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991.
992.
Pyeong Hwa Kim Jiaywei Tsauo Ji Hoon Shin Sung-Cheol Yun 《Journal of vascular and interventional radiology : JVIR》2017,28(4):522-531.e5
Purpose
To evaluate the safety and efficacy of transcatheter arterial embolization with N-butyl cyanoacrylate (NBCA) for the treatment of gastrointestinal (GI) bleeding via a meta-analysis of published studies.Materials and Methods
The MEDLINE/PubMed and EMBASE databases were searched for English-language studies from January 1990 to March 2016 that included patients with nonvariceal GI bleeding treated with transcatheter arterial embolization with NBCA with or without other embolic agents. The exclusion criteria were a sample size of < 5, no extractable data, or data included in subsequent articles or duplicate reports.Results
The cases of 440 patients (mean age, 63.8 y ± 14.3; 319 men [72.5%] and 121 women [27.5%]) from 15 studies were evaluated. Of these patients, 261 (59.3%) had upper GI bleeding (UGIB) and 179 (40.7%) had lower GI bleeding (LGIB). Technical success was achieved in 99.2% of patients with UGIB (259 of 261) and 97.8% of those with LGIB (175 of 179). The pooled clinical success and major complication rates in the 259 patients with UGIB in whom technical success was achieved were 82.1% (95% confidence interval [CI], 73.0%–88.6%; P = 0.058; I2 = 42.7%) and 5.4% (95% CI, 2.8%–10.0%; P = 0.427; I2 = 0.0%), respectively, and those in the 175 patients with LGIB in whom technical success was achieved were 86.1% (95% CI, 79.9%–90.6%; P = 0.454; I2 = 0.0%) and 6.1% (95% CI, 3.1%–11.6%; P = 0.382; I2 = 4.4%), respectively.Conclusions
Transcatheter arterial embolization with NBCA is safe and effective for the treatment of GI bleeding. 相似文献993.
Jihyun Kim Junshik Hong Seog Gyun Kim Kyung Hoon Hwang Minsu Kim Hee Kyung Ahn Sun Jin Sym Jinny Park Eun Kyung Cho Dong Bok Shin Jae Hoon Lee 《Nuclear Medicine and Molecular Imaging》2014,48(3):187-195
Purpose
The purpose of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) measured by 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab-containing immunochemotherapy.Methods
Patients with newly diagnosed DLBCL who underwent pre-treatment torso FDG-PET/CT scan taken within 10 days before treatment were included. MTV was defined as the volume of hypermetabolic tissue with a standardized uptake value (SUV) greater than a threshold value of 2.5 and calculated using volume viewer software. Association of MTV with patient characteristics and survival were compared.Results
A total of 96 patients were evaluated. During a median follow-up period of 27.8 months, 3-year event-free survival (EFS) and overall survival was 69.5 % and 72.9 %, respectively. The Ann Arbor staging showed a limitation of prognosis because there was no difference of EFS between patients with Ann Arbor stage II and those with stage III. On the contrary, among patients with Ann Arbor stage II or III disease (n?=?53), the higher MTV group showed significantly inferior EFS compared with the lower MTV group.Conclusions
In the current study, we identified the pre-treatment MTV measured by FDG-PET/CT as a potential predictor of survival in patients with DLBCL treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP), at least in Ann Arbor stage II and III disease. 相似文献994.
Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves. 总被引:9,自引:0,他引:9
STUDY DESIGN: The mechanical properties of multilevel human cervical spines were investigated by applying pure rotational moments to each specimen and measuring multidirectional intervertebral motions. OBJECTIVES: To document intervertebral main and coupled motions of the cervical spine in the form of load-displacement curves. SUMMARY OF BACKGROUND DATA: Although a number of in vivo and in vitro studies have attempted to delineate normal movement patterns of the cervical spine, none has explored the complexity of the whole cervical spine as a three-dimensional structure. METHODS: Sixteen human cadaveric specimens (C0-C7) were used for this study. Pure rotational moments of flexion-extension, bilateral axial torque, and bilateral lateral bending were applied using a specially designed loading fixture. The resulting intervertebral motions were recorded using stereophotogrammetry and depicted as a series of load-displacement curves. RESULTS: The resulting load-displacement curves were found to be nonlinear, and both rotation and translation motions were coupled with main motions. With flexion-extension moment loading, the greatest degree of flexion occurred at C1-C2 (12.3 degrees), whereas the greatest degree of extension was observed at C0-C1 (20.2 degrees). With axial moment loading, rotation at C1-C2 was the largest recorded (56.7 degrees). With lateral bending moments, the average range of motion for all vertebral levels was 7.9 degrees. CONCLUSIONS: The findings of the present study are relevant to the clinical practice of examining motions of the cervical spine in three dimensions and to the understanding of spinal trauma and degenerative diseases. 相似文献
995.
Yoshiro Ogata Shoichi Hishinuma Junichi Matsui Iwao Ozawa Shin Takahashi 《Journal of Hepato-Biliary-Pancreatic Surgery》1994,1(4):372-378
Twenty-six patients who underwent pyloruspreserving pancreaticoduodenectomy (PPPD) for ductal cancer of the head of the pancreas
between 1983 and 1993 were reviewed. Gastrointestinal continuity was restored by the methods of Imanaga (n=21) and Traverso (n=5). Combined resection of the portal vein and/or superior mesenteric vein was performed in 13 patients. Surgical complications
occurred in 5 patients, but there were no postoperative deaths. Delayed gastric emptying was observed in 42% of patients.
The median survival time for all 26 patients was 13 months. Three patients survived for more than 3 years, and one of them
is currently alive without recurrence at 10 years. Differences in survival rates were not apparent between patients who underwent
PPPD with and without portal vein resection. Survival rate after PPPD was compared with that after pancreaticoduodenectomy
(PD) performed between 1974 and 1992; the difference was not significant. Patients who underwent noncurative PPPD had a significantly
better survival rate than those who underwent noncurative PD (P<0.05). PPPD has improved the quality of life of the resected patients, without reducing survival rate. At present, PPPD by
the Imanaga procedure could be the best choice for management of cancer of the pancreatic head. 相似文献
996.
997.
Endovascular stent grafting of the descending thoracic aorta after arch repair in acute type A dissection 总被引:1,自引:0,他引:1
An endovascular stent graft was successfully deployed to the primary entry site in the proximal descending thoracic aorta after total aortic arch replacement using the "elephant trunk" technique in acute type A aortic dissection. The residual false lumen of the descending aorta was thrombosed completely after stent grafting. The elephant trunk was feasible for a proximal landing zone for stent grafting of the descending aorta. Stent grafting in combination with aortic arch replacement was a safe and effective procedure, and may be an alternative choice in carefully selected patients with type A aortic dissection. 相似文献
998.
Qi Yao Shaobai Wang Jae-Hyuk Shin Guoan Li Kirkham Wood 《European spine journal》2013,22(12):2702-2709
Objective
Recently, interspinous process devices have attracted much attention since they can be implanted between the lumbar spinous processes (LSP) of patients with degenerative disc disease (DDD) and degenerative spondylolisthesis (DLS) using a minimally invasive manner. However, the motion characters of the LSP in the DLS and DDD patients have not been reported. This study is aimed at investigating the kinematics of the lumbar spinous processes in patients with DLS and DDD.Methods
Ten patients with DDD at L4–S1 and ten patients with DLS at L4–L5 were studied. The positions of the vertebrae (L2–L5) at supine, standing, 45° trunk flexion, and maximal extension positions were determined using MRI-based models and dual fluoroscopic images. The shortest ISP distances were measured and compared with those of healthy subjects that have been previously reported.Results
The shortest distance of the interspinous processes (ISP) gradually decreased from healthy subjects to DDD and to DLS patients when measured in the supine, standing, and extension positions. During supine-standing and flexion–extension activities, the changes in the shortest ISP distances in DDD patients were 2 ± 1.2 and 4.8 ± 2.1 mm at L4–L5; in DLS patients they were 0.5 ± 0.4 and 2.8 ± 1.7 mm at L4–L5, respectively. The range of motion is increased in DDD patients but decreased in DLS patients when compared with those of the healthy subjects. No significantly different changes were detected at L2–L3 and L3–L4 levels.Conclusion
At the involved level, the hypermobility of the LSP was seen in DDD and hypomobility of the LSP in DLS patients. The data may be instrumental for improving ISP surgeries that are aimed at reducing post-operative complications such as bony fracture and device dislocations. 相似文献999.
Chung IS Kim HY Shin YH Ko JS Gwak MS Sim WS Kim GS Lee SK 《Clinical transplantation》2012,26(4):539-543
A characteristic pattern of hemodynamic changes that may occur in reperfusion phase of liver transplantation (LT) is known as post-reperfusion syndrome (PRS). In this study, we determined the frequency of PRS and evaluated possible predictors of PRS. The medical records of 152 patients who underwent living donor LT were reviewed. PRS was defined as a decrease in mean arterial pressure of more than 30% from the baseline value for more than one min during the first five min after reperfusion. The frequency of PRS was determined, and patients were divided into two groups: PRS group and non-PRS group. Donor factors, preoperative and intraoperative recipient factors, and postoperative outcomes were compared between the two groups. PRS occurred in 58 recipients (34.2%). Preoperative model for end-stage liver disease scores of recipients and percentage of graft steatotic changes were higher in PRS group. PRS group showed higher heart rates and lower hemoglobin values preoperatively. Before reperfusion, PRS group received more transfusion and their urine output was less than that of non-PRS group. Postoperatively, peak bilirubin during the first five d after LT was higher in PRS group. In conclusion, both severity of liver disease and graft steatosis may increase risk for PRS in LT. Further prospective studies of PRS in its relationship to outcome are indicated. 相似文献
1000.
Familial Nonmedullary Thyroid Carcinoma Characterized by
Multifocality and a High Recurrence Rate in a Large Study
Population 总被引:1,自引:4,他引:1
Uchino S Noguchi S Kawamoto H Yamashita H Watanabe S Yamashita H Shuto S 《World journal of surgery》2002,26(8):897-902
First-degree relatives of persons with
thyroid cancer are known to be at relatively high risk for the disease.
To better understand the clinicopathologic characteristics of familial
nonmedullary thyroid carcinoma (FNMTC), we carried out a retrospective
study in which we identified individuals treated at our institution who
had at least one first-degree relative with the disease. We used data
obtained from our patient records to compare the features of 258 cases
of the disease with the features of sporadic papillary or follicular
thyroid carcinoma in another group of patients. The 258 patients
represented 154 families and were selected from among 6458 patients
with papillary or follicular thyroid carcinoma who underwent
thyroidectomy between 1946 and 2000. Compared to the patients with
sporadic disease, the FNMTC patients were more likely to have
intraglandular dissemination (28.5% vs. 40.7%; p <
0.0001) and multiple benign nodules (29.8% vs. 41.5%;
p <0.0001). There were no significant differences
between the two types of patients in terms of gender, age, tumor
diameter, adhesion to or invasion of the surrounding tissues,
macroscopic metastasis observed at surgery, histology, presence of
single benign nodules, presence of chronic thyroiditis, microscopic
metastasis, or rate of lymph node metastasis. Recurrence was
statistically frequent in the FNMTC patients compared with that in the
sporadic disease patients (16.3% vs. 9.6%; p =
0.0005), and the disease-free survival rate was significantly poorer in
the FNMTC patients (p = 0.0041 by the Wilcoxon test
and p <0.0001 by the log-rank test). No significant
difference in the overall survival rate was found between the two
groups. Multivariate analysis by Cox’s proportional hazards method
showed FNMTC to be an independent predictor of shorter disease-free
survival (risk ratio 1.88; confidence interval 1.35–2.54;
p = 0.0003). Locoregional recurrence in the
ipsilateral or contralateral lymph nodes and contralateral thyroid lobe
was significantly more frequent in the FNMTC patients than in the
sporadic disease patients, whereas no difference was found regarding
distant metastases. We conclude that FNMTC is a clinically distinct
entity with an aggressive nature. Because of the frequent presence of
benign nodules, multifocality, and high rate of locoregional
recurrence, total or near-total thyroidectomy with modified radical
neck dissection in FNMTC patients is recommended. 相似文献