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991.
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992.
三维超声技术及其在肝癌诊治中的应用 总被引:2,自引:0,他引:2
介绍三维超声成像技术的原理,讨论三维超声在肝癌的诊断性应用及在肝脏手术和介入中的治疗性应用。 相似文献
993.
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
994.
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995.
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
996.
目的 探讨保护控尿功能的前列腺癌根治术的技术要点.方法 对收治的94例T1b~T2c前列腺癌患者行保留控尿功能的前列腺癌根治术,即腹腔镜下精细解剖前列腺尖部,保护EUS及其控尿神经,膀胱颈后唇成形后与尿道吻合;并同前期42例行常规前列腺癌根治术(LRP)的患者比较,术后30、60和90 d评估患者的控尿状况.控尿标准: 站立或行走时无尿液漏出,或全天使用尿垫不超过1块.结果 术后30、60 d控尿率LRP组为27.7%(13/47)、66.0%(31/47);CSLRP组为55.3%(26/47)、85.1%(40/47),均有统计学差异(χ2=7.406,4.663,P<0.05).术后90 d两组控尿率为78.7%(37/47)和91.5%(43/47)(χ2=3.02,P>0.05).结论 利用腹腔镜的优点,保护EUS和膀胱颈后唇成形加强尿道后壁,能明显加快前列腺癌根治术后控尿的恢复时间. 相似文献
997.
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
998.
Pierpaolo Sileri Vito Maria Stolfi Giampiero Palmieri Alessandra Mele Alessandro Falchetti Sara Di Carlo Achille Lucio Gaspari 《Journal of gastrointestinal surgery》2007,11(12):1662-1668
Stapled hemorrhoidopexy is widely accepted to treat hemorrhoids, but serious complications have been reported. In this prospective
audit, we correlated clinical outcome with pathological findings. From January 2003 to April 2007, 94 patients underwent hemorrhoidopexy.
Macroscopic appearance of the specimen (shape, size, and depth) was recorded. Microscopically, the presence of columnar, transitional,
and squamous epithelium, the involvement of circular/longitudinal smooth muscle, and features of mucosal prolapse were assessed.
Clinical outcome was evaluated by a validated questionnaire. Postoperative pain, secretion, and bleeding durations were 12.7 +/− 10.6,
5.6 +/− 9.6, and 6.3 +/− 8.4 days. Patient’s return to work averaged 16.7 +/− 10.7 days. Fissure, skin tags, and anal strictures
were observed in 23.4%. Seven patients experienced pain for a significantly longer period of time. All specimens contained
columnar mucosa, but 29.8% contained columnar and transitional epithelium and 12.8% contained columnar, anal transitional,
and stratified squamous epithelium. Smooth muscle was observed in 62.7%. Pain was significantly increased if transitional
epithelium was present in the specimen. No correlation or differences were observed if smooth muscle was present, although
postoperative bleeding was more frequent. Hemorrhoidopexy is safe and effective. The specimen should always be sent for pathology
examination. Only columnar epithelium should be present and, although the presence of smooth muscle does not influence the
outcome in terms of functional results, its presence may play a role in postoperative bleeding.
Presented as poster at the Digestive Disease Week, May 2007, Washington, USA 相似文献
999.
Status,challenges and facilitators of consumer involvement in Australian health and medical research
Background
The emergent international practice of involving consumers in health research is driven, in part, by the growing share of health research that can only be applied in and emerge from knowledge that is shaped by human values and societal contexts. This is the first investigation of its kind to identify the current prevalence, challenges, enabling factors and range of approaches to consumer involvement in health and medical research in Australia. 相似文献1000.