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Aim
To investigate characteristics and outcome among patients suffering in-hospital cardiac arrest (IHCA) with the emphasis on gender and age.Methods
Using the Swedish Register of Cardiopulmonary Resuscitation, we analyzed associations between gender, age and co-morbidities, etiology, management, 30-day survival and cerebral function among survivors in 14,933 cases of IHCA. Age was divided into three ordered categories: young (18–49 years), middle-aged (50–64 years) and older (65 years and above). Comparisons between men and women were age adjusted.Results
The mean age was 72.7 years and women were significantly older than men. Renal dysfunction was the most prevalent co-morbidity. Myocardial infarction/ischemia was the most common condition preceding IHCA, with men having 27% higher odds of having MI as the underlying etiology. A shockable rhythm was found in 31.8% of patients, with men having 52% higher odds of being found in VT/VF. After adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30 days. Older individuals were managed less aggressively than younger patients. Increasing age was associated with lower 30-day survival but not with poorer cerebral function among survivors.Conclusion
When adjusting for various confounders, it was found that men had a 10% lower chance than women of surviving to 30 days after in-hospital cardiac arrest. Older individuals were managed less aggressively than younger patients, despite a lower chance of survival. Higher age was, however, not associated with poorer cerebral function among survivors. 相似文献Background Context
In Lenke 1C and 2C curves, the choice between selective thoracic fusion (STF) versus non-selective thoracic fusion as the optimal surgical treatment is controversial.Objective
This study aimed to assess the radiological and clinical outcome of patients with Lenke 1C and 2C curves treated with STF.Study Design
This is a retrospective study.Patient Sample
A total of 44 patients comprised the study sample.Methods
Forty-four patients with Lenke 1C and 2C curves with adolescent idiopathic scoliosis who underwent STF were reviewed. Radiological parameters and Scoliosis Research Society (SRS)-22r scores were assessed preoperatively, postoperatively, and on final follow-up. The incidence of coronal decompensation, lumbar decompensation, and adding-on phenomenon were reported.Results
Mean follow-up duration was 45.1±12.3 months and mean age was 17.0±5.1 years. The preoperative middle thoracic and thoracolumbar/lumbar (MT:TL/L) Cobb angle ratio was 1.4±0.3 and the MT:TL/L apical vertebra translation (AVT) ratio was 1.6±0.8. Final follow-up coronal balance was ?13.0±11.5?mm, main thoracic AVT was 6.9±11.8?mm, and lumbar AVT was ?20.4±13.8?mm (p<.05). Lumbar Cobb angle improved from 47.5°±7.8° to 24.9°±8.2° after operation and 23.3°±9.8° at final follow-up. The spontaneous lumbar curve correction rate was 50.9%. There were 9 patients (20.5%) who had coronal decompensation, 4 patients (9.1%) who had lumbar decompensation, and 11 patients (25.0%) who had adding-on phenomenon. We did not perform any revision surgery. The SRS-22r scores improved significantly in the overall scores, self-image, and mental health domain.Conclusions
Selective thoracic fusion led to improvement in the radiological and clinical outcome for patients with Lenke 1C and 2C. Although no patients required revision surgery, the rate of coronal decompensation, lumbar decompensation, and adding-on phenomenon are significant. 相似文献Materials and methods: This qualitative study used in-depth individual interviews for data collection among 13 people with Parkinson’s disease. Interviews were systematically analyzed using qualitative content analysis with an inductive approach.
Results: Three main themes arose: Falls – avoided and intended highlights the wide spectrum of fall perceptions, ranging from worse-case scenario to undramatized events; Balance identity incorporates how gradual deterioration in balance served as a reminder of disease progression and how identifying themselves as “aware not afraid” helped certain participants to maintain balance confidence despite everyday activity restriction; Training as treatment recounts how participants used exercise as disease self-management with the aim to maintain independence in daily life. Interpretation of the underlying patterns of these main themes resulted in the overarching theme Training as treatment when battling problems with balance and falls.
Conclusions: Whereas certain participants expressed a fear of falling which they managed by activity restriction, others described being confident in their balance despite avoidance of balance-challenging activities. Training was used as treatment to self-manage disease-related balance impairments in order to maintain independence in daily life.
- Implication for Rehabilitation
People with Parkinson’s disease require early advice about the positive effects of physical activity as well as strategies for self-management in order to ease the psychological and physical burden of progressive balance impairment.
Fear of falling should be investigated alongside activity avoidance in this group in order to provide a more accurate insight into the scope of psychological concerns regarding balance and falls in everyday life.
Certain people with Parkinson’s disease define their balance according to activities they continue to participate in, while others who express fear-related activity avoidance require help to adapt balance-challenging activities in order to maintain balance confidence and avoid physical inactivity.