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91.
92.
Summary A review is made of the current management strategies of abscesses in basal ganglia and thalamus, based on a review of the literature and three of our own cases. Clinical picture, aetiology, diagnostic, surgical treatment and outcome are discussed. Stereotactic abscess puncture in combination with temporary drainage and rinsing of the abscess cavity in combination with systemic medication of antibiotics has become the management of choice with satisfactory results. 相似文献
93.
腰穿放液治疗160例外伤性蛛网膜下腔出血的体会 总被引:1,自引:0,他引:1
目的:探讨腰穿放液对外伤性蛛网膜下腔出血的作用。方法:对160名外伤性蛛网膜下腔出血的病人行腰穿放液,少则2次,多则7次。结果:所有病人症状均好转,从脑脊液的力学上看脑脊液恢复正常性状的时间缩短,结论:腰穿放液治疗外伤性蛛网膜下腔出血是十分有效的方法,近期内临床症状明显改善,远期并发症减少。 相似文献
94.
Masao Tanaka Hiroyuki Konomi Hiroaki Matsunaga Kazunori Yokohata Naruhiro Utsunomiya Torahiko Takeda 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(1):16-19
Technical improvements, such as mechanical lithotripsy, stenting or nasobiliary drainage, and wire-guided cannulation, have reduced the risk of complications in endoscopic sphincterotomy. To determine the extent of this reduction in risk, we assessed the medical records of 1352 patients with common bile duct stones in whom the procedure was conducted. Complications examined were: acute cholangitis and pancreatitis. Stone clearance was achieved in 1256 patients (92.8%), with an overall morbidity rate of 7.7% and a mortality rate of 0.15%. One hundred and forty-two patients had stones with a diameter greater than 20mm; 97 of these patients did not undergo lithotripsy. Cholangitis occurred in 10 of these 97 patients (10.3%), whereas, in the 45 patients who underwent lithotripsy, there were no cases of cholangitis (P=0.02). Stone removal was not immediately accomplished or attempted in 396 patients. In 82 of these patients in whom a stent or a nasobiliary drain was placed in the common bile duct, the incidence of cholangitis was 1.2%, significantly less (P=0.045) than the incidence of 6.4% in the other 314 patients given no stenting or nasobiliary drain. To overcome difficult cannulation, precut sphincterotomy was conducted in 134 patients and wireguided sphincterotomy, a recently introduced procedure, was conducted in 55 patients. When the precutting technique was used, the incidence of acute pancreatitis was significantly higher (8/134; 6.0%) than that in the patients in whom the standard procedure was conducted, i.e., neither the precut technique nor wire-guided ES was used (23/1218; 1.9%) (P=0.008). There were no cases of pancreatitis in the 55 patients in whom wire-guided sphincterotomy was performed, although the difference was not statistically significant because of the small number of patients (P=0.06). Based on these findings, we conclude that improved technologies have led to a significant reduction of complications in endoscopic sphincterotomy. 相似文献
95.
M. Kneissel P. Roschger W. Steiner D. Schamall G. Kalchhauser A. Boyde M. Teschler-Nicola 《Calcified tissue international》1997,61(2):95-100
There is abundant data on cancellous bone in the aging human spine, but little relating to the growing vertebral cancellous
bone in childhood and adolescence. The purpose of this study was to map vertebral cancellous bone in a growth and age series
of historic skeletal samples and to make comparisons with data published on recent material. Lumbar vertebral bodies were
collected from 65 skeletons (0–60 years) from a medieval Nubian population. Ethnohistoric information was collected to interpret
conditions that might have influenced bone structure and metabolism. The cancellous bone was studied three dimensionally,
using stereophotography and scanning electron microscopy and morphometrically by performing a semiautomatic structural analysis
on digitized backscattered electron images of polymethacrylate-embedded material. The cancellous bone structure in the children
consisted mainly of a densely packed, uniform network of small rodlike trabeculae. The greatest bone volume fraction with
small, more platelike trabeculae was observed during adolescence. In young adults, larger platelike trabeculae were present
in the central zone and smaller trabeculae in the superior and inferior zones, as described for modern skeletal material.
Structural changes associated with aging were observed much sooner than in modern man. By the estimated age of approximately
50–60 years, the predominant architectural elements were slender rarified rods in both sexes. The ethnohistorical data suggest
that this was essentially a black African population of physically active peasants, not likely to suffer Vitamin D insufficiency
or deficient calcium intake. Thus an earlier onset of the biological age changes in cancellous bone found in modern populations
was probably prevalent.
Received: 1 March 1996 / Accepted: 31 December 1996 相似文献
96.
报告手术治疗腰椎间盘突出症合并退行性腰椎管狭窄症104例。术后随访90例,随诊时6个月~6年。优良率86.5%,无腰椎不稳和腰椎滑脱等并发症。为获得优良效果,作者强调在处理椎间盘突出的同时必须彻底解除侧隐窝及神经根管,黄韧带肥厚对神经根的压迫,才能彻底根除症状 相似文献
97.
Glutamine and Other Amino Acid Losses During Continuous Venovenous Hemodiafiltration 总被引:2,自引:0,他引:2
I. Novák V. rámek H. Pittrová Z. Ruavý P. Têinský S. Lacigová M. Eiselt L. Kohoutková E. Veselá K. Opatrný Jr. 《Artificial organs》1997,21(5):359-363
Abstract: Serum amino grams and daily losses of glutamine (Gin) and other amino acids (AAs) into diafiltrate were measured during the first 5 days of continuous venovenous hemodiafiltration (CVVHDF) in 6 ICU patients with acute renal failure (ARF). Four patients had ARF as a part of multiple organ failure (MOF) of septic origin, and 2 patients had isolated ARF because of primary renal disease. During the study, all the patients received defined total parenteral nutrition (TPN). The mean daily AA losses into dialysate were relatively low (0.61 ± 0.1 g N ) and reached 4.5% of the daily AA substitution. Gln represented 32.7 ± 5.9% of the total AA losses (0.19 ± 0.04 g N ). Serum levels of Gin (p = 0.002) and of most other AAs were significantly lower in the patients than in the control subjects (AA analysis in 16 healthy volunteers). Phenylalanine (Phe) was the only AA that was increased significantly (p < 0.01) in the patients. The mean patient serum concentrations of Phe and tyrosine were significantly higher (p < 0.03) than the correspondent concentrations in dialysate, but the lysine concentration was higher in dialysate (p < 0.03). The serum and dialysate concentrations of other AAs did not differ. Gin in serum decreased significantly (p < 0.03) on the second day of CVVHDF but returned to the baseline levels subsequently. Serum concentrations of Phe increased on the second day of CVVHDF (p < 0.05). Serum concentrations of other AAs remained stable during the whole study. We conclude that Gin losses into dialysate during CVVHDF are relatively low, but CVVHDF itself may induce changes in Gin metabolism and distribution that are reflected by a decrease of serum Gin levels at the institution of this treatment. Therefore, the need for Gin supplementation in ICU patients is even greater in the first days of CVVHDF. 相似文献
98.
99.
Ping Zhao 《中国结合医学杂志》1995,1(3):197-200
AStudyonExtension-FlexionDynamicLumbarSpineRadiographsinPatientswithLumbarIntervertebralDiscHerniationAStudyonExtension-Flexi... 相似文献
100.
Anterior lumbar fusion using a hybrid interbody graft 总被引:3,自引:0,他引:3
Summary This is a radiographic report of 40 patients (20 men, 20 women) who underwent anterior lumbar interbody fusions (73 levels)
utilizing a “hybrid” interbody graft composed of femoral cortical allograft (FCA) bone and iliac crest cancellous autograft
bone. The average age at surgery was 38 years (range 17–64 years), and follow-up averaged 1.4 years (range 1.0–2.4 years).
Nineteen of the patients had undergone previous lumbar surgery. Thirty-two patients (63 levels) underwent anterior fusion
combined with some type of posterior fixation, and eight patients (10 levels) had no posterior fixation. Types of posterior
fixation included: for 20 patients (36 levels) Steffee variable screw placement fixation, for 10 patients (23 levels) translaminar
facet screws (TFS), for 1 patient (3 levels) Knodt rods and for 1 patient (1 level) facet screws. Based on the persistence
of lucent lines at the graft-host interface, three patients (one level each) were felt to have non-unions at their latest
follow-ups at 1.4, 1.5 and 2.0 years, respectively. Two of these patients had no posterior fixation, and the other had TFS
fixation. The overall fusion rate was 96% (70 of 73 levels). The fusion rate for all levels treated with posterior fixation
was 98% compared with 75% for those without fixation. Intervertebral disc heights (IVDH) were measured on all films and corrected
for magnification with computer assistance. On average, the IVDH was increased postoperatively but returned to preoperative
values at follow-up. IVDH loss was independent of the type of instrumentation used. No complications arose from the use of
the hybrid graft. Incorporation of the allograft portion of the graft is slow and was felt to be complete in only 7 of the
73 levels at follow-up. We conclude that the hybrid interbody graft technique is a safe and reliable method for performing
anterior lumbar interbody fusions and should be combined with some type of posterior fixation. Long-term follow-up will be
required to assess the behaviour of the allograft until incorporation is complete. 相似文献