全文获取类型
收费全文 | 29879篇 |
免费 | 2857篇 |
国内免费 | 48篇 |
专业分类
耳鼻咽喉 | 310篇 |
儿科学 | 1135篇 |
妇产科学 | 618篇 |
基础医学 | 3843篇 |
口腔科学 | 538篇 |
临床医学 | 3688篇 |
内科学 | 5111篇 |
皮肤病学 | 507篇 |
神经病学 | 2915篇 |
特种医学 | 884篇 |
外国民族医学 | 1篇 |
外科学 | 4233篇 |
综合类 | 728篇 |
一般理论 | 24篇 |
预防医学 | 3600篇 |
眼科学 | 455篇 |
药学 | 2307篇 |
1篇 | |
中国医学 | 45篇 |
肿瘤学 | 1841篇 |
出版年
2023年 | 215篇 |
2022年 | 291篇 |
2021年 | 816篇 |
2020年 | 448篇 |
2019年 | 770篇 |
2018年 | 919篇 |
2017年 | 646篇 |
2016年 | 625篇 |
2015年 | 701篇 |
2014年 | 987篇 |
2013年 | 1408篇 |
2012年 | 1974篇 |
2011年 | 2057篇 |
2010年 | 1106篇 |
2009年 | 978篇 |
2008年 | 1599篇 |
2007年 | 1605篇 |
2006年 | 1555篇 |
2005年 | 1523篇 |
2004年 | 1381篇 |
2003年 | 1302篇 |
2002年 | 1240篇 |
2001年 | 719篇 |
2000年 | 624篇 |
1999年 | 541篇 |
1998年 | 259篇 |
1997年 | 210篇 |
1996年 | 252篇 |
1995年 | 201篇 |
1994年 | 193篇 |
1993年 | 172篇 |
1992年 | 393篇 |
1991年 | 393篇 |
1990年 | 429篇 |
1989年 | 381篇 |
1988年 | 303篇 |
1987年 | 330篇 |
1986年 | 273篇 |
1985年 | 293篇 |
1984年 | 236篇 |
1983年 | 187篇 |
1982年 | 149篇 |
1981年 | 134篇 |
1980年 | 129篇 |
1979年 | 207篇 |
1978年 | 162篇 |
1977年 | 133篇 |
1976年 | 112篇 |
1974年 | 138篇 |
1973年 | 115篇 |
排序方式: 共有10000条查询结果,搜索用时 631 毫秒
971.
Elizabeth FitzSullivan MD Sara A. Lari BS Benjamin Smith MD Abigail S. Caudle MD Savitri Krishnamurthy MD Anthony Lucci MD Elizabeth A. Mittendorf MD PhD Gildy V. Babiera MD Dalliah M. Black MD Jamie L. Wagner DO Isabelle Bedrosian MD Wendy Woodward MD Sarah M. Gainer MD Rosa Hwang MD Funda Meric-Bernstam MD Kelly K. Hunt MD Henry M. Kuerer MD PhD 《Annals of surgical oncology》2013,20(13):4103-4112
Background
The impact of close margins in patients with ductal carcinoma-in situ (DCIS) treated with mastectomy is unclear; however, this finding may lead to a recommendation for postmastectomy radiotherapy (PMRT). We sought to determine the incidence and consequences of close margins in patients with DCIS treated with mastectomy.Methods
The records of 810 patients with DCIS treated with mastectomy from 1996 through 2009 were reviewed. Clinical and pathologic factors were analyzed with respect to final margin status. Median follow-up was 6.3 years.Results
Overall, 94 patients (11.7 %) had close margins (positive, n = 5; negative but ≤1 mm, n = 54; 1.1–2.9 mm, n = 35). Independent risk factors for close margins included multicentricity, pathologic lesion size ≥1.5 cm, and necrosis, but not age, use of skin-sparing mastectomy, or immediate reconstruction (p > 0.05). Seven patients received PMRT, and none had a locoregional recurrence (LRR). Among the remaining 803 patients, the 10-year LRR rate was 1 % (5.0 % for margins ≤1 mm, 3.6 % for margins 1.1–2.9 mm, and 0.7 % for margins ≥3 mm [p < 0.001]). The 10-year rate of contralateral breast cancer was 6.4 %. On multivariate analysis, close margins was the only independent predictor of LRR (p = 0.005).Conclusions
Close margins occur in a minority of patients undergoing mastectomy for DCIS and is the only independent risk factor for LRR. As the LRR rate in patients with close margins is low and less than the rate of contralateral breast cancer, PMRT is not warranted except for patients with multiple close/positive margins that cannot be surgically excised. 相似文献972.
Gina M. Howell MD Sally E. Carty MD Michaele J. Armstrong PhD Michael T. Stang MD Kelly L. McCoy MD David L. Bartlett MD Linwah Yip MD FACS 《Annals of surgical oncology》2013,20(11):3491-3496
Background
The purpose of this study was to describe a single-institution experience with adrenal metastasectomy and to elucidate factors that may bear prognostic significance.Methods
This is a single-center, retrospective review of patients with adrenal metastasis who underwent adrenalectomy performed with curative intent between 2000 and 2012. The Kaplan–Meier method was used to evaluate overall survival from time of adrenalectomy to death or last follow-up. Primary endpoint was death from any cause. Clinical variables were examined for association with survival.Results
The study included 62 patients with mean age of 60 (±12) years; 55 % (34 of 62) were male, 85 % (53 of 62) presented with isolated adrenal metastasis, and 82 % (51 of 62) had metachronous disease with median disease-free interval (DFI) of 22 months (range, 6–217 months). Non-small cell lung cancer (NSCLC) was the most common primary comprising 50 % of cases. Median survival for the study population was 30 months (range, 1–145 months) and 5-year survival was 31 %. Patients with NSCLC had significantly shortened survival compared with non-NSCLC with median and 5-year survival of 17 versus 47 months and 27 % versus 38 %, respectively (p = .033). Synchronous metastasis (p = .028) and DFI < 12 months (p = .038) were also associated with worse survival outcome, though male gender (p = .69) and oligometastatic disease (p = .62) were not.Conclusions
Adrenal metastasectomy resulted in median survival of 30 months and 5-year survival of 31 %. Shorter survival was associated with lung primary, short disease-free interval, and synchronous metastasis, but not with the presence of oligometastatic disease provided that the primary cancer and additional metastatic lesions were adequately controlled and amenable to resection. 相似文献973.
974.
975.
Kaitlyn J. Kelly Emily Winslow David Kooby Neha L. Lad Alexander A. Parikh Charles R. Scoggins Syed Ahmad Robert C. Martin Shishir K. Maithel H. J. Kim Nipun B. Merchant Clifford S. Cho Sharon M. Weber 《Journal of gastrointestinal surgery》2013,17(7):1209-1217
Introduction
Current National Comprehensive Cancer Network guidelines recommend neoadjuvant therapy for borderline resectable pancreatic adenocarcinoma to increase the likelihood of achieving R0 resection. A consensus has not been reached on the degree of venous involvement that constitutes borderline resectability. This study compares the outcome of patients who underwent pancreaticoduodenectomy with or without vein resection without neoadjuvant therapy.Methods
A multi-institutional database of patients who underwent pancreaticoduodenectomy was reviewed. Patients who required vein resection due to gross vein involvement by tumor were compared to those without evidence of vein involvement.Results
Of 492 patients undergoing pancreaticoduodenectomy, 70 (14 %) had vein resection and 422 (86 %) did not. There was no difference in R0 resection (66 vs. 75 %, p?=?NS). On multivariate analysis, vein involvement was not predictive of disease-free or overall survival.Conclusion
This is the largest modern series examining patients with or without isolated vein involvement by pancreas cancer, none of whom received neoadjuvant therapy. Oncological outcome was not different between the two groups. These data suggest that up-front surgical resection is an appropriate option and call into question the inclusion of isolated vein involvement in the definition of “borderline resectable disease.” 相似文献976.
977.
978.
979.
980.