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1.
G. Toffoli I. Robieux D. Fantin M. Gigante S. Frustaci G. L. Nicolosi M. De Cicco & M. Boiocchi 《British journal of clinical pharmacology》1997,44(3):255-260
Aims In an attempt to reverse multidrug resistance, in a recent trial of verapamil in association with doxorubicin, we used escalating doses of continuous intravenous (i.v.) verapamil under close haemodynamic monitoring. We report the pharmacokinetics of escalating doses of verapamil.
Methods We studied nine patients [
seven males, two females; median age 46 years (range, 31–57)] with advanced adenocarcinoma of the colon and normal renal, hepatic, and cardiac functions. After a loading dose (0.15 mg kg−1 followed by 12 h continuous i.v. infusion at 0.20 mg kg−1 h−1 ), the infusion rate (ko) of verapamil was increased every 24 h (0.25, 0.30, 0.35, and 0.40 mg kg−1 h−1 ). The highest rate was maintained for 48 h. Doxorubicin was given as a continuous i.v. infusion from 12 to 108 h (n=4) or 60 to 108 h (n=5). Blood samples and urine collections were taken every 12 h. Verapamil and nor-verapamil were assayed by high performance liquid chromatography. We calculated systemic clearance of verapamil (CL=ko/Css ) and renal clearance (CLr) of verapamil and nor-verapamil. The Cssvs rate relationship was fitted to a Michaelis-Menten equation: Css=ko(Km+Css )/(V Vm ).
Results CL was dose-dependent and in all nine patients a significant reduction in CL was observed over the dose range (mean CL±s.d. were 0.51±0.31, 0.38±0.16, 0.32±0.18, and 0.27±0.11 l h−1 kg−1, respectively, at 0.25, 0.30, 0.35, and 0.40 mg kg−1 h−1; P=0.0001). Css increased more than proportionally to the dose rate and the Cssvs rate relationship was best defined by a Michaelis-Menten equation (Km=730 μg l−1; V Vm=0.55 mg kg−1 h−1 ), (r=0.994; P=0.006). CLr of verapamil and nor-verapamil was not saturable but the contribution to the elimination was only 2 to 4% of the dose.
Conclusions These findings suggest a non-linear, capacity-limited metabolic clearance of high-dose verapamil. Using escalating infusion rates, high verapamil concentrations (1500–2500 ng ml−1 ) were achieved without major toxicity. Saturable clearance may cause higher bioavailability and slower elimination of verapamil after acute oral overdoses. 相似文献
2.
Alain Djacoba Tehindrazanarivelo Jean Marc Visy Marie-Germaine Bousser 《Cephalalgia : an international journal of headache》1992,12(5):318-320
We report two patients with ipsilateral attacks of cluster headache and chronic paroxysmal hemicrania. The first patient, a 33-year-old man, started having attacks of chronic cluster headache at the age of 27. At 33, they were replaced by typical attacks of ipsilateral chronic paroxysmal hemicrania which showed a dramatic improvement with indomethacin 150 mg daily. After two days of complete remission, cluster headache attacks reappeared and persisted until verapamil, 360 mg a day, was added to indomethacin. The second patient, a 45-year-old man, first developed attacks of episodic cluster headache at the age of 35. At 44, he experienced ipsilateral typical attacks of chronic paroxysmal hemicrania, and two months later attacks of cluster headache. Under verapamil 240 mg daily, attacks of cluster headache disappeared, but those of chronic paroxysmal hemicrania increased in frequency until indomethacin 150 mg daily was added. These observations suggest a close relationship but not a similarity between cluster headache and chronic paraoxysmal hemicrania, and show the practical therapeutic interest of maintaining this distinction. 相似文献
3.
M. Vincenzi T. Morlino P. Allegri E. Barbieri F. Cappelletti U. Delio R. Ometto P. Maiolino 《Clinical cardiology》1981,4(1):15-21
Alterations in cardiovascular function induced by the acute intravenous administration of verapamil (5 or 10 mg) in 52 patients (29 with ischemic heart disease and 23 without heart disease) were evaluated with use of invasive techniques (right and left heart catheterization, left ventricular cineangiography, and coronary arteriography). The most significant changes were represented by a decrease in systemic vascular resistance and systemic arterial pressure, and an increase in heart rate and cardiac output. Contractility indexes were not depressed in either group, and altered ventricular wall motion tended to improve to a slightly smaller degree than in patients treated with nitroglycerin. The use of verapamil in patients with ischemic heart disease appears to be safe, and concern about the negative inotropic influences in humans no longer seems justified. 相似文献
4.
The effects of quercetin have been investigated on the gastrointestinal propulsion of charcoal meal in mice. Quercetin reduced the rate of intestinal transit and this effect was potentiated by verapamil. 相似文献
5.
G. N. Kryzhanovskii V. K. Reshetnyak M. L. Kukushkin M. P. Gorizontova V. S. Smirnova 《Bulletin of experimental biology and medicine》1992,114(3):1217-1220
Laboratory of Pathophysiology of Pain and Laboratory of General Pathology of the Microcirculation, Research Institute of General Pathology and Pathological Physiology, Russian Academy of Medical Sciences, Moscow. Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 114, No. 9, pp. 229–231, September, 1992. 相似文献
6.
T T Chen T A Lane M C Doody M R Caudle 《American journal of reproductive immunology (New York, N.Y. : 1989)》1992,28(1):43-50
Macrophages and their secretory products, cytokines, play an integral role in many reproductive processes. In this study we examined the effect of conditioned media from cultured human peritoneal macrophages on progesterone production by granulosa cells and the role of calcium in this process. Macrophages were pretreated with various concentrations of a calcium channel blocker (verapamil) or a calcium ionophore (A23187). Macrophage-conditioned media (MCM) or cell-free media that contained calcium channel modifiers were added at three dose levels to cultured porcine granulosa cells. Progesterone production and LH receptor content were determined. Macrophage-conditioned media alone elevated basal progesterone production, but significantly attenuated granulosa cell LH receptor content. These effects were neither potentiated nor suppressed by pretreating macrophages with verapamil. However, production of the LH receptor lowering factor(s) appeared to be suppressed by calcium ionophore. We conclude that (1) one or more factors produced by macrophages have a net stimulatory effect on basal progesterone production and these factor(s) may not be calcium-dependent and (2) macrophage-derived secretory products reduce granulosa cell LH receptor content. The production of these factor(s) may be calcium-dependent. 相似文献
7.
YESIM TUNCOK SEBNEM APAYDIN SULE KALKAN MEHMET ATES & HULYA GUVEN 《International journal of experimental pathology》1996,77(5):207-212
The goal of this study was to compare the effects of glucagon and amrinone on mean arterial pressure (MAP) and heart rate, when used alone and in combination, in an anaesthetized rat model of verapamil toxicity. Rats were anaesthetized and the carotid artery was cannulated for MAP and heart rate measurements. Jugular and femoral veins were cannulated for drug administration. After verapamil infusion (15 mg/kg/h), control animals were given normal saline solution and the other groups received amrinone (0.1 or 0.2 mg/kg/min), glucagon (0.3 mg/kg bolus followed by 0.1 or 0.2 mg/kg/min infusion), glucagon plus amrinone (0.1 mg/kg/min and 0.1 mg/kg/min respectively) or glucagon plus amrinone (0.2 mg/kg/min and 0.1 mg/kg/min respectively). Glucagon (0.2 mg/kg/min) significantly increased MAP when compared to the control group ( P < 0.01). The combination of glucagon and amrinone did not produce a synergistic effect for the recovery of MAP. Furthermore, this combination masked the positive effects of glucagon (0.2 mg/kg/min) on MAP.Glucagon (0.2 mg/kg/min) increased the heart rates compared with those of the control group ( P < 0.05). Additionally, amrinone (0.1 mg/kg/min) plus glucagon (0.1 mg/kg/min) increased the heart rates ( P < 0.05). Finally, glucagon dose dependently recovered MAP. While amrinone depressed MAP in combination with glucagon, it did not alter the positive chronotropic effect of high dose glucagon. 相似文献
8.
人参皂甙Rg1对缺氧豚鼠心肌细胞游离钙浓度降低作用的研究 总被引:6,自引:0,他引:6
目的探讨人参皂甙(ginsentosides,Gin)单体Rgl及维拉帕米(verapamil,Ver)对豚鼠心肌细胞内游离钙浓度([Ca2+]i)变化的影响.方法采用离体豚鼠心脏Langendorff法灌注,胶原酶Ⅰ型分离心肌细胞,用荧光指示剂方法(Fura-2/AM)标记心肌([Ca2+]i)变化.将心肌细胞悬液分为3组对照组、Rgl组和Ver组.观察缺氧后心肌[Ca2+]i的变化.结果(1)正常氧状态心肌[Ca2+]i均值为(125.4±10.3)nmol/L(n=20).(2)缺氧状态下,心肌[Ca2+]i增加与缺氧时间(程度)直线相关,相关系数r为0.98左右.(3)Rgl对缺氧后心肌[Ca2+]i增加明显延缓.结论Rgl在缺氧条件下,使心肌[Ca2+]i明显下降,从而阻止心肌细胞内钙超载,其作用与Ver相似,我们认为Rgl具有心肌细胞的保护作用. 相似文献
9.
盐酸维拉帕米脉冲控释片人体内的药代动力学及生物利用度研究 总被引:1,自引:0,他引:1
目的:比较盐酸维拉帕米脉冲释放片与其片芯在人体的药代动力学特征及生物利用度。方法:采用拉丁方设计,将志愿者8人随机分为3组,交叉口服Ⅲ,Ⅳ型脉冲片和片芯,以片芯为对照制剂,考察体内脉冲控释效果。结果:Ⅲ型脉冲片在体内的时滞为4h,而cmax,AUC等与片芯无明显差异,达到设计要求。结论:该研究制备的脉冲释放制剂为防治心血管疾病的凌晨发作提供了一个良好的剂型选择。 相似文献
10.
目的:介绍心肌细胞培养方法和研究比色分析法测定活心肌细胞.方法:接种不同数量细胞培养后行噻唑兰(MTT)比色分析;正常培养、含不同浓度维拉帕米培养的细胞行MTT代谢比色分析,并测乳酸脱氢酶(LDH)活性.结果:比色值与接种细胞数量、细胞释放的LDH活性呈高度相关(r=0.996、-0.986,P<0.01).结论:MTT比色分析法可用于测定活心肌细胞. 相似文献