全文获取类型
收费全文 | 1562篇 |
免费 | 109篇 |
国内免费 | 10篇 |
学科分类
医药卫生 | 1681篇 |
出版年
2023年 | 16篇 |
2022年 | 7篇 |
2021年 | 23篇 |
2020年 | 21篇 |
2019年 | 40篇 |
2018年 | 35篇 |
2017年 | 37篇 |
2016年 | 33篇 |
2015年 | 50篇 |
2014年 | 60篇 |
2013年 | 83篇 |
2012年 | 104篇 |
2011年 | 119篇 |
2010年 | 63篇 |
2009年 | 58篇 |
2008年 | 87篇 |
2007年 | 100篇 |
2006年 | 91篇 |
2005年 | 85篇 |
2004年 | 79篇 |
2003年 | 63篇 |
2002年 | 70篇 |
2001年 | 16篇 |
2000年 | 23篇 |
1999年 | 26篇 |
1998年 | 10篇 |
1997年 | 18篇 |
1996年 | 12篇 |
1995年 | 16篇 |
1994年 | 13篇 |
1993年 | 12篇 |
1992年 | 19篇 |
1991年 | 12篇 |
1990年 | 13篇 |
1989年 | 15篇 |
1988年 | 9篇 |
1986年 | 5篇 |
1985年 | 7篇 |
1984年 | 7篇 |
1982年 | 6篇 |
1981年 | 5篇 |
1979年 | 6篇 |
1978年 | 7篇 |
1977年 | 6篇 |
1975年 | 5篇 |
1968年 | 7篇 |
1967年 | 7篇 |
1966年 | 5篇 |
1965年 | 6篇 |
1946年 | 4篇 |
排序方式: 共有1681条查询结果,搜索用时 234 毫秒
991.
Nick Meier Anders Perner Ronni Plovsing Steffen Christensen Lone M. Poulsen Anne C. Brøchner Bodil S. Rasmussen Marie Helleberg Jens U. S. Jensen Lars P. K. Andersen Hanna Siegel Michael Ibsen Vibeke L. Jørgensen Robert Winding Susanne Iversen Henrik P. Pedersen Christoffer Sølling Ricardo S. Garcia Jens Michelsen Thomas Mohr George Michagin Ulrick S. Espelund Helle Bundgaard Lynge Kirkegaard Margit Smitt Sigurdur Sigurdsson David L. Buck Niels-Erik Ribergaard Helle S. Pedersen Mette Helene Toft Trine B. Jonassen Frederik Mølgaard Nielsen Emilie K. Madsen Trine N. Haberlandt Louise Sophie Bredahl Nicolai Haase 《Acta anaesthesiologica Scandinavica》2023,67(9):1239-1248
Background
Among ICU patients with COVID-19, it is largely unknown how the overall outcome and resource use have changed with time, different genetic variants, and vaccination status.Methods
For all Danish ICU patients with COVID-19 from March 10, 2020 to March 31, 2022, we manually retrieved data on demographics, comorbidities, vaccination status, use of life support, length of stay, and vital status from medical records. We compared patients based on the period of admittance and vaccination status and described changes in epidemiology related to the Omicron variant.Results
Among all 2167 ICU patients with COVID-19, 327 were admitted during the first (March 10–19, 2020), 1053 during the second (May 20, 2020 to June 30, 2021) and 787 during the third wave (July 1, 2021 to March 31, 2022). We observed changes over the three waves in age (median 72 vs. 68 vs. 65 years), use of invasive mechanical ventilation (81% vs. 58% vs. 51%), renal replacement therapy (26% vs. 13% vs. 12%), extracorporeal membrane oxygenation (7% vs. 3% vs. 2%), duration of invasive mechanical ventilation (median 13 vs. 13 vs. 9 days) and ICU length of stay (median 13 vs. 10 vs. 7 days). Despite these changes, 90-day mortality remained constant (36% vs. 35% vs. 33%). Vaccination rates among ICU patients were 42% as compared to 80% in society. Unvaccinated versus vaccinated patients were younger (median 57 vs. 73 years), had less comorbidity (50% vs. 78%), and had lower 90-day mortality (29% vs. 51%). Patient characteristics changed significantly after the Omicron variant became dominant including a decrease in the use of COVID-specific pharmacological agents from 95% to 69%.Conclusions
In Danish ICUs, the use of life support declined, while mortality seemed unchanged throughout the three waves of COVID-19. Vaccination rates were lower among ICU patients than in society, but the selected group of vaccinated patients admitted to the ICU still had very severe disease courses. When the Omicron variant became dominant a lower fraction of SARS-CoV-2 positive patients received COVID treatment indicating other causes for ICU admission. 相似文献992.
Igor Zindovic Tomas Gudbjartsson Anders Ahlsson Simon Fuglsang Jarmo Gunn Emma C. Hansson Vibeke Hjortdal Kati Järvelä Anders Jeppsson Ari Mennander Christian Olsson Emily Pan Johan Sjögren Anders Wickbom Arnar Geirsson Shahab Nozohoor 《The Journal of thoracic and cardiovascular surgery》2019,157(4):1324-1333.e6
Objectives
To evaluate the effect of preoperative malperfusion on 30-day and late mortality and postoperative complications using data from the Nordic Consortium for Acute Type A Aortic Dissection (ATAAD) registry.Methods
We studied 1159 patients who underwent ATAAD surgery between January 2005 and December 2014 at 8 Nordic centers. Multivariable logistic and Cox regression analyses were performed to identify independent predictors of 30-day and late mortality.Results
Preoperative malperfusion was identified in 381 of 1159 patients (33%) who underwent ATAAD surgery. Thirty-day mortality was 28.9% in patients with preoperative malperfusion and 12.1% in those without. Independent predictors of 30-day mortality included any malperfusion (odds ratio, 2.76; 95% confidence interval [CI], 1.94-3.93), cardiac malperfusion (odds ratio, 2.37; 95% CI, 1.34-4.17), renal malperfusion (odds ratio, 2.38; 95% CI, 1.23-4.61) and peripheral malperfusion (odds ratio, 1.95; 95% CI, 1.26-3.01). Any malperfusion (hazard ratio, 1.72; 95% CI, 1.21-2.43), cardiac malperfusion (hazard ratio, 1.89; 95% CI, 1.24-2.87) and gastrointestinal malperfusion (hazard ratio, 2.25; 95% CI, 1.18-4.26) were predictors of late mortality. Malperfusion was associated with significantly poorer survival at 1, 3, and 5 years (95.0% ± 0.9% vs 88.7% ± 1.9%, 90.1% ± 1.3% vs 84.0% ± 2.4%, and 85.4% ± 1.7% vs 80.8% ± 2.7%; log rank P = .009).Conclusions
Malperfusion has a significant influence on early and late outcomes in ATAAD surgery. Management of preoperative malperfusion remains a major challenge in reducing mortality associated with surgical treatment of ATAAD. 相似文献993.
INTRODUCTION: Airway hyperresponsiveness (AHR) is a key feature of asthma and can be assessed by the use of bronchial provocation tests. A test using inhaled dry powder mannitol for diagnosing asthma is now regulatory approved in 20 countries. AREAS COVERED: This paper reviews the literature on inhaled mannitol from the first publication in 1997 until present (October 2011). It discusses the current knowledge on the clinical usefulness as a tool for diagnosing and managing asthma. EXPERT OPINION: Inhaled mannitol can be regarded as a safe, standardized, specific, but less sensitive, tool for the diagnosis of asthma in both children and adults. Discomfort, in terms of cough, during the test occurs in 85.3% of subjects, but rarely (1.3%) leads to discontinuation. Headache (6.1%), pharyngolaryngeal pain (2.6%) and cough (1.3%) are the most frequent adverse events that occur on the day of the test. The test holds several advantages compared with existing tests; there is no need for additional equipment (i.e., a nebulizer) besides a spirometer; it requires no cleaning and has only one standard operating protocol. In a new study using mannitol for monitoring mild and moderate persistent asthma in primary care, the number of mild exacerbations was reduced. 相似文献
994.
Nguyen NT Rasch V Bygbjerg IC Mogensen HO 《The Journal of the Association of Nurses in AIDS Care》2012,23(4):339-349
There is a need to understand how social and cultural expectations of being a woman shape the challenges women face when trying to access antiretroviral therapy (ART) and to continue the treatment over time. Based on a 7-month prospective study of 15 HIV-infected women, the particular challenges met by these women in northern Vietnam are discussed in this article. We argued that, by taking ART to maintain their health and to fulfill their responsibilities to family and community, the women managed to reclaim the "moral worth" they had lost as a result of having HIV infection. At the same time, certain social and economic contingencies related to ART made it difficult for the women to uphold this moral position. The study demonstrated the importance of understanding the meanings and implications of ART in specific social contexts to understand how social support structures could be established to ensure treatment continuation. 相似文献
995.
Delusions in persons with schizophrenia who have limited insight have been targeted with different treatment modalities with equivocal results. Working with the Guided Self-Determination method used in shared decision-making and problem solving, a 55-year-old male diagnosed with schizophrenia gained insight into his own delusions during a period of six weeks with individual training. The case study is based on qualitative data, reflection sheets, and interview and field notes from the Guided Self-Determination training. The patient's new insight developed in a process from resistance to receptiveness and then from doubt to reaching a new system in his thoughts. 相似文献
996.
997.
998.
999.
Bialuk I Whitney S Andresen V Florese RH Nacsa J Cecchinato V Valeri VW Heraud JM Gordon S Parks RW Montefiori DC Venzon D Demberg T Guroff MR Landucci G Forthal DN Franchini G 《Vaccine》2011,30(1):78-94
The role of antibodies directed against the hyper variable envelope region V1 of human immunodeficiency virus type 1 (HIV-1), has not been thoroughly studied. We show that a vaccine able to elicit strain-specific non-neutralizing antibodies to this region of gp120 is associated with control of highly pathogenic chimeric SHIV89.6P replication in rhesus macaques. The vaccinated animal that had the highest titers of antibodies to the amino terminus portion of V1, prior to challenge, had secondary antibody responses that mediated cell killing by antibody-dependent cellular cytotoxicity (ADCC), as early as 2 weeks after infection and inhibited viral replication by antibody-dependent cell-mediated virus inhibition (ADCVI), by 4 weeks after infection. There was a significant inverse correlation between virus level and binding antibody titers to the envelope protein, (R = −0.83, p = 0.015), and ADCVI (R = −0.84 p = 0.044). Genotyping of plasma virus demonstrated in vivo selection of three SHIV89.6P variants with changes in potential N-linked glycosylation sites in V1. We found a significant inverse correlation between virus levels and titers of antibodies that mediated ADCVI against all the identified V1 virus variants. A significant inverse correlation was also found between neutralizing antibody titers to SHIV89.6 and virus levels (R = −0.72 p = 0.0050). However, passive inoculation of purified immunoglobulin from animal M316, the macaque that best controlled virus, to a naïve macaque, resulted in a low serum neutralizing antibodies and low ADCVI activity that failed to protect from SHIV89.6P challenge. Collectively, while our data suggest that anti-envelope antibodies with neutralizing and non-neutralizing Fc(R-dependent activities may be important in the control of SHIV replication, they also demonstrate that low levels of these antibodies alone are not sufficient to protect from infection. 相似文献
1000.
Homminga I Pieters R Langerak AW de Rooi JJ Stubbs A Verstegen M Vuerhard M Buijs-Gladdines J Kooi C Klous P van Vlierberghe P Ferrando AA Cayuela JM Verhaaf B Beverloo HB Horstmann M de Haas V Wiekmeijer AS Pike-Overzet K Staal FJ de Laat W Soulier J Sigaux F Meijerink JP 《Cancer cell》2011,19(4):484-497