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991.
Background
Influenza and pneumococcal vaccination are recommended for a number of clinical risk groups including patients treated with major immunosuppressant disease modifying anti-rheumatic drugs. Such immunisation is not only safe but immunogenic in patients with rheumatic diseases. We sought to establish dual vaccination rates and significant influencing factors amongst our hospital rheumatology outpatients. 相似文献992.
Nobuhito Morota 《Child's nervous system》2007,23(9):1007-1014
Purpose The author describes the history of functional posterior rhizotomy (FPR), the surgical procedure currently used, and the results
together with its future perspective in Japan. The modern form of FPR was introduced to Japan in 1995, and the first surgery
was carried out in 1996. Despite initial resistance from orthopedic surgeons, the procedure has eventually gained wide recognition
in the country.
Materials and Methods The author has operated on 98 patients (60 boys and 38 girls, aged from 2 to 19 years old) by the end of 2006. Most patients
were mild to severely disabled children with spastic hypertonia because of cerebral palsy and other diseases. The surgical
procedure used is based on the Peacock’s procedure with some modification for the mildly disabled children whose spasticity
was predominantly the muscles of the ankle joint. Intraoperative neurophysiology was an indispensable tool for preserving
urogenital function and for judging which root/rootlet to be cut.
Results Seventeen to 83% of the root/rootlets were found to be abnormal and were cut, clearly correlating with the degree of disability.
However, there was a wide difference in the cutting rate, even in children with the same degree of disability. The result
of surgery in this group of patients was the same as in previously published data. Twenty out of 51 patients (39%) followed
for more than a year at the current institute showed improved locomotion after FPR. Thirty patients (59%) demonstrated suprasegmental
effects after FPR.
Conclusion The role of FPR will grow in importance as a treatment for spasticity in Japan in the future. 相似文献
993.
Kuniaki Nakahara Satoru Shimizu Satoshi Utsuki Sachio Suzuki Hidehiro Oka Kiyotaka Fujii 《Child's nervous system》2007,23(8):863-865
Objects We evaluated whether the presence of lacunar skull deformity (LSD) with myelomeningocele is a predictive factor for subsequent
hydrocephalus development.
Materials and methods We reviewed the clinical and radiological records of 18 infants with myelomeningocele, divided the patients into groups with
(group A, n=9) and without (group B, n=9) ventriculomegaly at birth and assessed whether the presence of LSD was predictive of the necessity for ventriculoperitoneal
shunt (VPS) placement.
Results LSD was present in five group A patients. All nine group A patients underwent VPS placement. Among the group B patients, five
had LSD; they underwent VPS placement. A significantly higher proportion of those with ventricle enlargement or LSD at birth
required VPS placement (p=0.0001).
Conclusion Adding to the ventriculomegaly at birth, the presence of LSD alerts to the necessity to monitor these infants closely to determine
the necessity for VPS placement. 相似文献
994.
995.
Paolo Miletto 《European journal of nuclear medicine and molecular imaging》2007,34(2):304-304
996.
James A. Case Bai Ling Hsu Timothy M. Bateman S. James Cullom 《Journal of nuclear cardiology》2007,14(3):324-333
Background High-quality attenuation maps are critical for attenuation correction of myocardial perfusion single photon emission computed
tomography studies. The filtered backprojection (FBP) approach can introduce errors, especially with low-count transmission
data. We present a new method for attenuation map reconstruction and examine its performance in phantom and patient data.
Methods and Results The Bayesian iterative transmission gradient algorithm incorporates a spatially varying gamma prior function that preferentially
weights estimated attenuation coefficients toward the soft-tissue value while allowing data-driven solutions for lung and
bone regions. The performance with attenuation-corrected technetium 99m sestamibi clinical images was evaluated in phantom
studies and in 50 low-likelihood patients grouped by body mass index (BMI). The algorithm converged in 15 iterations in the
phantom studies. For the clinical studies, soft-tissue estimates had significantly greater uniformity of mediastinal coefficients
(mean SD, 0.005 cm−1 vs 0.011 cm−1; P<.0001). The accuracy and uniformity of the Bayesian iterative transmission gradient algorithm were independent of BMI, whereas
both declined at higher BMI values with FBP. Attenuation-corrected perfusion images showed improvement in myocardial wall
variability (4.8% to 4.1%, P=.02) for all BMI groups with the new method compared with FBP.
Conclusion This new method for attenuation map reconstruction provides rapidly converging and accurate attenuation maps over a wide spectrum
of patient BMI values and significantly improves attenuation-corrected perfusion images. 相似文献
997.
Frank Makowiec Stefan Post Hans-Detlev Saeger Norbert Senninger Heinz Becker Michael Betzler Heinz J. Buhr Ulrich T. Hopt German Advanced Surgical Treatment Study Group 《Journal of gastrointestinal surgery》2005,9(8):1080-1087
Despite decreasing mortality rates, morbidity is still high after pancreatic head resection. Comparative data in the United
States and Europe show a relationship between hospital volume and mortality. Treatment strategies vary frequently, partially
because of the lack of evidence-based data. We performed a multi-institutional analysis in Germany evaluating current numbers,
indications, techniques, and complication rates of pancreatic head resection. Questionnaires were completed by seven high-volume
surgical departments regarding quantitative and qualitative aspects of pancreatic head resections in the period from 1999
to 2004 (five prospective and two retrospective institutional databases). A total of 1454 pancreatic head resections (944
for malignancy) were reported. Mean annual hospital volume ranged from 14 to 52 (10 to 43 in malignancy). Mortality was between
1.1% and 4.8%, morbidity was between 24% and 46%, and pancreatic leakage was between 9% and 20%. In malignant disease, all
centers perform standard lymphadenectomy and regard arterial infiltration as a contraindication for resection. However, the
rate of portal vein resection varied from 0% to 28%. No consensus is seen on the type of surgery for malignancy and chronic
pancreatitis. After resection for pancreatic cancer less than one fourth of the patients receive adjuvant therapy. The results
of our analysis in Germany confirm that pancreatic head resection can be performed with low mortality in specialized units.
Variations in indications, operative technique, and perioperative care may demonstrate the lack of evidence-based data and/or
personal and institutional experience. The low number of patients receiving adjuvant therapy after resection of pancreatic
cancer suggests that more efforts must be made to establish novel adjuvant therapies under randomized study conditions.
Presented at the Forty-Sixth Annual Meeting of The Society for Surgery of the Alimentary Tract, Chicago, Illinois, May 14–18,
2005 (oral presentation). 相似文献
998.
Takahiko Misao Kanji Minamoto Hideharu Nakano Masataka Yamane Yosuke Yamamoto Katashi Satoh 《General thoracic and cardiovascular surgery》2005,53(6):309-312
A 64-year-old female was found to have localized ground-glass opacity (GGO) in the middle lobe on a chest computed tomography (CT) for screening. Middle lobectomy with video-assisted thoracoscopic surgery (VATS) was undertaken, and pathological diagnosis was a bronchioloalveolar carcinoma (BAC) in stage IA. A follow-up CT a year following the surgery revealed localized GGO in area S6 of the left lung. However, it disappeared during the gravitation-dependent gradient in the observation period. The patient was scanned again under prone position to exclude the gravitational effect, resulting in definite detection of the GGO. Left extended S6 segmentectomy with VATS was performed, and pathological diagnosis was a BAC in stage IA. As GGO existing in a gravitation-dependent area may be masked by the gravitation-dependent density, a change of the scanning position may lead to a proper detection of the tumor for the diagnosis of BAC. 相似文献
999.
1000.