全文获取类型
收费全文 | 21803篇 |
免费 | 1758篇 |
国内免费 | 419篇 |
专业分类
耳鼻咽喉 | 144篇 |
儿科学 | 581篇 |
妇产科学 | 396篇 |
基础医学 | 1954篇 |
口腔科学 | 481篇 |
临床医学 | 2298篇 |
内科学 | 5515篇 |
皮肤病学 | 290篇 |
神经病学 | 1041篇 |
特种医学 | 1047篇 |
外科学 | 1991篇 |
综合类 | 2047篇 |
现状与发展 | 1篇 |
一般理论 | 1篇 |
预防医学 | 2565篇 |
眼科学 | 534篇 |
药学 | 1704篇 |
7篇 | |
中国医学 | 337篇 |
肿瘤学 | 1046篇 |
出版年
2024年 | 17篇 |
2023年 | 801篇 |
2022年 | 1070篇 |
2021年 | 1839篇 |
2020年 | 1486篇 |
2019年 | 1641篇 |
2018年 | 1503篇 |
2017年 | 981篇 |
2016年 | 677篇 |
2015年 | 716篇 |
2014年 | 1611篇 |
2013年 | 1391篇 |
2012年 | 950篇 |
2011年 | 1079篇 |
2010年 | 891篇 |
2009年 | 826篇 |
2008年 | 897篇 |
2007年 | 831篇 |
2006年 | 628篇 |
2005年 | 549篇 |
2004年 | 415篇 |
2003年 | 406篇 |
2002年 | 306篇 |
2001年 | 248篇 |
2000年 | 203篇 |
1999年 | 183篇 |
1998年 | 137篇 |
1997年 | 121篇 |
1996年 | 146篇 |
1995年 | 135篇 |
1994年 | 110篇 |
1993年 | 105篇 |
1992年 | 121篇 |
1991年 | 85篇 |
1990年 | 107篇 |
1989年 | 91篇 |
1988年 | 90篇 |
1987年 | 49篇 |
1986年 | 61篇 |
1985年 | 79篇 |
1984年 | 73篇 |
1983年 | 40篇 |
1982年 | 50篇 |
1981年 | 43篇 |
1980年 | 39篇 |
1979年 | 37篇 |
1978年 | 23篇 |
1977年 | 29篇 |
1976年 | 15篇 |
1974年 | 12篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
71.
Milan Milojevic Patrick W. Serruys Joseph F. Sabik David E. Kandzari Erick Schampaert Ad J. van Boven Ferenc Horkay Imre Ungi Samer Mansour Adrian P. Banning David P. Taggart Manel Sabaté Anthony H. Gershlick Andrzej Bochenek Jose Pomar Nicholas J. Lembo Nicolas Noiseux John D. Puskas Arie Pieter Kappetein 《Journal of the American College of Cardiology》2019,73(13):1616-1628
Background
The randomized EXCEL (Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial reported a similar rate of the 3-year composite primary endpoint of death, myocardial infarction (MI), or stroke in patients with left main coronary artery disease (LMCAD) and site-assessed low or intermediate SYNTAX scores treated with percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Whether these results are consistent in high-risk patients with diabetes, who have fared relatively better with CABG in most prior trials, is unknown.Objectives
In this pre-specified subgroup analysis from the EXCEL trial, the authors sought to examine the effect of diabetes in patients with LMCAD treated with PCI versus CABG.Methods
Patients (N = 1,905) with LMCAD and site-assessed low or intermediate CAD complexity (SYNTAX scores ≤32) were randomized 1:1 to PCI with everolimus-eluting stents versus CABG, stratified by the presence of diabetes. The primary endpoint was the rate of a composite of all-cause death, stroke, or MI at 3 years. Outcomes were examined in patients with (n = 554) and without (n = 1,350) diabetes.Results
The 3-year composite primary endpoint was significantly higher in diabetic compared with nondiabetic patients (20.0% vs. 12.9%; p < 0.001). The rate of the 3-year primary endpoint was similar after treatment with PCI and CABG in diabetic patients (20.7% vs. 19.3%, respectively; hazard ratio: 1.03; 95% confidence interval: 0.71 to 1.50; p = 0.87) and nondiabetic patients (12.9% vs. 12.9%, respectively; hazard ratio: 0.98; 95% confidence interval: 0.73 to 1.32; p = 0.89). All-cause death at 3 years occurred in 13.6% of PCI and 9.0% of CABG patients (p = 0.046), although no significant interaction was present between diabetes status and treatment for all-cause death (p = 0.22) or other endpoints, including the 3-year primary endpoint (p = 0.82) or the major secondary endpoints of death, MI, or stroke at 30 days (p = 0.61) or death, MI, stroke, or ischemia-driven revascularization at 3 years (p = 0.65).Conclusions
In the EXCEL trial, the relative 30-day and 3-year outcomes of PCI with everolimus-eluting stents versus CABG were consistent in diabetic and nondiabetic patients with LMCAD and site-assessed low or intermediate SYNTAX scores.(Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization [EXCEL]; NCT01205776) 相似文献72.
73.
Obesity can spread more easily if it is not perceived negatively. This issue may be more pronounced among the poor, a conjecture that we test in this paper. We start with general evidence on the concave relationship between income and obesity, both across countries and within Mexico, a country characterized by very unequal development levels and the highest obesity rate in the world. We suggest a general model that explains this stylized fact from a simple necessary condition, namely, the complementarity between nonfood consumption and health concerns. Then, we test the direct effect of overweight on mental health among Mexican women. We find a positive effect of obesity in the low consumption group and a depressing effect among the rich. This result is robust to the inclusion of a range of confounders (childhood conditions, lifestyle variables, food expenditure, and household shocks) and after instrumenting individual fatness by the variation in genetic predisposition. The complementarity between living standards and weight concerns may reflect different norms, different labor market penalties, or simply different returns to healthy time across the social spectrum. 相似文献
74.
BackgroundAlthough colitis has been reported in patients treated with immune checkpoint inhibitors (ICIs), associations between colitis and ICIs had not been thoroughly assessed in real-world studies. Here, we identified and characterized significant colitis-associated with ICIs.MethodsBased on the Food and Drug Administration Adverse Event Reporting System (FAERS) from January 2004 to December 2019, the disproportionality analysis and Bayesian analysis, including the reporting odds ratio (ROR), the proportional reporting ratio (PRR), the Bayesian confidence propagation neural network (BCPNN) and the multi-item gamma Poisson shrinker (MGPS) algorithms were adopted to data mining of the suspected adverse events of colitis after ICIs administrating. Clinical characteristics of patients with ICIs-associated colitis and the time to onset of colitis following different ICI regimens were collected.ResultsA total of 3786 reports of colitis adverse events were identified with ICIs. Seven ICI monotherapies were associated with the reporting of colitis. Statistically significant ROR, PRR, information component (IC), and empirical Bayesian geometric mean (EBGM) emerged for all ICI monotherapies and combination therapies. ICIs-associated colitis affected mostly male (53.51%), with a wide mean age range (60.65 to 72 years). Colitis adverse events were commonly reported in patients with melanoma and lung cancer. Adverse outcomes of colitis concerning ICI were mainly outcomes of hospitalization-initiated or prolonged and other serious. Among colitis cases, 17.43% cases of colitis concerning ICI lead to death. The adverse event of colitis occurred earliest in ipilimumab monotherapy with a median time to onset of 64.21 days (IQR: 27–69 days) among all monotherapies.ConclusionsICI may lead to severe and disabling ICIs-associated colitis during therapy. Analysis of FAERS data identified signals for adverse events of colitis with ICI regimens. Practitioners should consider the factors that may increase the likelihood of colitis. The findings support a continued surveillance and risk factor identification studies. 相似文献
75.
76.
77.
78.
《中国现代医生》2020,58(14):5-8
目的研究经导管动脉化疗栓塞(TACE)对原发性肝癌患者的疗效及中性粒细胞/淋巴细胞计数比(NLR)、血小板/淋巴细胞计数比(PLR)的影响。方法选择2015年6月~2019年1月我院接诊的原发性肝癌患者80例作为研究对象,采用随机数表法将患者分为两组,每组各40例。对照组予传统肝切除术治疗,观察组采用TACE治疗。对比两组治疗后的临床效果,NLR、PLR、癌胚抗原(CEA)、可溶性B7-H4、可溶性白细胞介素-2受体(sIL-2R)及并发症发生情况。结果治疗后,两组患者的总有效率分别为75.00%和52.50%,观察组高于对照组,差异有统计学意义(P0.05);治疗前,两组患者NLR、PLR水平对比,差异无统计学意义(P0.05);治疗后,患者NLR、PLR水平下降,观察组低于对照组,差异有统计学意义(P0.05);治疗前,两组患者CEA、B7-H4、sIL-2R水平对比,差异无统计学意义(P0.05);治疗后,两组患者CEA、B7-H4、sIL-2R水平下降,观察组低于对照组,差异有统计学意义(P0.05);两组患者并发症发生率分别为17.50%、40.00%,观察组低于对照组,差异有统计学意义(P0.05)。结论在原发性肝癌患者中使用TACE效果显著,可有效改善患者肿瘤标志物水平,减少并发症,值得推广应用。 相似文献
79.
目的:通过研究医改背景下某三甲医院合理使用医用耗材的管理成效,探索科学的医用耗材控费路径。方法:深圳市某三甲医院实施耗材使用管控方案,对该医院管控方案实施前后耗材使用数据进行统计分析。结果:2016-2018年,全院百元医疗收入(不含药品收入)中卫生材料费用呈现下降趋势,对于百元医疗收入(不含药品收入)中耗材费用,骨关节外科、骨脊柱外科、心内科连续2年降低,耗材管控方案实施后,骨关节外科、骨脊柱外科、心内科的单台手术耗材费下降,胸外科、胃肠外科有所上升。结论:耗材合理使用管理措施取得成效;为进一步提高耗材管理效率,可采取单病种管理、优化耗材遴选准入机制、实施耗材供应链精益管理等措施。 相似文献
80.
《European journal of surgical oncology》2020,46(5):804-810
IntroductionEstablished preoperative prognostic factors for risk stratification of patients with biliary tract cancer (BTC) are lacking. A prognostic value of the inflammation-based Glasgow Prognostic Score (GPS) and Modified Glasgow Prognostic Score (mGPS) in BTC has been indicated in several Eastern cohorts. We sought to validate and compare the prognostic value of the GPS and the mGPS for overall survival (OS), in a large Western cohort of patients with BTC.Material and methodsWe performed a retrospective single-center study for the period 2009 until 2017. 216 consecutive patients that underwent surgical exploration with a diagnosis of perihilar cholangiocarcinoma (PHCC), intrahepatic cholangiocarcinoma (IHCC), or gallbladder cancer (GBC) were assessed. GPS and mGPS were calculated where both CRP and albumin were measured pre-operatively (n = 168/216). Survival was analyzed by Kaplan-Meier estimate and uni-/multivariate Cox regression.ResultsGPS and mGPS were negatively associated with survival (p < 0.001/p < 0.001), and the association was significant in all three subgroups. GPS, but not the mGPS, identified an intermediate risk group: with GPS = 1 having better OS than GPS = 2 (p = 0.003), but worse OS than GPS = 0 (p = 0.008). In multivariate analyses of resected patients, GPS (p = 0.001) and mGPS (p = 0.03) remained significant predictors of survival, independent of postoperatively available risk factors.ConclusionsPreoperative GPS and mGPS are independent prognostic factors in BTC. The association to OS was shown in all patients undergoing exploration, in resected patients only, and in both cholangiocarcinoma and gallbladder cancer. Furthermore, GPS – which weights hypoalbuminemia higher – could identify an intermediate risk group. 相似文献