全文获取类型
收费全文 | 1351篇 |
免费 | 109篇 |
国内免费 | 3篇 |
专业分类
耳鼻咽喉 | 7篇 |
儿科学 | 46篇 |
妇产科学 | 62篇 |
基础医学 | 203篇 |
口腔科学 | 4篇 |
临床医学 | 163篇 |
内科学 | 333篇 |
皮肤病学 | 7篇 |
神经病学 | 135篇 |
特种医学 | 40篇 |
外科学 | 226篇 |
综合类 | 10篇 |
预防医学 | 74篇 |
眼科学 | 10篇 |
药学 | 66篇 |
中国医学 | 7篇 |
肿瘤学 | 70篇 |
出版年
2023年 | 13篇 |
2022年 | 16篇 |
2021年 | 38篇 |
2020年 | 31篇 |
2019年 | 41篇 |
2018年 | 39篇 |
2017年 | 28篇 |
2016年 | 20篇 |
2015年 | 36篇 |
2014年 | 48篇 |
2013年 | 84篇 |
2012年 | 134篇 |
2011年 | 101篇 |
2010年 | 79篇 |
2009年 | 65篇 |
2008年 | 76篇 |
2007年 | 57篇 |
2006年 | 68篇 |
2005年 | 62篇 |
2004年 | 47篇 |
2003年 | 63篇 |
2002年 | 57篇 |
2001年 | 18篇 |
2000年 | 13篇 |
1999年 | 17篇 |
1998年 | 15篇 |
1997年 | 9篇 |
1996年 | 13篇 |
1995年 | 11篇 |
1994年 | 5篇 |
1993年 | 4篇 |
1992年 | 5篇 |
1990年 | 5篇 |
1986年 | 4篇 |
1985年 | 7篇 |
1984年 | 7篇 |
1983年 | 4篇 |
1982年 | 16篇 |
1981年 | 7篇 |
1980年 | 6篇 |
1979年 | 6篇 |
1978年 | 9篇 |
1977年 | 6篇 |
1976年 | 6篇 |
1975年 | 7篇 |
1974年 | 4篇 |
1973年 | 9篇 |
1971年 | 6篇 |
1970年 | 9篇 |
1967年 | 6篇 |
排序方式: 共有1463条查询结果,搜索用时 31 毫秒
41.
42.
43.
Antonio M. Lacy Cedric Adelsdorfer Salvadora Delgado Patricia Sylla David W. Rattner 《Surgical endoscopy》2013,27(1):339-346
Background
Natural orifice translumenal endoscopic surgery (NOTES) represents the evolution of surgery towards less invasive procedures. The feasibility of NOTES transrectal approach has increased its clinical applicability. This report describes a first series of minilaparoscopy-assisted transrectal low anterior resection with double purse-string end-to-end circular stapler anastomoses.Methods
Between March and April 2012 three selected patients underwent transrectal minilaparoscopy-assisted natural orifice surgery total mesorectal excision for rectal cancer. All the oncologic principles of open/laparoscopic low anterior resection for rectal cancer were strictly fulfilled. Two patients underwent neoadjuvant treatment. Laparoscopic visualization and assistance was provided through one 10-mm umbilical port and two ports, one of which was used as stoma site (5 mm) and the other as a drain site (2 mm needle port). The specimen was transected transanally followed by the confection of double purse-string lateral/end-to-end anastomoses. There were no intraoperative complications.Results
Mean operative time was 143 min. Oral intake was initiated on the second postoperative day. Patients were discharged home by day 5. The pathology unit confirmed that distal and circumferential margins were free of tumor invasion, and quality of mesorectum resection was reported satisfactory. One patient had to be readmitted because of severe dehydration due to increased ileostomy output. The patient was discharged at the third day after the readmission without renal failure.Conclusions
In this preliminary report, transrectal minilaparoscopy-assisted low anterior resection was feasible and safe. Lateral/end-to-end anastomoses can be considered an interesting alternative to the double-stapling technique. However, it is necessary to further study and develop these procedures, along with careful patient selection, before transrectal low anterior resection may be considered for routine clinical use. 相似文献44.
Tola B. Omotosho Fashokun Heidi S. Harvie Megan O. Schimpf Cedric K. Olivera Lee B. Epstein Marjorie Jean-Michel Kristin E. Rooney Sunil Balgobin Okechukwu A. Ibeanu Rajiv B. Gala Rebecca G. Rogers 《International urogynecology journal》2013,24(1):91-97
Introduction and hypothesis
We describe differences in sexual activity and function in women with and without pelvic floor disorders (PFDs).Methods
Heterosexual women ≥40 years of age who presented to either urogynecology or general gynecology clinics at 11 clinical sites were recruited. Women were asked if they were sexually active with a male partner. Validated questionnaires and Pelvic Organ Prolapse Quantification (POP-Q) examinations assessed urinary incontinence (UI), fecal incontinence (FI), and/or pelvic organ prolapse (POP). Sexual activity and function was measured by the Female Sexual Function Index (FSFI). Student’s t test was used to assess continuous variables; categorical variables were assessed with Fisher’s exact test and logistic regression. Univariate and multivariate analyses were used to assess the impact of pelvic floor disorders (PFDs) on FSFI total and domain scores.Results
Five hundred and five women met eligibility requirements and gave consent for participation. Women with and without PFDs did not differ in race, body mass index (BMI), comorbid medical conditions, or hormone use. Women with PFDs were slightly older than women without PFDs (55.6?+?10.8 vs. 51.6?+?8.3 years, P <0.001); all analyses were controlled for age. Women with PFDs were as likely to be sexually active as women without PFDs (61.6 vs. 75.5 %, P?=?0.09). There was no difference in total FSFI scores between cohorts (23.2?+?8.5 vs. 24.4?+?9.2, P?=?0.23) or FSFI domain scores (all P?=?NS).Conclusion
Rates of sexual activity and function are not different between women with and without PFDs. 相似文献45.
Among the constituent cell types of the multiple sclerosis (MS) plaque, the astrocyte has been the least considered as a player in the pathogenesis of the lesion. Traditionally, it has been assigned a secondary scarring role with little or no role in lesion formation or repair. However, the recent upsurge of interest in the demyelinating condition neuromyelitis optica (NMO) has resulted in NMO being identified as the first disease of myelin in which primary damage to astrocytes, resulting from a humoral immune response that forms against the water channel aquaporin‐4, has been documented. This finding in NMO prompted us to re‐examine data and material from cases of MS displaying active lesions. Our reappraisal revealed unambiguous early damage to perivascular astrocyte end‐feet and to hypertrophic astrocytes in the adjacent parenchyma, but whether this was a primary event was difficult to evaluate due to concomitant edema and inflammation in these acute lesions. The astrocyte damage was long‐lasting since resolving lesions displaying remyelination also showed defects in the integrity of the astrocytic covering around blood vessels. Analysis of our findings and of the astrocytic literature supports multiple roles for the astrocyte in the evolution of changes encountered in MS depending upon lesion stage and lesion topography. At variance with the somewhat inhibitory role of the astrocyte is the abundant and growing evidence for this cell to actively participate in both lesion development and repair. We propose that the unequivocal selective early involvement of the astrocyte in MS lesions may have therapeutic relevance. © 2013 Wiley Periodicals, Inc. 相似文献
46.
47.
Clementine Levy Guillaume Lassailly Mehdi El Amrani Flavien Vincent Cedric Delhaye Thibault Meurice Emmanuel Boleslawski Guillaume Millet Massih Ningarhari Stephanie Truant Alexandre Louvet Philippe Mathurin Gilles Lebuffe Franois‐Ren Pruvot Sbastien Dharancy 《American journal of transplantation》2020,20(9):2567-2570
Severe aortic stenosis is a widespread valve disease, constituting a contraindication to organ transplantation due to cardiovascular morbidity and projected mortality. Mortality after conventional surgical aortic valve replacement in cirrhotic patients depends upon the Child–Pugh class. In the past few years, transcatheter aortic valve replacement has progressively become the treatment of choice for high‐risk patients with severe aortic stenosis. Here, we report the cases of 3 cirrhotic patients who became eligible for liver transplantation after successful transcatheter aortic valve replacement as bridge therapy. 相似文献
48.
Jacques Monteil Valerie Le Brun-Ly Florent Cachin Xavier Zasadny Jean-François Seitz Olivier Mundler Marie Selvy Denis Smith Eric Rullier Sandrine Lavau-Denes Guillaume Lades Anais Labrunie Cedric Lecaille Nathalie Valli Sophie Leobon Eric Terrebonne Elise Deluche Nicole Tubiana-Mathieu 《Digestive and liver disease》2021,53(2):231-237
BackgroundA surveillance program was performed in colorectal cancer (CRC) patients after surgery, to diagnose asymptomatic recurrence.AimsTo assess whether 18-FDG positron emission tomography/CT (PET/CT) improved the detection of recurrence during a 3-year follow-up.MethodsA multicentre, two-arm randomised prospective trial comparing different 36-month follow-up strategies. Complete colonoscopy was performed at baseline and after 3 years and clinical exams with imaging every 3 months. The conventional arm (A) received carcinoembryonic antigen, liver echography, and alternated between lung radiography and computed tomography (CT) scans. The experimental arm (B) received PET/CT.ResultsA total of 365 patients with colon (79.4%) or rectal cancer (20.6%), stages II (48.2%) or III (50.8%), were enroled in this study. At 36 months, intention-to-treat analysis revealed recurrence in 31 (17.2%) patients in arm A and 47 (25.4%) in arm B (p = 0.063). At 3 years, 7 of 31 relapses (22.5%) in arm A were surgically treated with curative intent, compared to 17 of 47 (36.2%) in arm B (p = 0.25). The rates of recurrence and new cancers were higher in arm B than arm A (p = 0.038).ConclusionsPET/CT follow-up every 6 months did not increase the rate of recurrence at 3 years or the rate of surgically treated recurrence compared with conventional follow-up. 相似文献
49.
50.
STUDY OBJECTIVES: This study examines long-term trends in incidence rates of hospitalized pulmonary sarcoidosis in a large cohort of Navy personnel, and evaluates the possible relationship of sarcoidosis with occupation. DESIGN: Incidence rates of first hospitalizations were determined for black and white male Navy enlisted personnel on active duty from 1975 to 2001. SETTING: Navy service includes a potential for exposure to a variety of substances, including nonskid coatings used on ship decks that may be aerosolized during removal. Particulate matter containing aluminum, titanium, and silicates has been identified in nonskid samples. Specific occupational groups may have had greater exposure potential than others. PATIENTS OR PARTICIPANTS: Hospitalized cases included sarcoidosis (n = 674), asthma (n = 3,536), emphysema and chronic bronchitis (n = 1,103), respiratory conditions due to fumes and vapors (n = 61), and pneumoconiosis (n = 51) observed in 9,953,607 person-years of active-duty service. INTERVENTIONS: None. However, improvements were made in personal protective gear and other countermeasures to prevent or limit respiratory exposures during service. MEASUREMENTS AND RESULTS: Annual overall hospitalized sarcoidosis incidence rates per 100,000 were 24.9 for black men and 3.5 for white men (black/white ratio of 7.1, p < 0.0001). Annual incidence rates in blacks declined markedly, particularly since 1989, but the black/white ratio remained high through 1999. Occupational associations were present in blacks and whites. Black ship's servicemen (23 cases) and aviation structural mechanics specializing in structures (12 cases) had more than twice the expected incidence rate compared to all blacks, and white mess management specialists (15 cases) had twice the overall white incidence rate. CONCLUSIONS: There was a steep decline in incidence of hospitalized sarcoidosis in blacks in the Navy. Occupational associations suggest the possibility that a dust or moisture-related lung disease may have been erroneously classified as sarcoidosis, or, alternatively, that sarcoidosis had a previously unrecognized occupational component. 相似文献