全文获取类型
收费全文 | 206590篇 |
免费 | 15499篇 |
国内免费 | 5072篇 |
专业分类
耳鼻咽喉 | 1644篇 |
儿科学 | 2826篇 |
妇产科学 | 3309篇 |
基础医学 | 24922篇 |
口腔科学 | 4055篇 |
临床医学 | 15052篇 |
内科学 | 28597篇 |
皮肤病学 | 2378篇 |
神经病学 | 12599篇 |
特种医学 | 7676篇 |
外国民族医学 | 4篇 |
外科学 | 22889篇 |
综合类 | 28662篇 |
现状与发展 | 25篇 |
一般理论 | 8篇 |
预防医学 | 15616篇 |
眼科学 | 2373篇 |
药学 | 27267篇 |
102篇 | |
中国医学 | 13245篇 |
肿瘤学 | 13912篇 |
出版年
2024年 | 206篇 |
2023年 | 2797篇 |
2022年 | 3917篇 |
2021年 | 8925篇 |
2020年 | 7632篇 |
2019年 | 7373篇 |
2018年 | 7366篇 |
2017年 | 7895篇 |
2016年 | 8134篇 |
2015年 | 7651篇 |
2014年 | 9610篇 |
2013年 | 13361篇 |
2012年 | 11045篇 |
2011年 | 13046篇 |
2010年 | 8503篇 |
2009年 | 8470篇 |
2008年 | 9783篇 |
2007年 | 10629篇 |
2006年 | 9917篇 |
2005年 | 9060篇 |
2004年 | 7750篇 |
2003年 | 6834篇 |
2002年 | 5419篇 |
2001年 | 4809篇 |
2000年 | 4042篇 |
1999年 | 3422篇 |
1998年 | 2688篇 |
1997年 | 2762篇 |
1996年 | 2331篇 |
1995年 | 2193篇 |
1994年 | 2133篇 |
1993年 | 1769篇 |
1992年 | 1639篇 |
1991年 | 1535篇 |
1990年 | 1320篇 |
1989年 | 1078篇 |
1988年 | 1047篇 |
1987年 | 942篇 |
1986年 | 869篇 |
1985年 | 1251篇 |
1984年 | 995篇 |
1983年 | 752篇 |
1982年 | 781篇 |
1981年 | 635篇 |
1980年 | 604篇 |
1979年 | 488篇 |
1978年 | 311篇 |
1977年 | 267篇 |
1976年 | 246篇 |
1975年 | 189篇 |
排序方式: 共有10000条查询结果,搜索用时 30 毫秒
91.
Haya Mohammed BSc MChB M. Yousuf Salmasi MRCS Massimo Caputo PhD Gianni D. Angelini PhD Hunaid A. Vohra PhD 《Journal of cardiac surgery》2020,35(6):1209-1219
Background
Limited data exists demonstrating the efficacy of minimally invasive surgery (MIS) compared to median sternotomy (MS) for multiple valvular disease (MVD). This systematic review and meta-analysis aims to compare operative and peri-operative outcomes of MIS vs MS in MVD.Methods
PubMed, Ovid, and Embase were searched from inception until August 2019 for randomized and observational studies comparing MIS and MS in patients with MVD. Clinical outcomes of intra- and postoperative times, reoperation for bleeding and surgical site infection were evaluated.Results
Five observational studies comparing 340 MIS vs 414 MS patients were eligible for qualitative and quantitative review. The quality of evidence assessed using the Newcastle-Ottawa scale was good for all included studies. Meta-analysis demonstrated increased cardiopulmonary bypass time for MIS patients (weighted mean difference [WMD], 0.487; 95% confidence interval [CI], 0.365-0.608; P < .0001). Similarly, aortic cross-clamp time was longer in patients undergoing MIS (WMD, 0.632; 95% CI, 0.509-0.755; P < .0001). No differences were found in operative mortality, reoperation for bleeding, surgical site infection, or hospital stay.Conclusions
MIS for MVD have similar short-term outcomes compared to MS. This adds value to the use of minimally invasive methods for multivalvular surgery, despite conferring longer operative times. However, the paucity in literature and learning curve associated with MIS warrants further evidence, ideally randomized control trials, to support these findings.92.
93.
94.
Dan Azagury Tara E Mokhtari Luis Garcia Ulysses S Rosas Trit Garg Homero Rivas John Morton 《Surgery》2019,165(3):565-570
Background
Laparoscopic Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic adjustable gastric banding all lead to substantial weight loss in obese patients. Long-term weight loss can be highly variable beyond 1-year postsurgery. This study examines and compares the frequency distribution of weight loss and lack of treatment effect rates after laparoscopic Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic adjustable gastric banding.Methods
A total of 1,331 consecutive patients at a single academic institution were reviewed from a prospectively collected database. Preoperative data collected included demographics, body mass index, and percent excess weight loss. Postoperative BMI and %EWL were collected at 12, 24, and 36 months. Percent excess weight loss was analyzed by the percentiles of excess weight lost, and the distribution of percent excess weight loss was evaluated in 10% increments. Lack of a successful treatment effect was defined as <25% excess weight loss.Results
Of the 1,331 patients, 72.4% (963) underwent laparoscopic Roux-en-Y gastric bypass, 18.3% (243) laparoscopic sleeve gastrectomy, and 9.4%(125) laparoscopic adjustable gastric banding. Mean percent excess weight loss was greatest for laparoscopic Roux-en-Y gastric bypass, followed by laparoscopic sleeve gastrectomy, and then by laparoscopic adjustable gastric banding at every time point: at 2 years mean percent excess weight loss was 77.9± 24.4 for laparoscopic Roux-en-Y gastric bypass, 50.8 ± 25.8 for laparoscopic sleeve gastrectomy, and 40.8± 25.9 for laparoscopic adjustable gastric banding (P < .0001). The rates of a successful treatment effect s for laparoscopic Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic adjustable gastric banding were 0.9%, 5.2%, and 24.3% at 1 year; 0.3%, 11.1%, and 26.0% at 2 years; and 1.0%, 25.3%, and 30.2% at 3 years. At 1 year, the odds ratio of lack of a successful treatment effect of laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass was 6.305 (2.125–19.08; P?=?.0004), the odds ratio for laparoscopic adjustable gastric banding versus laparoscopic Roux-en-Y gastric bypass was 36.552 (15.64–95.71; P < .0001), and the odds ratio for laparoscopic adjustable gastric banding versus laparoscopic sleeve gastrectomy was 5.791 (2.519–14.599; P < .0001). At 2 years, the odds ratio for laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass increased to 70.7 (9.4–531.7; P < .0001), the odds ratio for laparoscopic adjustable gastric banding versus laparoscopic Roux-en-Y gastric bypass increased to 128.1 (16.8–974.3; P < .0001), and the odds ratio for laparoscopic adjustable gastric banding versus laparoscopic sleeve gastrectomy decreased to 1.8 (0.9–3.6; P?=?.09).Conclusion
This study emphasizes the existing variability in weight loss across bariatric procedures as well as in the lack of a treatment effect for each procedure. Although laparoscopic adjustable gastric banding has the greatest rate of a lack of a successful treatment effect, the rate remained stable over 3 years postoperatively. Laparoscopic sleeve gastrectomy showed a doubling in the rate of a lack of a successful treatment effect every year reaching 25% at year 3. The rates for lack of a successful treatment effect for laparoscopic Roux-en-Y gastric bypass remained stable at about 1% for the first 3 years postoperatively. 相似文献95.
96.
目的观察飞秒激光小切口角膜基质透镜取出术(SMILE)术后超早期患者视觉质量变化,探讨其变化发生的可能原因。方法选取中低度近视患者23例46眼行SMILE术,术前及术后24 h超早期行主观视觉质量问卷,测量最佳矫正视力的全程视力(远视力5 m,中视力60 cm,近视力33 cm)、对比敏感度(CS)、眩光敏感度(GS)及集合近点(NPC)和调节幅度(AA)。结果视觉质量主观问卷显示术后超早期主观视觉质量较术前下降(P=0.001)。术后裸眼视力(UCVA)明显提高(P=0.0001)。术前与术后最佳矫正视力(BCVA)中远视力没有变化(P=0.096),而中视力和近视力均较术前下降(P=0.039,0.003)。术后CS、GS降低(PCS=0.0001,PGS=0.04),NPC、AA较术前无明显变化(P=0.68,0.13)。结论SMILE术后超早期患者可获得预期理想远视力,但中、近视力尚未恢复。超早期中出现的异常视觉质量改变可能与对比敏感度和眩光敏感度的改变有关。 相似文献
97.
桃红四物汤,活血祛瘀之经典名方。该文对近年来桃红四物汤的化学成分、药理作用以及临床应用研究进展进行总结与分析。目前,桃红四物汤不同提取部位化学成分的研究较为系统,其药理作用研究主要集中在活血化瘀、调经镇痛、促进骨折愈合等方面,临床可应用于多系统、多脏腑疾病的治疗,例如妇科疾病、内科疾病、骨伤科疾病、皮肤科疾病等。在此基础上,依照质量标志物(Q-marker)有效、特有、传递与溯源、可测和处方配伍的"五原则"对桃红四物汤Q-marker进行预测分析,提示阿魏酸、芍药苷、苦杏仁苷、芍药内酯苷、梓醇、没食子酸、羟基红花黄色素A可作为该复方的Q-marker,后续可选择这些Q-marker为指标,根据药材、饮片、中间体、对应实物的量值传递进行桃红四物汤全程质量控制并创建其质量可溯源体系。 相似文献
98.
99.
Robert J. Motzer MD Bernard Escudier MD Saby George MD Hans J. Hammers MD PhD Sandhya Srinivas MD Scott S. Tykodi MD PhD Jeffrey A. Sosman MD Elizabeth R. Plimack MD Giuseppe Procopio MD David F. McDermott MD Daniel Castellano MD Toni K. Choueiri MD Frede Donskov MD PhD Howard Gurney MD Stéphane Oudard MD Martin Richardet MD PhD Katriina Peltola MD PhD Ajjai S. Alva MD Michael Carducci MD John Wagstaff MD Christine Chevreau MD Satoshi Fukasawa MD Yoshihiko Tomita MD PhD Thomas C. Gauler MD Christian K. Kollmannsberger MD Fabio A. Schutz PhD James Larkin MD PhD David Cella PhD M. Brent McHenry PhD Shruti Shally Saggi BEng Nizar M. Tannir MD 《Cancer》2020,126(18):4156-4167
100.
目的:讨论普通变异型免疫缺陷病(common variable immunodeficiency disease,CVID)的发病机制、临床表现及治疗方法。方法:报道1例普通变异型免疫缺陷病合并肝硬化患者并复习相关文献。结果:普通变异型免疫缺陷病是临床少见病,易误诊,病因不清,临床表现复杂,部分患者病程中可出现肝功能异常,甚至并发肝硬化。结论:临床反复感染的患者应考虑CVID的可能,须进一步作血浆免疫球蛋白的检测确诊。对已经确诊患者定期补充静脉丙种球蛋白,同时还应定期检查肝功能。 相似文献