全文获取类型
收费全文 | 94427篇 |
免费 | 4081篇 |
国内免费 | 267篇 |
专业分类
耳鼻咽喉 | 1150篇 |
儿科学 | 1985篇 |
妇产科学 | 2680篇 |
基础医学 | 8261篇 |
口腔科学 | 2688篇 |
临床医学 | 9484篇 |
内科学 | 20050篇 |
皮肤病学 | 2081篇 |
神经病学 | 8265篇 |
特种医学 | 4988篇 |
外国民族医学 | 2篇 |
外科学 | 20353篇 |
综合类 | 896篇 |
现状与发展 | 1篇 |
一般理论 | 16篇 |
预防医学 | 3420篇 |
眼科学 | 2412篇 |
药学 | 2406篇 |
5篇 | |
中国医学 | 195篇 |
肿瘤学 | 7437篇 |
出版年
2023年 | 4742篇 |
2022年 | 6746篇 |
2021年 | 6949篇 |
2020年 | 8071篇 |
2019年 | 4630篇 |
2018年 | 3935篇 |
2017年 | 3970篇 |
2016年 | 3971篇 |
2015年 | 3255篇 |
2014年 | 7788篇 |
2013年 | 5369篇 |
2012年 | 3333篇 |
2011年 | 2661篇 |
2010年 | 4415篇 |
2009年 | 4164篇 |
2008年 | 2078篇 |
2007年 | 2077篇 |
2006年 | 1885篇 |
2005年 | 1458篇 |
2004年 | 1229篇 |
2003年 | 1332篇 |
2002年 | 1229篇 |
2001年 | 1168篇 |
2000年 | 1066篇 |
1999年 | 1206篇 |
1998年 | 809篇 |
1997年 | 667篇 |
1996年 | 708篇 |
1995年 | 638篇 |
1994年 | 486篇 |
1993年 | 393篇 |
1992年 | 528篇 |
1991年 | 507篇 |
1990年 | 501篇 |
1989年 | 484篇 |
1988年 | 512篇 |
1987年 | 366篇 |
1986年 | 196篇 |
1985年 | 271篇 |
1984年 | 275篇 |
1983年 | 206篇 |
1982年 | 210篇 |
1981年 | 183篇 |
1980年 | 162篇 |
1979年 | 183篇 |
1978年 | 154篇 |
1977年 | 104篇 |
1976年 | 120篇 |
1975年 | 104篇 |
1974年 | 97篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
71.
72.
73.
《The Canadian journal of cardiology》2022,38(7):1100-1110
The Fontan procedure is a staged palliation for various complex congenital cardiac lesions, including tricuspid atresia, pulmonary atresia, hypoplastic left heart syndrome, and double-inlet left ventricle, all of which involve a functional single-ventricle physiology. The complexity of the patients’ original anatomy combined with the anatomic and physiologic consequences of the Fontan circulation creates challenges. Teens and adults living with Fontan palliation will need perioperative support for noncardiac surgery, peripartum management for labour and delivery, interventions related to their structural heart disease, electrophysiology procedures, pacemakers, cardioversions, cardiac surgery, transplantation, and advanced mechanical support. This review focuses on the anesthetic and intensive care unit (ICU) management of these patients during their perioperative journey, with an emphasis on the continuity of preintervention planning, referral pathways, and postintervention ICU management. Requests for recipes and doses of medications are frequent; however, as in normal anesthesia and ICU practice, the method of anesthesia and dosing are dependent on the presenting medical/surgical conditions and the underlying anatomy and physiologic reserve. A patient with Fontan palliation in their early 20s attending school full-time with a cavopulmonary connection is likely to have more reserve than a patient in their late 40s with an atriopulmonary Fontan at home waiting for a heart transplant. Each case will require an anesthetic and critical care plan tailored to the situation. The critical care environment is a natural extension of the anesthetic management of a patient, with complex considerations for a patient with Fontan palliation. 相似文献
74.
75.
《Clinical genitourinary cancer》2022,20(1):95.e1-95.e6
IntroductionThis study aimed to evaluate the concordance in tumor stage and grade between ureteroscopic (URS) biopsy and radical nephroureterectomy (RNU) in patients with upper tract urothelial carcinoma (UTUC).Patients and MethodsRecords of 1,214 UTUC patients who had undergone URS biopsy followed by RNU were included. Univariable and multivariable logistic regression analyses were performed to identify factors contributing to the pathological upstaging.ResultsThe concordance between URS biopsy-based clinical and RNU pathological staging was 34.5%. Clinical understaging occurred in 59.5% patients. Upstaging to muscle-invasive disease occurred in 240 (41.7%) of 575 patients diagnosed with ≤cT1 disease. Of those diagnosed with muscle-invasive disease on final pathology, 89.6% had been clinically diagnosed with ≤cT1 disease. In the univariable analyses, computed tomography urography (CTU)–based invasion, ureter location, hydronephrosis, high-grade cytology, high-grade biopsy, sessile architecture, age, and women sex were significantly associated with pathological upstaging (P < .05). In the multivariable analyses, CTU-based invasion and hydronephrosis remained associated with pathological upstaging (P < .05). URS biopsy-based clinical and pathological gradings were concordant in 634 (54.2%) patients. Clinical undergrading occurred in 496 (42.4%) patients.ConclusionsClinical understaging/undergrading and upstaging to muscle-invasive disease occurred in a high proportion of UTUC patients undergoing RNU. Despite the inherent selection bias, these data underline the challenges of accurate UTUC staging and grading. In daily clinical practice, URS biopsy and CTU offer the most accurate preoperative information albeit with limited predictive value when used alone. These findings should be considered when utilizing preoperative, risk-adapted strategies. 相似文献
76.
《Current problems in cardiology》2022,47(10):101297
Atrial fibrillation (AF) has a strong impact on the quality of life (QOL) of patients and anticoagulation has a lot to do with it. We evaluated the QOL of patients with nonvalvular AF who start treatment with apixaban in Latin America. QOL was analyzed through a questionnaire developed to evaluate anticoagulated patients, which was completed by them 3 months after starting treatment. We included 521 patients from Uruguay, Bolivia, Ecuador, Paraguay, and Peru. A high index of general treatment satisfaction (5.34 ± 0.46) and self-efficacy (5.11 ± 0.68) were observed; the distress index was low (1.77 ± 0.88), as was the perception of daily hassles (1.35 ± 0.49) and strain social network related to medication (1.21 ± 0.34). Patients with AF who started treatment with apixaban has good satisfaction and self-efficacy scores with low index of stress, few daily limitations and social disruptions. 相似文献
77.
《Practical radiation oncology》2022,12(6):e512-e516
Stereotactic body radiation therapy (SBRT) is commonly used to treat early-stage non-small cell lung cancer. Beam arrangements for SBRT include multiple entry and exit pathways resulting in irregular low-dose distributions within normal lung parenchyma. An improved understanding of posttreatment radiographic changes may improve the ability to predict clinical complications including radiation pneumonitis as well as assist in early detection of local failures. Radiation treatment planning is conducted using software systems separate from diagnostic radiology, often not accessible to the diagnostic radiologist. We developed a workflow for interfacing radiation dose information from lung SBRT treatments with a diagnostic radiology picture archiving and communication system (PACS). In an anonymized PACS study folder, SBRT dose maps depicting high-dose, low-dose, and nonirradiated lung volumes were viewable side by side with pretreatment and follow-up diagnostic computed tomography scans. Clinical utility was evaluated by 2 thoracic diagnostic radiologists reviewing posttreatment diagnostic follow-up scans in the PACS both with and without radiation dose maps available. The addition of the biologically effective dose map did not significantly change identification rates of radiation induced lung injury) (92% vs 95%; P = .32) but did significantly decrease radiologic suspicion for local recurrence (22% vs 8%; P = .003). The addition of biologically effective dose maps significantly increased confidence in identifying radiation induced lung injury (7.75 vs 8.82; P = .004) and local recurrence (5.5 vs 6.6; P = .005). The recommendation for additional workup was not significantly different (10% vs 7%; P = .41). We demonstrated the feasibility and clinical utility of a workflow generating simplified radiation dose maps that are viewable within a PACS for diagnostic radiology review. 相似文献
78.
79.
80.