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41.
Riccardo Memeo Nicola de’Angelis Philippe Compagnon Chady Salloum Daniel Cherqui Alexis Laurent Daniel Azoulay 《World journal of surgery》2014,38(11):2919-2926
Background
Laparoscopic liver resection is considered a safe and feasible alternative to open surgery for malignant liver lesions. However, laparoscopic surgery in cirrhotic patients remains challenging. The aim of this retrospective case–control study was to compare morbidity, mortality, and long-term patient survival between laparoscopic liver resections (LLR) and open liver resections (OLR) for hepatocellular carcinoma (HCC) in patients with histologically proven cirrhosis.Methods
A total of 45 patients treated with LLR were matched by cause of cirrhosis, Child-Pugh score, type of surgical resection (subsegmentectomy, segmentectomy, and bisegmentectomy), tumor number, tumor size, and alpha-fetoprotein value with 45 patients treated with OLR. Pre-, intra-, and post-operative variables were compared between groups.Results
Compared with OLR, the LLR group displayed a significantly shorter operative time (140 vs. 180 min; p = 0.02), shorter hospital stay (7 vs. 12 days; p < 0.0001), and lower morbidity rate (20 vs. 45 % of patients; p = 0.01). A higher rate of R0 resection was observed in the LLR group than in the OLR group (95 vs. 85 %; p = 0.03). Postoperative ascites was more frequently observed in the OLR group (18 vs. 2 %; p = 0.01). Mortality, patient, and disease-free survival rates were similar between groups. The 1-, 5-, and 10-year survival rates were 88, 59, and 12 %, respectively, in the LLR group and 63, 44, and 22 % in the OLR group (p = 0.27).Conclusions
Significantly shorter operative times, better resection margins, lower postoperative complications, and shorter hospital stay were observed in the LLR group compared with the OLR group. LLR and OLR have similar overall and disease-free survival rates in cirrhotic HCC patients. 相似文献42.
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46.
Maria Carmen Mir Riccardo Autorino Dinesh Samarasekera Joseph Klink Andrew J Stephenson Jihad H Kaouk 《International journal of urology》2014,21(2):212-214
The aim of our report was to describe the feasibility of robotic retroperitoneal lymph node dissection in the contemporary era. We suggest the linear port location and 90° robotic docking as the main key to minimizing instrument clashing and improving the range of surgical accessibility. 相似文献
47.
Chady Salloum Daren Subar Riccardo Memeo Claude Tayar Alexis Laurent Alexandre Malek Daniel Azoulay 《Journal of robotic surgery》2014,8(2):119-124
Laparoscopic liver surgery is now an established practice in many institutions. It is a safe and feasible approach in the hands of trained surgeons. The introduction of robotics into surgery represents progression in the field of minimally invasive surgery but has seen a slow uptake in the hepatopancreaticobiliary subspeciality. We report our initial experience in 20 cases of laparoscopic robotic liver resection (LRLR). From March 2011 to April 2013 patients with lesions within the liver were assessed and consented for laparoscopic robotic liver surgery. This is a retrospective analysis of a prospectively kept database on preoperative details and intraoperative and postoperative outcomes. During the time period there were 20 LRLRs. The median age was 62 years (range 39–80 years) with a male to female ratio of 14:6. Ten patients had left lateral sectionectomies, 10 patients had atypical segmental resections; 14 patients had resections for malignancies, 6 patients had resections for benign disease. One case was converted to open resection. The mean operating time was 176.4 ± 74.6 min (range 60–300 min), the mean blood loss was 107 ± 106 ml (range 50–700 ml) and the mean hospital stay was 6.5 ± 3.7 days (range 2–16 days). Two patients required blood transfusions. The incidence of postoperative complications was 10 % (n = 2). LRLR overcomes some of the disadvantages of conventional laparoscopic surgery. It is a technically feasible and safe approach for wedge resections and left lateral sectionectomy of the liver without oncological compromise. However, this surgical technique requires advanced laparoscopic skills and there is an associated steep learning curve. Further studies are needed to determine the potential advantages of this technique for the patient compared to the traditional laparoscopic approach. 相似文献
48.
Francesco Santullo Alberto Biondi Ferdinando C.M. Cananzi Valeria Fico Flavio Tirelli Riccardo Ricci Gianluca Rizzo Claudio Coco Claudio Mattana Domenico DUgo Roberto Persiani 《American journal of surgery》2018,215(1):71-77
Background
The aim of this study was to identify stage II colon cancer patients with a high risk of recurrence.Methods
All patients who underwent surgery for stage II colon cancer (CC) were retrospectively enrolled and sub-grouped according to TNM staging (IIa-b-c) and stage IIa in high (IIaHR) and low risk (IIaLR) according to pathologic features.The primary outcomes measured were the 5-year overall survival (OS) and disease-free survival (DFS).Results
A total of 214 patients were reviewed. Only a maximum tumor diameter<4 cm in the IIaLR group was associated with a higher recurrence rate than a large tumor size (5-year DFS 71.7%vs.87.6%, p = 0.028).The DFS in the large IIaLR CC group was better than that in the IIaHR and IIb-c groups (5-year DFS: 92.7%vs.79.3%, p = 0.023). In contrast, the recurrence rate in the small IIaLR CC group was similar to that in the IIaHR, IIb-c stage CC group.Conclusions
In stage IIa CC evaluation of the tumor size as a prognostic factor may help identify patients who could benefit from additional postoperative therapy. 相似文献49.
Holger J. Klein Fabienne Lehner Riccardo Schweizer Barbara Rüsi-Elsener Jakob Nilsson Jan A. Plock 《Burns : journal of the International Society for Burn Injuries》2018,44(5):1330-1335
Background
Since the inception of clinical VCA almost two decades ago, burn victims have been identified as immunologically complex patients owing to preformed HLA antibodies. However, it remains unclear whether the detected HLA antibodies are the result of former alloantigenic events or if their de novo formation occurs during primary burn care.Methods
Patients with burns >20% of total body surface area (TBSA) admitted to Zurich Burn Centre between May 2015 and September 2016 were screened for HLA antibodies at admission and 6 months post trauma. The influence of glycerol-preserved donor skin and red blood cell transfusion on HLA antibody formation was investigated.Results
Thirty-seven patients (7 females and 30 males) with an average age of 45.2 ± 19.1 years and average affected TBSA of 38.5% ± 18.9% were screened for HLA antibodies. Five patients (13.5%) showed preformed HLA antibodies at admission. Only 3 patients demonstrated verified de novo sensitization during acute burn care. Six patients treated with donor skin and blood transfusions showed no occurrence of HLA antibodies after 6 months. One patient died after 2 weeks due to infectious and thromboembolic complications – however, HLA antibodies were already detected.Conclusion
Formation of HLA antibodies during acute burn care might be lower than that previously expected by using glycerol-preserved donor skin and restrictive administration of blood products. Modern concepts of burn care may contribute to a revised outlook on burn patients as potential candidates for VCA. 相似文献50.
Francesco?PorpigliaEmail author Riccardo?Bertolo Enrico?Checcucci Daniele?Amparore Riccardo?Autorino Prokar?Dasgupta Peter?Wiklund Ashutosh?Tewari Evangelos?Liatsikos Cristian?Fiori The ESUT Research Group 《World journal of urology》2018,36(2):201-207