全文获取类型
| 收费全文 | 2055592篇 |
| 免费 | 153228篇 |
| 国内免费 | 3170篇 |
专业分类
| 耳鼻咽喉 | 29761篇 |
| 儿科学 | 64306篇 |
| 妇产科学 | 54564篇 |
| 基础医学 | 291560篇 |
| 口腔科学 | 58930篇 |
| 临床医学 | 178860篇 |
| 内科学 | 408016篇 |
| 皮肤病学 | 44133篇 |
| 神经病学 | 160556篇 |
| 特种医学 | 81472篇 |
| 外国民族医学 | 725篇 |
| 外科学 | 324155篇 |
| 综合类 | 42152篇 |
| 现状与发展 | 2篇 |
| 一般理论 | 580篇 |
| 预防医学 | 148098篇 |
| 眼科学 | 46194篇 |
| 药学 | 156163篇 |
| 5篇 | |
| 中国医学 | 4292篇 |
| 肿瘤学 | 117466篇 |
出版年
| 2018年 | 20580篇 |
| 2017年 | 15781篇 |
| 2016年 | 17436篇 |
| 2015年 | 19724篇 |
| 2014年 | 27253篇 |
| 2013年 | 40960篇 |
| 2012年 | 56005篇 |
| 2011年 | 59046篇 |
| 2010年 | 35252篇 |
| 2009年 | 33625篇 |
| 2008年 | 56933篇 |
| 2007年 | 60538篇 |
| 2006年 | 61305篇 |
| 2005年 | 59371篇 |
| 2004年 | 57820篇 |
| 2003年 | 55879篇 |
| 2002年 | 54827篇 |
| 2001年 | 107754篇 |
| 2000年 | 111820篇 |
| 1999年 | 94403篇 |
| 1998年 | 23962篇 |
| 1997年 | 21417篇 |
| 1996年 | 21848篇 |
| 1995年 | 20560篇 |
| 1994年 | 19269篇 |
| 1993年 | 17813篇 |
| 1992年 | 73449篇 |
| 1991年 | 71269篇 |
| 1990年 | 69187篇 |
| 1989年 | 66622篇 |
| 1988年 | 61107篇 |
| 1987年 | 59824篇 |
| 1986年 | 55800篇 |
| 1985年 | 53544篇 |
| 1984年 | 39217篇 |
| 1983年 | 33084篇 |
| 1982年 | 18298篇 |
| 1981年 | 16352篇 |
| 1979年 | 34976篇 |
| 1978年 | 23865篇 |
| 1977年 | 20451篇 |
| 1976年 | 18442篇 |
| 1975年 | 20151篇 |
| 1974年 | 23847篇 |
| 1973年 | 22760篇 |
| 1972年 | 21239篇 |
| 1971年 | 19704篇 |
| 1970年 | 18651篇 |
| 1969年 | 17179篇 |
| 1968年 | 15578篇 |
排序方式： 共有10000条查询结果，搜索用时 0 毫秒
31.
Elizabeth D. Krebs Robert B. Hawkins J. Hunter Mehaffey Clifford E. Fonner Alan M. Speir Mohammed A. Quader Jeffrey B. Rich Leora T. Yarboro Nicholas R. Teman Gorav Ailawadi 《The Journal of thoracic and cardiovascular surgery》2019,157(4):1533-1542.e2
Objectives
Expedient extubation after cardiac surgery has been associated with improved outcomes, leading to postoperative extubation frequently during overnight hours. However, recent evidence in a mixed medical-surgical intensive care unit population demonstrated worse outcomes with overnight extubation. This study investigated the impact of overnight extubation in a statewide, multicenter Society of Thoracic Surgeons database.Methods
Records from 39,812 patients undergoing coronary artery bypass grafting or valve operations (2008-2016) and extubated within 24 hours were stratified according to extubation time between 06:00 and 18:00 (day) or between 18:00 and 6:00 (overnight). Outcomes including reintubation, mortality, and composite morbidity-mortality were evaluated using hierarchical regression models adjusted for Society of Thoracic Surgeons predictive risk scores. To further analyze extubation during the night, a subanalysis stratified patients into 3 groups: 06:00 to 18:00, 18:00 to 24:00, and 24:00 to 06:00.Results
A total of 20,758 patients were extubated overnight (52.1%) and were slightly older (median age 66 vs 65 years, P < .001) with a longer duration of ventilation (4 vs 7 hours, P < .001). Day and overnight extubation were associated with equivalent operative mortality (1.7% vs 1.7%, P = .880), reintubation (3.7% vs 3.4%, P = .141), and composite morbidity-mortality (8.2% vs 8.0%, P = .314). After risk adjustment, overnight extubation was not associated with any difference in reintubation, mortality, or composite morbidity-mortality. On subanalysis, those extubated between 24:00 and 06:00 exhibited increased composite morbidity-mortality (odds ratio, 1.18; P = .001) but no difference in reintubation or mortality.Conclusions
Extubation overnight was not associated with increased mortality or reintubation. These results suggest that in the appropriate clinical setting, it is safe to routinely extubate cardiac surgery patients overnight. 相似文献32.
Ángel Becerra Héctor Trujillo Lucía Valencia Aurelio Rodríguez‐Pérez 《Brazilian Journal of Anesthesiology》2019,69(2):200-203
Background and objectives
A prompt and effective management of trauma patient is necessary. The aim of this case report is to highlight the importance of intraoperative echocardiography as a useful tool in patients suffering from refractory hemodynamic instability no otherwise explained.Case report
A 41 year‐old woman suffered a car accident. At the emergency department, no abnormalities were found in ECG or chest X‐ray. Abdominal ultrasound revealed the presence of abdominal free liquid and the patient was submitted to urgent exploratory laparotomy. Nevertheless, she persisted suffering arterial hypotension and metabolic acidosis. Looking for the reason of her hemodynamic instability, intraoperative transthoracic echocardiography was performed, finding out the presence of pericardial effusion. Once the cardiac surgeon extracted pericardial clots, patient's situation improved clinically and analytically.Conclusion
Every anesthesiologist should be able to use the intraoperative echocardiography as an effective tool in order to establish the appropriate measures to promote the survival of patients suffering severe trauma. 相似文献33.
34.
35.
36.
37.
38.
Autoimmune comorbid diseases associated with lichen planus: a nationwide case–control study 
下载免费PDF全文
下载免费PDF全文 39.
M.T. Leccia N. Auffret F. Poli J.‐P. Claudel S. Corvec B. Dreno 《Journal of the European Academy of Dermatology and Venereology》2015,29(8):1485-1492
Acne vulgaris (acne) is a chronic inflammatory disease of the sebaceous gland, characterized by follicular hyperkeratinization, excessive colonization by Propionibacterium acnes (P. acnes) as well as immune reactions and inflammation. Despite an armamentarium of topical treatments available including benzoyl peroxide, retinoids and azelaic acid, topical antibiotics in monotherapies, especially erythromycin and clindamycin, are still used in Europe to treat acne. This intensive use led to antimicrobial‐resistant P. acnes and staphylococci strains becoming one of the main health issues worldwide. This is an update on the current topical acne treatments available in Europe, their mechanism of action, their potential to induce antimicrobial resistance and their clinical efficacy and safety. 相似文献
40.
Pradeep Balasubramanian M.D. C. R. Srinivas M.D. Pavai Arunachalam M.S. M.Ch. K. S. Thirumurthy M.S. M.Ch. P. R. Rajkumar M.S. M.Ch. H. Manuvidhya M.B.B.S. 《Pediatric dermatology》2015,32(3):e78-e81
We report on a child with several café au lait spots in association with a lumbar lipomeningomyelocele as an apparently new association. Cutaneous markers, the identification of which plays a crucial role in the early diagnosis and management of spinal malformations, can accompany occult spinal dysraphism. Herein we report a case of lumbar lipomeningomyelocele associated with an overlying café au lait spot that served as a marker of occult spinal dysraphism. The patient also had segmental café au lait spots on the face, making the association unique. 相似文献