全文获取类型
| 收费全文 | 1177319篇 |
| 免费 | 75781篇 |
| 国内免费 | 3045篇 |
专业分类
| 耳鼻咽喉 | 16104篇 |
| 儿科学 | 36981篇 |
| 妇产科学 | 32482篇 |
| 基础医学 | 165406篇 |
| 口腔科学 | 35407篇 |
| 临床医学 | 93710篇 |
| 内科学 | 242612篇 |
| 皮肤病学 | 26243篇 |
| 神经病学 | 94675篇 |
| 特种医学 | 44269篇 |
| 外国民族医学 | 361篇 |
| 外科学 | 174602篇 |
| 综合类 | 20962篇 |
| 现状与发展 | 1篇 |
| 一般理论 | 334篇 |
| 预防医学 | 96494篇 |
| 眼科学 | 26616篇 |
| 药学 | 83483篇 |
| 19篇 | |
| 中国医学 | 2885篇 |
| 肿瘤学 | 62499篇 |
出版年
| 2021年 | 11437篇 |
| 2019年 | 11730篇 |
| 2018年 | 17305篇 |
| 2017年 | 12734篇 |
| 2016年 | 13172篇 |
| 2015年 | 14894篇 |
| 2014年 | 20271篇 |
| 2013年 | 29798篇 |
| 2012年 | 43075篇 |
| 2011年 | 45384篇 |
| 2010年 | 25797篇 |
| 2009年 | 23417篇 |
| 2008年 | 40384篇 |
| 2007年 | 43035篇 |
| 2006年 | 42276篇 |
| 2005年 | 41815篇 |
| 2004年 | 39785篇 |
| 2003年 | 37882篇 |
| 2002年 | 35587篇 |
| 2001年 | 48577篇 |
| 2000年 | 50050篇 |
| 1999年 | 42433篇 |
| 1998年 | 11827篇 |
| 1997年 | 10525篇 |
| 1996年 | 10491篇 |
| 1995年 | 9623篇 |
| 1994年 | 9221篇 |
| 1992年 | 31911篇 |
| 1991年 | 30489篇 |
| 1990年 | 29761篇 |
| 1989年 | 28546篇 |
| 1988年 | 26527篇 |
| 1987年 | 25892篇 |
| 1986年 | 24943篇 |
| 1985年 | 23690篇 |
| 1984年 | 17658篇 |
| 1983年 | 15044篇 |
| 1982年 | 8930篇 |
| 1979年 | 16408篇 |
| 1978年 | 11393篇 |
| 1977年 | 9724篇 |
| 1976年 | 9148篇 |
| 1975年 | 10212篇 |
| 1974年 | 12147篇 |
| 1973年 | 11686篇 |
| 1972年 | 11072篇 |
| 1971年 | 10242篇 |
| 1970年 | 9888篇 |
| 1969年 | 9349篇 |
| 1968年 | 9033篇 |
排序方式： 共有10000条查询结果，搜索用时 15 毫秒
1.
A. D. Kane J. Soar R. A. Armstrong E. Kursumovic M. T. Davies F. C. Oglesby L. Cortes C. Taylor I. K. Moppett S. Agarwal J. Cordingley J. Dorey S. J. Finney G. Kunst D. N. Lucas G. Nickols R. Mouton J. P. Nolan B. Patel V. J. Pappachan F. Plaat B. R. Scholefield J. H. Smith L. Varney T. M. Cook collaborators 《Anaesthesia》2023,78(6):701-711
Detailed contemporary knowledge of the characteristics of the surgical population, national anaesthetic workload, anaesthetic techniques and behaviours are essential to monitor productivity, inform policy and direct research themes. Every 3–4 years, the Royal College of Anaesthetists, as part of its National Audit Projects (NAP), performs a snapshot activity survey in all UK hospitals delivering anaesthesia, collecting patient-level encounter data from all cases under the care of an anaesthetist. During November 2021, as part of NAP7, anaesthetists recorded details of all cases undertaken over 4 days at their site through an online survey capturing anonymous patient characteristics and anaesthetic details. Of 416 hospital sites invited to participate, 352 (85%) completed the activity survey. From these, 24,177 reports were returned, of which 24,172 (99%) were included in the final dataset. The work patterns by day of the week, time of day and surgical specialty were similar to previous NAP activity surveys. However, in non-obstetric patients, between NAP5 (2013) and NAP7 (2021) activity surveys, the estimated median age of patients increased by 2.3 years from median (IQR) of 50.5 (28.4–69.1) to 52.8 (32.1–69.2) years. The median (IQR) BMI increased from 24.9 (21.5–29.5) to 26.7 (22.3–31.7) kg.m–2. The proportion of patients who scored as ASA physical status 1 decreased from 37% in NAP5 to 24% in NAP7. The use of total intravenous anaesthesia increased from 8% of general anaesthesia cases to 26% between NAP5 and NAP7. Some changes may reflect the impact of the COVID-19 pandemic on the anaesthetic population, though patients with confirmed COVID-19 accounted for only 149 (1%) cases. These data show a rising burden of age, obesity and comorbidity in patients requiring anaesthesia care, likely to impact UK peri-operative services significantly. 相似文献
2.
M.S. Iqbal G. Vashisht R. McMenemin P. Atherton F. McDonald T. Simmons A. Bradshaw J. Kovarik H. Turnbull L. Dodd P. Mulvenna A. Greystoke 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(2):e1-e10
Aims
Concomitant chemoradiation is the standard of care in patients with inoperable non-small cell lung cancer. The purpose of this study was to analyse the survival outcome and toxicity data of using hypofractionated chemoradiation.Materials and methods
One hundred patients were treated from June 2011 to November 2016. Treatment consisted of 55 Gy in 20 daily fractions concurrently with split-dose cisplatin vinorelbine chemotherapy over 4 weeks followed by two cycles of cisplatin vinorelbine only. Survival was estimated using Kaplan–Meier and Cox regression was carried out for known prognostic factors. A systematic search of literature was conducted using Medline, Embase and Cochrane databases and relevant references included.Results
In total, 97% of patients completed radiotherapy and 73% of patients completed all four cycles of chemotherapy. One patient died of a cardiac event during consolidative chemotherapy. There were two cases of grade 4 toxicities (one sepsis, one renal impairment). Grade 3 toxicities included nausea/vomiting (17%), oesophagitis (15%), infection with neutropenia (12%) and pneumonitis (4%). Clinical benefit was seen in 86%. Two-year progression-free survival and overall survival rates were 49% and 58%, respectively. The median progression-free survival and overall survival were 23.4 and 43.4 months, respectively. The only significant prognostic factor was the number of chemotherapy cycles received (P = 0.02). The systematic review identified 13 relevant studies; a variety of regimens were assessed with variable reporting of outcomes and toxicity but with overall an improvement in survival over time.Conclusion
Our experience compared with the original phase II trial showed improved treatment completion rates and survival with acceptable morbidity. With appropriate patient selection this regimen is an effective treatment option for locally advanced non-small cell lung cancer. This study helps to benchmark efficacy and toxicity rates while considering the addition of new agents to hypofractionated concurrent chemoradiotherapy. The agreement of a standard regimen for assessment in future trials would be beneficial. 相似文献3.
Elizabeth Farfán-Santos 《Medical anthropology》2019,38(6):523-536
ABSTRACTUndocumented Mexican immigrants have had to regularly confront a prohibiting health care system despite alienation, marginalization, and the threat of deportation. In this article, I explore the impact of political exclusion and alienating discourses on the health habitus of undocumented Mexican mothers through the narrative of one mother, Marta Garza, who finds herself at the painful intersection of political and medical alienation. Marta’s narrative reflects an analytical framework that centers undocumented motherhood as a space of necessary resilience and strain, wherein she is forced to advocate for her children’s health despite prohibitive barriers and dangerous potential consequences. 相似文献
4.
Milan Milojevic Patrick W. Serruys Joseph F. Sabik David E. Kandzari Erick Schampaert Ad J. van Boven Ferenc Horkay Imre Ungi Samer Mansour Adrian P. Banning David P. Taggart Manel Sabaté Anthony H. Gershlick Andrzej Bochenek Jose Pomar Nicholas J. Lembo Nicolas Noiseux John D. Puskas Arie Pieter Kappetein 《Journal of the American College of Cardiology》2019,73(13):1616-1628
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5.
N. Shor R. Deschamps A. Cobo Calvo E. Maillart H. Zephir J. Ciron C. Papeix F. Durand-Dubief A. Ruet X. Ayrignac M. Cohen K. Deiva D. Laplaud B. Bourre B. Audoin N. Collongues S. Vukusic F. Cotton R. Marignier 《Revue neurologique》2021,177(1-2):39-50
Our knowledge of the radiological spectrum of myelin oligodendrocyte glycoprotein antibody associated disease (MOGAD) is growing rapidly. An update on the radiological features of the disease, and its evolution is thus necessary. Magnetic resonance imaging (MRI) has an increasingly important role in the differential diagnosis of MOGAD particularly from aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (AQP4-NMOSD), and multiple sclerosis (MS). Differentiating these conditions is of prime importance because the management is different between the three inflammatory diseases, and thus could prevent further attack-related disability. Therefore, identifying the MRI features suggestive of MOGAD has diagnostic and prognostic implications. We herein review optic nerve, spinal cord and the brain MRI findings from MOGAD adult patients, and compare them to AQP4-NMOSD and MS. 相似文献
6.
7.
8.
Peet J. van der Vyver Farzana Paleker Martin Vorster Francois A. de Wet 《Journal of endodontics》2019,45(1):62-67
Introduction
The aim of this study was to evaluate the root canal shaping effect of instruments manufactured from nickel titanium, M-Wire, and Gold wire with different glide path preparation techniques.Methods
One hundred thirty-five mesiobuccal canals of extracted human maxillary molars were randomly divided into 3 equal groups (N = 45) for glide path preparation with K-files (KF) (Dentsply Sirona, Ballaigues, Switzerland), One G (OG) files (Micro-Mega, Besançon, France), and ProGlider (PG) files (Dentsply Sirona). Specimens of each glide path group were further divided equally into 3 groups for instrumentation with ProTaper Next (PTN, Dentsply Sirona), One Shape (OS, Micro-Mega), and WaveOne Gold (WOG, Dentsply Sirona) systems (n = 15). Micro–computed tomographic imaging was used to scan teeth before instrumentation and after shaping to compare centering ratio and canal transportation values at the apical, midroot, and coronal levels and the overall changes in canal volume. Data sets were statistically analyzed (analysis of variance and Kruskal-Wallis H tests).Results
The centering ratios for all groups were statistically similar at all levels. Apical canal transportation was significantly high for K/OS and K/PTN (P = .003). Midroot canal transportation was significantly high for K/PTN, K/OS, and OG/OS (P = .0003). Coronal canal transportation was significantly high for K/PTN and K/OS (P = .011). The highest change in canal volume was observed with all PTN groups and the lowest with PG/WOG (P = .06).Conclusions
WOG manufactured from Gold wire combined with PG showed better root canal shaping ability and removed less dentin from the canal walls. The nickel-titanium (OS) and M-Wire (PTN) instruments used in combination with KF significantly transported more canals. PTN removed the most dentin from the canal walls regardless of the GPP technique. 相似文献9.
Arne de Niet Michel M.P.J. Reijnen Clark J. Zeebregts 《Journal of vascular surgery》2019,69(2):348-356
Objective
The objective of this study was to investigate the feasibility of a specific custom-made fenestrated aortic cuff in the treatment of complex abdominal aortic aneurysms (AAAs).Methods
Between 2013 and 2016, a total of 57 custom-made Fenestrated Anaconda (Vascutek, Inchinnan, Scotland, UK) aortic cuffs were placed in 38 centers worldwide. All centers were invited to participate in this retrospective analysis. Postoperative and follow-up data included the presence of adverse events, necessity for reintervention, and renal function.Results
Fifteen clinics participated, leading to 29 cases. Median age at operation was 74 years (interquartile range [IQR], 71-78 years); five patients were female. Two patients were treated for a para-anastomotic AAA after open AAA repair, 19 patients were treated because of a complicated course after primary endovascular AAA repair, and 8 cases were primary procedures for AAA. A total of 76 fenestrations (mean, 2.6 per case) were used. Four patients needed seven adjunctive procedures. Two patients underwent conversion, one because of a dissection of the superior mesenteric artery and one because of perforation of a renal artery. Median operation time was 225 minutes (IQR, 150-260 minutes); median blood loss, 200 mL (IQR, 100-500 mL); and median contrast volume, 150 mL (IQR, 92-260 mL). Primary technical success was achieved in 86% and secondary technical success in 93%. The 30-day morbidity was 7 of 29 with a mortality rate of 4 of 29. Estimated glomerular filtration rate remained unchanged before and after surgery (76 to 77 mL/min/m2). Between preoperative and median follow-up of 11 months, estimated glomerular filtration rate was reduced statistically significantly (76 to 63 mL/min/m2). During follow-up, 9 cases had an increase in aneurysm sac diameter (5 cases >5 mm); 14 cases had a stable or decreased aneurysm sac diameter; and in 2 cases, no aneurysm size was reported. No type I endoleak was reported, and two cases with a type III endoleak were treated by endovascular means during follow-up. Survival, reintervention-free survival, and target vessel patency at 1 year were 81% ± 8%, 75% ± 9%, and 99% ± 1%, respectively. After 2 years, these numbers were 81% ± 8%, 67% ± 11%, and 88% ± 6%, respectively. During follow-up, the two patients with a type III endoleak needed endograft-related reinterventions.Conclusions
Treatment with this specific custom-made fenestrated aortic cuff is feasible after complicated previous (endovascular) aortic repair or in complex AAAs. The complexity of certain AAA cases is underlined in this study, and the Fenestrated Anaconda aortic cuff is a valid option in selected cases in which few treatment options are left. 相似文献10.
Andrea Garatti Andrea Daprati Marzia Cottini Claudio F. Russo Margherita Dalla Tomba Giovanni Troise Antonio Salsano Francesco Santini Roberto Scrofani Francesca Nicolò Elisa Mikus Alberto Albertini Luca Di Marco Davide Pacini Marco Picichè Loris Salvador Guglielmo M. Actis Dato Paolo Centofanti Lorenzo Menicanti 《The Annals of thoracic surgery》2021,111(4):1242-1251
- Download : Download high-res image (165KB)
- Download : Download full-size image