全文获取类型
收费全文 | 200465篇 |
免费 | 15338篇 |
国内免费 | 4399篇 |
专业分类
耳鼻咽喉 | 1379篇 |
儿科学 | 3208篇 |
妇产科学 | 4068篇 |
基础医学 | 25230篇 |
口腔科学 | 3721篇 |
临床医学 | 14873篇 |
内科学 | 24302篇 |
皮肤病学 | 2276篇 |
神经病学 | 13872篇 |
特种医学 | 6906篇 |
外国民族医学 | 3篇 |
外科学 | 22325篇 |
综合类 | 26457篇 |
现状与发展 | 21篇 |
一般理论 | 8篇 |
预防医学 | 15832篇 |
眼科学 | 2224篇 |
药学 | 27263篇 |
70篇 | |
中国医学 | 13006篇 |
肿瘤学 | 13158篇 |
出版年
2023年 | 2464篇 |
2022年 | 3514篇 |
2021年 | 7440篇 |
2020年 | 6930篇 |
2019年 | 6835篇 |
2018年 | 6926篇 |
2017年 | 7580篇 |
2016年 | 7593篇 |
2015年 | 7116篇 |
2014年 | 8648篇 |
2013年 | 12737篇 |
2012年 | 10097篇 |
2011年 | 12463篇 |
2010年 | 8145篇 |
2009年 | 8182篇 |
2008年 | 9725篇 |
2007年 | 10611篇 |
2006年 | 10108篇 |
2005年 | 9195篇 |
2004年 | 7938篇 |
2003年 | 7068篇 |
2002年 | 5489篇 |
2001年 | 4952篇 |
2000年 | 4145篇 |
1999年 | 3481篇 |
1998年 | 2585篇 |
1997年 | 2624篇 |
1996年 | 2407篇 |
1995年 | 2244篇 |
1994年 | 2192篇 |
1993年 | 1846篇 |
1992年 | 1706篇 |
1991年 | 1601篇 |
1990年 | 1394篇 |
1989年 | 1134篇 |
1988年 | 1104篇 |
1987年 | 1005篇 |
1986年 | 913篇 |
1985年 | 1336篇 |
1984年 | 1074篇 |
1983年 | 799篇 |
1982年 | 844篇 |
1981年 | 687篇 |
1980年 | 659篇 |
1979年 | 537篇 |
1978年 | 358篇 |
1977年 | 303篇 |
1976年 | 285篇 |
1975年 | 221篇 |
1974年 | 160篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
1.
《Journal of pediatric surgery》2023,58(7):1274-1280
BackgroundPerianal abscesses and anal fistulas are common. The principle of intention-to-treat has not been considered in previous systemic reviews. Thus, the comparison between primary and post-recurrence management was confused, and the recommendation of primary treatment is obscure. The current study aims to identify the optimal initial treatment for pediatric patients.MethodsUsing PRISMA guidelines, studies were identified from MEDLINE, EMBASE, PubMed, Cochrane Library, and Google Scholar without any language or study design restriction. The inclusion criteria include original articles or articles with original data, studies of management for a perianal abscess with or without anal fistula, and patient age of <18 years. Patients with local malignancy, Crohn's disease, or other underlying predisposing conditions were excluded. Studies without analyzing recurrence, case series of <5, and irrelevant articles were excluded in the screening stage. Of the 124 screened articles, 14 articles had no full texts or detailed information. Articles written in a language other than English or Mandarin were translated by Google Translation first and confirmed with native speakers. After the eligibility process, studies that compared identified primary managements were then included in the qualitative synthesis.ResultsThirty-one studies involving 2507 pediatric patients met the inclusion criteria. The study design consisted of two prospective case series of 47 patients and retrospective cohort studies. No randomized control trials were identified. Meta-analyses for recurrence after initial management were performed with a random-effects model. Conservative treatment and drainage revealed no difference (Odds ratio [OR], 1.222; 95% Confidential interval [CI]: 0.615–2.427, p = 0.567). Conservative management had a higher risk of recurrence than surgery without statistical significance (OR 0.278, 95% CI: 0.109–0.707, p = 0.007). Compared with incision/drainage, surgery can prevent recurrence remarkably (OR 4.360, 95% CI: 1.761–10.792, p = 0.001). Subgroup analysis of different approaches within conservative treatment and operation was not performed for lacking information.ConclusionStrong recommendations cannot be made due to the lack of prospective or randomized controlled studies. However, the current study based on real primary management supports initial surgical intervention for pediatric patients with perianal abscesses and anal fistula to prevent recurrence.Level of evidenceType of study: Systemic review; Evidence level: Level II. 相似文献
2.
3.
《Journal of the American Medical Directors Association》2022,23(10):1683-1690.e2
ObjectivesTo examine changes in urinary continence for post-acute, Complex Continuing Care hospital patients from time of admission to short-term follow-up, either in hospital or after discharge to long-term care or home with services.DesignRetrospective cohort study of patients in Complex Continuing Care hospitals using clinical data collected with interRAI Minimum Data Set 2.0 and interRAI Resident Assessment Instrument Home Care.Setting and ParticipantsAdults aged 18 years and older, admitted to Complex Continuing Care hospitals in Ontario, Canada, between 2009 and 2015 (n = 78,913).MethodsA multistate transition model was used to characterize the association between patient characteristics measured at admission and changes in urinary continence state transitions (continent, sometimes continent, and incontinent) between admission and follow-up.ResultsThe cohort included 27,896 patients. At admission, 9583 (34.3%) patients belonged to the continent state, 6441 (23.09%) patients belonged to the sometimes incontinent state, and the remaining 11,872 (42.6%) patients belonged to the incontinent state. For patients who were continent at admission, the majority (62.7%) remained continent at follow-up. However, nearly a quarter (23.9%) transitioned to the sometimes continent state, and an additional 13.4% became incontinent at follow-up. Several factors were associated with continence state transitions, including cognitive impairment, rehabilitation potential, stroke, Parkinson’s disease, Alzheimer’s disease and related dementias, and hip fracture.Conclusions and ImplicationsThis study suggests that urinary incontinence is a prevalent problem for Complex Continuing Care hospital patients and multiple factors are associated with continence state transitions. Standardized assessment of urinary incontinence is helpful in this setting to identify patients in need of further assessment and patient-centered intervention and as a quality improvement metric to examine changes in continence from admission to discharge. 相似文献
4.
5.
6.
7.
8.
9.
《Radiography》2022,28(2):353-359
Patient contact shielding has been in use for many years in radiology departments in order to reduce the effects and risks of ionising radiation on certain organs. New technologies in projection imaging and CT scanning such as digital receptors and automatic exposure control (AEC) systems have reduced doses and improved image consistency. These changes and a greater understanding of both the benefits and the risks from the use of shielding have led to a review of shielding use in radiology. A number of professional bodies have already issued guidance in this regard. This paper represents the current consensus view of the main bodies involved in radiation safety and imaging in Europe: European Federation of Organisations for Medical Physics, European Federation of Radiographer Societies, European Society of Radiology, European Society of Paediatric Radiology, EuroSafe Imaging, European Radiation Dosimetry Group (EURADOS), and European Academy of DentoMaxilloFacial Radiology (EADMFR). It is based on the expert recommendations of the Gonad and Patient Shielding (GAPS) Group formed with the purpose of developing consensus in this area. The recommendations are intended to be clear and easy to use. They are intended as guidance, and they are developed using a multidisciplinary team approach. It is recognised that regulations, custom and practice vary widely on the use of patient shielding in Europe and it is hoped that these recommendations will inform a change management program that will benefit patients and staff. 相似文献
10.