全文获取类型
收费全文 | 2623篇 |
免费 | 125篇 |
国内免费 | 15篇 |
专业分类
耳鼻咽喉 | 7篇 |
儿科学 | 25篇 |
妇产科学 | 6篇 |
基础医学 | 255篇 |
口腔科学 | 2篇 |
临床医学 | 163篇 |
内科学 | 20篇 |
皮肤病学 | 11篇 |
神经病学 | 18篇 |
特种医学 | 199篇 |
外科学 | 1667篇 |
综合类 | 185篇 |
预防医学 | 83篇 |
眼科学 | 18篇 |
药学 | 87篇 |
中国医学 | 15篇 |
肿瘤学 | 2篇 |
出版年
2024年 | 4篇 |
2023年 | 57篇 |
2022年 | 109篇 |
2021年 | 85篇 |
2020年 | 102篇 |
2019年 | 123篇 |
2018年 | 119篇 |
2017年 | 64篇 |
2016年 | 44篇 |
2015年 | 41篇 |
2014年 | 155篇 |
2013年 | 141篇 |
2012年 | 112篇 |
2011年 | 167篇 |
2010年 | 170篇 |
2009年 | 150篇 |
2008年 | 145篇 |
2007年 | 115篇 |
2006年 | 124篇 |
2005年 | 85篇 |
2004年 | 64篇 |
2003年 | 39篇 |
2002年 | 45篇 |
2001年 | 37篇 |
2000年 | 51篇 |
1999年 | 60篇 |
1998年 | 45篇 |
1997年 | 49篇 |
1996年 | 11篇 |
1995年 | 22篇 |
1994年 | 23篇 |
1993年 | 11篇 |
1992年 | 7篇 |
1991年 | 4篇 |
1989年 | 8篇 |
1988年 | 11篇 |
1987年 | 5篇 |
1986年 | 4篇 |
1985年 | 15篇 |
1984年 | 12篇 |
1983年 | 20篇 |
1982年 | 20篇 |
1981年 | 12篇 |
1980年 | 12篇 |
1979年 | 11篇 |
1978年 | 10篇 |
1977年 | 12篇 |
1976年 | 11篇 |
1975年 | 10篇 |
1973年 | 3篇 |
排序方式: 共有2763条查询结果,搜索用时 31 毫秒
1.
《Burns : journal of the International Society for Burn Injuries》2019,45(7):1553-1561
BackgroundKnowledge of the epidemiology of burn-related fatalities is limited, with most previous studies based on hospital and burn centre data only.AimsTo describe the epidemiological characteristics of all burn-related fatalities in Australia and New Zealand, and to identify any trends in burn-related fatality incidence over the study period.MethodsData from the National Coronial Information System, including data for pre-hospital and in-hospital burn-related fatality cases, was used to examine the characteristics of burn-related fatalities occurring in Australia and New Zealand from 2009 to 2015. Burn-related fatality rates per 100,000 population were estimated, and incidence trends assessed using Poisson regression analysis.ResultsOf the 310 burn-related fatalities that occurred in Australia and New Zealand, 2009–2015, 41% occurred in a pre-hospital setting. Overall, most burn-related fatality cases were fire related, occurred at home, and were of people aged 41–80 years. One quarter of all burn-related fatalities were a result of intentional self-harm. The population incidence of all burn-related fatalities combined, and for NSW, decreased over the study period.ConclusionsThis study has identified the importance of examining all burn-related fatalities. If this is not done, vulnerable population subgroups will be missed and prevention efforts poorly targeted. 相似文献
2.
3.
《Burns : journal of the International Society for Burn Injuries》2022,48(8):1909-1916
BackgroundThis study aims to compare the use of one-per-mil tumescent solution (a mixture of epinephrine and 0.2% lidocaine in a ratio of 1:1,000,000 in normal saline solution) and tourniquet to create clear operative fields and to evaluate the functional outcomes after post burn hand contracture surgery.MethodsThe subjects of this randomized controlled trial were divided into one-permil tumescent technique and tourniquet group for a similar surgical procedure. Three independent assessors evaluated the clarity of the operative fields through recorded videos for the first 15 min and the first 10-minute of each hour of the surgery. Functional outcome was evaluated at least three months postoperatively using total active and passive motion (TAM and TPM) of each digit. Malondialdehyde (MDA) and tumor necrosis factor alpha (TNF-α) were tested during baseline (5 min before the procedures), ischemia phase, and reperfusion phase (a phase when the blood flow returned to the tissue).Results35 subjects were included in this study: 17 in the tumescent group and 18 in the tourniquet group. We found a significant difference in the clarity of operative field between tumescent and tourniquet groups, 5 vs 35 bloodless operative fields, respectively (p < 0.05). TAM and TPM of each digit before surgery and 3 months postoperatively showed no significant difference between both groups (p > 0.05). Furthermore, we found no difference in MDA and TNF-α levels between both groups at their respective phases.ConclusionsThe use of one-per-mil tumescent technique does not replace tourniquet use to create bloodless operative fields in burned hand contracture surgery. However, the postoperative functional results were similar in both groups showing that tumescent technique can be used as an alternative to tourniquet without compromising outcomes. The MDA and TNF-α examinations do not provide conclusive outcomes regarding ischemia and reperfusion injury. 相似文献
4.
目的探讨早期联用美罗培南(MEP)和大剂量重组人生长激素(rhGH)对严重烫伤免疫抑制大鼠肠源性感染的影响。方法Wistar大鼠54只随机分为对照组、烧伤组和治疗组(C1组、C2组、C3组),后两大组制成25%总体表面积(TBSA)Ⅲ°烫伤免疫抑制模型,伤后2h给予rhGH1.33IU/kg、MEP20mg/kg,伤后8、24h检测门静脉血清内毒素(LPS)、腔静脉血清肿瘤坏死因子-α(TNF-α)含量,肝功能变化和肠道细菌移位率。结果C3(MEP+rhGH治疗)组LPS和TNF-α含量均显著低于其他组(P<0.01),与对照组差异无统计学意义(P>0.05),C3组未发现肠道细菌移位且肝功能检测指标显著低于其他组(P<0.01),与对照组差异无统计学意义(P>0.05)。结论早期联用MEP和rhGH治疗严重烫伤免疫抑制大鼠能显著减轻或防止肠道细菌/内毒素移位,减少炎症介质释放,保护脏器功能。 相似文献
5.
醋酸精氨酸对创烧伤患者预后的影响及安全性分析——86例多中心、随机、双盲、安慰剂对照试验 总被引:1,自引:0,他引:1
目的观察服用醋酸精氨酸对创烧伤患者预后的影响及可能出现的不良反应。方法采用多中心、随机、双盲、安慰剂平行对照的研究方法,将96例创烧伤患者(实际完成86例)随机分为治疗组和对照组,治疗组41例,服用醋酸精氨酸0.4 g·kg-1·d-1;对照组45例,服用安慰剂酪氨酸,剂量同前,均连用7 d。两组患者采用等氮、等热量的营养支持疗法。比较患者创面(切口)愈合时间、住院时间及不良反应发生情况。结果创伤患者治疗组(29例)创面(切口)愈合时间和住院时间分别为(11.1±2.8)、(19±6)d,明显短于对照组(13.2±5.5)、(22±6)d(33例,P< 0.05);烧伤患者治疗组(12例)创面愈合时间和住院时间各为(20±5)、(28±6)d,与对照组(22±8)、(29±8)d(12例)比较,差异无统计学意义(P>0.05)。在整个试验过程中,患者出现的不良反应为恶心、腹泻,其中治疗组1例占2.44%,对照组1例占2.22%,两组比较差异无统计学意义(P= 1.000)。以上不良反应停药后消失。结论服用醋酸精氨酸能显著促进创伤患者创面(切口)愈合,缩短住院时间,且无明显不良反应,但对烧伤患者的预后无明显改善,这可能与病例数较少有关,其确切疗效有待于通过大样本的临床试验予以确定。 相似文献
6.
CD14+单核细胞人类白细胞抗原DR表达率与脓毒症关系的研究 总被引:15,自引:0,他引:15
目的了解烧伤延迟复苏时CDl4^+单核细胞人类白细胞抗原DR(HLA—DR)表达率的变化,分析其与脓毒症的关系。方法选择烧伤面积大于30%TBSA的25例烧伤延迟复苏患者,于伤后1、3、7、14、28d取外周血,其中7例患者住院期间并发脓毒症,于脓毒症发生后连续2d亦取其外周血。另取20例健康体检者外周血作为对照。流式细胞仪检测CD14^+单核细胞HLA.DR表达率,酶联免疫吸附测定法检测血浆中肿瘤坏死因子α(TNF—α)、白细胞介素10(IL-10)的浓度。结果非脓毒症患者伤后1、3、7、14、28dCD14^+单核细胞HLA—DR表达率分别为(15±6)%、(74±5)%、(264±17)%、(284-16)%、(474-16)%,明显低于健康体检者[(924±10)%,P〈0.01];脓毒症患者发生脓毒症后1、2d,该指标亦明显低于健康体检者及非脓毒症患者伤后1、7、14、28d(P〈0.01)。脓毒症患者TNF—d检出率及TNF—α、IL-10浓度,均高于非脓毒症患者和健康体检者(P〈0.05或P〈0.01)。伤后1、7、28d,外周血CD14^+单核细胞HLA—DR表达率与IL—10浓度呈显著负相关(r分别为-0.9963、-0.7459、-0.8474,P〈0.01)。结论烧伤延迟复苏患者免疫功能低下,促炎性介质释放量增加,并发脓毒症时则更为严重。外周血CD14^+单核细胞HLA—DR表达率可作为动态检测患者免疫功能状态的有效指标。 相似文献
7.
自体表皮细胞培养与异体真皮组合应用研究 总被引:13,自引:0,他引:13
严重烧伤病人皮肤修复中主要未解决的问题是真皮的替代。动物实验结果表明,异体皮移植后5天,用自体培养表皮细胞膜片覆盖真皮床,14天后复合皮成活率是84.6%±2.4%。组织学检查证实表皮已形成了复层结构,可见基底层、颗粒层和角质层。临床应用中,异体皮移植后10天,去除异体表皮覆盖病人的自体培养表皮,35天后未见排斥征象,异体真皮促进了培养表皮的分层、成熟和完整,组织学检查证实表皮细胞的边缘清楚,已分化形成颗粒层和角质层,真皮多细胞,已血管化,但表皮嵴缺乏。 相似文献
8.
目的:通过阻断烫伤早期大鼠中枢和下丘脑室旁核γ-氨基丁酸的作用,观察大鼠心血管指标和存活时间的改变。方法:制备大鼠30%总体表面积Ⅲ度烫伤模型;借助脑立体定向仪行中枢内注射;运用四导生理仪记录血压和心肌力学指标。结果:烫伤早期大鼠中枢和下丘脑室旁核γ-氨基丁酸作用的阻断可明显回升其血压、左心室收缩压、左心室内压最大变化速率和延长存活时间。结论:提示中枢γ-氨基丁酸对大鼠烫伤早期心血管功能有影响,部 相似文献
9.
Early multiple organ dysfunction syndrome appears to be facilitated with bacterial translocation in severely burn injury, yet the mechanisms of bacterial translocation remains in dispute. The aim of this study was to investigate the potential role of intestinal bifidobacteria in the pathogenesis of gut-derived bacteria/endotoxin translocation following burns and the effects of bifidobacterial supplement on gut barrier. Methods: Wistar rats were randomly divided into burn group (Burn, n=60),sham burn group (SB, n=10) in experiment Ⅰ , and burn + saline group (BS, n=30), burn + bifidobacteria group (BB, n=30), and sham-burn + saline group (SS, n= 10) in experiment Ⅱ. Animals in BB group were fed bifidobacterial preparation (5 × 109 CFU/ml) after burns, 1.5ml,twice daily. Animals in BS and SS were fed saline. Samples were taken on days 1, 3, and 5 in burn groups, and on day 3 in sham-burn groups. The incidence of bacteria/endotoxin translocation and counts of Bifidobacterium, Fungi and Escherichia coli in gut mucosa were determined with standard methods. The levels of sIgA in mucus of small intestine were measured by RIA. The positive sIgA expression in lamina propria and ileum mucosal injury was evaluated light microscopically by blinded examiners. Results: Our results showed that the incidence of bacterial translocation was increased after burns, which was accompanied by significant decrease in number of bifidobacteria but significant increase in E. coli and fungi in gut mucosa, and elevation of levels of plasma endotoxin and IL-6 (P<0. 001).The incidence of bacterial translocation was markedly reduced after 3- and 5-day supplementation of bifidobacteria compared with control group (P<0.05). The counts of mucosal bifidobacteria were increased by 4- to 40-fold,while E. coli and fungi were decreased by 2- to 30-fold and 10- to 150-fold, respectively, after bifidobacterial supplementation in contrast to control group. The damage of mucosa tended to be less pronounced after 3-day bifidobacteria-supplemented formula compared with control group [grade 2(0-6) vs. grade 4(3-6), P<0.05]. Moreover, the expression and release of sIgA was markedly augmented after 3-day bifidobacteria-supplementation formula and it returned to normal range on day 5. Conclusion: The decrease in counts and proportion of bifidobacteria in mucous membrane flora may play an important role in the development of bacteria/endotoxin translocation following thermal injury. The supplement of exogenous bifidobacteria could per se improve gut barriers, and attenuate bacteria/endotoxin translocation secondary to major burns. 相似文献
10.
目的单因素观察吸入性损伤或烧伤后血清免疫反应性降钙素(iCT)的变化,分析其诊断意义。方法将24只犬随机分为单纯吸入性损伤后中度(A)、重度(B)、特重度损伤(C)组及单纯重度烧伤(D)组,每组6只。吸人性损伤犬均在伤后6 h行纤维支气管镜检查,以明确其损伤程度。分别于不同时相点抽取犬静脉血检测iCT含量,抽取动脉血做血气分析。结果(1)经纤维支气管镜检查,证实A、B、C组犬符合吸入性损伤的预期程度。(2)与伤前值(38±22)ng/L比较,各组吸人性损伤犬iCT含量在伤后1 h均明显升高(P<0.05),伤后4 h明显高于D组(P(0.05),其中A组于24 h达峰值(453±224)ng/L,B、C组在48 h内呈进行性升高。D组犬iCT含量在伤后2 h开始持续升高,至伤后48 h为(125±41)ng/L。(3)血气分析结果显示,与伤前值(109±8)mm Hg (1 mm Hg=0.133 kPa)比较,A、D两组氧分压(PaO2)伤后各时相点无明显差异(P>0.05),B、C组犬从伤后8 h和伤后4 h开始持续下降,分别为(65±6)、(71±9)mm Hg。与二氧化碳分压(PaCO2)的伤前值(38±5)mm Hg比较,C组犬伤后24 h PaCO2开始升高[(52±11)mm Hg]。结论在吸入性损伤后8 h内,iCT的变化明显早于血气分析指标,其诊断意义接近纤维支气管镜检查。 相似文献