全文获取类型
收费全文 | 58159篇 |
免费 | 4459篇 |
国内免费 | 1092篇 |
专业分类
耳鼻咽喉 | 295篇 |
儿科学 | 777篇 |
妇产科学 | 756篇 |
基础医学 | 2963篇 |
口腔科学 | 380篇 |
临床医学 | 6975篇 |
内科学 | 5824篇 |
皮肤病学 | 348篇 |
神经病学 | 1686篇 |
特种医学 | 1211篇 |
外科学 | 3639篇 |
综合类 | 13063篇 |
现状与发展 | 3篇 |
一般理论 | 38篇 |
预防医学 | 17871篇 |
眼科学 | 272篇 |
药学 | 4347篇 |
297篇 | |
中国医学 | 2145篇 |
肿瘤学 | 820篇 |
出版年
2024年 | 168篇 |
2023年 | 979篇 |
2022年 | 1757篇 |
2021年 | 2466篇 |
2020年 | 2705篇 |
2019年 | 1916篇 |
2018年 | 1810篇 |
2017年 | 1752篇 |
2016年 | 1798篇 |
2015年 | 1737篇 |
2014年 | 4106篇 |
2013年 | 4488篇 |
2012年 | 3945篇 |
2011年 | 4286篇 |
2010年 | 3451篇 |
2009年 | 3017篇 |
2008年 | 3310篇 |
2007年 | 3098篇 |
2006年 | 2703篇 |
2005年 | 2214篇 |
2004年 | 1804篇 |
2003年 | 1463篇 |
2002年 | 1078篇 |
2001年 | 944篇 |
2000年 | 838篇 |
1999年 | 651篇 |
1998年 | 588篇 |
1997年 | 537篇 |
1996年 | 473篇 |
1995年 | 510篇 |
1994年 | 323篇 |
1993年 | 221篇 |
1992年 | 227篇 |
1991年 | 272篇 |
1990年 | 237篇 |
1989年 | 190篇 |
1988年 | 208篇 |
1987年 | 159篇 |
1986年 | 182篇 |
1985年 | 171篇 |
1984年 | 156篇 |
1983年 | 118篇 |
1982年 | 118篇 |
1981年 | 85篇 |
1980年 | 96篇 |
1979年 | 54篇 |
1978年 | 77篇 |
1977年 | 73篇 |
1976年 | 62篇 |
1975年 | 47篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
1.
Yosuke Homma Takashi Shiga Hiraku Funakoshi Dai Miyazaki Atsushi Sakurai Yoshio Tahara Ken Nagao Naohiro Yonemoto Arino Yaguchi Naoto Morimura 《The American journal of emergency medicine》2019,37(2):241-248
Objective
This study assessed the association between the timing of first epinephrine administration (EA) and the neurological outcomes following out-of-hospital cardiac arrests (OHCAs) with both initial shockable and non-shockable rhythms.Methods
This was a post-hoc analysis of a multicenter prospective cohort study (SOS-KANTO 2012), which registered OHCA patients in the Kanto region of Japan from January 2012 to March 2013. We included consecutive adult OHCA patients who received epinephrine. The primary result included 1-month favorable neurological outcomes defined as cerebral performance category (CPC) 1 or 2. Secondary results included 1-month survival and return of spontaneous circulation (ROSC) after arrival at the hospital. Multivariable logistic regression analysis determined the association between delay per minute of the time from call to first EA in both pre- or in-hospital settings and outcomes.Results
Of the 16,452 patients, 9344 were eligible for our analyses. In univariable analysis, the delay in EA was associated with decreased favorable neurological outcomes only when the initial rhythm was a non-shockable rhythm. In multivariable analyses, delay in EA was associated with decreased ROSC (adjusted odds ratio [OR] for one minute delay, 0.97; 95% confidence interval [CI], 0.96–0.98) and 1-month survival (adjusted OR, 0.95; 95% CI, 0.92–0.97) when the initial rhythm was a non-shockable rhythm, whereas during a shockable rhythm, delay in EA was not associated with decreased ROSC and 1-month survival.Conclusions
While assessing the effectiveness of epinephrine for OHCA, we should consider the time-limited effects of epinephrine. Additionally, consideration of early EA based on the pathophysiology is needed. 相似文献2.
王磊 《中华老年口腔医学杂志》2006,4(1):41-42
目的:通过对近两年社区卫生服务中心327例老年病人拔牙临床观察,探讨基层社区老年病人的特点。方法:通过心理、精神和技术方面的配合,安全顺利地完成拔牙术。结果:除5例病人术后感头晕外,其余均顺利完成且病人满意。结论:社区卫生服务中心除具备熟练的技术外,医患之间心理沟通是必不可少的。 相似文献
3.
This report describes a model for identifying sets of teaching abilities considered to be effective for medical school teaching staff, based on roles teachers assume and functions they are expected to perform as instructors. The specification of these teaching abilities was the first step in the development of a comprehensive course on Medical Instruction at the Basic Institute of Medical and Agricultural Biology of the State University of Sao Paulo, Botucatu, Brazil, where the senior author is employed. The work was based on the assumption that medical school teachers are expected to assume a variety of teaching roles and that identification and specification of the abilities that define their roles can result in more effective and efficient teaching. 相似文献
4.
During 1983 and 1984, 1305 patients underwent 1,400 pulmonary artery (PA) catheterizations. Successful placement was achieved in 1397 (99.6%) of 1,403 attempts. The catheters were inserted via the right internal jugular vein on 1364 occasions. The median duration of monitoring was 28 h with a range from 3 to 220 h. Central venous puncture complications included carotid artery puncture in 67 instances (4.8%) and pneumothorax in one patient. Insertion of the catheters was associated with supraventricular arrhythmias on 11 occasions, ventricular arrhythmias on 930 (66.4%), right bundle branch block on two and a total heart block on one occasion. Eighteen (2.3%) of the 794 cultured catheter tips were positive. An in situ time of more than 72 h was associated with a significantly higher percentage (7.2%) of positive tip cultures compared with an in situ time of less than 72 h (P less than 0.01). Repeated PA catheterization was not associated with significantly more complications than the initial catheterization. The results show that monitoring with a PA catheter in cardiac surgical patients is associated with a low incidence of morbidity. 相似文献
5.
A questionnaire survey of career choices was carried out among 112 medical graduates, after one year's internship (group I), during their National Youth Corps programme in Kaduna, Lagos, Cross River and Oyo states of Nigeria, and 365 final-year medical undergraduates (group 2) in the colleges of medicine in the corresponding states. A total of 13% in group I and 40% in group 2 were undecided as regards their first choice. Obstetrics and gynaecology was the most popular first choice in both groups. General practice ranked fifth among group I, but displaced surgery to rank second among group 2. The differences were statistically significant. A total of 41% of group I and 46% of group 2 preferred to work in a teaching hospital, reflecting the high preference for surgical specialties. Twenty-six per cent and 33.7% of respondents in groups 1 and 2 respectively wished to own their own practice or work in the private sector. General practice is a new specialty and its growth is supported by a national postgraduate training programme. A shift towards general practice is seen compared with previous studies of career preference among Nigerian medical graduates and students. This may be due to a changing balance of supply and demand in the medical work-force, or a better assessment of the nation's health problems and manpower needs. 相似文献
6.
Detection of Atrial Fibrillation by Implanted Devices with Wireless Data Transmission Capability 总被引:3,自引:0,他引:3
NIRAJ VARMA† BRUCE STAMBLER SUNG CHUN† 《Pacing and clinical electrophysiology : PACE》2005,28(S1):S133-S136
Remote telemetry may facilitate the management of implantable devices. We tested the reliability of a new automatic, wireless home monitoring (HM) system that archives data every 24 hours. We retrospectively analyzed archival data from 276 consecutive pacing system implants to define temporal atrial fibrillation (AF) patterns and associated ventricular rate. An "AF day" was defined by a >20%/24 hour mode switch (MS) duration, irrespective of the MS number. Management decisions resulting from transmissions were noted. A pilot study confirmed that 89% of 22,356 transmissions were successful, of which >90% were received in <5 minutes. Data integrity was 100% preserved. Overall, AF developed in 29 patients (10.5%), representing a total of 645 AF days (mean = 22.2 ± 29.6 AF, median = 9 days), over 12 ± 2 months of monitoring. AF was infrequent (50% of 24 hours. Ventricular rates during 645 AF days in 29 patients averaged 95.1 ± 9.9 beats/min (median = 94 beats/min). Ventricular rates were >80 beats/min in 25 ± 30 AF days (median = 11 days). HM enabled rapid anticoagulation decisions. In recipients of implantable devices, automatic wireless telemetry with HM was efficient and reliable. Its application may overcome some current challenges in AF management by early notification and precise measurement of both AF burden and ventricular rate during AF. 相似文献
7.
厄贝沙坦治疗高血压患者的临床效果观察 总被引:1,自引:0,他引:1
目的:观察厄贝沙坦治疗高血压患者的临床效果。方法:选择2007年1月~2009年1月来本院就诊的高血压患者200例,随机分为两组,厄贝沙坦组100例,采用厄贝沙坦治疗4周;对照组100例采用依那普利治疗,观察患者用药前后动态血压、心脏功能变化,并评价临床疗效。结果:厄贝沙坦组患者治疗总有效率为97%,均未出现明显不良反应:与对照组比较.差异有统计学意义,P〈0.05。厄贝沙坦组治疗后24h、白昼和夜间平均收缩压和舒张压与治疗前比较,差异有统计学意义,P〈0.05;用药后血压晨峰也显著降低,与治疗前比较,差异有统计学意义,P〈0.05:但与对照组间比较,差异无统计学意义,P〉0.05。结论:厄贝沙坦治疗高血压疗效满意,安全性较高,还可降低患者的心脑血管意外的风险。 相似文献
8.
9.
Factor Xa-activated whole blood clotting time (Xa-ACT) for bedside monitoring of dalteparin anticoagulation during haemodialysis. 总被引:1,自引:1,他引:0
Rolf Dario Frank Vincent M Brandenburg Regina Lanzmich Jürgen Floege 《Nephrology, dialysis, transplantation》2004,19(6):1552-1558
BACKGROUND: Low molecular weight heparins (LMWH) like dalteparin are increasingly used for anticoagulation during haemodialysis (HD). The available laboratory tests for monitoring LMWH anticoagulation are time-consuming and expensive, and the suitability of the conventional activated clotting time (ACT) is controversial. A simple and cheap bedside test would be useful. METHODS: We studied the factor Xa-activated whole blood clotting time (Xa-ACT) in vitro and in vivo in nine patients undergoing chronic HD with i.v. dalteparin bolus anticoagulation and compared it with the conventional ACT. Plasma anti-factor Xa (antiXa) activity was determined with a chromogenic assay. Thrombin-antithrombin complexes were measured to detect coagulation activation. RESULTS: Xa-ACT and ACT were prolonged with rising dalteparin concentration. In vitro, both clotting times were strongly correlated with the antiXa levels (r = 0.94 and 0.89, respectively). Nevertheless, compared with the ACT, the Xa-ACT was considerably more sensitive to the LMWH in vitro (healthy blood: Xa-ACT 90 s/U vs ACT 26 s/U; uraemic blood: Xa-ACT 96 s/U vs ACT 31 s/U) as well as in vivo (Xa-ACT 81 s/U vs ACT 22 s/U) and reflected different intensities of anticoagulation. An initial dalteparin bolus of 80+/-11 U/kg body weight was able to prevent coagulation activation for up to 4 h of HD. CONCLUSION: For monitoring LMWH anticoagulation the Xa-ACT was superior to the conventional ACT in vitro as well as in vivo during HD. The Xa-ACT can be useful as a LMWH bedside test. The ACT was not sensitive enough to serve as a LMWH monitoring tool. 相似文献
10.
介绍了蓬辣滩水电站泄洪闸门的状况、计算机监控系统改造方案的结构和特点及闸门定轮轴承的改造情况,通过上述改造,提高了泄洪设备运行的自动化水平,同时也为其他闸门工程提供参考。 相似文献