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991.
Zsolt Balogh Cino Bendinelli Timothy Pollitt Rosemary A. Kozar Frederick A. Moore 《European journal of trauma and emergency surgery》2008,34(4):369-377
Postinjury abdominal compartment syndrome (ACS) has evolved during the 1980s together with the introduction of damage control
surgery (DCS) principles. DCS made it possible to salvage severely injured trauma patients who previously would have exsanguinated
due to uncontrollable coagulopathic bleeding. These patients had severe hemorrhagic shock; their abdomens were tightly packed
and had ongoing massive resuscitation. ACS is a lethal complication of the damage control patients. For today the pathophysiological
characteristics of ACS are described, the intra-abdominal pressure is measured on many intensive care units. Postinjury ACS
(primary and secondary) is one of the better characterized etiological types of ACS: risk factors, diagnostic criteria, independent
predictors and preventive strategies are all well documented. Since the mortality of full-blown postinjury ACS is still unacceptably
high and does not seem to improve with earlier decompression, prevention is the recommended strategy to decrease the morbidity
and mortality. Open abdomen is one of the important preventive strategies but it is not free from morbidity and mortality.
With aggressive open abdomen management in postinjury ACS these complications can be minimized. More importantly, timely hemorrhage
control and hemostatic resuscitation are the likely solutions for more efficient prevention of the postinjury ACS. 相似文献
992.
Kavin G. Shah Derry Rajan Jeffrey Nicastro Ernesto P. Molmenti Gene Coppa 《The Indian journal of surgery》2012,74(2):146-148
Bariatric surgery has been demonstrated to be an effective treatment for morbid obesity. The purpose of this study is to investigate
the incidence of pre- and post-operative deep venous thrombosis (DVT) in Lap-Band surgical patients. This study group comprised
56 consecutive patients who underwent Lap-Band surgery. Mean age and body mass index were 38 years (range: 18–64 years) and
50.9 kg/m2 (range: 53–74 kg/m2), respectively. All the patients were screened with duplex ultrasonography pre- and post-operatively. There were no iliac,
femoral, or popliteal vein thromboses detected at any given point of time. No patient had any clinical signs or symptoms of
DVT post-operatively. There were no observable differences attributable to DVT prophylaxis. This data suggest that in the
setting of chemical and mechanical prophylaxis, the incidence of DVT in patients undergoing Lap-Band surgery at an established
bariatric centre is minimal. 相似文献
993.
Hai-Tao Chen Quan-Cai Cai Jian-Ming Zheng Xiao-Hua Man Hui Jiang Bin Song Gang Jin Wei Zhu Zhao-Shen Li 《Annals of surgical oncology》2012,19(3):464-474
Background
Delta-like ligand 4 (DLL4)-Notch signaling plays a key role in tumor angiogenesis, but its prognostic value in patients with pancreatic ductal adenocarcinoma (PDAC) remains unclear. Our aim was to determine whether high DLL4 expression is correlated with poor prognosis after curative resection for PDAC.Methods
Surgical specimens obtained from 89 patients with PDAC were immunohistochemically assessed for DLL4 and vascular endothelial growth factor receptor 2 (VEGFR-2) expression. Prognostic significance of DLL4 expression was evaluated by Kaplan–Meier method and Cox regression. The correlations of DLL4 expression with VEGFR-2 expression, tumor stage, and lymph node metastasis were examined by chi-square test and multivariate logistic regression.Results
There were 38 (42.7%) and 51 patients who showed high and low DLL4 expression, respectively. Survival curves showed that patients with low DLL4 expression had a significantly better survival than those with high DLL4 expression (P < .001). Multivariate survival analysis demonstrated that high DLL4 expression was independently associated with both reduced overall survival (hazard ratio [HR] 2.24; 95% confidence interval [95% CI] 1.14–4.38) and reduced progression-free survival (HR 2.37; 95% CI 1.22–4.60). Multivariate logistic regression analyses showed that high DLL4 expression was independently associated with both advanced tumor stage (odds ratio [OR] 6.84; 95% CI 2.42–9.36) and lymph node metastasis (OR 3.27; 95% CI 1.04–10.34). We also found a positive correlation between DLL4 and VEGFR-2 expression (P < .001).Conclusions
High DLL4 expression is significantly associated with poor prognosis for surgically resected PDAC, advanced tumor stage, and lymph node metastasis. Application of adjuvant therapy targeting DLL4-Notch signaling may improve prognosis.994.
Use of endoscopic stents to manage patients with malignant obstructive jaundice is a well accepted measure. Interpretation
of the results of endoscopic stenting must be made with reference to the level of the bile duct obstruction. Results were
generally unsatisfactory for hilar lesions, especially when the intrahepatic ducts were segregated into multiple isolated
systems. After deployment, stent dysfunction due to clogging by biliary sludge is apparently an inevitable process for the
conventional plastic stent. Considerable efforts had been made to prolong the stent patency by changing its physical configuration,
coating the inner lumen, and the choice of material but with little success. The development of a self-expandable metal stent
is a major advance, but the benefits derived from a larger stent lumen are compromised by the initial expense and the tumor
ingrowth through the wires for all models available commercially. Current data failed to substantiate the value of routine
preoperative biliary decompression, as there is no reduction in the morbidity and mortality rates after surgery. Although
biased patient selection may have resulted in the negative observations made, repeated clinical trials should probably focus
on patients with distal bile duct tumors who are preparing for a major pancreatic resection. As a definitive palliative measure,
endoscopic stenting is a more cost-effective option than surgery for patients with limited life expectancy based on data regarding
plastic stents. The recommendations are evolving however, as there is progressive refinement of laparoscopic surgery techniques
and designs of endoscopic stents. 相似文献
995.
PURPOSE: We report our experience of diagnosing and treating hepatic angiomyolipoma (HAML), a rare benign mesenchymal tumor. METHODS: We analyzed retrospectively the clinicopathologic, radiological, and operative data of 25 patients who underwent surgery for HAML at our institute between November 2001 and May 2006. RESULTS: Most patients (20/25) were asymptomatic and had normal liver function. Ultrasonography (US) showed a heterogeneous hyperechoic mass in 13 of 23 patients, precontrast computed tomography (CT) showed that all of 12 lesions scanned were hypodense, and magnetic resonance imaging (MRI) showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images in most (5/6) lesions. Marked enhancement in the arterial phase was seen in 10 of 12 lesions on CT scans and in 6 of 6 lesions on MRI scans. All tumors were composed of varying proportions of smooth muscle, adipose tissue, and blood vessels, and showed positive immunohistochemical staining for HMB-45. All patients underwent partial hepatectomy and there was no evidence of recurrence after a median follow-up of 43 months. CONCLUSION: The radiological features of HAML vary according to its histological components. The definitive diagnosis of HAML is challenging and depends on the presence of HMB-45-positive myoid cells. Hepatic angiomyolipoma is treated effectively with surgery and the prognosis is good. 相似文献
996.
补阳还五汤对小鼠额叶皮质神经元胞体形态影响的定量研究 总被引:6,自引:0,他引:6
用体视学方法统计饲补阳还五汤小鼠大脑额叶皮质神经元胞体、细胞核、核仁的8个有关形态参数,结果发现补阳组与对照组比较,在性成熟期胞体体密度Vv1、细胞核体密度Vv2、核仁体密度Vv3均明显减小,细胞核比表面δ3明显增大,在老年期8个参数均无明显变化。结果表明补阳还五汤有一定程度促进生长和恢复大脑功能的作用。 相似文献
997.
以乙烯-醋酸乙烯共聚物通过等离子体接枝丙烯酸以达到阻燃的目的。接技后样品的点燃时间延长、极取氧指数提高、成炭量增加,说明接枝后的侧基(-COOH,-COONa和-COOK)在热降解过程中不仅知身参与成炭,而且强有力地促进了基体聚合物的成炭过程。 相似文献
998.
蝮蛇抗栓酶治疗硬皮病的临床观察 总被引:4,自引:0,他引:4
赖松青 《重庆医科大学学报》1990,15(4):312-314
蝮蛇抗栓酶治疗硬皮病还未见报道,本文治疗10例,其中系统型7例、局限型3例,具有一定疗效 相似文献
999.
目的 探索核因子κB(NF-κB)、Notch-1和Ki-67在结肠癌组织中的表达及其临床意义.方法 收集泸州医学院附属医院病理科2008年12月至2010年1月存档结肠蜡块120例,其中结肠腺瘤20例;结肠癌90例,包括高分化腺癌45例,中分化腺癌33例,低分化腺癌12例;结肠正常黏膜组织10例.采用免疫组织化学的方... 相似文献
1000.
目的:观察氨溴索联合抗生素治疗社区获得性肺炎(CAP)的临床效果。方法选择社区获得性肺炎患者92例,根据治疗方案不同分为试验组和对照组。试验组46例应用头孢哌酮钠联合氨溴索治疗,对照组46例在治疗过程中不联合应用氨溴索。观察治疗期间患者体温、白细胞计数以及胸部X线的变化。结果试验组治愈40例,好转6例,总有效率为100.00﹪;对照组治愈26例,好转13例,无效7例,总有效率为84.78﹪,2组比较差异显著(P〈0.05)。结论在抗生素的基础上联合应用氨溴索可以提高CAP患者的治愈率,缩短抗生素应用时间。 相似文献