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21.
目的:研究C型骨盆骨折合并髋关节中心性脱位的临床疗效。方法:13例患者中男8例,女5例;年龄23~65岁,平均36.5岁。骨盆骨折分型:C1型8例,C2型3例,C3型2例。髋臼“T”形骨折2例,粉碎性骨折9例,双柱骨折2例。均采用手术治疗,术前术后均采用股骨髁上牵引,术中采用髂腹股沟入路,必要时附加患髋后外侧切口,术中采用重建钢板固定。结果:本组随访时间6~28个月,平均13.4个月。髋臼骨折复位后残存移位:0~1mm9例,2~3mm2例,4~5mm2例,无>5mm者。髂骨骨折复位后各向残存移位:0~1mm9例,2~5mm3例,>5mm1例。3例原发性坐骨神经损伤的患者,术后3个月内其感觉、运动功能全部获得恢复。1例继发性坐骨神经损伤,术后6个月恢复。异位骨化2例,股骨头坏死、髋臼及股骨头软骨坏死、髋关节创伤性关节炎5例,患者关节疼痛、活动受限,影响功能。疗效综合评定:优8例,良1例,可2例,差2例。结论:C型骨盆骨折合并髋关节中心性脱位通过手术治疗,能够最大程度恢复其解剖结构,术后关节功能恢复较好。 相似文献
22.
创伤性睾丸脱位5例报告 总被引:1,自引:0,他引:1
目的 探讨创伤性睾丸脱位的诊断和治疗。方法 对所收治的5例患的诊治情况进行分析研究,并结合复习有关献。结果 1例手法复位成功,4例行手术复位.1例发生睾丸萎缩后切除患睾。结论 创伤性睾丸脱位临床少见,漏误诊率较高。对骨盆部、会阴部、阴囊部外伤患应警惕本病;详细检查阴囊及睾丸.确诊后尽早行手法或手术复位固定.定期随访。 相似文献
23.
24.
Eichi Itadera Yoshimasa Miyake Yoichi Nakatsuka Hirofumi Akazawa Shigeru Mitani Kiyoshi Aoki 《Journal of orthopaedic science》1996,1(4):252-258
We report satisfactory results with a new operative treatment, conducted via an extensive anterolateral approach, involving
360 degree circumferential capsulotomy, for residual subluxation in congenital dislocation of the hip (CDH). Long-term radiographic
results of this procedure (group A) were compared retrospectively with the results of partial capsulotomy (group B), which
preserved the posteroinferior joint capsule. The mean center edge angle in group A (22.5°) was greater than that in group
B (16.0°). Satisfactory results were achieved in 11 of 15 hips (73%) (Severin class I or II) in group A, and in 5 of 12 hips
(42%) in group B. These results suggest that whole circumferential capsulotomy can remove obstacles to complete reduction,
and that acetabular development can be expected in hips reduced by the procedure, without the performance of innominate osteotomy.
We believe that our technique is a useful alternative for the treatment of residual subluxation in CDH. 相似文献
25.
Posterior dislocations of the sternoclavicular joint are uncommon, but are potentially quite serious. Radiologic diagnosis and management are frequently difficult. The specialized projections available are not widely known, and the role of plain films is poorly understood. The incidence, pathomechanics, and clinical manifestations of such dislocations are presented and the radiologic diagnosis is discussed. 相似文献
26.
全锁髓内钉的设计及其临床应用 总被引:30,自引:0,他引:30
锁式髓内钉是近十余年来国际上有关髓内钉骨折内固定技术的三大进展之一。我院骨科在参考Huckstep钉的基础上,设计了改进型Huckstep钉(即全锁髓内钉,简称全锁钉,下同)及其手术器械和手术方法,不需要X线辅助设备,用于治疗复杂股骨骨折。自1987年4月~1992年12月用全锁钉治疗复杂股骨骨折48例,其中男33例、女15例;年龄最大55岁,最小20岁,平均34.6岁。致伤原因:车祸21例、高处坠落伤14例、工业伤10例、其他3例。骨折部位:股骨干上1/3骨折17例、中1/3骨折4例、下1/3骨折5例、全股骨多处骨折5例(其中股骨骨折合并股骨颈骨折3例、合并转子间骨折和转子下骨折各1例)、股骨转子间骨折12例,股骨转子下骨折5例。48例中39例获得随访,最长107个月,最短42个月,平均66.4个月。优30例(76.9%),良7例(18.0%),失败2例(5.1%)。 相似文献
27.
James N. Gladstone MD Kevin E. Wilk PT James R. Andrews MD 《Operative Techniques in Sports Medicine》1997,5(2):78-87
Nonoperative treatment is generally the choice for Type I and II acromioclavicular (AC) joint injuries. The situation issomewhat more controversial when Type III AC dislocations are considered, particularly with respect to athletes and heavy laborers. A number of recent studies have supported conservative treatment in these groups. There is general consensus as to the need for surgical intervention for Type IV, V, and VI AC injuries. Integral to any form of management, nonoperative or operative, is a rehabilitation program that addresses range of motion, strength, and neuromuscular control. We describe our program, which is divided into four phases: (1) Pain control and immediate protected range of motion and isometric exercises; (2) strengthening exercises using isotonic contractions and proprioceptive neuromuscular facilitation (PNF) exercises; (3) Unrestricted functional participation with the goal of increasing strength, power, endurance, and neuromuscular control; and (4) return to activity with sport specific functional drills. An athlete is ready to return to competitive sports once the following criteria are met: full range of motion (ROM), no pain or tenderness, satisfactory clinical exam, and demonstration of adequate strength on isokinetic testing. The unique considerations in a throwing athlete with an AC injury are also addressed. The primary goal of the nonoperative treatment protocol is to return the athlete to full activities as quickly and as safely as possible. 相似文献
28.
Objectives To retrospectively review the results of closed reduction for developmental dysplasia of the hip (DDH), and analyze the causative for the dissatisfactory results of radiolagieal. Methods From 1997 to 2005 the results of closed reduction for DDH in 60 children (77 hips) over 4.5 years period were retrospectively reviewed. Radiological final results of the patients were evaluated with Severin classification. The causative factors made from medical records and radiographs were used to make statistical analysis. Results Seventy-three percent of the patients (56/77) had satisfactory results according to Severin classification. Twenty-one hips classed as SeverinⅢ-Ⅴ. Seventeen of the 21 hips had a reconstructive procedure. Avaseular necrosis was observed in 29 hips (38%). The most important parameters affecting the result were age at reduction (P < 0. 05) and avascular necrosis (P < 0.05).Conclusions In order to achieve better clinical and radioiogical results, the infants suffering from the DDH should be treated in the early stage. The postoperative avascular necrosis usually leads to poor prohnosis. 相似文献
29.
Abstract – Dental injuries are common following facial trauma. This article presents a rare injury: the dislocation of a third molar into the maxillary sinus after complex mandibular and maxillary tuberosity fractures. The possible mechanism and clinical treatment are discussed. 相似文献
30.
A Comparative Study on the Close Reduction of Arytenoid Dislocation under Indirect and Direct Laryngoscope 总被引:3,自引:0,他引:3
To assess the curative effects of different reduction techniques on the dislocation of cricoarytenoid joint caused by intubation,indirect laryngoscope (IL) and direct laryngoscope (DL) were utilized for the closed reduction of the displaced arytenoid under local anesthesia.23 patients who underwent the reduction for dislocated arytenoid under IL or DL from January 1991 to June 2001 were reviewed.The data were collected on the duration of the laryngeal injury,times of receiving reduction,side-effects after the treatment and the period for voice to returen to normal.The relationship between the duration of the laryngeal lesion and the period of the voice rehabilitation was examined.13 patients received the reduction under IL and 10 patients under DL,Except the times of the reduction,which showed significant difference,no differences were found between IL group and DL group in the course and the period of voice rehabilitation,as well as sore throat after the manipulation.The patients‘ voice recovery was positively related to their course of disease in both IL and DL group.It is coucluded that the recovery of normal voice is obviously affected by the duration of arytenoid dislocation.The reduction under Il is as effective as under DL in the treatment of arytenoid dislocation.Reduction by DL is better suit the patients with long time course of disease. 相似文献