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991.
Michael R. Davies Angelina Tang Daria Motamedi C. Benjamin Ma Brian T. Feeley Drew Lansdown 《Seminars in Arthroplasty》2022,32(1):74-81
BackgroundTotal shoulder arthroplasty (TSA) is an increasingly common treatment for end-stage glenohumeral osteoarthritis. Current established radiographic measures and classification systems do not predict patient-reported outcomes from TSA. We hypothesized that the MRI-based Shoulder Osteoarthritis Severity (SOAS) Score would correlate with subjective improvement following TSA.MethodsPatients undergoing TSA with preoperative shoulder MRIs and pre- and postoperative ASES scores with minimum 2-year follow-up were included from a prospectively collected institutional shoulder arthroplasty database. SOAS scores, which is measured from 0 to 100 with an increasing score reflecting greater global degenerative changes, were assessed by two independent reviewers, and Samilson-Prieto grade and Walch classification were scored by one reviewer. Average SOAS scores were correlated with demographic factors and pre-, post-, and change (Δ) in ASES scores. Statistical analysis was performed with STATA with Pearson's correlation, one-way ANOVA, and ROC analysis, with significance defined by p <.05.Results30 patients (age 63 ± 10 years, 14 females, 16 males) who underwent primary anatomic TSA were included. The intraclass correlation coefficient (ICC) for total SOAS scores calculated by reviewers was 0.91. SOAS score correlated significantly with ΔASES (r = 0.61, p = .0003) and preoperative ASES (r = -0.37, p = .042), with greater MRI-based degenerative change associated with greater improvement after TSA and lower preoperative ASES score. No significant relationship was found between either Samilson-Prieto or Walch classification and SOAS or ASES scores. No significant relationship was found between SOAS scores and age, sex, or BMI. Using an MCID of 21 as previously reported, an ROC curve was generated and found to have an AUC of 0.96. A SOAS score cut-point of 36.25 was found to maximize sensitivity and specificity in predicting reaching MCID.ConclusionWe observed a significant positive correlation between the MRI-based SOAS score and functional improvement following TSA measured using change in ASES scores, indicating that patients with more advanced degenerative changes on MRI had greater improvement after shoulder replacement surgery. We found that the correlation strength was highest when comparing total SOAS score to ΔASES as opposed to any individual sub-component of the SOAS score. The MRI-based SOAS score for shoulder osteoarthritis may be a valuable tool for predicting patient outcomes following TSA.Level of evidenceLevel III; Retrospective Cohort Comparison; Prognosis Study 相似文献
992.
Peta Ellen Tehan Morgan Brian Hawes Joanne Hurst Mathew Sebastian Benjamin John Peterson Vivienne Helaine Chuter 《Wound repair and regeneration》2022,30(1):24-33
Australia has the second highest rate of non-traumatic lower extremity amputation (LEA) globally. Australia's large geographical size is one of the biggest challenges facing limb preservation services and may be contributing to LEA. The aim of this study was to determine what factors contribute to the likelihood of LEA in people with active foot ulceration in regional Australia. This retrospective cohort study audited patients with active foot ulceration in a multidisciplinary high risk foot service (HRFS) in regional Australia. Neurological, vascular and wound characteristics were systematically extracted, along with demographic information. Participants were followed for at least 12 months until healing or LEA occurred. Correlations between LEA and clinical and demographic characteristics were assessed using the Pearson's product moment correlation coefficient and chi squared test for independence. Significant variables (p < 0.05) were included in the model. Direct logistic regression assessed the independent contribution of significantly correlated variables on the likelihood of LEA. Of note, 1876 records were hand screened with 476 participants (25%) meeting the inclusion criteria. Geographical distance from the HRFS, toe systolic pressure (TSP), diabetes and infection were all significantly correlated with LEA and included in the logistic regression model. TSP decrease of 1 mmHg (OR 1.02, 95% CI 1.01–1.03), increased geographical distance (1 km) from HRFS (OR 1.006, 95% CI 1.001–1.01) infection (OR 2.08, 95% CI 1.06–4.07) and presence of diabetes (OR 3.77, 95% CI 1.12–12.65) were all significantly associated with increased likelihood of LEA. HRFS should account for the disparity in outcomes between patients living in close proximity to their service, compared to those in rural areas. Optimal management of diabetes, vascular perfusion and control of infection may also contribute to preventing LEA in people with active foot ulceration. 相似文献
993.
Soldozy Sauson Yağmurlu Kaan Kumar Jeyan Elarjani Turki Burks Josh Jamshidi Aria Luther Evan Liu Kenneth C. Benjamin Carolina G. Starke Robert M. Park Min S. Syed Hasan R. Shaffrey Mark E. Komotar Ricardo J. 《Neurosurgical review》2022,45(2):1255-1261
Neurosurgical Review - As the aging population continues to grow, so will the incidence of age-related conditions, including idiopathic normal pressure hydrocephalus (iNPH). The pathogenesis of... 相似文献
994.
Canisius Julian Wagner Andrea Bunk Eva Christina Spille Dorothee Cäcilia Stögbauer Louise Grauer Oliver Hess Katharina Thomas Christian Paulus Werner Stummer Walter Senner Volker Brokinkel Benjamin 《Neurosurgical review》2022,45(4):2767-2775
Neurosurgical Review - Treatment of meningiomas refractory to surgery and irradiation is challenging and effective chemotherapies are still lacking. Recently, in vitro analyses revealed decitabine... 相似文献
995.
Ravi Krupa Killen Annabel Alexander Angus Bell-Davies Frances Biganiro Sebintu James Brazeal Aurelia Butoyi Jean Marie Vianney Diaz Fabio Edgardo Drabile Romeo Fanny Marvin Fernie Lucila Gunawardana Shannon Hartley Emma Hawu Yolisa N. Hendron Holly Joseph Stephanie Alcine Lamahewage Ananda Mahagedera Ruwantha Manirambona Emery Morisho Benjamin Kitambala Muchunu Patrick Niyukuri Alliance Ntaganda Edmond Orliacq Francisco Orliacq Josefina Wobenjo Adili Young Pablo Lakhoo Kokila Ford Kathryn 《World journal of surgery》2022,46(3):476-485
World Journal of Surgery - The Global Initiative for Children's Surgery (GICS) group produced the Optimal Resources for Children’s Surgery (OReCS) document in 2019, listing standards of... 相似文献
996.
Retroperitoneal varices simulating masses 总被引:1,自引:0,他引:1
Howard R. Gould M.D. Sacha Benjamin Albert J. Alter Andrew B. Crummy David T. Atwell 《Abdominal imaging》1982,7(1):335-339
Retroperitoneal varices in portal hypertension may simulate the appearance of neoplastic masses or adenopathy. Contrast-enhanced CT scans clarify the diagnosis of large vascular channels. Three patients with large retroperitoneal varices demonstrated on CT had confirmation by angiography. 相似文献
997.
Dillard E Luchette FA Sears BW Norton J Schermer CR Reed RL Gamelli RL Esposito TJ 《The American journal of emergency medicine》2007,25(7):823-830
Objective
The purpose of this study was to determine if statistical models for prediction of chest injuries would outperform the clinician's (MD) ability to identify injured patients at risk for a thoracic injury diagnosed by chest radiograph (CXR).Design
A prospective observational study was done during a 12-month period.Setting
The study was conducted in a level I trauma center.Patients
Injured patients meeting trauma team activation criteria were enrolled to the study.Interventions
Physical examination findings by a clinician were interpreted and CXR was performed.Outcome measures
The accuracy of 2 mathematical models is compared against the accuracy of clinician's clinical judgment in predicting an injury by CXR. Two newly constructed multivariate models, binary logistic regression (LR) and classification and regression tree (CaRT) analysis, are compared to previously published data of clinician clinical assessment of probability of thoracic injury identified by CXR.Results
Data for 757 patients were analyzed. Classification and regression tree analysis developed a stepwise decision tree to determine which signs/symptoms were indicative of an abnormal CXR finding.The sensitivity (CaRT, 36.6%; LR, 36.3%; MD, 58.7%), specificity (CaRT, 98.3%; LR, 98.2%; MD, 96.4%), and error rates (CaRT, 0.93; LR, 0.94; MD, 0.82) show that the mathematical decision aids are less sensitive and risk more misclassification compared to clinician judgment in predicting an injury by CXR.Conclusion
Clinician judgment was superior to mathematical decision aids for predicting an abnormal CXR finding in injured patients with chest trauma. 相似文献998.
Michael Mengel Alexandre Loupy Mark Haas Candice Roufosse Maarten Naesens Enver Akalin Marian C. Clahsen‐van Groningen Jessy Dagobert Anthony J. Demetris Jean‐Paul Duong van Huyen Juliette Gueguen Fadi Issa Blaise Robin Ivy Rosales Jan H. Von der Thüsen Alberto Sanchez‐Fueyo Rex N. Smith Kathryn Wood Benjamin Adam Robert B. Colvin 《American journal of transplantation》2020,20(9):2305-2317
999.
Marcus R. Pereira Sumit Mohan David J. Cohen Syed A. Husain Geoffrey K. Dube Lloyd E. Ratner Selim Arcasoy Meghan M. Aversa Luke J. Benvenuto Darshana M. Dadhania Sandip Kapur Lorna M. Dove Robert S. Brown Russell E. Rosenblatt Benjamin Samstein Nir Uriel Maryjane A. Farr Michael Satlin Catherine B. Small Thomas J. Walsh Rosy P. Kodiyanplakkal Benjamin A. Miko Justin G. Aaron Demetra S. Tsapepas Jean C. Emond Elizabeth C. Verna 《American journal of transplantation》2020,20(7):1800-1808
Solid organ transplant recipients may be at a high risk for SARS‐CoV‐2 infection and poor associated outcomes. We herein report our initial experience with solid organ transplant recipients with SARS‐CoV‐2 infection at two centers during the first 3 weeks of the outbreak in New York City. Baseline characteristics, clinical presentation, antiviral and immunosuppressive management were compared between patients with mild/moderate and severe disease (defined as ICU admission, intubation or death). Ninety patients were analyzed with a median age of 57 years. Forty‐six were kidney recipients, 17 lung, 13 liver, 9 heart, and 5 dual‐organ transplants. The most common presenting symptoms were fever (70%), cough (59%), and dyspnea (43%). Twenty‐two (24%) had mild, 41 (46%) moderate, and 27 (30%) severe disease. Among the 68 hospitalized patients, 12% required non‐rebreather and 35% required intubation. 91% received hydroxychloroquine, 66% azithromycin, 3% remdesivir, 21% tocilizumab, and 24% bolus steroids. Sixteen patients died (18% overall, 24% of hospitalized, 52% of ICU) and 37 (54%) were discharged. In this initial cohort, transplant recipients with COVID‐19 appear to have more severe outcomes, although testing limitations likely led to undercounting of mild/asymptomatic cases. As this outbreak unfolds, COVID‐19 has the potential to severely impact solid organ transplant recipients. 相似文献
1000.