全文获取类型
收费全文 | 25007篇 |
免费 | 1819篇 |
国内免费 | 423篇 |
专业分类
耳鼻咽喉 | 257篇 |
儿科学 | 475篇 |
妇产科学 | 488篇 |
基础医学 | 1436篇 |
口腔科学 | 516篇 |
临床医学 | 2985篇 |
内科学 | 3767篇 |
皮肤病学 | 115篇 |
神经病学 | 1344篇 |
特种医学 | 585篇 |
外科学 | 4151篇 |
综合类 | 3319篇 |
现状与发展 | 1篇 |
预防医学 | 3134篇 |
眼科学 | 558篇 |
药学 | 3239篇 |
19篇 | |
中国医学 | 368篇 |
肿瘤学 | 492篇 |
出版年
2024年 | 60篇 |
2023年 | 455篇 |
2022年 | 812篇 |
2021年 | 1122篇 |
2020年 | 996篇 |
2019年 | 897篇 |
2018年 | 873篇 |
2017年 | 895篇 |
2016年 | 930篇 |
2015年 | 928篇 |
2014年 | 1673篇 |
2013年 | 1860篇 |
2012年 | 1505篇 |
2011年 | 1655篇 |
2010年 | 1204篇 |
2009年 | 1160篇 |
2008年 | 1156篇 |
2007年 | 1070篇 |
2006年 | 993篇 |
2005年 | 818篇 |
2004年 | 692篇 |
2003年 | 618篇 |
2002年 | 447篇 |
2001年 | 441篇 |
2000年 | 396篇 |
1999年 | 333篇 |
1998年 | 312篇 |
1997年 | 306篇 |
1996年 | 248篇 |
1995年 | 335篇 |
1994年 | 220篇 |
1993年 | 191篇 |
1992年 | 204篇 |
1991年 | 184篇 |
1990年 | 176篇 |
1989年 | 143篇 |
1988年 | 146篇 |
1987年 | 136篇 |
1986年 | 120篇 |
1985年 | 118篇 |
1984年 | 91篇 |
1983年 | 54篇 |
1982年 | 53篇 |
1981年 | 34篇 |
1980年 | 38篇 |
1979年 | 32篇 |
1978年 | 37篇 |
1977年 | 24篇 |
1975年 | 11篇 |
1973年 | 19篇 |
排序方式: 共有10000条查询结果,搜索用时 0 毫秒
81.
异丙酚及氯胺酮靶控输注全静脉麻醉临床应用 总被引:4,自引:1,他引:3
目的 研究异丙酚复合不同镇痛剂量氯胺酮靶控输注全静脉麻醉临床应用的可行性及对血流动力学、麻醉恢复的影响。方法 择期手术患者 80例 ,分别采用异丙酚 (P组 ,n =16)及复合氯胺酮血药浓度 0 2 0mg/L(PK1组 ,n =16) ,0 40mg/L(PK2 组 ,n =16) ,0 60mg/L(PK3 组 ,n =16)和 0 80mg/L(PK4组 ,n =16)全静脉麻醉 ,采用微机控制Graseby 3 5 0 0输液泵靶控输注异丙酚或氯胺酮 ,连接Aspect-A10 0 0型脑电监护仪监测脑电变化 ,观察两组患者血流动力学改变及麻醉恢复情况。结果 单用异丙酚患者随着异丙酚血药浓度升高脑电双频指数 (BIS)值降低 ,呈明显负相关 (P <0 0 5 ) ,氯胺酮血药浓度从 0 2 0mg/L增至 0 80mg/L ,BIS值无明显变化 (P >0 0 5 )。与P组相比 ,PK1,PK2 ,PK3 ,PK4组异丙酚用量减少约 15 %~ 40 % ,PK4组停药至睁眼时间明显延长 ,其余各组无明显差异 (P >0 0 5 )。术中P ,PK1组收缩压、舒张压升高 ,PK2 ,PK3 ,PK4组无明显改变。术后无躁动、不良回忆等并发症。结论 异丙酚复合镇痛剂量的氯胺酮 (0 40~ 0 60mg/L)靶控输注全静脉麻醉具有血流动力学稳定、减少异丙酚用量、无明显术后并发症等优点。 相似文献
82.
髁突形态与覆深度关系的研究 总被引:1,自引:0,他引:1
目的 探讨髁突形态与不同覆深度的关系。方法 选择正常者、开畸形患者、覆正常的错畸形患者和深覆畸形患者各 5 0人 ,均为 18至 2 6岁成人。应用曲面断层片研究左右两侧的髁突形态 ,分别测量并计算上部髁突高度 /升支高度比 (UCH/RH)和髁突高度 /宽度比 (TCH/CW )。将髁突形态分为四种类型 :直立型 (类A) ,前倾型 (类B) ,后倾型 (类C)和尖型 (类D)。结果 开组的上部髁突高度相对升支高度明显小于其他各组 (P <0 0 0 1)。正常组的髁突形态比较粗壮 ,高度宽度比明显小于其他各组 (P <0 0 0 1)。类A和类B属于正常髁突形态 ,占正常组的 99%。类C和类D属于异常髁突形态 ,且在开组中的比例明显高于正常覆组或深覆组。另外 ,只有开组中显示上部髁突高度两侧不对称 (P <0 0 5 )。结论 开组髁突形态与其他各组相比明显不同。 相似文献
83.
南京口岸1987—1993年艾滋病监测报告 总被引:1,自引:1,他引:0
本文报道了南京卫生检疫局1987~1993连续7年对南京口岸重点人群进行艾滋病监测的情况.7年来南京局共监测各类标本43085份,在外籍留学生中检出HIV感染者2例,另外还检出4份进口人血丙种球旦白HIV抗体阳性.该局对检出的2侧HIV感染者及4份阳性进口人血丙种球旦白进行了游行病学调查和处理.并对艾滋病监测管理的有关问题进行了探讨. 相似文献
84.
Masahiko Kawaguchi Masakazu Kuro Hisatoshi Ohsumi Toshito Nakajima Yoshihiro Kuriyama Jun Karasawa 《Journal of anesthesia》1994,8(1):60-63
We assessed the local cerebral blood flow (LCBF) in 40 patients under fentanyl-diazepam anesthesia. The measurement of LCBF
was made using 50%–70% stable xenon with 20 min of inhalation interval and a shuttle method for computed tomography imaging.
All patients were anesthetized with 5.95±1.76 μg·kg−1 fentanyl and 0.22±0.07 mg·kg−1 diazepam under mechanical ventilation during CBF measurement. The values and distribution of LCBF on non-affected hemisphere
appeared to be unaltered by fentanyldiazepam anesthesia. We also assessed the cerebral carbon dioxide reactivity in 6 patients.
The cerebral carbon dioxide reactivity, expressed as percentage change in LCBF per unit change in arterial carbon dioxide
partial pressure, was 5.39±1.07, and there were no significant differences of reactivity among regions studied. In conclusion,
we showed reference values of LCBF and carbon dioxide reactivity, measured by stable xenon-enhanced computed tomography, in
patients under fentanyl-diazepam anesthesia. Carbon dioxide reactivity was preserved in all regions including gray matter,
white matter, and basal ganglia. 相似文献
85.
Summary A ring-shaped electrode was developed and used in 20 patients to record evoked electromyographic responses directly from the extraocular muscles during skull base surgery. Intra-operative monitoring with this electrode helps the surgeon to localize the nerves that innervate the extraocular muscles precisely and to refrain from disturbing important neural structures during operations. Such monitoring also provides some insight into the pathophysiology of the dysfunction of these nerves resulting from skull base lesions. 相似文献
86.
Bayesian decision theoretic approaches (BDTAs) have been widely studied in the literature as tools for designing and conducting phase II clinical trials. However, full Bayesian approaches that consider multiple endpoints are lacking. Since the monitoring of toxicity is a major goal of phase II trials, we propose an adaptive group sequential design using a BDTA, which characterizes efficacy and toxicity as correlated bivariate binary endpoints. We allow trade‐off between the two endpoints. Interim evaluations are conducted group sequentially, but the number of interim looks and the size of each group are chosen adaptively based on current observations. We utilize a loss function consisting of two components: the loss associated with accruing, treating, and monitoring patients, and the loss associated with making incorrect decisions. The performance of our Bayesian modeling, and the operating characteristics of decision rules under a wide range of loss function parameters are evaluated using seven scenarios in a simulation study. Our method is illustrated in the context of a single‐arm phase II trial of bevacizumab, gemcitabine, and oxaliplatin in patients with metastatic pancreatic adenocarcinoma. Copyright © 2009 John Wiley & Sons, Ltd. 相似文献
87.
Takashi Toyonaga Eisei Nishino Toshio Dozaiku Chie Ueda Tomoomi Hirooka 《Digestive endoscopy》2007,19(Z1):S14-S18
The gastric vasculature responsible for intraoperative bleeding in endosocpic submucosal dissection (ESD) is the ramified vascular network occupying the middle of the submucosal layer and large vessels penetrating the muscle layer. Appropriate management for these vessels must be addressed. The trimming of the ramified vascular network can be safely performed with coagulation mode following shallow mucosal cutting. A large penetrating vessel usually requires precoagulation prior to dissection. These procedures are effectively performed with the water jet short needle knife (Flush knife). 相似文献
88.
Background Many centers use local anesthesia for adult inguinal hernia surgery in the setting of day-case surgery. There are no reports
on, or guidelines for, use of anesthesia for inguinal hernia surgery in adolescents. We describe our initial experience with
the use of local anesthesia and intravenous sedation for inguinal hernia surgery in adolescents in the setting of a day-surgery
facility.
Methods The charts of 14 consecutive adolescent patients (aged 12–17) who had inguinal hernia surgery from July 2004 to March 2005
were reviewed retrospectively. Intravenous sedation was administered 1–3 min before injection of local anesthetic. Sedation
consisted of midazolam 0.085 mg kg−1 and either fentanyl 0.85 μg kg−1 or ketamine 0.085 mg kg−1, according to the preference of the anesthesiologist. Additional sedation with half the initial dose was administered if
required. Local anesthesia using a combination of lignocaine and bupivacaine was administered by the surgeon with infiltration
in the skin and deep tissues.
Results Fourteen adolescents aged 12–17 years (mean 14.8 ± 1.37), weighing 34–100 kg (mean 61.2 ± 16.5), had 15 inguinal hernia repairs
with sedation and local anesthesia. All the patients were male. All completed the surgery with sedation and local anesthesia.
None required conversion to general anesthesia. There were no immediate or subsequent complications. Mean time from the end
of surgery to discharge home was under 2 h (mean 106 ± 36 min). Examination of patient charts did not reveal any complaints
regarding the surgery or the postoperative course at the postoperative follow up visit.
Conclusions The use of local anesthesia with intravenous sedation for inguinal hernia repair in the adolescent age group seems feasible
and requires further prospective study. 相似文献
89.
I. M. E. Wentholt A. Maran N. Masurel R. J. Heine J. B. L. Hoekstra J. H. DeVries 《Diabetic medicine》2007,24(5):527-532
Aims We quantified the occurrence and duration of nocturnal hypoglycaemia in individuals with Type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) or multiple‐injection therapy (MIT) using a continuous subcutaneous glucose sensor. Methods A microdialysis sensor was worn at home by 24 patients on CSII (mean HbA1c 7.8 ± 0.9%) and 33 patients on MIT (HbA1c 8.7 ± 1.3%) for 48 h. Occurrence and duration of nocturnal hypoglycaemia were assessed and using multivariate regression analysis, the association between HbA1c, diabetes duration, treatment type (CSII vs. MIT), fasting and bedtime blood glucose values, total daily insulin dose and mean nocturnal glucose concentrations, and hypoglycaemia occurrence and duration was investigated. Results Nocturnal hypoglycaemia ≤ 3.9 mmol/l occurred in 33.3% of both the CSII‐ (8/24) and MIT‐treated patients (11/33). Mean (± sd ; median, interquartile range) duration of hypoglycaemia ≤ 3.9 mmol/l was 78 (± 76; 57, 23–120) min per night for the CSII‐ and 98 (± 80; 81, 32–158) min per night for the MIT‐treated group. Multivariate regression analysis showed that bedtime glucose value had the strongest association with the occurrence (P = 0.026) and duration (P = 0.032) of nocturnal hypoglycaemia. Conclusions Microdialysis continuous glucose monitoring has enabled more precise quantification of nocturnal hypoglycaemia occurrence and duration in Type 1 diabetic patients. Occurrence and duration of nocturnal hypoglycaemia were mainly associated with bedtime glucose value. 相似文献
90.
P A Zartner R P Handke A M Brecher M B E Schneider 《Europace : European pacing, arrhythmias, and cardiac electrophysiology》2007,9(3):192-193
A 4-year-old girl with post-surgical complete atrioventricular block received an epicardial dual chamber pacemaker system. During further growth intermittent exit block occurred, first misinterpreted as neurological seizures. The epicardial lead was replaced using a transvenous approach, and a pacemaker with an integrated home monitoring facility was implanted. After her discharge, a rise in the pacing threshold automatically initiated an event message. On the basis of this information, the patient was called in and imminent dislodgement of the ventricular lead was diagnosed by x-ray. The lead was repositioned and was found stable over 1-year follow-up. 相似文献