全文获取类型
收费全文 | 22585篇 |
免费 | 1305篇 |
国内免费 | 539篇 |
专业分类
耳鼻咽喉 | 113篇 |
儿科学 | 287篇 |
妇产科学 | 462篇 |
基础医学 | 1917篇 |
口腔科学 | 603篇 |
临床医学 | 2872篇 |
内科学 | 3726篇 |
皮肤病学 | 133篇 |
神经病学 | 446篇 |
特种医学 | 701篇 |
外科学 | 6818篇 |
综合类 | 2948篇 |
预防医学 | 973篇 |
眼科学 | 206篇 |
药学 | 1457篇 |
19篇 | |
中国医学 | 347篇 |
肿瘤学 | 401篇 |
出版年
2024年 | 42篇 |
2023年 | 561篇 |
2022年 | 947篇 |
2021年 | 1423篇 |
2020年 | 1379篇 |
2019年 | 1120篇 |
2018年 | 1006篇 |
2017年 | 726篇 |
2016年 | 690篇 |
2015年 | 693篇 |
2014年 | 1610篇 |
2013年 | 1638篇 |
2012年 | 1160篇 |
2011年 | 1308篇 |
2010年 | 1071篇 |
2009年 | 1047篇 |
2008年 | 985篇 |
2007年 | 892篇 |
2006年 | 855篇 |
2005年 | 754篇 |
2004年 | 688篇 |
2003年 | 575篇 |
2002年 | 484篇 |
2001年 | 359篇 |
2000年 | 326篇 |
1999年 | 246篇 |
1998年 | 227篇 |
1997年 | 192篇 |
1996年 | 170篇 |
1995年 | 164篇 |
1994年 | 147篇 |
1993年 | 115篇 |
1992年 | 117篇 |
1991年 | 56篇 |
1990年 | 73篇 |
1989年 | 61篇 |
1988年 | 70篇 |
1987年 | 84篇 |
1986年 | 56篇 |
1985年 | 52篇 |
1984年 | 45篇 |
1983年 | 33篇 |
1982年 | 34篇 |
1981年 | 29篇 |
1980年 | 27篇 |
1979年 | 24篇 |
1978年 | 14篇 |
1977年 | 13篇 |
1976年 | 12篇 |
1975年 | 10篇 |
排序方式: 共有10000条查询结果,搜索用时 46 毫秒
41.
《Clinical breast cancer》2020,20(6):e757-e760
IntroductionWe previously developed a convolutional neural networks (CNN)-based algorithm to distinguish atypical ductal hyperplasia (ADH) from ductal carcinoma in situ (DCIS) using a mammographic dataset. The purpose of this study is to further validate our CNN algorithm by prospectively analyzing an unseen new dataset to evaluate the diagnostic performance of our algorithm.Materials and MethodsIn this institutional review board-approved study, a new dataset composed of 280 unique mammographic images from 140 patients was used to test our CNN algorithm. All patients underwent stereotactic-guided biopsy of calcifications and underwent surgical excision with available final pathology. The ADH group consisted of 122 images from 61 patients with the highest pathology diagnosis of ADH. The DCIS group consisted of 158 images from 79 patients with the highest pathology diagnosis of DCIS. Two standard mammographic magnification views (craniocaudal and mediolateral/lateromedial) of the calcifications were used for analysis. Calcifications were segmented using an open source software platform 3D slicer and resized to fit a 128 × 128 pixel bounding box. Our previously developed CNN algorithm was used. Briefly, a 15 hidden layer topology was used. The network architecture contained 5 residual layers and dropout of 0.25 after each convolution. Diagnostic performance metrics were analyzed including sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve. The “positive class” was defined as the pure ADH group in this study and thus specificity represents minimizing the amount of falsely labeled pure ADH cases.ResultsArea under the receiver operating characteristic curve was 0.90 (95% confidence interval, ± 0.04). Diagnostic accuracy, sensitivity, and specificity was 80.7%, 63.9%, and 93.7%, respectively.ConclusionProspectively tested on new unseen data, our CNN algorithm distinguished pure ADH from DCIS using mammographic images with high specificity. 相似文献
42.
Bone stock preservation is crucial when performing total hip replacement in young patients. The aim is to save good bone stock
for a possible revision procedure. Furthermore, there is an increasing demand from young and active patients to receive a
new joint which allows a normal or nearly normal life style. With this in mind, we began, in 1993, to develop a new femoral
implant. The purpose of this ultra-short stem was a physiologic strain distribution on the proximal femur with a proximal
load transfer from the implant to the femoral bone. Main features were an almost complete absence of the diaphyseal portion
of the stem, a well defined lateral flare with load transfer on the lateral column of the femur, and a very high femoral neck
cut. These innovations resulted in a conservative implant on both the bone stock and the soft tissues. This implant, in the
first years, was recommended only for young and active patients. Over the last thirteen years, this project has undergone
several modifications but the basic principles of the implant have remained the same. In the present review, we present the
rationale, the surgical technique and the clinical and experimental results so far obtained with this implant. 相似文献
43.
Objective To investigate the clinical effects of total hip arthroplasty (THA) for bony ankylosis in patients with ankylosing spondylitis and the significance of postoperative rehabilitation. Meth-ods From October 1998 to May 2007, 28 patients (46 hips) suffered from ankylosing spondylitis with hip bony ankylosis underwent THA. There were 27 males, 1 female, with the mean age of 38.9 years (range 22 to 58 years). Posterior lateral hip incision was performed in 34 hips, and modified anterior lateral combined with lateral hip incision in 12 hips. Forty hips applied cementless THA and 6 hips applied mixed THA. Har-ris scores, VAS scores and total hip range of motion in all patients were compared pre-and postoperatively to evaluate the clinical effects. Results All patients were followed up from 10 months to 64 months, with the mean time of 38.2 months. No paralysis, decubitus, and lung infection were found. Joint dislocation hap-pened in 1 case 2 weeks after operation, and was cured with close reduction. Heterotopic bone formation with Brooker Ⅰ was found in 6 hips and Brooker Ⅱ in 2 hips. Harris score increased from 28.3±10.3 preop-eratively to 82.7±7.6 postoperatively. VAS score changed from 3.5±1.4 preoperatively to 3.8±1.8 postopera-tively, and no significance was found. The hip movement range increased from 15.6°±9.3° preoperatively to 133.7°±17.6° postoperatively. Bony ankylosis in all patients disappeared and the hip function improved sig-nificantly after operation. Conclusion THA is the optimal method to treat the ankylosing spondylitis with hip bony ankylosis. Early rehabilitation is necessary to improve hip function. 相似文献
44.
目的:分析钛-瓷修复体失败的原因。方法:对38例瓷裂的钛-瓷修复体进行分析:①肉眼观察烤瓷崩瓷部铸件的表面颜色并用便携式厚度测试仪测量其厚度,与未发生瓷裂的正常镰铬合金烤瓷比较;②观察烤瓷崩瓷的部位;③X-ray检测铸件内部气孔。结果:本组崩瓷的钛-瓷修复体,其断层或有气泡,或金属表面氧化层明显增厚(P〈0.05)。而且,所有发生崩瓷的部位均在受力点或因技工本身操作不当引起。结论:钛-瓷修复体失败的原因与加工过程中工艺、瓷的受力点以及与钛元素化学性能有关。 相似文献
45.
Early micromotion of implant components and periprosthetic bone loss in patients undergoing total knee arthroplasty are thought
to contribute to late aseptic loosening. In the pursuit of longer implant survival, the administration of bisphosphonates
may be advocated as a means to buffer implants against microinstability and periprosthetic bone loss. A bibliographic search
identified one metaanalysis and two randomised controlled trials dealing with this topic. Current evidence supports the hypothesis
that the inhibiting effects of bisphosphonates on bone resorption reduce implant micromotion and periprosthetic bone loss
at the one-year follow-up. Tested bisphosphonates include clodronate, pamidronate and alendronate. However, a decline in periprosthetic
BMD is observed at the three-year follow-up following a sixmonth course of bisphosphonate administration. Length of follow-up
in available studies is currently too short to determine whether bisphosphonates increase the longevity of implants. Furthermore,
the optimal dose, modality and length of bisphosphonate administration have yet to be determined. 相似文献
46.
Ross手术自1967年应用于临床以来,已被用于各种原因引起的主动脉瓣狭窄、左心室流出道梗阻和二尖瓣病变。Ross手术经历了诸如根部置换、圆筒形包埋技术、瓣环缩小技术、Ross—Konno手术和自体肺动脉瓣二尖瓣置换术(Ross—Kabbani手术或RossⅡ手术)。由于自体肺动脉瓣有不需抗凝、大小适宜、能存活、生长和长期耐久的特性,并具有良好的血流动力学表现和对细菌性心内膜炎有抵抗力的优点,尤其适用于妊娠期妇女、儿童和青少年。现就Ross手术的外科技术、手术指征、选择标准、外科处理主动脉瓣狭窄、左心室流出道梗阻和二尖瓣病变的临床应用进展和效果进行综述。 相似文献
47.
Ashutosh Singh M.Ch. Vidyut Kumar Sinha M.Ch. Jayant Khandekar M.Ch. Nandkishor Agrawal M.Ch. Anil Patwardhan M.Ch. Dr. Jagdish Kharideparkar M.Ch. 《Indian Journal of Thoracic and Cardiovascular Surgery》2006,22(2):121-125
Objective The degree of Left Ventricular Mass Index (LVMI) regression following aortic valve replacement correlates with long-term survival.
This study aims to assess the extent of LVMI regression at 3 months following aortic valve replacement (AVR) with different
types and sizes of mechanical valves in rheumatic aortic valve disease.
Methods The LVMI regression was studied in 34 consecutive patients, undergoing elective AVR for rheumatic aortic stenosis and/or regurgitation.
They were grouped in A and B, matched in age, body surface area and pre-operative LVMI, receiving respectively a tilting disc
and a bileaflet mechanical valve. The LVMI was calculated by M-mode echocardiography using the Devereux' formula pre-operatively
and three months post-operatively. The trend of LVMI reduction was compared between the two groups and amongst the patients
with stenotic, regurgitant and mixed aortic valve, pathologies; and receiving different sizes of valves.
Results The mean preoperative LVMI was 199g±79.5 g/m2. At three months post aortic valve replacement, the mean LVMI was 130g±49.0 g/m2. There was a significant reduction of LVMI post-operatively (p=0.001) at three months follow-up. The extent of LVMI regression
following surgery amongst the groups A and B did not vary significantly (p=0.92). The extent of LVMI regression did not vary
significantly in patients with different aortic valve pathology nor with different sizes of the valves implanted.
Conclusions There is a significant early LVMI regression following aortic valve replacement in rheumatic aortic valve disease. The type
and the size of the mechanical prosthesis or the rheumatic pathology do not appear to influence this regression. 相似文献
48.
Migration of Kirschner (K) wires from the upper extremity joints has often been reported, but it is less common from the lower
extremities. In this report, we describe an 85-year-old man treated, during a hip replacement procedure, with a K-wire because
of a trochanteric fracture; after one year, the K-wire was found in the popliteal fossa. This report illustrates the first
case of K-wire migration in the popliteal area of the knee and suggests avoiding the use of free K-wires without any tension
banding. 相似文献
49.
目的:对行人工关节置换手术的高龄股骨颈骨折患者进行围手术期综合处理,探讨其围手术期治疗的必要性与重要性。方法:68例股骨颈骨折的高龄患者,男28例,女40例;年龄70~88岁,平均76.4岁。所有患者于关节置换术前采用有效的降糖,降压,营养心肌,保肝,纠正贫血、低蛋白血症等综合处理,控制合并症。患者全身情况、脏器功能状况可耐受手术后行人工关节置换手术。结果:所有患者均安全渡过手术期,切口Ⅰ期愈合。1例术后早期出现腹泻并发症,经应用制霉菌素及金双岐调节肠道菌群,腹泻控制。按Harris标准评价疗效,优39例,良24例,可5例,优良率92.6%。结论:严格有效的围手术期综合治疗是处理高龄股骨颈骨折患者行人工关节置换手术的安全保障。 相似文献
50.