全文获取类型
收费全文 | 21390篇 |
免费 | 1640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 | 771篇 |
肿瘤学 | 685篇 |
出版年
2024年 | 29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 687 毫秒
21.
22.
23.
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24.
25.
Benjamin R. Griffin J. Pedro Teixeira Sophia Ambruso Michael Bronsert Jay D. Pal Joseph C. Cleveland T. Brett Reece David A. Fullerton Sarah Faubel Muhammad Aftab 《The Journal of thoracic and cardiovascular surgery》2021,161(4):1346-1355.e3
ObjectivesSevere acute kidney injury (AKI) is a known risk factor for infection and mortality. However, whether stage 1 AKI is a risk factor for infection has not been evaluated in adults. We hypothesized that stage 1 AKI following cardiac surgery would independently associate with infection and mortality.MethodsIn this retrospective propensity score–matched study, we evaluated 1620 adult patients who underwent nonemergent cardiac surgery at the University of Colorado Hospital from 2011 to 2017. Patients who developed stage 1 AKI by Kidney Disease Improving Global Outcomes creatinine criteria within 72 hours of surgery were matched to patients who did not develop AKI. The primary outcome was an infection, defined as a new surgical-site infection, positive blood or urine culture, or development of pneumonia. Secondary outcomes included in-hospital mortality, stroke, and intensive care unit (ICU) and hospital length of stay (LOS).ResultsStage 1 AKI occurred in 293 patients (18.3%). Infection occurred in 20.9% of patients with stage 1 AKI compared with 8.1% in the no-AKI group (P < .001). In propensity-score matched analysis, stage 1 AKI independently associated with increased infection (odds ratio [OR]; 2.24, 95% confidence interval [CI], 1.37-3.17), ICU LOS (OR, 2.38; 95% CI, 1.71–3.31), and hospital LOS (OR, 1.30; 95% CI, 1.17-1.45).ConclusionsStage 1 AKI is independently associated with postoperative infection, ICU LOS, and hospital LOS. Treatment strategies focused on prevention, early recognition, and optimal medical management of AKI may decrease significant postoperative morbidity. 相似文献
26.
27.
28.
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
29.
S. Nishida J. J. Gaynor N. Nakamura F. Butt H. G. Illanes J. Kadono G. W. Neff D. M. Levi J. I. Moon G. Selvaggi T. Kato P. Ruiz A. G. Tzakis J. R. Madariaga 《American journal of transplantation》2006,6(1):140-149
A retrospective study of 1058 liver transplant recipients was performed to determine: (i) the incidence, etiology, timing, clinical features and treatment of refractory ascites (RA), (ii) risk factors for RA development, (iii) predictors of RA disappearance, (iv) predictors of survival following RA and (v) the impact of RA on patient survival. Sixty-two patients (5.9%) developed RA and its disappearance occurred in 27/62 cases. Patients having hepatitis C virus (HCV) had a significantly higher hazard rate of developing RA (p < 0.00001). No other baseline characteristic was associated with RA. Cox stepwise regression analysis of the hazard rate of RA disappearance found two significant factors: HCV recurrence as the reason for developing RA implied a poorer outcome (p = 0.006), whereas an unknown reason implied a favorable outcome (p = 0.02). In addition, survival following RA was significantly poorer among patients having bacterial peritonitis or HCV recurrence. Finally, the mortality rate was significantly (nearly 8.6 times) higher in patients following RA development while it was ongoing (p < 0.00001); however, if the RA disappeared, then the additional risk of death also disappeared. This study illustrates the importance of developing an optimal treatment strategy to (i) effectively treat RA if it develops and (ii) prevent hepatitis C recurrence. 相似文献
30.
It is important to determine when to use and when to avoid calcineurin inhibitors (CNIs). CNIs are associated with kidney dysfunction in some, but not all, transplant recipients. CNI-sparing protocols have their own drug-specific limitations. Two major clinical series suggest the benefit of routine CNI-sparing approaches, but our review suggests weaknesses in both. Ongoing studies are needed to determine which subgroups of recipients will benefit from CNIs. 相似文献