全文获取类型
收费全文 | 70607篇 |
免费 | 4942篇 |
国内免费 | 2204篇 |
专业分类
耳鼻咽喉 | 502篇 |
儿科学 | 1341篇 |
妇产科学 | 2903篇 |
基础医学 | 8417篇 |
口腔科学 | 1568篇 |
临床医学 | 5551篇 |
内科学 | 6984篇 |
皮肤病学 | 926篇 |
神经病学 | 5482篇 |
特种医学 | 1756篇 |
外国民族医学 | 8篇 |
外科学 | 5409篇 |
综合类 | 9674篇 |
现状与发展 | 4篇 |
一般理论 | 6篇 |
预防医学 | 5517篇 |
眼科学 | 1745篇 |
药学 | 11920篇 |
67篇 | |
中国医学 | 5181篇 |
肿瘤学 | 2792篇 |
出版年
2023年 | 925篇 |
2022年 | 1281篇 |
2021年 | 2451篇 |
2020年 | 2153篇 |
2019年 | 2154篇 |
2018年 | 2125篇 |
2017年 | 2121篇 |
2016年 | 2129篇 |
2015年 | 2044篇 |
2014年 | 3894篇 |
2013年 | 5367篇 |
2012年 | 3819篇 |
2011年 | 4299篇 |
2010年 | 3431篇 |
2009年 | 3171篇 |
2008年 | 3127篇 |
2007年 | 3211篇 |
2006年 | 2791篇 |
2005年 | 2559篇 |
2004年 | 2143篇 |
2003年 | 2168篇 |
2002年 | 1670篇 |
2001年 | 1562篇 |
2000年 | 1306篇 |
1999年 | 1275篇 |
1998年 | 1134篇 |
1997年 | 1147篇 |
1996年 | 1044篇 |
1995年 | 1021篇 |
1994年 | 881篇 |
1993年 | 772篇 |
1992年 | 723篇 |
1991年 | 644篇 |
1990年 | 678篇 |
1989年 | 602篇 |
1988年 | 464篇 |
1987年 | 394篇 |
1986年 | 474篇 |
1985年 | 611篇 |
1984年 | 592篇 |
1983年 | 380篇 |
1982年 | 485篇 |
1981年 | 411篇 |
1980年 | 398篇 |
1979年 | 295篇 |
1978年 | 252篇 |
1977年 | 218篇 |
1976年 | 204篇 |
1975年 | 137篇 |
1974年 | 117篇 |
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
41.
《The Journal of thoracic and cardiovascular surgery》2023,165(1):149-158.e4
BackgroundCoronary artery bypass grafting (CABG) improves survival in patients with heart failure and severely reduced left ventricular systolic function (LVEF). Limited data exist regarding adverse cardiovascular event rates after CABG in patients with heart failure with midrange ejection fraction (HFmrEF; LVEF > 40% and < 55%).MethodsWe analyzed data on isolated CABG patients from the Veterans Affairs national database (2010-2019). We stratified patients into control (normal LVEF and no heart failure), HFmrEF, and heart failure with reduced LVEF (HFrEF) groups. We compared all-cause mortality and heart failure hospitalization rates between groups with a Cox model and recurrent events analysis, respectively.ResultsIn 6533 veterans, HFmrEF and HFrEF was present in 1715 (26.3%) and 566 (8.6%) respectively; the control group had 4252 (65.1%) patients. HFrEF patients were more likely to have diabetes mellitus (59%), insulin therapy (36%), and previous myocardial infarction (31%). Anemia was more prevalent in patients with HFrEF (49%) as was a lower serum albumin (mean, 3.6 mg/dL). Compared with the control group, a higher risk of death was observed in the HFmrEF (hazard ratio [HR], 1.3 [1.2-1.5)] and HFrEF (HR, 1.5 [1.2-1.7]) groups. HFmrEF patients had the higher risk of myocardial infarction (subdistribution HR, 1.2 [1-1.6]; P = .04). Risk of heart failure hospitalization was higher in patients with HFmrEF (HR, 4.1 [3.5-4.7]) and patients with HFrEF (HR, 7.2 [6.2-8.5]).ConclusionsHeart failure with midrange ejection fraction negatively affects survival after CABG. These patients also experience higher rates myocardial infarction and heart failure hospitalization. 相似文献
42.
43.
摘要:目的对尿液 10项肾损伤标志物检测试剂进行性能评价,并评估其临床适用性。方法对北京利德曼公司尿液a1 微球蛋白(u-a|MG)、总蛋白(u-TP)、免疫球蛋白G(u-IgG) 、微量清蛋白(u-Alb)、中性粒细胞明胶酶相关脂质运载蛋白(u-NGAL)、半胱氨酸蛋白酶抑制剂C(u-CysC).视黄醇结合蛋白(u-RBP)、β2微球蛋白(u-β2MG)、N-乙酰-β-D-氨基葡萄糖苷酶(u-NAG).、转铁蛋白(u-Trf)检测试剂盒进行性能评价。正确度和精密度验证参考美国临床和实验室标准协会(CLSI)EP15-A3,验证物质采用ERM-DA470k、ERM-DA471、B2M-NIBSC等参考物质及纯度物质;线性验证参考CLSI EP06;抗干扰能力参考CISI EP07;不同检测系统间比对参考CISI EP09。结果正确度方面,10 项标志物检测试剂测定标准物质在低值、中值、高值的偏倚分别为-2.69% ~4.67%、-3.60% ~3.33% .-2.38% ~3.02%;不精密度方面,重复性以不精密度表示,在低值和高值处分别为1.90%~5.43%、0.63% ~2.42%,室内不精密度为2.27%~5.63%、1.09%~3.41%,均满足临床要求;10项尿液标志物线性范围在0.06~4.40 mg/L至21.83~2 146.77 mg/L之间。抗干扰方面,u-1 MG、u-Alb、u-β2MG、u-Trf 、u-CysC、u-NAG分别在血红蛋白终浓度≤8 g/L、≤8 g/L、≤4 g/L、≤4 g/L、≤2g/L、≤1 g/L时,未受到明显干扰(百分偏差≤+ 10%) ,而u-TP、u-IgG、
u-RBP、u-NGAL在血红蛋白终浓度≥0.125 g/L时即受干扰。不同检测系统间偏差超出临床允许范围。结论尿液 10项肾损伤标志物的正确度、精密度、线性范围和抗血红蛋白干扰能力满足临床需要,不同检测系统间标志物测量结果可比性欠佳。 相似文献
44.
Marta López-Fauqued Laura Campora Frédérique Delannois Mohamed El Idrissi Lidia Oostvogels Ferdinandus J. De Looze Javier Diez-Domingo Thomas C. Heineman Himal Lal Janet E. McElhaney Shelly A. McNeil Wilfred Yeo Fernanda Tavares-Da-Silva 《Vaccine》2019,37(18):2482-2493
Background
The ZOE-50 (NCT01165177) and ZOE-70 (NCT01165229) phase 3 clinical trials showed that the adjuvanted recombinant zoster vaccine (RZV) was ≥90% efficacious in preventing herpes zoster in adults. Here we present a comprehensive overview of the safety data from these studies.Methods
Adults aged ≥50 (ZOE-50) and ≥70 (ZOE-70) years were randomly vaccinated with RZV or placebo. Safety analyses were performed on the pooled total vaccinated cohort, consisting of participants receiving at least one dose of RZV or placebo. Solicited and unsolicited adverse events (AEs) were collected for 7 and 30?days after each vaccination, respectively. Serious AEs (SAEs) were collected from the first vaccination until 12?months post-last dose. Fatal AEs, vaccination-related SAEs, and potential immune-mediated diseases (pIMDs) were collected during the entire study period.Results
Safety was evaluated in 14,645 RZV and 14,660 placebo recipients. More RZV than placebo recipients reported unsolicited AEs (50.5% versus 32.0%); the difference was driven by transient injection site and solicited systemic reactions that were generally seen in the first week post-vaccination. The occurrence of overall SAEs (RZV: 10.1%; Placebo: 10.4%), fatal AEs (RZV: 4.3%; Placebo: 4.6%), and pIMDs (RZV: 1.2%; Placebo: 1.4%) was balanced between groups. The occurrence of possible exacerbations of pIMDs was rare and similar between groups. Overall, except for the expected local and systemic symptoms, the safety results were comparable between the RZV and Placebo groups irrespective of participant age, gender, or race.Conclusions
No safety concerns arose, supporting the favorable benefit-risk profile of RZV. 相似文献45.
《Journal of vascular and interventional radiology : JVIR》2020,31(5):760-768.e1
PurposeTo investigate dynamic variables obtained from retrospective computed tomography angiography for ability to predict thoracic endovascular aortic repair (TEVAR) outcomes in patients with complicated type B aortic dissection (cTBAD).Materials and MethodsSeventy-nine patients with cTBAD who received TEVAR from March 2009 to June 2018 were retrospectively enrolled. Relative true lumen area (r-TLA) was computed at the level of tracheal bifurcation every 5% of all R-R intervals. Parameters that reflect the state of intimal motion were evaluated, including difference between maximum and minimum r-TLA (D-TLA) and true lumen collapse. The endpoints comprised early (≤ 30 days) and late (> 30 days) outcomes after intervention.ResultsOverall early mortality rate was 13.9% (11/79), and early adverse events rate was 24.1% (19/79). Patients who received TEVAR within 2 days of symptom onset demonstrated the worst outcomes. A longer time of r-TLA < 25% in 1 cardiac cycle (P = .049) and larger D-TLA (P < .001) were correlated to an increased early death. In addition, D-TLA was an independent predictor of early mortality. Area under the curve of D-TLA was 0.849 (95% confidence interval 0.730–0.967) for predicting early mortality and 0.742 (95% CI 0.611–0.873) for predicting early adverse events. Survival and event-free survival rates during follow-up were decreased in the D-TLA > 21.5% group compared with the D-TLA ≤ 21.5% group (all P < .001).ConclusionsLarger D-TLA is correlated with worse postoperative outcomes and might be a crucial parameter for future risk stratification in patients with cTBAD. 相似文献
46.
47.
48.
《Clinical neurophysiology》2019,130(9):1562-1569
ObjectiveConventional deep brain stimulation (DBS) systems with ring-shaped leads generate spherical electrical fields. In contrast, novel directional leads use segmented electrodes. Aim of this study was to quantify the impedance variations over time in subjects with the directional Cartesia-Boston® system.MethodsImpedance records, programming settings, and clinical data of 11 consecutive Parkinsonian patients implanted with DBS directional leads in two Italian centers (Udine and Vicenza) were retrospectively evaluated. Data were collected before starting stimulation (in the operating room and at days 5 and 40) and after switching stimulation on at the successive follow-up visits (1, 6 and 12 months).ResultsDirectional leads have significantly higher impedance than ring leads. Stimulated contacts had always lower impedance compared to non-stimulated contacts. Before DBS-on, all contacts had higher impedance in the operating room, with an initial decrease five days post-surgery and a subsequent increase at day 40, more evident for directional contacts. The impedance of directional leads increased post-implantation at 1 and 6 months with a plateau at 12 months.ConclusionsThere was a significant difference between the directional and ring leads at baseline (before activation of DBS) and during follow-up (chronic DBS).SignificanceOur study reveals new information about the impedance of segmented electrodes that is useful for patient management during the initial test period, as well as during long-term DBS follow-up. 相似文献
49.
Takashi Murakami Naoto Sakamoto Akihito Nagahara 《Journal of gastroenterology and hepatology》2019,34(10):1685-1695
Sessile serrated adenoma/polyps (SSA/Ps) are early precursor lesions in the serrated neoplasia pathway, which results in BRAF‐mutated colorectal carcinomas with not only high levels of microsatellite instability but also microsatellite stable. SSA/Ps with advanced histology, including cytological dysplasia or minimally invasive carcinomas, are important lesions because SSA/Ps are considered major contributors to “interval cancers” and these lesions can rapidly become dysplastic or invasive carcinomas. Clinicopathologically, SSA/Ps with dysplasia or invasive carcinoma were associated with advanced age, female sex, and proximal colon. Although SSA/Ps with submucosal invasive carcinoma were smaller and invaded less deeply into the submucosal layer than conventional tubular adenomas with submucosal invasive carcinoma, SSA/Ps with submucosal invasive carcinoma frequently had a mucinous component and exhibited a higher potential for lymphatic invasion and lymph node metastasis. In an SSA/P series, endoscopic characteristics, including (semi)pedunculated morphology, double elevation, central depression, and reddishness, may help accurately diagnose SSA/Ps with advanced histology. Removal of SSA/Ps with dysplasia or invasive carcinoma was recommended. Endoscopic treatment such as endoscopic mucosal resection or endoscopic submucosal dissection is useful for those lesions. However, surgical resection with lymph node dissection might be indicated when SSA/Ps with invasive carcinoma are endoscopically suspected, because these have the high risk of lymph node metastasis. Greater awareness may promote further research into improving the detection, recognition, and complete resection rates of SSA/Ps with dysplasia or invasive carcinoma and reduce the interval cancer rates. 相似文献
50.
目的:研究Visumax飞秒激光辅助的准分子激光原位角膜磨镶术(LASIK)术中不透明气泡层(OBL)产生的类型、相关影响因素及其临床意义。方法:回顾性分析。收集2016 年7 月1 日至8 月20 日在南京医科大学附属眼科医院行飞秒LASIK的患者154 例(300 眼)的临床资料,等效球镜度为(-5.88±1.51)D。飞秒激光采用Zeiss公司 Visumax飞秒激光仪,将术中产生的OBL分为瓣外OBL、瓣内快速OBL和瓣内慢速OBL。300 眼按角膜曲率平均K值分为A组(<42 D)、B组(42~46 D)和C组(>46 D);按角膜瓣的厚度分为D组(100 μm)、E组(110 μm)和F组(120 μm);按角膜厚度分为G组(<500 μm)、H组(500~540 μm)和I组(>540 μm)。统计不同角膜曲率、角膜瓣厚度、角膜厚度情况下3 种OBL产生的比例,并采用多元Logistic回归模型进行统计分析。结果:300 眼均发生OBL。以瓣外OBL作为参照,角膜瓣越薄,越容易出现瓣内快速OBL(r=-0.719,P=0.034)和瓣内慢速OBL(r=-0.875,P=0.044)。以瓣内慢速OBL作为参照,角膜曲率越高,越容易出现瓣内快速OBL(r=0.923,P=0.046);角膜瓣越厚,越容易出现瓣外OBL(r=0.897,P=0.044)。结论:OBL的产生与角膜曲率、角膜瓣厚度、角膜厚度均存在一定的相关性,但瓣外OBL、瓣内快速OBL和瓣内慢速OBL对Visumax飞秒激光辅助的LASIK术后视觉质量的影响及远期疗效仍有待进一步观察研究。 相似文献