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171.
172.
Abstract
Background: In recent years, biomaterials are being found and frequently utilized in bone defects. They have also gained significant precedence
in hand surgery.
Objectives: The respective requirements for such replacement material will be cited and acknowledged in this article. The individual material
groups will also be referred to in this review. An introduction to some of the customary bone replacement materials will be
cited and concluded with a corresponding recommendation.
Conclusion: The implantation of autologous cancellous bone is still regarded today as the “gold standard”. Nevertheless, the usage of
bone replacement material can be an enormous advantage in certain indications.
The original article can be found online at
There was an error in the author’s affiliation and the address for correspondence was incomplete. Please note the correct
institution and complete address:
Department of Orthopedics and Traumatology, Hand-, Foot- and Reconstructive Surgery, Kreiskrankenhaus Gummersbach GmbH, Germany.
Alexander von Friesen, MD Department of Orthopedics and Traumatology, Hand-, Foot- and Reconstructive Surgery Kreiskrankenhaus
Gummersbach GmbH Wilhelm-Breckow-Allee 20 51643 Gummersbach Germany Phone (+49/2261) 171-575, Fax -449 e-mail: Friesen@kkh-gummersbach.de 相似文献
173.
体重指数对全膝关节置换术后功能的影响 总被引:4,自引:0,他引:4
目的回顾性分析体重指数(BMI)对骨关节炎(OA)患者全膝关节置换术(TKA)后功能的影响.方法由同一组医生使用同一种假体对320例(520膝)骨关节炎患者行全膝关节置换.按体重指数分为4组非肥胖组(BMI<25.0 kg/m2)、超重组(BMI 25.1~27.0 kg/m2)、肥胖组(BMI 27.1~30.0kg/m2)和病理性肥胖组(BMI>30.0 kg/m2),分别记录术前及随访时HSS膝评分、功能评分、膝关节最大屈曲、伸直度数和并发症.结果术前超重组、肥胖组和病理性肥胖组功能评分较非肥胖组低(P<0.05),但膝评分差异无显著性.通过平均28.3个月的随访,无论膝评分和功能评分各组术后均明显提高,各组提高的幅度比较差异无显著性.虽然超重组、肥胖组和病理性肥胖组术后最大屈曲、伸直度数较非肥胖组小,但是改善幅度仍相当,差异无显著性(P>0.05).肥胖组和病理性肥胖组围手术期并发症明显增高(P<0.05),在总共93例(181膝)中,有14膝(9.2%)出现伤口并发症,其中1膝(0.5%)感染,感染发生于术后10周内,与伤口并发症有关;2膝(1.3%)内侧副韧带损伤.超重组166例(258膝)中有6膝(2.3%)出现伤口并发症,无感染及内侧副韧带损伤病例.非肥胖组61例(81膝)中有1膝(1%)出现伤口并发症,无感染及内侧副韧带损伤病例.结论TKR是进展期OA患者有效的治疗措施,肥胖并不是膝关节置换手术的障碍.但围手术期并发症增多,包括伤口愈合、感染、内侧副韧带损伤,应注意伤口缝合技术和保护内侧副韧带. 相似文献
174.
Satoshi Tobe Kazunori Yoshida Masahiro Yamaguchi Haruko Nishimura Masahito Kawata 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(7):308-310
Papillary fibroelastoma (PFE) is a rare and benign cardiac tumor typically found on the valvular endocardium. In most cases,
PFE is identified incidentally on echocardiography or during cardiac surgery. The patient was a 73-year-old man who had been
treated for hepatocellular carcinoma for 5 years. On echocardiography, a 2.5-cm diameter mass was detected in the pulmonary
trunk just above the pulmonary valve. Through a transpulmonary arterial approach with cardiopulmonary bypass, the mass identified
on the commissure of the right and posterior pulmonary cusp was surgically excised together with the attached endocardium.
Despite the benign histology of PFE, lethal embolic events such as stroke, myocardial infarction, and pulmonary embolism are
reported in some cases. To prevent such complications, tumor identification and surgical excision are essential. 相似文献
175.
G. Kostopanagiotou A. Pandazi I. Andreadou A. Doufas I. Chondroudaki T. Kotsis D. Rizos C. Costopanagiotou V. Smyrniotis 《European journal of vascular and endovascular surgery》2005,30(6):648-653
OBJECTIVE: We investigated the dose-related effect of dopexamine and dopamine on free radical production and lipid peroxidation estimated by MDA measurements in an ischaemia-reperfusion model of supraceliac aortic repair. DESIGN: Prospective, randomized, blinded experimental study. MATERIALS: Twenty-five healthy pigs. METHODS: All experiments were performed under general endotracheal anaesthesia. Supraceliac aortic cross clamping was performed in all pigs. The pigs were randomly assigned into five groups (n=5 in each group) and received a continuous intravenous infusion of normal saline (CTL), dopamine 2 microg kg(-1)min(-1) (dopa 2), dopamine 8 microg kg(-1)min(-1) (dopa 8), dopexamine 2 microg kg(-1)min(-1) (dopex 2), dopexamine 8 microg kg(-1)min(-1) (dopex 8). Cardiac output, mean arterial pressure, arterial blood gas analysis and blood sampling for plasma MDA measurements (to reveal lipid peroxidation) were recorded after induction of anaesthesia (baseline), 60 and 120 min after cross-clamping of aorta (ischaemia phase), and 60 and 120 min after restoration of flow (reperfusion phase). RESULTS: Dopexamine and dopamine at 8 microgkg(-1)min(-1) reduced MDA at 60 and 120 min after reperfusion. CONCLUSION: Dopexamine seems superior to dopamine in reducing oxygen free radicals and subsequent lipid peroxidation during reperfusion after supraceliac aortic cross clamping in pigs. 相似文献
176.
177.
178.
Manoj Todkar 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2006,16(2):1-4
We report outcome of 9-year follow-up of 50 Charnley cemented primary arthroplasties in 47 patients performed between 1996 and 1999. The minimum follow-up period was 5 years with a mean of 7 years. All hip joints were thoroughly assessed preoperatively to document patients’ functional level and Harris hip score was calculated. All the patients were disabled because of pain in hip and 45 (90%) had used walking aids. At follow-up all patients were living. The radiographs of all patients were available for the entire follow-up period. Of the 50 operated hips, only 2 patients (4%) complained of pain while all the rest were free of pain. Postoperatively only 10 (20%) patients used support for walking. At follow-up none of the hips were revised. Two patients (4%) had dislocation in postoperative period in which reduction was done under anesthesia. In one patient (2%) prosthesis and cement was removed because of deep infection. In two patients (4%) radiolucent clear zone was seen at bone cement interface on acetabular side and three (6%) patients had it on femoral component. None of the patients developed deep vein thrombosis or heterotopic bone. In postoperative period the Harris hip score was calculated in each case and compared with the preoperative score to evaluate the outcome. Significant improvement was found in Harris hip score after surgery. 相似文献
179.
股内侧肌中间入路与内侧髌旁入路在初次全膝关节置换中的对比研究 总被引:1,自引:0,他引:1
目的对股内侧肌中间入路和内侧髌旁人路在全膝关节置换术(TKA)手术相关参数和术后早期康复的相关参数进行比较。方法自2004年3月~2006年3月将34例同期双膝TKA患者两侧膝关节的手术入路进行随机分配,一侧采用股内侧肌中间入路,另一侧采用内侧髌旁人路。比较两组的外科参数和临床参数,外科参数包括暴露的难易程度、手术时间、术中失血量和外侧支持带需要松解的比例。临床参数包括术后静息和运动时疼痛、直腿抬高时间、主动屈曲到90。的时间、术后膝关节活动度及并发症。结果两组手术时间无明显差异,与内侧髋旁人路比较采用股内侧肌中间入路一侧的膝关节术中失血较少[(286.0±29.8)mL/us.(368.0±35.8)mL,P〈0.05],外翻膝需要做外侧支持带松解的比例较小(20%us 50%,P〈0.05),术后l周内疼痛较轻(P〈0.05),能较早地进行主动直腿抬高[(1.8±0.3)d us.(4.5±0.8)d,P〈0.01],较早地屈曲到90^o[(3.2±0.8)d us(7.1±1.2)d,P〈0.01],术后45d活动度改善较快[(107^o±20^o)us、(98^o±12^o),P〈0.05]。结论因为股内侧肌中间入路对伸膝装置和髌周血管丛的破坏较少,TKA后功能恢复早期,比内侧髌旁人路更具有优势。 相似文献
180.
Bartolo Zingone Elisabetta Rauber Giuseppe Gatti Aniello Pappalardo Bernardo Benussi Gabriella Forti Umberto Tognolli Marco Gabrielli 《European journal of cardio-thoracic surgery》2007,31(6):990-997
Objective: Severe atherosclerosis of the ascending aorta and arch frequently causes difficulties during heart operations, hindering surgical manoeuvres and potentially leading to systemic embolism. The aim of our study was to assess the safety and effectiveness of replacing the atherosclerotic ascending aorta in this setting. Methods: Aortic atherosclerosis was characterized by epiaortic ultrasonographic scanning in 90.1% of 1927 consecutive adult patients undergoing cardiac operations, and by computed tomographic chest scanning in selected cases. Thirty-six of the 152 patients requiring major derangements from our standard practice due to aortic atherosclerosis underwent replacement of the ascending aorta and constitute the study group. Replacement of the aorta was extended to the arch in 13 cases (36.1%). It was associated with single or multiple valve surgery in 34 patients (94.4%) and with coronary revascularization in 30 (83.3%). Two patients (5.6%) underwent coronary bypass grafting without valve surgery. A cryoablation procedure was associated in three patients with permanent atrial fibrillation. Deep hypothermic circulatory arrest was employed in 34 patients (94.4%), while proximal aortic disease allowed conventional distal crossclamping in 2 cases. The risk of operative mortality was estimated by the logistic EuroSCORE both with and withholding the variable ‘surgery of the thoracic aorta’. All survivors were followed-up for 1–41 months (16 ± 12). Results: Two patients died in the hospital (5.6%) and two during follow-up, for a cumulative survival of 91.3% and 85.6% at 1 and 3 years, respectively (hospital deaths included). The hospital death rate compared favourably with the expected estimates of 25.5% (p < 0.05) and 10.3% (p = 0.67) obtained by the EuroSCORE full model and without ‘aortic surgery’, respectively. In-hospital adverse neurologic events occurred in six patients (16.7%), including stroke in one patient (2.8%) and neurocognitive disturbances in five (13.9%), although they were all transient and cleared before discharge. Excess bleeding required re-exploration in four patients (11.1%), and one more patient underwent emergency grafting for acute postoperative coronary occlusion. Ten patients (38.5%) were intubated for longer than 24 h. Conclusion: Despite significant perioperative morbidity, replacement of the severely atherosclerotic aorta is worth consideration to avert expectedly higher death and stroke rates. 相似文献