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31.
32.
蛛网膜下腔注入小剂量吗啡术后镇痛与PCEA比较研究 总被引:1,自引:0,他引:1
目的 :探讨蛛网膜下腔小剂量吗啡术后镇痛的临床效果并与 PCEA相比较。方法 :将 ASA I~II级 6 0例妇科择期手术患者 ,随机分为两组 ,每组 30例。实验组采用腰麻 ,局麻药为 0 .75 %布比卡因 10~ 15 m g加入吗啡 0 .5 mg。对照组采用腰麻复合 PCEA,局麻药 0 .75 %布比卡因 10~ 15 mg,术后 PCEA。术后镇痛效果以视觉模拟评分 (VAS)、Ram say镇静评分、BCS舒适评分、成功率、不良反应并结合医疗费用比进行评价。结果 :VAS评分两组在 4、8、36 h时段无显著性差异 (P>0 .0 5 ) ;实验组在 12、2 4 h镇痛效果优于对照组 ,4 8、5 4 h对照组优于实验组。 BCS舒适评分、Ram say镇静评分两组间无显著性差异。结论 :蛛网膜下腔注入小剂量的吗啡用于术后镇痛的效果并不亚于 PCEA,如采用医疗费用与治疗效果比 ,更优于后者 相似文献
33.
The role of endoscopic extraperitoneal herniorrhaphy (EEPH) in the management of giant scrotal hernias has not been well
defined, and the technical details relating to operations on such hernias have not been described. We present our experience
with 17 patients undergoing repair of giant scrotal hernias. Foley catheter bladder decompression was routinely employed.
The Retzius space was developed early in the procedure and hernia sac contents were reduced in all cases. The inferior epigastric
vessels were likewise divided in all patients. The average operative time was 76 min and all patients were discharged home
the same day. There have been no recurrences on follow-up. There was no mortality, and morbidity was limited to seroma formation
in two patients. We conclude that with certain technical modifications, EEPH can be safely employed for the treatment of giant
scrotal hernias.
Received: 7 May 1996/Accepted: 12 July 1996 相似文献
34.
Summary
The compartment syndrome (cs) is characterized by an increased tissue pressure in a limited space. Pathophysiologically, it
is a multifactorial disease that is potentially induced by an initial trauma and develops according to the existence of cofactors.
Cofactors are, for instance, the circulation of the patient and the initial treatment of the impending cs. In particular,
the microcirculation is altered with endothelial destruction, development of a capillary leak, protein loss from intravasal
space and the development of an interstitial and intracellular third space. An impaired drainage of the lymphatic and venous
system causes a venous infarction. An arterial infarction results if the tissue pressure exceeds the arteriolar pressure.
An accompanying ischemia reperfusion mechanism increases the trauma load. In disadvantageous cases, the patients are in danger
of developing a multi-organ deficiency syndrome (MODS) by an uncontrolled inflammatory reaction, by intravasal volume loss
and by a myonephropathic systemic reaction. Clinically, the patients suffer a disproportionate amount of pain, followed by
neurological signs. Especially in noncompliant patients, tissue pressure measurement is useful. Resuscitation of the circulation
as well as splitting of casts is important. In case of a manifest cs, dermatofasciotomy has to be performed as an emergency
operation. Even if cs is diagnosed early and fasciotomy is carried out early, the development of sequellae cannot be avoided
in every single case.
相似文献
35.
目的探索硬膜外导管置入脓腔引流对口腔颌面部脓肿的疗效。方法采用既往常规切开引流的患者作为对照组。治疗组为经面部皮肤用18号硬膜外穿刺针穿刺入脓腔,置入硬膜外导管,在口内做切口旋转引流条,或经颌下作小切口,置入负压引流管,经硬膜外导管滴注抗生素盐水冲洗脓腔,比较两者拔出引流物的时间,并行U检验。结果治疗组与对照组比较,差异具有统计学意义(P<0.01)。结论经硬膜外穿刺针置管引流术,具有创伤小、炎症消失快、有效缩短病程、愈后不留瘢痕的特点。 相似文献
36.
本文分析了20例有明确蛛网膜下腔出血病史的正常颅压脑积水患者的临床表现,其中有智能、步态障碍、尿失禁三联征典型表现者占11例(55%),有其中二个症状者4例。CT是诊断脑积水的首选检查。本文还结合文献对正常颅压脑积水的发生发展,与之有关的因素及临床表现进行讨论。 相似文献
37.
T. Fest A. Rozenbaum F. Cattin R. Chambers J. -P. Carbillet J. -F. Bonneville 《Neuroradiology》1988,30(6):569-570
Summary We report a case of non-Hodgkin's lymphoma with CNS involvement confined to the epidural space causing cranial suture diastasis. Cerebrospinal fluid and bone marrow were normal. Two cases only of cranial epidural lymphoma have been reported in the literature; in both cases, the leptomeninges were also involved but without suture diastasis. 相似文献
38.
The present study was conducted to examine changes in water concentration in the ventral prostate of adult rats at different intervals following castration. The prostatic dry weight was obtained by drying the fresh prostate at 70 degrees C for at least 110 hr and the prostatic water content was calculated from its wet and dry weight. Under normal conditions, the prostatic water concentration ranges from 81.9 to 82.7% in uncastrated rats. The prostatic water concentration started to increase at 8 hr postcastration (83.1%) but this increase was not statistically significant. By 16 hr postcastration, the prostatic water concentration (83.8%) became significantly higher than that of the uncastrated animals. In rats of day 1 to day 10 postcastration, the prostate contained significantly more water (84.4%-84.7%) than those in uncastrated animals. By day 21 postcastration, the prostatic water concentration (81.5%) was not significantly different from that of uncastrated rats. Unlike the prostate, the skeletal muscle did not significantly change the water concentration following castration. The 51Cr-EDTA space in the prostate was not significantly different in rats before and after castration. These results indicate that water imbibition in the rat prostate is associated with an active period of prostatic regression and that the change in the 51Cr-EDTA space during prostatic regression is not the major cause of water imbibition in the tissue. Therefore, the present findings suggest that castration-induced water imbibition in the rat prostate is caused by an increase in the intracellular water space. 相似文献
39.
A.P. Uzel R. Massicot P. Grignon V. Casoli 《Journal of orthopaedics and traumatology》2003,4(1):45-49
We report the case of a fracture separation of the articular pillar at the lower cervical spine. The trauma, following a
brass knuckles, repeats almost in an experimental way the rotation and extension mechanism given in literature for the genesis
of such injuries. From the admission in the orthopaedic service to the surgery, the development went in a characteristic way
towards a rotatory displacement.
Received: 12 July 2002, Accepted: 18 August 2002
Correspondence to: R. Massicot 相似文献
40.
This study was undertaken into rats to investigate changes in the hepatic lymph vessels and the space of Disse in endotoxaemia and to examine their relationship with the development of endotoxin-induced hepatic injury. Lymph stasis, namely dilatation of the lymph vessels and oedema, developed rapidly in the medium-sized portal canals, the large portal canals, and the liver hilum after endotoxin injection, but not in the small portal canals. Such changes reached their maximum 4-8 h after endotoxin injection and had recovered markedly by 16 h after the injection. The space of Disse remained within normal limits during this period. These findings suggest that the intrahepatic lymph stasis in endotoxaemia may be caused by a reduction in the pumping activity of the extrahepatic and the intrahepatic large lymph vessels rather than by an increase of lymph formation in the liver lobules. There was no evidence suggesting a direct relationship between the disturbance of hepatic lymph flow and the development of hepatic injury in endotoxaemia. 相似文献