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11.
S-A Ivarsson D Bergqvist NR Lundström E Maly KO Nilsson C Wattsgård 《Acta paediatrica (Oslo, Norway : 1992)》1992,81(12):1044-1048
We report a case of Takayasu's disease with severe renovascular hypertension in a girl from Eritrea. In the "burn-out" phase after the erythrocyte sedimentation rate had normalized, reconstructive vascular surgery was performed as further progression of the disease seemed unlikely. However, probably due to her growth, the graft rotated and a second operation was successfully performed. 相似文献
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Results of randomized controlled trials of low-versus high-osmolality contrast media 总被引:1,自引:0,他引:1
The authors reviewed 100 randomized controlled trials (RCTs) conducted in humans to compare safety or efficacy of new low-osmolality contrast media (LOM) with that of high-osmolality contrast media (HOM). Findings of the 43 RCTs judged to be of the highest quality suggest that the efficacy of LOM in imaging is equal or superior to that of HOM for all routes of administration. Heat sensation occurred less often with LOM for all routes and pain occurred less often with LOM for intraarterial routes. No differences were seen in nephrotoxicity or in frequency of nausea, vomiting, urticaria, bronchospasm, laboratory test abnormalities, or neurologic events. Greater cardiovascular changes were seen with HOM, including increased or decreased heart rate, increased left ventricular end-diastolic pressure, decreased systolic pressure, and QT prolongation, depending on route of administration. To demonstrate whether a reduction in clinically significant adverse outcomes truly occurs with LOM, trials will need to enlist larger numbers of patients and employ appropriate outcome measures. Future trials should stratify patients according to their risk of adverse reactions to provide better information about benefits of LOM in low- versus high-risk patients. 相似文献
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Charu Mahajan Girija Prasad Rath Parmod Kumar Bithal Hemanshu Prabhakar Rahul Yadav Surya Kumar Dube 《Journal of anesthesia》2010,24(6):845-848
Purpose
Various strategies have been proposed to reduce discomfort of pain after rocuronium injection. These studies have shown pretreatment of drugs such as fentanyl and lidocaine to be effective. In a prospective randomized study, we evaluated whether pretreatment with local warming at injection site using an air-warming device could effectively alleviate pain induced by rocuronium.Methods
Ninety patients undergoing spinal surgeries were randomly divided into two groups: group C (control) and group T (treatment). Patients in group T were subjected to warming at 40°C for 1 min prior to injecting 1 ml (10 mg) of rocuronium at the site of venous access. Patients were then assessed for any discomfort and to quantify their discomfort on a 5-point scale.Results
Age, sex, and weight were comparable between the two groups. Pain on rocuronium administration was reported by 88.9% patient in group C versus 66.7% in group T (p < 0.05). Severe pain was significantly less in group T (35.6% vs. 8.9%).Conclusion
Application of warmth over the vascular access prior to rocuronium administration effectively reduces injection-related pain. 相似文献17.
Transcatheter Splenic Artery Occlusion for Treatment of
Splenic Artery Steal Syndrome After Orthotopic Liver
Transplantation 总被引:9,自引:0,他引:9
Uflacker R Selby JB Chavin K Rogers J Baliga P 《Cardiovascular and interventional radiology》2002,25(4):300-306
Purpose: To review
some aspects of the problem of splenic artery steal syndrome as cause of
ischemia in transplanted livers and treatment by selective splenic artery
occlusion. Materials and Methods: Eleven liver
transplant patients from a group of 350 patients, nine men and two women,
ranging in age from 40 years to 61 years (mean 52 years), presented with
biochemical evidences of liver ischemia and failure, ranging from one to 60
days following orthotopic liver transplantation. Diagnosis of splenic artery
steal syndrome was suspected by elevated enzymes, Doppler ultrasound and
confirmed by celiac angiogram. Patients with confirmed hepatic artery
thrombosis before angiography were excluded from the study. Embolization with
Gianturco coils was performed. Results: All
patients were treated by splenic artery embolization with Gianturco coils. The
11 patients improved clinically within 24 hours of the procedure with
significant change in the biochemical and clinical parameters. Followup ranged
from one month to two years. One of the 11 patient initially improved, but
developed hepatic artery thrombosis within 24 hours of the embolic treatment,
requiring surgical repair. Conclusion: Splenic
artery steal syndrome following liver transplantation surgery can be diagnosed
by celiac angiography, and effectively treated by splenic artery embolization
with coils. Embolization is one of the treatments available, it is minimally
invasive, and leads to immediate clinical improvement. Hepatic artery
thrombosis is a possible complication of the procedure. 相似文献
18.
Using contrast-enhanced helical CT to visualize arterial extravasation after blunt abdominal trauma: incidence and organ distribution. 总被引:3,自引:0,他引:3
Dorcas C Yao R Brooke Jeffrey Stuart E Mirvis Arnold Weekes Michael P Federle Connie Kim Michael J Lane Priya Prabhakar Randall Radin Philip W Ralls 《AJR. American journal of roentgenology》2002,178(1):17-20
OBJECTIVE: We evaluated the incidence and organ distribution of arterial extravasation identified using contrast-enhanced helical CT in patients who had sustained abdominal visceral injuries and pelvic fractures after blunt trauma. SUBJECTS AND METHODS: Five hundred sixty-five consecutive patients from four level I trauma centers who had CT scans showing abdominal visceral injuries or pelvic fractures were included in this series. The presence or absence of arterial extravasation, as well as the anatomic sites of arterial extravasation, was noted. We obtained clinical follow-up data, including surgical or angiographic findings. RESULTS: In our series, 104 (18.4%) of 565 patients had arterial extravasation. Of the 104 patients, 81 (77.9%) underwent surgery, embolization, or both. The combined rate of surgery or embolization in patients with arterial extravasation was statistically higher than expected at all four institutions (p <0.001). The spleen was the most common organ injured, occurring in 277 (49.0%) of 565 patients, and arterial extravasation occurred in 49 (17.7%) of 277 patients with splenic injury. Several other visceral injuries were associated with arterial extravasation, including hepatic, renal, adrenal, and mesenteric injuries. CONCLUSION: Based on the limited reports of arterial extravasation in the nonhelical CT literature, the percentage (18%) of clinically stable patients in our study with CT scans showing arterial extravasation was higher than anticipated. This finding likely reflects the improved diagnostic capability of helical CT. Although the spleen and liver were the organs most commonly associated with arterial extravasation, radiologists should be aware that arterial extravasation may be associated with several other visceral injuries. 相似文献
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