收费全文 | 18821篇 |
免费 | 1194篇 |
国内免费 | 83篇 |
耳鼻咽喉 | 90篇 |
儿科学 | 742篇 |
妇产科学 | 451篇 |
基础医学 | 2494篇 |
口腔科学 | 287篇 |
临床医学 | 1676篇 |
内科学 | 4100篇 |
皮肤病学 | 456篇 |
神经病学 | 1986篇 |
特种医学 | 578篇 |
外科学 | 2224篇 |
综合类 | 91篇 |
一般理论 | 16篇 |
预防医学 | 1389篇 |
眼科学 | 313篇 |
药学 | 1317篇 |
中国医学 | 30篇 |
肿瘤学 | 1858篇 |
2023年 | 191篇 |
2022年 | 150篇 |
2021年 | 510篇 |
2020年 | 377篇 |
2019年 | 523篇 |
2018年 | 688篇 |
2017年 | 540篇 |
2016年 | 539篇 |
2015年 | 657篇 |
2014年 | 810篇 |
2013年 | 1079篇 |
2012年 | 1516篇 |
2011年 | 1356篇 |
2010年 | 859篇 |
2009年 | 718篇 |
2008年 | 1195篇 |
2007年 | 1171篇 |
2006年 | 1105篇 |
2005年 | 1034篇 |
2004年 | 982篇 |
2003年 | 895篇 |
2002年 | 730篇 |
2001年 | 169篇 |
2000年 | 131篇 |
1999年 | 189篇 |
1998年 | 125篇 |
1997年 | 91篇 |
1996年 | 75篇 |
1995年 | 81篇 |
1994年 | 70篇 |
1993年 | 69篇 |
1992年 | 162篇 |
1991年 | 155篇 |
1990年 | 117篇 |
1989年 | 104篇 |
1988年 | 107篇 |
1987年 | 96篇 |
1986年 | 91篇 |
1985年 | 90篇 |
1984年 | 67篇 |
1983年 | 51篇 |
1982年 | 29篇 |
1980年 | 33篇 |
1979年 | 55篇 |
1978年 | 33篇 |
1977年 | 22篇 |
1976年 | 23篇 |
1973年 | 32篇 |
1971年 | 22篇 |
1967年 | 21篇 |
Background
In the emergency department, rib fractures are a common finding in patients who sustain chest trauma. Rib fractures may be a sign of significant, underlying pathology, especially in the elderly patients where rib fractures are associated with significant morbidity and mortality. To date, no studies have evaluated the ability of ultrasound to detect rib fractures using cadaver models and subsequently use this model as a teaching tool.Objectives
The purpose of this study was to determine if it is possible to generate rib fractures on cadaver models which could be accurately identified using ultrasound.Methods
This was a cross-sectional study performed during one session at a cadaver lab. A single hemithorax from four adult cadavers were used as models. Single rib fractures on each of rib five through eight were created. Four subjects, blinded to the normal versus fractured ribs, were asked to identify the presence of a fracture on each rib.Results
A total of 8 of 16 potential ribs had fractured induced by study staff. Mean accuracy was 55% for all subjects. The overall sensitivity and specificity for detecting rib fractures was 50% (CI: 31.89–68.11) and 59.38% (CI: 35.69–73.55) respectively. The overall PPV and NPV was 55.17% and 54.29% respectively.Conclusions
In this pilot study, subjects were not able to detect induced rib fractures using ultrasound on cadaver models. The use of this model as a teaching tool in the detection of rib fractures requires further investigation. 相似文献XR-hysterosalpingography currently represents the gold standard for tubal pathology evaluation. Magnetic resonance-HSG is an innovative technique. With our study, we aim to comprehend if and how MR-HSG, compared to traditional XR-HSG, could give us this additional information in the diagnostic/therapeutic process.
Materials and methodsThis study included 19 patients between 30 and 42 years old (average age 37.7) affected by infertility. Patients underwent contextually both XR-HSG and MR-HSG, using a single catheterization. The dynamic MR-HSG exam consisted a MR sequence during contrast administration through the cervical catheter.
ResultsBoth XR-HSG and MR-HSG documented that 15 of the 19 patients had bilateral tubal patency, while four patients had monolateral tubal patency. However, MR-HSG allowed us to diagnose additional findings:
-
Two active endometriosis foci in adnexal localization and a condition of adenomyosis
-
A unicornuate uterus malformation
-
A submucous uterine myoma near the tubal ostium
-
A decrease of the ovarian reserve in a patient
So MR-HSG could potentially detect in 10/19 (52%) women the cause of their infertility, compared to 4/19 (21%) detected with XR-HSG and about 30% of women would have resulted as false negatives if we only used XR-HSG.
Finally, with a questionnaire, we demonstrated that MR-HSG is less painful than XR-HSG.
ConclusionsThese data thus confirm that XR-HSG and MR-HSG present the same diagnostic of assessing tubal patency. We also demonstrated that MR-HSG is able to detect further collateral findings that could likewise be a possible therapeutic target and it could possibly become the new gold standard in female infertility diagnostics.
相似文献