全文获取类型
收费全文 | 78363篇 |
免费 | 5436篇 |
国内免费 | 1690篇 |
专业分类
耳鼻咽喉 | 3135篇 |
儿科学 | 898篇 |
妇产科学 | 1512篇 |
基础医学 | 2002篇 |
口腔科学 | 3142篇 |
临床医学 | 7100篇 |
内科学 | 7148篇 |
皮肤病学 | 703篇 |
神经病学 | 2553篇 |
特种医学 | 1265篇 |
外国民族医学 | 20篇 |
外科学 | 26231篇 |
综合类 | 10577篇 |
现状与发展 | 6篇 |
一般理论 | 2篇 |
预防医学 | 2759篇 |
眼科学 | 6736篇 |
药学 | 3166篇 |
167篇 | |
中国医学 | 849篇 |
肿瘤学 | 5518篇 |
出版年
2024年 | 164篇 |
2023年 | 2069篇 |
2022年 | 2538篇 |
2021年 | 4300篇 |
2020年 | 4217篇 |
2019年 | 3587篇 |
2018年 | 3453篇 |
2017年 | 3001篇 |
2016年 | 3009篇 |
2015年 | 3067篇 |
2014年 | 5996篇 |
2013年 | 5627篇 |
2012年 | 4555篇 |
2011年 | 4779篇 |
2010年 | 3773篇 |
2009年 | 3565篇 |
2008年 | 3432篇 |
2007年 | 3419篇 |
2006年 | 2972篇 |
2005年 | 2601篇 |
2004年 | 2250篇 |
2003年 | 1825篇 |
2002年 | 1459篇 |
2001年 | 1392篇 |
2000年 | 1176篇 |
1999年 | 1071篇 |
1998年 | 905篇 |
1997年 | 843篇 |
1996年 | 619篇 |
1995年 | 504篇 |
1994年 | 449篇 |
1993年 | 362篇 |
1992年 | 302篇 |
1991年 | 306篇 |
1990年 | 206篇 |
1989年 | 195篇 |
1988年 | 200篇 |
1987年 | 202篇 |
1986年 | 155篇 |
1985年 | 183篇 |
1984年 | 163篇 |
1983年 | 109篇 |
1982年 | 112篇 |
1981年 | 110篇 |
1980年 | 83篇 |
1979年 | 49篇 |
1978年 | 35篇 |
1977年 | 34篇 |
1976年 | 26篇 |
1975年 | 21篇 |
排序方式: 共有10000条查询结果,搜索用时 46 毫秒
51.
Rohi Shah Nomaan Sheikh Jitendra Mangwani Nicolette Morgan Hamidreza Khairandish 《Journal of Clinical Orthopaedics and Trauma》2021,12(1):138
Demographic projections for hip fragility fractures indicate a rising annual incidence by virtue of a multimorbid, ageing population with more noncommunicable diseases (NCDs). NCDs are characterised by slow progression and long duration ranging from ischaemic cardiovascular disease, cerebrovascular disease, diabetes, chronic obstructive pulmonary disease to various cancers. Management of this disease burden often involves commencing patients on oral anticoagulants to reduce the risk of thromboembolic events. The use of direct oral anticoagulants (DOACs) in clinical practice has increased due to their rapid onset of action, short half-life and predictable anticoagulant effects, without the need for routine monitoring. Safe and timely surgical intervention relies on reversal of anticoagulants. However, the lack of specific evidence-based guidelines for the perioperative management of patients on DOACs with hip fractures has proved challenging; in particular, the accessibility of DOAC-specific assays, justification of the cost-benefit ratio of targeted reversal agents and indications for neuraxial anaesthesia. This has led to potentially avoidable delays in surgical intervention. Following a literature review of the pharmacokinetic and pharmacodynamics of commonly used DOACs in our region including the role of surrogate markers, we propose a systematic, evidence-based guideline to the perioperative management of hip fractures DOACs. We believe this standardised protocol can be easily replicated between hospitals. We recommend that if patients are deemed suitable for a general anaesthesia, with satisfactory renal function, optimal surgical time should be 24 h following the last ingested dose of DOAC. 相似文献
52.
冯莹 《中国实用外科杂志》2020,40(5):531-536
易栓症是外科围手术期静脉血栓栓塞症(VTE)的防治重点。对于接受手术的止凝血障碍病人,需要谨慎评估VTE的个体风险,同时兼顾手术和麻醉的性质、出血障碍类型和严重程度、年龄、体重指数(BMI)、血栓形成史、恶性肿瘤和其他高危共患病。VTE风险应与已知出血障碍病人使用抗凝相关的出血风险平衡。实验室检查有助于发现和判断血栓与出血的病因,对病人的止凝血代偿能力作出评估,并对抗凝药物的合理使用提供依据。对上述病人,建议术后不常规使用药物预防血栓,尤其是血友病病人,但围手术期因子替代和止血药物的过度应用仍存在导致血栓的风险。使用低分子肝素(LMWH)和直接口服抗凝剂前应评估肾小球滤过率。当血小板计数<50×109/L,LMWH短期减量应用可能相对安全,监测抗Хa水平可用于调整中重度血小板减少症病人LMWH的剂量。主要消化道出血停止和重新使用华法林应至少相隔7 d。对于高血栓栓塞风险和术后高出血风险病人,术后当晚和术后第1天减量应用直接口服抗凝剂是一种可取的做法。 相似文献
53.
54.
目的:探讨三种不同引流方式对食管癌术后颈部吻合口瘘的引流效果。方法:收集从2013年1月到2016年9月在我科行食管癌手术并术后发生颈部吻合口瘘患者,比较入组患者所采用的不同颈部引流方式的优劣。结果:共有83例患者纳入研究,有34例进入A组,行纱布条引流组;28例进入B组,行造瘘袋引流组;21例进入C组,行胃管负压引流组。所有入组患者一般资料和手术资料对比无明显统计学差异(P>0.05)。观察指标对比结果显示,C组患者瘘口愈合时间较其他两组时间短[(15.90±4.18)天vs(14.60±4.41)天vs(9.65±3.80)天],住院时间较其他两组短[(18.10±4.17)天vs(16.20±3.78)天vs(12.30±3.29)天],换药次数较其他两组少[(37.55±8.75)天vs(14.5±3.23)天vs(10.00±2.05)天],抗生素使用时间也较其他组明显减少[(13.10±2.49)天vs(10.85±1.84)天vs(7.20±1.74)天]。结论:颈部放置负压引流有助于食管癌术后颈部吻合口瘘愈合,值得临床推广与进一步研究。 相似文献
55.
A mixed‐method study of effects of a therapeutic play intervention for children on parental anxiety and parents' perceptions of the intervention 下载免费PDF全文
56.
57.
Rosario Gulias-Cañizo Anell Lagunes-Guillén Arturo González-Robles Erika Sánchez-Guzmán Federico Castro-Muñozledo 《Burns : journal of the International Society for Burn Injuries》2019,45(2):398-412
Background
Since recent reports have shown that (-)-Epigallocatechin-3-gallate (EGCG) could be used for treating proliferative and inflammatory disorders, we explored its use for the management of corneal chemical burns.Materials and methods
Initially, EGCG was assayed on the rabbit corneal epithelial cell line RCE1(5T5) to establish the best testing conditions, and to avoid unwanted outcomes in the experimental animals. Then, we studied its effects on cell proliferation, cell cycle progression and cell differentiation. Afterwards, we instilled EGCG in experimental grade II corneal alkali burns in mice, three times a day up to 21 days, and evaluated by slit lamp examination and histological sections of corneal epithelial, corneal endothelial and stromal edema, as well as the presence of inflammatory cells and neovascularization.Results
EGCG reduced cell growth and led to a decline in the proportion of proliferative cells in a concentration dependent manner. At 10 μM, EGCG promoted cell differentiation, an effect not related with apoptosis or cytotoxicity. When 10 μM EGCG was instilled in corneal alkali burns in mice three times a day up to 21 days, EGCG significantly reduced corneal opacity and neovascularization. The improved clinical appearance of the cornea was associated to a controlled epithelial growth; epithelial morphology was similar to that observed in normal epithelium and contrasted with the hyperproliferative, desquamating epithelium observed in control burn wounds. EGCG reduced corneal, stromal and endothelial edema, and wound inflammation.Conclusion
This work constitutes the first evidence for the use of EGCG in the acute phase of a corneal alkali burn, representing a possible novel alternative to improve patient outcomes as an add-on therapy. 相似文献58.
目的观察妇科腹腔镜手术围术期碳水化合物口服疗法和传统禁饮食方案两种不同的临床处理措施对于术后胰岛素抵抗(IR)的影响。
方法选取2018年2月至8月入住徐州医科大学附属医院妇科,行腹腔镜下全子宫切除手术的非糖尿病患者共98例,将采用围术期碳水化合物口服疗法者作为观察组(50例),采用传统禁饮食方案者作为对照组(48例)。检测所有病例的术前、术后第1天及第3天的空腹血糖(FPG)及空腹胰岛素(FINS),并利用稳态模式评估法计算稳态模型胰岛素抵抗指数(HOME-IR)。对于观察组与对照组患者术前、术后第1天和术后第3天的FPG、FINS和HOME-IR等指标,组间比较采用独立样本t检验。两组患者术后腹胀、术后24 h通气、术后发热的发生情况的比较采用确切概率法检验。
结果观察组与对照组比较,术前和术后第1天FPG差异无统计学意义(P均>0.05),术后第3天FPG明显降低[(4.34±0.59)mmol/L vs (4.96±0.64)mmol/L],差异有统计学意义(t=-4.96,P=0.002)。观察组与对照组比较,术前和术后第1天FINS差异无统计学意义(P均>0.05),术后第3天FINS明显降低[(45.39±13.55)mIU/L vs (51.18±9.34) mIU/L],差异有统计学意义(t=-2.46,P=0.033)。观察组与对照组比较,术前HOME-IR差异无统计学意义(P>0.05),术后第1天和术后第3天HOME-IR明显降低[(13.08±4.80)vs (15.03±4.11);(9.37±3.65)vs (11.30±2.55)],差异有统计学意义(t=-0.69,P=0.042;t=-3.99,P=0.033)。两组患者术后其他观察指标比较,观察组术后24 h通气率与对照组比较明显增高(76.0% vs 64.6%),差异有统计学意义(P=0.045)。两组患者在术后腹胀、术后发热的发生率方面差异无统计学意义(P均>0.05)。两组患者均未发生术中误吸。
结论妇科腹腔镜手术围术期应用碳水化合物口服疗法较传统禁饮食方案,能有效减轻术后IR程度,促进术后康复进程,且不增加围术期并发症的发生率。 相似文献
59.
60.
C. Carpentier C. Bobillier D. Blanchard B. Lallemant R. Garrel P. Gorphe R. Mastronicola S. Morinière 《European annals of otorhinolaryngology, head and neck diseases》2019,136(3):179-183
BackgroundCervical spondylodiscitis is a rare but severe complication of pharyngeal surgery.Material and methodsThis multicenter retrospective study reported all patients in the database of the French head and neck tumor study group (GETTEC) affected by cervical spondylodiscitis after transoral robotic surgery (TORS) for malignant pharyngeal tumor from January 2010 to January 2017.ObjectivesTo describe cases of post-TORS cervical spondylodiscitis, identify alarm signs, and determine optimal management of these potentially lethal complications.ResultsSeven patients from 6 centers were included. Carcinomas were located in the posterior pharyngeal wall. Tumor stage was T1 or T2. All patients had risk factors for spondylodiscitis. Mean time to diagnosis was 12.6 days. The interval between surgery and spondylodiscitis diagnosis ranged from 20 days to 4.5 months, for a mean 2.1 months. The most common symptom was neck pain (87%). Infections were polymicrobial; micro-organisms were isolated in 5 cases and managed by intravenous antibiotics, associated to medullary decompression surgery in 3 cases. Follow-up found favorable progression in 4 cases, and 3 deaths (mortality, 43%).ConclusionThis French multicenter study found elevated mortality in post-TORS spondylodiscitis, even in case of limited resection. Surgeons must be aware of this complication and alerted by persistent neck pain, fever, asthenia, impaired or delayed posterior pharyngeal wall wound healing or elevation of inflammatory markers. MRI is the most effective diagnostic radiological examination. 相似文献