cross-sectional and longitudinal analyses, we included 1585 participants free of coronary heart disease at baseline, with CAC measurements at baseline and at follow-up, and with either normal weight (BMI 18.5–24.9 kg/m2) or obesity (BMI ≥30.0 kg/m2) at baseline. We used four definitions of MHO. In our main analysis, we defined obese persons as metabolically healthy if they met ≤1 of the NCEP ATP III criteria for the definition of the metabolic syndrome – waist circumference was not taken into account because of collinearity with BMI.Persons with MHO had a higher prevalence of CAC than metabolically healthy normal weight (MHNW) persons (prevalence ratio = 1.59 (95% confidence interval 1.38–1.84) for the main analysis). Persons with MHO had slightly larger odds of CAC progression than persons with MHNW (odds ratios ranged from 1.17 (0.69–1.99) to 1.48 (1.02–2.13) depending on MHO definition and statistical approach).Conclusion
Our analyses on MHO CAC associations add to the evidence that MHO is not a purely benign health condition. 相似文献9.
Julian Jakob Roman von Wyl Odile Stalder Mark J. Pletcher Eric Vittinghoff Kali Tal Jamal S. Rana Stephen Sidney Jared P. Reis Reto Auer 《The American journal of medicine》2021,134(6):777-787.e9
BackgroundLong-term cardiovascular health effects of marijuana are understudied. Future cardiovascular disease is often indicated by subclinical atherosclerosis for which carotid intima-media thickness is an established parameter.MethodsUsing the data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of 5115 Black and white women and men at Year 20 visit, we studied the association between carotid intima-media thickness in midlife and lifetime exposure to marijuana (1 marijuana year = 365 days of use) and tobacco smoking (1 pack-year = 20 cigarettes/day for 365 days). We measured carotid intima-media thickness by ultrasound and defined high carotid intima-media thickness at the threshold of the 75th percentile of all examined participants. We fit logistic regression models stratified by tobacco smoking exposure, adjusting for demographics, cardiovascular risk factors, and other drug exposures.ResultsData was complete for 3257 participants; 2722 (84%) reported ever marijuana use; 374 (11%) were current users; 1539 (47%) reported ever tobacco smoking; 610 (19%) were current smokers. Multivariable adjusted models showed no association between cumulative marijuana exposure and high carotid intima-media thickness in never or ever tobacco smokers, odds ratio (OR) 0.87 (95% confidence interval [CI]: 0.63-1.21) at 1 marijuana-year among never smokers and OR 1.11 (95% CI: 0.85-1.45) among ever tobacco smokers. Cumulative exposure to tobacco was strongly associated with high carotid intima-media thickness, OR 1.88 (95%CI: 1.20-2.94) for 20 pack-years of exposure.ConclusionsThis study adds to the growing body of evidence that there might be no association between the average population level of marijuana use and subclinical atherosclerosis. 相似文献
10.
目的 探讨白细胞介素18(IL-18)和超敏C反应蛋白(high sensitivity-C reactive protein,hs-CRP)在亚临床甲减孕妇血清中的变化及其意义.方法 选取2013年10月至2015年3月在唐山市妇幼保健院妇产科检查的亚临床甲减(SCH)孕妇115例为观察组,根据甲状腺自身抗体情况分为A组(甲状腺自身抗体阳性的SCH孕妇)53例、B组(甲状腺自身抗体阴性的SCH孕妇)62例,另选同期健康体检孕妇50例为对照组.化学发光法检测促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb);ELISA法检测白细胞介素18(IL-18);全自动生化检测hs-CRP,对结果进行分析比较.结果 A组、B组孕妇血清IL-18和hs-CRP水平均高于对照组,差异有统计学意义(P<0.05);A组血清IL-18水平高于B组,差异有统计学意义(P<0.05).IL-18、hs-CRP与TSH呈正相关(r=0.494 ~0.627,P<0.05).结论 IL-18、hs-CRP共同参与SCH的病理生理过程,可作为SCH早期诊断、治疗和预后判断的重要指标. 相似文献