全文获取类型
收费全文 | 1285篇 |
免费 | 55篇 |
国内免费 | 4篇 |
专业分类
耳鼻咽喉 | 1篇 |
儿科学 | 23篇 |
妇产科学 | 12篇 |
基础医学 | 108篇 |
口腔科学 | 13篇 |
临床医学 | 93篇 |
内科学 | 261篇 |
皮肤病学 | 11篇 |
神经病学 | 250篇 |
特种医学 | 141篇 |
外科学 | 204篇 |
综合类 | 12篇 |
预防医学 | 112篇 |
眼科学 | 8篇 |
药学 | 36篇 |
中国医学 | 7篇 |
肿瘤学 | 52篇 |
出版年
2021年 | 19篇 |
2019年 | 9篇 |
2018年 | 20篇 |
2017年 | 11篇 |
2016年 | 17篇 |
2015年 | 25篇 |
2014年 | 27篇 |
2013年 | 36篇 |
2012年 | 44篇 |
2011年 | 56篇 |
2010年 | 43篇 |
2009年 | 28篇 |
2008年 | 57篇 |
2007年 | 52篇 |
2006年 | 59篇 |
2005年 | 54篇 |
2004年 | 35篇 |
2003年 | 52篇 |
2002年 | 58篇 |
2001年 | 44篇 |
2000年 | 54篇 |
1999年 | 39篇 |
1998年 | 26篇 |
1997年 | 24篇 |
1996年 | 20篇 |
1995年 | 20篇 |
1994年 | 16篇 |
1993年 | 11篇 |
1992年 | 28篇 |
1991年 | 20篇 |
1990年 | 29篇 |
1989年 | 30篇 |
1988年 | 20篇 |
1987年 | 25篇 |
1986年 | 23篇 |
1985年 | 24篇 |
1984年 | 21篇 |
1983年 | 14篇 |
1982年 | 11篇 |
1980年 | 13篇 |
1979年 | 13篇 |
1978年 | 7篇 |
1977年 | 7篇 |
1976年 | 10篇 |
1974年 | 7篇 |
1973年 | 9篇 |
1972年 | 8篇 |
1971年 | 8篇 |
1969年 | 8篇 |
1968年 | 7篇 |
排序方式: 共有1344条查询结果,搜索用时 15 毫秒
21.
22.
Dirk R. Bulian Linda Trump Jürgen Knuth Nicola Cerasani Markus M. Heiss 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2013,398(4):571-579
Introduction
Transvaginal/transumbilical cholecystectomy using rigid instruments (TVC) is an alternative to the traditional laparoscopic technique (LC). Due to a lack of long-term data, the transvaginal approach is still controversial.Methods
Our first 50 TVC patients and 50 LC patients from the same time period with the same limits according to age, BMI and ASA classification were asked 48 questions 2 years postoperatively (mean) about resuming sexual intercourse, the domains “satisfaction” and “pain” of the German Female Sexual Function Index, resuming everyday life, postoperative abdominal pain, subjective impairment, incisional hernias, satisfaction with the aesthetic result, the overall postoperative result, and others. Postoperative sexual satisfaction and pain were defined as main outcome. Forty-six TVC patients and 42 LC patients answered the questions (36 TVC patients and 25 LC patients could answer the questions about sexual function).Results
No significant differences were found for postoperative sexual function, change in menorrhea, vaginal discharge and postoperative abdominal pain. TVC patients felt significantly less impaired postoperatively (p?=?0.034). Two patients in the LC group developed a trocar hernia (p?=?0.225). TVC patients could resume everyday life significantly earlier (p?<?0.001) and were significantly more satisfied with the aesthetic (p?<?0.001) and the overall postoperative result (p?=?0.001). Significantly more TVC patients would recommend the applied surgical technique to friends and family (p?<?0.001).Conclusions
This long-time prospective data acquisition from 88 or, for some data, 61 patients accounts for the safety of TVC, particularly with regard to sexual function. Additionally, it found less postoperative impairment, quicker recovery and improved satisfaction for TVC as compared to LC. 相似文献23.
24.
Biehl C. Rupp M. Kern S. Heiss C. ElKhassawna T. Szalay G. 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2020,30(8):1499-1504
European Journal of Orthopaedic Surgery & Traumatology - Rheumatoid arthritis is a chronic inflammatory disease. The associated involvement of hands and tendons is over 90% and impairs overall... 相似文献
25.
Dirk Rolf Bulian Jurgen Knuth Nicola Cerasani Jonas Lange Michael Alfred Ströhlein Axel Sauerwald Markus Maria Heiss 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2014,399(6):717-724
Introduction
For cholecystectomy (CHE), both the needlescopic three-trocar technique with 2–3-mm instruments (needlescopic cholecystectomy (NC)) and the umbilically assisted transvaginal technique with rigid instruments (transvaginal cholecystectomy (TVC)) have been established for further reduction of the trauma remaining from laparoscopy.Methods
To compare the further outcome of both techniques for elective CHE in female patients, we analyzed the secondary end points of a prospective randomized single-center trial (needlescopic versus transvaginal cholecystectomy (NATCH) trial; ClinicalTrials.gov Identifier: NCT0168577), in particular, satisfaction with aesthetics, overall satisfaction, abdominal pain, and incidence of trocar hernias postoperatively at both 3 and 6 months. After 3 months, the domains “satisfaction” and “pain” of the German version of the Female Sexual Function Index (FSFI-d) were additionally evaluated to detect respective complications. A gynecological control examination was conducted in all TVC patients after 6 months.Results
Forty patients were equally randomized into the therapy and the control groups between February 2010 and June 2012. No significant differences were found for overall satisfaction with the surgical result, abdominal pain, sexual function, and the rate of trocar hernias. However, aesthetics were rated significantly better by TVC patients both after 3 and after 6 months (P?=?0.004 and P?<?0.001). There were no postoperative pathological gynecological findings.Conclusions
Following TVC, there is a significantly better aesthetic result as compared to NC, even at 3 and 6 months after the procedure. No difference was found for sexual function. 相似文献26.
Alexander E White Andrew FW Ho Nur Shahidah Nurul Asyikin Le Xuan Liew Pin Pin Pek Jade PH Kua Michael YC Chia Yih Yng Ng Shalini Arulanandam Sieu-Hon Benjamin Leong Marcus EH Ong 《Singapore medical journal》2021,62(8):438
Care for patients who experience out-of-hospital cardiac arrest (OHCA) has rapidly evolved in the past decade. Increased sophistication of care in the community, emergency medical services (EMS) and hospital setting is associated with improved patient-centred outcomes. Notably, Utstein survival doubled from 11.6% to 23.1% between 2011 and 2016. These achievements involved collaboration between policymakers, clinicians and researchers, and were made possible by a strategic interplay of policy, research and implementation. We review the development and current state of OHCA in Singapore using primary population-based data from the Pan-Asian Resuscitation Outcomes Study and an unstructured search of research databases. We discuss the roles of important milestones in policy, community, dispatch, EMS and hospital interventions. Finally, we relate these interventions to relevant processes and outcomes, such as the relationship between the strategic implementation of bystander cardiopulmonary resuscitation and placement of automated external defibrillator with return of spontaneous circulation, survival to discharge and survival with favourable neurological outcomes. 相似文献
27.
Christian Heiss Petra Kleinbongard Andrè Dejam Sandra Perré Hagen Schroeter Helmut Sies Malte Kelm 《Journal of the American College of Cardiology》2005,46(7):1276-1283
OBJECTIVES: This study was designed to assess the effect of flavanol-rich food on the circulating pool of bioactive nitric oxide (NO) and endothelial dysfunction in smokers. BACKGROUND: Studies suggest that smoking-related vascular disease is caused by impaired NO synthesis and that diets rich in flavanols can increase bioactive NO in plasma. METHODS: In smokers (n = 11), the effects of flavanol-rich cocoa on circulating NO species in plasma (RXNO) measured by reductive gas-phase chemiluminescence and endothelial function as assessed by flow-mediated dilation (FMD) were characterized in a dose-finding study orally administering cocoa containing 88 to 370 mg flavanols and in a randomized double-blind crossover study using 100 ml cocoa drink with high (176 to 185 mg) or low (<11 mg) flavanol content on two separate days. In addition to cocoa drink, ascorbic acid and NO-synthase inhibitor L-NMMA (n = 4) were applied. RESULTS: There were significant increases in RXNO (21 +/- 3 nmol/l to 29 +/- 5 nmol/l) and FMD (4.5 +/- 0.8% to 6.9 +/- 0.9%, each p < 0.05) at 2 h after ingestion of 176 to 185 mg flavanols, a dose potentially exerting maximal effects. These changes correlated with increases in flavanol metabolites. Cocoa-associated increases in RXNO and FMD were reversed by L-NMMA. Ascorbic acid had no effect. CONCLUSIONS: The circulating pool of bioactive NO and endothelium-dependent vasodilation is acutely increased in smokers following the oral ingestion of a flavanol-rich cocoa drink. The increase in circulating NO pool may contribute to beneficial vascular health effects of flavanol-rich food. 相似文献
28.
29.
Life-threatening intrathoracic complications during treatment with extracorporeal membrane oxygenation 总被引:1,自引:0,他引:1
J B Zwischenberger R E Cilley R B Hirschl K F Heiss V R Conti R H Bartlett 《Journal of pediatric surgery》1988,23(7):599-604
Extracorporeal membrane oxygenation (ECMO) has been successful (greater than 80% survival) in 35 centers in greater than 900 newborns with severe respiratory failure having an estimated mortality of greater than 80% on conventional management. During the last 3 years we have treated 79 newborns with 74 survivors (94%). Their diagnoses included meconium aspiration, persistent fetal circulation, respiratory distress syndrome, congenital diaphragmatic hernia, and sepsis. Seven patients (9%) had life-threatening intrathoracic complications requiring emergent intervention while on ECMO: tension hemothorax (3), tension pneumothorax (2), and pericardial tamponade (2). Pericardial tamponade and tension hemothorax and pneumothorax show a similar pathophysiology of increasing intrapericardial pressure and decreasing venous return. Perfusion is initially maintained by the nonpulsatile flow of the ECMO circuit before further decrease in venous return results in decreasing ECMO flow and progressive hemodynamic deterioration. Each of the seven patients demonstrated a clinical triad that includes increasing PaO2 and decreasing peripheral perfusion (as evidenced by decreasing pulse pressure and decreasing SvO2) followed by decreasing ECMO flow with progressive deterioration. The diagnoses were confirmed by transillumination, chest x-ray, or cardiac echocardiogram. Initial emergent placement of a percutaneous drainage catheter was temporizing in all seven cases. However, four patients required emergent thoracotomy for definitive treatment while still on ECMO. All seven patients were weaned from ECMO and are short-term survivors (6 months to 3.5 years). As use of ECMO for newborn severe respiratory failure increases, responsible physicians must be familiar with life-threatening intrathoracic complications and appropriate treatment strategies. 相似文献
30.
Rennert J Jung EM Schreyer AG Hoffstetter P Heiss P Feuerbach S Zorger N 《World journal of gastroenterology : WJG》2011,17(13):1739-1745
AIM: To evaluate the benefit and effectiveness of MRarterioportography (MR-AP) to achieve the highest sensitivity for detection and evaluation of hepatocellular carcinoma (HCC). METHODS: Twenty liver cirrhosis patients with suspected HCC were included before transarterial chemoembolization. In all patients double-enhanced Magnetic resonance imaging (MRI) was performed. A bolus of 10 mL Magnevist was injected through a selectively placed catheter in the superior mesenteric artery and MRI of the liver was per... 相似文献