首页 | 本学科首页   官方微博 | 高级检索  
文章检索
  按 检索   检索词:      
出版年份:   被引次数:   他引次数: 提示:输入*表示无穷大
  收费全文   2494627篇
  免费   202776篇
  国内免费   4478篇
耳鼻咽喉   36640篇
儿科学   77834篇
妇产科学   66413篇
基础医学   352550篇
口腔科学   71411篇
临床医学   224708篇
内科学   489737篇
皮肤病学   51546篇
神经病学   211874篇
特种医学   102087篇
外国民族医学   900篇
外科学   380945篇
综合类   57106篇
现状与发展   1篇
一般理论   1002篇
预防医学   196221篇
眼科学   59020篇
药学   186082篇
  4篇
中国医学   4642篇
肿瘤学   131158篇
  2018年   26353篇
  2017年   20507篇
  2016年   22985篇
  2015年   26005篇
  2014年   36364篇
  2013年   54784篇
  2012年   74771篇
  2011年   77999篇
  2010年   45862篇
  2009年   43537篇
  2008年   74305篇
  2007年   79255篇
  2006年   80175篇
  2005年   78663篇
  2004年   75614篇
  2003年   73248篇
  2002年   72249篇
  2001年   116471篇
  2000年   120616篇
  1999年   101956篇
  1998年   28961篇
  1997年   26428篇
  1996年   26165篇
  1995年   25180篇
  1994年   23684篇
  1993年   22025篇
  1992年   80963篇
  1991年   77914篇
  1990年   75080篇
  1989年   72252篇
  1988年   67120篇
  1987年   66029篇
  1986年   62491篇
  1985年   59533篇
  1984年   45065篇
  1983年   38346篇
  1982年   23342篇
  1981年   20761篇
  1979年   42286篇
  1978年   29713篇
  1977年   24957篇
  1976年   23389篇
  1975年   24736篇
  1974年   30456篇
  1973年   28794篇
  1972年   27004篇
  1971年   24879篇
  1970年   23422篇
  1969年   21693篇
  1968年   19773篇
排序方式: 共有10000条查询结果,搜索用时 46 毫秒
41.

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   
42.
43.
44.

Objective

Comparative survival between neoadjuvant chemotherapy and adjuvant chemotherapy for patients with cT2-4N0-1M0 non–small cell lung cancer has not been extensively studied.

Methods

Patients with cT2-4N0-1M0 non–small cell lung cancer who received platinum-based chemotherapy were retrospectively identified. Exclusion criteria included stage IV disease, induction radiotherapy, and targeted therapy. The primary end point was disease-free survival. Secondary end points were overall survival, chemotherapy tolerance, and ability of Response Evaluation Criteria In Solid Tumors response to predict survival. Survival was estimated using the Kaplan–Meier method, compared using the log-rank test and Cox proportional hazards models, and stratified using matched pairs after propensity score matching.

Results

In total, 330 patients met the inclusion criteria (n = 92/group after propensity-score matching; median follow-up, 42 months). Five-year disease-free survival was 49% (95% confidence interval, 39-61) for neoadjuvant chemotherapy versus 48% (95% confidence interval, 38-61) for adjuvant chemotherapy (P = .70). On multivariable analysis, disease-free survival was not associated with neoadjuvant chemotherapy or adjuvant chemotherapy (hazard ratio, 1.1; 95% confidence interval, 0.64-1.90; P = .737), nor was overall survival (hazard ratio, 1.21; 95% confidence interval, 0.63-2.30; P = .572). The neoadjuvant chemotherapy group was more likely to receive full doses and cycles of chemotherapy (P = .014/0.005) and had fewer grade 3 or greater toxicities (P = .001). Response Evaluation Criteria In Solid Tumors response to neoadjuvant chemotherapy was associated with disease-free survival (P = .035); 15% of patients receiving neoadjuvant chemotherapy (14/92) had a major pathologic response.

Conclusions

Timing of chemotherapy, before or after surgery, is not associated with an improvement in overall or disease-free survival among patients with cT2-4N0-1M0 non–small cell lung cancer who undergo complete surgical resection.  相似文献   
45.
46.
47.
48.
49.
50.
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号