收费全文 | 4403篇 |
免费 | 274篇 |
国内免费 | 31篇 |
耳鼻咽喉 | 67篇 |
儿科学 | 85篇 |
妇产科学 | 176篇 |
基础医学 | 508篇 |
口腔科学 | 163篇 |
临床医学 | 332篇 |
内科学 | 952篇 |
皮肤病学 | 79篇 |
神经病学 | 201篇 |
特种医学 | 162篇 |
外国民族医学 | 1篇 |
外科学 | 885篇 |
综合类 | 82篇 |
预防医学 | 310篇 |
眼科学 | 195篇 |
药学 | 281篇 |
中国医学 | 8篇 |
肿瘤学 | 221篇 |
2023年 | 37篇 |
2022年 | 42篇 |
2021年 | 177篇 |
2020年 | 80篇 |
2019年 | 140篇 |
2018年 | 157篇 |
2017年 | 123篇 |
2016年 | 128篇 |
2015年 | 122篇 |
2014年 | 216篇 |
2013年 | 247篇 |
2012年 | 294篇 |
2011年 | 360篇 |
2010年 | 200篇 |
2009年 | 173篇 |
2008年 | 247篇 |
2007年 | 237篇 |
2006年 | 217篇 |
2005年 | 202篇 |
2004年 | 180篇 |
2003年 | 158篇 |
2002年 | 147篇 |
2001年 | 68篇 |
2000年 | 74篇 |
1999年 | 54篇 |
1998年 | 19篇 |
1997年 | 17篇 |
1996年 | 23篇 |
1995年 | 17篇 |
1994年 | 19篇 |
1993年 | 15篇 |
1992年 | 54篇 |
1991年 | 50篇 |
1990年 | 47篇 |
1989年 | 49篇 |
1988年 | 29篇 |
1987年 | 29篇 |
1986年 | 33篇 |
1985年 | 30篇 |
1984年 | 25篇 |
1983年 | 14篇 |
1982年 | 12篇 |
1981年 | 9篇 |
1979年 | 20篇 |
1978年 | 11篇 |
1976年 | 10篇 |
1974年 | 10篇 |
1973年 | 12篇 |
1971年 | 11篇 |
1970年 | 9篇 |
Objectives
Iatrogenic injury of the Profunda Femoris Artery (PFA) at time of hip fixation surgery can increase morbidity and mortality and prolong the hospital stay. This is an injury that tends to pass unnoticed as a cause of postoperative deterioration despite being frequently reported in the literature. Our study aims to describe the anatomy of the PFA in relation to the medial femoral cortex with specific emphasis on its orientation relative to the position of a sliding hip screw side plate construct. By doing so we are able to present clear guidance to orthopaedic surgeons on how to avoid iatrogenic PFA injury at the time of hip fracture fixation.Methods
Using Computed Tomography Angiographic (CTA) studies, the course of the PFA in relation to the medial femoral cortex was traced in 44 patients (28 males and 16 females) with mean age of 65.6 years. Coronal and axial CT sections were cross-linked to specify the position of the PFA at 1?cm intervals.Results
The course of the artery could be divided into three parts relative to a fixed reference point. Proximal and distal parts of the artery were in a safer position in comparison to the middle part of the artery that was found very close to the femoral cortex and along the coronal axis of the femur (mean angle 2.9° from the femoral coronal axis and 13.8?mm from the medial femoral cortex). Using the commercially available side plate constructs, this part of the artery corresponded to the distal part of the plate (third and fourth holes).Conclusion
Special attention needs to be practiced by the operating surgeon while drilling into the third and fourth holes of the side plate. 相似文献Background
The randomized EXCEL (Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial reported a similar rate of the 3-year composite primary endpoint of death, myocardial infarction (MI), or stroke in patients with left main coronary artery disease (LMCAD) and site-assessed low or intermediate SYNTAX scores treated with percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). Whether these results are consistent in high-risk patients with diabetes, who have fared relatively better with CABG in most prior trials, is unknown.Objectives
In this pre-specified subgroup analysis from the EXCEL trial, the authors sought to examine the effect of diabetes in patients with LMCAD treated with PCI versus CABG.Methods
Patients (N = 1,905) with LMCAD and site-assessed low or intermediate CAD complexity (SYNTAX scores ≤32) were randomized 1:1 to PCI with everolimus-eluting stents versus CABG, stratified by the presence of diabetes. The primary endpoint was the rate of a composite of all-cause death, stroke, or MI at 3 years. Outcomes were examined in patients with (n = 554) and without (n = 1,350) diabetes.Results
The 3-year composite primary endpoint was significantly higher in diabetic compared with nondiabetic patients (20.0% vs. 12.9%; p < 0.001). The rate of the 3-year primary endpoint was similar after treatment with PCI and CABG in diabetic patients (20.7% vs. 19.3%, respectively; hazard ratio: 1.03; 95% confidence interval: 0.71 to 1.50; p = 0.87) and nondiabetic patients (12.9% vs. 12.9%, respectively; hazard ratio: 0.98; 95% confidence interval: 0.73 to 1.32; p = 0.89). All-cause death at 3 years occurred in 13.6% of PCI and 9.0% of CABG patients (p = 0.046), although no significant interaction was present between diabetes status and treatment for all-cause death (p = 0.22) or other endpoints, including the 3-year primary endpoint (p = 0.82) or the major secondary endpoints of death, MI, or stroke at 30 days (p = 0.61) or death, MI, stroke, or ischemia-driven revascularization at 3 years (p = 0.65).Conclusions
In the EXCEL trial, the relative 30-day and 3-year outcomes of PCI with everolimus-eluting stents versus CABG were consistent in diabetic and nondiabetic patients with LMCAD and site-assessed low or intermediate SYNTAX scores.(Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization [EXCEL]; NCT01205776) 相似文献Weight regain (WR) and insufficient weight loss (IWL) after sleeve gastrectomy (SG) are challenging issues. This study aimed to evaluate the predictors of WR and IWL after SG.
MethodsIn this retrospective analytical study, 568 patients who underwent SG at Hazrat-e Rasool General Hospital, Tehran, Iran, between January 2015 and April 2022 were evaluated. A total of 333 patients were included. WR and IWL were evaluated by multiple criteria such as a BMI of > 35 kg/m2, an increase in BMI of > 5 kg/m2 above nadir, an increase in weight of > 10 kg above nadir, percentage of excess weight loss (%EWL) < 50% at 18 months, an increase in weight of > 25% of EWL from nadir at 36 months, and percentage of total weight loss (%TWL) < 20% at 36 months. All participants were followed up for 36 months.
ResultThe univariate analysis showed that preoperative BMI, obstructive sleep apnea, metformin consumption, and grades 2 and 3 fatty liver disease were associated with WR and IWL (P < 0.05). WR or IWL incidence varied (0–19.3%) based on different definitions. The multivariate analysis showed that a preoperative BMI of > 45 kg/m2 [odds ratioAdjusted (ORAdj) 1.77, 95% CI: 1.12–4.11, P = 0.038] and metformin consumption [ORAdj: 0.48, 95% CI: 0.19–0.78, P = 0.001] were associated with WR and IWL after SG, regardless of the definition of WR or IWL.
ConclusionThis study showed that preoperative BMI of > 45 kg/m2, obstructive sleep apnea, metformin consumption, and grades 2 and 3 of fatty liver disease were associated with WR or IWL.
Graphical abstract 相似文献