全文获取类型
收费全文 | 1475篇 |
免费 | 125篇 |
国内免费 | 6篇 |
专业分类
耳鼻咽喉 | 16篇 |
儿科学 | 52篇 |
妇产科学 | 31篇 |
基础医学 | 221篇 |
口腔科学 | 40篇 |
临床医学 | 78篇 |
内科学 | 326篇 |
皮肤病学 | 12篇 |
神经病学 | 156篇 |
特种医学 | 88篇 |
外科学 | 237篇 |
综合类 | 43篇 |
一般理论 | 1篇 |
预防医学 | 57篇 |
眼科学 | 33篇 |
药学 | 95篇 |
中国医学 | 4篇 |
肿瘤学 | 116篇 |
出版年
2023年 | 17篇 |
2022年 | 29篇 |
2021年 | 61篇 |
2020年 | 24篇 |
2019年 | 42篇 |
2018年 | 40篇 |
2017年 | 33篇 |
2016年 | 59篇 |
2015年 | 56篇 |
2014年 | 61篇 |
2013年 | 72篇 |
2012年 | 113篇 |
2011年 | 108篇 |
2010年 | 55篇 |
2009年 | 60篇 |
2008年 | 89篇 |
2007年 | 98篇 |
2006年 | 80篇 |
2005年 | 82篇 |
2004年 | 68篇 |
2003年 | 56篇 |
2002年 | 43篇 |
2001年 | 35篇 |
2000年 | 28篇 |
1999年 | 25篇 |
1998年 | 13篇 |
1997年 | 10篇 |
1996年 | 9篇 |
1995年 | 12篇 |
1994年 | 7篇 |
1992年 | 5篇 |
1991年 | 18篇 |
1990年 | 8篇 |
1989年 | 6篇 |
1988年 | 5篇 |
1987年 | 11篇 |
1986年 | 6篇 |
1985年 | 5篇 |
1984年 | 9篇 |
1983年 | 3篇 |
1982年 | 3篇 |
1979年 | 4篇 |
1975年 | 3篇 |
1974年 | 3篇 |
1968年 | 3篇 |
1967年 | 2篇 |
1966年 | 2篇 |
1965年 | 3篇 |
1946年 | 3篇 |
1945年 | 2篇 |
排序方式: 共有1606条查询结果,搜索用时 0 毫秒
71.
72.
Subramaniam P Behari S Singh S Jain VK Chhabra DK 《Surgical neurology》2002,58(5):338-43; discussion 343
BACKGROUND: Intradural subpial lipomas not associated with spinal dysraphism, account for less than 1% of spinal cord tumors. The simultaneous existence of multiple intradural subpial lipomas with dumb-bell extradural extension through the intervertebral foramen in the same patient without any evidence of spinal dysraphism has not been previously reported. CASE DESCRIPTION: A 38-year-old man presented with progressive spastic paraparesis, and weakness of right elbow extension and opposition of the medial three fingers. He also had ascending paraesthesia from the C6 dermatome to the saddle region and loss of joint and position sense of both lower limbs with hesitancy and precipitancy of micturition. There was no spinal tenderness, deformity, neurocutaneous markers, or spinal dysraphism. The total duration of illness was 11 years.The oblique views of the plain radiographs of the cervical spine revealed an enlarged right C7-D1 intervertebral foramen. The T1- and T2-weighted magnetic resonance (MR) images showed two intradural, hyperintense lesions (with extensive loss of signal on fat suppression sequences), one extending from C5 to D2 and the other opposite the C3-4 disc space. The parasagittal and axial images showed the extradural component of the lesion emerging from the right C7-D1 intervertebral foramen.At surgery, a C2 to D2 laminectomy was performed. The lipoma, enclosed in a fine pial membrane, was situated on the right posterolateral aspect of the cord. The right-sided nerve roots from the C6 to D1 levels were completely enmeshed by the lipoma. There was a separate superficial subpial lipoma adherent to the posterior aspect of the cord at the C3-4 level. A distinct area of normal cord was present between the two lesions. A subtotal decompression of the lesions including the component emerging through the right C7-D1 intervertebral foramen and a duraplasty were performed.At follow-up after 18 months, the posterior column impairment, lower limb hypoaesthesia, and right upper limb paraesthesia had improved. However, residual elbow extension and lower limb weakness, mild lower limb spasticity and sphincteric dysfunction persisted. CONCLUSIONS: The multiplicity of intradural subpial lipomas without spinal dysraphism points to a dysembryogenetic basis similar to that seen in patients with spinal dysraphism that results in lipomas, but in which the defect is not severe enough to give rise to coexisting vertebral and soft tissue anomalies. The dumb-bell extradural extension through the intervertebral foramen is extremely rare. The magnetic resonance imaging and surgical principles are discussed. 相似文献
73.
74.
75.
Two patients with histologically proven diagnosis of peritoneal mesothelioma are presented. Both patients had CT scans of the abdomen. The second patient was also examined with MRI. 相似文献
76.
77.
RM Subramaniam J Sherriff K Holmes MC Chan B Shadbolt 《Journal of Medical Imaging and Radiation Oncology》2006,50(5):442-446
This study was conducted to establish clinicians’ perspectives of a set of radiology curriculum topics for medical student teaching, which were held to be important by radiologists. A questionnaire was sent to clinicians in all specialties. Forty‐six clinicians (51.1%) out of 90 returned the questionnaires. All curriculum topics were scored above an average of 4 (agree). The five highest ranking curriculum topics in order of importance were: developing a system for viewing chest radiographs (5.59), developing a system for viewing abdominal radiographs (5.56), developing a system for viewing bone and joint radiographs (5.33), distinguishing normal structures from abnormal in chest and abdominal radiographs (5.33) and identifying gross bone or joint abnormalities in skeletal radiographs (5.22). Correlative analysis between speciality groups showed surgical and medical specialities were significantly different in their responses of two learning outcomes: basic knowledge about the contrast media benefits and risks (P= 0.01) and ability to select the most appropriate and the most cost‐effective methods of radiological investigations for clinical situations (P= 0.03). Acute specialities were not significantly different from the other two groups for these two learning outcomes. There was no statistically significant difference for other learning outcomes between the three speciality groups. 相似文献
78.
Experience with video-assisted thoracoscopic surgery in the management of complicated pneumonia in children 总被引:2,自引:0,他引:2
PURPOSE: The aim of this study was to assess the impact of video assisted thoracoscopic surgery (VATS) in the management of empyema in children. METHODS: This report involves cases of complicated pneumonia in children requiring surgical intervention after failure of medical treatment with antibiotics, with or without drainage from November 1997 to October 1999. The impact of VATS has been studied prospectively from October 1998 when VATS was introduced. The results have been compared with the previous year when similar cases were dealt with open thoracotomy. These 2 groups of patients with VATS (V) or without VATS (O) were studied for their progress in hospital and the final outcome. RESULTS: A total of 39 immunocompetent children with community-acquired pneumonia were studied. There were 17 cases in O and 22 in V. There were 2 conversions to open thoracotomy in V. Both of these cases required resection of the lung parenchyma for severe necrosis and bronchopleural fistula. The mean age in years was 5.3 (O) and 4.9 (V). Parameters that were significantly less in V compared with O include timing of referral (O, 13.6 days; V, 5.3 days), number of lung resections (O, 8; V, 2), blood transfusion (O, 14; V, 2), analgesia requirements (O, 7.8 days; V, 2.9 days), postoperative length of stay in hospital (O, 10.4 days; V, 4.6 days), time to become normothermic (O, 5.6 days; V, 1.7 days); and time to removal of chest drains (O, 6.0 days; V, 2.7 days). Cosmesis is superior in cases of VATS compared with open thoracotomy. All the children recovered well on follow-up with resolution of symptoms and no recurrences. CONCLUSIONS: (1) VATS has ushered in a new era of hope for patients with complicated pneumonia. (2) Thoracotomy, lung resections, and the attending morbidity rate have decreased. (3) Patients are being referred earlier by the physicians because the management protocol is changing. 相似文献
79.
Akila Subramaniam Brett D. Einerson Christina T. Blanchard Britt K. Erickson Jeff Szychowski Charles A. Leath Joseph R. Biggio Warner K. Huh 《Gynecologic oncology》2019,152(1):127-132
Objectives
Opportunistic salpingectomy is a cost-effective strategy recommended for ovarian cancer (OvCa) risk reduction at the time of gynecologic surgery in women who have completed childbearing. We aimed to evaluate the cost-effectiveness of opportunistic salpingectomy compared to standard tubal ligation (TL) during cesarean delivery.Study design
A cost-effectiveness analysis using decision modeling to compare opportunistic salpingectomy to TL at the time of cesarean using probabilities of procedure completion derived from a trial. Probability and cost inputs were derived from local data and the literature. The primary outcome was the incremental cost-effectiveness ratio (ICER) in 2017?U.S. dollars per quality-adjusted life year (QALY) at a cost-effectiveness threshold of $100,000/QALY. One- and two-way sensitivity analyses were performed for all variables. A probabilistic sensitivity analysis determined the proportion of simulations in which each strategy would be cost-effective.Results
Opportunistic salpingectomy was cost-effective compared to TL with an ICER of $26,616 per QALY. In 10,000 women desiring sterilization with cesarean, opportunistic salpingectomy would result in 17 fewer OvCa diagnoses, 13 fewer OvCa deaths, and 25 fewer unintended pregnancies compared to TL – with an associated cost increase of $4.7 million. The model was sensitive only to OvCa risk reduction from salpingectomy and TL. Opportunistic salpingectomy was not cost-effective if its cost was >$3163.74 more than TL, if the risk-reduction of salpingectomy was <41%, or if the risk-reduction of TL was >46%. In probabilistic sensitivity analysis opportunistic salpingectomy was cost effective in 75% of simulations.Conclusions
In women undergoing cesarean with sterilization, opportunistic salpingectomy is likely cost-effective and may be cost-saving in comparison to TL for OvCa risk reduction. 相似文献80.
The incidence of the ‘heparin-rebound’ phenomenon after protamine neutralization of systemic heparinization required for cardiopulmonary bypass (CPB) was investigated. Heparin-effect was detected in 43% of patients studied at 2h, 31% at 4h, and 37% at 8h after reversal of circuit heparin on CPB. Heparin-rebound was shown to be associated with a small but significant increase in postoperative bleeding which was not of clinical importance. 相似文献