全文获取类型
收费全文 | 325738篇 |
免费 | 15308篇 |
国内免费 | 9425篇 |
专业分类
耳鼻咽喉 | 2720篇 |
儿科学 | 8672篇 |
妇产科学 | 4936篇 |
基础医学 | 33846篇 |
口腔科学 | 4343篇 |
临床医学 | 32310篇 |
内科学 | 52308篇 |
皮肤病学 | 3127篇 |
神经病学 | 23583篇 |
特种医学 | 15007篇 |
外国民族医学 | 75篇 |
外科学 | 43254篇 |
综合类 | 26369篇 |
现状与发展 | 38篇 |
一般理论 | 26篇 |
预防医学 | 29264篇 |
眼科学 | 7197篇 |
药学 | 25771篇 |
147篇 | |
中国医学 | 9436篇 |
肿瘤学 | 28042篇 |
出版年
2024年 | 415篇 |
2023年 | 1955篇 |
2022年 | 5475篇 |
2021年 | 7379篇 |
2020年 | 5516篇 |
2019年 | 4953篇 |
2018年 | 26652篇 |
2017年 | 21813篇 |
2016年 | 23858篇 |
2015年 | 8134篇 |
2014年 | 9906篇 |
2013年 | 9609篇 |
2012年 | 19701篇 |
2011年 | 34128篇 |
2010年 | 27756篇 |
2009年 | 18756篇 |
2008年 | 28461篇 |
2007年 | 30164篇 |
2006年 | 9101篇 |
2005年 | 9836篇 |
2004年 | 8682篇 |
2003年 | 9058篇 |
2002年 | 6431篇 |
2001年 | 3238篇 |
2000年 | 3118篇 |
1999年 | 2901篇 |
1998年 | 1832篇 |
1997年 | 1854篇 |
1996年 | 1311篇 |
1995年 | 1251篇 |
1994年 | 1086篇 |
1993年 | 672篇 |
1992年 | 777篇 |
1991年 | 716篇 |
1990年 | 695篇 |
1989年 | 557篇 |
1988年 | 484篇 |
1987年 | 379篇 |
1986年 | 304篇 |
1985年 | 271篇 |
1984年 | 173篇 |
1983年 | 120篇 |
1982年 | 75篇 |
1981年 | 65篇 |
1980年 | 79篇 |
1979年 | 77篇 |
1974年 | 55篇 |
1938年 | 60篇 |
1932年 | 56篇 |
1930年 | 46篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
991.
Liu-Guan Bian Qing-Fang Sun Wuttipong Tirakotai Wei-Guo Zhao Helmut Bertalanffy Jian-Kang Shen 《Skull base》2007,17(2):145-151
We report a patient with a posterior inferior cerebellar artery (PICA) aneurysm and an incidental facial nerve schwannoma at the cerebellopontine angle (CPA). A 46-year-old woman presented with the sudden onset of a severe headache, nausea, and vomiting. She had no other abnormal neurological symptoms and signs. Computed tomography (CT) showed hemorrhage in the fourth ventricle. Cerebral angiography demonstrated an aneurysm arising from the tonsillomedullary segment of the left PICA. A facial nerve schwannoma was incidentally found as the aneurysm was being clipped. The aneurysm was clipped via a left transcondylar approach. Subsequently, the schwannoma (2 x 3 x 2 mm) was resected from the facial nerve fascicles, and the facial nerve was preserved. Postoperatively, the patient developed mild to moderate dysfunction of the facial nerve (House-Brackmann grade III [H-B III]) but her hearing was intact. Both a facial nerve schwannoma involving the CPA and an aneurysm involving the PICA can be managed through the transcondylar approach. An asymptomatic facial nerve schwannoma can be resected safely with minimal facial nerve dysfunction. 相似文献
992.
Camiel De Bruijn Rob de Bie Jacques Geraets Marielle Goossens Wim van den Heuvel Geert van der Heijden Math Candel Geert-Jan Dinant 《BMC musculoskeletal disorders》2007,8(1):112
Background
The education and activation programme (EAP) aims at coping with psychosocial determinants to prevent the development of chronic shoulder complaints (SCs). The effect of the EAP on functional limitations and patient-perceived recovery after 6 and 26 weeks is evaluated in a randomised clinical trial. 相似文献993.
Intra-operative quick insulin assay to confirm complete resection of insulinomas guided by selective arterial calcium injection (SACI) 总被引:1,自引:0,他引:1
Oliver Gimm Evelyn König Phuong Nguyen Thanh Michael Brauckhoff Wolfram Karges Henning Dralle 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(6):679-684
Background and aims Insulinomas are rare endocrine disorders. Pre-operatively, conventional imaging techniques often fail to localise the tumor.
In addition, due to the lack of quick insulin assays, intra-operative confirmation of complete resection was impossible until
recently.
Materials and methods Six patients with biochemical evidence of an insulinoma underwent pre-operative localisation studies and selective arterial
calcium injection (SACI). In addition, insulin was measured before surgery and every 10–15 min after resection of the tumor
using a quick insulin assay.
Results Pre-operative localisation studies identified the tumor correctly as follows: endosonography: three of four, magnetic resonance
imaging: two of four and SACI: six of six. Tumors in the head and body were enucleated while those in the tail were resected
(n = 2, each). Those three patients, in whom magnetic resonance imaging and/or endosonography could localise the tumors pre-operatively,
underwent laparoscopic surgery while the remaining three patients underwent open surgery. Intra-operatively, insulin dropped
to normal levels within 20 min in all cases. After a follow-up of 0.8–3 years, all patients remained biochemically cured.
Conclusions Pre-operatively, SACI appears to be a very sensitive localisation technique and may be most helpful in guiding the surgeon
if conventional imaging techniques fail to localise the tumor. Complete removal of an insulinoma can be reliably predicted
using a quick insulin assay.
This paper was presented at the 2nd Biennial Meeting of the European Society of Endocrine Surgeons (ESES), May 18–20, 2006,
Krakow, Poland. 相似文献
994.
Sedigheh Sadat Tavafian Ahmadreza Jamshidi Kazem Mohammad Ali Montazeri 《BMC musculoskeletal disorders》2007,8(1):21
Background
Different interventions can reduce the burden of the chronic low back pain. One example is the use of a 'Back School Programme'. This is a brief therapy that uses a health education method to empower participants through a procedure of assessment, education and skill development. This study aimed to evaluate to what extent the programme could improve quality of life in those who suffer from the condition. 相似文献995.
颅内破裂动脉瘤手术时机的探讨(附237例分析) 总被引:8,自引:1,他引:7
目的探讨颅内破裂动脉瘤手术时机与临床预后的关系。方法回顾性分析2005年我院收治的237例颅内破裂动脉瘤,其中196例行手术治疗。按入院时Hunt—Hess分级将手术病人分为A组(Ⅰ~Ⅲ级)162例,B组(Ⅳ、Ⅴ级)34例;根据手术时间分为早期手术组(SAH3d内手术)19例,延期手术组(SAH4~10d手术)82例,晚期手术组(SAH11d之后手术)95例。比较不同手术期别动脉瘤术中破裂率、术后1个月GOS评分及术后主要并发症(脑血管痉挛、脑积水)发生率,并进行统计学分析。结果24例(10.1%)因再出血丧失治疗机会。术中动脉瘤破裂早期手术组3例(15,8%),延期手术组8例(9.8%),晚期手术组6例(613%)。术后脑血管痉挛发生率早期手术组为15,8%,延期手术组为19,5%,晚期手术组为17,9%。脑积水发生率以晚期手术组最高(14,7%)。对术后1个月GOS评分Ridit分析结果显示:A、B两组中均以早期手术组治疗效果最佳.延期手术次之.晚期手术最差。结论早期手术可规避颅内破裂动脉瘤再出血的风险,降低主要并发症发生率。对于各个级别(包括Ⅳ、Ⅴ级)的SAH病人,均应根据治疗者的手术经验与技巧和所在医院的条件,及早诊断,尽早手术。 相似文献
996.
Özgür Aydin 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(1):105-109
Introduction Scar endometriosis develops in and is adjacent to surgical scars at the site of previous abdominal operations. The most frequent
clinical presentation of the disease is that of a palpable subcutaneous mass near surgical scars associated with cyclic pain
and swelling during menses. Endometriosis of the surgical scar is often referred to the general surgeons because the clinical
presentation suggests an incisional hernia or other conditions related to the general surgery. Cyclical symptoms such as pain
and swelling, in relation to surgical scars, which worsen at the time of menstruation, are nearly pathognomonic of scar endometriosis.
However, often the diagnosis of endometriosis is not suggested until after histology has been performed.
Case report We present two cases of cutaneous endometriosis that has occurred on the site of previous cesarean section scar area. 相似文献
997.
Bastiaan R Klarenbeek Alexander AFA Veenhof Elly SM de Lange Willem A Bemelman Roberto Bergamaschi Piet Heres Antonio M Lacy Wim T van den Broek Donald L van der Peet Miguel A Cuesta 《BMC surgery》2007,7(1):16
Backround
Diverticulosis is a common disease in the western society with an incidence of 33–66%. 10–25% of these patients will develop diverticulitis. In order to prevent a high-risk acute operation it is advised to perform elective sigmoid resection after two episodes of diverticulitis in the elderly patient or after one episode in the younger (< 50 years) patient. Open sigmoid resection is still the gold standard, but laparoscopic colon resections seem to have certain advantages over open procedures. On the other hand, a double blind investigation has never been performed. The Sigma-trial is designed to evaluate the presumed advantages of laparoscopic over open sigmoid resections in patients with symptomatic diverticulitis. 相似文献998.
Mustafa Hassan Kaki M. York Haihong Li Qin Li David S. Sheps 《Journal of nuclear cardiology》2007,14(3):308-313
Background Reduced left ventricular ejection fraction (LVEF) is a risk factor for poor outcomes in patients with coronary artery disease
(CAD). Mental stress-induced myocardial ischemia (MSIMI) also identifies a subset of CAD patients at increased risk for future
cardiovascular events. Susceptibility to MSIMI in patients with CAD and reduced LVEF is unknown.
Methods and Results We enrolled 182 patients (67 women) with a mean age of 64 years and a documented history of CAD in this study. Baseline resting
ejection fraction was determined by use of technetium 99m sestamibi gated single photon emission computed tomography. Abnormal
LVEF was defined as less than 45% for men and less than 50% for women (based on published norms for our software [Cedars-Sinai
Medical Center]). All participants underwent mental stress testing with a public speaking task. Rest/stress myocardial perfusion
single photon emission computed tomography was performed via conventional methodology. Images were visually compared for number
and severity of perfusion defects by use of a scoring method from 0 to 4. A summed difference score was calculated as the
difference between summed stress and rest scores. A score of greater than 3 was considered abnormal. MSIMI developed in 19%
of patients with normal LVEF and 31% of those with reduced LVEF. There is no statistically significant difference between
the two groups (P=.11).
Conclusions CAD patients with left ventricular dysfunction are equally susceptible to MSIMI as those with normal LVEF.
This study was supported by grants HL 070265 and HL 072059 from the National Heart. Lung, and Blood Institute. This material
is also the result of work supported by resources and with the use of facilities at the Department of Veterans. Affairs Medical
Center, Gainesville, Fla. 相似文献
999.
1999年1月~2006年12月我科应用显微支撑喉镜术、电视喉内窥镜术及间接喉镜术治疗声带良性病变108例,报道如下。 相似文献
1000.
Everson L. A. Artifon Airton Z. Rodrigues Sergio Marques Bhawna Halwan Paulo Sakai Claudio Bresciani Atul Kumar 《Journal of gastrointestinal surgery》2007,11(12):1686-1691
Background Exploratory laparoscopy is commonly undertaken in patients with highly suspicious biliary and pancreatic lesions to facilitate
diagnosis and staging cancer is present. If an unresectable tumor is identified, a second endoscopic procedure may be required
do deploy a self-expandable metal stent (SEMS) for palliation. As endoscopic retrograde cholangio pancreatography (ERCP) may
be unsuccessful in up to 20% of patients, we evaluated the feasibility and safety of deployment of self-expandable metal stents
at the same time as the initial laparoscopy.
Patients and Methods A total of 23 eligible patients (8 male and 15 female) with malignant obstruction of the common bile duct underwent deployment
of SEMS at laparoscopy. Primary outcome measure was the successful laparoscopic deployment of stent and secondary outcome
measure was complications rates.
Results Indications for stent deployment were unresectable pancreatic cancer in 18, cholangiocarcinoma in two, neuroendocrine tumor
in one and ampullary adenocarcinoma in two patients. The median age was 73 years (range 49–93). Twenty-two of 23 stents were
deployed successfully: 17 stents were deployed transcystically and five via a choledochotomy. Median times for laparoscopic
exploration and SEMS deployment were 165 min (range 105–230) and 20 min (range 10–50), respectively. Pre- and post-procedures
median total bilirubin were 9.4 mg/dl (range 5.4–17.5) and 4.0 (range 2.6–7.1). The median size of the pancreatic mass was
3 cm (range 2–5 cm) and that of the common bile duct (CBD) from 9.2 mm (range 7.2–17.4). The mean duration of laparoscopy
was 170 min (range 120–230 min) and that for stent deployment 23 min (range 10–50 min). Complications included bleeding, obstruction,
and wound infection. Bleeding occurred on day 7 in two patients and on day 30 in one patient; bleeding occurred at the gastrojejunal
anastomosis site and was successfully treated with endoscopic hemostasis. A total of three stent obstructions were identified:
one each at 60, 90, and 120 days follow-up. All complications were successfully managed endoscopically. There were a total
of seven deaths, six as a result of progressive cancer and one of surgical wound infection and ensuing complications.
Conclusion This study demonstrates that laparoscopic deployment of self-expandable metal bile duct stents is feasible and safe. This
option appears to be a reasonable option in patients with inoperable malignant obstruction of the distal common bile duct. 相似文献