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961.
Development and external validation of nomograms predicting distant metastases and overall survival after neoadjuvant chemotherapy and surgery for patients with nonmetastatic osteosarcoma: A multi‐institutional study 下载免费PDF全文
Koichi Ogura MD Tomohiro Fujiwara MD Hideo Yasunaga MD PhD Hiroki Matsui MPH Dae‐Geun Jeon MD Wan Hyeong Cho MD Hiroaki Hiraga MD Takeshi Ishii MD Tsukasa Yonemoto MD Hiroto Kamoda MD Toshifumi Ozaki MD Eiji Kozawa MD Yoshihiro Nishida MD Hideo Morioka MD Toru Hiruma MD Shigeki Kakunaga MD Takafumi Ueda MD Yusuke Tsuda MD Hirotaka Kawano MD Akira Kawai MD 《Cancer》2015,121(21):3844-3852
962.
963.
Purpose
This study aimed to establish radiographic standard values for cervical spine morphometry, alignment, and range of motion (ROM) in both male and female in each decade of life between the 3rd and 8th and to elucidate these age-related changes.Methods
A total of 1,230 asymptomatic volunteers underwent anteroposterior (AP), lateral, flexion, and extension radiography of the cervical spine. There were at least 100 men and 100 women in each decade of life between the 3rd and 8th. AP diameter of the spinal canal, vertebral body, and disc were measured at each level from the 2nd to 7th cervical vertebra (C2–C7). C2–C7 sagittal alignment and ROM during flexion and extension were calculated using a computer digitizer.Results
The AP diameter of the spinal canal was 15.8 ± 1.5 [mean ± standard deviation (SD)] mm at the mid-C5 level, and 15.5 ± 2.0 mm at the C5/6 disc level. The disc height was 5.8 ± 1.3 mm at the C5/6 level, which was the minimum height, and the maximum height was at the C6/7 level. Both the AP diameter of the spinal canal and disc height decreased gradually with increasing age. The C2–C7 sagittal alignment and total ROM were 13.9 ± 12.3° in lordosis and 55.3 ± 16.0°, respectively. The C2–C7 lordotic angle was 8.0 ± 11.8° in the 3rd decade and increased to 19.7 ± 11.3 in the 8th decade, whereas the C2–C7 ROM was 67.7 ± 17.0° in the 3rd decade and decreased to 45.0 ± 12.5 in the 8th decade. The extension ROM decreased more than the flexion ROM, and lordotic alignment progressed with increasing age. There was a significant difference in C2–C7 alignment and ROM between men and women.Conclusions
The standard values and age-related changes in cervical anatomy, alignment, and ROM for males and females in each decade between the 3rd and 8th were established. Cervical lordosis in the neutral position develops with aging, while extension ROM decreases gradually. These data will be useful as normal values for the sake of comparison in clinical practice. 相似文献964.
Mori M Iida H Miki K Tsugane E Sasaki M Nagayama R Noguchi T Manabe H Ohta F Iimura Y 《Surgery today》2012,42(5):470-474
This report presents the case of an 84-year-old woman who developed tetanus 3 days after the resection of a gangrenous small
intestine caused by obturator hernia incarceration. The diagnosis of tetanus was clinically made after the appearance of generalized
spastic contractions with opisthotonus. Clostridium tetani organisms residing in the gastrointestinal tract were presumed to have been endogenously inoculated into the strangulated
intestine, where it produced tetanospasmin, causing tetanus. The patient successfully recovered after aggressive intensive
care. There have been 16 case reports of tetanus occurring after gastrointestinal surgical procedures. Primary care physicians
should thus be aware of the fact that, although extremely rare, C. tetani residing in the gastrointestinal tract can provide a possible endogenous source of tetanus infection. 相似文献
965.
Kakeji Y Nakanoko T Yoshida R Eto K Kumashiro R Ikeda K Egashira A Saeki H Oki E Morita M Ikeda T Maehara Y 《Surgery today》2012,42(6):554-558
Purpose
Gastrointestinal stromal tumors (GISTs) should be surgically resected, even those smaller than 5?cm in size, which is the threshold of clinical malignancy for submucosal tumors (SMTs) in the gastrointestinal tract. This study reviewed the use of laparoscopic surgery for gastric partial resection of GISTs or SMTs that were suspected to be GISTs.Methods
Eighteen patients underwent laparoscopic partial resection of the stomach for GISTs or SMTs. The tumor location was confirmed by intraluminal endoscopy. One-half of the circumference around the tumor was dissected, and the tumor was turned toward the abdominal cavity. The nonresected part of the tumor and the edge of the incision line was lifted up using forceps, and the incision line was closed using laparoscopic stapling devices.Results
Two cases were diagnosed as GIST by endoscopic biopsy. Six patients underwent endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) examinations, which diagnosed five GISTs. There were 18 tumors smaller than 5?cm, including 10 GISTs, 4 leiomyomas, 3 schwannomas, and one heterotopic pancreas.Conclusions
Endoscopic ultrasound-guided FNAB is recommended for definite preoperative diagnosis of histopathologically unknown SMTs to determine the indications for surgery. The laparoscopic approach with the assistance of endoscopy is useful for improving the curability, with minimal invasiveness for the partial resection of GISTs. 相似文献966.
Michael Rink MD Daniel Sjoberg Evi Comploj MD Vitaly Margulis MD Evanguelos Xylinas MD Richard K. Lee MD Jens Hansen MD Eugene K. Cha MD Jay D. Raman MD Mesut Remzi MD Karim Bensalah MD Giacomo Novara MD Surena F. Matin MD Felix K. Chun MD Eiji Kikuchi MD Wassim Kassouf MD Juan I. Martinez-Salamanca MD Yair Lotan MD Christian Seitz MD Armin Pycha MD Richard Zigeuner MD Pierre I. Karakiewicz MD Douglas S. Scherr MD Andrew J. Vickers MD Shahrokh F. Shariat MD 《Annals of surgical oncology》2012,19(13):4337-4344
Purpose
To describe the natural history and identify predictors of cancer-specific survival in patients who experience disease recurrence after radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC).Methods
Of 2,494 UTUC patients treated with RNU without neoadjuvant chemotherapy, 597 patients experienced disease recurrence. A total of 148 patients (25?%) received adjuvant chemotherapy before disease recurrence. Multivariable Cox regression model addressed time to cancer-specific mortality after disease recurrence.Results
The median time from RNU to disease recurrence was 12?months (interquartile range 5?C22). A total of 491 (82?%) of 597 patients died from UTUC, and 8 patients (1.3?%) died from other causes. The median time from disease recurrence to death of UTUC was 10?months. Actuarial cancer-specific survival estimate at 12?months after disease recurrence was 35?%. On multivariable analysis that adjusted for the effects of standard clinicopathologic characteristics, higher tumor stages [hazard ratio (HR) pT3 vs. pT0?CT1: 1.66, p?=?0.001; HR pT4 vs. pT0?CT1: 1.90, p?=?0.002], absence of lymph node dissection (HR 1.28, p?=?0.041), ureteral tumor location (HR 1.44, p?<?0.0005) and a shorter interval from surgery to disease recurrence (p?<?0.0005) were significantly associated with cancer-specific mortality. The adjusted 6-, 12- and 24-month postrecurrence cancer-specific mortality was 73, 60 and 57?%, respectively.Conclusions
Approximately 80?% of patients who experience disease recurrence after RNU die within 2?years after recurrence. Patients with non-organ-confined stage, absence of lymph node dissection, ureteral tumor location and/or shorter time to disease recurrence died of their tumor more quickly than their counterparts. These factors should be considered in patient counseling and risk stratification for salvage treatment decision making. 相似文献967.
Okada S Tokunaga E Kitao H Akiyoshi S Yamashita N Saeki H Oki E Morita M Kakeji Y Maehara Y 《Annals of surgical oncology》2012,19(5):1499-1507
Background
BRCA1 and BRCA2 are two major tumor suppressor genes for hereditary breast and ovarian cancer. In sporadic breast cancer, although somatic mutations of these genes are rare, loss of heterozygosity (LOH) at BRCA1 and BRCA2 loci is common. 相似文献968.
Jeffery C. Wheat Alon Z. Weizer J. Stuart Wolf Yair Lotan Mesut Remzi Vitaly Margulis Christopher G. Wood Francesco Montorsi Marco Roscigno Eiji Kikuchi Richard Zigeuner Cord Langner Christian Bolenz Theresa M. Koppie Jay D. Raman Mario Fernández Pierre Karakiewizc Umberto Capitanio Karim Bensalah Jean-Jacques Patard Shahrokh F. Shariat 《Urologic oncology》2012,30(3):252-258
ObjectiveCarcinoma in situ (CIS) is associated with increased risk of progression when found with high-grade non-muscle-invasive bladder cancer, yet its impact is less clear in the upper urinary tract. In the current study, we evaluated the impact of concomitant CIS on recurrence-free survival and cancer-specific survival following radical nephroureterectomy for upper tract urothelial carcinoma (UTUC).Materials and methodsA multi-institutional retrospective cohort of 1,387 patients undergoing radical nephroureterectomy was identified. Concomitant CIS was defined as the presence of CIS in association with another pathologic stage; patients with CIS alone were excluded from the analysis. The presence of concomitant CIS served as the exposure variable with disease recurrence and cancer-specific mortality as the outcomes. Organ-confined disease was defined as AJCC/UICC stage II or lower.ResultsConcomitant CIS was identified in 371 of 1,387 (26.7%) patients and was significantly more common in patients with a previous bladder cancer history, high grade, and high stage tumors. In a multivariable analysis, concomitant CIS was a predictor of disease recurrence (HR = 1.25, P = 0.04) and cancer specific mortality (HR = 1.34, P = 0.05) for patients with organ-confined UTUC, but not in the entire cohort. Other prognostic variables, such as grade, stage, lymphovascular invasion, and lymph node status, were associated with poorer overall and recurrence-free survival for all patients.ConclusionThe presence of concomitant CIS in patients with organ-confined UTUC is associated with a higher risk of recurrent disease and cancer-specific mortality. This information may be useful in refining surveillance protocols and in more appropriate selection of patients for adjuvant chemotherapy. 相似文献
969.
970.
Akimoto T Shiizaki K Sugase T Watanabe Y Yoshizawa H Otani N Numata A Takeshima E Yamazaki T Miki T Ito C Pastor JV Iwazu Y Saito O Muto S Kuro-o M Kusano E 《Clinical and experimental nephrology》2012,16(3):442-447