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1.
目的 探讨糖化血红蛋白(Glycosylated hemoglobin,HbA1c)、空腹胰岛素(Fasting insulin,INS)及服糖后2小时胰岛素(Insulin 2 hours after oral glucose tolerance test,INS-2H)与高血压发病的风险。方法 本研究采用全人群多阶段整群随机抽样方法,抽取了贵州省12个区(县)的48个乡镇共9 280人进行调查,排除基线HbA1c、INS及INS-2H缺失及有高血压病史者,最终纳入1 684例进入分析。中位随访6.23年。采用Cox生存回归分析HbA1c、INS及INS-2H与高血压发病的相关性。PAF及Survival计算人群归因危险百分比。结果 HbA1c和INS-2H每升高一个单位,高血压发病风险分别增加31.5%和1.1%。HbA1c高水平组发病风险是低水平组的2.87倍。相比第一分位组,INS-2H第四分位组发病风险增加73.6%。HbA1c水平控制在6.3 mmol/L及以下可降低人群8.6%的发病。INS-2H水平分别控制在8.81 mIU/L、15.60 mIU/L、24.30 mIU/L以下,可降低人群22.6%、11.9%和6.8%的发病。年龄>42岁组的人群中,HbA1c高水平组发病风险是低水平组的2.84倍; INS-2H第二、三、四分位组发病风险分别是第一分位组的2.001倍、2.145倍和2.145倍。男性人群中,HbA1c高水平组发病风险是低水平组的2.760倍; INS-2H第三、四分位组发病风险是第一分位组的1.828倍和2.116倍。结论 HbA1c及INS-2H是高血压发病的危险因素,在年龄>42岁和男性人群更为敏感。控制HbA1c及INS-2H能有效降低人群高血压发病。 相似文献
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【目的】观察芒针对刺神阙与曲泉穴治疗脑卒中后尿潴留的临床疗效。【方法】将70例脑卒中后尿潴留患者随机分为治疗组和对照组,每组各35例。2组患者均给予基础治疗,对照组给予常规针刺治疗,治疗组给予芒针对刺神阙与曲泉穴治疗。6 d为1个疗程,2个疗程之间间隔1 d,连续治疗2个疗程。治疗2周后,评价2组临床疗效,观察2组患者治疗前后膀胱最大容量及残余尿量的变化情况,比较2组患者治疗前后中医症状积分的变化情况。【结果】(1)治疗后,2组患者的膀胱最大容量、残余尿量均明显改善(P<0.05),且治疗组在改善膀胱最大容量、残余尿量方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的排尿无力、小腹坠胀、倦怠乏力及总分均明显改善(P<0.05),且治疗组在改善排尿无力、小腹坠胀、倦怠乏力及总分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗组总有效率为82.86%(29/35),对照组为71.43%(25/35)。治疗组疗效优于对照组,差异有统计学意义(P<0.05)。【结论】芒针对刺神阙与曲泉穴治疗脑卒中后尿潴留,能明显改善患者的临床症状,有效改善患者的膀胱功能,疗效显著。 相似文献
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Evaluation of the ossification of the medial clavicular epiphysis plays a key role in forensic age estimation. The purpose of the present study was to assess a new numerical cut-off at the age of 18 years, taking into consideration Magnetic Resonance (MR) images of the medial clavicular epiphysis. We analyzed 163 MR scans of Italian subjects aged between 14 and 25 years. Using the data obtained we calculated two ratios: REM-1 (ratio between the length of the whole epiphysis and the length of the metaphysis) and REM-2 (ratio between the length of epiphyseal-metaphyseal fusion and the length of the metaphysis). In 68 out of 163 cases it was not possible to measure REM-2. The reproducibility was demonstrated using the Intraclass Correlation Coefficient (ICC) (Cronbach’s alpha > 0.80). REM-1 and REM-2 were compared in each category of age (adult and minor) by the Wilcoxon signed-rank test. The cut-off points for measurements of REM-1 and REM-2 were determined by logistic regression. For REM-1, the cut-off scores were 0.83 for all individuals (accuracy = 94.77%) and males (accuracy = 96.05%), and 0.86 for females (accuracy = 92.30%). For REM-2, the cut-off values were 0.40 for all individuals and males (accuracy = 100.00%), and 0.41 for females (accuracy = 100.00%). Finally, receiver operating characteristic (ROC) curves for age classification based on REM-1 and REM-2 were constructed, showing that REM-2 had the highest discriminative power. Thus, a new cut-off model for predicting the age of majority has been introduced, conducting a quantitative analysis thanks to the use of a high-resolution imaging tool. 相似文献
5.
Background: A new VMAT method called “Augmented Arc” (or simply Aug Arc) is proposed. The aim of this study is to demonstrate the validity of the proposed method in different clinical cases. Basically, Aug Arc refers to the portion(s) of the VMAT arc that is augmented with an additional arc to improve the plan quality. The Aug Arc portions in the Arc is determined using an objective function-based scoring method called “ψ – score”. Methods: To validate our approach, we have applied it in four clinical cases: Lung, Abdomen, Gynecologic (Gyn) and Pancreas. Basically, for Lung and Pancreas cases, four sets of plans were created, which are: (1) Single arc plan (S Arc), (2) Double arc plan (D Arc), (3) Partial Arc plan without Aug Arc (P Arc) and (4) Partial plan with Aug Arc (P+Aug Arc). For Abdomen and Gyn cases, three sets of plans were created, which are: (1) Single arc plan (S Arc), (2) Double arc plan (D Arc) and (3) Single Arc with Aug Arc (S+Aug Arc). To compute the “ψ – score”, an initial optimization was performed by using full Arc with 4-degree gantry spacing. Subsequently, Aug Arc portions were identified using the ψ – score plot in the single arc and partial arc scenarios. Results: The study finds that the proposed method is useful to improve the plan quality and plan deliverability for both centrically and non-centrically located tumors in terms of reducing the OAR dose, monitor units, beam on time and low dose volume without compromising the target coverage. Conclusion: The results indicate that the proposed approach could strike a balance between full double arc and single arc or partial arc in such a way that the planner can find a sweet spot of delivery parameters that result in optimal plan quality. 相似文献
6.
Domenico Pellegrino Lucia Calcagno Massimo Zimbone Salvatore Di Franco Antonella Sciuto 《Materials》2021,14(8)
In this study, 4H-SiC p–n junctions were irradiated with 700 keV He+ ions in the fluence range 1.0 × 1012 to 1.0 × 1015 ions/cm2. The effects of irradiation were investigated by current–voltage (I–V) and capacitance–voltage (C–V) measurements, while deep-level transient spectroscopy (DLTS) was used to study the traps introduced by irradiation defects. Modifications of the device’s electrical performances were observed after irradiation, and two fluence regimes were identified. In the low fluence range (≤1013 ions/cm2), I–V characteristics evidenced an increase in series resistance, which can be associated with the decrease in the dopant concentration, as also denoted by C–V measurements. In addition, the pre-exponential parameter of junction generation current increased with fluence due to the increase in point defect concentration. The main produced defect states were the Z1/2, RD1/2, and EH6/7 centers, whose concentrations increased with fluence. At high fluence (>1013 ions/cm2), I–V curves showed a strong decrease in the generation current, while DLTS evidenced a rearrangement of defects. The detailed electrical characterization of the p–n junction performed at different temperatures highlights the existence of conduction paths with peculiar electrical properties introduced by high fluence irradiation. The results suggest the formation of localized highly resistive regions (realized by agglomeration of point defects) in parallel with the main junction. 相似文献
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《Diagnostic and interventional imaging》2021,102(10):629-639
PurposeTo investigate the reproducibility of diffusion-weighted (DW) MRI and 18F-Fluorodeoxyglucose (18F-FDG)-Positron emission tomography/CT (PET/CT) in monitoring response to neoadjuvant chemotherapy in epithelial ovarian cancer.Materials and methodsTen women (median age, 67 years; range: 41.8–77.3 years) with stage IIIC-IV epithelial ovarian cancers were included in this prospective trial (NCT02792959) between 2014 and 2016. All underwent initial laparoscopic staging, four cycles of carboplatine-paclitaxel-based chemotherapy and interval debulking surgery. PET/CT and DW-MRI were performed at baseline (C0), after one cycle (C1) and before surgery (C4). Two nuclear physicians and two radiologists assessed five anatomic sites for the presence of ≥ 1 lesion. Target lesions in each site were defined and their apparent diffusion coefficient (ADC), maximal standardized uptake value (SUV-max), SUV-mean, SUL-peak, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were monitored (i.e., 10 patients × 5 sites × 3 time-points). Their relative early and late changes were calculated. Intra/inter-observer reproducibilities of qualitative and quantitative analysis were estimated with Kappa and intra-class correlation coefficients (ICCs).ResultsFor both modalities, inter- and intra-observer agreement percentages were excellent for initial staging but declined later for DW-MRI, leading to lower Kappa values for inter- and intra-observer variability (0.949 and 1 at C0, vs. 0.633 and 0.643 at C4, respectively) while Kappa values remained > 0.8 for PET/CT. Inter- and intra-observer ICCs were > 0.75 for SUV-max, SUL-peak, SUV-mean and their change regardless the time-point. ADC showed lower ICCs (range: 0.013–0.811). ANOVA found significant influences of the evaluation time, the measurement used (ADC, SUV-max, SUV-mean, SUV-max, SUL-peak, MTV or TLG) and their interaction on ICC values (P = 0.0023, P< 0.0001 and P =0.0028, respectively).ConclusionWhile both modalities demonstrated high reproducibility at baseline, only SUV-max, SUL-peak, SUV-mean and their changes maintained high reproducibility during chemotherapy. 相似文献
10.
目的探讨硅凝胶联合超脉冲CO2点阵激光术对剖宫产术后皮肤瘢痕的预防及治疗效果。方法前瞻性研究纳入2018年7~8月东莞市松山湖中心医院收治的100例剖宫产术后患者作为研究对象,分为观察组和对照组,各50例。对照组不予任何干预。观察组于手术伤口拆线后立即予硅凝胶涂抹,每日3次,3个月为1个疗程;观察组完成硅凝胶疗程后,有28例患者产生瘢痕,均立即采用超脉冲CO2点阵激光术治疗,每3个月1次,共3次。2组患者于产后3、6、9、12及18个月时采用温哥华瘢痕评分量表(VSS)对瘢痕形态进行评分,采用视觉模拟评分法(VAS)对瘢痕疼痛及瘙痒情况进行评分。记录观察组的临床疗效和治疗过程中发生的不良反应。结果产后3、6、9、12及18个月,观察组VSS评分[(6.00±1.31)、(5.38±1.35)、(4.78±1.23)、(4.20±1.1)、(3.92±1.00)分]、疼痛[(2.84±1.02)、(2.40±0.93)、(2.06±0.62)、(1.20±0.67)、(1.04±0.60)分]及瘙痒[(3.00±1.05)、(2.50±0.86)、(2.12±0.67)、(1.34±0.59)、(1.12±0.59)分]评分均呈逐渐下降趋势,且明显低于同一时间段对照组VSS评分[(6.60±1.56)、(6.44±1.25)、(6.38±1.21)、(6.46±1.51)、(6.48±1.47)分]、疼痛[(3.94±0.87)、(3.82±0.83)、(3.76±0.72)、(3.72±0.81)、(3.66±0.87)分]及瘙痒[(4.08±0.99)、(3.98±0.89)、(4.00±0.90)、(4.04±0.92)、(3.96±0.95)分]评分,差异均有统计学意义(P<0.05);而对照组VSS评分、疼痛及瘙痒评分均未见明显变化(P>0.05)。观察组经超脉冲CO2点阵激光术治疗后9个月(产后18个月),治疗的总有效率达92.9%,总显效率82.1%。观察组不良反应发生率低:轻度色素沉着14.29%,持续性红斑7.14%。结论硅凝胶联合超脉冲CO2点阵激光术对剖宫产术后皮肤瘢痕的预防及治疗效果满意,不良反应轻微,值得临床推广应用。 相似文献