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目的:探讨降低喉返神经损伤的方法。方法:2005年9月-2007年1月共有375例甲状腺手术患者,对其喉返神经损伤进行分析。结果:375例病人中有5例喉返神经损伤,其中甲状腺腺瘤3例,桥本甲状腺炎1例,甲状腺癌1例,损伤后立即行喉镜检查示声带处于外展位。给予营养神经治疗,15 d-3个月后完全恢复,喉镜检查示声带正常。结论:喉返神经损伤可以预防,关键是术者应熟悉喉返神经的解剖结构和变异,熟悉其与周围组织及血管的关系,要有手术区域的组织结构特别是喉返神经走行的“立体影像”。 相似文献
93.
目的探讨老年骨髓炎患者围术期护理的体会及经验。方法对32例老年骨髓炎患者围术期护理经验进行分析和总结。结果全组32例患者通过手术治疗及合理护理措施均得到治愈,无褥疮、肺部及泌尿系感染等并发症发生。结论老年骨髓炎患者体质差,合并症多,护理需认真、细致,并且根据术前、术中、术后按不同病情制订个案护理计划,预防并发症,能有效地提高手术成功率。 相似文献
94.
目的探讨和分析应用锁骨钩钢板内固定配合康复治疗锁骨远端骨折的新方法。方法42例应用锁骨钩钢板配合术后早期康复治疗锁骨远端骨折的患者全部得到了随访,随访时间2~46个月(平均15.6个月),患者年龄36~57岁,平均45.6岁。术后2d患肩按照制定的康复训练方法进行功能训练,最终随访按Lazzcano评价标准〔1〕评价治疗结果。结果42例患者术后X线检查均达到满意复位与固定,局部Lazzcano功能评定关节功能恢复优良率97.6%。结论应用锁骨钩钢板治疗锁骨远端骨折手术操作简单,配合术后完善的康复治疗,可得到非常满意的结果。 相似文献
95.
Fady K. Baddoura Isam W. Nasr Barbara Wrobel Qi Li Nancy H. Ruddle Fadi G. Lakkis 《American journal of transplantation》2005,5(3):510-516
Lymphoid neogenesis is the process by which ectopic lymphoid accumulations that resemble lymph nodes arise in nonlymphoid tissues. Such lymphoid accumulations, known as tertiary lymphoid organs (TLO), are observed in chronic autoimmunity and they propagate immune pathology by setting up local antigen presenting sites. Whether lymphoid neogenesis occurs in transplanted organs and contributes to rejection is not well understood. To begin to address this question, we retrospectively analyzed 319 murine cardiac allografts for microscopic evidence of lymph-node-like structures. We found 78 allografts that had either classical TLO, characterized by discrete T- and B-cell zones and high endothelial venules (HEV) expressing peripheral node addressin (PNAd) (n = 34), or PNAd(+) HEV without organized lymphoid accumulations (n = 44). These changes were present in both short- and long-lived allografts and were invariably associated with rejection. Importantly, they occurred in 78% of allografts undergoing chronic rejection (n = 85) but in only 7% of allografts undergoing primarily acute rejection (n = 184). These findings indicate that, like autoimmunity, alloimmunity is associated with lymphoid neogenesis in the target organ and suggest a role for local T-cell activation in chronic allograft rejection. 相似文献
96.
Tori Smedal Hildegunn Lygren Kjell‐Morten Myhr Rolf Moe‐Nilssen Bente Gjelsvik Olav Gjelsvik Liv Inger Strand 《Physiotherapy research international》2006,11(2):104-116
Background and Purpose . Patients with multiple sclerosis (MS) tend to have movement difficulties, and the effect of physiotherapy for this group of patients has been subjected to limited systematic research. In the present study physiotherapy based on the Bobath concept, applied to MS patients with balance and gait problems, was evaluated. The ability of different functional tests to demonstrate change was evaluated. Method . A single‐subject experimental study design with ABAA phases was used, and two patients with relapsing–remitting MS in stable phase were treated. Tests were performed 12 times, three at each phase: A (at baseline); B (during treatment); A (immediately after treatment); and A (after two months). The key feature of treatment was facilitation of postural activity and selective control of movement. Several performance and self‐report measures and interviews were used. Results . After intervention, improved balance was shown by the Berg Balance Scale (BBS) in both patients, and improved quality of gait was indicated by the Rivermead Visual Gait Assessment (RVGA). The patients also reported improved balance and gait function in the interviews and scored their condition as ‘much improved’. Gait parameters, recorded by an electronic walkway, changed, but differently in the two patients. Among the physical performance tests the BBS and the RVGA demonstrated the highest change, while no or minimal change was demonstrated by the Rivermead Mobility Index (RMI) and Ratings of Perceived Exertion (RPE). Conclusion . The findings indicate that balance and gait can be improved after physiotherapy based on the Bobath concept, but this should be further evaluated in larger controlled trials of patients with MS. Copyright © 2006 John Wiley & Sons, Ltd. 相似文献
97.
Augmentation technique with semitendinosus and gracilis tendons in chronic partial lesions of the ACL: clinical and arthrometric analysis 总被引:1,自引:0,他引:1
Roberto Buda Alberto Ferruzzi Francesca Vannini Lisa Zambelli Francesco Di Caprio 《Knee surgery, sports traumatology, arthroscopy》2006,14(11):1101-1107
Most of the techniques described in the literature for the repair of chronic partial ACL tears, don’t spare the intact portion of the ligament. The aim of this study was to perform a prospective analysis of the results of augmentation surgery using gracilis and semitendinosus tendons to treat partial sub-acute lesions of the ACL. This technique involves an “over the top” femoral passage, which enables salvage and strengthening of the intact portion of the ACL. The study included 47 patients treated consecutively at our institute from 1993 to 1998, with a mean injury-surgery interval of 18 weeks (range 12–36). The patients were followed up by clinical and instrumental assessment criteria at 3 months, 1 and 5 years after surgery. Clinical assessment was performed using the IKDC form. Subjective and functional parameters were assessed by the Tegner activity scale. Instrumental evaluation was done using the KT-2000 instrument: the 30-pound passive test and the manual maximum displacement test were performed. We obtained good or excellent results in 95.7% of cases. No recurrences in ligamentous laxity were observed. We believe that the described technique has the advantage of being compatible with ACL anatomy, and enables very rapid functional recovery. 相似文献
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