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71.
The role of JOA score as an indication for surgical or conservative treatment of symptomatic degenerative lumbar spinal stenosis 总被引:1,自引:0,他引:1
G. Costanzo P. Cellocco A. Di Francesco C. Rossi 《Journal of orthopaedics and traumatology》2005,6(3):150-153
Abstract
The aim of this study was to evaluate the short- to medium-term results (up to 2 years) of conservative and surgical treatments
of patients with symptomatic lumbar stenosis. To our knowledge, no previous study has provided strict indications for conservative
or surgical treatment. We retrospectively studied 184 patients, who were divided into 3 groups according to JOA (Japanese
Orthopaedic Association) score. A cutoff JOA score was arbitrarily fixed at 7.
Patients with a score ≤7 (n=12; group A) underwent surgery, while patients with a score >7 (n=172) were conservatively treated.
Group A included patients surgically treated within two months from diagnosis. Group B consisted of 144 patients who received
conservative treatment, while group C (28 patients) represented patients who underwent surgery after a period of failed conservative
treatment. The outcomes of surgical and conservative treatments were evaluated after 12 and 24 months, and were rated as satisfactory,
not totally satisfactory, not satisfactory or totally unsatisfactory. Conservative treatment consisted of physical, orthotic
and drug therapy, whereas surgical treatment included spinal decompression and instrumentation (if indicated), either rigidly
or dynamically performed. Surgery was indicated in 22% of all patients and we obtained excellent results in 85% of them. Operative
treatment provides excellent results for patients with severe clinical presentation (JOA score ≤7), while individuals with
mild to moderate spinal stenosis (JOA score >7) should receive conservative treatment. 相似文献
72.
K. Wang 《Annals of human genetics》2004,68(4):367-375
This article concerns the asymptotic properties of linkage tests for affected‐sib‐pair data under the null hypothesis of no linkage. We consider a popular single‐locus analysis model where the unknown parameters are the disease allele frequency, the three penetrances for the three genotypes at the disease locus, and the recombination fraction between the marker locus and the disease locus. These parameters are completely confounded under the null hypothesis of no linkage. We show that 1) If the total variance of the trait (i.e., the additive variance plus the dominance variance) is “separated” from 0, then the likelihood ratio statistic has an asymptotic 0.5χ20+ 0.5χ21 distribution; 2) If the prevalence of the trait is “separated” from 0 and the recombination fraction is fixed at 0, then the likelihood ratio statistic has an asymptotic distribution which is a mixture of χ20, χ21 and χ22 . The implications of these results are discussed. 相似文献
73.
【摘要】
目的 调查与静止性脑梗死(silent brain infarction,SBI)相关的独立影响因素,构建SBI风险预测量
表并验证。
方法 在单中心横断面研究中,前瞻性连续纳入无神经系统疾病既往史的体检者,收集其人口学
信息,高血压、糖尿病等血管危险因素,血脂、糖化血红蛋白、血浆同型半胱氨酸等化验结果录入数
据库。采用标准影像学操作规范进行头颅MRI扫描,并由影像学医师盲法判读,将受试者分为SBI组
和无SBI组。将所有受试者按照3∶1比例随机分为训练集和验证集,在训练集中采用单因素和多因素
Logistic回归分析SBI的独立影响因素,构建SBI预测量表。在训练集和验证集中应用ROC曲线检验量表
的区分度,应用Hosmer-Lemeshow分析检验量表的校准度。
结果 共有633例研究对象纳入研究,平均年龄52.0±10.5岁,女性272例(43.0%)。训练集(475
例)和验证集(158例)两个样本集合的基线特征均衡。校正混杂因素后多因素分析显示,年龄≥45
岁(OR 8.37,95%CI 1.12~62.80,P =0.039),高血压(OR 2.30,95%CI 1.08~4.90,P =0.032),同型半
胱氨酸(Q2~Q3:OR 6.89,95%CI 0.89~53.10,P =0.064;Q4:OR 13.6,95%CI 1.74~105.87,P =0.013)
与SBI风险独立相关。根据OR 值构建SBI危险评分(SBI risk score,SBI-RS)量表,量表赋值为:年龄
≥45岁赋值8分;有高血压赋值2分;同型半胱氨酸根据四分位分层分别赋值为0分、7分和14分。SBIRS
在训练集和验证集中ROC曲线显示曲线下面积分别为0.77(95%CI 0.69~0.84,P<0.001)和0.76
(95%CI 0.63~0.88,P<0.001),区分度良好。Hosmer-Lemeshow相关分析提示SBI-RS具有较好的校准度
(P>0.05)。
结论 在健康体检人群中,SBI -RS具有较好的区分度和校准度,可以帮助识别SBI高危人群。 相似文献
74.
Paolo R. Salvalaggio Katie Neighbors Susan Kelly Karan M. Emerick Kishore Iyer Riccardo A. Superina Peter F. Whitington Estella M. Alonso 《American journal of transplantation》2005,5(8):1868-1874
The Pediatric End-Stage Liver Disease (PELD) score was designed to reduce subjectivity in liver allocation and to advantage patients with a higher probability of waiting list mortality. The aims of this study were to determine the impact of PELD implementation for children with chronic liver disease and to assess whether PELD met its goal of standardization of liver allocation for children. This study used data reported to the United Network for Organ Sharing (UNOS) registry for children with chronic liver disease receiving primary cadaveric liver transplant between January 2000 and December 2001 (pre-PELD) and March 2002 and July 2003 (PELD). PELD reduced the percentage of children transplanted while in an intensive care unit and as status 1. A calculated PELD score was used for allocation in only 52% of recipients. Thirty percent were status 1 at transplant and PELD scores granted by exception were used for allocation in 18% of patients. There was regional variation in PELD score at allocation and use of exception scores with a significant relationship between PELD score and percentage of exception cases. Regional variation suggests that PELD has not resulted in standardization of listing practices in pediatric liver transplantation. 相似文献
75.
R. D’Anchise N. Manta E. Prospero C. Bevilacqua A. Gigante 《Journal of orthopaedics and traumatology》2005,6(1):36-43
Abstract
From our overall experience in 56 patients, we here report the treatment with matrix-induced autologous chondrocyte implantation (MACI) of 35 patients suffering from knee cartilage defects measuring about 4 cm2, and followed for a minimum of 6 months. A total of 36 knees were treated (1 patient on both knees) and clinically observed for 22 months (in some cases for over 39 months), in accordance with a standardised protocol. Subjective parameters (pain, well-being, functional state, symptoms during specific activity) and objective outcomes (IKDC score and Lysholm and Tegner scores) were recorded. One or 2 years after implantation, some biopsies of the regenerated cartilage were histologically evaluated. The subjective parameters (VAS pain score, 2.80±1.49, p<0.0001; change vs. basal score, 2.72) promptly normalized after 1 month, as did the objective ones (IKDC score after 6 months, 1.53±0.59, p<0.0001; change vs. basal score, 1.78). Similar results were observed after the treatment of a femoropatellar kissing lesion. The three cartilage biopsies that were analysed from different patients showed a tissue positivity to immunohistochemical markers of hyaline cartilage. The conclusions of this preliminary analysis are that the clinical outcome and histological evaluation suggest that MACI is able to relieve pain and restore the functionality of the knee, and that the treatment appears capable of regenerating hyaline cartilage. 相似文献
76.
Fifty-four specimens from patients undergoing radical prostatectomy for clinically confined prostate cancer between 1983 and 1987 were reviewed to determine the potential for flow cytometric (FCM) analysis of DNA ploidy and replication rate to predict disease recurrence. Each specimen was deparaffinized for FCM analysis and the pathology slides were reviewed by a single pathologist. FCM characteristics were correlated with pathological grade and stage, and both were correlated with disease status. In this series of patients, routine FCM analysis of DNA ploidy and replication rate failed to significantly enhance the ability of standard histopathological grading to predict disease recurrence in patients having clinically localized prostate cancer. Aneuploid tumors pathologically confined to the prostate did not appear to negatively affect prognosis. 相似文献
77.
目的 研究多发创伤患者早期血清促卵泡生成素(FSH)、促黄体生成素(LH)变化与创伤严重度和格拉斯哥昏迷评分的关系.方法 随机选取2003年3月~2004年2月急诊就诊的多发创伤患者93例,就诊时间均在伤后24h内,即时采集血样,采用放射免疫双抗体沉淀法测定血清FSH、LH水平,并另选20名健康体检者作为对照组.93例患者按照ISS评分予以分组(ISS<16分47例,25≥ISS≥16分24例,ISS>25分22例),其中合并颅脑损伤者按GCS评分分组ISS<16分14例,25≥ISS≥16分14例,ISS>25分12例,并比较各分组间FSH、LH水平.结果 严重创伤组(ISS>25分)与合并颅脑损伤组患者早期FSH、LH明显升高(P<0.01).ISS>25分组、25≥ISS≥16分组、ISS<16分组血清FSH、LH水平依次降低(P<0.05或0.01),且前2组明显高于对照组(P<0.01).合并颅脑损伤者中,GCS>8分组、8≥GCS>5分组、5≥GCS≥3分组血清FSH、LH水平依次降低,组间比较差异有显著性(P<0.05或0.01),且均显著高于对照组(P<0.05或0.01).结论 血清垂体前叶激素FSH、LH水平的改变与严重创伤、颅脑损伤的严重程度相关,可作为判断伤情、观察预后的参考指标. 相似文献
78.
79.
336例创伤数据对中国人创伤评分权重系数的评价 总被引:1,自引:0,他引:1
目的为了评价国内对TRISS评分权重系数的修订,对336例创伤患者分别用国外权重和国内权重评定伤情后进行比较。方法336例采用TRISS法计算生存概率Ps,所需权重分别采用新近报道的国内权重和国外MTOS权重。Ps≥0.5预测生存,Ps<0.5预测死亡,将预测生死与实际生死结果进行比较。结果中国人权重在敏感性和区别度方面高于国外权重,误判率低于国外权重。结论中国人权重对中国人的创伤程度评估有价值,为进一步精确修订权重,建议建立大型中国人创伤数据库 相似文献
80.
目的:联合临床检验指标及影像学特征构建一种能够术前识别胃癌浆膜浸润的模型。方法:选取2015年1月至2019年12月温州医科大学附属第一医院经病理证实的656例胃癌患者,采用随机数字表法分为建模组(394例)和验证组(262例)。收集建模组患者的脾脏影像学资料,对收集的数据进行套索回归并选取差异有统计学意义的特征来构建浆膜浸润预测模型。在最大约登指数下取肿瘤浸润风险评分截断值将患者分为高危组(238例)和低危组(418例),然后与其他浸润相关因素如BMI、年龄、性别、高血压、糖尿病等进行单变量和多变量Logistic回归分析,结合显著的独立影响因素共同建立可视化的浆膜浸润预测列线图。结果:将患者以肿瘤浸润评分≤-0.335分为低危组,>-0.335为高危组,经验证组验证,建模组和验证组的诊断准确性较为一致(P<0.001)。经浸润影响因素的单变量和多变量Logistic回归分析发现,影像组学肿瘤浸润评分(OR=2.9,95%CI=2.1~4.2,P<0.001)、术前低白蛋白(OR=1.3,95%CI=1.2~3.1,P=0.003)、血小板与淋巴细胞比值(OR=1.8,95%CI=1.2~2.7,P=0.004)、肿瘤分化程度(OR=2.6,95%CI= 1.8~3.7,P<0.001)是浆膜浸润的独立影响因素。基于这4个指标建立的预测模型能够较为准确地预测浆膜浸润风险,其AUC值为0.733。结论:基于脾脏影像的肿瘤浸润评分联合其他临床因素可准确预测胃癌浆膜浸润与否,提高诊断精度。 相似文献