全文获取类型
收费全文 | 2376篇 |
免费 | 129篇 |
国内免费 | 4篇 |
专业分类
耳鼻咽喉 | 29篇 |
儿科学 | 234篇 |
妇产科学 | 20篇 |
基础医学 | 213篇 |
口腔科学 | 74篇 |
临床医学 | 136篇 |
内科学 | 406篇 |
皮肤病学 | 64篇 |
神经病学 | 145篇 |
特种医学 | 116篇 |
外科学 | 305篇 |
综合类 | 315篇 |
预防医学 | 76篇 |
眼科学 | 33篇 |
药学 | 192篇 |
1篇 | |
中国医学 | 11篇 |
肿瘤学 | 139篇 |
出版年
2022年 | 17篇 |
2021年 | 51篇 |
2020年 | 28篇 |
2019年 | 29篇 |
2018年 | 51篇 |
2017年 | 28篇 |
2016年 | 42篇 |
2015年 | 62篇 |
2014年 | 83篇 |
2013年 | 90篇 |
2012年 | 119篇 |
2011年 | 142篇 |
2010年 | 121篇 |
2009年 | 85篇 |
2008年 | 97篇 |
2007年 | 113篇 |
2006年 | 110篇 |
2005年 | 85篇 |
2004年 | 108篇 |
2003年 | 76篇 |
2002年 | 59篇 |
2001年 | 64篇 |
2000年 | 72篇 |
1999年 | 60篇 |
1998年 | 46篇 |
1997年 | 40篇 |
1996年 | 36篇 |
1995年 | 22篇 |
1994年 | 33篇 |
1993年 | 17篇 |
1992年 | 47篇 |
1991年 | 51篇 |
1990年 | 33篇 |
1989年 | 36篇 |
1988年 | 39篇 |
1987年 | 26篇 |
1986年 | 21篇 |
1985年 | 25篇 |
1984年 | 17篇 |
1983年 | 20篇 |
1982年 | 16篇 |
1981年 | 10篇 |
1977年 | 10篇 |
1976年 | 16篇 |
1974年 | 17篇 |
1973年 | 21篇 |
1972年 | 11篇 |
1971年 | 10篇 |
1970年 | 10篇 |
1968年 | 9篇 |
排序方式: 共有2509条查询结果,搜索用时 375 毫秒
991.
JA Rauh-Hain M del Carmen NS Horowitz IA Alarcon E Ko AK Goodman AB Olawaiye 《BJOG : an international journal of obstetrics and gynaecology》2010,117(1):32-38
Objective To determine whether the presence of bowel obstruction at the time of initial presentation has any prognostic significance in these women.
Design Retrospective cohort study.
Setting Dedicated gynaecological oncology service of a large tertiary institution.
Population Women who had a bowel obstruction as part of their initial presentation of ovarian cancer were identified between 1995 and 2007. Each woman was matched with four control women (with disease but no obstruction).
Methods Women with disease were compared with controls to determine the impact, if any, of bowel obstruction at presentation. Several prognostic variables including bowel obstruction were also evaluated in a Cox proportional hazard model.
Main outcome measures Progression-free survival (PFS) and overall survival (OS).
Results Forty-eight women with disease and 192 controls were identified during the study period. The median follow-up period was 19 months among women with disease versus 20 months in controls. No differences were seen in demographics and clinical characteristics of the women. Optimal cytoreduction rate was similar between the two groups (75% versus 78%, P = 0.7). Patients with bowel obstruction had a shorter PFS and OS compared with controls [19 months versus 21 months ( P = 0.01) and 22 versus 35 months ( P = 0.008)], respectively. Bowel obstruction at presentation was an independent prognostic variable with a hazard ratio of 1.5 ( P = 0.009). Other prognostic variables were age, stage and extent of surgical cytoreduction.
Conclusions Bowel obstruction at the time of initial presentation is an adverse prognostic factor in women with ovarian cancer. 相似文献
Design Retrospective cohort study.
Setting Dedicated gynaecological oncology service of a large tertiary institution.
Population Women who had a bowel obstruction as part of their initial presentation of ovarian cancer were identified between 1995 and 2007. Each woman was matched with four control women (with disease but no obstruction).
Methods Women with disease were compared with controls to determine the impact, if any, of bowel obstruction at presentation. Several prognostic variables including bowel obstruction were also evaluated in a Cox proportional hazard model.
Main outcome measures Progression-free survival (PFS) and overall survival (OS).
Results Forty-eight women with disease and 192 controls were identified during the study period. The median follow-up period was 19 months among women with disease versus 20 months in controls. No differences were seen in demographics and clinical characteristics of the women. Optimal cytoreduction rate was similar between the two groups (75% versus 78%, P = 0.7). Patients with bowel obstruction had a shorter PFS and OS compared with controls [19 months versus 21 months ( P = 0.01) and 22 versus 35 months ( P = 0.008)], respectively. Bowel obstruction at presentation was an independent prognostic variable with a hazard ratio of 1.5 ( P = 0.009). Other prognostic variables were age, stage and extent of surgical cytoreduction.
Conclusions Bowel obstruction at the time of initial presentation is an adverse prognostic factor in women with ovarian cancer. 相似文献
992.
Liu AK Brandon J Foreman NK Fenton LZ 《中国神经肿瘤杂志》2009,7(3):209-209
BACKGROUND: Diffuse pontine glioma is a pediatric brain tumor with a median survival time of 1 year and few long-term survivors. Conventional MRI has not been shown to predict overall survival. With this dismal prognosis, clinical improvement after radiation therapy might be a more relevant issue. OBJECTIVE: To determine whether initial imaging would predict clinical response. MATERIALS AND METHODS: We performed a retrospective review of children with diffuse pontine glioma treated at The Children's Hospital, Denver, and the University of Colorado-Denver from 1995 to 2008. The 30 children were divided into two groups based on acute clinical response to radiation therapy. 相似文献
993.
Staying the Surgeon’s Hand: Role of Percutaneous Catheter Drainage in Acute Necrotising Pancreatitis
Routh?DronacharyaEmail author CS?Naidu AK?Singh Sharma?Sanjay Ranjan?Priya 《Hellēnikē cheirourgikē. Acta chirurgica Hellenica》2018,90(1):16-21
Introduction
Acute necrotising pancreatitis (NP) is associated with high morbidity and mortality. Patients with infected pancreatic necrosis (IPN) require some form of intervention in addition to medical management. Although there is no accepted consensus, it is generally agreed that the infected non-vital solid tissue needs to be removed in order to control the sepsis. The results of early surgery have not been encouraging, compared with cases where surgery was delayed or avoided. The placement of percutaneous catheter drains in such a situation helps to decrease the systemic inflammatory response and reverse organ dysfunction.Aims and objectives
The aim of this study was to review retrospectively the results of percutaneous catheter drainage (PCD) in patients with acute NP requiring intervention.Materials and methods
A retrospective study was conducted of patients presenting with acute NP from March 2012 to June 2015. Demographic, clinical, and perioperative information was retrieved from the medical records. The patients were initially managed in the intensive care unit (ICU) with goal-directed therapy and organ support where indicated. The patients with IPN and few with sterile pancreatic necrosis (SPN) who had persistent organ failure or whose clinical condition was deteriorating despite adequate medical support were subjected to some form of intervention. All the patients requiring PCD or surgical intervention were included in this study. These patients were divided into 3 groups based on the type of intervention: a) PCD only, b) PCD followed by surgical intervention, and (c) surgery alone. The outcome in these 3 groups was analyzed and the factors associated with failure of PCD were identified. In addition, the complications of SPN were investigated.Results
The records were reviewed of 46 patients diagnosed with acute NP, of which 23 required PCD or surgical intervention and were included in this study. The mean acute physiology and chronic health (APACHE II) score of these patients was 10.6 ± 3.45, while the mean bedside index of severity in acute pancreatitis (BISAP) score was 4.47 ± 0. 53. On contrast enhanced computed tomography (CECT) scan of the abdomen, 39% of the patients had >50% necrosis, with a mean CT severity index (CTSI) of 8.1 ± 1.9. Of the 21 patients treated initially with PCD, a step-up approach was applied in 8 patients, because of failure of PCD. The mean duration from admission to intervention was 19.5 days. A mean of 2.4 pigtail catheters were placed in each patient. Additional drains were placed in 3 patients. The duration of PCD ranged from 20 to 124 days. The mean ICU stay was 14.3 ± 3.2 days and the mean hospital stay was 35.8 ± 7.4 days. Post-intervention complications were recorded in 11 (47.8%) patients, of which 2 patients with PCD developed an external pancreatic fistula and 2 had bleeding. The mortality rate was 26% (6 patients).Conclusion
PCD is a feasible and successful modality of treatment for acute NP requiring intervention. With the use of PCD, surgical necrosectomy may be completely avoided or delayed until the condition of the patient is stable enough to sustain surgery.994.
995.
996.
997.
998.
Amy A. Sarma Chileshe Nkonde-Price Martha Gulati Claire S. Duvernoy Sandra J. Lewis Malissa J. Wood 《Journal of the American College of Cardiology》2017,69(1):92-101
Women are a consistent minority in the field of cardiology, with concerns regarding balancing career and parenting responsibilities often cited as a contributing factor to this under-representation. To investigate the impact that a career in cardiology may have on the family planning decisions of female cardiologists, the Women in Cardiology section of the American College of Cardiology conducted a voluntary anonymous survey. The following perspective highlights lessons learned from the survey, and potential solutions to the issues surrounding maternity leave, radiation exposure during pregnancy, and breastfeeding accommodations raised by these data. Given that most female cardiologists are pregnant at some point during their careers, particularly during the vulnerable periods of training and early career, improving the experience of pregnancy and early parenthood for all cardiologists may secure the best possible candidates to the field of cardiology. 相似文献
999.
M Nassimizadeh AK Nassimizadeh D Power 《Annals of the Royal College of Surgeons of England》2014,96(8):571-574
In September 1998 the world’s first hand transplant was performed in Lyon, France. A new era in reconstructive surgery had begun. This case highlighted the potential for composite tissue allotransplantation (CTA). While CTA is not a new technique, it unifies the principles of reconstructive microsurgery and transplant surgery, achieving the goals of absolute correction of a defect with anatomically and physiologically identical tissue with none of the issues of donor site morbidity associated with autologous tissue transfer.The adoption of this technique for non-life threatening conditions to improve quality of life has generated a number of new ethical considerations. Additionally, the prominence of transplanted hands has led to much discussion around the issue of body identity and psychological assessment of potential recipients. This is fundamental to any hand transplantation programme. With the advent of hand transplantation dawning in the UK, we review the many ethical considerations that contribute to this new frontier. 相似文献
1000.