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211.
Two cases are reported in which, after ACL reconstruction with autologous hamstring grafts, tibial polylactide interference
screws migrated into the knee joint. Clinically, both patients presented with recurrent locking of the joint. In one case,
a broken 15 mm-long tip of the screw was found intra-articularly. In the other case, the whole screw had migrated into the
joint cavity. The degradation process of polylactic acid, operative technique and bone quality are discussed as possible reasons
for these complications. 相似文献
212.
Benoit J. M. Pirotte Alphonse Lubansu Michael Bruneau Chakir Loqa Nathalie Van Cutsem Jacques Brotchi 《Child's nervous system》2007,23(11):1251-1261
Objective The objective of this study was to evaluate whether the rigid application of a sterile protocol for shunt placement was applicable
on a routine basis and allowed the reduction of shunt infections (SI) in children.
Materials and methods Since 2001, a rigid sterile protocol for shunt placement in children using neither antibiotic-impregnated catheters nor laminar
airflow was prospectively applied at Erasme Hospital, Brussels, Belgium. For assessing the protocol efficacy before continuation,
we preliminarily analyzed the results of the first 100 operated children (43 females, 57 males, 49 aged <12 months; 115 consecutive
shunt placement/revision procedures). All procedures were performed by the same senior surgeon, one assistant, one circulating
nurse, one anesthesiologist. The sterile protocol was rigidly imposed to these four staff members: uniformed surgical technique;
limited implant and skin edge manipulation; minimized human circulation in the room; scheduling surgery as first morning operation;
avoiding postoperative cerebrospinal fluid (CSF) leak; double gloving; procedures of less than 30-min duration; systemic antibiotics
prophylaxis. We analyzed separately: (1) children carrying an increased risk of SI (n = 38) due to preoperative external ventricular drainage, CSF leak, meningitis, glucocorticoids, chemotherapy; (2) children
aged <12 months; (3) procedures for shunt revision.
Results Errors in protocol application were recorded in 71/115 procedures. They were mainly done by non-surgical staff, decreased
with time and were medically justified in some young children. Surprisingly, no SI occurred (follow-up, 4 to 70 months). One
child developed an appendicitis with peritonitis (Streptococcus faecalis) after 6 months. No SI was found. After peritonitis was cured, shunt reinsertion was uneventful.
Conclusion These preliminary results suggest that a uniform and drastic sterile surgical technique for shunt placement: (1) can be rigidly
applied on a routine basis; (2) can lower the early SI rate below 1%; (3) might have a stronger impact to reduce SI than using
antibiotic-impregnated catheters and optimizing the operative environment such as using laminar airflow and reducing the non-surgical
staff. This last issue will be evaluated further in the present ongoing protocol. 相似文献
213.
214.
Seong-Woong Kim Kyu-Won Shim Nick Plesnila Yong-Oock Kim Joong-Uhn Choi Dong-Seok Kim 《Child's nervous system》2007,23(2):201-206
Objects We designed several distraction devices and applied these instruments in 14 patients with varying types of craniosynostosis.
The aim of this report is to clarify the advantages and disadvantages of these surgical methods and to discuss current concepts
for the surgical strategy in the treatment of craniosynostosis.
Methods From January 2000 to July 2005, 28 patients with craniosynostosis were retrospectively analyzed. Surgical treatment was performed
on 14 patients using the distraction method with internal distraction devices that we designed, in which 5 patients had plagiocephaly,
3 brachycephaly, and 6 scaphocephaly. All patients underwent preoperative and postoperative evaluations, which included the
patient’s neurological state, and three-dimensional CT.
Results With distraction devices, the time required for the surgery could be shortened almost 3 1/3 h; the bleeding during the surgery
was decreased with reduced requirement of more than 200 ml of blood transfusion as compared with remodeling surgery. Postoperatively
achieved distraction distances varied from 30.0 to 47.5 mm (mean, 42.99 mm). The average increased volume percent of cranium
in distraction surgery group was 20.9% (range, −11.5 to 58.9%) after full distraction.
Conclusion With distraction surgery, satisfactory cranial volume expansion and aesthetically pleasing morphological states were achieved
in all cases, and the efficacy was statistically significantly high as compared with remodeling method. 相似文献
215.
A Comparative Study on the Effect of BCG-PSN and Thymopeptides on T-lymphocyte Subsets of Normal and Immunosuppressed Mice 总被引:2,自引:0,他引:2
Polysaccharidenucleicacidfractionofbacilluscalmetteguerin (BCG PSN ,SiqikangInjection)andthymopeptidesarenowtwowidelyusedimmunomod ulatorsinclinicalpractice .Theyareusuallyusedasanadjuvanttherapyforvirusinfection ,autoimmunediseasesandneoplasms ,whichhavebeenclinicallyprovedtobeeffective .Somereportsdemonstratedthattheybothcanstimulatetheproliferationanddif ferentiationofT lymphocytes.However ,theexactmechanismshavenotbeenelucidatedyet .InordertocomparetheirmodulatingmechanismsonT lympho c… 相似文献
216.
Koichi Murata Yasuaki Nakagawa Takashi Suzuki Masahiko Kobayashi Seiya Kotani Takashi Nakamura 《Knee surgery, sports traumatology, arthroscopy》2007,15(10):1261-1263
Intraosseous ganglia of the glenoid are rare, and their etiology is unknown. This report describes a case of an intraosseous
ganglion about to cause fracture of the glenoid. The patient was a 61-year-old woman with a painful left shoulder with a limited
range of motion. Her symptoms did not improve after non-operative treatment. Arthroscopic examination showed a cartilage defect
and erosion in the posteroinferior portion of the glenoid, behind which computed tomography (CT) showed a cystic lesion of
the glenoid. There was no communication between the cyst and the joint space. The patient was treated by curettage and an
autogenous cancellous bone graft from the iliac crest. Two years after the operation, the patient was almost free from pain,
and CT showed good integration of the bone graft. 相似文献
217.
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