全文获取类型
收费全文 | 21392篇 |
免费 | 1639篇 |
国内免费 | 607篇 |
专业分类
耳鼻咽喉 | 50篇 |
儿科学 | 1373篇 |
妇产科学 | 112篇 |
基础医学 | 1876篇 |
口腔科学 | 98篇 |
临床医学 | 2126篇 |
内科学 | 3071篇 |
皮肤病学 | 371篇 |
神经病学 | 232篇 |
特种医学 | 898篇 |
外科学 | 7986篇 |
综合类 | 2020篇 |
预防医学 | 721篇 |
眼科学 | 99篇 |
药学 | 1143篇 |
5篇 | |
中国医学 | 772篇 |
肿瘤学 | 685篇 |
出版年
2024年 | 30篇 |
2023年 | 410篇 |
2022年 | 575篇 |
2021年 | 768篇 |
2020年 | 886篇 |
2019年 | 891篇 |
2018年 | 884篇 |
2017年 | 822篇 |
2016年 | 784篇 |
2015年 | 708篇 |
2014年 | 1278篇 |
2013年 | 1334篇 |
2012年 | 1163篇 |
2011年 | 1297篇 |
2010年 | 1153篇 |
2009年 | 1152篇 |
2008年 | 1055篇 |
2007年 | 949篇 |
2006年 | 987篇 |
2005年 | 879篇 |
2004年 | 730篇 |
2003年 | 615篇 |
2002年 | 520篇 |
2001年 | 450篇 |
2000年 | 440篇 |
1999年 | 328篇 |
1998年 | 283篇 |
1997年 | 229篇 |
1996年 | 230篇 |
1995年 | 229篇 |
1994年 | 213篇 |
1993年 | 155篇 |
1992年 | 177篇 |
1991年 | 107篇 |
1990年 | 94篇 |
1989年 | 88篇 |
1988年 | 91篇 |
1987年 | 91篇 |
1986年 | 71篇 |
1985年 | 74篇 |
1984年 | 47篇 |
1983年 | 30篇 |
1982年 | 50篇 |
1981年 | 30篇 |
1980年 | 35篇 |
1979年 | 29篇 |
1978年 | 26篇 |
1977年 | 24篇 |
1976年 | 26篇 |
1974年 | 24篇 |
排序方式: 共有10000条查询结果,搜索用时 0 毫秒
11.
Joseph Wheatley Zhengyang Liu Joel Loth Mark P. Plummer Jahan C. Penny-Dimri Reny Segal Julian Smith Luke A. Perry 《Acta anaesthesiologica Scandinavica》2023,67(2):131-141
Background
Patients undergoing cardiac surgery are at significant risk of developing postoperative acute kidney injury (AKI). Neutrophil–lymphocyte ratio (NLR) is a widely available inflammatory biomarker which may be of prognostic value in this setting.Methods
We conducted a systematic review and meta-analysis of studies reporting associations between perioperative NLR with postoperative AKI. We searched Medline, Embase and the Cochrane Library, without language restriction, from inception to May 2022 for relevant studies. We meta-analysed the reported odds ratios (ORs) with 95% confidence intervals (CIs) for both elevated preoperative and postoperative NLR with risk of postoperative AKI and need for renal replacement therapy (RRT). We conducted a meta-regression to explore inter-study statistical heterogeneity.Results
Twelve studies involving 10,724 participants undergoing cardiac surgery were included, with eight studies being deemed at high risk of bias using PROBAST modelling. We found statistically significant associations between elevated preoperative NLR and postoperative AKI (OR 1.45, 95% CI 1.18–1.77), as well as postoperative need for RRT (OR 2.37, 95% CI 1.50–3.72). Postoperative NLR measurements were not of prognostic significance.Conclusions
Elevated preoperative NLR is a reliable inflammatory biomarker for predicting AKI following cardiac surgery. 相似文献12.
《Clinical Lymphoma, Myeloma & Leukemia》2022,22(8):608-617
BackgroundConsiderable progress has been made in therapeutic options for multiple myeloma (MM). Understanding the current landscape of MM treatment options and associated outcomes in the real world is important in providing key insights into clinical and knowledge gaps which could be targeted for further optimization.MethodsThe Canadian Myeloma Research Group Database (CMRG-DB) is a prospectively maintained disease-specific database with >7000 patients. The objective of this study was to describe the trends in the treatment landscape and outcomes including early mortality, time to next treatment, and overall survival (OS) in each line of treatment stratified by autologous stem cell transplant (ASCT) receipt among newly-diagnosed MM patients in Canada between 2007 and 2018.ResultsA total of 5154 patients were identified among which 3030 patients (58.8%) received an upfront ASCT and 2124 (41.2%) did not. At diagnosis, the median age was 64 years and 58.6% were males. Bortezomib and lenalidomide were most frequently used (>50%) in first and second-line treatment respectively among both the ASCT and non-ASCT cohort. The median OS was 122.0 months (95% Cl 115.0-135.0 months) and 54.3 months (95% CI 50.8-58.8 months) for the ASCT and non-ASCT cohort respectively with an incremental decrease in OS in each subsequent line of treatment.ConclusionWe present the largest study to date in the Canadian landscape showing the characteristics, therapy usage, and outcomes among MM patients. This information will be critical in benchmarking current outcomes and provide key insight into areas of unmet needs and gaps for improvement of MM patients nationally. 相似文献
13.
《Journal of Medical Imaging and Radiation Sciences》2015,46(4):442-449
The purpose of this literature review is to investigate clinical treatment methods of total body irradiation within the context of a clinical department adopting a paediatric cohort with no existing technique. An extensive review of the literature was conducted using PubMed, Science Direct, Google Scholar, and Clinicians Knowledge Network. Articles were limited to nonhelical tomotherapy, nonparticle therapies, and those using hyperfractionated regimes. Total marrow irradiation was excluded because of national treatment and trial limitations. Of the numerous patient positioning methods present within the literature, the most comfortable and reproducible positioning methods for total body irradiation include both supine and the supine and/or prone combination. These positions increased stability and patient comfort during treatment, while also facilitating computed tomography data acquisition at the simulation stage. Ideally, dose calculations should be performed using a three-dimensional treatment planning system and quality assurance procedures that include in vivo dosimetry measurements. The available literature also suggests inhomogeneity correction factors and intensity modulation are superior to conventional open field techniques and should be implemented within developing protocols. Dynamic machine dose modulation is suggested to reduce department impact, removing the need for tissue compensators and accessory shielding devices, while providing significant improvements to treatment time and dose accuracy. Further long-term survival and intensity modulation studies are warranted, including direct comparisons of both dose modulation and treatment efficiency. 相似文献
14.
15.
16.
17.
18.
19.
Bimal Bhindi Christine M. Lohse Phillip J. Schulte Ross J. Mason John C. Cheville Stephen A. Boorjian Bradley C. Leibovich R. Houston Thompson 《European urology》2019,75(5):766-772
Background
Partial nephrectomy (PN) is generally favored for cT1 tumors over radical nephrectomy (RN) when technically feasible. However, it can be unclear whether the additional risks of PN are worth the magnitude of renal function benefit.Objective
To develop preoperative tools to predict long-term estimated glomerular filtration rate (eGFR) beyond 30 d following PN and RN, separately.Design, setting, and participants
In this retrospective cohort study, patients who underwent RN or PN for a single nonmetastatic renal tumor between 1997 and 2014 at our institution were identified. Exclusion criteria were venous tumor thrombus and preoperative eGFR <15 ml/min/1.73 m2.Intervention
RN and PN.Outcome measurements and statistical analysis
Hierarchical generalized linear mixed-effect models with backward selection of candidate preoperative features were used to predict long-term eGFR following RN and PN, separately. Predictive ability was summarized using marginal , which ranges from 0 to 1, with higher values indicating increased predictive ability.Results and limitations
The analysis included 1152 patients (13 206 eGFR observations) who underwent RN and 1920 patients (18 652 eGFR observations) who underwent PN, with mean preoperative eGFRs of 66 ml/min/1.73 m2 (standard deviation [SD] = 18) and 72 ml/min/1.73 m2 (SD = 20), respectively. The model to predict eGFR after RN included age, diabetes, preoperative eGFR, preoperative proteinuria, tumor size, time from surgery, and an interaction between time from surgery and age (marginal ). The model to predict eGFR after PN included age, presence of a solitary kidney, diabetes, hypertension, preoperative eGFR, preoperative proteinuria, surgical approach, time from surgery, and interaction terms between time from surgery and age, diabetes, preoperative eGFR, and preoperative proteinuria (marginal ). Limitations include the lack of data on renal tumor complexity and the single-center design; generalizability needs to be confirmed in external cohorts.Conclusions
We developed preoperative tools to predict renal function outcomes following RN and PN. Pending validation, these tools should be helpful for patient counseling and clinical decision-making.Patient summary
We developed models to predict kidney function outcomes after partial and radical nephrectomy based on preoperative features. This should help clinicians during patient counseling and decision-making in the management of kidney tumors. 相似文献20.
子宫内膜异位症其异位内膜组织虽然在形态学上呈良性表现,却具有类似恶性肿瘤的生物学特性。中医学一般认为,“正虚伏邪”为恶性肿瘤的病机特点;那么,肾虚血瘀既属于“正虚伏邪”的范畴,又体现了EMs发病学和疾病发生、发展过程中的主要特点。在“病证相应”的中医治则之下,补肾化瘀法的临床疗效主要表现为:缓解痛经症状、提高受孕率,以及调整月经周期。本文基于EMs与恶性肿瘤的相关性,通过分析补肾化瘀法治疗EMs的理论依据及其抑制异位内膜侵袭的调控机制,主要包括解除免疫抑制、阻断局部微血管新生等,旨在阐明其疗效显著的原因,为临床推广提供可靠的基础研究证据。 相似文献