| 收费全文 | 430714篇 |
| 免费 | 30271篇 |
| 国内免费 | 10177篇 |
| 耳鼻咽喉 | 4741篇 |
| 儿科学 | 11596篇 |
| 妇产科学 | 7259篇 |
| 基础医学 | 32757篇 |
| 口腔科学 | 8764篇 |
| 临床医学 | 50219篇 |
| 内科学 | 61567篇 |
| 皮肤病学 | 5114篇 |
| 神经病学 | 24358篇 |
| 特种医学 | 11129篇 |
| 外国民族医学 | 34篇 |
| 外科学 | 45039篇 |
| 综合类 | 67698篇 |
| 现状与发展 | 17篇 |
| 一般理论 | 33篇 |
| 预防医学 | 42227篇 |
| 眼科学 | 6455篇 |
| 药学 | 38574篇 |
| 538篇 | |
| 中国医学 | 37896篇 |
| 肿瘤学 | 15147篇 |
| 2024年 | 1462篇 |
| 2023年 | 7086篇 |
| 2022年 | 12730篇 |
| 2021年 | 17663篇 |
| 2020年 | 16648篇 |
| 2019年 | 21645篇 |
| 2018年 | 19089篇 |
| 2017年 | 16359篇 |
| 2016年 | 13703篇 |
| 2015年 | 12782篇 |
| 2014年 | 25883篇 |
| 2013年 | 27115篇 |
| 2012年 | 23105篇 |
| 2011年 | 25401篇 |
| 2010年 | 20830篇 |
| 2009年 | 18666篇 |
| 2008年 | 18316篇 |
| 2007年 | 19047篇 |
| 2006年 | 16741篇 |
| 2005年 | 14435篇 |
| 2004年 | 11635篇 |
| 2003年 | 10263篇 |
| 2002年 | 8166篇 |
| 2001年 | 7399篇 |
| 2000年 | 6057篇 |
| 1999年 | 5295篇 |
| 1998年 | 4331篇 |
| 1997年 | 4129篇 |
| 1996年 | 3556篇 |
| 1995年 | 3458篇 |
| 1994年 | 3284篇 |
| 1993年 | 2594篇 |
| 1992年 | 2655篇 |
| 1991年 | 2271篇 |
| 1990年 | 2008篇 |
| 1989年 | 1756篇 |
| 1988年 | 1674篇 |
| 1987年 | 1469篇 |
| 1985年 | 4113篇 |
| 1984年 | 5131篇 |
| 1983年 | 3558篇 |
| 1982年 | 4061篇 |
| 1981年 | 3740篇 |
| 1980年 | 3317篇 |
| 1979年 | 3064篇 |
| 1978年 | 2684篇 |
| 1977年 | 2000篇 |
| 1976年 | 2257篇 |
| 1975年 | 1691篇 |
| 1974年 | 1477篇 |
Aims
Variations of the anatomy of donor hepatic arteries increase the number of arterial anastomoses during liver transplantation and, possibly, the incidence of hepatic artery thrombosis (HAT). In this study, we describe the arterial anatomic variations in liver grafts procured and transplanted by a single center in Greece, the techniques of arterial anastomosis, and their effect on the incidence of early HAT.Materials and Methods
From January 2013 to December 2017, the arterial anatomy of 116 grafts procured for liver transplantation were recorded, as well as the technique of arterial anastomosis and the incidence of early hepatic artery thrombosis (HAT <30 days).Results
A single hepatic artery was recorded in 72.41% of the procured grafts, an aberrant left hepatic artery (accessory or replaced) in 18 grafts (15.52%), and an aberrant right hepatic artery (accessory or replaced) in 17 grafts (14.66%), while other variations were observed in less than 1% of the procured livers. Of the 116 primary liver transplantations, 6 patients (5.17%) developed early HAT <30 days. Two of these patients (1.72%) had 1 anastomosis of the hepatic artery and 4 (3.45%) had 2 anastomoses due to anatomic variations.Conclusions
Anatomic variations of the hepatic artery in liver grafts is a common finding and increase the incidence of early HAT but not to a degree to make these grafts unusable. 相似文献Objectives
The current study investigated the effects of two exercise interventions on cognitive function amongst breast cancer survivors.Design
Pilot randomised-controlled trial.Methods
Seventeen female cancer survivors (mean: 62.9 ± 7.8 years) were randomised into three groups: high-intensity interval training (HIIT, n = 6); moderate-intensity continuous training (MOD, n = 5); or wait-list control (CON, n = 6). The HIIT and MOD groups exercised on a cycle ergometer 3 days/week for 12-weeks. Primary outcomes were cognitive function assessments utilising CogState. Secondary outcomes were resting middle cerebral artery blood flow velocity, cerebrovascular reactivity and aerobic fitness (VO2peak). Data were analysed with General Linear Mixed Models and Cohen’s d effect sizes were calculated.Results
All 17 participants who were randomised were available for follow-up analysis and adherence was similar for HIIT and MOD (78.7 ± 13.2% vs 79.4 ± 12.0%; p = 0.93). Although there were no significant differences in the cognitive and cerebrovascular outcomes, HIIT produced moderate to large positive effects in comparison to MOD and CON for outcomes including episodic memory, working memory, executive function, cerebral blood flow and cerebrovascular reactivity. HIIT significantly increased VO2peak by 19.3% (d = 1.28) and MOD had a non-significant 5.6% (d = 0.72) increase, compared to CON which had a 2.6% decrease.Conclusions
This study provides preliminary evidence that HIIT may be an effective exercise intervention to improve cognitive performance, cerebrovascular function and aerobic fitness in breast cancer survivors. Considering the sample size is small, these results should be confirmed through larger clinical trials. 相似文献Methods: Day 3 to day 7 after admission to a stroke unit, 64 persons with stroke were assessed twice, using the SwePASS, by two physiotherapists. Inter-rater reliability was determined using percentage-agreement and the rank-invariant method: relative position, relative concentration, and relative rank variance.
Results: The raters showed a percentage agreement of ≥75% in the assessments using the SwePASS. For 9 of the 12 items, the percentage agreement was >80%. For 8 of the 12 items, there was a statistically significant change in position, revealed in relative position values between 0.08 and 0.15. Three items had statistically significant positive relative concentration values between ?0.11 and 0.10. Except for a statistically significant negligible relative variance value of 0.01 for the items 1 and 8, there was no relative variance.
Conclusions: The SwePASS shows an acceptable inter-rater reliability, albeit with potential for improvement. The reliability can be improved by a consensus how to interpret the scale between the raters prior to implementation in the clinic. 相似文献
Background
Physicians treating nonvalvular atrial fibrillation (AF) assess stroke and bleeding risks when deciding on anticoagulation. The agreement between empirical and physician-estimated risks is unclear. Furthermore, the association between patient and physician sex and anticoagulation decision-making is uncertain.Methods
We pooled data from 2 national primary care physician chart audit databases of patients with AF (Facilitating Review and Education to Optimize Stroke Prevention in Atrial Fibrillation and Coordinated National Network to Engage Physicians in the Care and Treatment of Patients with Atrial Fibrillation Chart Audit) with a combined 1035 physicians (133 female, 902 male) and 10,927 patients (4567 female and 6360 male).Results
Male physicians underestimated stroke risk in female patients and overestimated risk in male patients. Female physicians estimated stroke risk well in female patients but underestimated the risk in male patients. Risk of bleeding was underestimated in all. Despite differences in risk assessment by physician and patient sex, > 90% of patients received anticoagulation across all subgroups. There was modest agreement between physician estimated and calculated (ie, CHADS2 score) stroke risk: Kappa scores were 0.41 (0.35-0.47) for female physicians and 0.34 (0.32-0.36) for male physicians.Conclusions
Our study is the first to examine the association between patient and physician sex influences and stroke and bleeding risk estimation in AF. Although there were differences in agreement between physician estimated stroke risk and calculated CHADS2 scores, these differences were small and unlikely to affect clinical practice; further, despite any perceived differences in the accuracy of risk assessment by sex, most patients received anticoagulation. 相似文献Design: A mixed-methods design, applying the Schwartz and Sprangers response shift (RS) model. RS is a cognitive process wherein, in response to a change in health status, individuals change internal standards, values, or conceptualization of QOL
Setting: Community-dwelling participants who receive medical treatment at a major Midwestern medical system and nearby Veterans’ Affairs hospital.
Participants: A purposive sample of participants with SCI (N?=?40) completed semi-structured interviews and accompanying quantitative measures.
Interventions: Not applicable.
Outcome Measures: Qualitative data were analyzed using content analysis to identify themes. Analysis of variance were performed to detect differences based on themes and QOL, well-being, and demographic and injury characteristics.
Results: Four RS themes were identified, capturing the range of participant perceptions of QOL. The themes ranged from complete RS, indicating active engagement in maintaining QOL, to awareness and comparisons redefining QOL, to a relative lack of RS. Average QOL ratings differed as a function of response shift themes. PROMIS Global Health, Anxiety, and Depression also differed as a function of RS themes.
Conclusion: The RS model contextualizes differences in QOL definitions, appraisals, and adaptations in a way standardized QOL measures alone do not. 相似文献