全文获取类型
| 收费全文 | 14975篇 |
| 免费 | 1355篇 |
| 国内免费 | 355篇 |
专业分类
| 耳鼻咽喉 | 2篇 |
| 儿科学 | 294篇 |
| 妇产科学 | 173篇 |
| 基础医学 | 1019篇 |
| 口腔科学 | 7篇 |
| 临床医学 | 1269篇 |
| 内科学 | 606篇 |
| 皮肤病学 | 31篇 |
| 神经病学 | 206篇 |
| 特种医学 | 228篇 |
| 外国民族医学 | 11篇 |
| 外科学 | 7342篇 |
| 综合类 | 2029篇 |
| 现状与发展 | 1篇 |
| 预防医学 | 273篇 |
| 眼科学 | 6篇 |
| 药学 | 881篇 |
| 7篇 | |
| 中国医学 | 233篇 |
| 肿瘤学 | 2067篇 |
出版年
| 2024年 | 60篇 |
| 2023年 | 223篇 |
| 2022年 | 454篇 |
| 2021年 | 572篇 |
| 2020年 | 576篇 |
| 2019年 | 540篇 |
| 2018年 | 538篇 |
| 2017年 | 563篇 |
| 2016年 | 478篇 |
| 2015年 | 599篇 |
| 2014年 | 1050篇 |
| 2013年 | 1016篇 |
| 2012年 | 784篇 |
| 2011年 | 1019篇 |
| 2010年 | 856篇 |
| 2009年 | 788篇 |
| 2008年 | 712篇 |
| 2007年 | 703篇 |
| 2006年 | 749篇 |
| 2005年 | 637篇 |
| 2004年 | 557篇 |
| 2003年 | 511篇 |
| 2002年 | 435篇 |
| 2001年 | 369篇 |
| 2000年 | 252篇 |
| 1999年 | 198篇 |
| 1998年 | 183篇 |
| 1997年 | 146篇 |
| 1996年 | 117篇 |
| 1995年 | 97篇 |
| 1994年 | 125篇 |
| 1993年 | 71篇 |
| 1992年 | 73篇 |
| 1991年 | 59篇 |
| 1990年 | 73篇 |
| 1989年 | 52篇 |
| 1988年 | 55篇 |
| 1987年 | 58篇 |
| 1986年 | 37篇 |
| 1985年 | 46篇 |
| 1984年 | 46篇 |
| 1983年 | 36篇 |
| 1982年 | 34篇 |
| 1981年 | 19篇 |
| 1980年 | 25篇 |
| 1979年 | 24篇 |
| 1978年 | 27篇 |
| 1977年 | 10篇 |
| 1976年 | 9篇 |
| 1973年 | 11篇 |
排序方式： 共有10000条查询结果，搜索用时 15 毫秒
991.
992.
目的比较不同剂量羟考酮对肝切除手术患者麻醉恢复期导尿管相关膀胱刺激征(catheter-related bladder discomfort, CRBD)的预防效果。方法择期全麻下行开腹肝叶切除手术的男性患者120例,年龄18～60岁,BMI 20～27 kg/m~2,ASAⅠ或Ⅱ级,随机分为三组,每组40例,术毕前30 min静推生理盐水5 ml(C组)、羟考酮0.1mg/kg(O1组)或0.15mg/kg(O2组)。记录苏醒时间和气管拔管时间,CRBD评分、VAS疼痛评分和不良反应。结果 O1和O2组CRBD发生率分别为30.0%和27.5%,明显低于C组的52.5%(P0.05)。O1和O2组中到重度CRBD的发生率均为5%,明显低于C组的25%(P0.05)。与C组比较,拔管后O1组和O2组VAS评分明显降低(P0.05),但O1组和O2组VAS评分差异无统计学意义。术后C组有4例恶心呕吐,O1组有1例恶心呕吐,O2组有1例寒战,三组不良反应发生率差异无统计学意义。结论术毕前30 min给予羟考酮0.1mg/kg可降低开腹肝切除术后CRBD的发生率和严重程度,并有更好的镇痛效果。 相似文献
993.
目的探讨基于决策辅助的术前教育在三镜联合治疗胆囊并胆总管结石患者加速康复外科中的应用效果。方法选取行三镜联合治疗胆囊并胆总管结石患者60例,采用随机数字表法将患者分成干预组和对照组各30例。对照组采取常规术前教育,干预组采取基于决策辅助的术前教育。结果干预结束时,干预组决策参与满意度得分和术后治疗依从性得分显著高于对照组,干预组术后首次排气时间、引流时间和住院时间显著短于对照组(P0.05,P0.01)。结论基于决策辅助的术前教育有助于提高三镜联合治疗胆囊并胆总管结石患者的决策参与满意度、术后治疗依从性,有利于促进患者术后恢复。 相似文献
994.
Ghazi M. Al Edwan Hammam H. Mansi Omar Nabeeh M. Atta Mohammad M. Shaath Rawand Al Adwan Waleed Mahafza Kameel M. Afram Omar Ababneh Deema Al Adwan Muheilan M. Muheilan 《Journal of pediatric surgery》2019,54(3):595-599
Objective
The purpose of this study is to evaluate the effect of Intravesical Botulinum toxin injection on the symptoms and urodynamic parameters in pediatric patients with idiopathic overactive bladder (iOAB) refractory to medical treatment.Materials and methods
The study was designed as an open-label uncontrolled therapeutic clinical trial. The eligible patients who underwent Intravesical botulinum toxin injection were evaluated before treatment. The evaluation included a 7-day paper bladder diary to assess OAB symptoms (frequency, urgency urinary incontinence (UUI) and nocturnal enuresis (NE)), filling the Arabic International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI short form), and conducting urodynamic study. The Urodynamic parameters obtained were the maximum filling detrusor pressure, cystometric bladder capacity, and compliance. After 12?weeks of the intravesical injection, the patients were revaluated and the results were compared using paired samples t-test.Results
The study enrolled 75 patients. And of those, statistical analysis was done on 46 patients who did follow the study protocols. The mean age was 8.9?years and male to female ratio was 1:4. There was a statistically significant improvement in overactive bladder symptoms and urodynamic parameters in the patient injected with botulinum toxin with minimal side effects.Conclusion
The evidence in this study would support the safety and efficacy of Intravesical botulinum toxin injection in children with refractory idiopathic OAB with significant improvement of symptoms, quality of life, as well as urodynamic parameters.Type of Study
Open-label uncontrolled therapeutic clinical trial.Level of Evidence
III 相似文献995.
Adam Tucker Seamus O’Brien Emer Doran Nicola Gallagher David E. Beverland 《The Journal of arthroplasty》2019,34(1):40-46.e1
Background
Valgus knee deformity accounts for only 10% of total knee arthroplasties (TKAs), but is frequently considered the most challenging to manage. This study provides a 10-year follow-up on a previously reported series of severe valgus knees performed using an unconstrained mobile-bearing TKA with a modified technique to validate this technique.Methods
A consecutive series of 275 predominantly cementless TKAs in 262 patients were performed for severe valgus (≥10°) deformity and prospectively followed to 10 years. Patient-reported outcome measures included the Oxford Knee Score, American Knee Society Score, Bartlett Patellar Score, and the Short Form 12 questionnaire.Results
Average valgus deformity was reduced from 15.6° to 3.8° (P < .001). At a mean follow-up of 10.4 years (range, 9.5-14.1), 90 (34.4%) patients had died. Of the reviewed survivors, the mean Oxford Knee Score was 27.8 ± 9.8, with an American Knee Society clinical score of 85.6 ± 17.0 and a functional score of 65.1 ± 20.4, with 78% of patients reporting good to excellent results. To date, there has been 1 (0.36%) revision and 13 (4.73%) reoperations. Kaplan-Meier implant survival was 99.6% at 10 years.Conclusion
Despite its challenging nature, the valgus knee is associated with excellent survivorship and satisfactory long-term results using this modified technique.Level of Evidence
Level IV. 相似文献996.
Eric So Bryan Van Dyke Maria R. McGann Roberto Brandao David Larson Christopher F. Hyer 《The Journal of foot and ankle surgery》2019,58(1):62-65
The Lapidus bunionectomy is performed to treat hallux valgus. Recurrence of the deformity remains a concern. A transverse intermetatarsal screw spanning the base of the first metatarsal to the base of the second can increase stability. The neurovascular bundle is located within the proximity of this screw. In this study, we assessed the structures at risks with the use of this technique. In 10 specimens, a guide wire was placed, and a 4.0-mm cannulated screw was inserted. The neurovascular bundle was dissected and inspected for direct trauma to the neurovascular bundle, and the proximity of the screw was measured using a digital caliper. Ten cadaveric specimens were used. The dorsalis pedis artery and deep peroneal nerve were free from injury in 9 of 10 specimens. In those 9 specimens, the neurovascular bundle was located dorsal in relation to the screw. The mean distance of the screw to the neurovascular bundle was 7.1 ± 3.3 mm. The mean distance from the screw to the first tarsometatarsal joint (TMTJ) was 14.7 ± 4.3 mm. The mean distance from the screw as it entered the second metatarsal to the second TMTJ was 18.0 ± 7.2 mm. In 1 specimen, the screw was found to be traversing through the neurovascular bundle. The distance from the screw to the first TMTJ was 15.0 mm. The distance of the screw from where it entered the second metatarsal to the second TMTJ was 24.0 mm. Although the intermetatarsal screw avoided the neurovascular cases in most instances, there is some anatomic risk to the neurovascular bundle. Further study is warranted to evaluate clinical results using the intermetatarsal screw for the modified Lapidus procedure. 相似文献
997.
Amy Klapheke Stanley A. Yap Kevin Pan Rosemary D. Cress 《Urologic oncology》2018,36(6):308.e19-308.e25
Objective
To evaluate how socioeconomic status and other demographic factors are associated with the receipt of chemotherapy and subsequent survival in patients diagnosed with metastatic bladder cancer.Methods
Using data from the California Cancer Registry, we identified 3,667 patients diagnosed with metastatic urothelial carcinoma of the urinary bladder between 1988 and 2014. The characteristics of patients who did and did not receive chemotherapy as part of the first course of treatment were compared using chi-square tests. Logistic regression was used to identify predictors of chemotherapy treatment. Fine and Gray competing-risks regression and Cox proportional hazards regression were used to estimate bladder cancer-specific and all-cause mortality, respectively.Results
Less than half (46.3%) of patients received chemotherapy. Patients from the lowest socioeconomic quintile were half as likely to have chemotherapy as those from highest quintile (odds ratio = 0.5, 95% CI: 0.4, 0.7). Unmarried patients were significantly less likely to receive treatment (odds ratio = 0.6, 95% CI: 0.5, 0.7). Not receiving chemotherapy was associated with greater mortality from bladder cancer (subdistribution hazard ratio = 1.4, 95% CI: 1.3, 1.5) and from all causes (hazard ratio = 2.0, 95% CI: 1.8, 2.1).Conclusions
We found clear disparities in chemotherapy treatment and survival with respect to socioeconomic and marital status. Future studies should explore the possible reasons why patients with low socioeconomic status and who are unmarried are less likely to have chemotherapy. 相似文献998.
目的 :探讨内侧切口改良Chevron截骨结合外侧组织松解治疗轻中度拇外翻的临床疗效。方法:自2015年7月至2016年6月采用改良Chevron截骨结合外侧组织松解治疗轻中度拇外翻患者26例,其中男2例,女24例;年龄45~65(54.6±4.8)岁;病程1~5(7.5±3.3)个月。术后12个月末次随访时测量患足HVA(拇外翻角)、IMA(第1、2跖骨间角),并采用AOFAS评分比较手术前后临床疗效。结果:术后26例患足切口均Ⅰ期愈合,未出现切口感染、跖骨头坏死、拇外翻畸形复发等并发症,其中2例出现皮肤轻度麻木症状,考虑皮神经损伤引起。26例患者获得随访,时间6~12(9.12±2.06)个月,术前HVA(30.01±3.71)°、IMA(14.00±1.50)°与术后的(9.41±4.16)°、(7.00±0.60)°比较差异有统计学意义。术前AOFAS评分为54.77±9.59与术后的92.73±5.47比较差异有统计学意义,其中优19例,良7例。结论:内侧单切口行改良Chevron截骨(必要时加做Akin截骨)并Acutrak全螺纹无头加压螺钉固定,并适度松解关节外侧软组织以治疗轻、中度拇外翻,具有暴露充分、操作简便、固定牢固、愈合较快的优势,而且通过适度的外侧松解,必要时Akin截骨配合内侧关节囊紧缩,较好地恢复内外侧软组织平衡,取得了较为满意的临床效果。 相似文献
999.
Mohammad Abufaraj Guido Dalbagni Siamak Daneshmand Simon Horenblas Ashish M. Kamat Ryu Kanzaki Alexandre R. Zlotta Shahrokh F. Shariat 《European urology》2018,73(4):543-557
Context
The role of surgery in metastatic bladder cancer (BCa) is unclear.Objective
In this collaborative review article, we reviewed the contemporary literature on the surgical management of metastatic BCa and factors associated with outcomes to support the development of clinical guidelines as well as informed clinical decision-making.Evidence acquisition
A systematic search of English language literature using PubMed-Medline and Scopus from 1999 to 2016 was performed.Evidence synthesis
The beneficial role of consolidation surgery in metastatic BCa is still unproven. In patients with clinically evident lymph node metastasis, data suggest a survival advantage for patients undergoing postchemotherapy radical cystectomy with lymphadenectomy, especially in those with measurable response to chemotherapy (CHT). Intraoperatively identified enlarged pelvic lymph nodes should be removed. Anecdotal reports of resection of pulmonary metastasis as part of multimodal approach suggest possible improved survival in well-selected patients. Cytoreductive radical cystectomy as local treatment has also been explored in patients with metastatic disease, although its benefits remain to be assessed.Conclusions
Consolidative extirpative surgery may be considered in patients with clinically evident pelvic or retroperitoneal lymph nodal metastases but only if they have had a response to CHT. Surgery for limited pulmonary metastases may also be considered in very selected cases. Best candidates are those with resectable disease who demonstrate measurable response to CHT with good performance status. In the absence of data from prospective randomized studies, each patient should be evaluated on an individual basis and decisions made together with the patient and multidisciplinary teams.Patient summary
Surgical resection of metastases is technically feasible and can be safely performed. It may help improve cancer control and eventually survival in very selected patients with limited metastatic burden. In a patient who is motivated to receive chemotherapy and to undergo extirpative surgical intervention, surgery should be discussed with the patient among other consolidation therapies in the setting of multidisciplinary teams. 相似文献1000.
Uğur Şaylı Elif Çiğdem Altunok Melih Güven Budak Akman Jnev Biros Ayşe Şaylı 《Acta orthopaedica et traumatologica turcica》2018,52(3):167-173