全文获取类型
收费全文 | 7519篇 |
免费 | 294篇 |
国内免费 | 89篇 |
专业分类
耳鼻咽喉 | 89篇 |
儿科学 | 147篇 |
妇产科学 | 329篇 |
基础医学 | 737篇 |
口腔科学 | 240篇 |
临床医学 | 564篇 |
内科学 | 2039篇 |
皮肤病学 | 92篇 |
神经病学 | 457篇 |
特种医学 | 365篇 |
外科学 | 1359篇 |
综合类 | 29篇 |
一般理论 | 7篇 |
预防医学 | 260篇 |
眼科学 | 361篇 |
药学 | 292篇 |
中国医学 | 5篇 |
肿瘤学 | 530篇 |
出版年
2024年 | 6篇 |
2023年 | 76篇 |
2022年 | 133篇 |
2021年 | 216篇 |
2020年 | 132篇 |
2019年 | 197篇 |
2018年 | 245篇 |
2017年 | 132篇 |
2016年 | 186篇 |
2015年 | 185篇 |
2014年 | 295篇 |
2013年 | 421篇 |
2012年 | 569篇 |
2011年 | 679篇 |
2010年 | 411篇 |
2009年 | 405篇 |
2008年 | 578篇 |
2007年 | 647篇 |
2006年 | 596篇 |
2005年 | 527篇 |
2004年 | 415篇 |
2003年 | 318篇 |
2002年 | 253篇 |
2001年 | 43篇 |
2000年 | 16篇 |
1999年 | 20篇 |
1998年 | 44篇 |
1997年 | 26篇 |
1996年 | 28篇 |
1995年 | 23篇 |
1994年 | 11篇 |
1993年 | 9篇 |
1992年 | 9篇 |
1991年 | 1篇 |
1990年 | 2篇 |
1989年 | 7篇 |
1988年 | 3篇 |
1987年 | 5篇 |
1986年 | 2篇 |
1984年 | 8篇 |
1983年 | 7篇 |
1982年 | 2篇 |
1981年 | 2篇 |
1980年 | 3篇 |
1978年 | 3篇 |
1977年 | 2篇 |
1976年 | 1篇 |
1974年 | 1篇 |
1966年 | 1篇 |
1956年 | 1篇 |
排序方式: 共有7902条查询结果,搜索用时 0 毫秒
991.
Spiros D Nikolaos R Ioannis C 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2011,15(4):499-503
Objective:
Previous endocrine neck surgery (PENS) in patients with sporadic primary hyperparathyroidism (PHP) is considered a contraindication for minimally invasive parathyroidectomy (MIP). The purpose of our study was to determine the effectiveness of MIP in such patients.Methods:
From January 2004 to December 2009, 270 patients with PHP were treated in our department; 30 had had PENS in the past. Eighteen were selected to have MIP, while the other 12 had traditional neck explorations. Selection criteria for MIP were unilateral single- or double-gland disease localized preoperatively with at least 2 concordant imaging techniques and patient informed consent. Imaging studies included high-resolution neck ultrasound and sestamibi scan in most patients, and CT scan, selective venous sampling, and MRI in 7 patients. Unilateral explorations via a lateral approach with the patients under local (UALA in 13 patients), general (MIP in 4 patients), or local followed by general anesthesia (1 patient) were performed.Results:
Sixteen of the 17 patients became normocalcemic after the operation. There was no conversion to traditional exploration. A single adenoma was found in 16 patients and hyperplasia in one. One patient underwent a successful parathyroidectomy 8 months later via mesothoracoscopy, because the parathyroid gland was localized correctly but was beyond access via neck. There were no postoperative complications. Mean duration of the procedure and length of stay were similar to MIP in patients without PENS. Mean follow-up of 33 months (range, 4 to 70) did not reveal any recurrence.Conclusion:
These results illustrate that MIP is a valuable option in select patients with sporadic PHP and PENS. Localization with 2 or more concordant imaging techniques could avoid intraoperative sestamibi or qPTH testing with low morbidity (0%), high biochemical cure rate (100% in this series), rapid recovery, and finally substantially lower the cost of the procedure. 相似文献992.
993.
994.
Triantos CK Kehagias I Nikolopoulou V Burroughs AK 《The American journal of the medical sciences》2011,341(3):222-226
The most common complications of umbilical hernias in patients with cirrhosis and ascites include leakage, ulceration, rupture and incarceration. If such a complication is present, there is a high mortality rate after surgical repair. Elective repair is the most effective choice, as it prevents complications with a lower mortality. However, the control of ascites before and/or after repair is mandatory but may not always be possible with diuretics and paracentesis. Portal decompression by transjugular intrahepatic portosystemic shunt (TIPS) with better control of ascites may allow these patients to undergo surgery. Patients with cirrhosis and umbilical hernias should be referred for consideration of an elective surgical repair with mesh, preferably after optimal management of ascites. There should be a low threshold for placement of a TIPS to facilitate surgery and reduce the chance of severe recurrence of ascites. If surgery is contraindicated, a TIPS must be considered for control of ascites. 相似文献
995.
Tsioufis C Thomopoulos C Soldatos N Kasiakogias A Andrikou I Kordalis A Toutouzas K Giamarelos G Tousoulis D Kallikazaros I Stefanadis C 《The American journal of cardiology》2011,(1):52-58
To address whether periodontal disease indexes are associated with urinary albumin-to-creatinine ratio (UACR) in conditions of high and low systemic inflammation as reflected by levels of high-sensitivity C-reactive protein (hs-CRP) in untreated hypertensive patients, we studied 242 hypertensive patients 51 ± 9 years old (24-hour systolic/diastolic blood pressure [BP] 132 ± 10/83 ± 8 mm Hg) with varying severity of periodontal disease evaluated by 3 periodontal disease indexes (PDIs) (i.e., mean clinical loss of attachment, maximum probe depth, and gingival bleeding index). Patients underwent BP measurements, echocardiography, and periodontal examination, and from fasting blood samples we assessed metabolic profile and hs-CRP. From 2 nonconsecutive overnight spot urine samples we evaluated UACR. With respect to median hs-CRP and UACR levels (1.67 mg/L and 10 mg/g, respectively), the total population was divided into patients with low-UACR/low-hs-CRP (n = 65), low-UACR/high-hs-CRP (n = 63), high-UACR/low-hs-CRP (n = 51), and high-UACR/high-hs-CRP (n = 63). PDIs differed among the 4 groups, and those with high UACR had significantly higher 24-hour systolic BP compared to those with low UACR. UACR was determined by all periodontal disease indexes, hs-CRP, and the interaction of each periodontal disease index with hs-CRP. In addition, mean clinical loss of attachment was the strongest determinant of the high-UACR/high-hs-CRP pattern among all studied periodontal disease indexes. In conclusion, in untreated middle-aged hypertensive patients, periodontal disease indexes and hs-CRP have a synergistic effect on UACR levels independently of the underlying hemodynamic load. 相似文献
996.
997.
998.
Filiopoulos V Koutis I Trompouki S Hadjiyannakos D Lazarou D Vlassopoulos D 《Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy》2011,15(1):20-27
Sevelamer hydrochloride (SH) has been reported to aggravate metabolic acidosis and hyperkalemia. This study was performed to evaluate acid-base status and serum potassium changes after replacing SH with lanthanum carbonate (LC) in hemodialysis patients. SH was prescribed for 24 weeks in 14 stable hemodialysis patients and replaced by LC in a similar treatment schedule. Laboratory tests, including indices of acid-base status, nutrition, bone/mineral metabolism, and dialysis adequacy, were performed monthly during the study. Dialysate bicarbonate, potassium and calcium concentrations remained constant. Serum bicarbonate and pH rose, and serum potassium dropped significantly under LC. Alkaline phosphatase also decreased significantly under LC. No significant differences were observed in the other studied parameters between the two treatment periods. Control of serum phosphate was similar under both phosphate-binders and no differences were observed in calcium, Ca × P product, CRP, or lipid levels. Dialysis adequacy was constantly kept within K/DOQI target-range. Although full compliance to treatment was reported, three patients on LC complained of gastrointestinal upset and/or a metallic taste, and four had difficulty chewing the LC tablet. LC improves metabolic acidosis and hyperkalemia in hemodialysis patients previously under SH. Although both medications are well-tolerated, the gastrointestinal side-effects appear to occur more frequently with LC; a fact that, together with difficulties in chewing the tablet, may result in decreased compliance. 相似文献
999.
Purpose: One possible cause for surgical failure following temporal lobectomy for the treatment of epilepsy due to classical hippocampal sclerosis (CHS) is the presence of more widespread cortical changes. Neocortical changes in CHS shown by quantitative neuroimaging studies may involve hippocampal projection pathways. Our aim was to quantitate neocortical pathology using a postmortem series of brains from patients with epilepsy and CHS. Methods: Sections from 13 cortical regions from both left and right hemispheres, including hippocampal projection pathways, were examined from nine epilepsy patients with unilateral CHS (4), bilateral CHS (2), non‐CHS (3), and non–epilepsy controls (4). Using GFAP, CD68, and NPY immunohistochemistry as markers of acquired neocortical pathology, quantitative analysis of the staining fractions in the cortex and white matter was carried out. Key Findings: Higher staining fractions were observed for all markers in both cortex and white matter in CHS patients, which was significantly different for CD68 and NPY compared to controls (p < 0.05) but not to non‐CHS epilepsy cases. There was no significant difference between staining fractions in left and right hemispheres for unilateral CHS cases. Regional analysis showed preferential gliosis and microgliosis of temporal poles, frontal poles, and orbitofrontal cortex in epilepsy cases. Significance: This study supports acquired neocortical pathology in epilepsy patients both with and without CHS. Cortical pathology does not show lateralization to the side of CHS. Preferential involvement of the temporal and frontal poles may relate to other factors, such as cortical injury associated with seizures, rather than involvement through hippocampal pathways. 相似文献
1000.