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61.
Omar Hayani Lyall AJ Higginson Baldwin Toye Ian G Burwash 《The Canadian journal of cardiology》2009,25(4):e130-e132
Infective endocarditis caused by zoonotic microorganisms is an uncommon clinical entity. A 55-year-old man was diagnosed with endocarditis due to Capnocytophaga canimorsus, a commensal bacterium contained in the saliva of dogs, that involved the aortic and tricuspid valves and was complicated by a para-aortic valve abscess and aorta-to-right atrial fistula. The patient was successfully treated with antibiotic therapy and surgical intervention. C canimorsus endocarditis should be considered in patients with culture-negative endocarditis, particularly in immunosuppressed, asplenic or alcoholic individuals who have recently suffered a dog bite or have had close contact with dogs. 相似文献
62.
63.
After the introduction of the colposcope for the examination of children suspected of being sexually abused in Leeds, a study was undertaken to describe the findings in detail. A total of 109 consecutive prepubertal girls, mean age 70.4 months were assessed including colposcopic genital and anal examination, and peer group review of reports and photographs. Fifty nine children had signs consistent with blunt force penetrating trauma (hymenal transection/major notch, scar, or hymenal attenuation). Transections were encountered most commonly at 6 o'clock (directly posterior). In 46 the hymenal orifice was gaping with thigh abduction only and in 47 the hymenal orifice transverse diameter was greater than 4 mm on labial separation. Overall, physical findings were commonly present and in only two cases were no signs recorded. Non-specific and frequent findings included patterns of labial and introital reddening. Supportive hymenal signs including swelling, rounding of edge, thickening, distortion, and loss of symmetry were common. Labial fusion was present in 20. Urethral dilatation with labial separation was noted in 14. Physical findings including normality are consistent with abuse and even minor anogenital signs as well as negative findings should be documented. Colposcopy and photography are valuable tools in peer review, teaching, and case management. 相似文献
64.
AJ Blethyn HR Jenkins R Roberts K Verrier Jones 《Archives of disease in childhood》1995,73(6):534-535
Little objective evidence has been published to support the claim that constipation is an important contributory factor in recurrent urinary tract infection (UTI) in childhood. Using a radiological scoring system, two observers assessed faecal loading from abdominal radiographs of children with proved UTIs. There was a significant increase in the degree of faecal loading in children with UTI when compared with controls (r = 0.237). This difference was mainly accounted for by girls with recurrent (greater than five) UTIs. This study confirms an association between recurrent UTI and faecal loading. Further studies are needed to establish if there is a causal relationship and benefits from treatment. 相似文献
65.
Soberón-Mobarak A Díaz-Aparicio E Torres-Armenta J Adams LG Suárez-Güemes F 《Vaccine》2000,18(26):3018-3020
The objective of this study was to determine if B. abortus rough mutant strains RB51 and rfbK are eliminated in goat milk. Thirty milk goats were divided into two groups. Group I was inoculated with 4x10(10) cfu/ml of B.abortus RB51 strain and Group II with 1x10(9) cfu/ml of B. abortus rfbK strain by subcutaneous route in the right axilary region. Milk samples were taken aseptically on a daily basis for the first 30 days and weekly for the second and third months. The samples were inoculated on Farrell's media and incubated under 5-10% CO(2) at 37 degrees C for 10 days. The suspicious colonies were recultured in Farrell's media. There were no isolations of bacteria with characteristics of Brucella from any of the milk samples collected during 90 days of the study. It was concluded that neither of the strains used at these doses were eliminated by milk in goats inoculated during lactation. 相似文献
66.
Geller AC Zhang Z Sober AJ Halpern AC Weinstock MA Daniels S Miller DR Demierre MF Brooks DR Gilchrest BA 《Journal of the American Academy of Dermatology》2003,48(1):34-41
BACKGROUND: In response to the precipitous increase of melanoma, the American Academy of Dermatology (AAD) has coupled melanoma/skin cancer education with free skin cancer screening programs throughout the United States since 1985. The purpose of this analysis is to investigate the risk factors, access to dermatologic services, and screening results of participants in AAD-sponsored programs during the first 15 years that this service was available to the US public. METHODS: Before screening, participants completed a standardized AAD screening form. Screening forms were counted in the AAD central office and recorded in annual summaries. Forms were sent for keypunching and returned to the AAD on a computer disk annually. In 1999, disks were sent to Boston University and a master file was created. RESULTS: Computerized records were available for 819,019 screening forms and 639,835 individuals. In all, 65% of screenees had at least 1 risk factor and 33% had at least 2 risk factors. Of screenees, 33% reported a changing mole and 37% had skin type I or II. Among all screenees, nearly 80% did not have a regular dermatologist, 78% reported no prior AAD skin cancer screening, 60% had never had their skin checked by any doctor, and 51% would not have seen a doctor for skin cancer without the free screening. Nearly 30% of screenees had a presumptive diagnosis of skin cancer or a precursor lesion. Melanomas confirmed by postscreening biopsy were more likely than those in population-based registries to be less than 1.50 mm in thickness. CONCLUSIONS: AAD national screening and educational programs have expanded to all 50 states, provided educational messages about sun protection and early detection to millions, and served many US citizens with an above average risk for skin cancer and suboptimal access to dermatologic care. Screenees had a disturbingly high point prevalence of malignant and premalignant skin lesions. Sustained commitment by the AAD leadership and membership to the screening program is critical to reducing the morbidity and mortality of skin cancer. 相似文献
67.
Background
The Licensing Act 2003 (The Act) was implemented on the 24th November 2005 across England and Wales. The Act allowed more flexible and longer opening hours for licensed premises. We investigated the effect of The Act on alcohol related attendances to an inner city emergency department in Birmingham, UK. 相似文献68.
Extralobar pulmonary sequestration was found in a newborn premature infait that presented with non-immune hydrops fetalis, massive bilateral hydrothorax and polyhydramnios in utero. The baby died of severe respiratory insufficiency 15 h after birth. Postmortem examination revealed distended lymphatic vessels in the sequestered lung tissue probably due to impeded lymph drainage. We suggest that not extralobar pulmonary sequestration itself but a subsequent massive unilateral hydrothorax due to severe obstruction of lymph drainage was the cause of the non-immune hydrops fetalis, pulmonary hypoplasia and polyhydramnios. If these symptoms are diagnosed before delivery, a search for extralobar pulmonary sequestration is indicated. 相似文献
69.
70.
To estimate the incidence and causes of secondary thrombocytosis in children, a 12 month study of all patients attending a children's hospital and discovered to have a platelet count over two times the upper normal limit (> 800 x 10(9)/l) was undertaken. Data so obtained were analysed both separately and together with those from two previous studies to gain as broad a perspective as possible. Of 7916 children who had platelet counts during the study period, 36 (0.5%) produced a value > 800 x 10(9)/l; there were 19 boys and 17 girls. There was a preponderance of young infants (median age 13 months). Twenty seven of the 36 had some sort of associated infection, bacterial in 18 and viral in nine. The other nine were either recovering from anti-neoplastic chemotherapy (n = 6), were post-operative (n = 2), or simply iron deficient (n = 1). Combining these patients with those described in previous studies allowed a review of 139 unselected children with very high platelet counts. Fifty three (38%) had infections, 29 (20%) had traumatic or surgical tissue damage, 16 (11%) had malignant disease undergoing chemotherapy or surgery, and 13 (9%) had connective tissue or autoimmune disorders. Secondary thrombocytosis is not rare and is most frequently seen in very young infants after infection. It can arise in a wide variety of other circumstances including rebound from myelosuppression, iron lack, or as part of an acute phase response. It is clinically unimportant in terms of morbidity and requires no treatment other than that for the primary condition. 相似文献