全文获取类型
收费全文 | 73049篇 |
免费 | 7036篇 |
国内免费 | 3054篇 |
专业分类
耳鼻咽喉 | 651篇 |
儿科学 | 1518篇 |
妇产科学 | 1059篇 |
基础医学 | 9613篇 |
口腔科学 | 1349篇 |
临床医学 | 8211篇 |
内科学 | 12859篇 |
皮肤病学 | 1185篇 |
神经病学 | 4367篇 |
特种医学 | 2726篇 |
外国民族医学 | 33篇 |
外科学 | 8358篇 |
综合类 | 8095篇 |
现状与发展 | 13篇 |
一般理论 | 17篇 |
预防医学 | 5393篇 |
眼科学 | 1989篇 |
药学 | 6457篇 |
61篇 | |
中国医学 | 2974篇 |
肿瘤学 | 6211篇 |
出版年
2024年 | 136篇 |
2023年 | 927篇 |
2022年 | 1523篇 |
2021年 | 3353篇 |
2020年 | 2365篇 |
2019年 | 2292篇 |
2018年 | 2526篇 |
2017年 | 2106篇 |
2016年 | 1992篇 |
2015年 | 2801篇 |
2014年 | 3538篇 |
2013年 | 3726篇 |
2012年 | 5270篇 |
2011年 | 5575篇 |
2010年 | 3514篇 |
2009年 | 2938篇 |
2008年 | 3806篇 |
2007年 | 3784篇 |
2006年 | 3748篇 |
2005年 | 3325篇 |
2004年 | 2660篇 |
2003年 | 2414篇 |
2002年 | 2154篇 |
2001年 | 1944篇 |
2000年 | 1885篇 |
1999年 | 1792篇 |
1998年 | 860篇 |
1997年 | 772篇 |
1996年 | 630篇 |
1995年 | 532篇 |
1994年 | 531篇 |
1993年 | 359篇 |
1992年 | 747篇 |
1991年 | 687篇 |
1990年 | 625篇 |
1989年 | 626篇 |
1988年 | 585篇 |
1987年 | 513篇 |
1986年 | 434篇 |
1985年 | 436篇 |
1984年 | 300篇 |
1983年 | 216篇 |
1982年 | 145篇 |
1981年 | 129篇 |
1979年 | 235篇 |
1978年 | 122篇 |
1977年 | 128篇 |
1976年 | 116篇 |
1974年 | 139篇 |
1972年 | 130篇 |
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
81.
Victor Aboyans Louis Labrousse Philippe Lacroix Jér?me Guilloux Seifeddine Sekkal Alexandre Le Guyader Elisabeth Cornu Marc Laskar 《European journal of cardio-thoracic surgery》2006,30(2):300-304
BACKGROUND: Despite major improvement in surgical techniques and intensive care management, stroke remains one of the most devastating complications of coronary artery bypass grafting (CABG). We aimed to determine factors predicting the occurrence of stroke during CABG. A special interest was focused on preoperative therapies. METHODS: We prospectively enrolled 810 consecutive candidates for CABG alone in a specific database, including all pre- and perioperative data (history, clinical, therapeutic, cardiac catheterization, surgical and intensive care data). Univariate tests and then multiple logistic regression analysis were used to determine independent predictive factors. RESULTS: During the first postoperative month, stroke occurred in 11 cases and transient ischemic attack (TIA) in 4 additive cases (cumulative rate: 1.85%). After the multivariate analysis, the following factors remained significant (p<0.05) in the predictive model, with corresponding odds ratios between brackets: redo cardiac surgery (7.45), unstable cardiac status (4.74), past history of cerebrovascular disease (4.14), past history of peripheral arterial disease (3.55), whereas the presence of preoperative statins was protective (0.24, 95% IC: 0.07-0.78). The addition of perioperative data (aortic calcification, postoperative arrhythmia, on/off-pump surgery) did not change the final predictive model. CONCLUSION: To our knowledge, this is the first real-world observational report highlighting the interest of statins for the prevention of stroke in the very special situation of CABG. Even though according to randomized trials coronary patients have a benefit from these drugs, a special level of interest should be directed towards those presenting the above-mentioned risk factors. 相似文献
82.
Y. Patrice Le Treut M.D. Jean Hardwigsen M.D. Pascal Ananian M.D. Jean Saïsse M.D. Emilie Grégoire M.D. Hubert Richa M.D. Pierre Campan M.D. 《Journal of gastrointestinal surgery》2006,10(6):855-862
Tumor thrombus in major vasculature is a frequent finding with a poor long-term prognosis in patients with hepatocellular
carcinoma (HCC). The utility of surgical resection is still controversial. This study compared morbidity and survival after
resection for HCC with and without tumor thrombus. Data of 108 patients who underwent major hepatic resection for HCC were
prospectively recorded. Patients were divided into two groups. The venous thrombectomy (VT) group included 26 patients who
had HCC with tumor thrombus in the portal or hepatic veins. The matched control group included 82 patients who had HCC without
tumor thrombus. Surgical technique, early outcome, and late survival were analyzed in each group. Multivariate analysis was
performed to assess the prognostic value of this feature. Surgical technique was comparable in the VT and control group with
regard to extent of hepatectomy, procedure duration, and transfusion requirements. Early postoperative outcome was also comparable.
Actuarial survival at 1, 3, and 5 years was 38%, 20%, and 13%, respectively, in the VT group (median: 9 months) versus 74%,
56%, and 33%, respectively, in the control group (median: 41 months). In the subgroup of patients with tumor thrombus limited
to the portal vein, actuarial survival at 1, 3, and 5 years was 50%, 26%, and 17%, respectively, (median: 12 months) and two
patients lived longer than 5 years. Multivariate analysis showed that incomplete resection, alphafetoprotein level greater
than 100 N, more than two tumor nodules, and tumor thrombus in major vasculature were independent factors of poor prognosis.
Survival after resection for HCC with tumor thrombus in the major vasculature is poorer than after resection for HCC without
tumor thrombus. However, an aggressive surgical strategy can provide significant survival with comparable morbidity in selected
cases, that is, tumor thrombus located in the portal vein only and expected complete resection of the lesions. 相似文献
83.
目的探讨迪索泰(Fixion^TM)可膨胀髓内钉系统在长骨骨折中的应用价值与技术特点。方法随机选取四肢长骨骨折病例21例,应用Fixion^TM系统内固定,术后评定骨折愈合情况与患肢功能。结果术后随访2~18个月,21例均达到骨折愈合,Johner—Wruhs评分优良率85.7%。结论Fixion^TM可膨胀髓内钉系统操作方法简捷,具有良好的髓腔适配,可以采用微创侵入方式,实现骨折快速稳定的髓内固定,临床治疗长骨骨折预后良好。 相似文献
84.
Ayad Al Darrab Jerome Fan Christopher M B Fernandes Rosanne Zimmerman Rhonda Smith Andrew Worster Teresa Smith Kelly O'Connor 《European journal of emergency medicine》2006,13(1):32-35
STUDY OBJECTIVES: Use of fast track has been shown to improve the emergency department flow of less urgent patients. It has been speculated, however, that this could negatively affect the care of urgent patients. The objective of this study was to determine whether a dedicated fast track for less urgent patients [Canadian Triage and Acuity scale category 4/5 (CTAS 4/5)] affected (1) the time to assessment for urgent patients (CTAS 3), (2) the length of stay for less urgent patients (CTAS 4 and 5), and (3) the left-without-being-seen rate. METHODS: In June 2003, fast track was opened in our emergency department from 13:00 to 19:00 h. A before-after intervention comparison analysis was completed for 1 week in Aug 2002 and the same week in Aug 2003. Data collected included (1) time to assessment of CTAS 3 patients, (2) the length of stay for CTAS 4/5 patients, and (3) percentage of patients who left without being seen. RESULTS: A total of 368 patients were reviewed for 2002 and 380 patients were reviewed for 2003. Median time to assessment of CTAS 3 patients presenting from 13:00 to 19:00 h was reduced from 66 min (Interquartile range: 40, 94 min) in 2002 to 60 min (IQR: 38, 108 min) after fast track was open in 2003 (P = 0.95). Median length of stay of CTAS 4 and 5 patients was reduced from 170 min (IQR: 111, 256 min) to 110 min (IQR: 69, 185 min) (P < 0.001). The overall left-without-being-seen rate decreased from 5% (20/368) to 2% (9/380). CONCLUSION: A dedicated fast track for CTAS 4/5 patients can reduce the length of stay and the left-without-being-seen rate with no impact on CTAS 3 patients seen in the main emergency department. 相似文献
85.
INTRODUCTION Alzheimer disease can be classified into familial Alzheimer disease (FAD) and sporadic Alzheimer disease (SAD)[1]. Among FAD, ear- ly-onset FAD(EOFAD) is a familialform in which the onset ofsymptoms occurs before the age of 60 to 65 years, an… 相似文献
86.
二甲双胍对多囊卵巢综合征患者胰岛素样生长因子-1的影响 总被引:2,自引:0,他引:2
目的探讨二甲双胍对多囊卵巢综合征(PCOS)患者血清胰岛素样生长因子-1(IGF-1)及胰岛素样生长因子结合蛋白-1(IGFBP-1)水平的影响及其作用机制,明确二甲双胍治疗的临床效果。方法2002年1—11月对山西医科大学第二医院24例PCOS患者给予二甲双胍500mg,一日3次,8~24周治疗,比较治疗前后血清IGF-1、IGFBP-1、空腹胰岛素及睾酮水平,并对月经恢复、排卵、妊娠情况进行分析。结果二甲双胍可降低血清空腹胰岛素及睾酮水平,能显著升高IGFBP-1水平,治疗前后血清IGF—1水平差异无显著性。单纯二甲双胍治疗后月经恢复率为41.67%(10/24);自然排卵率为25.00%(6/24),自然妊娠率为12.50%(3/24)。二甲双胍加促排卵治疗共18个周期,排卵周期率66.67%(12/18),妊娠周期率为11.11%(2/18)。结论二甲双胍可以降低血清空腹胰岛素及睾酮水平,增高IGFBP-1水平,可以改善卵泡微环境,有助于月经恢复,提高促排卵和妊娠率.是治疗PCOS的重要手段。 相似文献
87.
Chronicsofttissuelesionisaspeciallymedicalterm,andanimportantpathologicalchangesofdiseases,suchaschronicoveruseinjuriesandconversionofacuteinjuriesinlowbackorfrominter-vertebraldiscprotrusion,anddislocationofintervertebraljointsaswell,whichmainlycauseseverepaininlowback犤1犦.Manypresentmethods(oralmedicine,massage,anestheticblock,physicalthera-piesetc.)havebeenusedforrelievingthepain,whichdemandsagreatfiscalsupportannually.Unfortunately,thereportsonthemechanismsandeffectofthem… 相似文献
88.
Reversal of diabetes in BB rats by transplantation of encapsulated pancreatic islets 总被引:8,自引:0,他引:8
Prolonged survival of pancreatic islet allografts implanted in diabetic BB rats was achieved by encapsulation of individual islets in a protective biocompatible alginate-polylysine-alginate membrane without immunosuppression. Intraperitoneal transplantation of the encapsulated islets reversed the diabetic state of the recipients within 3 days and maintained normoglycemia for 190 days. Normal body weight and urine volume were maintained during this period, and no cataracts were detected in the transplant recipients. In contrast, control rats receiving transplants of unencapsulated islets experienced normoglycemia for less than 2 wk. These results demonstrated that microencapsulation can protect allografted islets from both graft rejection and autoimmune destruction without immunosuppression in an animal model that mimics human insulin-dependent diabetes. 相似文献
89.
尘肺是我国工业生产中危害最严重的职业病。1988年以来,郑州市持续开展了尘肺流行病学调查。1992年全市粉尘作业厂矿接尘人数为103542人,尘肺累积病人2758例,其中现患2541例,死亡217例。尘肺累积患病比为2.59%,现患率为2.39%,病死率为7.87%。尘肺累积病例以巩义市、郑州矿务局、密县为较多;按系统以煤炭(包括县煤炭)、机械、轻工、有色金属为多;尘肺病主要为矽肺及煤工尘肺。统计分析各种尘肺的发病工龄、发病年龄、死亡年龄以及各期别晋级年限等数据。对郑州市尘肺的发展趋势作了预测。 相似文献
90.