全文获取类型
收费全文 | 33070篇 |
免费 | 2311篇 |
国内免费 | 877篇 |
专业分类
耳鼻咽喉 | 146篇 |
儿科学 | 712篇 |
妇产科学 | 439篇 |
基础医学 | 2290篇 |
口腔科学 | 271篇 |
临床医学 | 4317篇 |
内科学 | 9396篇 |
皮肤病学 | 110篇 |
神经病学 | 423篇 |
特种医学 | 1428篇 |
外科学 | 9286篇 |
综合类 | 3945篇 |
现状与发展 | 1篇 |
预防医学 | 864篇 |
眼科学 | 262篇 |
药学 | 1582篇 |
20篇 | |
中国医学 | 313篇 |
肿瘤学 | 453篇 |
出版年
2024年 | 49篇 |
2023年 | 723篇 |
2022年 | 1231篇 |
2021年 | 1905篇 |
2020年 | 1866篇 |
2019年 | 1734篇 |
2018年 | 1623篇 |
2017年 | 1150篇 |
2016年 | 1042篇 |
2015年 | 1172篇 |
2014年 | 2410篇 |
2013年 | 2323篇 |
2012年 | 1574篇 |
2011年 | 1828篇 |
2010年 | 1477篇 |
2009年 | 1517篇 |
2008年 | 1404篇 |
2007年 | 1387篇 |
2006年 | 1274篇 |
2005年 | 1121篇 |
2004年 | 938篇 |
2003年 | 841篇 |
2002年 | 737篇 |
2001年 | 606篇 |
2000年 | 505篇 |
1999年 | 444篇 |
1998年 | 397篇 |
1997年 | 334篇 |
1996年 | 334篇 |
1995年 | 277篇 |
1994年 | 257篇 |
1993年 | 238篇 |
1992年 | 215篇 |
1991年 | 147篇 |
1990年 | 144篇 |
1989年 | 121篇 |
1988年 | 118篇 |
1987年 | 117篇 |
1986年 | 105篇 |
1985年 | 101篇 |
1984年 | 100篇 |
1983年 | 70篇 |
1982年 | 78篇 |
1981年 | 41篇 |
1980年 | 47篇 |
1979年 | 38篇 |
1978年 | 27篇 |
1977年 | 15篇 |
1976年 | 20篇 |
1973年 | 13篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
91.
92.
心脏机械膜瓣置换术后血浆蛋白C和蛋白S活性变化及其与INR的关系 总被引:4,自引:0,他引:4
目的:探讨机械瓣膜置换术后口服华法令抗凝的患者血浆蛋白C(PC)、蛋白S(PS)活性改变的意义及其与国际标准IL比值(INR)的关系。方法:动态监测15例心脏机械瓣膜置换术后口服抗凝药初期患者服药1-2 d、3~10 d及1个月的PC、PS活性及INR值。结果:患者组PC、PS活性低于正常对照组(P<0.05),特别是术后3-10 d PC、PS活性明显低于正常对照组(P<0.01),已下降到正常的50%左右,而此时INR尚未达到治疗范围,提示口服抗凝药治疗初期在人体凝血功能未下调时,抗凝系统功能已经开始下降,有发生血栓的倾向;并且,随着抗凝强度的增高(INR低于1.5-高于2.5),PC、PS活性明显下降。结论:口服华法令抗凝患者在监测INR的同时,需要进行血浆PC、PS活性监测,以更好地预防血栓的发生。 相似文献
93.
Takahisa Okano Matthew D. Horton Gary G. Fermanis David A. Horton 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(8):437-439
We report a re-do case of severe aortic valve stenosis due to pannus formation 29 years after an aortic Starr-Edwards caged-ball
valve implantation. A huge shelf of calcified and thick pannus tissue below the valve had reduced the already small orifice
by at least a third in surface area. The explanted Starr-Edwards valve revealed no mechanical or structural failure. Early
detection and treatment of pannus outgrowth is essential in order to prevent life-threatening prosthetic valve malfunctions. 相似文献
94.
目的 评价超声心动图对主动脉窦瘤破裂合并畸形的诊断价值,探讨漏诊原因,以提高诊断阳性率。方法 回顾分析23例主动脉窦瘤破裂合并畸形的超声心动图特征,比较超声心动图与手术诊断结果。结果 超声心动图对主动脉窦瘤破裂合并畸形诊断符合率为86.95%(20/23),漏诊率为13.04%(3/23)。结论 超声心动图检查对诊断主动脉窦瘤破裂合并畸形有重要的临床价值,全面掌握超声知识,仔细认真地检查可避免漏诊。 相似文献
95.
Gabriel Mircescu Dimitrie Capsa Maria Covic Mirela Gherman Caprioara Gheorghe Gluhovschi Ovidiu Golea Nicolae Ursea Liliana Garneata Vasile Cepoi Nicolae Constantinovici Adrian Covic 《Nephrology, dialysis, transplantation》2004,19(12):2971-2980
INTRODUCTION. This report describes the current status of nephrology and renal replacement therapy (RRT) in Romania, a country with previously limited facilities, highlighting national changes in the European context. METHODS: Trends in RRT development were analysed in 2003, on a national basis, using the same questionnaires as in previous surveys (1991, 1995). Survival data and prognostic risk factors were calculated retrospectively from a large representative sample of 2284 patients starting RRT between January 1, 1995 and December 31, 2001 (44% of the total RRT population investigated). RESULTS: In 2003, RRT incidence [128 per million population (p.m.p.)] and prevalence (250 p.m.p.) were six and five times higher, respectively, than in 1995. The annual rate of increase in the stock of RRT patients (11%) was supported mainly by an exponential development of the continuous ambulatory peritoneal dialysis (CAPD) population (+600%), while the haemodialysis (HD) growth rate was stable (+33%) and renal transplantation made a marginal contribution. Renal care infrastructure followed the same trend: nephrology departments (+100%) and nephrologists (+205%). The characteristics of RRT incident patients changed accordingly to current European epidemiology (increasing age and prevalence of diabetes and nephroangiosclerosis). The estimated overall survival of RRT patients in Romania was 90.6% at 1 year [confidence interval (CI) 89.4-91.8] and 62.2% at 5 years (CI 59.4-65.0). Patients' survival was negatively influenced (Cox regression analysis) by age >65 years (P < 0.001), lack of pre-dialysis monitoring by a nephrologist [P = 0.01, hazards ratio (HR) = 0.8], severe anaemia, lack of erythropoetin treatment (P < 0.001, HR = 0.6), and co-morbidity, e.g. cardiovascular diseases (P < 0.001, HR = 1.8) and diabetes mellitus (P < 0.001, HR = 2.2). CONCLUSIONS: Although the rate of increase in RRT patient stock in 1996-2003 in Romania was the highest in Europe, the prevalence remained below the European mean. As CAPD had the greatest expansion, followed by HD, an effective transplantation programme must be set up to overcome the imbalance. The quality of RRT appears to be good and survival was similar to that in other registries. Further evolution implies strategies of prevention, based on national surveys, supported by the Romanian Renal Registry. 相似文献
96.
目的总结瓣膜置换患者行胆道手术的术前用药方法。方法对38例瓣膜置换后在服用华法令过程中因胆道疾病需行择期手术治疗的患者随机分为2组,肝功能正常组(A组)23例、肝功能不正常组(B组)15例均于术前3d停服华法令,B组术前12h肌注VitK110mg。术前无应用华法令历史的患者115例做为对照组。结果38例患者停药2d后A组血浆凝血酶原时间与对照组差异无显著意义,B组于术前12h肌注VitK110mg后,血浆凝血酶原时间与对照组相比差异也无显著性意义。结论瓣膜置换患者在抗凝期间行胆道手术,只要准备充分,围手术期是安全的。 相似文献
97.
Ramanathan Sundar Varma Shashi Kumar Rao Kolli Madhusudana Muralidharan Srinivasan 《Indian Journal of Thoracic and Cardiovascular Surgery》2004,20(4):164-166
Background Extended trans septal (ETS) approach for mitral valve surgery often divides the artery to the Sino-Atrial node. The clinical
implication of this is contentious. We analyzed our early results with ETS approach.
Methods Between June 1998 and September 2003 eleven patients underwent mitral valve surgery by ETS approach. Six were females. Age
ranged from 19 years to 67 years (median 40 years). Six underwent mitral valve replacement (MVR). Four underwent aortic and
mitral (double) valve replacement (DVR). One had mitral valve repair. Three had additional procedures (tricuspid valve repair=1,
Coronary artery bypass=1, Aorto bifemoral graft=1). Cardiopulmonary bypass ranged from 64 minutes to 77 minutes (median 72
minutes) for MVR and 112 minutes to 178 minutes (median 140 minutes) for DVR. Aortic cross clamp times ranged from 39 minutes
to 52 minutes (median 47 minutes) for MVR and 74 minutes to 120 minutes (median 95 minutes) for DVR.
Results There was no mortality or morbidity attributed to the ETS approach. One early death in emergency DVR was due to heart failure.
Three patients needed seqeuntial pacing in the immediate post-operative period. Nine out of ten survivors were back to their
preoperative rhythms on hospital discharge (6 sinus rhythm; 3 atrial fibrillation). One patient with preoperative trifascicular
block who underwent reoperation to fix a paravalvular mitral leak needed a permanent pacemaker (VVI). The follow-up ranged
from 1 month to 64 months (median 6 months) and is 100% complete. There was no late death or new arrhythmia.
Conclusions Extended trans septal approach is safe. It gives excellent exposure of the mitral valve. division of the sinus node artery
is not deleterious in the short to intermediate term.
Presented at the 50th Annual Meeting of IACTS. New Delhi, Feb. 2004. 相似文献
98.
99.
舒芬太尼对心脏瓣膜置换术患者麻醉诱导期血液动力学的影响 总被引:1,自引:0,他引:1
目的观察舒芬太尼对心脏瓣膜置换术患者麻醉诱导期血液动力学的影响。方法心脏瓣膜置换手术患者20例,随机分为舒芬太尼组(S组,n=10)和芬太尼组(F组,n=10)。全麻诱导:咪唑安定0.1~0.3mg/kg,维库溴铵0.1~0.2mg/kg。S组使用舒芬太尼1μg/kg,F组使用芬太尼10μg/kg。血液动力学监测:心电Ⅱ导联示波,有创动静脉测压,放置6腔Swan-Ganz导管,采用美国Baxter-2型连续心排血量多功能监测仪,测定心脏指数(CI)和肺毛细血管嵌压(PCWP)。观察心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、心脏指数(CI)和肺毛细血管嵌压(PCWP)。分别于麻醉诱导前(T1)、麻醉诱导后气管插管前(T2)、插管后1分钟(T3)、5分钟(T4)和10分钟(T5)记录观察指标。结果HR、MAP、CVP和PCWP两组变化趋势基本一致。麻醉诱导后及气管插管后部分时间S组HR和MAP低于F组(P<0.05或P<0.01),插管后S组CVP明显高于F组(P<0.05或P<0.01)。麻醉诱导或气管插管后,F组CI明显下降(P<0.05或P<0.01),S组均无明显变化。观察期间PCWP均无明显变化。结论舒芬太尼可安全的用于心脏瓣膜置换手术。 相似文献
100.