全文获取类型
收费全文 | 9353篇 |
免费 | 442篇 |
国内免费 | 95篇 |
专业分类
耳鼻咽喉 | 150篇 |
儿科学 | 159篇 |
妇产科学 | 59篇 |
基础医学 | 918篇 |
口腔科学 | 197篇 |
临床医学 | 766篇 |
内科学 | 848篇 |
皮肤病学 | 81篇 |
神经病学 | 954篇 |
特种医学 | 282篇 |
外科学 | 1548篇 |
综合类 | 1342篇 |
一般理论 | 1篇 |
预防医学 | 1063篇 |
眼科学 | 144篇 |
药学 | 998篇 |
3篇 | |
中国医学 | 183篇 |
肿瘤学 | 194篇 |
出版年
2023年 | 160篇 |
2022年 | 309篇 |
2021年 | 399篇 |
2020年 | 314篇 |
2019年 | 361篇 |
2018年 | 359篇 |
2017年 | 294篇 |
2016年 | 310篇 |
2015年 | 308篇 |
2014年 | 762篇 |
2013年 | 811篇 |
2012年 | 612篇 |
2011年 | 622篇 |
2010年 | 496篇 |
2009年 | 446篇 |
2008年 | 432篇 |
2007年 | 374篇 |
2006年 | 326篇 |
2005年 | 254篇 |
2004年 | 216篇 |
2003年 | 183篇 |
2002年 | 156篇 |
2001年 | 142篇 |
2000年 | 118篇 |
1999年 | 99篇 |
1998年 | 105篇 |
1997年 | 71篇 |
1996年 | 64篇 |
1995年 | 71篇 |
1994年 | 57篇 |
1993年 | 38篇 |
1992年 | 46篇 |
1991年 | 39篇 |
1990年 | 30篇 |
1989年 | 44篇 |
1988年 | 30篇 |
1987年 | 27篇 |
1986年 | 14篇 |
1985年 | 51篇 |
1984年 | 41篇 |
1983年 | 37篇 |
1982年 | 28篇 |
1981年 | 35篇 |
1980年 | 21篇 |
1979年 | 25篇 |
1978年 | 17篇 |
1977年 | 17篇 |
1976年 | 22篇 |
1975年 | 31篇 |
1973年 | 14篇 |
排序方式: 共有9890条查询结果,搜索用时 0 毫秒
1.
Anand Dayama Nikolaos Tsilimparis Stephen Kolakowski Nathaniel M. Matolo Misty D. Humphries 《Journal of vascular surgery》2019,69(1):156-163.e1
Background
Chronic limb-threatening ischemia (CLTI), defined as ischemic rest pain or tissue loss secondary to arterial insufficiency, is caused by multilevel arterial disease with frequent, severe infrageniculate disease. The rise in CLTI is in part the result of increasing worldwide prevalence of diabetes, renal insufficiency, and advanced aging of the population. The aim of this study was to compare a bypass-first with an endovascular-first revascularization strategy in patients with CLTI due to infrageniculate arterial disease.Methods
We reviewed the American College of Surgeons National Surgical Quality Improvement Program targeted lower extremity revascularization database from 2012 to 2015 to identify patients with CLTI and isolated infrageniculate arterial disease who underwent primary infrageniculate bypass or endovascular intervention. We excluded patients with a history of ipsilateral revascularization and proximal interventions. The end points were major adverse limb event (MALE), major adverse cardiovascular event (MACE), amputation at 30 days, reintervention, patency, and mortality. Multivariable logistic regression was used to determine the association of a bypass-first or an endovascular-first intervention with outcomes.Results
There were 1355 CLTI patients undergoing first-time revascularization to the infrageniculate arteries (821 endovascular-first revascularizations and 534 bypass-first revascularizations) identified. There was no significant difference in adjusted rate of 30-day MALE in the bypass-first vs endovascular-first revascularization cohort (9% vs 11.2%; odds ratio [OR], 0.73; 95% confidence interval [CI], 0.50-1.08). However, the incidence of transtibial or proximal amputation was lower in the bypass-first cohort (4.3% vs 7.4%; OR, 0.60; CI, 0.36-0.98). Patients with bypass-first revascularization had higher wound complication rates (9.7% vs 3.7%; OR, 2.75; CI, 1.71-4.42) compared with patients in the endovascular-first cohort. Compared with the endovascular-first cohort, the incidence of 30-day MACE was significantly higher in bypass-first patients (6.9% vs 2.6%; adjusted OR, 3.88; CI, 2.18-6.88), and 30-day mortality rates were 3.23% vs 1.8% (adjusted OR, 2.77; CI, 1.26-6.11). There was no difference in 30-day untreated loss of patency, reintervention of treated arterial segment, readmissions, and reoperations between the two cohorts. In subgroup analysis after exclusion of dialysis patients, there was also no significant difference in MALE or amputation between the bypass-first and endovascular-first cohorts.Conclusions
CLTI patients with isolated infrageniculate arterial disease treated by a bypass-first approach have a significantly lower 30-day amputation. However, this benefit was not observed when dialysis patients were excluded. The bypass-first cohort had a higher incidence of MACE compared with an endovascular-first strategy. These results reaffirm the need for randomized controlled trials, such as the Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL-2) trial and Best Endovascular vs Best Surgical Therapy in Patients with Critical Limb Ischemia (BEST-CLI), to provide level 1 evidence for the role of endovascular-first vs bypass-first revascularization strategies in the treatment of this population of challenging patients. 相似文献2.
3.
4.
酶联免疫吸附试验、间接荧光抗体试验、间接免疫过氧化物酶染色试验诊断人体旋毛虫病的初步研究 总被引:2,自引:0,他引:2
用ELISA、IFA和IIP试验检测11例旋毛虫病人血清特异性抗体,阳性率分别为72.72%、81.82%和81.82%。它们之间无统计学差异,3项试验结果间存在良好一致性。 同时检测了30份健康献血员血清和20例其他寄生虫病人血清(包括华支睾吸虫病、四川肺吸虫病、日本血吸虫病、包虫病和阿米巴肝脓肿),旋毛虫病人组的ELISA、IFA和IIP阳性率明显为高。 由于3项免疫学试验均具有较好的特异性和灵敏性,故可以单独或联合用于人体旋毛虫病的诊断和流行病学调查。 相似文献
5.
6.
Tarek A. Amer Tarek F. Elwakil Mahmoud S. Elbasiouny 《European journal of plastic surgery》2007,30(2):67-73
Haemangiomas are the most common tumours of infancy. They typically proliferate then involute with considerable variation
as regards to their rates of proliferation and involution. Haemangioma of the nasal tip is a lesion of special characteristics.
During proliferation, it expands, contracts and deviates the nasal cartilages. Particularly, it regresses slowly and frequently
involutes incompletely. That is why excision of the lesion is frequently suggested. The present study was conducted to evaluate
open rhinoplasty after initial non-excision treatment modalities namely, intra-lesional corticosteroid injections and laser
treatment, as a protocol of treatment for nasal tip haemangiomas. Twelve patients with nasal tip haemangiomas were included
in the present study. Patients of both sexes, of different ages, with deep and mixed haemangiomas were studied. Disfigurement
was the constant presenting symptom. Initial non-excision treatment reported different responses as denoted by the regression
of the lesions’ size. Haemangiomas constantly extended between the medial crura of the alar cartilages as noted by the constant
widening of the columella pre-operatively and the obvious separation of the nasal cartilages intra-operatively. This separation
was constantly found to require approximation by sutures. The results of the present study concluded that whenever an early
presentation with nasal tip haemangioma could be established, initial non-excision treatment followed by open rhinoplasty
could be a useful protocol of treatment. Within the limitations of the present study, this protocol could achieve an early,
safe and effective treatment for nasal tip haemangiomas with provisionally acceptable cosmetic outcomes so far. 相似文献
7.
腹腔镜手术与开放手术治疗精索静脉曲张的对比性研究(附273例分析) 总被引:5,自引:0,他引:5
目的:对比研究腹腔镜和开放手术精索静脉高位结扎术治疗精索静脉曲张的疗效。方法:回顾分析121例腹腔镜和152例开放手术精索静脉高位结扎术的临床资料,比较两种方法在手术时间、术后住院天数及综合治疗费用及术后止痛药应用等的差异。结果:两组在手术时间、术后住院天数及止痛药应用等方面差异均有高度显著性(P<0.01),腹腔镜组均优于开放手术组;综合治疗费用两组差异无显著性(P>0.05)。结论:腹腔镜治疗精索静脉曲张较开放手术具有创伤小、康复快,术后住院时间短及美容效果好等优点。 相似文献
8.
汕头卫生检疫局空港处对汕头航空口岸—宗入境二级货包的监测过程及对有关运输工作人员作了放射知识问卷调查。从中发现。运输单位货物存放设施落后。有关工作人员放射卫生知识欠缺,对放射污染可能造成的危害缺乏正确的认识。为此,笔者提出了自己的看法,以期对放射监测工作的进一步完善提供参考。 相似文献
9.
目的 评价开放复位可塑形钛板内固定治疗跟骨骨折的疗效。方法 对33例(37足)以后关节突移位为主的跟骨骨折,行跟骨外侧入路、开放性复位可塑形钛板螺钉内固定,必要时行植骨术(18例)。结果 平均随访11.5个月,参照Mary—land food score评分,对患足是否疼痛、步态、距下关节及踝关节活动度、是否支架辅助、术后X线摄片等加以评估,19足疗效为优,17足为良,1足可。其中钛板断裂1例,手术切口皮缘坏死1例,换药后自愈。结论 跟骨外侧入路开放复位可塑形钛板螺钉内固定,必要时植骨术是治疗跟骨骨折的有效方法。 相似文献
10.
21例心内直视术后急性心包填塞的临床分析 总被引:1,自引:1,他引:0
目的:分析21例心内直视术后急性心包填塞的临床特点,探讨其发生原因、预防、救治及其二次开胸的早期指征。方法:对1991年1月-2005年12月心内直视术(共1096例)后21例急性心包填塞二次开胸(发生率1.92%)病例进行总结分析。结果:急性心包填塞患者经二次剖胸解除心包填塞后17例痊愈出院,4例死亡,二次剖胸手术死亡率为19.05%。二次剖胸手术者所患疾病包括先天性心脏病6例,瓣膜病13例,大血管手术1例,心脏移植1例。结论:减少心内直视术后出血、渗血是避免术后发生急性心包填塞的关键,早期诊断并尽早行二次剖胸手术可明显降低围手术期死亡率。 相似文献