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1.
目的 了解铜陵市人民医院2017年临床分离细菌对抗菌药物的耐药状况。方法 对2017年1-12月临床分离菌采用纸片扩散法(KB)进行药敏试验,按CLSI 2017年版标准判读药敏试验结果,采用WHONET 5.6软件进行数据分析。结果 临床分离细菌共3436株,其中革兰阳性菌719株,占20.9%;革兰阴性菌2717株,占79.1%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为23.8%和72.3%,耐甲氧西林株对β-内酰胺类抗生素和其他测试抗菌药物的耐药率显著高于甲氧西林敏感株,未发现对万古霉素和替考拉宁耐药的葡萄球菌。粪肠球菌对青霉素、氨苄西林和呋喃妥因的耐药率较低,屎肠球菌对氯霉素的耐药率较低,5.3%屎肠球菌对万古霉素耐药。大肠埃希菌、克雷伯菌属(肺炎克雷伯菌和产酸克雷伯菌)和奇异变形菌中ESBLs的检出率分别为41.4%、50.7%和19.4%。肠杆菌科细菌中克雷伯菌属和沙雷菌属对碳青霉烯类抗生素耐药率较高,分别为37.5%和36.0%,其他菌属的耐药率低于3%。鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别80.3%和79.1%;铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为29.7%和28.4%。肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌中广泛耐药株的检出率分别为31.3%(171/546)、0.6%(3/508)和0.7%(3/416)。结论 本院革兰阴性菌呈增多趋势,尤其广泛耐药的肺炎克雷伯菌应引起高度关注,做好细菌耐药性监测,加强临床抗菌药物的合理使用和医院感染控制。  相似文献   
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压电基因传感器阵列检测MRSA的实验研究   总被引:5,自引:1,他引:4  
目的:探讨以压电传感阵列技术检测耐甲氧西林葡萄球菌的可行性。方法:收集临床64株葡萄球菌标本,对其耐药标志基因mecA基因和金黄色葡萄球菌特有基因femA增后应用压电传感器阵列进行检测,并以PCR电泳检测作参照,与目前采用的常规药物敏感试验进行对比分析。结果:传感器分析与PCR电泳分析结果完全一致,而此两种方法与常规培养加药敏法比较。结果略有差异。所有64株葡萄球菌中,2株耐甲氧西林金黄色葡萄球菌(MRSA)的mecA为阴性,2株甲氧西林敏感金黄色葡萄球菌(MSSA)的mecA为阳性,1株耐甲氧西林凝固酶性葡萄球菌(MRCNS)的mecA为阴性;2株甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS)的mecA为阳性。结论:以压电传感阵列技术同时检测femA基因和mecA基因,既可鉴定出是否为金黄色葡萄球菌,又可判断其耐药类型,能为危重病人感染MRSA时的诊断和治疗提供依据。  相似文献   
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Bacterial ghosts (BGs) are empty bacterial envelopes of Gram-negative bacteria produced by controlled expression of cloned gene E, forming a lysis tunnel structure within the envelope of the living bacteria. BGs are devoid of cytoplasmic content and possess all bacterial bio-adhesive surface properties in their original state while not posing any infectious threat. BGs are ideally suited as an advanced drug delivery system (ADDS) for toxic substances in tumor therapy. The inner space of BGs can be loaded with either single components or combinations of peptides, drugs or DNA which provides an opportunity to design new types of (polyvalent) drug delivery vehicles. Uptake of BGs loaded with Doxorubicin (Dox) by CaCo2 cells led to effective Dox release from endo-lysosomal compartments and accumulation in the nucleus. Viability and proliferative capacity of the cells were significantly decreased (2–3 orders of magnitude) after internalization of Dox loaded BGs as compared to cells incubated with free Dox. The same effect was observed with leukemia cells. Melanoma cells also revealed a high capability to internalize BGs. These results indicate that BGs are able to target a range of types of cancer. BGs have also been investigated as DNA delivery vectors. Studies show DNA loaded BGs are efficiently phagocytosed and internalized by both professional APCs and tumor cells with up to 82% of cells expressing the plasmid-encoded reporter gene. Our studies with BGs as an ADDS system contribute (i) to optimize drug delivery for the treatment of cancer; (ii) define specific conditions for selection and preparation of BG formulations; (iii) and provide a background for the clinical application of BGs in cancer therapy.  相似文献   
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目的通过对耐多药结核病例化疗疗效的分析,探讨MDR-TB的治疗方法.方法 86例住院的MDR-TB病人中,浸润型肺结核72例,慢性纤维空洞型肺结核14例.痰标本经Bactec-960培养、鉴定均有结核杆菌生长,药敏试验耐异烟肼、利福平(HR)26例,耐异烟肼、利福平、链霉素(HRS)及耐异烟肼、利福平、乙胺丁醇(HER)者38例,耐异烟肼、利福平、链霉素、乙胺丁醇(HRSE)22例.应用丁胺卡那霉素(A)、左旋氧氟沙星(L)及对氨基水杨酸钠(P)为基础化疗方案,加用1~2种未曾应用过的抗痨药物,平均治疗3个月.结果 86例病人痰菌阴转率70.9%,病灶吸收好转率77.9%,空洞治疗有效率58.3%.疗效较好,治疗过程中未出现严重的药物不良反应.结论 ALP组成的化疗方案对细胞内外的结核菌都有杀灭作用,三药联用协同作用好,副作用不多,是治疗MDR-TB的较好的化疗方案.  相似文献   
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Of the possible iodine-labelled Toxoplasma gondii surface proteins, P30 (apparent Mr 30,000) is the principal one recognized by acute and convalescent anti-toxoplasma sera. This protein which comprises from 3 to 5% of the total parasite protein was used to raise a panel of parasiticidal monoclonal anti-P30 antibodies. One of these monoclonal antibodies was able to select a resistant mutant from a large population of chemically mutagenized wild-type P strain parasites. This mutant retained the wild type sensitivity to other non-P30 parasiticidal monoclonal antibodies as well as polyclonal anti-P30 rabbit sera. Analysis of surface radioiodinated wild type and mutant parasites showed that the mutant had a quantitative reduction in the amount of P30. A comparison of surface biotin labelled wild type and resistant parasites by two dimensional electrophoresis showed that the mutant lacked one and possibly two of several proteins that make up wild type P30. Western blot analysis indicated that the mutant was devoid of antigenically reactive P30. These findings further support the hypothesis that antigenic variants of T. gondii can be induced and may involve the major surface membrane antigens of the parasite.  相似文献   
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膀胱癌组织P-gp,GST-π和TOPO-Ⅱ表达评估灌注化疗   总被引:1,自引:0,他引:1  
目的:探讨膀胱癌的多药耐药性(MDR),指导灌注化疗用药。方法:采用免疫组化法检测44例膀胱癌病理标本中P-糖蛋白(P-gp)、谷胱肽S转移酶(GST-π)和拓扑异构酶(TOPO—Ⅱ)的表达,评估肿瘤耐药谱。结果:①P-gp检测显示,54.5%的病例对阿毒索、丝裂毒索、长春新碱等抗生索类和生物碱类抗癌药高耐药。②GST-π检测显示仅34.1%的病例对顺铂、环磷酰胺等高耐药,而反有56.8%的病例对该类药无耐药或低度耐药。③TOPO-Ⅱ检测显示对阿霉索、柔红毒索、VP16等TOPO-Ⅱ抑制剂类抗癌药,仅13.6%的病例高度耐药,29.5%中度耐药。56.8%低度耐药。结论:检测膀胱癌MDR,了解多药耐药谱,可指导灌注化疗用药。  相似文献   
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Abstract: Recently, successful results of ulcerative colitis (UC) treatments with leukocyte apheresis have been reported by several institutes. To certify the efficacy of leukocyte apheresis in refractory UC patients, a multicenter open label trial was conducted, and results were analyzed. Fifty patients diagnosed with active steroid‐resistant UC were enrolled in this study from 14 medical centers. Using a centrifugal cell separator (Component Collection System, Haemonetics), leukocyte apheresis was performed once a week for 5 weeks. General conditions and abdominal symptoms were recorded daily, and laboratory tests were followed weekly. Changes of colonoscopic and histological manifestations of luminal activity through the study period were evaluated. At the end of the study period, stool frequency was decreased to less than 4 times a day in 68.4% (26 of 38) and serum C‐reactive protein (CRP) concentration was normalized in 56.7% (17 of 30) of the patients. Colonoscopic remission was achieved in 57.7% (26 of 45), and histological improvement was noted in 54.1% (20 of 37) of the patients tested. Improved disease activity was demonstrated in 74% (37 of 50) of the patients by general assessment criteria. Analysis of the trial data confirmed the valid clinical efficacy of leukocyte apheresis by centrifugal cell separator in refractory UC patients.  相似文献   
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