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1.
刘洁  张晶晶  沈梅  张清源   《四川医学》2022,43(9):936-939
<正>腭裂术后腭咽闭合不全(velopharyngeal insufficiency,VPI)是腭裂修复术后常见的并发症,初次接受腭裂修复术的患者中术后约有4.9%~27%存在不同程度的腭咽闭合不全,最终导致异常语音[1-8]。手术矫正被认为是矫正腭裂术后VPI最有效的方法之一,其中Furlow’s反向双Z法(Furlow’s double opposing Z method,Furlow法)被用作矫正VPI已经有30余年的历史,如今Furlow法因其可以在矫正VPI的同时,又可以明显降低诸如阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)等术后并发症的几率,  相似文献   
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总结1例外阴Paget’s病术后创面感染的护理体会,利用伤口评估三角工具对患者创面进行评估,通过使用液体伤口敷料联合银离子敷料控制感染,富血小板血浆技术促进伤口愈合,个体化健康教育提高患者治疗依从性的整体干预方案对伤口进行有效管理,结果显示伤口愈合效果良好。  相似文献   
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BACKGROUND Surgery for gastric cancer is a complex procedure and lymphadenectomy is often mandatory.Postoperative mortality and morbidity after curative gastric cancer surgery is not insignificant.AIM To evaluate the factors determining mortality and morbidity in a population of patients undergoing R0 resection and D2 lymphadenectomy for gastric cancer.METHODS A retrospective analysis of clinical data and pathological characteristics(age,sex,primary site of the tumor,Lauren histotype,number of positive lymph nodes resected,number of negative lymph nodes resected,and depth of invasion as defined by the standard nomenclature)was conducted in patients with gastric cancer.For each patient we calculated the Kattan’s score.We arbitrarily divided the study population of patients into two groups based on the nomogram score(<100 points or≥100 points).Prespecified subgroups in these analyses were defined according to age(≤65 years or>65 years),and number of lymph nodes retrieved(≤35 lymph nodes or>35 lymph nodes).Uni-and multivariate analysis of clinical and pathological findings were performed to identify the factors affecting postoperative mortality and morbidity.RESULTS One-hundred and eighty-six patients underwent a curative R0 resection with D2 lymphadenectomy.Perioperative mortality rate was 3.8%(7 patients);a higher mortality rate was observed in patients aged>65 years(P=0.002)and in N+patients(P=0.04).Following univariate analysis,mortality was related to a Kattan’s score≥100 points(P=0.04)and the presence of advanced gastric cancer(P=0.03).Morbidity rate was 21.0%(40 patients).Surgical complications were observed in 17 patients(9.1%).A higher incidence of morbidity was observed in patients where more than 35 lymph nodes were harvested(P=0.0005).CONCLUSION Mortality and morbidity rate are higher in N+and advanced gastric cancer patients.The removal of more than 35 lymph nodes does not lead to an increase in mortality.  相似文献   
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Xin Liu  Hua Li  Shen Qu  Qiao Yu  Hui Lin  Yan-Long Bi 《国际眼科》2022,15(9):1538-1543
AIM: To evaluate the efficacy and safety of full-thickness sutures combined with intracameral air injection (FTS-AI) versus pre-Descemet’s membrane sutures combined with intracameral air injection (PDS-AI) in the management of acute corneal hydrops in keratoconus. METHODS: The research included 8 patients (8 eyes) suffering from acute corneal hydrops caused by keratoconus. Four patients were randomly assigned to FTS-AI. And the other four were randomly assigned to PDS-AI. Corneal oedema, visual acuity, corneal thickness were assessed during follow-up. RESULTS: The demographics, preoperative duration of symptoms and severity of corneal hydrops between the two groups were not significantly different. The mean corneal oedema resolution time after FTS-AI and PDS-AI were 11±1.15 and 15±1.41d, respectively (P=0.005). The maximum corneal thickness of the scarred region decreased in both groups at one week postoperatively (P<0.05). No obvious difference was found in the mean maximal corneal thickness between the two groups postoperatively. The BCVA improved significantly after FTS-AI and PDS-AI at three months postoperatively. No obvious difference was found in the BCVA after FTS-AI and PDS-AI at three months postoperatively. CONCLUSION: FTS-AI and PDS-AI are safe and effective therapies to accelerate the resolution of corneal oedema in acute corneal hydrops secondary to keratoconus. Despite faster resolution of corneal oedema in the FTS-AI group, we recommend PDS-AI to avoid potential endothelium cell damage.  相似文献   
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AIM: To compare the diagnostic ability of glaucoma parameters measured by the optical coherence tomography (OCT) in normal, preperimetric glaucoma (PPG) and perimetric glaucoma (PG) patients. METHODS: This cross-sectional observational study includes 127 eyes of 127 subjects. Patients were divided into PPG (51 eyes), PG (46 eyes), and normal controls (30 eyes) based on clinical optic disc assessment and Humphrey visual field changes. The Heidelberg Spectralis OCT machine using Glaucoma Module Premium Edition software was used to measure the retinal nerve fiber layer (RNFL) and Bruch’s membrane opening-minimum rim width (BMO-MRW) to assess the optic nerve head and ganglion cell layer (GCL) thickness in the macula. RESULTS: RNFL, MRW, and GCL thickness were all significantly thinner in PG compared to PPG and the normal group. The BMO-MRW parameters showed better specificity (>70%) at 90% specificity compared to both RNFL and GCL parameters to discriminate normal, PPG, and PG patients. All BMO-MRW parameters showed higher area under curves (AUC) compared to RNFL and GCL parameters with the highest AUC observed in the superotemporal sector of the BMO-MRW (AUC=0.819 and and 0.897 between normal and PPG and PG groups respectively). CONCLUSION: While the BMO-MRW best discriminates PPG and PG against normal eyes, GCL parameters poorly differentiate the three groups.  相似文献   
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AIM:To observe the changes in Schlemm’s canal(SC),trabecular meshwork(TM),and anterior chamber relevant parameters after small incision lenticule extraction(SMILE) of myopia patients.METHODS:A total of 58 eyes from 30 patients who underwent SMILE were divided into a low and moderate myopia group(group A,32 eyes) and a high myopia group(group B,26 eyes).The diameter and area of the SC,the width and thickness of TM obtained by CIRRUS HD-OCT5000,and the related anterior chamber parameters obtained by Pentacam anterior segment analysis system,accommodation amplitude(AMP) were observed pre-and postoperatively.The preoperative intraocular pressure(IOP) and postoperative correction of intraocular pressure(IOPcc) were measured.RESULTS:The diameter and area of the SC in the two groups were significantly increased postoperatively(all P<0.01).The TM width of the patients in the two groups were increased at 1mo after surgery(both P<0.01),but the TM thickness did not change(P>0.05).The corneal curvature,central anterior chamber depth,and anterior chamber volume decreased after SMILE surgery(all P<0.01).There was a weak negative correlation between the SC area change and AMP change in group A(r=-0.362,P<0.01).The postoperative IOP decreased after correction by Shah formula(P<0.05).CONCLUSION:SC and TM in myopia patients change in the early postoperative stage of SMILE and the IOP is decline.  相似文献   
8.
AIM: To compare the ocular fundus features of highly myopic eyes with and without macular Bruch’s membrane (BM) defects and investigate the associations between macular BM defects and other myopic lesions. METHODS: This retrospective, observational case series included 262 eyes (139 patients) with high myopia (HM) refractive error ≥-6.0 diopters (D) or axial length ≥26.5 mm from March 2019 to December 2019. The patients underwent a comprehensive ophthalmic examination, including swept-source optical coherence tomography (SS-OCT). The features of macular BM defects and other ocular fundus lesions were examined in OCT images. RESULTS: Totally 51 eyes (19.5%) were detected with macular BM defects, which were characterized by a lack of BM, retinal pigment epithelium (RPE), and an almost complete loss of photoreceptors or choriocapillaris. Eyes with macular BM defects had worse best-corrected visual acuity (BCVA) than those without (P<0.001). Dome-shaped macula (DSM, P=0.042), retinal cysts (P=0.006), choroidal neovascularization (CNV, P<0.001), choroidal defects and abnormality (P=0.003), scleral defects (P=0.015), scleral deformation (P=0.005), posterior staphyloma (P=0.011), and perforating vessels (P<0.001) occurred more frequently in eyes with macular BM defects. In multivariate analysis, the presence of macular BM defects remained the significant association with presence of DSM (P=0.013), scleral defects (P=0.015), posterior staphyloma (P=0.001), perforating vessels (P<0.001) and CNV (P=0.004). CONCLUSION: Macular BM defects has a prevalence of approximately 20% in HM and it has tight association with other myopic fundus lesions. BM might be crucial in the pathogenesis of myopic fundus lesions due to its biomechanical function. A comprehensive understanding of BM’s role is useful for further researches about myopic lesions.  相似文献   
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目的:建立抗脂肪肝治疗药4,4’-二甲氧基-5,6,5’,6’-双(亚甲二氧基)-2’-吗啉亚甲基联苯-2-甲酸甲酯甲磺酸盐(简称IMH)中氯代烷烃类遗传毒性杂质4,4’-二甲氧基-5,6,5’,6’-双(亚甲二氧基)-2’-氯甲基-2-甲酸甲酯(简称氯代物)的分析方法。方法:采用正相高效液相色谱(NP-HPLC)法,选用Phenomenex Luna~? Silica色谱柱(250 mm×4.6 mm, 5μm),以正己烷-异丙醇(95∶5)为流动相,流速0.8 mL·min-1,检测波长226 nm,柱温35℃,进样量50μL;采用外标法对氯代物进行定量。结果:在水相中易分解的氯代物在该正相色谱方法条件下能够达到有效分离,专属性良好;氯代物质量浓度在0.03~3.0μg·mL-1的范围内呈现良好的线性关系,检测限和定量限分别为0.15 ng和0.31 ng;平均回收率处于99%~103%,精密度及溶液稳定性良好。3批实测样品中均未检出氯代物,表明后续工艺能有效清除本品中的氯代物。结论:该色谱方法快速、准确、灵敏,能够对IMH中的氯代物进行...  相似文献   
10.
目的:建立防风饮片中掺混水防风的检测方法,并将其作为补充检验方法对市场中防风饮片掺伪情况进行研判。方法:首先采用薄层色谱法(TLC),对水防风区别于防风的特征性成分[3’(S),4’(R)-双当归酰氧基-3’,4’-二氢花椒内酯]进行初筛,如果供试品溶液色谱中出现水防风特征斑点,则采用高效液相液相色谱法(HPLC)对其进行定量,色谱条件:Agilent Extent C18色谱柱(250 mm×4.6 mm, 5μm),乙腈-水(60∶40)为流动相,等度洗脱,流速为1.0 mL·min-1,检测波长为324 nm。如果量值超出拟定限度,则判定防风饮片中掺有水防风。如有必要采用高效液相-质谱联用法(HPLC-MS)进行确证。结果:TLC、HPLC方法专属性、重复性、耐用性均较好,对2019年国家药品抽检的236批次防风饮片进行了检测,其中17批次检出水防风的特征成分[3’(S),4’(R)-双当归酰氧基-3’,4’-二氢花椒内酯],且超过拟定限量,占比为7.2%,存在掺伪情况。结论:建立的方法可快速进行防风中掺混水防风的定性定量检测,有效地控...  相似文献   
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