全文获取类型
收费全文 | 33338篇 |
免费 | 2191篇 |
国内免费 | 202篇 |
专业分类
耳鼻咽喉 | 316篇 |
儿科学 | 561篇 |
妇产科学 | 448篇 |
基础医学 | 4654篇 |
口腔科学 | 887篇 |
临床医学 | 3448篇 |
内科学 | 7109篇 |
皮肤病学 | 688篇 |
神经病学 | 3707篇 |
特种医学 | 1953篇 |
外科学 | 5302篇 |
综合类 | 184篇 |
一般理论 | 7篇 |
预防医学 | 1417篇 |
眼科学 | 686篇 |
药学 | 1956篇 |
中国医学 | 68篇 |
肿瘤学 | 2340篇 |
出版年
2024年 | 28篇 |
2023年 | 268篇 |
2022年 | 515篇 |
2021年 | 886篇 |
2020年 | 626篇 |
2019年 | 812篇 |
2018年 | 931篇 |
2017年 | 799篇 |
2016年 | 926篇 |
2015年 | 1130篇 |
2014年 | 1359篇 |
2013年 | 1646篇 |
2012年 | 2684篇 |
2011年 | 2789篇 |
2010年 | 1674篇 |
2009年 | 1494篇 |
2008年 | 2381篇 |
2007年 | 2381篇 |
2006年 | 2229篇 |
2005年 | 2178篇 |
2004年 | 1971篇 |
2003年 | 1789篇 |
2002年 | 1650篇 |
2001年 | 286篇 |
2000年 | 199篇 |
1999年 | 266篇 |
1998年 | 312篇 |
1997年 | 234篇 |
1996年 | 184篇 |
1995年 | 159篇 |
1994年 | 129篇 |
1993年 | 122篇 |
1992年 | 71篇 |
1991年 | 59篇 |
1990年 | 57篇 |
1989年 | 37篇 |
1988年 | 37篇 |
1987年 | 29篇 |
1986年 | 29篇 |
1985年 | 26篇 |
1984年 | 45篇 |
1983年 | 32篇 |
1982年 | 33篇 |
1981年 | 27篇 |
1980年 | 17篇 |
1978年 | 12篇 |
1977年 | 12篇 |
1974年 | 10篇 |
1931年 | 7篇 |
1927年 | 8篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
991.
Roland Ladurner Inga Drosse Costanza Chiapponi Dominik Bürklein Volkmar Jansson Andreas Kokott Bettina Hoffmann Günter Ziegler Wolf Mustchler Thomas Mussack Matthias Schieker 《Surgical endoscopy》2013,27(6):1991-1996
Background
In this study, we evaluate a new bioadhesive for intra-abdominal onlay mesh fixation of a polypropylene–polyvinylchloride graft.Methods
Three pieces of a commercially available polypropylene/polyvinylfluoride mesh, each 3 × 3 cm in size, and three pieces of the same mesh coated with a polysaccharide bioadhesive were fixated to the surface of the anterior abdominal wall of 30 New Zealand white rabbits. The fixation was performed either by using four transabdominal Prolene® 4/0 sutures, four spiral tacks (Protack 5 mm Tyco), or cyanoacrylate glue (Glubran® GEM, Viareggio, Italy). Each mesh position and the according kind of fixation were randomized before implantation. The animals were sacrificed 12 weeks postoperatively. After determining the extent of intra-abdominal adhesions, the meshes were excised en bloc with the anterior abdominal wall for tensile strength measurements and histological analysis.Results
All meshes coated with the bioadhesive adhered to the intact peritoneum without extra fixation. Irrespective of the fixation technique coated meshes led to more and stronger adhesions. Mesh shrinkage by scarring was increased in coated meshes fixed with glue and low in uncoated meshes fixed with tacks. Testing the tensile strength, coated meshes fixed with transfascial sutures achieved the best results (16.14 ± 6.1 N), whereas coated meshes fixed with glue showed the lowest strength (10.39 ± 4.81 N). The foreign body reaction was considerably more distinctive using coated mesh. The mesh ingrowth was not influenced by this reaction.Conclusions
All meshes coated with the new bioadhesive were self-adhesive in that way; they stayed in position when attached to the peritoneum. Although this may facilitate intra-operative mesh fixation, the bioadhesive displayed several disadvantages, such as stronger adhesions and an increased shrinkage of the implant. The tensile strength was not influenced by the use of the bioadhesive. At present, we see no major advantage for polysaccharide bioadhesive applied in this study. 相似文献992.
The authors are grateful for the interesting perspectives given by Buchs and colleagues in their letter to the editor entitled “3D Laparoscopy: A Step Toward Advanced Surgical Navigation.” Shutter-based 3D video systems failed to become established in the operating room in the late 1990s. To strengthen the starting conditions of the new 3D technology using better monitors and high definition, the authors give suggestions for its practical use in the clinical routine. But first they list the characteristics of single-channeled and bichanneled 3D laparoscopes and describe stereoscopic terms such as “comfort zone,” “stereoscopic window,” and “near-point distance.” The authors believe it would be helpful to have the 3D pioneers assemble and share their experiences with these suggestions. Although this letter discusses “laparoscopy,” it would also be interesting to collect experiences from other surgical disciplines, especially when one is considering whether to opt for bi- or single-channeled optics. 相似文献
993.
Stephan Vogt Arne J. Venjakob Klaus Stöckl Thomas Tischer Philipp J. Jost Andreas B. Imhoff Eckart Thein Hermann Anetzberger 《Archives of orthopaedic and trauma surgery》2013,133(9):1233-1241
Background
Blood flow in various organs is determined by an autoregulatory mechanism that guarantees constant organ perfusion over a wide range of arterial blood pressure changes. This physiological principle has been proven for the kidney, brain and intestinal tract, but so far not for bone. This study was carried out to determine whether there is an autoregulatory mechanism of bone or not.Methods
The fluorescent microsphere reference sample method was used to determine blood flow within the bone and kidneys. Eight anesthetized female New Zealand rabbits received left ventricular injections of fluorescent microspheres over a wide range of arterial pressure levels prior to removal of kidney, femur and tibia. Blood flow values were calculated by measurement of fluorescence intensity in kidney and bone and correlated to fluorescence intensity in the peripheral blood (reference sample).Results
Despite a reduction of mean arterial pressure from 100 to 80 mmHg bone blood flow remained constant. Further reduction of mean arterial pressure results in a linear decrease in bone blood flow.Conclusion
The correlation between arterial pressure and organ perfusion in the bone is similar to blood flow within the kidney, indicating the presence of an autoregulated blood flow mechanism within the bone tissue. 相似文献994.
Anke M. J. Kuijpers MD Boj Mirck MD Arend G. J. Aalbers MD Simon W. Nienhuijs MD PhD Ignace H. J. T. de Hingh MD PhD Martinus J. Wiezer MD PhD Bert van Ramshorst MD PhD Robert J. van Ginkel MD PhD Klaas Havenga MD PhD Andreas J. Bremers MD PhD Johannes H. W. de Wilt MD PhD Elisabeth A. te Velde MD PhD Vic J. Verwaal MD PhD 《Annals of surgical oncology》2013,20(13):4224-4230
Purpose
This nationwide study evaluated results of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastasis of colorectal origin in the Netherlands following a national protocol.Methods
In a multi-institutional study prospective databases of patients with peritoneal carcinomatosis (PC) from colorectal cancer and pseudomyxoma peritonei (PMP) treated according to the Dutch HIPEC protocol, a uniform approach for the CRS and HIPEC treatment, were reviewed. Primary end point was overall survival and secondary end points were surgical outcome and progression-free survival.Results
Nine-hundred sixty patients were included; 660 patients (69 %) were affected by PC of colorectal carcinoma and the remaining suffered from PMP (31 %). In 767 procedures (80 %), macroscopic complete cytoreduction was achieved. Three-hundred and thirty one patients had grade III–V complications (34 %). Thirty-two patients died perioperatively (3 %). Median length of hospital stay was 16 days (range 0–166 days). Median follow-up period was 41 months (95 % confidence interval (CI), 36–46 months). Median progression-free survival was 15 months (95 % CI 13–17 months) for CRC patients and 53 months (95 % CI 40–66 months) for PMP patients. Overall median survival was 33 (95 % CI 28–38 months) months for CRC patients and 130 months (95 % CI 98–162 months) for PMP patients. Three- and five-year survival rates were 46 and 31 % respectively in case of CRC patients and 77 and 65 % respectively in case of PMP patients.Conclusions
The results underline the safety and efficacy of cytoreduction and HIPEC for PC from CRC and PMP. It is assumed the uniform Dutch HIPEC protocol was beneficial. 相似文献995.
996.
997.
Verena I. Seliger David Rodman Fredrick Van Goor Andreas Schmelz Peter Mueller 《Journal of cystic fibrosis》2013,12(6):706-713
BackgroundIvacaftor, a cystic fibrosis transmembrane regulator (CFTR) potentiator, decreased sweat chloride concentrations and improved clinical measures in cystic fibrosis (CF) patients with the G551D mutation.ResultsSweat chloride measurements at day 15 had an overall positive predictive value (PPV) of 86.3%, a negative predictive value (NPV) of 65.5%, sensitivity of 73.9%, and specificity of 80.9% for an FEV1 improvement of ≥ 5% from baseline at week 16. For ivacaftor patients the median FEV1 improvement was 16.7%; for placebo patients 0.4%. For patients aged 6–11 years who received ivacaftor and who had a sweat chloride decrease of ≥ 40 mmol/L from baseline at day 15, a median weight gain of 11.2% at week 16, compared to 6% for those with a smaller decrease was observed.ConclusionsChanges in sweat chloride concentration at day 15 following treatment with ivacaftor may have sufficient predictive potential to identify individuals that show improvement in pulmonary function and weight gain after 16 weeks of treatment. 相似文献
998.
Michael Untch Bernd Gerber Nadia Harbeck Christian Jackisch Norbert Marschner Volker M?bus Gunter von Minckwitz Sibylle Loibl Matthias W. Beckmann Jens-Uwe Blohmer Serban-Dan Costa Thomas Decker Ingo Diel Thomas Dimpfl Wolfgang Eiermann Tanja Fehm Klaus Friese Fritz J?nicke Wolfgang Janni Walter Jonat Marion Kiechle Uwe K?hler Hans-Joachim Lück Nicolai Maass Kurt Possinger Achim Rody Anton Scharl Andreas Schneeweiss Christoph Thomssen Diethelm Wallwiener Anja Welt 《Breast care (Basel, Switzerland)》2013,8(3):221-229
Zusammenfassung
Alle zwei Jahre findet in St. Gallen (Schweiz) die internationale Konsensuskonferenz zur Behandlung des primären Mammakarzinoms statt. Da sich das internationale Panel in St. Gallen aus Experten unterschiedlicher Länder zusammensetzt, spiegelt der Konsensus ein internationales Meinungsbild wider. Vor diesem Hintergrund erscheint es aus deutscher Sicht sinnvoll, die Abstimmungsergebnisse für den Therapiealltag in Deutschland zu konkretisieren. Eine deutsche Arbeitsgruppe mit acht Brustkrebsexperten, von denen zwei Mitglieder des internationalen St. Gallen-Panels sind, hat daher die Abstimmungsergebnisse der St. Gallen-Konsensuskonferenz (2013) für den Klinikalltag in Deutschland kommentiert. Inhaltliche Schwerpunkte der diesjährigen St. Gallen-Konferenz waren operative Fragestellungen der Brust und der Axilla, strahlentherapeutische und systemische Therapieoptionen sowie die klinische Relevanz der Tumorbiologie. Intensiv diskutiert wurde der klinische Einsatz von Multigen-Assays, inkl. ihrer Bedeutung für die individuelle Therapieentscheidung. 相似文献999.
Giuseppe Zimmitti Robert E. Roses Andreas Andreou Junichi Shindoh Steven A. Curley Thomas A. Aloia Jean-Nicolas Vauthey 《Journal of gastrointestinal surgery》2013,17(1):57-65
Background
Advances in technique, technology, and perioperative care have allowed for the more frequent performance of complex and extended hepatic resections. The purpose of this study was to determine if this increasing complexity has been accompanied by a rise in liver-related complications.Methods
A large prospective single-institution database of patients who underwent hepatic resection was used to identify the incidence of liver-related complications. Liver resections were divided into an early era and a late era with equal number of patients (surgery performed before or after 18 May 2006). Patient characteristics and perioperative factors were compared between the two groups.Results
Between 1997 and 2011, 2,628 hepatic resections were performed, with a 90-day morbidity and mortality rate of 37 and 2 %, respectively. We identified higher rates of repeat hepatectomy (12.2 vs 6.1 %; p?<?0.001), two-stage resection (4.0 vs 1 %; p?<?0.001), extended right hepatectomy (17.6 vs 14.6 %; p?=?0.04), and preoperative portal vein embolization (9.1 vs 5.9 %; p?<?0.001) in the late era. The incidence of perihepatic abscess (3.7 vs 2.1 %; p?=?0.02) and hemorrhage (0.9 vs 0.3 %; p?=?0.045) decreased in the late era and the incidence of hepatic insufficiency (3.1 vs 2.6 %; p?=?0.41) remained stable. In contrast, the rate of bile leak increased (5.9 vs 3.7 %; p?=?0.011). Independent predictors of bile leak included bile duct resection, extended hepatectomy, repeat hepatectomy, en bloc diaphragmatic resection, and intraoperative transfusion.Conclusions
The complexity of liver surgery has increased over time, with a concomitant increase in bile leak rate. Given the strong association between bile leak and other poor outcomes, the development of novel technical strategies to reduce bile leaks is indicated. 相似文献1000.