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141.
为了观察经皮穿刺注射无水乙醇对肺组织的局部作用和全身影响 ,为经皮穿刺注射无水乙醇 (PEI)治疗肺癌的安全性和可行性提供依据 ,我们进行了家兔肺内PEI的初步实验研究。结果显示 :PEI后的第 1天至第 3天 ,注射局部的肺组织发生凝固性坏死 ,周围肺水肿、充血 ,伴大量嗜中性白细胞浸润。 1~ 2周后 ,肺局灶性上皮细胞肉芽组织增生 ,最后纤维化。PEI早期既无大面积肺组织坏死 ,亦无明显的全身副作用。本研究结果提示 ,肺内PEI是安全可行的 相似文献
142.
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144.
目的;比较不同方法切除胃肠道息肉和癌前病变的疗效。方法:本文采用高频电和其它不同方法对胃肠道息肉和癌前病变切除和切割。结果:对小的扁平息肉用高频电灼除或热活检安全有效。一次的灼除达100%。圈套适应胃结肠有蒂息肉。对大的有蒂或分叶状息肉需分次圈套切除,圈套和烧灼或热活检结合可避免肠穿孔发生。双胃镜代替双腔治疗胃镜行粘膜切除胃内平坦和扁平隆起性非典型增生灶操作容易,病灶切除彻底。息肉切除后常于局部形成溃疡,术后应常规给予酸抑制剂和粘膜保护剂治疗。结论:内镜-高频电是切除胃肠道有蒂和无蒂息肉的有效方法,粘膜染色后,双胃镜行粘膜和术治疗胃内癌前病变切实可行。 相似文献
145.
目的:探讨含重组人碱性成纤维细胞生长因子(recombinant human basic fibroblast growth factor,rhbFGF)和重组人骨形态发生蛋白-2(recombinant human bone morphogenetic protein-2,rhBMP-2)骨水泥在骨质疏松性腰椎压缩性骨折(osteoporotic vertebral compression fracture,OVCF)患者经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗的应用价值。方法:回顾性分析2018年1月至2021年1月收治的103例行PKP手术治疗的OVCF患者,男40例,女63例;年龄61~78(65.72±3.29)岁。受伤原因:滑倒33例,跌倒42例,提重物受伤28例。根据填充骨水泥不同分为3组:磷酸钙组34例,男14例,女20例,年龄(65.1±3.3)岁,填充磷酸钙骨水泥;rhBMP-2组34例,男12例,女22例,年龄(64.8±3.2)岁,填充含rhBMP-2的骨水泥;rhbFGF+rhBMP-2组35例,男14例,女21例,年龄(65.1±3.6)岁,填充含rhbFGF和rhBMP-2的骨水泥。比较3组Oswestry 功能障碍指数(Oswestry dysfunction index,ODI)、骨密度、椎体前缘丢失高度、伤椎前缘压缩率、疼痛视觉模拟评分(visual simulation score,VAS)及再骨折发生率。结果:所有患者获得12个月随访。3组术后ODI、VAS呈下降(P<0.001),骨密度增高(P<0.001),椎体前缘丢失高度、伤椎前缘压缩率呈先下降后缓慢上升趋势(P<0.001),rhbFGF+rhBMP-2组术后第1、6、12个月ODI、VAS均低于rhBMP-2组和磷酸钙组(P<0.05),术后第6、12个月骨密度大于rhBMP-2组和磷酸钙组(P<0.05)。rhbFGF+rhBMP-2组术后第6、12个月椎体前缘丢失高度、伤椎前缘压缩率均低于rhBMP-2组和磷酸钙组(P<0.05)。3组再骨折发生率比较差异无统计学意义(P>0.05)。结论:含rhbFGF和rhBMP-2骨水泥可更有效地增加OVCF患者骨密度,获得术后满意的临床和放射学效果,显著改善临床症状。 相似文献
146.
147.
Implementation of percutaneous dilation tracheotomy – value of preincisional ultrasonic examination?
BACKGROUND: In this observational study we have evaluated the implementation of percutaneous dilation tracheotomy (PDT), using the forceps dilation technique (Portex) in a multidisciplinary ICU. METHODS: We included a preincisional ultrasonic evaluation of the neck in order to visualise the isthmus glandula thyroidea and major vessels. The observational period comprised one year. PDT was performed in 28 patients. RESULTS: Implementation of PDT was uneventful. Duration of insertion was 10 min (4-40 min). Total time of tracheostomy was 8 days (1-65 days). In nine cases, the proximal end of the isthmus was overlying the space between the 1st and 2nd tracheal ring, which was considered the optimal insertion site. This resulted in seven cases of insertion between the cricoidea and the 1st tracheal ring and in two cases in a more distal insertion. Nineteen tracheotomies were performed in the interstice between the 1st and 2nd tracheal ring. In nine patients, major vessels were overlying the trachea. In none of the patients did this information result in an altered insertion site. Two cases of minor bleeding were observed; both stopped upon compression. In two patients the primary tube size (8.0) was too big and a smaller tube had to be inserted. In one patient the tube was maladapted to the stoma and had to be interchanged with an ordinary tracheostomial tube on the 5th day of tracheostomy. CONCLUSION: Based on the experience gathered in this study and information from the literature, we have abandoned the routine use of ultrasonic examination of the neck prior to PDT. In order to achieve and maintain routine, we suggest that the procedure is performed by a restricted number of doctors. 相似文献
148.
Seemann MD Seemann O Bonél H Suckfüll M Englmeier KH Naumann A Allen CM Reiser MF 《European radiology》1999,9(9):1851-1858
Recent developments in 3D reconstructions can enhance the quality and diagnostic value of axial 2D image data sets with direct
benefits for clinical practice. To show the possible advantages of a hybrid rendering method [color-coded 3D shaded-surface
display (SSD)- and volume rendering method] with the possibility of virtual endoscopy we have specifically highlighted the
use in relation to the middle and inner ear structures. We examined 12 patients with both normal findings and postoperative
changes, using image data sets from high-resolution spiral computed tomography (HRSCT). The middle and inner ear was segmented
using an interactive threshold interval density volume-growing method and visualized with a color-coded SSD rendering method.
The temporal bone was visualized using a transparent volume rendering method. The 3D- and virtual reconstructions were compared
with the axial 2D source images. The evaluated middle and inner ear structures could be seen in their complete form and correct
topographical relationship, and the 3D- and virtual reconstructions indicated an improved representation and spatial orientation
of these structures. A hybrid and virtual endoscopic method could add information and improve the value of imaging in the
diagnosis and management of patients with middle or inner ear diseases making the understanding and interpretation of axial
2D CT image data sets easier. The introduction of an improved rendering algorithm aids radiological diagnostics, medical education,
surgical planning, surgical training, and postoperative assessment.
Received: 22 July 1998; Revised: 15 April 1999; Accepted: 19 April 1999 相似文献
149.
Percutaneous endoscopic gastrostomy in burn patients 总被引:2,自引:0,他引:2
Background: Prolonged enteral feedings are required occasionally in seriously burned individuals. We have employed percutaneous endoscopic
gastrostomy (PEG) in selected patients who require particularly prolonged access, thus prompting this review.
Methods: The PEG procedure was performed under general anesthesia in combination with another surgical procedure using a variety of
commercially available needle and guidewire kits in 14 patients.
Results: These 14 patients had an average age of 55.2 ± 6.6 years and a burn involving 38 ± 8% of the body surface. Eleven of these
patients had suffered an inhalation injury. The tubes were placed an average of 57 ± 10.5 days after injury through unburned
and unharvested skin in four patients (28%), healed donor sites in five patients (35%), healed burn in one patient (1%), and
grafted burn in four patients (28%). One patient, whose catheter was placed through a grafted fascial excision, developed
moderate local wound erosion. Tubes were known to have been left in place as long as 155 days. However, most were removed
in rehabilitation hospitals, and we were unable to determine how long most were left in place. We are unaware of any problems
with the tubes occurring after discharge from the acute care setting.
Conclusions: In selected patients, PEG can provide more comfortable access for prolonged enteral feedings than nasogastric tubes and can
be placed with minimal morbidity.
Received: 29 March 1998/Accepted: 1 August 1998 相似文献
150.
Dermal exposure assessment of polycyclic aromatic hydrocarbons: in vitro percutaneous penetration from lubricating oil 总被引:2,自引:0,他引:2
Sartorelli P Cenni A Matteucci G Montomoli L Novelli MT Palmi S 《International archives of occupational and environmental health》1999,72(8):528-532
Objectives: Percutaneous penetration of polycyclic aromatic hydrocarbons (PAHs) is affected by various factors connected to exposure
conditions. The nature of the matrix, such as that of oil, can strongly affect their percutaneous penetration. Risk assessment
should consider these effects. We examined the effect of matrix on percutaneous penetration of PAHs, particularly that of
lubricating oil. Methods: The test apparatus consisted of an in vitro static diffusion cell system using full-thickness monkey (Cercopithecus aetiops) skin as the membrane and saline solution with gentamycin sulfate and 4% bovine serum albumin as receptor fluid. Chemical
analysis of PAHs in the samples obtained from cells was carried out by inverse-phase HPCL, and the results were read by spectrofluorimetry.
Results: Comparing the penetration of 13 PAHs from a lubricating oil and from acetone solution with artificial sweat resulted in a
significantly slower passage from the oil matrix for acenaphthene, anthracene, phenanthrene, fluoranthene, naphthalene, pyrene,
fluorene (Mann-Whitney U test, P < 0.05). No significant differences in the passage were found for chrysene because, in the test with oil, its concentration
was very often below the detection limit. For benzo[a]anthracene, benzo[b]fluoranthene, benzo[k]fluoranthene, and benzo[a]pyrene it was possible to demonstrate a passage through the skin only when compounds were applied in acetone solution with
artificial sweat. Conclusions: The results of the study suggest the necessity of dermal penetration data relevant for risk assessment, obtained under experimental
conditions similar to the real exposure conditions.
Received: 7 January 1999 / Accepted: 10 July 1999 相似文献