全文获取类型
收费全文 | 6690篇 |
免费 | 260篇 |
国内免费 | 46篇 |
学科分类
医药卫生 | 6996篇 |
出版年
2023年 | 36篇 |
2022年 | 71篇 |
2021年 | 119篇 |
2020年 | 78篇 |
2019年 | 75篇 |
2018年 | 112篇 |
2017年 | 101篇 |
2016年 | 118篇 |
2015年 | 139篇 |
2014年 | 171篇 |
2013年 | 231篇 |
2012年 | 322篇 |
2011年 | 435篇 |
2010年 | 211篇 |
2009年 | 194篇 |
2008年 | 337篇 |
2007年 | 451篇 |
2006年 | 472篇 |
2005年 | 454篇 |
2004年 | 439篇 |
2003年 | 470篇 |
2002年 | 519篇 |
2001年 | 92篇 |
2000年 | 95篇 |
1999年 | 106篇 |
1998年 | 144篇 |
1997年 | 98篇 |
1996年 | 99篇 |
1995年 | 66篇 |
1994年 | 57篇 |
1993年 | 54篇 |
1992年 | 61篇 |
1991年 | 72篇 |
1990年 | 57篇 |
1989年 | 63篇 |
1988年 | 45篇 |
1987年 | 52篇 |
1986年 | 31篇 |
1985年 | 35篇 |
1984年 | 27篇 |
1983年 | 19篇 |
1982年 | 15篇 |
1981年 | 16篇 |
1980年 | 21篇 |
1979年 | 15篇 |
1978年 | 14篇 |
1977年 | 10篇 |
1974年 | 12篇 |
1973年 | 8篇 |
1966年 | 7篇 |
排序方式: 共有6996条查询结果,搜索用时 0 毫秒
1.
Yosuke Homma Takashi Shiga Hiraku Funakoshi Dai Miyazaki Atsushi Sakurai Yoshio Tahara Ken Nagao Naohiro Yonemoto Arino Yaguchi Naoto Morimura 《The American journal of emergency medicine》2019,37(2):241-248
Objective
This study assessed the association between the timing of first epinephrine administration (EA) and the neurological outcomes following out-of-hospital cardiac arrests (OHCAs) with both initial shockable and non-shockable rhythms.Methods
This was a post-hoc analysis of a multicenter prospective cohort study (SOS-KANTO 2012), which registered OHCA patients in the Kanto region of Japan from January 2012 to March 2013. We included consecutive adult OHCA patients who received epinephrine. The primary result included 1-month favorable neurological outcomes defined as cerebral performance category (CPC) 1 or 2. Secondary results included 1-month survival and return of spontaneous circulation (ROSC) after arrival at the hospital. Multivariable logistic regression analysis determined the association between delay per minute of the time from call to first EA in both pre- or in-hospital settings and outcomes.Results
Of the 16,452 patients, 9344 were eligible for our analyses. In univariable analysis, the delay in EA was associated with decreased favorable neurological outcomes only when the initial rhythm was a non-shockable rhythm. In multivariable analyses, delay in EA was associated with decreased ROSC (adjusted odds ratio [OR] for one minute delay, 0.97; 95% confidence interval [CI], 0.96–0.98) and 1-month survival (adjusted OR, 0.95; 95% CI, 0.92–0.97) when the initial rhythm was a non-shockable rhythm, whereas during a shockable rhythm, delay in EA was not associated with decreased ROSC and 1-month survival.Conclusions
While assessing the effectiveness of epinephrine for OHCA, we should consider the time-limited effects of epinephrine. Additionally, consideration of early EA based on the pathophysiology is needed. 相似文献2.
3.
Tsutomu Yasutake Daisuke Nagatomo Toshihiko Mizuta Yuichiro Eguchi Takanori Kumagai Keisuke Ario Iwata Ozaki Tateo Kuno Kazuma Fujimoto 《Nihon Shokakibyo Gakkai zasshi》2007,104(12):1752-1757
A 16-year-old man was admitted to our hospital with nausea, general fatigue, and consciousness disturbance along with extreme hyperammoniemia eight days after the onset of symptoms. Familial history and the high concentration of orotic acid in urine lead us to a diagnosis of OTCD. We immediately initiated intensive treatment such as continuous hemodiafiltration and sodium benzoate administration; however, the patient died twelve days after admission. Since OTCD is not so rare and can be found in all ages, it should be considered fundamental for evaluation of hyperammoniemia. This case suggested that for a better prognosis of OTCD patients it is very important to prevent such an onset, and to make an as early as possible diagnosis and start to treatment. 相似文献
4.
Tadamasa Miyauchi Hiroshi Takiya Toshihiko Sawamura Eiji Murakami 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(4):206-209
Pericardial abscess is rare in healthy individuals, especially the amebic type. We report a case of pericardial abscess and
cardiac tamponade due to intrapericardial rupture of an amebic liver abscess. A 31-year old Japanese male complained of fever
to a local hospital. A liver mass was discovered in his left hepatic lobe by an abdominal echogram. He was referred to the
internal department of our hospital and was treated with quinolone antibiotics. Two weeks after medication, he suddenly complained
of epigastralgia and severe orthopnea and was admitted. Abdominal computed tomographic scan showed an enlarged liver mass,
and massive pericardial effusion suggested cardiac tamponade. He underwent an emergency subxiphoid partial pericardiectomy
under local anesthesia. 1,000 ml of light brownish fluid was removed and his condition improved. Although no ameba was cultivated
from the pus, the amebic serological test was positive. Metronidazole was administered and the patients was discharged 31
days after surgery. 相似文献
5.
Kodama Hideya; Fukuda Jun; Karube Hiroko; Matsui Toshihiko; Shimizu Yasushi; Tanaka Toshinobu 《Human reproduction (Oxford, England)》1995,10(8):1962-1967
This study was aimed at assessing the outcome of in-vitro fertilization(IVF) and embryo transfer in patients with polycystic ovariansyndrome (PCOS). The results of IVF and embryo transfer in PCOSpatients (PCOS group, 78 cycles of 26 patients) were comparedwith those of a control group (423 cycles in 202 patients withoutmale factor; age and ovarian stimulation protocol were matched).Although the pregnancy rate per transfer was not different inthe two groups of patients (25 versus 34%, PCOS versus controlgroup), the PCOS group had a significantly lower pregnancy rateper follicle aspiration (19 versus 31%, P < 0.05). A notableresult was a significantly higher incidence of embryo transfercancellations in the PCOS group (22 versus 8%, P < 0.01),which resulted from unpredictable failure of either oocyte recoveryor fertilization. The incidence of unexplained complete failureof fertilization was significantly higher in the PCOS group(18 versus 5%, P < 0.01). These results may reflect a reducedquality of the oocytes in the PCOS group, and there was a subgroupof PCOS patients who repeatedly produced poor results of treatment.Although the ovarian stimulation regimen best suited to PCOSpatients remains to be determined, special care should be takenduring ovarian stimulation, especially when the PCOS patientshad experienced unexplained failure of oocyte recovery or fertilizationin the previous treatment cycle(s). 相似文献
6.
Shoji Matsushima Yuko Sakai Yoshiki Hira Masamichi Kato Tsukasa Shigemitsu Yoichi Shiga 《Journal of pineal research》1993,14(3):145-150
Abstract: Light microscopic observations on the superficial pineal gland of Wistar-King rats were made to examine whether or not pineal volume and pinealocyte size, expressed as nuclear density, at daytime or nighttime are affected by long-term exposure to 50 Hz rotating magnetic field (MF) at 5.0 μT. Determinations of pineal volume and pinealocyte size were repeated twice (April and October) during the year. Size of pinealocytes in MF-exposed and sham-exposed rats exhibited, in addition to the difference between peripheral and central regions, regional differences in a proximodistal direction; pinealocytes in the distal and middle-peripheral regions were usually larger than those in the proximal and middle-central regions at daytime or nighttime. In October, distal and proximal pinealocytes showed significant day-night changes in size in sham-exposed rats, but not in MF-exposed animals. The situations in the two groups were almost reversed in April. Significant day-night differences were scarcely found in pinealocyte size in the middle region in the two groups. Throughout the study, pineal volume and pinealocyte size in each region were generally the same between MF-exposed and sham-exposed rats at daytime or nighttime. The results suggest that pinealocytes in the distal and proximal regions, but not those in the middle region, are affected by MF-exposure; day-night differences in sizes of distal and proximal pinealocytes appear in April and disappear in October under the influence of MF. MF may exert an effect on mechanisms controlling day-night rhythms of pinealocyte size in the rat. 相似文献
7.
8.
Toshihiko Imakiire Yuichi Kikuchi Muneharu Yamada Taketoshi Kushiyama Keishi Higashi Naomi Hyodo Kojiro Yamamoto Takashi Oda Shigenobu Suzuki Soichiro Miura 《Hypertension research》2007,30(7):635-642
The mechanisms of hypertensive nephrosclerosis are not fully understood. In experimental models of the disease, inflammatory reactions such as macrophage infiltration play an important role. In human hypertensive nephrosclerosis, however, there have been few studies examining the role of inflammation histologically. We investigated whether the number of infiltrating macrophages was increased in human hypertensive nephrosclerosis, and evaluated the effects of a blockade of the renin-angiotensin system on clinical and histological findings. We examined macrophage infiltration using immunohistochemistry in renal biopsy specimens obtained from 16 patients with hypertensive nephrosclerosis, 5 patients with IgA nephropathy, 5 patients with membranous nephropathy, and 5 patients with minimal change nephrotic syndrome. The number of infiltrating macrophages in glomeruli was significantly larger in the patients with hypertensive nephrosclerosis than in those with minimal change nephrotic syndrome. The patients with hypertensive nephrosclerosis were divided into groups based on their use of antihypertensive agents at the time of renal biopsy. We investigated the effects of antihypertensive agents on clinical findings, macrophage infiltration, and monocyte chemoattractant protein-1 expression. There was no difference in clinical findings between the hypertensive groups. The numbers of infiltrating macrophages and monocyte chemoattractant protein-1-positive cells in glomeruli were significantly smaller in patients treated with an angiotensin-converting enzyme inhibitor or angiotensin II type 1 receptor blocker, whereas calcium channel blockers had no influence on histological findings. In conclusion, inflammation is involved in the progression of human hypertensive nephrosclerosis and the inflammatory process is inhibited by blocking the renin-angiotensin system. 相似文献
9.
10.
Noriyo Kimura Satomi Yonemoto Toshihiko Machiguchi Xuan Li Hideki Kimura Haruyoshi Yoshida 《Hypertension research》2006,29(8):573-580
The major glomerular abnormalities in hypertensive nephrosclerosis are described as glomerular obsolescence (GO), glomerulosclerosis (GS), and glomerular collapse (GC). However, glomerular cellular changes caused by hypertensive insults have not been well analyzed. Using an immunoenzyme method, we examined eleven biopsy samples from patients with hypertensive nephrosclerosis for two synthetic and secreting phenotypes, a-smooth muscle actin (alpha-SMA) and collagen type III (Col. III), and two apoptotic phenotypes, pro-apoptotic molecule Bax and anti-apoptotic molecule BcI-2. Together with the glomerular and vascular changes and interstitial fibrosis (IF) area, the results were scored quantitatively and semi-quantitatively and compared to the clinical findings, which included systolic blood pressure (SBP), mean arterial pressure (MAP), serum creatinine levels (sCr) and creatinine clearance (Ccr), using univariate and multivariate analyses. As a result, GS was frequently observed in the mild-to-moderate hypertensive group (140 < or = SBP<180 mmHg), whereas GC was positively correlated with SBP. Furthermore, there was a positive correlation of GS with mesangial alpha-SMA and Col. III, suggesting that GS was the reflection of these synthetic and secreting phenotypic changes in mesangial cells. Endothelial Bax was positively correlated with Ccr (p<0.01); in contrast, podocytic Bax was positively correlated with sCr (p<0.05) and showed a tendency to correlate with MAP (p=0.054). In conclusion, these findings support the view that mesangial synthetic and secreting phenotypic changes may be a reflection of cellular activation caused by mild-to-moderate hypertension and that apoptotic phenotypic expression in podocytes, rather than endothelial cells, may be related to the development of a severe form of hypertensive nephrosclerosis. 相似文献