收费全文 | 2145篇 |
免费 | 160篇 |
国内免费 | 5篇 |
耳鼻咽喉 | 19篇 |
儿科学 | 59篇 |
妇产科学 | 86篇 |
基础医学 | 327篇 |
口腔科学 | 14篇 |
临床医学 | 166篇 |
内科学 | 392篇 |
皮肤病学 | 9篇 |
神经病学 | 364篇 |
特种医学 | 80篇 |
外科学 | 258篇 |
综合类 | 14篇 |
预防医学 | 175篇 |
眼科学 | 21篇 |
药学 | 155篇 |
肿瘤学 | 171篇 |
2023年 | 18篇 |
2022年 | 28篇 |
2021年 | 73篇 |
2020年 | 37篇 |
2019年 | 45篇 |
2018年 | 64篇 |
2017年 | 59篇 |
2016年 | 49篇 |
2015年 | 51篇 |
2014年 | 60篇 |
2013年 | 99篇 |
2012年 | 142篇 |
2011年 | 169篇 |
2010年 | 98篇 |
2009年 | 72篇 |
2008年 | 103篇 |
2007年 | 135篇 |
2006年 | 107篇 |
2005年 | 106篇 |
2004年 | 113篇 |
2003年 | 73篇 |
2002年 | 94篇 |
2001年 | 34篇 |
2000年 | 26篇 |
1999年 | 32篇 |
1998年 | 12篇 |
1997年 | 15篇 |
1996年 | 11篇 |
1995年 | 8篇 |
1994年 | 9篇 |
1992年 | 18篇 |
1991年 | 30篇 |
1990年 | 22篇 |
1989年 | 22篇 |
1988年 | 16篇 |
1987年 | 21篇 |
1986年 | 25篇 |
1985年 | 31篇 |
1984年 | 20篇 |
1983年 | 13篇 |
1981年 | 10篇 |
1979年 | 18篇 |
1978年 | 13篇 |
1976年 | 13篇 |
1975年 | 8篇 |
1974年 | 13篇 |
1973年 | 8篇 |
1972年 | 7篇 |
1970年 | 9篇 |
1969年 | 8篇 |
Purpose
Non-fusion treatment for adolescent idiopathic scoliosis generates interest due to the potential for growth preservation and mobility. Using an established porcine scoliotic model, this study aims to evaluate the global alignment and the morphology of the spine with and without application of a non-fusion corrective tether.Methods
At 12 weeks of age, 21 immature Yorkshire pigs had an induction of scoliosis. Once a 50° Cobb angle was obtained; animals were placed into one of the following groups: a scoliosis model group (SM, n = 11) where animals were euthanized, tether release group (TR, n = 5) where the inducing tether was removed, and an anterior correction group (AC, n = 5) where the inducing tether was removed and non-fusion corrective tether was applied. TR and AC were observed for a further 20 weeks and then euthanized. Post-mortem CT scans were used to create 3D spinal reconstructions to obtain global and morphologic parameters.Results
Maximal Cobb angle of the scoliotic deformity was significantly lower for AC (27.9° ± 12.0°) than for the two other groups (TR 52.7° ± 10.0°, SM 48.3° ± 7.6°). AC experienced an increase in kyphosis (24.2° ± 15.9°) compared to TR (7.1° ± 6.4°). Correction in the axial plane was also observed in AC versus TR. Correction of vertebral wedging was found for AC compared to SM and TR in the three apical vertebrae.Conclusions
3D realignment of scoliotic curves was observed with application of the corrective tether. The correction was the product of both mechanical action and growth modulation. These findings are encouraging for future development of a non-fusion device for the treatment of immature scoliotic curves. 相似文献Introduction and hypothesis
The aim was to review complications associated with pelvic organ prolapse surgery.Methods
Every 4 years and as part of the Fifth International Collaboration on Incontinence we reviewed the English-language scientific literature after searching PubMed, Medline, Cochrane library and Cochrane database of systematic reviews, published up to January 2012. Publications were classified as level 1 evidence (randomised controlled trials [RCT] or systematic reviews), level 2 (poor quality RCT, prospective cohort studies), level 3 (case series or retrospective studies) and level 4 (case reports). The highest level of evidence was utilised by the committee to make evidence-based recommendations based upon the Oxford grading system. Grade A recommendation usually depends on consistent level 1 evidence. Grade B recommendation usually depends on consistent level 2 and/or 3 studies, or “majority evidence” from RCTs. Grade C recommendation usually depends on level 4 studies or “majority evidence? from level 2/3 studies or Delphi processed expert opinion. Grade D “no recommendation possible” would be used where the evidence is inadequate or conflicting and when expert opinion is delivered without a formal analytical process, such as by Delphi.Results and conclusions
Transvaginal mesh has a higher re-operation rate than native tissue vaginal repairs (grade A). If a synthetic mesh is placed via the vaginal route, it is recommended that a macroporous polypropylene monofilament mesh should be used. At sacral colpopexy mesh should not be introduced or sutured via the vaginal route and silicone-coated polyester, porcine dermis, fascia lata and polytetrafluoroethylene meshes are not recommended as grafts. Hysterectomy should also be avoided (grade B). There is no evidence to recommend routine local or systemic oestrogen therapy before or after prolapse surgery using mesh. The first cases should be undertaken with the guidance of an experienced surgeon in the relevant technique (grade C). Expert opinion suggests that by whatever the surgical route pre-operative urinary tract infections are treated, smoking is ceased and antibiotic prophylaxis is undertaken. It is recommended that a non-absorbable synthetic mesh should not be inserted into the rectovaginal septum when a rectal injury occurs. The placement of a non-absorbable synthetic mesh into the vesicovaginal septum may be considered after a bladder injury has been repaired, if the repair is considered to be satisfactory. It is possible to perform a hysterectomy in association with the introduction of a non-absorbable synthetic mesh inserted vaginally, but this is not recommended routinely. 相似文献Introduction and hypothesis
Despite good anatomical outcomes of pelvic organ prolapse (POP) repair by the vaginal route using synthetic mesh, complications limit their use. Clinical data are needed to generalize prolapse mesh repair by the vaginal route. The current study aims to evaluate midterm rectoanal function and clinical outcomes after transischioanal rectocele repair using a medium weight polypropylene mesh.Methods
Between March 2003 and June 2004, 230 patients with stage II–IV anterior and/or posterior POP were included in a prospective multicenter study. The current study is based on the analysis of the 116 patients who underwent a rectocele repair via the infracoccygeal route through the sacrospinous ligament. Anatomical cure was defined when rectocele was at stage <II in the Pelvic Organ Prolapse Quantification (POP-Q) system. Postoperative functional results were evaluated using the self-administered Pelvic Floor Distress Inventory (PFDI) and the Pelvic Floor Impact Questionnaire (PFIQ).Results
Of the 116 patients who received a posterior mesh with two arms via the infracoccygeal route through the sacrospinous ligament, midterm anatomical results were available for 78 women representing 67 % (78/116) of the operated patients. The mean follow-up was 36 (± 8.1) months. No rectal injury occurred during surgery. The objective success rate was 94.8 % and subjective (by patient satisfaction) was 93.23 %. Colorectal-Anal Impact (CRAI) and Colorectal-Anal Distress Inventory (CRADI) scores were both significantly decreased at midterm follow-up in comparison with baseline (42.7 at baseline vs 11.4 at 24- or 36-month follow-up, p?=?0.001 for CRAI, and 81.1 vs 34.4, p?<?0.001 for CRADI) highlighting the benefits of rectocele repair on colorectal-anal function.Conclusions
Polypropylene mesh with two arms via the infracoccygeal route through the sacrospinous ligament has good anatomical results at midterm follow-up with significant improvement in symptoms and quality of life and is associated with few complications. Obstructive symptoms reported in cases of rectocele can be improved by transvaginal mesh repair. 相似文献Areas covered: This review addresses the potential of phage therapy to treat RTIs and discusses preclinical and clinical results of phages administration in this context. Recent phage formulation and aerosolization attempts are also reviewed, raising technical challenges to achieve efficient pulmonary deposition via inhalation.
Expert opinion: Overall, the inhalation of phages as antibacterial treatment seems both clinically relevant and technically feasible. Several crucial points still need to be investigated, such as phage product pharmacokinetics and immunogenicity. Furthermore, given phage-specific features, appropriate regulatory and manufacturing guidelines will need to be defined. Finally, randomized controlled clinical trials should be carried out to establish phage therapy’s clinical positioning in the antimicrobial arsenal against RTIs. 相似文献
![点击此处可从《Transplant international》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Introduction and hypothesis
Obstetric trauma during childbirth is considered a major risk factor for postpartum urinary incontinence (UI), particularly stress urinary incontinence. Our aim was to investigate the relation between postpartum UI, mode of delivery, and urethral descent, and to define a group of women who are particularly at risk of postnatal UI.Methods
A total of 186 women were included their first pregnancy. Validated questionnaires about urinary symptoms during pregnancy, 2 and 12 months after delivery, were administered. Urethral descent was assessed clinically and by ultrasound at inclusion. Multivariate logistic regression analysis was used to determine the risk factors for UI during pregnancy, at 2 months and 1 year after first delivery.Results
The prevalence of UI was 38.6, 46.5, 35.6, and 34.4 % at inclusion, late pregnancy, 2 months postpartum, and 1 year postpartum respectively. No significant association was found between UI at late pregnancy and urethral descent assessed clinically or by ultrasound. The only risk factor for UI at 2 months postpartum was UI at inclusion (OR 6.27 [95 % CI 2.70–14.6]). The risk factors for UI at 1 year postpartum were UI at inclusion (6.14 [2.22–16.9]), body mass index (BMI), and urethral descent at inclusion, assessed clinically (7.21 [2.20–23.7]) or by ultrasound. The mode of delivery was not associated with urethral descent.Conclusions
Prenatal urethral descent and UI during pregnancy are risk factors for UI at 1 year postpartum. These results indicate that postnatal UI is more strongly influenced by susceptibility factors existing before first delivery than by the mode of delivery.![点击此处可从《The American journal of pathology》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Coronal malalignment (CM) is a challenging spinal deformity to treat. The kickstand rod (KR) technique is powerful for correcting truncal shift. This study tested the hypothesis that the KR technique provides superior coronal alignment correction in adult deformity compared with traditional rod techniques.
MethodsA retrospective evaluation of a prospectively collected multicenter database was performed. A 2:1 matched cohort of non-KR accessory rod and KR patients was planned based on preoperative coronal balance distance (CBD) and a vector of global shift. Patients were subgrouped according to CM classification with a 30-mm CBD threshold defining CM, and comparisons of surgical and clinical outcomes among groups was performed.
ResultsTwenty-one patients with preoperative CM treated with a KR were matched to 36 controls. KR-treated patients had improved CBD compared with controls (18 vs. 35 mm, P < 0.01). The postoperative CBD did not result in clinical differences between groups in patient-reported outcomes (P ≥ 0.09). Eight (38%) of 21 KR patients and 12 (33%) of 36 control patients with preoperative CM had persistent postoperative CM (P = 0.72). CM class did not significantly affect the likelihood of treatment failure (postoperative CBD > 30 mm) in the KR cohort (P = 0.70), the control cohort (P = 0.35), or the overall population (P = 0.31).
ConclusionsApplication of the KR technique to coronal spinal deformity in adults allows for successful treatment of CM. Compared to traditional rod techniques, the use of KRs did not improve clinical outcome measures 1 year after spinal deformity surgery but was associated with better postoperative coronal alignment.
相似文献