全文获取类型
收费全文 | 11068篇 |
免费 | 1137篇 |
国内免费 | 379篇 |
专业分类
耳鼻咽喉 | 99篇 |
儿科学 | 106篇 |
妇产科学 | 105篇 |
基础医学 | 1035篇 |
口腔科学 | 260篇 |
临床医学 | 1808篇 |
内科学 | 1496篇 |
皮肤病学 | 58篇 |
神经病学 | 1464篇 |
特种医学 | 656篇 |
外科学 | 1644篇 |
综合类 | 1179篇 |
一般理论 | 1篇 |
预防医学 | 808篇 |
眼科学 | 117篇 |
药学 | 977篇 |
27篇 | |
中国医学 | 506篇 |
肿瘤学 | 238篇 |
出版年
2024年 | 43篇 |
2023年 | 323篇 |
2022年 | 477篇 |
2021年 | 872篇 |
2020年 | 774篇 |
2019年 | 585篇 |
2018年 | 573篇 |
2017年 | 551篇 |
2016年 | 467篇 |
2015年 | 454篇 |
2014年 | 725篇 |
2013年 | 966篇 |
2012年 | 618篇 |
2011年 | 638篇 |
2010年 | 490篇 |
2009年 | 384篇 |
2008年 | 421篇 |
2007年 | 401篇 |
2006年 | 313篇 |
2005年 | 306篇 |
2004年 | 237篇 |
2003年 | 227篇 |
2002年 | 183篇 |
2001年 | 193篇 |
2000年 | 140篇 |
1999年 | 120篇 |
1998年 | 99篇 |
1997年 | 95篇 |
1996年 | 87篇 |
1995年 | 80篇 |
1994年 | 68篇 |
1993年 | 52篇 |
1992年 | 58篇 |
1991年 | 43篇 |
1990年 | 55篇 |
1989年 | 48篇 |
1988年 | 43篇 |
1987年 | 47篇 |
1986年 | 40篇 |
1985年 | 44篇 |
1984年 | 39篇 |
1983年 | 32篇 |
1982年 | 37篇 |
1981年 | 39篇 |
1980年 | 28篇 |
1979年 | 17篇 |
1978年 | 19篇 |
1976年 | 7篇 |
1975年 | 6篇 |
1973年 | 5篇 |
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
971.
Colette S. Inaba Christina Y. Koh Sarath Sujatha-Bhaskar Marija Pejcinovska Ninh T. Nguyen 《Surgery for obesity and related diseases》2018,14(10):1448-1453
Background
Laparoscopic sleeve gastrectomy (LSG) is associated with low morbidity and mortality and a short length of stay. Studies on the safety of same-day discharge after LSG are limited.Objective
To compare outcomes between same-day versus first-postoperative-day (POD1) discharge after LSG.Setting
Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program national database.Methods
The 2015 to 2016 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was analyzed for elective LSG cases with same-day or POD1 discharge. Open, revisional, and converted cases were excluded. Multivariate analysis was performed to compare adjusted 30-day mortality, morbidity, readmission, and reoperation for same-day versus POD1 discharge.Results
We examined 85,321 LSG cases, including 4728 same-day discharges and 80,593 POD1 discharges. Compared with POD1 discharges, same-day discharges were associated with higher overall morbidity (1.31% versus .84%, respectively; adjusted odds ratio [AOR] 1.72; P?=?.0002), a higher readmission rate (2.14% versus 1.64%, respectively; AOR 1.40; P?=?0.0034), and a higher reoperation rate (.61% versus .27%, respectively; AOR 2.35; P < .0001). There was no difference in mortality (.08% versus .04%, respectively; AOR 2.62; P?=?.0923).Conclusion
Same-day discharge after LSG is associated with increased complications, readmissions, and reoperations compared with POD1 discharge. Further studies are needed to examine objective criteria for safe same-day discharge after LSG. 相似文献972.
目的对传统的微柱层析法操作过程进行改良,以缩短层析柱分离样品的时间,从而提高该法测定糖化血红蛋白HBA1c的检测速度。方法利用负压装置对糖化血红蛋白HBA1c微层析柱下端进行负压引流,使液体过柱时间大幅缩短,显著提高糖化血红蛋白HBA1c检测速度。结果采用负压微柱层析法测定糖化血红蛋白HBA1c可将样品分离时间由原来的2 h缩短到15 min。经对比试验,改良方法与原方法无显著性差异(P>0.05),测定结果相关性显著(r=0.931,P<0.01);与高效液相色谱法测定结果亦呈显著性相关(r=0.946,P<0.01);该方法批内变异CV=3.63%,批间变异CV=4.11%。结论负压微柱层析法有效提高了糖化血红蛋白HBA1c检测速度,其测定结果与原方法无显著差异,且改良所需成本低廉,可应用于临床实验室HBA1c的快速测定。 相似文献
973.
Johnston M Bonetti D Joice S Pollard B Morrison V Francis JJ Macwalter R 《Disability and rehabilitation》2007,29(14):1117-1127
Purpose. Disability following stroke is highly prevalent and is predicted by psychological variables such as control cognitions and emotions, in addition to clinical variables. This study evaluated the effectiveness of a workbook-based intervention, designed to change cognitions about control, in improving outcomes for patients and their carers.
Method. At discharge, stroke patients were randomly allocated (with their carers) to a 5-week intervention (n = 103) or control (normal care: n = 100). The main outcome (at 6 months) was recovery from disability using a performance measure, with distress and satisfaction as additional outcomes.
Results. The intervention group showed significantly better disability recovery, allowing for initial levels of disability, than those in the control group, F(1,201) = 5.61, p = 0.019. Groups did not differ in distress or satisfaction with care for patients or carers. The only psychological process variable improved by the intervention was Confidence in Recovery but this did not mediate the effects on recovery.
Conclusions. A large proportion of intervention participants did not complete the workbook tasks. This was perhaps associated with the fairly low level of personal contact with workbook providers. The modest success of this intervention suggests that it may be possible to develop effective behavioural interventions to enhance recovery from disability in stroke patients. 相似文献
Method. At discharge, stroke patients were randomly allocated (with their carers) to a 5-week intervention (n = 103) or control (normal care: n = 100). The main outcome (at 6 months) was recovery from disability using a performance measure, with distress and satisfaction as additional outcomes.
Results. The intervention group showed significantly better disability recovery, allowing for initial levels of disability, than those in the control group, F(1,201) = 5.61, p = 0.019. Groups did not differ in distress or satisfaction with care for patients or carers. The only psychological process variable improved by the intervention was Confidence in Recovery but this did not mediate the effects on recovery.
Conclusions. A large proportion of intervention participants did not complete the workbook tasks. This was perhaps associated with the fairly low level of personal contact with workbook providers. The modest success of this intervention suggests that it may be possible to develop effective behavioural interventions to enhance recovery from disability in stroke patients. 相似文献
974.
Sae Young Jae Sudhir Kurl Jari A. Laukkanen Eun Sun Yoon Yoon-Ho Choi Bo Fernhall 《Annals of medicine》2017,49(5):404-410
Background: We examined whether slow heart rate recovery (HRR) after exercise testing as an estimate of impaired autonomic function is related to coronary artery calcification (CAC), an emerging marker of coronary atherosclerosis.Methods: We evaluated 2088 men who participated in a health-screening program that included measures of CAC and peak or symptom-limited cardiopulmonary exercise testing. HRR was calculated as the difference between peak heart rate (HR) during exercise testing and the HR at 2?min of recovery after peak exercise. We measured CAC using multidetector computed tomography to calculate the Agatston coronary artery calcium score. Advanced CAC was defined as a mean CAC >75th percentile for each age group.Results: HRR was negatively correlated with CAC (r?=??.14, p?.01). After adjusting for conventional risk factors, participants in the lowest quartile of HRR (<38 bpm) were 1.59 times (95% CI: 1.17–2.18; p?.05) more likely to have advanced CAC than their counterparts in the highest quartile of HRR (>52 bpm). Each 1 bpm decrease in HRR was associated with 1% increase in advanced CAC after adjusting for potential confounders.Conclusions: An attenuated HRR after exercise testing is associated with advanced CAC, independent of coronary risk factors and other related hemodynamic response.
- KEY MESSAGES
Slow heart rate recovery (HRR) after maximal exercise testing, indicating decreased autonomic function, is associated with an increased risk of cardiovascular event and mortality.
Slow HRR has been linked with the occurrence of malignant ventricular arrhythmias, but it remains unclear whether slow HRR is associated with an increased risk of coronary artery calcification (CAC), an emerging marker of coronary atherosclerosis.
An attenuated HRR after exercise testing was associated with advanced CAC, independent of coronary risk factors and other potential hemodynamic confounder, supporting the hypothesis that slow HRR is related to the burden of atherosclerotic coronary artery disease.
975.
James F. Fraser Jonathan R. Danoff Jorge Manrique Michael J. Reynolds William J. Hozack 《The Journal of arthroplasty》2018,33(12):3624-3628
Background
As total hip arthroplasty (THA) gains popularity in ambulatory surgery centers, it is important to understand the causes of failed same-day discharge (SDD). The purpose of this study is to (1) identify reasons for an overnight stay among patients selected as candidates for SDD following THA and (2) determine what pre-operative factors are more common among patients who fail SDD.Methods
This is a prospective cohort study of patients undergoing THA who were identified as candidates for SDD (<75 years, ambulate without walker, American Society of Anesthesiologists score 1-3, body mass index <40 kg/m2, and agreed to SDD pre-operatively). The primary outcome was the reason for not discharging home on the same day of surgery. Secondary outcomes included the proportion of patients who failed SDD and any pre-operative patient characteristics that could be linked to failed SDD.Results
Seventy-eight of 106 (74%) patients pre-selected for SDD were successfully discharged per protocol. Of the 28 (26%) patients who failed SDD, the most common reasons for failure were patient preference (12), dizziness or hypotension (8), failure to clear physical therapy (5), urinary retention (2), and pain management (1). There was a higher percentage of patients in the failed SDD group who reported multiple allergies (P = .02), anxiety/depression (P = .24), obstructive sleep apnea (P = .38), and rheumatoid arthritis (P = .02).Conclusion
SDD is a viable option for surgeons interested in rapid recovery THA. In a pool of patients selected for SDD, the main cause of SDD failure was a change in patient preference post-operatively, despite having agreed to SDD pre-operatively and meeting all discharge criteria. 相似文献976.
Background
Enhanced recovery programs (ERP) improve post-operative outcomes in proportion to how fully they are implemented. Maintaining an optimal level of application of all the ER components is thus essential. Our aim was to assess the sustainability of ER surgical components 2 years after their first implementation.Method
Patients undergoing elective colorectal resections were included in a prospective database. To retrospectively analyze compliance with ERP over a period of 24 months, the following components were considered: colonic preparation, surgical approach, nasogastric tube omission and absence of abdominal drainage.Results
2565 patients with a mean age of 63.6 ± 14.4 years from 63 colorectal centers were included. There were 1853 (72.2%) colectomies and 558 (21.7%) rectal resections. The median duration of hospital stay was 5 days [Interquartiles 4–8]. Overall morbidity was 21.9%, surgical morbidity was 8.1%, including 2.8% anastomotic fistulae. Overall, the ERP component most often applied with was postoperative nasogastric tube omission (93.6%), followed by laparoscopic approach (81.7%), absence of drainage (74.9%), and colonic preparation omission (67.3%). Implementation of surgical components significantly decreased over time: less laparoscopy (from 86.8% to 76.6%, p < 0.001), less drain omission (from 88.7% to 72%, p < 0.001), less nasogastric tube omission (from 100% to 93.4%, p = 0.002) and less colonic preparation omission (from 73.6% to 65.6%, p = 0.01).Conclusion
This large-scale study found that implementation of surgical components in ERP decreased over time. Further efforts are needed to sustain compliance with ERP and surgical teams should focus on repeated audits. 相似文献977.
978.
979.
Resuscitation from cardiac arrest in cats: influence of epinephrine dosage on brain recovery 总被引:4,自引:0,他引:4
Bernd Schmitz Matthias Fischer Kurt Bockhorst Mathias Hoehn-Berlage Konstantin-Alexander Hossmann 《Resuscitation》1995,30(3):251-262
The quality of brain recovery after cardiac arrest depends crucially on the speed of cardiac resuscitation because the low cerebral perfusion pressure during the resuscitation procedure facilitates the development of no-reflow. To accelerate return of spontaneous circulation, high dose epinephrine has been recommended but the effect on the dynamics of early brain recovery is still unknown. We, therefore, studied the dynamics of brain resuscitation after cardiopulmonary resuscitation (CPR) with standard and high dose epinephrine using non-invasive NMR techniques. Fifteen min cardiac arrest was induced in normothermic cats by ventricular fibrillation. CPR was performed using an inflatable pneumatic vest for cyclic chest compression. With the beginning of CPR the standard dose group received 0.02 mg/kg epinephrine (n = 6) and the high dose group received 0.2 mg/kg (n = 8). Brain recovery was monitored by magnetic resonance imaging of the apparent diffusion coefficient (ADC) of water for 3 h. Although high dose epinephrine treatment led to a significantly higher blood pressure during early reperfusion, rapidly changing heterogeneities of early brain recovery were observed in both groups. High dose epinephrine thus does not improve the quality of post-cardiac arrest brain recovery during the first 3 h of reperfusion. 相似文献
980.
纳洛酮治疗促进丘脑出血患者运动语言功能的恢复 总被引:4,自引:4,他引:4
目的:探讨纳洛酮对丘脑部高血压脑出血患者运动、语言功能的促进恢复作用。方法:44例丘脑部高血压脑出血并破入脑室内患者随机分成纳洛酮组和对照组,纳洛酮组22例,每天持续静脉注射纳络酮4.8mg,同时每天从脑室引流管中分10次共注入纳洛酮4mg,连续应用10d。对照组除未用纳洛酮外,其他治疗方法皆同纳洛酮组。同时观测两组患者第1,3,7,10天的哥拉斯格昏迷评分(GCS),代表患者的意识状况,大脑中动脉(MCA)的血流速度,血液流变学变化,血糖浓度,应激性溃疡发生率,语言和运动功能评分,哥拉斯格结局评分(GOS)评分。结果:纳洛酮组的GCS评分于第7天12.12±3.05,第10天12.66±3.25明显高于对照组10.23±4.01,10.89±4.21(P<0.05);纳洛酮组第3~7天内的MCA的平均血流速度、平均全血黏稠度和红细胞变形指数皆低于对照组(P<0.05);随访2个月时的运动、语言功能评分和GOS评分纳洛酮组皆高于对照组(P<0.05);纳洛酮组第7,10的血糖浓度低于对照组较接近正常值,应激性溃疡的发病率也较对照组低。结论:早期、多途径、大剂量应用纳洛酮能有效保护脑神经功能,降低机体损伤后应激反应的程度,促进脑神经功能的恢复。 相似文献