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11.
目的研究云南白药在围术期对全髋关节置换术术中出血量及术后引流量的影响。方法2006至2008年我科收治的股骨颈骨折行全髋关节置换术60例,随机分成两组,分别服用云南白药胶囊和空胶囊;术前术后测定凝血酶原时间(PT),记录全部病人术中出血量及术后24 h引流量。结果实验组和对照组病人的凝血酶原时间(PT)差异有统计学意义(P<0.01);试验组的术中出血量、术后24 h引流量分别为(380±78)ml(、336±77)ml,较对照组(481±77)ml(、418±68)ml明显减少,差异具有统计学意义(P<0.01)。结论云南白药胶囊能够明显减少全髋关节置换术围术期出血量。 相似文献
12.
M. Innocenti R. Civinini M. Villano C. Carulli E. Pratelli 《Journal of orthopaedics and traumatology》2007,8(2):106-109
Unicompartmental knee arthroplasty (UKA) is considered the treatment of choice in patients with single compartment arthritis
of the knee at early stages or with osteonecrosis limited to one compartment. However, results in the literature are still
controversial and it is a technically difficult procedure. The main goal of UKA is to restore the articular space of the afflicted
compartment, without influencing the limb alignment. Selection of patients and pre-operative planning are crucial. The necessity
to improve functional results and to reduce immobilization of the patients has led to the development of minimally invasive
surgery. Applied to UKA, this approach reduces blood loss and surgical time, causes fewer symptomatic postoperative complications,
and permits earlier recovery compared to the traditional incision. The shorter incision makes careful pre-operative planning
essential. We briefly review the indications for UKA, the pre-operative clinical and radiological assessment, and the surgical
procedure.
Proocedings of the Consensus Conference “TSS in hip and knee replacement” (Rapallo, Italy 22–24 June 2006) 相似文献
13.
François Lavigne P. Culpan T. Judet P. Piriou 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2009,19(5):321-325
Objective Stiffness and severe deformity pose a major challenge in total knee arthroplasty. Numerous techniques have been described
to gain exposure and improve knee flexion. Tibial tubercle osteotomy provides excellent and safe exposure of the joint, although
mechanical and wound complications have been reported.
Materials and methods We present a series of 32 consecutive complex primary total replacements where an osteotomy of the tibial tubercle was utilised.
Results The patients had a mean follow-up of 2 years and 11 months. Following the procedure, with the exception of one case complicated
with deep infection, all of the patients had improved clinically. The mean postoperative range of motion had increased to
102° (give P value < 0.005) and there were no cases of delayed union or non-union. A mechanical complication related to technique occurred
in one patient; there were no other cases with a postoperative extension lag.
Conclusion In this challenging population group, we have found a tibial tubercle tuberosity osteotomy to greatly facilitate exposure
without compromising the clinical and radiographic outcome. 相似文献
14.
C. Delaunay 《Interactive Surgery》2007,2(3-4):174-177
Assessment of possible low-wear with some former metal-on-metal (MoM) total hip arthroplasties (THA) led to the reintroduction
of metallic bearings in the late 80’s. The author reports on two studies of Metasul-28 mm cementless THA. In the first one
in a general population, impingement has been the main cause of osteolysis and Co level survey has been a good indicator of
Metasul bearing behaviour. In the second study, in a group of 83 less than 50-year-old and active patients, Metasul bearings
showed good wear resistance at 7.2 years mean follow-up. In both studies, no general toxic effect could have been detected
thus far. According to the current knowledge, it is always reasonable to expect low-wear and better THA longevity with use
of MoM bearings under the following conditions: 1) use of a CoCr alloy with high carbide concentration; 2) reduce impingement
risk (head without sleeve, slimmer as possible neck, perfectly adapted Morse cone from the same manufacturer, well — oriented
components); and 3) prefer cementless acetabular fixation. 相似文献
15.
Abstract: A pulsatile impeller assist heart and a total heart were tested as a chronic left ventricular assist device in 5 calves and an acute biventricular assist device in 4 pigs respectively, to evaluate their blood compatibility. During the left ventricular assist experiments, the indicators for hemolysis, thrombogenesis, renal dysfunction, and hepatic dysfunction were measured preoperatively, at the beginning of the pumping, 6 h postoperatively, and every following day. The results demonstrated that the impeller assist heart causes no severe blood damage nor organ dysfunction in the experiments lasting up to 11 days. In biventricular assist experiments, the number of red blood cells, white blood cells, platelets, and the he-matocrit, hemoglobin, free hemoglobin, and lactate dehy-drogenase levels were tested preoperatively at the beginning of the pumping and every 2 h postoperatively. The data remained in acceptable ranges during experiments lasting 6 h. It is confirmed that the authors' impeller assist heart and total heart have the advantages of simplicity, implantability, and pulsatility with good blood compatibility. 相似文献
16.
完全性肺静脉异位引流的手术治疗经验 总被引:15,自引:1,他引:14
为评估影响完全性肺静脉异位引流(TAPVD)手术纠治的因素,本组纳入了28例在中度低温体外循环和15例在深低温停循环下手术纠治者。结果手术死亡4例,死亡率9.3%。随访32例,2例肺静脉回流梗阻分别于术后5个月和2年3个月死亡。结论认为,TAPVD必须早期手术防止肺血管阻塞性病变;术后定期随访;改进手术方法,防止心房内补片粘连所致肺静脉回流梗阻。 相似文献
17.
18.
19.
Peter A. Blume DPM FACFAS J. Christopher Moore DPM David C. Novicki DPM FACFAS 《The Journal of foot and ankle surgery》2005,44(1):44-48
There are a number of proposed causes and treatment approaches for digital mucoid cysts. The described treatment outcomes for this cyst have been variable, with the highest success rate reported with complete excision and single-lobe skin flap closure. This report describes a bilobed flap reconstruction in conjunction with resection of the head of the middle phalanx. A retrospective review was undertaken to evaluate the recurrence rate, complications, and patient satisfaction with this combined procedure. Fifteen patients with an average follow-up of 4.6 years were evaluated. There were no recurrences, flap failures, or other major complications. The use of this flap allows for greater exposure than traditional semi-elliptical incisions while allowing the wide excisional defects to be closed primarily. 相似文献
20.
U. Böhling H. Schamberger U. Grittner J. Scholz 《Journal of orthopaedics and traumatology》2005,6(2):69-75
Abstract The objective of the study was to evaluate the precision, concordance, practicability and the early clinical outcome of the use of a computerised navigation system in a comparative study with a group of 100 patients. Two groups of 50 patients each underwent implantation of a bicondylar knee prosthesis either by means of the freehand navigation system or by means of technical instrumentation. We found that the computerised navigation system provided a higher precision than the technically instrumented implantation: 94% of the prostheses implanted with the navigation system have an alignment within a range of -3° to 3° on of the Mikulicz line. Only 46% of the patients operated by means of the technical instrumentation reached this aspired result. Furthermore, the navigation system showed smaller ranges in the deviation of the aspired alignment. The radiological and computer-modeled alignment values differed both pre- and postoperatively, but to a larger extent before surgery. The varus or valgus deviations of the axis were more distinct radiologically under the weight of the patient’s body than in the computer model. The clinical outcome examined by the use of the HSS score after a mean followup of 7 months is good in both groups, and without significant differences. On average, the duration of surgery was 13 minutes longer in the computerised navigation group. We conclude that the benefit of the computerised navigation system is represented by the high improvement of precision. Achieving early clinical results identical to those in the technical instrumentation group, we expect a reduction of aseptic loosening in the computerised navigation group. 相似文献