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91.
Pleural Lavage: A Novel Diagnostic Approach For Diagnosing Exudative Pleural Effusion 总被引:1,自引:0,他引:1
Mohamed KH Mobasher AA Yousef AI Salah A Ramadan MA Emam AK Alhayawan HM Light RW 《Lung》2000,178(6):371-379
Patients with pleural effusions frequently present a diagnostic and therapeutic challenge. The diagnosis is based on the
interpretation of the results of thoracentesis or pleural biopsy. When a malignant tumor metastasizes to the pleura, tumor
cells can be seeded over the mesothelial surface or in the subserous layer. In the former situation, tumor cells are abundant
in pleural fluid, but in the latter, few malignant cells are exfoliated into the pleural cavity, and microscopic deposits
may not be visualized at thoracoscopy. Pleural lavage cytologic study at the time of thoracoscopy has not been studied. The
purpose of this study was to assess the value of thoracoscopic pleural lavage as an adjuvant in the diagnostic workup of patients
with exudative pleural effusions. Fifty patients with exudative pleural effusions were investigated by pleural fluid cytologic
findings, Abram's pleural biopsy, thoracoscopy, and pleural lavage cytologic findings. After aspiration of all pleural fluid,
300 mL saline was instilled into the pleural cavity and then recovered for cytologic analysis. The final diagnoses were 32
malignant (64%), 15 tuberculous (30%), and 3 idiopathic (6%) effusions. In the malignant group, thoracoscopic biopsy had the
highest yield (94%) followed by lavage cytologic analysis (84%), fluid cytologic analysis (62%), and biopsy with Abram's needle
(50%). The sensitivity of combined thoracoscopy and lavage cytologic analysis was 96%. In the patients with tuberculous pleuritis,
the yield from the pathologic examination of the biopsy specimen was 93% with thoracoscopy and 60% with the Abrams needle.
The diagnostic yield with cytologic analysis on pleural lavage fluid is significantly higher than that on pleural fluid. This
is probably because the cells in the lavage fluid are fresher and better preserved than those in the regular pleural fluid,
which may have undergone degenerative changes, yielding false-negative results. Pleural lavage cytologic analysis should be
performed in patients with suspected malignant pleural effusion who are subjected to diagnostic thoracoscopy, because it may
provide additional information to thoracoscopic biopsy.
Accepted for publication: 21 November 2000 相似文献
92.
Saud M. Elsaughier Ramadan Ghaleb Amr Salah Amin Khaled Sayed elmaghraby Khaled Abdelghany Baraka 《The Egyptian Heart Journal》2018,70(4)
Background
Patent ductus arteriosus is generally associated with hyperdynamic status. Given the vascular shunt between the aorta and pulmonary artery, intrinsic aortic changes occur (aortic stiffness). In the present study, we attempted to assess the impact of PDA on aortic stiffness and its connection with cardiovascular function before and after transcatheter closure of PDA.Patient and methods
Our study consisted of 60 children who were preparing for transcatheter closure of PDA and 60 healthy controls. All patients had clinical and echocardiographic proof of hemodynamically significant PDA.Results
Patients with PDA exhibited significantly higher ASI than controls before closure (p-value?<?0.05). After closure, ASI was significantly reduced (p-value?<?0.05), but still higher than that of controls (p-value?<?0.05) at the six-month follow-up assessment. Patients with PDA had significantly lower LVEF than controls before closure (p-value?<?0.05). After closure, LVEF was significantly enhanced (p-value?<?0.05), and no significant difference was noted amongst patients and controls (p-value?<?0.05) at the six-month follow-up assessment.Conclusion
Aortic stiffness is significantly increased in patients with PDA regardless of PDA size. Aortic stiffness is related to reduced heart function. ASI may be valuable for observing the course of patients with PDA before and after intervention. 相似文献93.
Unilateral and Multilateral Congenital Coronary‐Pulmonary Fistulas in Adults: Clinical Presentation,Diagnostic Modalities,and Management With a Brief Review of the Literature 下载免费PDF全文
94.
Mona Kamal El-Ghamrawy Hanan F. El Behairy Amal El Menshawy Seham A. Awad Ahmed Ismail Mohamed Salah Gabal 《Indian journal of hematology & blood transfusion》2014,30(4):275-280
In sickle cell disease (SCD), ocular lesions result from stasis and occlusion of small eye vessels by sickled erythrocytes. Vaso-occlusive disease of the retina can be responsible for nonproliferative (NPR) and proliferative retinopathy (PR). Patients are often asymptomatic until serious complications arise as, vitreous hemorrhage and retinal detachment. This work aimed to study the frequency and pattern of ocular manifestations in Egyptian children and young adults with SCD. In this cross-sectional study, 40 steady state patients (80 eyes) aged 2–28 years (30 children and 10 young adults) with established diagnosis of SCD (26 with homozygous SS and 14 with S/β thalassemia underwent complete ophthalmic examination with dilated fundoscopy. Fluorescein angiography was performed for patients ≥12 years old. The overall frequency of retinal lesions was 47.5 % (46.2 and 50 % of SS and S/β patients respectively). PR and NPR were evident in 32.5 and 27.5 % of all enrolled patients respectively (five patients having both). Peripheral retinal occlusion was a frequent ocular finding in both groups; the youngest patient showing PR was 15 years old. Older age, longer disease duration and splenectomy were significantly more prevalent among patients with PR. Despite lack of visual symptoms, children and young adults are at risk of PR. Frequency of retinal lesions was comparable in SS and S/β patients. Periodic ophthalmologic examination starting at the age of 12 years is recommended for timely-identification of retinal lesions thus minimizing the risk of sight threatening retinopathy. 相似文献
95.
Sana Abu-Dahab Salah M. AbuRuz Khader Mustafa Yusef Sarhan 《Clinical rheumatology》2014,33(3):391-396
The aim of this study was to translate and validate the Arabic version of the Revised Fibromyalgia Impact Questionnaire (FIQR_A). Translation of the FIQR followed a worldwide-recognized approach to ensure the accuracy and equivalency of the translation from the English version of the FIQR. Following the translation of the FIQR, 92 women with fibromyalgia completed the FIQR_A, the Arabic Research ANd Development Short Form Health Survey (RAND SF-36), and the Arabic Hospital Anxiety and Depression Scales (HADS). The FIQR_A significantly correlated with RAND SF-36 domains and HADS. The correlations ranged from fair to moderate. For selected outcomes, Bland–Altman plots were consistent with Spearman’s correlations. Test–retest intraclass correlation coefficients were all significant and ranged from moderate to excellent. Internal consistency was found to be excellent. These observations suggest that the FIQR_A is a valid and reliable tool for both clinical practice and research purposes with Arabic speakers globally. 相似文献
96.
Pasteurellosis is one of the most important respiratory diseases facing economically valuable farm animals such as poultry, rabbit, cattle, goats and pigs. It causes severe economic loss due to its symptoms that range from primary local infection to fatal septicemia. Pasteurella multocida is the responsible pathogen for this contagious disease. Chemotherapeutic treatment of Pasteurella is expensive, lengthy, and ineffective due to the increasing antibiotics resistance of the bacterium, as well as its toxicity to human consumers. Though, biosecurity measures played a role in diminishing the spread of the pathogen, the immunization methods were always the most potent preventive measures. Since the early 1950s, several trials for constructing and formulating effective vaccines were followed. This up-to-date review classifies and documents such trials. A section is devoted to discussing each group benefits and defects. 相似文献
97.
Salah Uddin Khan LaShondra Berman Najmul Haider Nancy Gerloff Md Z. Rahman Bo Shu Mustafizur Rahman Tapan Kumar Dey Todd C. Davis Bidhan Chandra Das Amanda Balish Ausraful Islam Jens P. Teifke Nord Zeidner Steven Lindstrom Alexander Klimov Ruben O. Donis Stephen P. Luby H. L. Shivaprasad Andrea B. Mikolon 《Archives of virology》2014,159(3):509-518
We investigated unusual crow mortality in Bangladesh during January-February 2011 at two sites. Crows of two species, Corvus splendens and C. macrorhynchos, were found sick and dead during the outbreaks. In selected crow roosts, morbidity was ~1 % and mortality was ~4 % during the investigation. Highly pathogenic avian influenza virus H5N1 clade 2.3.2.1 was isolated from dead crows. All isolates were closely related to A/duck/India/02CA10/2011 (H5N1) with 99.8 % and A/crow/Bangladesh/11rs1984-15/2011 (H5N1) virus with 99 % nucleotide sequence identity in their HA genes. The phylogenetic cluster of Bangladesh viruses suggested a common ancestor with viruses found in poultry from India, Myanmar and Nepal. Histopathological changes and immunohistochemistry staining in brain, pancreas, liver, heart, kidney, bursa of Fabricius, rectum, and cloaca were consistent with influenza virus infection. Through our limited investigation in domesticated birds near the crow roosts, we did not identify any samples that tested positive for influenza virus A/H5N1. However, environmental samples collected from live-bird markets near an outbreak site during the month of the outbreaks tested very weakly positive for influenza virus A/H5N1 in clade 2.3.2.1-specific rRT-PCR. Continuation of surveillance in wild and domestic birds may identify evolution of new avian influenza virus and associated public-health risks. 相似文献
98.
N. Ben Salah W. El BorgiA. Chelbi F. Ben LakhalE. Gouider H. Aounallah SkhiriR. Hafsia 《Pathologie-biologie》2014
Objective
The determination of the cellular lineage in acute leukemia is a crucial step in the diagnosis and the later therapeutic conduct. In Tunisia, emerging country, some cases of acute leukemias are still treated on the basis of an only cytologic study because of lack of cytometry. Our objective is to realize a confrontation between cytology and flow cytometry in the diagnosis of AL and to analyze discrepancies.Patients and methods
The study concerns 100 cases of AL. A second double-blind examination of the bone marrow smears of acute leukemias is realized by two cytologists and confronted to immunophenotyping.Results
In two cases of AML, flow cytometry reassigned lineage into T ALL and biphenotypic AL. In three cases of ALL the lineage was reassigned into undifferentiated acute leukemia (2 cases) and biphenotypic acute leukemia (1 case). Lineage was not established in four cases, immunophenotyping allowed the diagnosis of B ALL in 3 cases, and of biphenotypic acute leukemia in 1 case. In both cases of discrepant findings, flow cytometry allowed the diagnosis of biphenotypic acute leukemia in a case and of AML in the other one.Conclusion
The cytological study remains insufficient in the diagnosis of lineage even with experimented cytologists. Immunophenotyping is essential in lineage assignment and reassignment. 相似文献99.
N. Ben Salah W. El Borgi F. Ben Lakhal M. Ben Mansour E. Gouider Y. Gorgi R. Bardi B. Zoueri R. Hafsia 《Transfusion Clinique et Biologique》2014,21(6):314-319
AimEvaluate the anti-erythrocyte and anti-HLA immunization rates in hemoglobinopathies.Patients and methodsCross-sectional study (October 2009–March 2010) on 83 patients followed for hemoglobinopathies. The irregular antibodies research is realized by two techniques: indirect Coombs and enzymatic technique on gel cards. The search for anti-HLA class I antibodies is done by complement dependent lymphocytotoxicity.ResultsThe mean age was 30 years (14–64 years), the sex ratio M/F is 0.84. Our series included 42 cases of sickle cell disease (29 homozygous sickle cell anemia and 13 sickle-thalassemia) and 41 cases of thalassemia syndromes (26 major and 15 intermediate). The anti-erythrocyte alloimmunization rate is 10.84% without difference between thalassemia syndromes and sickle cell disease. The autoimmunization rate (22.89%) is higher in thalassemia syndromes (41.46%) than in the sickle cell disease (7.14%) (P < 0.001). The anti-HLA immunization rate is 31.6% without difference between thalassemia syndromes and sickle cell disease. The young age, transfusion at a young age and the total number of transfusions are the factors that increase the risk of anti-erythrocyte autoimmunization. No clinicobiological parameter does influence the anti-erythrocyte and anti-HLA alloimmunization. There is no significant association between anti-erythrocyte and anti-HLA immunization.ConclusionThe erythrocyte and anti-HLA anti-immunization rates are high in our series. Preventive strategy is needed to ensure optimal blood safety. 相似文献
100.
Christopher?R?BurtonEmail author Sheila?Payne Mary?Turner Tracey?Bucknall Jo?Rycroft-Malone Pippa?Tyrrell Maria?Horne Lupetu?Ives?Ntambwe Sarah?Tyson Helen?Mitchell Sion?Williams Salah?Elghenzai 《BMC palliative care》2014,13(1):55