全文获取类型
收费全文 | 11150篇 |
免费 | 567篇 |
国内免费 | 280篇 |
专业分类
耳鼻咽喉 | 35篇 |
儿科学 | 514篇 |
妇产科学 | 360篇 |
基础医学 | 926篇 |
口腔科学 | 44篇 |
临床医学 | 676篇 |
内科学 | 2716篇 |
皮肤病学 | 54篇 |
神经病学 | 448篇 |
特种医学 | 145篇 |
外科学 | 1573篇 |
综合类 | 876篇 |
预防医学 | 2624篇 |
眼科学 | 5篇 |
药学 | 477篇 |
4篇 | |
中国医学 | 323篇 |
肿瘤学 | 197篇 |
出版年
2024年 | 9篇 |
2023年 | 242篇 |
2022年 | 481篇 |
2021年 | 691篇 |
2020年 | 563篇 |
2019年 | 613篇 |
2018年 | 569篇 |
2017年 | 356篇 |
2016年 | 440篇 |
2015年 | 370篇 |
2014年 | 960篇 |
2013年 | 718篇 |
2012年 | 565篇 |
2011年 | 825篇 |
2010年 | 558篇 |
2009年 | 669篇 |
2008年 | 650篇 |
2007年 | 599篇 |
2006年 | 408篇 |
2005年 | 353篇 |
2004年 | 249篇 |
2003年 | 192篇 |
2002年 | 133篇 |
2001年 | 93篇 |
2000年 | 66篇 |
1999年 | 64篇 |
1998年 | 50篇 |
1997年 | 48篇 |
1996年 | 29篇 |
1995年 | 34篇 |
1994年 | 25篇 |
1993年 | 32篇 |
1992年 | 20篇 |
1991年 | 13篇 |
1990年 | 19篇 |
1989年 | 13篇 |
1988年 | 19篇 |
1987年 | 20篇 |
1986年 | 14篇 |
1985年 | 29篇 |
1984年 | 27篇 |
1983年 | 17篇 |
1982年 | 22篇 |
1981年 | 16篇 |
1980年 | 14篇 |
1979年 | 21篇 |
1978年 | 22篇 |
1977年 | 10篇 |
1973年 | 8篇 |
1967年 | 8篇 |
排序方式: 共有10000条查询结果,搜索用时 23 毫秒
1.
2.
Keith B. Diamond Ivan J. Golub Asad M. Ashraf Samuel J. Swiggett Paul V. Romeo Jack Choueka 《Seminars in Arthroplasty》2022,32(1):15-22
BackgroundWhile studies have demonstrated favorable outcomes in utilization of primary total shoulder arthroplasty (TSA) for the treatment of glenohumeral osteoarthritis (OA), adverse events such as infections can still occur. Periprosthetic joint infections (PJIs) are associated with worse outcomes and patient morbidity. The purpose of this study was to: (1) compare patient demographics amongst TSA patients with and without PJIs following primary TSA; and (2) identify patient-related risk factors for PJIs following primary TSA.MethodsPatients undergoing primary TSA for the treatment of glenohumeral OA were identified using the Mariner administrative claims database by CPT code 23,472. Laterality modifiers were utilized to ensure PJIs were developing in the correct laterality as those patients undergoing primary TSA. Inclusion for the study group consisted of patients who developed PJIs within 2-years after the index procedure, whereas patients who did not develop PJIs served as the comparison cohort. Primary outcomes analyzed included patient demographics and patient-related risk factors for PJIs following primary TSA. A stepwise backwards elimination multivariate binomial logistic regression analyses was performed to determine the odds (OR) of PJIs in patients undergoing primary TSA. A P value less than .05 was considered statistically significant.ResultsThe query yielded 15,396 patients who underwent primary TSA for glenohumeral OA, of which 191 patients developed PJIs and 15,205 did not develop PJIs. The study found statistically significant differences amongst patients who did and did not develop PJIs following primary TSA with respect to age, sex, and presence of comorbid conditions. Risk factors associated with developing PJIs following primary TSA included: pathologic weight loss (OR: 2.06, P < .0001), obesity (OR: 1.56, P = .0001), male sex (OR: 1.52, P = .007), and peripheral vascular disease (OR: 1.46, P = .022).ConclusionAs the number of primary TSAs for the treatment of glenohumeral OA increase worldwide, identifying modifiable risk-factors to reduce the incidence of infection is critical. The study found various modifiable and non-modifiable risk factors associated with developing PJIs following primary TSA. This study is valuable to orthopedists in order to identify and risk-stratify patients with regard to PJI in the setting of primary TSA for OA.Level of EvidenceLevel III; Case-Control Study 相似文献
3.
4.
Charles A. Johnson Jared J. Reid William E. Allen Suvleen K. Singh Josef K. Eichinger Richard J. Friedman 《Seminars in Arthroplasty》2022,32(3):594-599
BackgroundThe purpose of this study is to evaluate the effect of body mass index (BMI) on discharge to a postacute care (PAC) facility following elective total shoulder arthroplasty (TSA).MethodsThe National Surgical Quality Improvement Program database was queried to identify adult patients (>18 years old) who underwent inpatient TSA for primary osteoarthritis between 2005 and 2018. Hemiarthroplasty, revision TSA, trauma indications, and outpatient procedures were excluded. Patient and perioperative data were identified. Univariate analysis and multivariate logistic regression were used to assess the relationship between BMI and discharge to PAC facilities.ResultsA total of 10,198 patients with a primary TSA were identified. The majority (93%) of patients were discharged home vs. 7% to PAC facilities. Patients discharged to PAC had significantly higher mean BMI (P = .006). After controlling for demographic and comorbid factors, BMI was the only modifiable risk factor that was independently associated with an increased risk of discharge to a PAC. For every increase in BMI point, there was an increased risk of discharge to a PAC by 2.9% (odds ratio [OR] 1.029, confidence interval [CI] 1.016-1.041, P < .001). Additional covariates associated with PAC discharge were older age (OR 1.113, CI 1.099-1.127, P < .001), female gender (OR 3.037, CI 2.489-3.705, P < .001), and dependent functional status (OR 8.322, CI 5.544-12.492, P < .001).ConclusionMost patients undergoing TSA were discharged home following surgery. While age, sex, and functional status also affect disposition, elevated BMI is the only modifiable risk factor that independently predicts PAC discharge. Consideration of patient BMI prior to elective TSA may greatly improve discharge planning and management of patient expectations. 相似文献
5.
Dandan Luo Carolyn L. Westhoff Alison B. Edelman Melissa Natavio Frank Z. Stanczyk William J. Jusko 《Contraception》2019,99(4):256-263
Objective
The objective was to evaluate the pharmacokinetics (PKs) of levonorgestrel (LNG)-containing combined oral contraceptives (COCs) in obese women.Study design
We pooled and reanalyzed data from 89 women with different body mass index (BMI) categories from four clinical studies. The LNG and ethinyl estradiol (EE) PKs were analyzed utilizing a zero-order absorption (K0), two-compartment PK model to evaluate key PK parameters in relation to a range of weights, BMI and body surface area (BSA).Results
Increasing of body habitus metrics is correlated with decreasing Cmax (p<.0001) and AUCτ (p<.05) for both LNG and EE, but no correlation was found for Cmin (p≥.17). Increasing weight and BMI were associated with a modest increase (p≤.056) of clearance (CL) and appreciable increases of central volume (V1, p<.05), distribution clearance (CLd, p≤.001) and peripheral volume (V2, p<.0001) for LNG. For EE, increases in CL (p≤.009) were found with greater weight, BMI and BSA. Values of V1, CLd and V2 also increased (p<.0001) in obese subjects. The half-life and steady-state volume were greater among obese women (p<.0001) for both LNG and EE. LNG and EE PK parameters correlated well (p≤.006 for all), indicating that individual subject physiology affected both drugs similarly.Conclusions
The primary effects of obesity on LNG and EE were a modest increase in CL and a marked increase in distribution parameters. We observed no obesity-related differences in trough LNG and EE concentrations.Implications
This population PK analysis demonstrated reduced systemic exposure to LNG/EE oral contraceptives in obese subjects (Cmax and AUCτ); these particular differences are unlikely to lower contraceptive effectiveness among obese women who are correctly using LNG-containing contraceptives. 相似文献6.
Angela J. Jacques-Tiura Deborah A. Ellis April Idalski Carcone Sylvie Naar Kathryn Brogan Hartlieb Elizabeth K. Towner Thomas N. Templin K.-L. Catherine Jen 《The Journal of adolescent health》2019,64(3):355-361
Objective
Successful weight loss interventions for African-Americans adolescents are lacking. Cognitive-behavioral interventions seek to develop weight loss skills (e.g., counting calories, goal setting, managing one's environment). Little is known about how well adolescents implement such skills in their daily lives. Study aims were to (1) examine weight loss skills utilization at midpoint and end of a 6-month cognitive-behavioral/motivational interviewing weight loss sequential multiple assignment randomized trial (SMART), and (2) determine if greater skill utilization predicted weight loss at treatment end and 3 months post-treatment.Method
One hundred and eighty six African-Americans adolescents with obesity and their caregiver were first randomly assigned to complete 3 months of cognitive-behavioral and motivational interviewing family-based weight loss treatment in their home or in the research office (Phase 1). Nonresponders (i.e., those who lost < 3% of initial weight, n?=?161) were rerandomized to 3 months of continued skills training (n?=?83) or contingency management (n?=?78) for Phase 2; responders were allocated to 3 months of relapse prevention (n?=?20). Adolescents’ frequency of weight loss skills utilization was assessed via questionnaire at treatment midpoint and end.Results
Higher treatment attendance was associated with better skill utilization. Higher skill utilization was associated with more weight loss at treatment end, whereas higher baseline confidence was associated with more weight loss at follow-up.Conclusions
This study indicates the importance of attending weight loss intervention sessions to develop and strengthen weight loss skills in African-American adolescents with obesity, and strengthening confidence to use such skills for continued weight loss. 相似文献7.
J. Shin J. Choi K.J. Kim 《Nutrition, metabolism, and cardiovascular diseases : NMCD》2019,29(2):144-151
Background and aim
The associations of long-term exposure to particulate matter <10 μm in size (PM10), nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), and ozone (O3) with cardiometabolic diseases (CMD) remain uncertain in the Korean population. Therefore, we sought to examine the associations between PM10, NO2, CO, SO2, and O3 and CMD using data collected from the Korean Community Health Survey.Methods and results
We selected 100,867 adults aged 19 years or older who had lived in the same domicile for ≥10 years and surveyed them to collect data on socioeconomic characteristics; health-related behaviors; obesity; and physician-diagnosed CMD history, including hypertension, diabetes mellitus, dyslipidemia, stroke, myocardial infarction, and ischemic heart disease. We calculated interquartile ranges for PM10, NO2, CO, SO2, and O3 from the 10 year average concentrations (2003–2012). Hypertension, diabetes mellitus, and dyslipidemia were positively associated with PM10, NO2, CO, SO2, and O3 after adjusting for confounding factors. Obesity was positively associated with PM10, NO2, SO2, and O3. On the other hand, we found no associations between stroke, myocardial infarction, and ischemic heart disease and exposure to PM10, NO2, CO, SO2, and O3 in these subjects. In subjects aged ≥65 years, the risk of dyslipidemia was markedly increased under exposure to NO2 and CO compared to subjects aged <65 years. The risk of obesity was also significantly increased under exposure to PM10 and NO2. However, sex differences in these associations were not found.Conclusion
Long-term exposure to PM10, NO2, CO, SO2, and O3 may be a risk factor of CMD in Korean adults. 相似文献8.
Carmil Azran Daniel Porat Noa Fine-Shamir Nirvana Hanhan Arik Dahan 《Surgery for obesity and related diseases》2019,15(2):333-341
Background
Bariatric surgery can lead to changes in the oral absorption of many drugs. Levothyroxine is a narrow therapeutic drug for hypothyroidism, a common condition among patients with obesity.Objective
The purpose of this work was to provide a mechanistic overview of levothyroxine absorption, and to thoroughly analyze the expected effects of bariatric surgery on oral levothyroxine therapy.Methods
We performed a systematic review of the relevant literature reporting the effects of bariatric surgery on oral levothyroxine absorption and postoperative thyroid function. A PubMed search for relevant keywords resulted in a total of 14 articles reporting levothyroxine status before versus after bariatric surgery.Results
Different mechanisms may support opposing trends as to levothyroxine dose adjustment postsurgery. On the one hand, based on impaired drug solubility/dissolution attributable to higher gastric pH as well as reduced gastric volume, compromised levothyroxine absorption is expected. On the other hand, the great weight loss, and altered set-point of thyroid hormone homeostasis with decreased thyroid-stimulating hormone after the surgery, may result in a decreased dose requirement.Conclusions
For patients after bariatric surgery, close monitoring of both the clinical presentation and plasma thyroid-stimulating hormone and T4 levels is strongly advised. Better understanding and awareness of the science presented in this article may help to avoid preventable complications and provide optimal patient care. 相似文献9.
《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2019,13(1):554-558
Metabolic Syndrome (MetS) is multivariate disease, clustered with socioeconomic and behavioral risk factors. Investigations about epidemiology estimative could be a prevention strategy.Aimto investigate the prevalence of metabolic syndrome and its associated factors in adult population in Fernando de Noronha Archipelago (PE-Brazil).MethodsA cross-sectional study was performed on a representative sample (N = 375) of adult residents of the region, aged 24–59 years, were harmonized according to the International Diabetes Federation (IDF) criteria.ResultsThe prevalence of metabolic syndrome was 45 (12%) and, the age was associated with MetS, which increases the chances to MetS development around 3% respectively (OR: 1.03; CI 95%: 1.002–1.070 P 0.0384). Waist circumference was elevated in female population 266 (70.74%), however, levels of fasting blood glucose (304 [80.85%]), blood pressure (375 [100%]), TG (302 [80.32]), and low HDLc (297 [78.99]) presented normal biochemical values. There is no significative difference for male and female gender and, the social and behavior factors did not present significative association.ConclusionThe Fernando de Noronha presents lower prevalence of MetS thus, shows associations for elderly people. The waist circumference was elevated on female population. The results of this study provide further evidence and underscore the need for public health strategies that include education about MetS, promotion of cardiometabolic health, and prevention of undesirable outcomes such as diabetes and cardiovascular disease. 相似文献
10.
目的研究肥胖型2型糖尿病患者联合采用西格列汀、二甲双胍治疗的临床效果。方法选择2018年10月—2020年4月该院100例肥胖型2型糖尿病患者为研究对象,采用随机数表法分成常规组和治疗组,每组50例。常规组予二甲双胍治疗,治疗组予二甲双胍+西格列汀治疗。比较两组治疗效果、血糖指标、体脂含量、胰岛功能指标及不良反应。。结果两组治疗效果比较,差异有统计学意义(P<0.05)。治疗后常规组血糖指标高于治疗组,差异有统计学意义(t=8.183、4.828、18.158,P<0.05)。治疗后常规组体脂含量高于治疗组,差异有统计学意义(t=5.993、7.657、4.420,P<0.05)。治疗后两组胰岛功能比较,差异有统计学意义(t=5.898、5.283、16.033,P<0.05)。常规组不良反应总发生率低于治疗组,但差异无统计学意义(χ2=0.136,P=0.712)。结论西格列汀、二甲双胍联合治疗肥胖型2型糖尿病效果确切。 相似文献