全文获取类型
收费全文 | 19558篇 |
免费 | 2638篇 |
国内免费 | 365篇 |
专业分类
耳鼻咽喉 | 284篇 |
儿科学 | 254篇 |
妇产科学 | 265篇 |
基础医学 | 965篇 |
口腔科学 | 205篇 |
临床医学 | 860篇 |
内科学 | 919篇 |
皮肤病学 | 140篇 |
神经病学 | 230篇 |
特种医学 | 768篇 |
外国民族医学 | 48篇 |
外科学 | 2072篇 |
综合类 | 2201篇 |
预防医学 | 821篇 |
眼科学 | 139篇 |
药学 | 964篇 |
10篇 | |
中国医学 | 403篇 |
肿瘤学 | 11013篇 |
出版年
2024年 | 34篇 |
2023年 | 285篇 |
2022年 | 529篇 |
2021年 | 855篇 |
2020年 | 858篇 |
2019年 | 794篇 |
2018年 | 767篇 |
2017年 | 815篇 |
2016年 | 878篇 |
2015年 | 861篇 |
2014年 | 1299篇 |
2013年 | 1458篇 |
2012年 | 1230篇 |
2011年 | 1310篇 |
2010年 | 1177篇 |
2009年 | 1100篇 |
2008年 | 941篇 |
2007年 | 1093篇 |
2006年 | 996篇 |
2005年 | 818篇 |
2004年 | 682篇 |
2003年 | 583篇 |
2002年 | 480篇 |
2001年 | 446篇 |
2000年 | 366篇 |
1999年 | 301篇 |
1998年 | 253篇 |
1997年 | 203篇 |
1996年 | 168篇 |
1995年 | 127篇 |
1994年 | 94篇 |
1993年 | 64篇 |
1992年 | 79篇 |
1991年 | 57篇 |
1990年 | 46篇 |
1989年 | 47篇 |
1988年 | 55篇 |
1987年 | 40篇 |
1986年 | 28篇 |
1985年 | 67篇 |
1984年 | 46篇 |
1983年 | 48篇 |
1982年 | 44篇 |
1981年 | 36篇 |
1980年 | 30篇 |
1979年 | 23篇 |
1978年 | 17篇 |
1977年 | 19篇 |
1976年 | 5篇 |
1975年 | 5篇 |
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
1.
Adjuvant irradiation is the standard treatment after breast conservative surgery. Normofractionated regimen with an overall treatment time of 5 to 6 weeks is often considered as a limiting factor for irradiation compliance. In order to answer this issue, moderate and more recently extreme hypofractionated protocols appeared. We report here oncological outcomes and toxicity of hypofractionated breast irradiation. After defining the frame of moderate and extreme hypofractionated breast irradiations based on overall treatment time, patient selection criteria were listed. According to their levels of proof, the results of moderate and extreme hypofractionated breast irradiation were analysed. Overall treatment time for moderate hypofractionated breast irradiation ranged from 3 to 4 weeks, while for extreme hypofractionated breast irradiation, it was less than 1 week. For moderate hypofractionated breast irradiation, whole breast irradiation was currently performed with or without lymph node irradiation. Moderate hypofractionated breast irradiation has proven to be as safe and as efficient as normofractionated breast irradiation with level IA evidence. For extreme hypofractionated breast irradiation, phase III randomized trials confirmed that accelerated partial breast irradiation was non-inferior in terms of local control compared to normofractionated whole breast irradiation (with external beam radiation therapy and multicatheter brachytherapy), with similar acute and late toxicity. While the use of intraoperative breast irradiation remains under debate, new very accelerated partial breast irradiation (overall treatment time not exceeding 2 days) protocols emerged with encouraging results. Accelerated partial breast irradiation is warranted for extreme hypofractionated breast irradiation and is indicated for low-risk breast cancers. Moderate and extreme hypofractionated breast irradiation regimens are validated and can be routinely proposed according to patient selection criteria. 相似文献
2.
3.
4.
5.
目的探讨接受选择性淋巴结照射(ENI)的食管鳞癌患者预后和失败模式。方法回顾性分析2005年1月至2012年12月河北医科大学第四医院收治的179例符合入组条件的食管鳞癌患者,分析肿瘤局部相关因素预测患者预后的价值,分析影响患者近期疗效、预后的影响因素,并对影响患者总生存率(OS)、无进展生存率(PFS)和复发的指标分别进行单因素和多因素分析。结果全组患者1、3、5年OS和PFS分别为77.1%、40.1%、26.0%和62.6%、30.6%、20.3%。多因素分析结果显示声音嘶哑、cN分期、cTNM分期、GTV-横径(GTV-D)和GTV-体积/长度(GTV-V/L)为影响患者OS的独立性影响因素(P<0.05);声音嘶哑、cTNM分期和近期疗效为影响患者PFS的独立性影响因素(P<0.05)。全组有75例(41.9%)患者出现复发,61例(34.1%)远处转移,其中19例(10.6%)为合并复发和远处转移。75例复发患者中64例(85.3%)患者为单纯食管复发,4例(5.3%)为单纯淋巴结复发,另7例(9.3%)患者为食管合并淋巴结复发。治疗后达完全缓解(CR)的63例患者中有18例患者出现复发,其中仅有2例患者出现淋巴结复发;logistic多因素分析结果显示患者周边组织/器官受侵、GTV-D和近期疗效为影响患者复发的独立性影响因素(P<0.05)。结论食管鳞癌患者接受ENI确实可行,其失败主要模式仍为食管复发;治疗前声音嘶哑、GTV-D和GTV-V/L较大、临床分期较晚和近期疗效不佳为患者预后较差的指标;肿瘤周边组织受侵、GTV-D和近期疗效是影响患者失败的独立性因素。 相似文献
6.
Whitney S. Brandt Wanpu Yan Jian Zhou Kay See Tan Joseph Montecalvo Bernard J. Park Prasad S. Adusumilli James Huang Matthew J. Bott Valerie W. Rusch Daniela Molena William D. Travis Mark G. Kris Jamie E. Chaft David R. Jones 《The Journal of thoracic and cardiovascular surgery》2019,157(2):743-753.e3
Objective
Comparative survival between neoadjuvant chemotherapy and adjuvant chemotherapy for patients with cT2-4N0-1M0 non–small cell lung cancer has not been extensively studied.Methods
Patients with cT2-4N0-1M0 non–small cell lung cancer who received platinum-based chemotherapy were retrospectively identified. Exclusion criteria included stage IV disease, induction radiotherapy, and targeted therapy. The primary end point was disease-free survival. Secondary end points were overall survival, chemotherapy tolerance, and ability of Response Evaluation Criteria In Solid Tumors response to predict survival. Survival was estimated using the Kaplan–Meier method, compared using the log-rank test and Cox proportional hazards models, and stratified using matched pairs after propensity score matching.Results
In total, 330 patients met the inclusion criteria (n = 92/group after propensity-score matching; median follow-up, 42 months). Five-year disease-free survival was 49% (95% confidence interval, 39-61) for neoadjuvant chemotherapy versus 48% (95% confidence interval, 38-61) for adjuvant chemotherapy (P = .70). On multivariable analysis, disease-free survival was not associated with neoadjuvant chemotherapy or adjuvant chemotherapy (hazard ratio, 1.1; 95% confidence interval, 0.64-1.90; P = .737), nor was overall survival (hazard ratio, 1.21; 95% confidence interval, 0.63-2.30; P = .572). The neoadjuvant chemotherapy group was more likely to receive full doses and cycles of chemotherapy (P = .014/0.005) and had fewer grade 3 or greater toxicities (P = .001). Response Evaluation Criteria In Solid Tumors response to neoadjuvant chemotherapy was associated with disease-free survival (P = .035); 15% of patients receiving neoadjuvant chemotherapy (14/92) had a major pathologic response.Conclusions
Timing of chemotherapy, before or after surgery, is not associated with an improvement in overall or disease-free survival among patients with cT2-4N0-1M0 non–small cell lung cancer who undergo complete surgical resection. 相似文献7.
This retrospective study aimed to evaluate radiation-induced pneumonitis (RIP) and a related condition that we define in this report—prolonged minimal RIP (pmRIP)—after stereotactic body radiotherapy (SBRT) for Stage I primary lung cancer in patients with chronic obstructive pulmonary disease (COPD). We assessed 136 Stage I lung cancer patients with COPD who underwent SBRT. Airflow limitation on spirometry was classified into four Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades, with minor modifications: GOLD 1 (mild), GOLD 2 (moderate), GOLD 3 (severe) and GOLD 4 (very severe). On this basis, we defined two subgroups: COPD-free (COPD −) and COPD-positive (COPD +). There was no significant difference in overall survival or cause-specific–survival between these groups. Of the 136 patients, 44 (32%) had pmRIP. Multivariate analysis showed that COPD and the Brinkman index were statistically significant risk factors for the development of pmRIP. COPD and the Brinkman index were predictive factors for pmRIP, although our findings also indicate that SBRT can be tolerated in early lung cancer patients with COPD. 相似文献
8.
Purpose
Chest wall pain is an uncommon but bothersome late complication following lung stereotactic body radiation therapy. Despite numerous studies investigating predictors of chest wall pain, no clear consensus has been established for a chest wall constraint. The aim of our study was to investigate factors related to chest wall pain in a homogeneous group of patients treated at our institution.Patients and methods
All 122 patients were treated with the same stereotactic body radiation therapy regimen of 48 Gy in three fractions, seen for at least 6 months of follow-up, and planned with heterogeneity correction. Chest wall pain was scored according to the Common Terminology Criteria for Adverse Events classification v3.0. Patient (age, sex, diabetes, osteoporosis), tumour (planning target volume, volume of the overlapping region between planning target volume and chest wall) and chest wall dosimetric parameters (volumes receiving at least 30, 40, and 50 Gy, the minimal doses received by the highest irradiated 1, 2, and 5 cm3, and maximum dose) were collected. The correlation between chest wall pain (grade 2 or higher) and the different parameters was evaluated using univariate and multivariate logistic regression.Results
Median follow-up was 18 months (range: 6–56 months). Twelve patients out of 122 developed chest wall pain of any grade (seven with grade 1, three with grade 2 and two with grade 3 pain). In univariate analysis, only the volume receiving 30 Gy or more (P = 0.034) and the volume of the overlapping region between the planning target volume and chest wall (P = 0.038) significantly predicted chest wall pain, but these variables were later proved non-significant in multivariate regression.Conclusion
Our analysis could not find any correlation between the studied parameters and chest wall pain. Considering our present study and the wide range of differing results from the literature, a reasonable conclusion is that a constraint for chest wall pain is yet to be defined. 相似文献9.
目的本文主要研究和探讨护理干预对放疗科头颈部肿瘤放疗患者生活质量的影响。方法将我院2017年2月份至2018年10月份收治的100例头颈部肿瘤放疗患者作为本次研究的对象,在随机原则的指导下把100例患者分为对照组和实验组,每组患者的数量为50例。对照组患者给予常规护理,实验组患者实施护理干预,对两组患者的生活质量、睡眠质量、护理满意度和护理依从性等进行对比分析。结果在生活质量、睡眠质量、护理满意度和护理依从性等方面,组间进行对比分析,实验组都明显优于对照组,P<0.05差异具有统计学意义。结论对头颈部肿瘤放疗患者实施护理干预可以让患者的生活质量、睡眠质量、护理依从性以及护理满意度等都得到显著的改善,从而让患者以一种积极、乐观的心态接受放疗,这对于放疗效果的提高具有重要的作用。总之,这一护理模式应该在临床中进行推广和使用。 相似文献
10.