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61.
Arthroscopic reconstruction of the anterior cruciate ligament using bone-patellar tendon-bone autograft: experience of the first 100 cases 总被引:1,自引:0,他引:1
Chaudhary D Monga P Joshi D Easwaran R Bhatia N Singh AK 《Journal of orthopaedic surgery (Hong Kong)》2005,13(2):147-152
PURPOSE: To review the results of patients who underwent arthroscopic reconstruction of the anterior cruciate ligament (ACL) via a single incision technique using a bone-patellar tendon-bone autograft. METHODS: Patients with ACL-deficient knees who were symptomatic and wanted to maintain an active lifestyle or continue sporting activities were included. ACL reconstruction using the bone-patellar tendon-bone graft was performed on 100 patients. One-year follow-up was completed in 78 patients who were then reviewed. The mean age of patients reviewed was 26.8 years (range, 21-39 years), of whom 35 (44.9%) were aged between 26 and 30 years. There were 73 men and 5 women (ratio, 14.6:1). Injuries on the right side outnumbered those on the left (44 versus 34). Sports injuries accounted for 66.7% (n = 52) of patients, motor vehicle accidents and household injuries accounted for 30.8% (n = 24) and 2.6% (n = 2), respectively. RESULTS: Excellent and good-to-excellent results were achieved in 7 (9%) and 61 (78.2%) of patients. Residual anterior knee pain (n = 18) was the most common complication, followed by difficulty in regaining full range of motion (n = 10) and divergence of femoral screw (n = 9). CONCLUSION: This procedure provides consistent and reproducible results in carefully selected patients and allows them an early return to sporting activities with minimal residual morbidity. 相似文献
62.
Teichman JM Cecconi PP Bernheim BD Novarro NK Monga M DaRosa D Resnick MI;Study Group 《American journal of surgery》2005,189(2):134-139
BACKGROUND: We examined three research questions: How do residents' debts and savings compare to the general public? How do surgical residents' financial choices compare to other residents? How may institutions help residents' personal financial decisions? METHODS: The Survey of Consumer Finances was modified and piloted tested to elicit financial information. The instrument was completed by 612 residents at 8 programs. RESULTS: Only 60% of residents budgeted expenses, and 25% and 10% maintained cash balances <611 dollars and unpaid credit card balances >10,000 dollars, respectively. Compared with controls, residents held greater median ratios of debt to household income (2.46 vs. 1.06, P <0.0001), fewer assets to income (0.64 vs. 2.28, P <0.0001), less net wealth to income -1.43 vs. 0.90, P <0.0001), and lower retirement savings balance to household income (0.01 vs. 0.12, P <0.0001). Surgery residents were the least financially conservative group. Mean annual resident contributions to retirement accounts were $1532 higher at institutions with versus without retirement plans (P <0.01). CONCLUSIONS: Resident debts are higher and savings lower than the general public. This behavior is most common among surgery residents. Residents save more for retirement when they are eligible for tax-deferred retirement plans. Graduate medical programs should instruct residents on financial management. 相似文献
63.
PURPOSE: To prospectively evaluate contrast enhancement on pulmonary computed tomographic (CT) angiograms obtained by using an iso-osmolar versus a low-osmolarity contrast agent to exclude pulmonary embolism. MATERIALS AND METHODS: Written patient consent was obtained on a form approved by the institutional review board, and the board approved the study. This prospective, randomized, double-blinded clinical trial included 47 patients referred for multi-detector row CT angiography to exclude pulmonary embolism over a 5-month period. Patients received either iohexol or iodixanol as an intravenous contrast agent. Three radiologists independently evaluated enhancement homogeneity and quality in designated pulmonary artery branches at four consecutive levels in the lower lobe of the left lung from lobar to subsegmental arteries. This evaluation was performed at a workstation separately for homogeneity and quality with two different three-level scales established with consensus. Percentages of each given score were compared with the chi2 test. The mean attenuation (expressed in Hounsfield units) for each contrast agent was compared with Student t test, and interobserver agreement (kappa value) was calculated. RESULTS: The percentages of arteries graded as excellent or not diagnostic were not statistically different (P >.05), with comparison of the two contrast agents at all levels. The intensity of enhancement (quantitative evaluation of enhancement by using mean attenuation of vessel lumen) was similar (P >.05) in the two groups. The kappa values varied from 0.35 to 0.56 among readers. CONCLUSION: Use of an iso-osmolar contrast agent at multi-detector row CT angiography to exclude pulmonary embolism did not significantly improve enhancement quality when this feature was compared with that of a low-osmolarity contrast agent. 相似文献
64.
WHO multinational study of three misoprostol regimens after mifepristone for early medical abortion 总被引:5,自引:0,他引:5
Honkanen H Piaggio G Hertzen H Bártfai G Erdenetungalag R Gemzell-Danielsson K Gopalan S Horga M Jerve F Mittal S Thi Nhu Ngoc N Peregoudov A Prasad RN Pretnar-Darovec A Shah RS Song S Tang OS Wu SC;WHO Research Group on Post-Ovulatory Methods for Fertility Regulation 《BJOG : an international journal of obstetrics and gynaecology》2004,111(7):715-725
65.
Monga M Premoli J Skemp N Durfee W 《Journal of endourology / Endourological Society》2004,18(7):654-656
BACKGROUND AND PURPOSE: Laparoscopic hand-assist devices have facilitated the broad application and acceptance of laparoscopy in urology and other surgical fields. This study evaluated forearm compression by these devices. MATERIALS AND METHODS: Five commercially available hand-assist devices were tested (Gelport, Intromit, PneumoSleeve, Handport, LapDisc). In three surgeons using a porcine model, compressive forces were measured along the paths of the median and ulnar nerves at the point of maximum proximal forearm circumference using FlexiForce A101 sensors. Glove size for all three surgeons was 7 1/2; however, the maximum forearm circumference ranged from 26 to 33 cm. The hand-assist devices were placed in pigs after skin and fascial incision (9 cm), and the insufflation pressure was set at 18 mm Hg. Surgeons subjectively rated the ease of device insertion and hand insertion, degree of forearm compression, and the development of paresthesias. RESULTS: The LapDisc was rated superior with regard to insertion. The Gelport was rated superior for hand insertion and removal; however, moderate to severe forearm compression and paresthesias were reported. The maximum forearm compression forces were highest with the LapDisc (97 mm Hg) and the Gelport (78 mm Hg) and lowest with the Handport (33 mm Hg). CONCLUSION: The choice of hand-assist device is dependent on its ease of use, efficacy at maintaining insufflation, and effect on the surgeon's performance and fatigue. The impact of forearm compression should be considered in the selection of the hand-assist device and in the development of new devices. 相似文献
66.
67.
Erectile dysfunction: current concepts and future directions 总被引:5,自引:0,他引:5
Major advances in science and medicine have led to improved understanding of the pathophysiology of erectile dysfunction. The development of reliable pharmacological therapy for erectile dysfunction has led to heightened awareness in the public and medical communities. This article reviews recent clinical advances and future research directions. 相似文献
68.
The objective of this prospective randomized placebo-controlled study was to determine the efficacy of sublingual misoprostol in facilitating cervical dilatation before surgical abortion in first trimester pregnancy. Sixty healthy pregnant women between 6 and 11 weeks of gestation opting for voluntary medical termination of pregnancy at All India Institute of Medical Sciences hospital were included in this study. Women were randomized to two groups, the study group (n = 30) received 400 micro g of sublingual misoprostol and the control group (n = 30) received placebo, 2 h prior to surgical abortion. Using Hegar's dilators, cervical dilatation prior to vacuum aspiration was measured. Other parameters assessed included the total time required for the procedure, intraoperative blood loss and associated side effects. The mean cervical dilatation in the misoprostol group was 7.7 mm as compared to 3.4 mm for placebo group. The average time required for pregnancy termination was significantly shorter (p < 0.001) in the misoprostol group. The procedure-related blood loss was also significantly decreased in the misoprostol group. However, side effects including pre-evacuation vaginal bleeding, lower abdominal pain, nausea and vomiting were significantly higher in the misoprostol group than in placebo group (p < 0.005). There was no case of hemorrhage or uterine perforation in either group. Sublingual misoprostol is effective in facilitating cervical dilatation prior to surgical abortion. Its usage significantly decreased the time of surgical evacuation and minimized blood loss during the procedure. 相似文献
69.
Fetal gastrointestinal malformations 总被引:1,自引:0,他引:1
Dadhwal V Kochhar S Mittal S Kumar S Agarwal S Arora V Barua A 《Indian journal of pediatrics》2001,68(1):27-30
In an audit to evaluate fetal gastrointestinal (GIT) malformations, case sheets of all mothers who gave birth to newborns
with GIT malformations were analysed regarding the maternal history, prenatal ultrasound and the postnatal structural malformations
and perinatal management. In 1999, eleven babies were born with gastrointestinal malformations, one was a still birth. Nine
had associated malformations of other systems, two had trisomy 21. Eight babies were operated in the immediate newborn period,
5 survived. Ultrasound was not very accurate in the diagnosis of GIT anomaly in this series. In view of associated chromosomal
and structural anomaly a fetal ECHO and genetic amniocentesis is warranted. Most of these babies require immediate surgery
after birth, so they need to be delivered in a centre which is equipped with good neonatal and pediatric surgery care. 相似文献
70.