全文获取类型
收费全文 | 7749篇 |
免费 | 414篇 |
国内免费 | 109篇 |
专业分类
耳鼻咽喉 | 26篇 |
儿科学 | 250篇 |
妇产科学 | 84篇 |
基础医学 | 532篇 |
口腔科学 | 141篇 |
临床医学 | 999篇 |
内科学 | 2155篇 |
皮肤病学 | 27篇 |
神经病学 | 168篇 |
特种医学 | 613篇 |
外国民族医学 | 1篇 |
外科学 | 1702篇 |
综合类 | 736篇 |
预防医学 | 146篇 |
眼科学 | 189篇 |
药学 | 362篇 |
2篇 | |
中国医学 | 81篇 |
肿瘤学 | 58篇 |
出版年
2024年 | 10篇 |
2023年 | 173篇 |
2022年 | 324篇 |
2021年 | 415篇 |
2020年 | 334篇 |
2019年 | 348篇 |
2018年 | 325篇 |
2017年 | 263篇 |
2016年 | 247篇 |
2015年 | 252篇 |
2014年 | 596篇 |
2013年 | 498篇 |
2012年 | 351篇 |
2011年 | 459篇 |
2010年 | 317篇 |
2009年 | 326篇 |
2008年 | 340篇 |
2007年 | 368篇 |
2006年 | 301篇 |
2005年 | 237篇 |
2004年 | 202篇 |
2003年 | 149篇 |
2002年 | 163篇 |
2001年 | 130篇 |
2000年 | 116篇 |
1999年 | 105篇 |
1998年 | 76篇 |
1997年 | 85篇 |
1996年 | 62篇 |
1995年 | 65篇 |
1994年 | 67篇 |
1993年 | 50篇 |
1992年 | 50篇 |
1991年 | 48篇 |
1990年 | 45篇 |
1989年 | 28篇 |
1988年 | 34篇 |
1987年 | 26篇 |
1986年 | 35篇 |
1985年 | 34篇 |
1984年 | 30篇 |
1983年 | 22篇 |
1982年 | 33篇 |
1981年 | 29篇 |
1980年 | 18篇 |
1979年 | 15篇 |
1978年 | 20篇 |
1976年 | 19篇 |
1975年 | 8篇 |
1974年 | 8篇 |
排序方式: 共有8272条查询结果,搜索用时 0 毫秒
1.
《Seminars in Arthroplasty》2015,26(1):28-33
While use of large heads in total hip arthroplasty (THA) continues to grow, concerns have been raised regarding anterior hip pain resulting from impingement of the prosthetic head against soft-tissues like the iliopsoas. To address these concerns, a new anatomically contoured head (ACH) was developed. In this study cadaver tests were utilized to show that iliopsoas impingement/tenting caused by conventional heads is significantly relieved with the more rounded and reduced distal profile of the ACH. Thus, the ACH implant may be able to decrease the risk of soft-tissue impingement with conventional heads, particularly in the smaller hip. 相似文献
2.
Stephan Koter Tina U. Cohnert Korbinian B. Hindermayr Jörg Lindenmann Maximilian Brückner Wolfgang K. Oswald Georg Werkgartner Doris Wagner 《Journal of vascular surgery》2019,69(4):1227-1232
Objective
Low psoas muscle area is shown to be an indicator for worse postoperative outcome in patients undergoing vascular surgical. Additionally, it has been associated with longer durations of hospital stay in patients with cancer who undergo surgery and subsequently greater health care costs in Europe and the United States. We sought to evaluate this effect on hospital expenditure for patients undergoing vascular repair in a health care system with universal access.Methods
Skeletal muscle mass was assessed on preoperative abdominal computed tomography scans of patients undergoing open aortic aneurysm repair in a retrospective fashion. The skeletal muscle index (SMI) was used to define low muscle mass. Health care costs were obtained for all patients and the relationship between a low SMI and higher costs was explored using linear regression and cross-sectional analysis.Results
We included 156 patients (81.5% male) with a median age of 72 years undergoing elective surgery for infrarenal abdominal aortic aneurysm in this analysis. The median SMI for patients with low skeletal muscle mass was 53.21 cm2/kg and for patients without, 70.07 cm2/kg. Hospital duration of stay was 2 days longer in patients with low skeletal muscle mass as compared with patients with normal (14 days vs 11 days; P = .001), as was duration of intensive care stay (3 days vs 1 day; P = .01). The median overall hospital costs were €10,460 higher for patients with a low SMI as compared with patients with a normal physical constitution (€53,739 [interquartile range, €45,007-€62,471] vs €43,279 [interquartile range, €39,509-€47,049]; P = .001). After confounder adjustment, a low SMI was associated with a 14.68% cost increase in overall hospital costs, for a cost increase of €6521.Conclusions
Low skeletal muscle mass is independently associated with higher hospital as well as intensive care costs in patients undergoing elective aortic aneurysm repair. Strategies to reduce this risk factor are warranted for these patients. 相似文献3.
Nirmanmoh Bhatia Buddhadeb Dawn Tariq S. Siddiqui Marcus F. Stoddard 《Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital》2015,42(1):16-24
Determining aortic stenosis (AS) severity is clinically important. Calculating aortic valve (AV) area by means of the continuity equation assumes a circular left ventricular outflow tract (LVOT). The full impact of this assumption in calculating AV area is unknown. Predictors of noncircular LVOT shape in patients with AS are undefined.In 109 adult patients with AS who underwent multiplanar transesophageal echocardiography, we calculated AV area by means of the standard continuity method and by a modified method involving planimetric LVOT area.We found 54 circular, 37 horizontal-oval, 8 vertical-oval, and 10 irregular LVOTs. Area derived by direct planimetry correlated better with the modified than the standard continuity method (r=0.89 vs r=0.85; both P=0.0001). Valve areas of patients with mild, moderate, or severe AS by planimetry were more often mischaracterized with use of the standard than modified method (29 vs 18; P <0.0001). Horizontal-oval AV area derived by planimetry (1.28 ± 0.55 cm2) was underestimated by the standard method (1.05 ± 0.47 cm2; P=0.001), but not by the modified method. Congenital AV morphology and low cardiac index were the only multivariate predictors of horizontal-oval shape. Low cardiac index was the only predictor of noncircular shape.More than half our patients with AS had noncircular LVOTs. Using the modified method reduces mischaracterizations of AS severity. Congenital AV morphology and low cardiac index predict horizontal-oval or noncircular shape. These data suggest the value of direct LVOT measurement to calculate AS severity in patients who have congenital AV or a low cardiac index. 相似文献
4.
D.A. Legemate P.M. Bossuyt 《European journal of vascular and endovascular surgery》2006,32(6):620-623
There is insufficient evidence that the surgical treatment of asymptomatic infrarenal aneurysms > 5.5 cm. is beneficial to patients. This is the result of serious complications of aneurysm surgery and the dearth of information from randomized trials. Based on evidence from the literature we defined scenarios and translated data into natural frequency trees to improve understanding of the uncertainty of help versus harm due to treatment of aneurysms. Our analysis shows that the majority of patients can expect little on longevity from surgery while they are at risk of dying from surgery or suffering from serious morbidity. We conclude that, as long as uncertainty persist, patients should be treated in hospitals that can show very low surgical mortality and major morbidity rates. To further resolve the problem of uncertainty randomized trials for larger aneurysms should be performed. Important issues to discuss are the lower and upper limits of the diameter of the aneurysms and the age and risk profiles of the patients to be included in such trials. 相似文献
5.
Dr. Menon Raj Gopal M.Ch. AlDelamie Taha FRCS Valliathu John FRCS Zacharias Sunny FRCS Lawati Al Adil FRCS Venkatraman M.Ch. 《Indian Journal of Thoracic and Cardiovascular Surgery》2006,22(3):173-177
Background Despite improving surgical techniques, treatment of heart valve disease in children remains controversial. Somatic growth
and adequate anticoagulation are of concern when children undergo valve replacement. We conducted this study to evaluate the
performance of valves in this age group.
Methods 42 children under the age of 13 years who underwent valve replacement were included in this study. Totally, 50 valves were
implanted in 42 patients: 48 were mechanical prostheses, two were bioprosthetic both in pulmonary position. 37 (74%) valves
were implanted in mitral position, 10 (20%) in aortic position, 1 (2%) in tricuspid position and 2 (4%) in pulmonary position.
Preoperatively, 14 (33,3%) patients were in New York Heart Association (NYHA) class IV, while 27 (64.2%) were in NYHA class
III.
Results There were 2 (4.7%) hospital deaths and 2 (4.7%) late deaths while 2 (4.7%) patients were lost to follow up. The mean follow
up period was 9.4 yrs. 35 (83.3%) patients are in NYHA Class I and free of all medications except warfarin. 3 (7.1%) patients
have undergone 5 successful pregnancies. The median INR was 2.23. Major thrombo-embolic episode occurred in 1 (2.3%) patient.
Conclusions In view of the problems of sizing, anticoagulation and need for re-operation at an early age, there is a reluctance to replace
valves in children. This study shows that despite these problems, valve replacement can be undertaken safely and successfully
in children, when repair has failed or not technically feasible. 相似文献
6.
Jean-Pierre Bassand René Faivre Pascal Berthout Jean-Claude Cardot Josette Verdenet Roland Bidet Jean-Pierre Maurat 《European journal of nuclear medicine and molecular imaging》1987,13(8):419-424
The influence of left ventricular volume variations and regurgitant fraction variations upon left ventricular ejection fraction, during exercise was examined using equilibrium radionuclide angiography in patients suffering from aortic regurgitation. Ejection fraction (EF), regurgitant fraction (RF), end diastolic volume (EDV) and end systolic volume (ESV) variations from rest to peak exercise were determined in 44 patients suffering from chronic aortic regurgitation (AR) and in 8 healthy volunteers (C). In C, EF increased (+0.10±0.03, P<0.01) and ESV decreased significantly (-23%±12%, P<0.01) RF and EDV did not vary significantly. In AR patients, EF, EDV and ESV did not vary significantly because of important scattering of individual values. Changes in EF and ESV were inversely correlated (r=-0.79, P<0.01) and RF decreased significantly (-0.12±0.10, P<0.01). Volumes and EF changes during exercise occurred in three different ways. In a 1st subgroup of 7 patients, EF increased (+0.09±0.03, P<0.05) in conjunction with a reduction of ESV (-24%±12%, P<0.05) without a significant change in EDV. In a 2nd group of 22 patients. EF decreased (-0.04±0.07, P<0.01) in association with an increase in ESV (+17%±16%, P<0.01) and no change in EDV. In a 3rd subgroup of 15 patients, EF decreased (-0.02±0.06, P<0.01) despite a reduction in ESV (-7%±6%, P<0.01) because of a dramatic EDV decrease (-10%±6%, P<0.05). In this subgroup, changes in EF were inversely correlated with changes in ESV (r=-0.55, P<0.01) and positively related to EDV variations (r=0.42, P=0.02). EDV related to EDV variations (r=0.42, P=0.02). EDV changes were weakly, but significantly, correlated to RF decrease (r=0.39, P<0.05). We conclude that changes in left ventricular ejection fraction during exercise in patients with chronic aortic regurgitation are significantly related in some patients to changes in ventricular loading conditions as well as contractile state. Therefore, a correct interpretation of EF changes during exercise requires the simultaneous determination of changes in LV volumes.Abbreviations EDV
end diastolic volume
- EF
ejection fraction
- ESV
end systolic volume
- LV
left ventricle
- RV
right ventricle 相似文献
7.
P.C.G. Simons A.A. Nawijn C.M.A. Bruijninckx B. Knippenberg E.H. de Vries H. van Overhagen 《European journal of vascular and endovascular surgery》2006,32(6):627-633
OBJECTIVE: To determine the safety and the long-term results of primary stent placement for localized distal aortic occlusive disease. DESIGN: Retrospective observational study. PATIENTS AND METHODS: From July 1998 to July 2005 17 patients (14 female and 3 men, mean age 57 years (39-80)) were treated for intermittent claudication. Five of these patients underwent additional endovascular treatment of focal iliac lesions. RESULTS: Technical success defined as residual stenosis of less than 50% or a trans-stenotic systolic pressure gradient <10% was achieved in 14 of 17 (82%) patients. Major complications included dissection at the puncture site in one patient and thrombosis of additional iliac stents in another patient. Both of these complications were successfully treated. During a mean follow-up of 27 months (range 1-86), four patients had recurrence of symptoms due to in-stent restenoses (n=2), femoral (n=1) or iliac occlusion (n=1), respectively. By Kaplan-Meier analysis, primary aortic hemodynamic patency was 83% at 3 years. Secondary aortic hemodynamic patency was 100%. The primary clinical patency was 68% at 3 years. CONCLUSION: Primary stent placement for distal aortic stenoses is an alternative to surgical treatment because of its high patency and relatively low complication rates. 相似文献
8.
Andrew Meikle Davison 《Forensic science, medicine, and pathology》2009,5(2):90-94
A 62-year-old male with no significant medical history developed thromboembolic complications in the lower limbs shortly after
an assault which involved punching and kicking to the trunk. Laparotomy revealed intra-abdominal injuries and an abdominal
aortic aneurysm. Death from multi-organ failure and sepsis occurred 9 days post-injury. The discussion concentrates on blunt
force trauma to the abdominal aorta, specifically on causation, mechanisms of injury and complications. 相似文献
9.
室间隔夹层瘤的超声诊断(附4例报告) 总被引:1,自引:0,他引:1
目的 总结室间隔夹层瘤的超声心动图诊断及临床应用价值。方法1985~2005年超声诊断罕见的室间隔夹层瘤4例。超声主要取左室长轴、四腔心、五腔心、大动脉短轴及非标准切面,观察主动脉窦的形态及结构:如扩张窦瘤的大小、窦壁厚度、窦瘤破口的部位、窦瘤破口与室间隔之间的关系,主动脉窦瘤与室间隔夹层瘤之间交通口的大小,测量形成室间隔夹层瘤的大小及夹层瘤左、右室面的厚度,结合彩色多普勒观察心动周期夹层瘤与主动脉窦瘤血流动态变化,频谱多普勒测量窦瘤与室间隔夹层瘤之间的血流速度。结果4例室间隔夹层瘤均为主动脉右窦破人室间隔基底段,且均行手术治疗证实超声诊断。结论超声心动图对室间隔夹层瘤可直接做出诊断,超声诊断价值在于早发现、早诊断、及早治疗,并可为外科选择手术方式提供重要的有价值的依据。 相似文献
10.