全文获取类型
| 收费全文 | 1600867篇 |
| 免费 | 133696篇 |
| 国内免费 | 2577篇 |
专业分类
| 耳鼻咽喉 | 21657篇 |
| 儿科学 | 52954篇 |
| 妇产科学 | 46266篇 |
| 基础医学 | 227966篇 |
| 口腔科学 | 47219篇 |
| 临床医学 | 141067篇 |
| 内科学 | 315047篇 |
| 皮肤病学 | 34103篇 |
| 神经病学 | 130238篇 |
| 特种医学 | 64775篇 |
| 外国民族医学 | 474篇 |
| 外科学 | 243885篇 |
| 综合类 | 39737篇 |
| 现状与发展 | 3篇 |
| 一般理论 | 544篇 |
| 预防医学 | 123023篇 |
| 眼科学 | 36511篇 |
| 药学 | 121321篇 |
| 3篇 | |
| 中国医学 | 2974篇 |
| 肿瘤学 | 87373篇 |
出版年
| 2018年 | 14811篇 |
| 2016年 | 12932篇 |
| 2015年 | 15050篇 |
| 2014年 | 20689篇 |
| 2013年 | 31406篇 |
| 2012年 | 42621篇 |
| 2011年 | 44848篇 |
| 2010年 | 26385篇 |
| 2009年 | 25347篇 |
| 2008年 | 43062篇 |
| 2007年 | 45309篇 |
| 2006年 | 46124篇 |
| 2005年 | 44749篇 |
| 2004年 | 44151篇 |
| 2003年 | 42233篇 |
| 2002年 | 41361篇 |
| 2001年 | 75696篇 |
| 2000年 | 78348篇 |
| 1999年 | 66405篇 |
| 1998年 | 17739篇 |
| 1997年 | 16353篇 |
| 1996年 | 16325篇 |
| 1995年 | 16029篇 |
| 1994年 | 15083篇 |
| 1993年 | 14227篇 |
| 1992年 | 55441篇 |
| 1991年 | 53788篇 |
| 1990年 | 52579篇 |
| 1989年 | 50857篇 |
| 1988年 | 47241篇 |
| 1987年 | 46574篇 |
| 1986年 | 44296篇 |
| 1985年 | 42856篇 |
| 1984年 | 32040篇 |
| 1983年 | 27576篇 |
| 1982年 | 16150篇 |
| 1981年 | 14442篇 |
| 1980年 | 13568篇 |
| 1979年 | 30469篇 |
| 1978年 | 21075篇 |
| 1977年 | 17769篇 |
| 1976年 | 16698篇 |
| 1975年 | 17575篇 |
| 1974年 | 21494篇 |
| 1973年 | 20677篇 |
| 1972年 | 18862篇 |
| 1971年 | 17780篇 |
| 1970年 | 16293篇 |
| 1969年 | 15272篇 |
| 1968年 | 13950篇 |
排序方式： 共有10000条查询结果，搜索用时 31 毫秒
201.
Bimal Bhindi Christine M. Lohse Phillip J. Schulte Ross J. Mason John C. Cheville Stephen A. Boorjian Bradley C. Leibovich R. Houston Thompson 《European urology》2019,75(5):766-772
Background
Partial nephrectomy (PN) is generally favored for cT1 tumors over radical nephrectomy (RN) when technically feasible. However, it can be unclear whether the additional risks of PN are worth the magnitude of renal function benefit.Objective
To develop preoperative tools to predict long-term estimated glomerular filtration rate (eGFR) beyond 30 d following PN and RN, separately.Design, setting, and participants
In this retrospective cohort study, patients who underwent RN or PN for a single nonmetastatic renal tumor between 1997 and 2014 at our institution were identified. Exclusion criteria were venous tumor thrombus and preoperative eGFR <15 ml/min/1.73 m2.Intervention
RN and PN.Outcome measurements and statistical analysis
Hierarchical generalized linear mixed-effect models with backward selection of candidate preoperative features were used to predict long-term eGFR following RN and PN, separately. Predictive ability was summarized using marginal , which ranges from 0 to 1, with higher values indicating increased predictive ability.Results and limitations
The analysis included 1152 patients (13 206 eGFR observations) who underwent RN and 1920 patients (18 652 eGFR observations) who underwent PN, with mean preoperative eGFRs of 66 ml/min/1.73 m2 (standard deviation [SD] = 18) and 72 ml/min/1.73 m2 (SD = 20), respectively. The model to predict eGFR after RN included age, diabetes, preoperative eGFR, preoperative proteinuria, tumor size, time from surgery, and an interaction between time from surgery and age (marginal ). The model to predict eGFR after PN included age, presence of a solitary kidney, diabetes, hypertension, preoperative eGFR, preoperative proteinuria, surgical approach, time from surgery, and interaction terms between time from surgery and age, diabetes, preoperative eGFR, and preoperative proteinuria (marginal ). Limitations include the lack of data on renal tumor complexity and the single-center design; generalizability needs to be confirmed in external cohorts.Conclusions
We developed preoperative tools to predict renal function outcomes following RN and PN. Pending validation, these tools should be helpful for patient counseling and clinical decision-making.Patient summary
We developed models to predict kidney function outcomes after partial and radical nephrectomy based on preoperative features. This should help clinicians during patient counseling and decision-making in the management of kidney tumors. 相似文献202.
Die Unfallchirurgie - Zur Diagnostik von Schultergelenkerkrankungen wird routinemäßig die Magnetresonanztomographie (MRT) durchgeführt. Diese kann entsprechend der klinischen... 相似文献
203.
204.
205.
206.
207.
A.B. Sanchez-Spitman J.J. Swen V.O. Dezentje D.J.A.R. Moes H. Gelderblom 《Expert review of clinical pharmacology》2019,12(6):523-536
Introduction: Tamoxifen dominates the anti-estrogenic therapy in the early and metastatic breast cancer setting. Tamoxifen has a complex metabolism, being mainly metabolized by CYP2D6 into its 30–100 times more potent metabolite, endoxifen. Recently, a phase I study in which endoxifen as an orally z-endoxifen hydrochloride has been successfully evaluated.
Areas covered: the principal pharmacogenetic and non-genetic differences in the pharmacology of tamoxifen and endoxifen are evaluated. To this end, references from PubMed, Embase or Web of Science, among others, were reviewed As non-genetic factors, important differences and similarities such age, or adherence to tamoxifen therapy are comprehensively illustrated. Additionally, since CYP2D6 genotypes are considered the main limitation of tamoxifen, many studies have investigated the association between the worsened clinical outcomes in patients with non-functional CYP2D6 genotypes. In this review, an overview of the research on this field is presented. Also, a summary describing the literature about individualizing tamoxifen therapy with endoxifen concentrations and its limitations is listed.
Expert opinion: z-endoxifen hydrochloride is only investigated in the metastatic setting, still more research is required before its place in therapeutics is known. Similarly, monitoring tamoxifen efficacy based on endoxifen concentrations might not be overall recommended due to the limited evidence available. 相似文献
208.
209.
J.A. Hannam S.J. Mitchell D. Cumin C. Frampton A.F. Merry M.R. Moore C.J. Kruger 《British journal of anaesthesia》2019,122(2):198-205
Background
Etomidate is frequently selected over propofol for induction of anaesthesia because of a putatively favourable haemodynamic profile, but data confirming this perception are limited.Methods
Patients undergoing cardiac surgery were randomised to induction of anaesthesia with propofol or etomidate. Phase I (n=75) was conducted as open-label, whereas Phase II (n=75) was double blind. Mean arterial blood pressure (MAP) and boluses of vasopressor administered after induction were recorded. The primary endpoint was the area under the curve below baseline MAP (MAP-time integral) during the 10 min after induction. Secondary endpoints were the use of vasopressors over the same period, and the effect of blinding on the aforementioned endpoints. Groups were compared using regression models with phase and anaesthetist as factors.Results
The mean difference between etomidate and propofol in the MAP-time integral below baseline was 2244 mm Hg s (95% confidence interval, 581–3906; P=0.009), representing a 34% greater reduction with propofol. Overall, vasopressors were used in 10/75 patients in the etomidate group vs 21/75 in the propofol group (P=0.38), and in 20/74 patients during the blinded phase vs 11/76 during the open-label phase (P=0.31). The interaction between randomisation and phase (open-labelled or blinded) was not significant for either primary (P=0.73) or secondary endpoints (P=0.90).Conclusions
Propofol caused a 34% greater reduction in MAP-time integral from baseline after induction of anaesthesia than etomidate, despite more frequent use of vasopressors with propofol, confirming the superior haemodynamic profile of etomidate in this context. The proportion of patients receiving vasopressors increased slightly, albeit not significantly, in both groups in the blinded phase.Clinical trial registration
Australian and New Zealand Clinical Trials Registry, ACTRN12614000717651. 相似文献210.
B. Davido R. Batista H. Fessi H. Michelon L. Escaut C. Lawrence M. Denis C. Perronne J. Salomon A. Dinh 《Médecine et maladies infectieuses》2019,49(3):214-218