全文获取类型
收费全文 | 3025篇 |
免费 | 174篇 |
国内免费 | 22篇 |
专业分类
耳鼻咽喉 | 100篇 |
儿科学 | 102篇 |
妇产科学 | 85篇 |
基础医学 | 261篇 |
口腔科学 | 51篇 |
临床医学 | 281篇 |
内科学 | 639篇 |
皮肤病学 | 241篇 |
神经病学 | 379篇 |
特种医学 | 167篇 |
外国民族医学 | 11篇 |
外科学 | 402篇 |
综合类 | 36篇 |
预防医学 | 241篇 |
眼科学 | 9篇 |
药学 | 113篇 |
中国医学 | 2篇 |
肿瘤学 | 101篇 |
出版年
2021年 | 29篇 |
2020年 | 21篇 |
2019年 | 17篇 |
2018年 | 36篇 |
2017年 | 35篇 |
2016年 | 61篇 |
2015年 | 57篇 |
2014年 | 74篇 |
2013年 | 125篇 |
2012年 | 83篇 |
2011年 | 99篇 |
2010年 | 79篇 |
2009年 | 91篇 |
2008年 | 88篇 |
2007年 | 104篇 |
2006年 | 98篇 |
2005年 | 74篇 |
2004年 | 82篇 |
2003年 | 76篇 |
2002年 | 71篇 |
2001年 | 83篇 |
2000年 | 80篇 |
1999年 | 108篇 |
1998年 | 89篇 |
1997年 | 80篇 |
1996年 | 85篇 |
1995年 | 65篇 |
1994年 | 75篇 |
1993年 | 49篇 |
1992年 | 95篇 |
1991年 | 46篇 |
1990年 | 63篇 |
1989年 | 74篇 |
1988年 | 84篇 |
1987年 | 60篇 |
1986年 | 54篇 |
1985年 | 37篇 |
1984年 | 52篇 |
1983年 | 28篇 |
1982年 | 32篇 |
1981年 | 35篇 |
1980年 | 27篇 |
1979年 | 23篇 |
1978年 | 21篇 |
1977年 | 20篇 |
1976年 | 22篇 |
1975年 | 17篇 |
1973年 | 22篇 |
1966年 | 18篇 |
1964年 | 16篇 |
排序方式: 共有3221条查询结果,搜索用时 281 毫秒
1.
Purpose
Chest wall pain is an uncommon but bothersome late complication following lung stereotactic body radiation therapy. Despite numerous studies investigating predictors of chest wall pain, no clear consensus has been established for a chest wall constraint. The aim of our study was to investigate factors related to chest wall pain in a homogeneous group of patients treated at our institution.Patients and methods
All 122 patients were treated with the same stereotactic body radiation therapy regimen of 48 Gy in three fractions, seen for at least 6 months of follow-up, and planned with heterogeneity correction. Chest wall pain was scored according to the Common Terminology Criteria for Adverse Events classification v3.0. Patient (age, sex, diabetes, osteoporosis), tumour (planning target volume, volume of the overlapping region between planning target volume and chest wall) and chest wall dosimetric parameters (volumes receiving at least 30, 40, and 50 Gy, the minimal doses received by the highest irradiated 1, 2, and 5 cm3, and maximum dose) were collected. The correlation between chest wall pain (grade 2 or higher) and the different parameters was evaluated using univariate and multivariate logistic regression.Results
Median follow-up was 18 months (range: 6–56 months). Twelve patients out of 122 developed chest wall pain of any grade (seven with grade 1, three with grade 2 and two with grade 3 pain). In univariate analysis, only the volume receiving 30 Gy or more (P = 0.034) and the volume of the overlapping region between the planning target volume and chest wall (P = 0.038) significantly predicted chest wall pain, but these variables were later proved non-significant in multivariate regression.Conclusion
Our analysis could not find any correlation between the studied parameters and chest wall pain. Considering our present study and the wide range of differing results from the literature, a reasonable conclusion is that a constraint for chest wall pain is yet to be defined. 相似文献2.
D Monnier† C Vidal‡ L Martin§ A Danzon¶ F Pelletier† E Puzenat† MP Algros†† D Blanc† R Laurent† PH Humbert† F Aubin† 《Journal of the European Academy of Dermatology and Venereology》2006,20(10):1237-1242
BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a rare malignant tumour of the skin, with an estimated incidence of 0.8 to five cases per 1 million people per year. OBJECTIVE: To study epidemiological, immunohistochemical and clinical features, delay in diagnosis, type of treatment and outcome of DFSP from 1982 to 2002. METHODS: Using data from the population-based cancer registry, 66 patients with pathologically proved DFSP were included (fibrosarcomatous DFSP were excluded). Each patient lived in one of the four departments of Franche-Comté (overall population of 1 million people) at the time of diagnosis. The main data sources came from public and private pathology laboratories and medical records. The rules of the International Agency for Research on Cancer were applied. RESULTS: The estimated incidence of DFSP in Franche-Comté was about three new cases per 1 million people per year. Male patients were affected 1.2 times as often as female patients were. The trunk (45%) followed by the proximal extremities (38%) were the most frequent locations. DFSP occurred mainly in young adults between 20 and 39 years of age. Mean age at diagnosis was 43 years, and the mean delay in diagnosis was 10.08 years. Our 66 patients initially underwent a radical local excision. Among them, 27% experienced one or more local recurrences during 9.6 years of follow-up. There was one regional lymph node recurrence without visceral metastases. These recurrences were significantly related to the initial peripheral resection margins. We observed a local recurrence rate of 47% for margins less than 3 cm, vs. only 7% for margins ranging from 3 to 5 cm [P=0.004; OR=0.229 (95%, CI=0.103-0.510)]. The mean time to a first local recurrence was 2.65 years. Nevertheless, there was no death due to the DFSP course at the end of the follow-up, and the final outcome was favourable. CONCLUSION: Our study emphasizes the importance of wide local excision with margins of at least 3 cm in order to prevent local recurrence. However, the recent development of inhibitors of signal transduction by the PDGFB pathway should soon modify the surgical strategy, which is often too mutilating. 相似文献
3.
4.
5.
6.
L. TIMMER-DE MIK M.D. D.M. BROEKHUIJSEN-VAN HENTEN M.D. † J.M. OLDHOFF M.D. PH.D. D.B. DE GEER M.D. ‡ V. SIGURDSSON M.D. PH.D. S.G.M.A. PASMANS M.D. PH.D. 《Pediatric dermatology》2009,26(3):358-360
Abstract: In Sweet's syndrome, the essential features are the characteristic morphology of the lesions, their histologic appearance, the dramatic response to corticosteroids and the absence of scarring. We report an 8-month-old infant in whom Sweet's syndrome was diagnosed and who developed acquired cutis laxa in the skin lesions. 相似文献
7.
BACKGROUND: Tinnitus is an uncomfortable symptom for the patient and an embarrassing one for the consulted physician. So far, there is no treatment that can be considered well established in terms of providing long-term reduction of tinnitus in excess of placebo effects. There is considerable evidence of pathophysiological similarity between tinnitus and chronic pain. Some forms of chronic pain can be treated by neurostimulation. OBJECTIVE: This study was designed to investigate the feasibility of neurostimulation of the cochlear nerve in order to reduce tinnitus. STUDY DESIGN: Pilot study. SETTING: Tertiary referral center. PATIENTS: Five patients with therapeutically refractory tinnitus were selected for this study. INTERVENTION: Placing a stimulation lead around the cochlear nerve through the suboccipital approach and connecting the stimulation lead to a pulse generator. MAIN OUTCOME MEASURES: The patients experienced 1) an absence of major or minor complications, such as death, meningitis, cranial nerve deficit, and vestibular problems; 2) tolerance of the procedure as considered by the patient; 3) relief of tinnitus in at least one patient. RESULTS: Implantation of the neurostimulation system was accomplished in each patient without any difficulty. None of the patients considered the treatment unbearable. No major or minor complications occurred in this study. Subjective tinnitus reduction was accomplished in four patients. CONCLUSION: Our preliminary data show that neurostimulation of the cochlear nerve is feasible, is bearable for the patient, and is a safe treatment modality without major complications. The effects on tinnitus are promising. 相似文献
8.
Leah L. Albers Deborah Anderson Leslie Cragin Susan Moore Daniels Christine Hunter Kay D. Sedler Dusty Teaf 《Journal of Midwifery & Women's Health》1996,41(4):269-276
We conducted an observational cohort study in three nurse-midwifery services to identify patient characteristics and clinical care measures related to perineal trauma at birth. Data were collected on all women who began care with a nurse-midwife in labor, using an adaptation of the Nurse-Midwifery Clinical Data Set (n = 3,049). Study variables included demographics, perineal management techniques and position for birth, and other intrapartum care and events. Univariate and multivariate analyses showed that episiotomy was strongly related to fetal bradycardia, prolonged second stage, ethnic status, and maternal education level. Warm compresses and flexion/counterpressure to slow delivery were protective. Spontaneous lacerations were influenced by these factors as well. The lateral position for birth was protective, and use of oils or lubricants and the lithotomy position increased lacerations. Multisite studies in nurse-midwifery practices may provide an ideal means of determining effective care measures in healthy populations. 相似文献
9.
HUGH F. MOLLOY F.A.C.D. ERIC LAMONT-GREGORY M.SC. CHRIS IDZIKOWSKI PH.D. F.B.PS.S. TERENCE J. RYAN D.M. F.R.C.P. 《International journal of dermatology》1993,32(9):668-672
Background. Extensive questioning of patients with a wide variety of skin disorders led to the impression that nocturnal overheating was probably an important factor in the initiation and the perpetuation of many skin disorders. Methods. In order to test the hypothesis, 12 “clean-skinned” subjects (6M/6F) aged 18 to 45 years were monitored electronically every 30 seconds during an 8 hour sleep period (2300 to 0700 hours), sleeping under a standard 10 tog duvet. Results. All the subjects were too hot by 3 to 4°C. All showed changes in their EEG patterns with reduced REM sleep, increased awakenings, and all showed changes in their sleep stage patterns. In addition, they all showed evidence of increased sweating in the “heat-sink” area. Conclusions. The mechanisms where by such changes could be implicated in the precipitation and perpetuation of skin disease are discussed. “Lifestyle” modification as a very effective, noninvasive, therapeutic regime is recommended. Further research along these lines would probably be very valuable and instructive. 相似文献
10.
Genital tract trauma is common following vaginal childbirth, and perineal pain is a frequent symptom reported by new mothers. The following techniques and care measures are associated with lower rates of obstetric lacerations and related pain following spontaneous vaginal birth: antenatal perineal massage for nulliparous women, upright or lateral positions for birth, avoidance of Valsalva pushing, delayed pushing with epidural analgesia, avoidance of episiotomy, controlled delivery of the baby's head, use of Dexon (U.S. Surgical; Norwalk, CT) or Vicryl (Ethicon, Inc., Somerville, NJ) suture material, the "Fleming method" for suturing lacerations, and oral or rectal ibuprofen for perineal pain relief after delivery. Further research is warranted to determine the role of prenatal pelvic floor (Kegel) exercises, general exercise, and body mass index in reducing obstetric trauma, and also the role of pelvic floor and general exercise in pelvic floor recovery after childbirth. 相似文献