全文获取类型
收费全文 | 55125篇 |
免费 | 4278篇 |
国内免费 | 174篇 |
专业分类
耳鼻咽喉 | 765篇 |
儿科学 | 1466篇 |
妇产科学 | 1025篇 |
基础医学 | 7362篇 |
口腔科学 | 869篇 |
临床医学 | 5893篇 |
内科学 | 11494篇 |
皮肤病学 | 587篇 |
神经病学 | 5279篇 |
特种医学 | 1939篇 |
外国民族医学 | 3篇 |
外科学 | 8804篇 |
综合类 | 1020篇 |
现状与发展 | 1篇 |
一般理论 | 50篇 |
预防医学 | 4710篇 |
眼科学 | 691篇 |
药学 | 3800篇 |
中国医学 | 61篇 |
肿瘤学 | 3758篇 |
出版年
2023年 | 309篇 |
2022年 | 576篇 |
2021年 | 1281篇 |
2020年 | 748篇 |
2019年 | 1210篇 |
2018年 | 1442篇 |
2017年 | 983篇 |
2016年 | 1131篇 |
2015年 | 1394篇 |
2014年 | 1859篇 |
2013年 | 2444篇 |
2012年 | 4059篇 |
2011年 | 4179篇 |
2010年 | 2279篇 |
2009年 | 2093篇 |
2008年 | 3466篇 |
2007年 | 3559篇 |
2006年 | 3482篇 |
2005年 | 3516篇 |
2004年 | 3142篇 |
2003年 | 2972篇 |
2002年 | 2722篇 |
2001年 | 753篇 |
2000年 | 607篇 |
1999年 | 637篇 |
1998年 | 582篇 |
1997年 | 520篇 |
1996年 | 430篇 |
1995年 | 440篇 |
1994年 | 377篇 |
1993年 | 344篇 |
1992年 | 439篇 |
1991年 | 416篇 |
1990年 | 392篇 |
1989年 | 356篇 |
1988年 | 334篇 |
1987年 | 307篇 |
1986年 | 322篇 |
1985年 | 306篇 |
1984年 | 268篇 |
1983年 | 234篇 |
1982年 | 224篇 |
1981年 | 230篇 |
1980年 | 169篇 |
1979年 | 207篇 |
1978年 | 188篇 |
1977年 | 163篇 |
1976年 | 145篇 |
1975年 | 124篇 |
1973年 | 150篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
41.
Penny Dash Chris Llewellyn Ben Richardson 《医院领导决策参考》2009,(20):29-32
医疗改革是一个世界性难题,各国在医疗改革中都会遇到各自相关的问题。改革艰巨,但并不是不可能完成,本文作者认为,通过关注以分区的方式提供医疗服务可以让医疗改革取得实效。本文从划定分区边界的方式出发,介绍了制定分区医疗战略的五个步骤,并讨论了各医疗系统成功实施各自战略所需采取的措施,这也可以为我国正在推行的医疗改革提供一定的借鉴和参考。 相似文献
42.
43.
Charlotte J. Harden Bernard M. Corfe J. Craig Richardson Peter W. Dettmar Jenny R. Paxman 《Nutrition Research》2009
This cross-sectional analysis evaluated the effect of age and body mass index (BMI) on Three-Factor Eating Questionnaire scores in males. Subjects (n = 60) were recruited according to BMI status. Each completed the 51-item Three-Factor Eating Questionnaire. The group was split at the median age to produce a “younger” and “older” group for statistical analysis. A 2-way between-groups analysis of variance revealed a significant main effect of BMI on disinhibition (P = .003) and hunger (P = .041) with higher levels found in overweight males compared to healthy-weight counterparts. A significant main effect of age on hunger (P = .046) demonstrated older males were less susceptible to hunger than younger males. These insights provide a better understanding of eating behavior across the male life cycle and may assist health professionals to better guide men in weight management in the light of rising overweight/obesity. 相似文献
44.
Philippe Topart Guillaume Becouarn Patrick Ritz 《Surgery for obesity and related diseases》2007,3(5):521-525
BACKGROUND: Of patients who have undergone gastric banding, 11-25% will require a major reoperation with band removal and conversion to another bariatric procedure after they have failed to lose sufficient weight or have developed dysphagia or reflux. The aim of this study was to evaluate the respective benefits of Roux-en-Y gastric band (RYGB) or biliopancreatic diversion with duodenal switch (BPD-DS) after failed gastric banding and whether 1 of the 2 procedures might be a better procedure for such cases. METHODS: RYGB or BPD-DS was performed according to the institutional protocols with synchronous band removal, irrespective of the reason for failure. RESULTS: Of the 53 patients, 32 underwent laparoscopic RYGB for a body mass index (BMI) of 43.1 +/- 6.4 kg/m(2) (BMI 45.8 +/- 6.4 kg/m(2) before laparoscopic adjustable gastric banding) and 21 underwent BPD-DS for a BMI of 46.0 +/- 5.5 kg/m(2) (BMI 49.6 +/- 5.2 kg/m(2) before laparoscopic adjustable gastric banding). BPD-DS required significantly longer operative times (239.7 +/- 55.8 versus 135 +/- 26.7 minutes) and resulted in more complications (62% versus 12.5%; P <.002). No patients died postoperatively. The 2 groups of patients had a similar BMI at 12 and 18 months after revision (BMI 33.4 +/- 5.6 kg/m(2) and 31.4 +/- 3.5 kg/m(2)). The weight loss was greater after BPD-DS than after RYGB compared with the prerevision weight loss (66.2% versus 58.8% excess weight loss) or initial weight (73% versus 61.8%), although this was not significant. CONCLUSION: Despite an excessive rate of complications that were, in part, related to the learning curve in this series, BPD-DS resulted in greater weight loss compared with RYGB. However, both procedures were successful after failed gastric banding. A more accurate definition of failure could help to determine the respective indications for revisional surgery. 相似文献
45.
We report a full-term male infant born to nonconsanguinous parents who had clinical features of Goldenhar syndrome and cri du chat syndrome. At birth, the infant was noted to have dysmorphic features with bilateral preauricular tags, rotated ears, bilateral epicanthic folds, a left epibulbar lipodermoid, and an accessory left nipple. After he was assessed for feeding difficulty and tachypnea, he was found to have esophageal atresia with tracheoesophageal fistula. In addition, he had a high-pitched, cat-like cry, characteristic of cri-du-chat syndrome. He also failed a hearing test. Chromosomal analysis and fluorescence in situ hybridisation studies showed an unbalanced karyotype with a terminal deletion of the segment p14 on the short arm of chromosome 5, which is consistent with the cri-du-chat locus. The association of Goldenhar syndrome and cri-du-chat syndrome in this patient suggests that the chromosome 5p14 locus may harbor a gene implicated with Goldenhar syndrome. 相似文献
46.
Nicolas Borenstein Valérie Chetboul Patrick Bruneval Mehrak Hekmati Renaud Tissier Luc Behr Geneviève Derumeaux Didier Montarras 《European journal of cardio-thoracic surgery》2007,31(3):444-451
OBJECTIVE: Cell therapy may be a promising alternative or adjunct to current treatment modalities for ischemic heart failure. But little is known on the impact of myogenic cell transplantation in large animal models of non-ischemic cardiomyopathy. The aim of the present study was to explore whether an ovine model of toxin-induced heart disease could benefit from non-cultured skeletal muscle cell transplantation. METHODS: Sequential intracoronary injections of doxorubicin (0.75 mg/kg) were carried out every 2 weeks until echocardiographic detection of myocardial dysfunction. Sheep were then randomly assigned to either non-cultured cell transplantation (n=8) or placebo injection (n=5). For the cell therapy group, a skeletal muscle biopsy (about 10 g) was explanted from each animal approximately 3h before grafting. After thoracotomy, 20 epicardial injections were carried out. The animals were assessed one last time before sacrifice, 2 months after the thoracotomy. Cells were tracked with cmDiI (red fluorescence) and characterized with immunohistochemistry with monoclonal antibodies to a fast skeletal isoform of myosin heavy chain. RESULTS: Two months after intramyocardial grafting, tissue Doppler imaging and conventional echocardiographic assessment of the groups showed a marked improvement in the non-cultured cell therapy group. Ejection fraction (EF) (p<0.05) as well as systolic endocardial velocities (p<0.01) improved versus the placebo group. CmDiI and skeletal myosin heavy chain expression was detected in all animals at 2 months after implantation confirming engraftment of skeletal muscle cells. CONCLUSIONS: In conclusion, our data indicate that non-cultured muscle cell transplantation is feasible and may translate into a functional benefit in an ovine model of dilated heart failure. 相似文献
47.
Michael Dietrich Christoph Meier Daniela Zeller Patrick Grueninger Roger Berbig Andreas Platz 《European journal of trauma and emergency surgery》2007,33(5):512-519
Abstract
Background: Primary shoulder hemiarthroplasty is an established treatment modality for complex fractures of the proximal humerus. Long-term
functional outcome is often disappointing. However, little is known about social implications particularly in the elderly.
Methods: A single-institution case series of consecutive geriatric patients (age > 70 years) treated with shoulder hemiarthroplasty
for complex fractures of the proximal humerus between 1994 and 1997 was analysed. Postoperative morbidity, long-term function,
radiological outcome and social implications were evaluated.
Results: Seventy-seven patients fulfilled the study criteria. Median age at the time of operation was 80 years (range 70–93 years).
Systemic and local postoperative complications were observed in 8% including 2 patients (3%) with revision surgery. Postoperative
mortality was 1%. Forty-eight patients (62%) were available for follow-up (median 49 months, range 25–80 months), 22 (29%)
died from causes unrelated to hemiarthroplasty before follow-up and 7 patients (9%) did not attend follow-up examination.
Median Constant-Murley score was 41 points (range 17–77 points). Long-term results concerning pain were satisfying. The Oxford
shoulder score ranged from 14 to 40 (median 30). Forty-one patients (85%) still lived in their original environment and managed
their daily life independently despite poor shoulder function. Four patients (8%) lived in a retirement home and 3 (6%) in
a nursery home. Eighty percent of our patients were still able to use public transportation, do the daily shopping and wash
their whole body by themselves.
Conclusion: Most patients managed their daily life independently despite poor shoulder function. 相似文献
48.
Patrick N Smith Jeffrey R Balzer Mustafa H Khan Rick A Davis Donald Crammond William C Welch Peter Gerszten Robert J Sclabassi James D Kang William F Donaldson 《The spine journal》2007,7(1):83-87
BACKGROUND CONTEXT: Intraoperative somatosensory evoked potential (SSEP) monitoring has been shown to reduce the incidence of new postoperative neurological deficits in scoliosis surgery. However, its usefulness during cervical spine surgery remains a subject of debate. PURPOSE: To determine the utility of intraoperative SSEP monitoring in a specific patient population (those with cervical radiculopathy in the absence of myelopathy) who underwent anterior cervical discectomy and fusion (ACDF) surgery. STUDY DESIGN: Retrospective review. PATIENT SAMPLE: A total of 1,039 nonmyelopathic patients who underwent single or multilevel ACDF surgery. The control group (462 patients) did not have intraoperative SSEP monitoring, whereas the monitored group (577 patients) had continuous intraoperative SSEP monitoring performed. OUTCOME MEASURE: A new postoperative neurological deficit. METHODS: SSEP tracings were reviewed for all 577 patients in the monitored group and all significant signal changes were noted. Medical records were reviewed for all 1,039 patients to determine if any new neurological deficits developed in the immediate postoperative period. RESULTS: None of the patients in the control group had any new postoperative neurological deficits. In the monitored group there were six instances of transient SSEP changes (1 due to suspected carotid artery compression; 5 thought to be due to transient hypotension) which resolved with the appropriate intraoperative intervention (repositioning of retractors; raising the arterial blood pressure). Upon waking up from anesthesia, one patient in the monitored group had a new neurological deficit (partial central cord syndrome) despite normal intraoperative SSEP signals. CONCLUSIONS: ACDF appears to be a safe surgical procedure with a low incidence of iatrogenic neurological injury. Transient SSEP signal changes, which improved with intraoperative interventions, were not associated with new postoperative neurological deficits. An intraoperative neurological deficit is possible despite normal SSEP signals. 相似文献
49.
Canadian Journal of Anesthesia/Journal canadien d'anesthésie - 相似文献
50.