全文获取类型
收费全文 | 44218篇 |
免费 | 2453篇 |
国内免费 | 114篇 |
专业分类
耳鼻咽喉 | 741篇 |
儿科学 | 1809篇 |
妇产科学 | 786篇 |
基础医学 | 5730篇 |
口腔科学 | 1101篇 |
临床医学 | 2929篇 |
内科学 | 10381篇 |
皮肤病学 | 1501篇 |
神经病学 | 3636篇 |
特种医学 | 1140篇 |
外国民族医学 | 1篇 |
外科学 | 6237篇 |
综合类 | 394篇 |
现状与发展 | 1篇 |
一般理论 | 21篇 |
预防医学 | 3900篇 |
眼科学 | 1269篇 |
药学 | 2701篇 |
中国医学 | 242篇 |
肿瘤学 | 2265篇 |
出版年
2023年 | 321篇 |
2022年 | 238篇 |
2021年 | 1123篇 |
2020年 | 538篇 |
2019年 | 1227篇 |
2018年 | 1987篇 |
2017年 | 1170篇 |
2016年 | 1000篇 |
2015年 | 882篇 |
2014年 | 1060篇 |
2013年 | 1857篇 |
2012年 | 3272篇 |
2011年 | 3703篇 |
2010年 | 1763篇 |
2009年 | 1015篇 |
2008年 | 2865篇 |
2007年 | 3003篇 |
2006年 | 2731篇 |
2005年 | 2827篇 |
2004年 | 2531篇 |
2003年 | 2454篇 |
2002年 | 2248篇 |
2001年 | 1492篇 |
2000年 | 1944篇 |
1999年 | 1055篇 |
1998年 | 261篇 |
1997年 | 166篇 |
1996年 | 159篇 |
1995年 | 146篇 |
1994年 | 110篇 |
1993年 | 100篇 |
1992年 | 145篇 |
1991年 | 128篇 |
1990年 | 100篇 |
1989年 | 92篇 |
1988年 | 96篇 |
1987年 | 73篇 |
1986年 | 85篇 |
1985年 | 87篇 |
1984年 | 83篇 |
1983年 | 60篇 |
1982年 | 50篇 |
1981年 | 42篇 |
1980年 | 45篇 |
1979年 | 36篇 |
1978年 | 35篇 |
1975年 | 34篇 |
1974年 | 39篇 |
1973年 | 32篇 |
1970年 | 29篇 |
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
1.
2.
Antonio Montalvo Afonso Fernando Ruiz Juretschke Rosario González Rodrigálvarez Olga Mateo Sierra Begoña Iza Vallejo Roberto García Leal Marc Valera Melé Vicente Casitas Hernando Jose Manuel Hernández Poveda Carlos Fernández Carballal 《Neurocirugía (Asturias, Spain)》2021,32(1):1-9
Background and objectivesThe treatment of deafferentation pain by spinal DREZotomy is a proven therapeutic option in the literature. In recent years, use of DREZotomy has been relegated to second place due to the emergence of neuromodulation therapies. The objectives of this study are to demonstrate that DREZotomy continues to be an effective and safe treatment and to analyse predictive factors for success.Patients and methodsA retrospective study was conducted of all patients treated in our department with spinal DREZotomy from 1998 to 2018. Bulbar DREZotomy procedures were excluded. A visual analogue scale (VAS) and the reduction of routine medication were used as outcome variables. Demographic, clinical and operative variables were analysed as predictive factors for success.ResultsA total of 27 patients (51.9% female) with a mean age of 53.7 years underwent DREZotomy. The main cause of pain was brachial plexus injury (BPI) (55.6%) followed by neoplasms (18.5%). The mean time of pain evolution was 8.4 years with a mean intensity of 8.7 according to the VAS, even though 63% of the patients had previously received neurostimulation therapy. Favourable outcome (≥ 50% pain reduction in the VAS) was observed in 77.8% of patients during the postoperative period and remained in 59.3% of patients after 22 months average follow-up (mean reduction of 4.9 points). This allowed for a reduction in routine analgesic treatment in 70.4% of them. DREZotomy in BPI-related pain presented a significantly higher success rate (93%) than the other pathologies (41.7%) (p = .001). No association was observed between outcome and age, gender, DREZ technique, duration of pain or previous neurostimulation therapies. There were six neurological complications, four post-operative transient neurological deficits and two permanent deficits.ConclusionDorsal root entry zone surgery is effective and safe for treating patients with deafferentation pain, especially after brachial plexus injury. It can be considered an alternative treatment after failed neurostimulation techniques for pain control. However, its indication should be considered as the first therapeutic option after medical therapy failure due to its good long-term results. 相似文献
3.
4.
J. Ripollés-Melchor C. Aldecoa E. Alday-Muñoz S. del Río A. Batalla E. del-Cojo-Peces R. Uña-Orejón J.L. Muñoz-Rodés J.V. Lorente Á.V. Espinosa C. Ferrando-Ortolà J.L. Jover A. Abad-Gurumeta J.M. Ramírez-Rodríguez A. Abad-Motos 《Revista espa?ola de anestesiología y reanimación》2021,68(7):373-383
BackgroundThe optimal regimen for intravenous administration of intraoperative fluids remains unclear. Our goal was to analyze intraoperative crystalloid volume administration practices and their association with postoperative outcomes.MethodsWe extracted clinical data from two multicenter observational studies including adult patients undergoing colorectal surgery and total hip (THA) and knee arthroplasty (TKA). We analyzed the distribution of intraoperative fluid administration. Regression was performed using a general linear model to determine factors predictive of fluid administration. Patient outcomes and intraoperative crystalloid utilization were summarized for each surgical cohort. Regression models were developed to evaluate associations of high or low intraoperative crystalloid with the likelihood of increased postoperative complications, mainly acute kidney injury (AKI) and hospital length of stay (LOS).Results7,580 patients were included. The average adjusted intraoperative crystalloid infusion rate across all surgeries was to 7.9 (SD 4) mL/kg/h. The regression model strongly favored the type of surgery over other patient predictors. We found that high fluid volume was associated with 40% greater odds ratio (OR 1.40; 95% confidence interval1.01-1.95, p = 0.044) of postoperative complications in patients undergoing THA, while we found no associations for the other types of surgeries, AKI and LOSConclusionsA wide variability was observed in intraoperative crystalloid volume administration; however, this did not affect postoperative outcomes. 相似文献
5.
6.
7.
Mariángeles González Fernández Elena Villamañán Inmaculada Jiménez-Nácher Francisco Moreno Chamaida Plasencia Francisco Gayá Alicia Herrero Alejandro Balsa 《Reumatología clinica》2021,17(6):335-342
ObjectiveTo assess the evolution of cost per patient/year and the cost per patient/year/drug in patients with rheumatoid arthritis (RA) receiving biological treatments. To analyze and quantify the factors influencing this evolution, such as the optimization of the biological drugs, the use of biosimilars, and official discounts and discounts obtained after negotiated procedures. In addition, to assess specific clinical parameters of disease activity in these patients.MethodsRetrospective, observational study conducted in a Spanish tertiary hospital. Adult patients diagnosed with RA under treatment from 2009 to 2017 were included.Results320, 270 and 389 patients were included in 2009, 2013 and 2017, respectively. The patient/year cost decreased from 10,789€ in 2009, 7491€ in 2013 to 7116€ in 2017. In 2017, due to the established competition, discounts of 14% and 29.5% were achieved on etanercept and its biosimilar; 11.5%, 17.8%, 17.9%, 17.3% on adalimumab, certolizumab, golimumab and tocilizumab IV respectively, and 24.6% and 43.1% on infliximab and its biosimilar. The percentage of patients optimized in 2017 was 35.2%. The annual saving in 2017 was 1,288,535€ (830,000€ due to dose optimization and/or administration regimens, 249,666€ corresponding to 7.5% of the official discount and 208,868€ after negotiated procedures).ConclusionThe annual cost per patient in RA decreased considerably due to different factors, such as discounts on the purchase of drugs due to official discounts and negotiated procedures, together with the optimization of therapies, the latter being the factor that contributed most to this decrease. 相似文献
8.
9.
John W Day Richard S Finkel Claudia A Chiriboga Anne M Connolly Thomas O Crawford Basil T Darras Susan T Iannaccone Nancy L Kuntz Loren D M Peña Perry B Shieh Edward C Smith Jennifer M Kwon Craig M Zaidman Meredith Schultz Douglas E Feltner Sitra Tauscher-Wisniewski Haojun Ouyang Deepa H Chand Jerry R Mendell 《Lancet neurology》2021,20(4):284-293