全文获取类型
收费全文 | 2826篇 |
免费 | 195篇 |
国内免费 | 86篇 |
专业分类
耳鼻咽喉 | 3篇 |
儿科学 | 8篇 |
妇产科学 | 7篇 |
基础医学 | 258篇 |
口腔科学 | 13篇 |
临床医学 | 360篇 |
内科学 | 695篇 |
皮肤病学 | 11篇 |
神经病学 | 33篇 |
特种医学 | 140篇 |
外科学 | 431篇 |
综合类 | 536篇 |
预防医学 | 64篇 |
眼科学 | 24篇 |
药学 | 194篇 |
中国医学 | 309篇 |
肿瘤学 | 21篇 |
出版年
2024年 | 7篇 |
2023年 | 56篇 |
2022年 | 93篇 |
2021年 | 110篇 |
2020年 | 131篇 |
2019年 | 101篇 |
2018年 | 88篇 |
2017年 | 117篇 |
2016年 | 103篇 |
2015年 | 139篇 |
2014年 | 224篇 |
2013年 | 230篇 |
2012年 | 192篇 |
2011年 | 184篇 |
2010年 | 155篇 |
2009年 | 148篇 |
2008年 | 149篇 |
2007年 | 149篇 |
2006年 | 119篇 |
2005年 | 104篇 |
2004年 | 69篇 |
2003年 | 45篇 |
2002年 | 72篇 |
2001年 | 48篇 |
2000年 | 41篇 |
1999年 | 34篇 |
1998年 | 35篇 |
1997年 | 27篇 |
1996年 | 13篇 |
1995年 | 15篇 |
1994年 | 19篇 |
1993年 | 11篇 |
1992年 | 9篇 |
1991年 | 6篇 |
1990年 | 7篇 |
1989年 | 1篇 |
1988年 | 2篇 |
1987年 | 5篇 |
1986年 | 6篇 |
1985年 | 8篇 |
1984年 | 5篇 |
1983年 | 4篇 |
1982年 | 9篇 |
1981年 | 6篇 |
1980年 | 3篇 |
1979年 | 1篇 |
1978年 | 4篇 |
1977年 | 3篇 |
排序方式: 共有3107条查询结果,搜索用时 15 毫秒
101.
目的探讨直接前方入路全髋关节置换术在治疗强直性髋关节炎中的临床效果。 方法回顾性分析2015年10月至2018年10月于福建省立医院行全髋关节置换术的强直性髋关节炎62例(66髋),纳入强直性脊柱炎合并髋关节炎行全髋关节置换的患者,排除脊柱畸形严重患者。根据手术入路分为直接前入路组和后外侧入路组,比较手术切口长度,术中出血量的差异,通过Harris髋关节功能评分、影像学评价两组患者手术效果。计量资料采用t检验,计数资料采用卡方检验。 结果直接前入路组和后外侧入路组在手术切口长度和术中出血量的差异无统计学意义(t=1.346、1.272,均为P>0.05)。末次随访平均(25±11)个月,所有患者均解除疼痛,恢复髋关节活动功能。直接前入路组Harris评分术前平均(61±14)分,术后平均(97.8±2.9)分。后外侧入路组Harris评分术前平均(59.3±14.3)分,术后平均(97.4±3.3)分。两组组内术后Harris评分均明显高于术前(t=14.229、14.729, P<0.001),但两组间差异无统计学意义(t =0.416, P>0.05)。术后X线片两组均无骨溶解及假体松动等征象,未发生术后并发症。 结论直接前方入路全髋关节置换治疗强直性髋关节炎的临床效果满意。 相似文献
102.
目的通过对血清骨代谢指标的动态检测探讨其与强直性脊柱炎(AS)发生发展的相关性,为AS的诊断预后及治疗提供客观依据。方法根据AS患者骶髂关节的病损程度分早期、进展期、晚期3期,选择各50例门诊及住院患者。对照组选择年龄及性别相匹配的50名健康对照者,取患者晨起空腹血样,采用电化学发光免疫(ECLIA)及酶联免疫吸附试验(ELISA)检测骨代谢相关指标:甲状旁腺素(PTH),总Ⅰ型前胶原氨基末端(N端)前肽(tPINP),骨钙素N端中分子片段(N-MID OT),I型胶原C端肽(β-CTX),25-羟基维生素D3[25-(OH)D3],Ⅰ型胶原交联羧基末端肽(ICTP)。对3期各组间数据进行比较及相关分析。结果①AS组血清中NMID OT、25-(OH)D3低于健康对照组,β-CTX、ICTP高于健康对照组,组间比较差异均有统计学意义(P<0.01);tPINP、PTH浓度水平在AS患者组与健康对照组组间无显著差异性(P>0.05)。②AS晚期组血清中N-MID OT、25-(OH)D3低于早期组,组间比较差异具有统计学意义(P<0.05);晚期组β-CTX、ICTP浓度水平高于早期组,组间比较差异均有统计学意义(P<0.05);晚期组与早期组tPINP、PTH在组间差异无统计学意义(P>0.05);随着AS疾病的进展,血清中N-MID OT、25-(OH)D3浓度水平逐渐降低,β-CTX、ICTP浓度水平显著升高。结论血清骨代谢指标在分期不同的AS患者中存在异常,不同指标参与了AS的骨吸收及骨转换过程,可为AS的诊断预后及治疗提供客观依据。 相似文献
103.
Hong Qi Zhang Jia Huang Chao Feng Guo Shao Hua Liu Ming Xing Tang 《European spine journal》2014,23(1):234-241
Study design
A retrospective clinical study.Objective
To evaluate the outcomes of two-level (T12 and L3) pedicle subtraction osteotomy (PSO) for severe thoracolumbar kyphosis in ankylosing spondylitis (AS), and to discuss the surgical strategies of this surgery.Background
Cases were limited on the results of two-level PSO for correction of severe kyphosis caused by AS, nor on surgical strategies of this type of surgery.Methods
From March 2006 to December 2010, nine consecutive AS patients with severe kyphotic deformity, underwent T12 and L3 PSOs. Chin-brow vertical angle (CBVA) and radiographic assessments which contain thoracic kyphosis (TK), lumbar lordosis (LL), global kyphosis (GK), and sagittal vertical axis were carefully recorded pre and postoperatively to evaluate the sagittal balance. Intra and postoperative complications were also registered. All patients were asked to fill out Oswestry Disability Index before surgery and at the last follow-up visit.Results
All nine patients (8M/1F), averaged 41.4 years old (range 35–51 years), were received two-level (T12 and L3) PSO, and were followed up after surgery for a mean of 39.9 months (range 24–68 months). Good cosmetic results were achieved in all patients. Mean correction at two-level PSO was 67.9 ± 5.5°. All CBVA, TK, LL, and GK were changed significantly after surgery (P < 0.05), the mean amount of correction of which were 59.5 ± 13.8, 34.7 ± 3.8, 33.2 ± 2.4, and 54.0 ± 14.8 degrees, respectively, and with a small loss of correction at the last follow-up visit. Sagittal imbalance was significantly improved from 27.3 ± 4.4 to 3.4 ± 0.7 cm postoperatively. Neither mortalities nor any major neurological complications were found. The mean ODI score was significantly improved from 53.4 ± 15.5 before surgery to 8.2 ± 4.7 at the last visit.Conclusion
The outcomes of follow-up showed that two-level (T12 and L3) PSO can effectively and safely correct severe thoracolumbar kyphosis in AS. 相似文献104.
105.
106.
目的比较强直性脊柱炎(AS)不同部位骨密度(BMD)测量精确性。方法对27例AS均行双能X线吸收法(DEXA)测定BMD,测定并记录腰椎、股骨颈和桡骨远端BMDZ值。记录患者病程,根据病程将患者分为A组(早期组,病程〈10年)和B组(晚期组,病程≥10年)。结果A、B组腰椎BMDZ值比较,差异有统计学意义(P〈0.05),股骨颈与桡骨远端BMDZ值2组间比较,差异无统计学意义(P〉0.05)。A组腰椎BMD更低,更能反映患者的低骨量状况;B组腰椎BMD增高,股骨颈BMD更能反映患者的低骨量状况。结论在早期AS患者中。腰椎BMD具有更好的精确性,更能准确反映其低骨量状态;但在晚期AS患者,腰椎BMD精确性降低,股骨颈BMD更能准确地反映其低骨量状态。 相似文献
107.
We present a 26-year-old man with edema, ascites and bloody diarrhea that later proved to be due to gastrointestinal and renal amyloidosis. Interestingly, he was also diagnosed as having ankylosing spondylitis,-possibly after a delay of 12 years. The obscure diagnosis and challenging treatment of secondary amyloidosis are further discussed.Electronic Supplementary Material Supplementary material (with figures in color) is available in the online version of this article at .Abbreviations AS
ankylosing spondylitis 相似文献
108.
Michael M. Ward Michael H. Weisman John C. Davis John D. Reveille 《Arthritis care & research》2005,53(5):710-717
Objective
To identify risk factors for functional limitations in patients with ankylosing spondylitis (AS) of at least 20 years' duration.Methods
Patients with AS for ≥20 years were enrolled in the cross‐sectional component of the Prospective Study of Outcomes in AS. All patients had clinical evaluations and completed questionnaires on functional limitations and potential risk factors. Functional limitations were assessed using the Bath Ankylosing Spondylitis Functional Index (BASFI; score range 0–100, higher scores indicate more limitations) and the Health Assessment Questionnaire for the Spondylarthropathies (HAQS). Risk factors included demographic characteristics, duration of AS, smoking status, number of comorbid medical conditions, recalled level of recreational activity in teens and twenties, occupational physical activity throughout life (rated 1 = little, 2 = moderate, 3 = heavy, and weighted by the number of years in each job), and history of AS in a first‐degree relative.Results
The 326 patients (74% men) had a mean ± SD age of 55.0 ± 10.7 years, a mean duration of AS symptoms of 31.7 ± 10.2 years, and a mean BASFI score of 40.7 ± 25.6. BASFI scores increased with higher lifetime occupational physical activity (r = 0.31; P < 0.0001), the number of comorbid conditions (r = 0.25; P < 0.0001), and the duration of AS (r = 0.12; P = 0.04). BASFI scores were higher among current smokers compared with former/nonsmokers (55.5 versus 38.9; P = 0.0002), and among nonwhites compared with whites (49.9 versus 39.3; P = 0.02). In multivariable analyses, lifetime occupational physical activity, current smoking, education level, number of comorbid conditions, and family history were significantly associated with BASFI scores. The same risk factors were associated with the HAQS.Conclusion
Functional limitations in patients with AS for ≥20 years are greater among those with a history of more physically demanding jobs, more comorbid conditions, and among smokers, and are less severe among those with higher levels of education and a family history of AS.109.
Seong-Bae An Keung-Nyun Kim Dong-Kyu Chin Keun-Su Kim Yong-Eun Cho Sung-Uk Kuh 《Journal of Korean Neurosurgical Society》2014,56(2):108-113
Objective
Ankylosing spondylitis is an inflammatory rheumatic disease mainly affecting the axial skeleton. The rigid spine may secondarily develop osteoporosis, further increasing the risk of spinal fracture. In this study, we reviewed fractures in patients with ankylosing spondylitis that had been clinically diagnosed to better define the mechanism of injury, associated neurological deficit, predisposing factors, and management strategies.Methods
Between January 2003 and December 2013, 12 patients with 13 fractures with neurological complications were treated. Neuroimaging evaluation was obtained in all patients by using plain radiography, CT scan, and MR imaging. The ASIA Impairment Scale was used in order to evaluate the neurologic status of the patients. Management was based on the presence or absence of spinal instability.Results
A total of 9 cervical and 4 thoracolumbar fractures were identified in a review of patients in whom ankylosing spondylitis had been diagnosed. Of these, 7 fractures were associated with a hyperextension mechanism. 10 cases resulted in a fracture by minor trauma. Posttraumatic neurological deficits were demonstrated in 11 cases and neurological improvement after surgery was observed in 5 of these cases.Conclusions
Patients with ankylosing spondylitis are highly susceptible to spinal fracture and spinal cord injury even after only mild trauma. Initial CT or MR imaging of the whole spine is recommended even if the patient''s symptoms are mild. The patient should also have early surgical stabilization to correct spinal deformity and avoid worsening of the patient''s neurological status. 相似文献110.
Cauda equina syndrome (CES) associated with dural ectasia is a rare neurologic complication in patients with longstanding ankylosing spondylitis (AS). We report a 68-year-old male with a 30-year history of AS who presented a typical symptom and signs of progressive CES, urinary incontinence and neuropathic pain of the lumbosacral radiculopathy. Computed tomography (CT) and magnetic resonance imaging (MRI) findings showed the unique appearances of dural ectasia, multiple dural diverticula, erosion of posterior element of the lumbar spine, tethering of the conus medullaris and adhesion of the lumbosacral nerve roots to the posterior aspect of the dural ectasia. Considering the progressive worsening of the clinical signs, detethering of the conus medullaris through resection of the filum terminale was performed through a limited laminectomy. However, the urinary incontinence did not improve and there was a partial relief of the neuropathic leg pain only. The possible pathogenetic mechanism of CES-AS and the dural ectasia in this patient with longstanding AS are discussed with a literature review. 相似文献