全文获取类型
收费全文 | 3093篇 |
免费 | 104篇 |
国内免费 | 57篇 |
专业分类
耳鼻咽喉 | 93篇 |
儿科学 | 75篇 |
妇产科学 | 306篇 |
基础医学 | 311篇 |
口腔科学 | 118篇 |
临床医学 | 212篇 |
内科学 | 159篇 |
皮肤病学 | 31篇 |
神经病学 | 51篇 |
特种医学 | 115篇 |
外科学 | 1021篇 |
综合类 | 288篇 |
预防医学 | 121篇 |
眼科学 | 85篇 |
药学 | 129篇 |
1篇 | |
中国医学 | 28篇 |
肿瘤学 | 110篇 |
出版年
2023年 | 35篇 |
2022年 | 78篇 |
2021年 | 106篇 |
2020年 | 129篇 |
2019年 | 123篇 |
2018年 | 137篇 |
2017年 | 105篇 |
2016年 | 109篇 |
2015年 | 115篇 |
2014年 | 182篇 |
2013年 | 188篇 |
2012年 | 168篇 |
2011年 | 157篇 |
2010年 | 132篇 |
2009年 | 149篇 |
2008年 | 140篇 |
2007年 | 132篇 |
2006年 | 143篇 |
2005年 | 96篇 |
2004年 | 120篇 |
2003年 | 81篇 |
2002年 | 75篇 |
2001年 | 70篇 |
2000年 | 71篇 |
1999年 | 55篇 |
1998年 | 45篇 |
1997年 | 41篇 |
1996年 | 25篇 |
1995年 | 30篇 |
1994年 | 24篇 |
1993年 | 16篇 |
1992年 | 12篇 |
1991年 | 11篇 |
1990年 | 7篇 |
1989年 | 7篇 |
1988年 | 11篇 |
1987年 | 20篇 |
1986年 | 9篇 |
1985年 | 16篇 |
1984年 | 7篇 |
1983年 | 10篇 |
1982年 | 7篇 |
1981年 | 5篇 |
1980年 | 8篇 |
1979年 | 8篇 |
1978年 | 4篇 |
1977年 | 12篇 |
1976年 | 7篇 |
1974年 | 3篇 |
1973年 | 6篇 |
排序方式: 共有3254条查询结果,搜索用时 15 毫秒
1.
《Cirugía espa?ola》2022,100(7):437-439
Complete liver mobilization for major resections sometimes causes liver tilting due to the release of the suspensory elements of the liver. Rarely this may take to a liver abnormal position with acute obstruction to venous flow at the suprahepatic level (Budd-Chiari syndrome). To avoid this complication, techniques such as post-operative stent implantation have been described. The case of a patient who underwent a complete mobilization of the liver for resection of the inferiour venous cava and a right renal tumor, was reported. After that, an acute Budd-Chiari Syndrome was observed caused of the liver malposition, which was solved with the placement of two silicone prostheses in the liver cell. 相似文献
2.
3.
4.
《Journal of pediatric urology》2022,18(2):183.e1-183.e5
5.
Edward De Wolf Karel Claes Casper E. Sommeling Dries Opsomer Mario Cherubino Salvatore Vieni Stan Monstrey Salvatore D’Arpa 《The journal of sexual medicine》2019,16(7):1111-1117
IntroductionThe free radial forearm (FRFA) flap is universally still considered as the gold standard technique in penile reconstruction. Typically, a considerably large flap is required, often involving almost the entire circumference of the forearm. Partial necrosis may occur at the distal-most (dorsoradial) part of the flap as a result of insufficient perfusion.AimTo describe a new technique using the posterior interosseous artery (PIOA) to supercharge FRFA phalloplasty.MethodsIn a 12-month period, all patients having FRFA flap phalloplasty were enrolled. Perioperative, after complete flap dissection, an indocyanine green perfusion scan was performed. In case of insufficient perfusion at the distalmost part of the flap, a supramicrosurgical anastomosis was performed between the FRFA pedicle and the PIOA (artery only).Main Outcome MeasuresStudied outcomes included the rate of marginal necrosis, surgical time, postoperative posterior interosseous nerve damage and urethral complications (fistula, stenosis or necrosis).ResultsA total of 27 FRFA flap phalloplasties was performed. Anastomosis of the PIOA was needed in 15 cases. No marginal necrosis was observed in these cases. There were no cases of postoperative posterior interosseous nerve damage. There were no significant differences in urethral complications (fistula, stenosis or necrosis) between the 2 groups.Clinical ImplicationsIn selected cases where insufficient perfusion of the dorsoradial part of the flap is present, patients may benefit from arterial supercharging to prevent postoperative marginal necrosis.Strength & LimitationsStrengths include a single surgeon, thus lending continuity of skill and technique, a consecutive series, and 100% short-term follow-up. Limitations include single institution series and a limited number of patients.ConclusionArterial supercharging is effective in improving perfusion of large FRFA flaps used in phalloplasty when dorsoradial hypoperfusion is detected on an indocyanine green perfusion scan. It is a technically challenging addition to the standard technique because of the small size of the vessels, the close relationship between the PIOA and the posterior interosseous nerve, and the vulnerability of the newly constructed intra-flap anastomosis.De Wolf E, Claes K, Sommeling CE, et al. Free Bipedicled Radial Forearm and Posterior Interosseous Artery Perforator Flap Phalloplasty. J Sex Med 2019;16:1111–1117. 相似文献
6.
7.
8.
Sabin J. Bozso Jeevan Nagendran Roderick G.G. MacArthur Michael W.A. Chu Bob Kiaii Ismail El-Hamamsy Raymond Cartier Ali Shahriari Michael C. Moon 《The Journal of thoracic and cardiovascular surgery》2019,157(5):1763-1771
Objectives
We describe the Canadian results of the Ascyrus Medical Dissection Stent (AMDS), a novel partially uncovered aortic arch hybrid graft implanted antegrade during hypothermic circulatory arrest to promote true lumen expansion and enhance aortic remodeling.Methods
From March 2017 to February 2018, 16 consecutive patients (66 ± 12 years; 38% female) presented with acute type A aortic dissections and underwent emergent surgical aortic repair with AMDS implantation. All patients presented with DeBakey I aortic dissection, with evidence of malperfusion in 50% (n = 8) of patients. All cases were performed under hypothermic circulatory arrest with an additional average duration for AMDS implantation time of 2.1 minutes.Results
All 16 device implantations were successful. Overall 30-day mortality was 6.3% (n = 1) and stroke occurred in 6.3% (n = 1) of cases. There was no incidence of device-related aortic injury or aortic arch branch vessel occlusion. During the follow-up period, 12 patients had completed at least 1 postoperative computed tomography scan. At initial follow-up computed tomography scan, complete or partial thrombosis, and remodeling of the aortic arch occurred in 91.7% of cases (n = 11/12) and in the proximal descending thoracic aorta, complete or partial thrombosis, and remodeling occurred in 91.7% (n = 11/12).Conclusions
Preliminary results suggest that the AMDS is a safe, feasible and reproducible adjunct to current surgical approaches for acute DeBakey I aortic dissection repair. Further, the AMDS manages malperfusion and promotes early positive remodeling in the aortic arch and distal dissected segments, with favorable FL closure rates at follow-up. Ongoing follow-up will provide additional insight into the long-term effects of the AMDS. 相似文献9.
Giacomo Strigini Michele Rendina Matteo Ghiara Fabrizio Quattrini Laura Ghidoni Valeria Burgio Pietro Maniscalco Francesco Benazzo 《Injury》2019,50(2):382-385
Introduction
In this retrospective study we have analyzed a consecutive series of patients affected by isolated radial head Mason III fractures and treated with bone resection or prosthesis.Patients and methods
This study includes 24 patients affected by fractures mentioned above and treated between July 2009 and November 2015.15 patients (average age 48 y.o.) have been treated with prosthesis. The remaining 9 (average age 573) have been treated with a capitellectomy instead.From a clinical point of view, we have evaluated the patients according to main performance indicators such as range of motion, pain, instability and Mayo Elbow Performance Score as parameters.Results
We have found similar results in both group, with an average MEPS value of 95 in the prosthesis group and 966 in the radial head resection group.The range of motion was similar too: between 1,3° and 1203° in the first group and between 4,4° and 120° in the second one. No significant complication has detected in any patient.Discussion
According to most recent literature, it is not precisely defined how to treat isolated Mason III fractures, contrary to what is defined in more complex pattern, in which prosthesis are now evaluated as the best indication.Due to radial head limited contribution to elbow stability, in absence of other bony or ligamentous lesions both capitellectomy and prosthesis can be good treatment in this kind of fracture.Conclusion
According to our experience and to the most recent literature, we recommend prosthesis in patient younger than 50 y.o., high demanding or manual worker, while in other cases we think that radial head resection can be the treatment of choice. 相似文献10.
《Revista espa?ola de cardiología》2022,75(5):412-420
Introduction and objectivesThis study aimed to determine the safety and efficacy of modifying the classic implantation technique for aortic transcatheter heart valve (THV) implantation to a cusp-overlap-projection (COP) technique to achieve a higher implantation depth and to reduce the burden of new permanent pacemaker implantation (PPMI) at 30 days. Aortic self-expanding THV carries an elevated risk for PPMI. A higher implantation depth minimizes the damage in the conduction system and may reduce PPMI rates.MethodsFrom March 2017, 226 patients were consecutively included: 113 patients were treated using the COP implantation technique compared with the previous 113 consecutive patients treated using the classic technique. In all patients, implantation depth was assessed by 3 methods (noncoronary cusp to the THV, mean of the noncoronary cusp and the left coronary cusp to the THV, and the deepest edge from the left coronary cusp and the noncoronary cusp to the THV).ResultsThe COP group had a lower implantation depth than the group treated with the classic technique (4.8 mm ± 2.2 vs 5.7 mm ± 3.1; P = .011; 5.8 mm ± 3.1 vs 6.5 mm ± 2.4; P = .095; 7.1 mm ± 2.8 vs 7.4 mm ± 3.2; P = .392). Forty patients (17.7%) required a new PPMI after the 30-day follow-up but this requirement was significantly lower in the COP group (12.4% vs 23%, P = .036). The COP implantation technique consistently protected against the main event (OR, 0.45; 95%CI, 0.21-0.97; P = .043), with similar procedural success rates and complications.ConclusionsThe COP implantation technique is a simple modification of the implantation protocol and provides a higher implantation depth of self-expanding-THV with lower conduction disturbances and PPMI rates. 相似文献