全文获取类型
收费全文 | 12636篇 |
免费 | 942篇 |
国内免费 | 302篇 |
专业分类
耳鼻咽喉 | 92篇 |
儿科学 | 269篇 |
妇产科学 | 34篇 |
基础医学 | 688篇 |
口腔科学 | 19篇 |
临床医学 | 1611篇 |
内科学 | 5875篇 |
皮肤病学 | 6篇 |
神经病学 | 102篇 |
特种医学 | 345篇 |
外科学 | 2663篇 |
综合类 | 1356篇 |
现状与发展 | 1篇 |
预防医学 | 212篇 |
眼科学 | 205篇 |
药学 | 345篇 |
3篇 | |
中国医学 | 36篇 |
肿瘤学 | 18篇 |
出版年
2024年 | 25篇 |
2023年 | 340篇 |
2022年 | 571篇 |
2021年 | 886篇 |
2020年 | 826篇 |
2019年 | 830篇 |
2018年 | 751篇 |
2017年 | 416篇 |
2016年 | 339篇 |
2015年 | 474篇 |
2014年 | 851篇 |
2013年 | 734篇 |
2012年 | 481篇 |
2011年 | 615篇 |
2010年 | 462篇 |
2009年 | 491篇 |
2008年 | 441篇 |
2007年 | 438篇 |
2006年 | 454篇 |
2005年 | 405篇 |
2004年 | 315篇 |
2003年 | 305篇 |
2002年 | 260篇 |
2001年 | 241篇 |
2000年 | 210篇 |
1999年 | 205篇 |
1998年 | 158篇 |
1997年 | 150篇 |
1996年 | 138篇 |
1995年 | 130篇 |
1994年 | 124篇 |
1993年 | 103篇 |
1992年 | 86篇 |
1991年 | 73篇 |
1990年 | 67篇 |
1989年 | 58篇 |
1988年 | 43篇 |
1987年 | 62篇 |
1986年 | 49篇 |
1985年 | 56篇 |
1984年 | 54篇 |
1983年 | 29篇 |
1982年 | 32篇 |
1981年 | 20篇 |
1980年 | 21篇 |
1979年 | 17篇 |
1978年 | 12篇 |
1976年 | 10篇 |
1974年 | 5篇 |
1973年 | 7篇 |
排序方式: 共有10000条查询结果,搜索用时 0 毫秒
21.
We studied 100 patients who underwent an isolated aortic valve replacement (AVR) between 1974 and 1991. The patients were divided into the following two groups and compared: group A, which consisted of 40 patients operated on before 1978 who underwent continuous left coronary perfusion with blood; and group B, which consisted of 60 patients operated on after 1979 in whom St. Thomas solution was used in combination with topical cardiac cooling. Moreover, we divided the group B patients into two subgroups: group Bl, who underwent AVR before 1986 during which we administered St. Thomas solution with ice slush every 30 min; and group B2, who had AVR after 1986 in which we used St. Thomas solution with a cold saline (4°C) solution and treated with a small amount of slushed ice every 15 min. The incidence of supraventricular tachycardias was 15% in group A, 50% in group BI, and 15% in group B2. The severity of preoperative New York Heart Association (NYHA) functional class, the type of valve lesions, cardiothoracic ratio, left ventricular function, aortic clamp time, bypass time, and use of drugs did not correlate with the incidence of supraventricular tachycardias in either group A or B. In group B2 patients, we paid a lot of attention to cooling the right atrium as well as the left ventricle by immersing the whole heart using a 4°C saline solution, which led to a remarkable reduction of the incidence of supraventricular tachycardia. This fact indicates that right atrial preservation is one of the most important factors for reducing the incidence of supraventricular tachycardia. 相似文献
22.
Camilla Nyboe Jonas A. Funder Morten H. Smerup Hans Nygaard J. Michael Hasenkam 《European journal of cardio-thoracic surgery》2006,29(6):1008-1013
Objective: Mechanical heart valves can cause thromboembolic complications, possibly due to abnormal flow patterns that produce turbulence downstream of the valve. The objective of this study was to investigate whether three different bileaflet valve designs would exhibit clinically relevant differences in downstream turbulent stresses. Methods: Three bileaflet mechanical heart valves (Medtronic Advantage®, CarboMedics© Orbis™ Universal and St. Jude Medical® Standard) were implanted into 19 female 90 kg pigs. Blood velocity was measured during open chest conditions in the cross sectional area downstream of the valves with 10 MHz ultrasonic probes connected to a modified Alfred® Pulsed Doppler equipment. As a measure of turbulence, Reynolds normal stress (RNS) was calculated at three different cardiac output ranges (3–4, 4.5–5.5, 6–7 L/min). Results: Data from 12 animals were obtained. RNS correlated with increasing cardiac outputs. The highest instantaneous RNS observed in these experiments was 47 N/m2, and the mean RNS taken spatially over the cross sectional area of the aorta during systole was between 3 N/m2 and 15 N/m2. In none of the cardiac output ranges RNS values exceeded the lower critical limit for erythrocyte or thrombocyte damage for any of the valve designs. Conclusions: Reynolds normal stress values were below 100 N/m2 for all three valve designs and the difference in design was not reflected in generation of turbulence. Hence, it is unlikely that any of the valve designs causes flow induced damage to platelets or erythrocytes. 相似文献
23.
目的 探讨抗菌处理对肺动脉瓣膜细胞活性和组织结构的影响因素及优化同种瓣膜的制备方法。方法 3组猪肺动脉瓣叶(n=6)浸泡在含抗生素的DMEM液中,在不同温度下孵育6h或24h。然后通过XTT比色法测定瓣膜细胞活性,用免疫组织化学荧光染色检测瓣膜细胞和细胞外基质,并行光镜观察。结果 抗菌时间为24h,37℃抗菌组与4℃抗菌组的瓣膜细胞活性与瓣膜组织结构无明显区别。抗菌6h组的瓣膜细胞活性与瓣膜组织结构明显优于抗菌24h组。结论 抗菌时间为24h时,抗菌温度对瓣膜细胞活性及结构完整性无明显影响。抗菌时间缩短至6h,有利于瓣膜细胞活性与结构完整性的保持。 相似文献
24.
Makoto Kamada Kenji Ohsaka Susumu Nagamine Hidemitsu Kakihata 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2003,51(10):552-556
Acute aortic dissection complicated with acute myocardial infarction (AMI) is the most fatal situation. We experienced the
successful treatment for acute type A aortic dissection complicated with inferior AMI following aortic valve replacement (AVR).
A 60-year-old man had had AVR for aortic regurgitation. Sixteen months after the AVR, he had a sudden onset of severe chest
pain with complete atrioventricular block. Immediately, temporary pacing and cardiac catheterization were conducted, showing
the occlusion of the right coronary artery due to acute type A aortic dissection. On his way to our hospital, direct current
shock was conducted 3 times for ventricular fibrillation. We replaced the ascending aorta combined with coronary artery bypass
grafting and the postoperative course was uneventful. The key to treat acute aortic dissection complicated with AMI is early
accurate diagnosis, prompt temporary pacing for bradycardia, defibrillation for lethal arrhythmia and insertion of a perfusion
catheter if possible. These preoperative hemodynamic stabilization gives us the chance to save these patients. 相似文献
25.
心脏瓣膜置换术后中远期疗效分析 总被引:8,自引:0,他引:8
目的 分析探讨心脏瓣膜置换术的中远期疗效。方法 1978年至 2 0 0 1年 12月 ,行瓣膜置换手术 2 14 1例 ,同期随访 16 81例 ,计 80 2 1 1人·年 ,平均 4 77人·年。通过回顾病因、手术方式、瓣膜类型等因素 ,观察术后病人心功能改善情况 ,病死率及并发症等 ,采用t检验 ,多因素回归等统计学方法分析。结果 92例死亡。总体生存率 5年为 (92 3± 2 2 ) % ,10年生存率为 (90 1± 2 7) %。并发症有血栓栓塞、机械瓣膜功能障碍、瓣周漏、溶血、机械瓣膜感染性心内膜炎。术后心功能 (NYHA)与术前比较有明显的提高。结论 1.机械瓣置换术后中远期疗效满意 ,病死率及并发症均较低 ;与术前心功能和手术种类直接相关 ;2 .使用保留瓣下结构及三尖瓣成形术对术后心功能恢复有明显效果 ;3.术中良好心肌保护是提高手术成功率的关键。 相似文献
26.
Twenty-two percutaneous transluminal balloon valvuloplasty procedures were performed on 21 patients with congenital pulmonary valve stenosis. The peak systolic pressure gradient was immediately reduced from 79.1 +/- 7.4 to 22.2 +/- 1.8 mmHg, (P less than 0.0001) and follow-up cardiac catheterization at 5.3 +/- 0.4 months in 19 patients revealed no further significant change in gradient (23.5 +/- 3.2 mmHg). The best results were obtained when balloons larger than the pulmonary annulus were used, i.e. an immediate residual transvalvular gradient of 22.0 +/- 2.2 mmHg with a balloon/annulus ratio greater than 1, as opposed to 44.2 +/- 5.4 with a balloon/annulus ratio = 1 (P less than 0.001). The angiographically determined cusp thickness of the stenotic pulmonary valves was significantly greater than that of the control group of 24 patients without pulmonary valve stenosis (1.21 +/- 0.09 vs 0.59 +/- 0.02 mmHg, P less than 0.00001). The relationship between this parameter and the residual transvalvular gradient at follow-up was found to be significant (r = 0.77, P less than 0.001). It is concluded that balloon size is a determinant factor in achieving good results with percutaneous balloon valvuloplasty although cusp thickness, a factor to which scant regard has hitherto been paid, also plays a significant role in the residual transvalvular gradient measured at follow-up. 相似文献
27.
28.
目的:观察吸入一氧化氮(NO)对心瓣膜置换术后肺动脉高压患者血流动力学的影响。方法:选择9例心瓣膜置换术后伴肺动脉高压的病人,吸入NO0.003%,观察三个时象点:吸入NO前;开始吸入NO后15分钟;停止吸入NO后15分钟。结果:吸入NO能显著降低肺动脉压和肺循环阻力指数(P<0.01),停止吸入NO15分钟后,肺动脉压和肺循环阻力指数恢复到原有水平。在整个观察过程中,心率、平均动脉压、中心静脉压、肺动脉楔压、体循环阻力指数和心脏指数均无显著变化(P>0.05)。结论:吸入NO具有选择性肺血管扩张作用,是治疗心瓣膜置换术后肺动脉高压的较理想药物。 相似文献
29.
W. N. HABRE E. F. VAN GESSEL CH. MAMIE R. CANTIENI P. M. SUTER 《Acta anaesthesiologica Scandinavica》1994,38(6):612-614
Severe aortic regurgitation was discovered in a young man 21 days after blunt chest trauma and after a prolonged febrile state with positive blood cultures. Using transoesophageal echocardiography (TEE), it was possible to make the differential diagnosis between traumatic rupture and endocarditis as the cause of valvular insufficiency. The use of TEE in the initial evaluation of severe thoracic trauma with an unclear clinical picture is recommended. This method is easy to use at the bedside and gives precise information on the aortic valve and the ascending aorta. 相似文献
30.
Surgically uncorrectable tricuspid valve disease in children is rare. However, when it happens the surgical options are very limited. Tricuspid valve replacement using a mechanical valve or stented bioprosthesis is impractical. Use of homografts in the “anatomic position” has its limitations. We report here the use of an extracardiac homograft connection between the right atrium and right ventricle in a 16-month-old boy in whom severe tricuspid valve stenosis developed after surgical repair of a complex ventricular septal defect associated with dextrocardia and anomalous systemic venous drainage. The patient remains well receiving no cardiac medication 12 months after the procedure. 相似文献