全文获取类型
收费全文 | 341289篇 |
免费 | 14261篇 |
国内免费 | 1186篇 |
专业分类
耳鼻咽喉 | 4133篇 |
儿科学 | 11210篇 |
妇产科学 | 8514篇 |
基础医学 | 44892篇 |
口腔科学 | 9149篇 |
临床医学 | 29336篇 |
内科学 | 66704篇 |
皮肤病学 | 7299篇 |
神经病学 | 25930篇 |
特种医学 | 16440篇 |
外国民族医学 | 103篇 |
外科学 | 51385篇 |
综合类 | 2955篇 |
现状与发展 | 2篇 |
一般理论 | 140篇 |
预防医学 | 26888篇 |
眼科学 | 7387篇 |
药学 | 23615篇 |
3篇 | |
中国医学 | 384篇 |
肿瘤学 | 20267篇 |
出版年
2021年 | 2898篇 |
2020年 | 2069篇 |
2019年 | 2864篇 |
2018年 | 6759篇 |
2017年 | 6372篇 |
2016年 | 6043篇 |
2015年 | 8110篇 |
2014年 | 9045篇 |
2013年 | 9930篇 |
2012年 | 19782篇 |
2011年 | 15469篇 |
2010年 | 8324篇 |
2009年 | 9647篇 |
2008年 | 11985篇 |
2007年 | 13363篇 |
2006年 | 13093篇 |
2005年 | 21221篇 |
2004年 | 22050篇 |
2003年 | 17264篇 |
2002年 | 12088篇 |
2001年 | 5760篇 |
2000年 | 2754篇 |
1999年 | 7372篇 |
1998年 | 2593篇 |
1997年 | 1894篇 |
1996年 | 1774篇 |
1992年 | 7627篇 |
1991年 | 7869篇 |
1990年 | 7939篇 |
1989年 | 7524篇 |
1988年 | 7013篇 |
1987年 | 6796篇 |
1986年 | 6453篇 |
1985年 | 5767篇 |
1984年 | 4221篇 |
1983年 | 3472篇 |
1979年 | 4189篇 |
1978年 | 2735篇 |
1977年 | 2184篇 |
1976年 | 1901篇 |
1975年 | 2766篇 |
1974年 | 3351篇 |
1973年 | 2959篇 |
1972年 | 2937篇 |
1971年 | 2877篇 |
1970年 | 2699篇 |
1969年 | 2556篇 |
1968年 | 2336篇 |
1967年 | 2239篇 |
1966年 | 1992篇 |
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
31.
Arthroscopic acromioclavicular joint excision is a commonly performed but technically demanding procedure. Incomplete excision can leave residual symptoms. We present a simple, reproducible technique ensuring satisfactory excision of the joint. 相似文献
32.
33.
Paul J. Devlin Brian W. McCrindle James K. Kirklin Eugene H. Blackstone William M. DeCampli Christopher A. Caldarone Ali Dodge-Khatami Pirooz Eghtesady James M. Meza Peter J. Gruber Kristine J. Guleserian Bahaaladin Alsoufi Linda M. Lambert James E. OBrien Erle H. Austin Jeffrey P. Jacobs Tara Karamlou 《The Journal of thoracic and cardiovascular surgery》2019,157(2):684-695.e8
Objective
Arch obstruction after the Norwood procedure is common and contributes to mortality. We determined the prevalence, associated factors, and practice variability of arch reintervention and assessed whether arch reintervention is associated with mortality.Methods
From 2005 to 2017, 593 neonates in the Congenital Heart Surgeons' Society Critical Left Heart Obstruction cohort underwent a Norwood procedure. Median follow-up was 3.7 years. Multivariable parametric models, including a modulated renewal analysis, were performed.Results
Of the 593 neonates, 146 (25%) underwent 218 reinterventions for arch obstruction after the Norwood procedure: catheter-based (n = 168) or surgical (n = 50) at a median age of 4.3 months (quartile 1-quartile 3, 2.6-5.7). Interdigitation of the distal aortic anastomosis was protective against arch reintervention. Development of ≥ moderate tricuspid valve regurgitation and right ventricular dysfunction at any point was associated with arch reintervention. Nonsignificant variables for arch reintervention included shunt type and preoperative aortic measurements. Surgical arch reintervention was protective against arch reintervention, but transcatheter reintervention was associated with increased reintervention. Arch reintervention was not associated with increased mortality. There was wide institutional variation in incidence of arch reintervention (range, 0-40 reinterventions per 100 years patient follow-up) and in preintervention gradient (range, 0-64 mm Hg).Conclusions
Interdigitation of the distal aortic anastomosis during the Norwood procedure decreased the risk of arch reintervention. Surgical arch reintervention is more definitive than transcatheter. Arch reintervention after the Norwood procedure is not associated with increased mortality. Serial surveillance for arch obstruction, integrated with changes in right ventricular function and tricuspid valve regurgitation, is recommended after the Norwood procedure to improve outcomes. 相似文献34.
35.
Anders Elm Pedersen Esben Gjerløff Wedebye Schmidt Jesper Freddie Sørensen Carsten Faber Boye Schnack Nielsen Kim Holmstrøm Silje Haukali Omland Peter Tougaard Søren Skov Bo Bang 《APMIS : acta pathologica, microbiologica, et immunologica Scandinavica》2015,123(7):547-555
TL1A is a TNF‐like cytokine which has been shown to co‐stimulate TH1 and TH17 responses during chronic inflammation. The expression of this novel cytokine has been investigated in inflammatory disorders like rheumatoid arthritis and inflammatory bowel disease, but little is known about expression and induction in psoriasis. Indeed, the pathogenesis in psoriasis is still not fully understood and it is speculated that cytokines other than TNF‐α are important in subsets of patients. Also, for patients with severe disease that are treated with systemic anti‐TNF‐α blockade, novel candidates to be used as disease and response biomarkers are of high interest. Here, we demonstrate TL1A expression in biopsies from psoriatic lesions. Also, we investigated spontaneous and induced TL1A secretion from PBMCs and blood levels from a cohort of psoriasis patients. Here, increased spontaneous secretion from PBMCs was observed as compared to healthy controls and a small subset of patients had highly elevated TL1A in the blood. Interestingly, activation of PBMCs with various cytokines showed a decreased sensitivity for TL1A activation in psoriasis patients compared to healthy controls.TL1A levels in blood and biopsies could not be correlated with disease activity with this patient cohort. Thus, additional large‐scale studies are warranted to investigate TL1A as a biomarker. 相似文献
36.
37.
Attachment is a behavioral and physiological system, which enables individual’s dynamic adaptation to its environment. Attachment develops in close interaction between an infant and his/her mother, plays an important role in the development of the infant’s brain, and influences the quality of interpersonal relationships throughout life.Security of attachment is believed to influence individual response to stress, exposing insecurely organized individuals to deregulated autonomic nervous system and exaggerated hypothalamic-pituitary-adrenal activity, which, in turn, produces increased and prolonged exposure to stress-hormones. Such stress responses may have considerable implications for the development of diverse health-risk conditions, such as insulin resistance and hyperlipidemia, shown by numerous studies.Although the mechanisms are not yet fully understood, there is compelling evidence highlighting the role of psychological stress in the development of type 1 diabetes (T1D). One of the possible contributing factors for the development of T1D may be the influence of attachment security on individual stress reactivity. Thus, the suggestion is that insecurely attached individuals are more prone to experience increased and prolonged influence of stress hormones and other mechanisms causing pancreatic beta-cell destruction.The present paper opens with a short overview of the field of attachment in children, the principal attachment classifications and their historic development, describes the influence of attachment security on individual stress-reactivity and the role of the latter in the development of T1D. Following is a review of recent literature on the attachment in patients with T1D with a conclusion of a proposed role of attachment organization in the etiology of T1D. 相似文献
38.
Torbj?rn Karlsson 《Upsala journal of medical sciences》2015,120(4):257-262
Background. Haemophagocytic lymphohistiocytosis (HLH) is a rare clinical syndrome characterized by fever, hepatosplenomegaly, cytopenia, and progressive multiple-organ failure. HLH in adults is often secondary to autoimmune diseases, cancer, or infections in contrast to familial HLH. Treatment of secondary HLH is directed against the triggering disease in addition to immunosuppressive therapy, the latter commonly according to the HLH-2004 protocol.Methods. We conducted a retrospective study to identify triggering diseases, disease-specific and immunosuppressive therapy administered, and prognosis in adult patients with secondary HLH. Patient data were collected from October 2010 to January 2015.Results. Ten adult patients with secondary HLH were identified. Seven were men, and the median age at diagnosis was 62 years. Five cases were triggered by malignant disease and five by infection. The median patient fulfilled five of the eight HLH-2004 diagnostic criteria. All patients fulfilled the criteria fever, cytopenia, and ferritin >500 µg/L. Median time from hospital admission to HLH diagnosis was 20 days. Four patients received immunosuppressive therapy according to the HLH-2004 protocol. The prognosis was dismal, especially for the patients with malignancy-associated HLH, of whom all died.Conclusion. HLH should be suspected in patients who present with fever, cytopenia, and ferritin >500 µg/L. Secondary HLH has a dismal prognosis. None of the patients with HLH triggered by malignancy survived. Achieving remission of the triggering disease seems to be important for a favourable outcome as, in all surviving patients, the haemophagocytic syndrome resolved after remission of the underlying infection. 相似文献
39.
40.
Accuracy and Precision of Acetabular Component Placement With Imageless Navigation in Obese Patients
Leonard T. Buller Alexander S. McLawhorn Jose A. Romero Peter K. Sculco David J. Mayman 《The Journal of arthroplasty》2019,34(4):693-699