全文获取类型
收费全文 | 2895篇 |
免费 | 158篇 |
国内免费 | 23篇 |
专业分类
耳鼻咽喉 | 56篇 |
儿科学 | 132篇 |
妇产科学 | 37篇 |
基础医学 | 232篇 |
口腔科学 | 69篇 |
临床医学 | 283篇 |
内科学 | 539篇 |
皮肤病学 | 33篇 |
神经病学 | 142篇 |
特种医学 | 69篇 |
外科学 | 754篇 |
综合类 | 34篇 |
预防医学 | 100篇 |
眼科学 | 67篇 |
药学 | 237篇 |
中国医学 | 8篇 |
肿瘤学 | 284篇 |
出版年
2024年 | 2篇 |
2023年 | 26篇 |
2022年 | 60篇 |
2021年 | 151篇 |
2020年 | 63篇 |
2019年 | 100篇 |
2018年 | 150篇 |
2017年 | 100篇 |
2016年 | 123篇 |
2015年 | 108篇 |
2014年 | 159篇 |
2013年 | 194篇 |
2012年 | 279篇 |
2011年 | 266篇 |
2010年 | 158篇 |
2009年 | 116篇 |
2008年 | 190篇 |
2007年 | 183篇 |
2006年 | 164篇 |
2005年 | 121篇 |
2004年 | 117篇 |
2003年 | 96篇 |
2002年 | 61篇 |
2001年 | 12篇 |
2000年 | 13篇 |
1999年 | 17篇 |
1998年 | 8篇 |
1997年 | 2篇 |
1996年 | 6篇 |
1995年 | 4篇 |
1994年 | 4篇 |
1991年 | 1篇 |
1990年 | 2篇 |
1989年 | 1篇 |
1988年 | 6篇 |
1987年 | 4篇 |
1986年 | 1篇 |
1985年 | 1篇 |
1984年 | 1篇 |
1980年 | 1篇 |
1979年 | 2篇 |
1974年 | 2篇 |
1973年 | 1篇 |
排序方式: 共有3076条查询结果,搜索用时 15 毫秒
41.
Anil Agarwal Manish Pruthi 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2011,21(6):411-415
Tubercular osteomyelitis is an important differential diagnosis of non-traumatic lesions of clavicle in children, particularly
in developing countries. Diagnosis at this site is difficult due to poor visualization caused by overlapping anatomical structures.
We report 3 cases of tubercular osteomyelitis of clavicle in children. All the cases were proven histologically before start
of antitubercular treatment. One case required surgical debridement, and other 2 cases were treated with medical management
only. Suspicion and obtaining tissues from multiple sites for examination is the key to diagnosis of this rare pathology.
Multidrug antitubercular drugs with or without debridement is curative. 相似文献
42.
Atul Deodhar Manish Mittal Patrick Reilly Yanjun Bao Shivaji Manthena Jaclyn Anderson Avani Joshi 《Clinical rheumatology》2016,35(7):1769-1776
This study aimed to identify providers involved in diagnosing ankylosing spondylitis (AS) following back pain diagnosis in the USA and to identify factors leading to the delay in rheumatology referrals. The Truven Health MarketScan® US Commercial Database was searched for patients aged 18–64 years with back pain diagnosis in a non-rheumatology setting followed by AS diagnosis in any setting during January 2000–December 2012. Patients with a rheumatologist visit on or before AS diagnosis were considered referred. Cox regression was used to determine factors associated with referral time after adjusting for age, sex, comorbidities, physician specialty, drug therapy, and imaging procedures. Of 3336 patients included, 1244 (37 %) were referred to and diagnosed by rheumatologists; the others were diagnosed in primary care (25.7 %), chiropractic/physical therapy (7 %), orthopedic surgery (3.8 %), pain clinic (3.6 %), acute care (3.4 %), and other (19.2 %) settings. Median time from back pain diagnosis to rheumatology referral was 307 days and from first rheumatologist visit to AS diagnosis was 28 days. Referred patients were more likely to be younger (hazard ratio [HR]?=?0.986; p?<?0.0001), male (HR?=?1.15; p?=?0.0163), diagnosed with uveitis (HR?=?1.49; p?=?0.0050), referred by primary care physicians (HR?=?1.96; p?<?0.0001), prescribed non-steroidal anti-inflammatory drugs (HR?=?1.55; p?<?0.0001), disease-modifying antirheumatic drugs (HR?=?1.33; p?<?0.0001), and tumor necrosis factor inhibitors (HR?=?1.40; p?=?0.0036), and to have had spinal/pelvic X-ray prior to referral (HR?=?1.28; p?=?0.0003). During 2000–2012, most patients with AS were diagnosed outside of rheumatology practices. The delay before referral to rheumatology was 10 months; AS diagnosis generally followed within a month. Earlier referral of patients with AS signs and symptoms may lead to more timely diagnosis and appropriate treatment. 相似文献
43.
44.
45.
Rajendra Kumar Gokhroo Kaul Anushri M.T. Tarik C. Kailash N. Rajesh K. Ashish G. Manish C. Subhash 《Indian heart journal》2021,73(2):205-210
BackgroundSacubitril/Valsartan (ARNI) has now class 1 recommendation for treatment of heart failure with reduced ejection fraction (HFrEF). It has been shown to reduce cardiovascular morbidity & mortality in Heart failure with reduced ejection fraction (HFrEF) and significant improvement in all echocardiographic parameters besides TEI index. Tei index is a marker of inflammation, myocardial cell metabolism and its contractile function has not been evaluated as a distinctive entity so we took up this study to evaluate the effects of ARNI on the LV functions using two dimensional (2D)ECHO parameters in Indian population and to assess TEI index for myocardial function.Methods256 patients with class II, III or IV HF and EF<40% were enrolled. 171(66.8%) were males and 85(33.2%) were females. Patients were evaluated at baseline, 6 and 12 months for LVEF, LV mass &,LVMPI. Drug was discontinued in 2 patients due to angioedema, in 5 patients due to acute kidney injury and in 2 patients due to hypotension. LV mass measurement done by linear echocardiographic method and Flow Doppler method used for TEI index calculation.ResultsBaseline parameters in 247 patients were mean EF = 26.33 ± 6.28%, mean LV mass = 270.84 ± 68.94 gm, mean Tei Index = 0.852 ± 0.22. ARNI use was associated with an average gradual increase in EF, from a mean baseline of 26.33 ± 6.28% to 33.88 ± 7.73%(p = 0.000001) after 1 year of treatment. There was a significant progressive reduction of 57.97 g/m2 in mean LV mass index after 1 year of treatment (p = 0.000001).TEI index showed significant reduction from baseline mean 0.85 ± 0.22 to 0.70 ± 0.12(p = 0.000001)after 1 year of treatment.ConclusionUse of ARNI as additive adjunct to standard care of treatment resulted in significant progressive decline in LV mass and increase in TEI index. 相似文献
46.
David A. Talan Sukhjit S. Takhar Anusha Krishnadasan William R. Mower Daniel J. Pallin Manish Garg Jon Femling Richard E. Rothman Johanna C. Moore Alan E. Jones Frank Lovecchio Jonathan Jui Mark T. Steele Amy M. Stubbs William K. Chiang Gregory J. Moran 《Annals of emergency medicine》2021,77(1):32-43
47.
Timothy R. Holden MD MS Manish N. Shah MD MPH Tommy A. Gibson Robert E. Weiss PhD Annick N. Yagapen MPH CCRP Susan E. Malveau MSBE David H. Adler MD MPH Aveh Bastani MD Christopher W. Baugh MD MBA Jeffrey M. Caterino MD MPH Carol L. Clark MD MBA Deborah B. Diercks MD MPH Judd E. Hollander MD Bret A. Nicks MD MHA Daniel K. Nishijima MD MAS Kirk A. Stiffler MD Alan B. Storrow MD Scott T. Wilber MD Benjamin C. Sun MD MPP 《Academic emergency medicine》2018,25(8):880-890
Objectives
Syncope and near‐syncope are common in patients with dementia and a leading cause of emergency department (ED) evaluation and subsequent hospitalization. The objective of this study was to describe the clinical trajectory and short‐term outcomes of patients who presented to the ED with syncope or near‐syncope and were assessed by their ED provider to have dementia.Methods
This multisite prospective cohort study included patients 60 years of age or older who presented to the ED with syncope or near‐syncope between 2013 and 2016. We analyzed a subcohort of 279 patients who were identified by the treating ED provider to have baseline dementia. We collected comprehensive patient‐level, utilization, and outcomes data through interviews, provider surveys, and chart abstraction. Outcome measures included serious conditions related to syncope and death.Results
Overall, 221 patients (79%) were hospitalized with a median length of stay of 2.1 days. A total of 46 patients (16%) were diagnosed with a serious condition in the ED. Of the 179 hospitalized patients who did not have a serious condition identified in the ED, 14 (7.8%) were subsequently diagnosed with a serious condition during the hospitalization, and an additional 12 patients (6.7%) were diagnosed postdischarge within 30 days of the index ED visit. There were seven deaths (2.5%) overall, none of which were cardiac‐related. No patients who were discharged from the ED died or had a serious condition in the subsequent 30 days.Conclusions
Patients with perceived dementia who presented to the ED with syncope or near‐syncope were frequently hospitalized. The diagnosis of a serious condition was uncommon if not identified during the initial ED assessment. Given the known iatrogenic risks of hospitalization for patients with dementia, future investigation of the impact of goals of care discussions on reducing potentially preventable, futile, or unwanted hospitalizations while improving goal‐concordant care is warranted.48.
Ashok Kumar Reddy Raja Rami Reddy Muralidhar Rao Paruvelli Srinivas Ambatipudi Alka Rani Sikander A. K. Lodhi Juturi Maruthi Lokabhi Reddy K. Ramakanth Reddy Niraj Pandey Rituraj Videkar Manish Kumar Sinha Ajit Babu Majji Nilanjana Deb-Jorder Atul Kumar Sahu Jyostna Myneni Anina Abraham 《International ophthalmology》2015,35(1):37-42
49.
Sohan Lal Solanki Saneya Pandrowala Abhirup Nayak Manish Bhandare Reshma P Ambulkar Shailesh V Shrikhande 《World journal of gastroenterology : WJG》2021,27(21):2758-2770
Artificial intelligence (AI) demonstrated by machines is based on reinforcement learning and revolves around the usage of algorithms. The purpose of this review was to summarize concepts, the scope, applications, and limitations in major gastrointestinal surgery. This is a narrative review of the available literature on the key capabilities of AI to help anesthesiologists, surgeons, and other physicians to understand and critically evaluate ongoing and new AI applications in perioperative management. AI uses available databases called “big data” to formulate an algorithm. Analysis of other data based on these algorithms can help in early diagnosis, accurate risk assessment, intraoperative management, automated drug delivery, predicting anesthesia and surgical complications and postoperative outcomes and can thus lead to effective perioperative management as well as to reduce the cost of treatment. Perioperative physicians, anesthesiologists, and surgeons are well-positioned to help integrate AI into modern surgical practice. We all need to partner and collaborate with data scientists to collect and analyze data across all phases of perioperative care to provide clinical scenarios and context. Careful implementation and use of AI along with real-time human interpretation will revolutionize perioperative care, and is the way forward in future perioperative management of major surgery. 相似文献
50.
Osteoporosis in elderly: prevention and treatment 总被引:16,自引:0,他引:16
Osteoporosis is a major clinical problem in older women and men. Almost any bone can fracture as a result of the increased bone fragility of osteoporosis. These fractures are associated with higher health care costs, physical disability, impaired quality of life, and increased mortality. Because the incidence of osteoporotic fracture increases with advancing age, measures to diagnose and prevent osteoporosis and its complications assume a major public health concern. BMD is a valuable tool to identify patients at risk for fracture, to make therapeutic decisions, and to monitor therapy. Several other modifiable and nonmodifiable risk factors for osteoporosis have also been identified. Treatment of potentially modifiable risk factors along with exercise and calcium and vitamin D supplementation forms an important adjunct to pharmacologic management of osteoporosis. Improved household safety can reduce the risk of falls. Hip protectors have been found to be effective in nursing home population. The pharmacologic options include bisphosphonates, HRT, SERMs and calcitonin. PTH had received FDA advisory committee approval. Alendronate has been approved for treatment of osteoporosis in men, and other treatments for men are under evaluation. 相似文献