全文获取类型
收费全文 | 29731篇 |
免费 | 1524篇 |
国内免费 | 174篇 |
专业分类
耳鼻咽喉 | 181篇 |
儿科学 | 723篇 |
妇产科学 | 412篇 |
基础医学 | 3752篇 |
口腔科学 | 774篇 |
临床医学 | 1890篇 |
内科学 | 7985篇 |
皮肤病学 | 471篇 |
神经病学 | 2438篇 |
特种医学 | 1022篇 |
外科学 | 4616篇 |
综合类 | 164篇 |
一般理论 | 1篇 |
预防医学 | 798篇 |
眼科学 | 390篇 |
药学 | 2166篇 |
中国医学 | 89篇 |
肿瘤学 | 3557篇 |
出版年
2023年 | 149篇 |
2022年 | 306篇 |
2021年 | 516篇 |
2020年 | 276篇 |
2019年 | 368篇 |
2018年 | 531篇 |
2017年 | 371篇 |
2016年 | 458篇 |
2015年 | 531篇 |
2014年 | 658篇 |
2013年 | 837篇 |
2012年 | 1297篇 |
2011年 | 1469篇 |
2010年 | 836篇 |
2009年 | 743篇 |
2008年 | 1318篇 |
2007年 | 1508篇 |
2006年 | 1451篇 |
2005年 | 1533篇 |
2004年 | 1468篇 |
2003年 | 1396篇 |
2002年 | 1487篇 |
2001年 | 1031篇 |
2000年 | 997篇 |
1999年 | 950篇 |
1998年 | 470篇 |
1997年 | 366篇 |
1996年 | 378篇 |
1995年 | 258篇 |
1994年 | 253篇 |
1993年 | 251篇 |
1992年 | 600篇 |
1991年 | 544篇 |
1990年 | 579篇 |
1989年 | 509篇 |
1988年 | 471篇 |
1987年 | 475篇 |
1986年 | 410篇 |
1985年 | 421篇 |
1984年 | 301篇 |
1983年 | 210篇 |
1982年 | 148篇 |
1979年 | 227篇 |
1978年 | 160篇 |
1977年 | 149篇 |
1974年 | 139篇 |
1971年 | 140篇 |
1970年 | 140篇 |
1968年 | 143篇 |
1967年 | 144篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
991.
Hiroaki Nakashima Yasutsugu Yukawa Shiro Imagama Keigo Ito Testuro Hida Masaaki Machino Shunsuke Kanbara Daigo Morita Nobuyuki Hamajima Naoki Ishiguro Fumihiko Kato 《European spine journal》2013,22(7):1526-1532
Purpose
There have been few reports on the risk factors for tracheostomy and the possibility of patients for decannulation. The purpose of this study was to identify factors necessitating tracheostomy after cervical spinal cord injury (SCI) and detect features predictive of successful decannulation in tracheostomy patients.Methods
One hundred and sixty four patients with cervical fracture/dislocation were retrospectively reviewed. The patients comprised 142 men and 22 women with a mean age of 44.9 years. The clinical records were reviewed for patients’ demographic data, smoking history, level of cervical spine injury, injury patterns, neurological status, evidence of direct thoracic trauma and head injury, tracheostomy placement, and decannulation. Risk factors necessitating tracheostomy and factors predicting decannulation were statistically analysed.Results
Twenty-five patients (15.2 %) required tracheostomy. Twenty-one patients were successfully decannulated. Smoking history (relative risk [RR], 3.05; p = 0.03) and complete SCI irrespective of injury level (C1–4 complete SCI: RR, 67.55; p < 0.001, C5–7 complete SCI: RR, 57.88; p < 0.001) were significant risk factors necessitating tracheostomy. C1–4 complete SCI was more frequent among those who could not be decannulated. However, even in patients with high cervical complete SCI at the time of injury, patients regaining sufficient movement to shrug their shoulders within 3 weeks after injury could later be decannulated.Conclusions
The risk factors for tracheostomy after complete SCI were a history of smoking and complete paralysis irrespective of the level of injury. High cervical level complete SCI was found to be a risk factor for the failure of decannulation in patients without shoulder shrug within 3 weeks after injury. 相似文献992.
Shintaro Akamoto Seiji Noge Jun Uemura Norikatsu Maeda Minoru Ohshima Hirotaka Kashiwagi Naoki Yamamoto Masao Fujiwara Shinichi Yachida Takehiro Takama Masanobu Hagiike Keiichi Okano Hisashi Usuki Yasuyuki Suzuki 《Surgery today》2013,43(5):580-582
Although extraperitoneal colostomy is often performed to prevent postoperative parastomal hernia formation following an open abdominoperineal resection of lower rectal cancer, it has not been widely employed laparoscopically because of the difficulty associated with the extraperitoneal route. This paper describes a laparoscopic extraperitoneal sigmoid colostomy using the Endo Retract? Maxi instrument. This surgical technique is easy, and helps to prevent the development of parastomal hernias. 相似文献
993.
Naoki Yamanaka Eishi Nagai Kenoki Ohuchida Junji Ueda Hiroki Toma Shuji Shimizu Yasunori Oda Masao Tanaka 《Surgery today》2013,43(8):859-864
Purpose
The role of gastrectomy for patients with positive peritoneal cytology, but a negative macroscopic peritoneal implant (P?/cy+), remains unclear. The aim of this study was to evaluate laparoscopic gastrectomy for P?/cy+ patients.Methods
This study reviewed a prospectively maintained gastric cancer database of gastric-cancer patients those underwent surgical resection. P?/cy+ gastric cancer that had invaded the subserosa, or deeper layers, of the stomach wall without distant organ metastases was considered operable in this institution. P?/cy+ patients underwent either open or laparoscopic gastrectomy with D2 lymphadenectomy. The short-term results were examined to assess differences in outcome between the two groups.Results
Eighteen P?/cy+ patients without distant organ metastases underwent surgery between 2000 and 2010. Laparoscopic gastrectomy was performed in nine patients and open gastrectomy in nine patients. The estimated blood loss was significantly smaller, the resumption of food intake earlier, and the length of postoperative hospital stay shorter in the patients that underwent laparoscopic gastrectomy than in the patients that underwent open gastrectomy. There were no significant differences in the 2-year survival rates between the groups.Conclusion
Laparoscopic gastrectomy for P?/cy+ patients is a minimally invasive and safe oncologic procedure with good short-term results. 相似文献994.
Takanori Inose Tatsuya Miyazaki Shigemasa Suzuki Naritaka Tanaka Makoto Sakai Akihiko Sano Takehiko Yokobori Makoto Sohda Masanobu Nakajima Minoru Fukuchi Hiroyuki Kato Hiroyuki Kuwano 《Surgery today》2013,43(8):877-882
Purpose
Nonspecific esophageal motility disorder (NEMD) is a vague category that includes patients with poorly defined contraction abnormalities observed during esophageal manometry. This study investigated the therapeutic effects of the video-assisted thoracoscopic surgery (VATS) approach using long myotomy and fundopexy for NEMD.Methods
The VATS approach using myotomy and fundopexy was performed for 4 patients of NEMD between 2005 and 2008. A total of 4 patients with NEMD that underwent treatment at our institution were analyzed retrospectively.Results
The patients included 2 males and 2 females with a median age of 48 years (range 21–74 years). The median duration of NEMD symptoms was 58 months (range 4–108 months). Dysphagia was a primary symptom in all patients. Chest pain was a primary symptom in 3 of 4 patients (75 %). Treatment with medication was attempted before the operation. The median operative time was 344.5 min (range 210–476 min). The median time before starting oral feeding was 2.5 days (range 2–22 days). All patients achieved a significant improvement of their previous condition.Conclusions
The VATS approach using myotomy and fundopexy for NEMD is a good treatment in cases resistant to medication and balloon dilation. 相似文献995.
Jun Takahashi Hirokazu Kobayashi Shinji Wakabayashi Masao Deguchi Hidehiro Ito Yuji Mogami Hirotaka Tanikawa Hiroyuki Nakagawa Hideki Moriya Ryohei Ashizawa Kenji Takahara Hisatoshi Kinoshita Yutaka Tateiwa Hiromichi Misawa Takahiro Tsutsumimoto Taku Nakakohji Yohei Yuzawa Akihito Sawaumi Yohei Hidai Satoshi Matsuda Isao Nakamura Shigeyuki Toba Mikio Kamimura Takeshi Nakane Hiroki Hirabayashi Hiroyuki Hashidate Nobuhide Ogihara Keijiro Mukaiyama Hiroyuki Kato Kuniyoshi Ohtsuka 《Journal of orthopaedic science》2013,18(2):208-215
Background
Quality of life (QOL) is a concern for patients with lumbar spinal stenosis (LSS). In this study, QOL was examined using the 5-item EuroQol (EQ-5D).Methods
QOL and activities of daily living (ADL) were surveyed for 91 patients who visited 18 medical institutions in our prefecture and were diagnosed with LSS-associated intermittent claudication. A second survey was performed after ≥6 weeks for 79 of the subjects to evaluate therapy with limaprost (an oral prostaglandin E1 derivative) or etodolac (an NSAID). Symptoms, maximum walking time, QOL, ADL items, and relationships among these variables were investigated for all 91 patients. Leg pain, leg numbness, and low back pain while walking were surveyed by use of VAS scores (0–100).Results
Leg pain, leg numbness, and low back pain while walking (VAS ≥25) were present in 83.5, 62.6, and 54.9 % of the patients in the first survey, and approximately half of the patients had a maximum walking time <15 min. The mean EQ-5D utility value for QOL was 0.59 ± 0.12. This value was significantly associated with maximum walking time (p = 0.030) based on classification of patients into groups with walking times <7.5, 7.5–15, 15–30, and >30 min, showing that maximum walking time affected health-related QOL. Of the 79 patients who completed the second survey, 56 had taken limaprost and 23 (control group) had received etodolac. Limaprost improved possible walking time, reduced ADL interference, and significantly increased the EQ-5D utility score, whereas no significant changes occurred in the control group. Maximum walking time was prolonged by ≥10 min and the EQ-5D utility value was improved by ≥0.1 points in significantly more patients in the limaprost group than in the control group.Conclusion
According to the findings of this survey, at an average of 8 weeks after administration limaprost improved symptoms, QOL, and ADL in LSS patients whereas treatment with an NSAID reduced pain but did not have any other effects. 相似文献996.
Keijiro Mukaiyama Jun Takahashi Hiroki Hirabayashi Nobuhide Ogihara Shugo Kuraishi Masayuki Shimizu Hiroyuki Kato 《Journal of orthopaedic science》2013,18(5):687-692
Background
Despite remarkable improvement in Cobb angle after surgery for scoliosis, many patients have a residual rib hump. We studied the factors responsible for this hump and their influence on patient satisfaction.Methods
We recruited 2 men and 38 women (mean age 14.9 years) who underwent skip pedicle screw fixation combined with direct vertebral body derotation for adolescent idiopathic scoliosis with Lenke type 1 and 2 curves. Hump size was evaluated by measuring apical trunk rotation (ATR). Patients with postoperative ATR ≤10° were categorized as group A and those with postoperative ATR >10° as group B. We analyzed postoperative self-image and satisfaction subscores of the SRS-22 questionnaire. We also compared the rate of postoperative improvement in ATR between patients who underwent additional Ponte osteotomy and those who did not.Results
Preoperative ATR, preoperative apical translation, and preoperative and postoperative apical rotation significantly differed between groups A and B. In contrast, Cobb angles before and after surgery, Cobb angle correction rates, apical translation after correction, and postoperative self-image and satisfaction scores did not differ significantly between the groups. However, the rate of improvement in ATR showed a strong correlation with self-image (correlation coefficient 0.64) and satisfaction (correlation coefficient 0.52). This improvement rate did not differ significantly between subjects who underwent additional Ponte osteotomy and those who did not.Conclusions
Preoperative apical rotation and ATR were clearly related to postoperative residual hump. For decreasing the postoperative rib hump, removal of the deformation by apical rotation was considered more important than correction of Cobb angle. Patient satisfaction and self-image scores were not significantly related to postoperative residual hump size, but they were influenced by improvement in ATR. 相似文献997.
Noboru Hanaoka MD Ryu Ishihara MD Yoji Takeuchi MD Motoyuki Suzuki MD Hirokazu Uemura MD Takashi Fujii MD Kunitoshi Yoshino MD Noriya Uedo MD Koji Higashino MD Takashi Ohta MD Hiromitsu Kanzaki MD Masao Hanafusa MD Kengo Nagai MD Fumi Matsui MD Hiroyasu Iishi MD Masaharu Tatsuta MD Yasuhiko Tomita MD 《Head & neck》2013,35(9):1248-1254
998.
999.
Ganesh Sankaranarayanan Kai Matthes Arun Nemani Woojin Ahn Masayuki Kato Daniel B. Jones Steven Schwaitzberg Suvranu De 《Surgical endoscopy》2013,27(5):1607-1616
Introduction and study aim
Natural orifice translumenal endoscopic surgery (NOTES) is an emerging surgical technique that requires a cautious adoption approach to ensure patient safety. High-fidelity virtual-reality-based simulators allow development of new surgical procedures and tools and train medical personnel without risk to human patients. As part of a project funded by the National Institutes of Health, we are developing the virtual transluminal endoscopic surgery trainer (VTEST?) for this purpose. The objective of this study is to conduct a structured needs analysis to identify the design parameters for such a virtual-reality-based simulator for NOTES.Methods
A 30-point questionnaire was distributed at the 2011 National Orifice Surgery Consortium for Assessment and Research meeting to obtain responses from experts. Ordinal logistic regression and the Wilcoxon rank-sum test were used for analysis.Results
A total of 22 NOTES experts participated in the study. Cholecystectomy (CE, 68 %) followed by appendectomy (AE, 63 %) (CE vs AE, p = 0.0521) was selected as the first choice for simulation. Flexible (FL, 47 %) and hybrid (HY, 47 %) approaches were equally favorable compared with rigid (RI, 6 %) with p < 0.001 for both FL versus RI and HY versus RI. The transvaginal approach was preferred 3 to 1 to the transgastric. Most participants preferred two-channel (2C) scopes (65 %) compared with single (1C) or three (3C) or more channels with p < 0.001 for both 2C versus 1C and 2C versus 3C. The importance of force feedback and the utility of a virtual NOTES simulator in training and testing new tools for NOTES were rated very high by the participants.Conclusion
Our study reinforces the importance of developing a virtual NOTES simulator and clearly presents expert preferences. The results of this analysis will direct our initial development of the VTEST? platform. 相似文献1000.
Mai Sato Shuichi Ito Masao Ogura Koichi Kamei Isao Miyairi Ippei Miyata Masataka Higuchi Kentaro Matsuoka 《Pediatric nephrology (Berlin, Germany)》2013,28(1):145-149