全文获取类型
收费全文 | 1944篇 |
免费 | 121篇 |
国内免费 | 8篇 |
专业分类
耳鼻咽喉 | 13篇 |
儿科学 | 119篇 |
妇产科学 | 59篇 |
基础医学 | 210篇 |
口腔科学 | 89篇 |
临床医学 | 157篇 |
内科学 | 380篇 |
皮肤病学 | 40篇 |
神经病学 | 99篇 |
特种医学 | 44篇 |
外科学 | 258篇 |
综合类 | 50篇 |
一般理论 | 4篇 |
预防医学 | 98篇 |
眼科学 | 116篇 |
药学 | 168篇 |
中国医学 | 11篇 |
肿瘤学 | 158篇 |
出版年
2024年 | 3篇 |
2023年 | 40篇 |
2022年 | 90篇 |
2021年 | 151篇 |
2020年 | 67篇 |
2019年 | 110篇 |
2018年 | 119篇 |
2017年 | 80篇 |
2016年 | 96篇 |
2015年 | 92篇 |
2014年 | 144篇 |
2013年 | 143篇 |
2012年 | 191篇 |
2011年 | 196篇 |
2010年 | 97篇 |
2009年 | 78篇 |
2008年 | 68篇 |
2007年 | 71篇 |
2006年 | 39篇 |
2005年 | 21篇 |
2004年 | 23篇 |
2003年 | 26篇 |
2002年 | 24篇 |
2001年 | 10篇 |
2000年 | 6篇 |
1999年 | 8篇 |
1998年 | 3篇 |
1997年 | 2篇 |
1996年 | 3篇 |
1995年 | 2篇 |
1994年 | 1篇 |
1993年 | 1篇 |
1992年 | 2篇 |
1991年 | 1篇 |
1990年 | 7篇 |
1989年 | 8篇 |
1988年 | 4篇 |
1987年 | 10篇 |
1986年 | 5篇 |
1985年 | 5篇 |
1984年 | 2篇 |
1983年 | 1篇 |
1982年 | 1篇 |
1981年 | 4篇 |
1979年 | 3篇 |
1978年 | 2篇 |
1977年 | 2篇 |
1975年 | 3篇 |
1974年 | 5篇 |
1972年 | 3篇 |
排序方式: 共有2073条查询结果,搜索用时 0 毫秒
1.
Stress Testing Versus CT Angiography in Patients With Diabetes and Suspected Coronary Artery Disease
Abhinav Sharma Adrian Coles Nishant K. Sekaran Neha J. Pagidipati Michael T. Lu Daniel B. Mark Kerry L. Lee Hussein R. Al-Khalidi Udo Hoffmann Pamela S. Douglas 《Journal of the American College of Cardiology》2019,73(8):893-902
Background
The optimal noninvasive test (NIT) for patients with diabetes and stable symptoms of coronary artery disease (CAD) is unknown.Objectives
The purpose of this study was to assess whether a diagnostic strategy based on coronary computed tomographic angiography (CTA) is superior to functional stress testing in reducing adverse cardiovascular (CV) outcomes (CV death or myocardial infarction [MI]) among symptomatic patients with diabetes.Methods
PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) was a randomized trial evaluating an initial strategy of CTA versus functional testing in stable outpatients with symptoms suggestive of CAD. The study compared CV outcomes in patients with diabetes (n = 1,908 [21%]) and without diabetes (n = 7,058 [79%]) based on their randomization to CTA or functional testing.Results
Patients with diabetes (vs. without) were similar in age (median 61 years vs. 60 years) and sex (female 54% vs. 52%) but had a greater burden of CV comorbidities. Patients with diabetes who underwent CTA had a lower risk of CV death/MI compared with functional stress testing (CTA: 1.1% [10 of 936] vs. stress testing: 2.6% [25 of 972]; adjusted hazard ratio: 0.38; 95% confidence interval: 0.18 to 0.79; p = 0.01). There was no significant difference in nondiabetic patients (CTA: 1.4% [50 of 3,564] vs. stress testing: 1.3% [45 of 3,494]; adjusted hazard ratio: 1.03; 95% confidence interval: 0.69 to 1.54; p = 0.887; interaction term for diabetes p value = 0.02).Conclusions
In diabetic patients presenting with stable chest pain, a CTA strategy resulted in fewer adverse CV outcomes than a functional testing strategy. CTA may be considered as the initial diagnostic strategy in this subgroup. (PROspective Multicenter Imaging Study for Evaluation of Chest Pain [PROMISE]; NCT01174550) 相似文献2.
3.
Sandeep Nijhawan Mukul Rastogi Ashish Joshi Atul Shende Manish Tandon Dinesh Singla Amit Mathur Subhash Nepalia Ramesh Roop Rai 《Digestive endoscopy》2007,19(2):80-82
Background: Ingestion of coins is a common clinical problem in children. Many of the coins are ferromagnetic and can be retrieved with the help of a magnet. We describe the use of a novel endoscopic accessory for removing ferromagnetic coins. Material and methods: Two magnet discs of 1.5 cm diameter were joined to a 200 cm steel wire of 0.75 mm thickness with a terminal 5 cm spring. A Teflon tube (160 cm, 7 F) was used along with this instrument as a sleeve. The use of this accessory was analyzed prospectively in subjects presenting with a history of coin ingestion. The time taken for removal of coins, complications during the procedure and failure rate was noted. Effect of the magnet on cardiac rhythm was also noted during the procedure. Results: A total of 55 children (mean age 5.1 ± 2.3 years) with coin ingestion presented over a period of 1 year. Forty‐four coins were ferromagnetic. All ferromagnetic coins were removed successfully. Mean time for removal was 68 ± 22 s. No complications were encountered. Conclusion: The novel magnetic instrument is precise, safe and quick for the removal of ferromagnetic coins under direct vision. 相似文献
4.
Postprostatectomy incontinence in men is a devastating condition impacting the quality of life profoundly. Various types of
male sling procedures have been introduced over the years. The bone-anchored male sling appears to be effective and safe in
intermediate-term follow-up. It is certainly more effective than collagen implant and may provide an alternative treatment
option in patients with mild to moderate incontinence. In the short term, other novel procedures seem promising. In spite
of new technology, the artificial urinary sphincter continues to provide high patient satisfaction and cure rates. 相似文献
5.
Anjali Ramaswamy Nina N. Brodsky Tomokazu S. Sumida Michela Comi Hiromitsu Asashima Kenneth B. Hoehn Ningshan Li Yunqing Liu Aagam Shah Neal G. Ravindra Jason Bishai Alamzeb Khan William Lau Brian Sellers Neha Bansal Pamela Guerrerio Avraham Unterman Victoria Habet Carrie L. Lucas 《Immunity》2021,54(5):1083-1095.e7
- Download : Download high-res image (177KB)
- Download : Download full-size image
6.
The restorative effect of naps on perceptual deterioration 总被引:4,自引:0,他引:4
Mednick SC Nakayama K Cantero JL Atienza M Levin AA Pathak N Stickgold R 《Nature neuroscience》2002,5(7):677-681
Human performance on visual texture discrimination tasks improves slowly (over days) in the absence of additional training. This 'slow learning' requires nocturnal sleep after training and is limited to the region of visual space in which training occurred. Here, we tested human subjects four times in one day and found that with repeated, within-day testing, perceptual thresholds actually increased progressively across the four test sessions. This performance deterioration was prevented either by shifting the target stimuli to an untrained region of visual space or by having the subjects take a mid-day nap between the second and third sessions. 相似文献
7.
Dhruva Sharma Ganapathy Subramaniam Neha Sharma 《Indian Journal of Thoracic and Cardiovascular Surgery》2021,37(3):323
Cardiac surgeries especially involving crux of the heart as performed in tetralogy of Fallot (TOF) and pulmonary stenosis are mainly responsible for junctional ectopic tachycardia (JET). Diversified antiarrhythmic agents have been used in an impressive way to treat JET but showed suboptimal efficacy and varied associated adverse effects. But, ivabradine has proved as final crusader for its treatment. We report our initial experience of 4 cases in last 6 months with ivabradine in the management of postoperative JET. Encouraged by various reports and our increasing experience with ivabradine in heart failure population, we have moved to ivabradine as the first drug of choice for postoperative JET. Bradycardia was the only significant adverse effect in our series. The availability of atrial and ventricular pacing wires or at least transvenous temporary pacing should be ensured before starting ivabradine. 相似文献
8.
Rohit R. Badia Solomon Woldu Hiten D. Patel Nirmish Singla Arnav Srivastava Joseph G. Cheaib Phillip M. Pierorazio Aditya Bagrodia 《Urologic oncology》2021,39(2):136.e19-136.e25
BackgroundThe American Joint Committee on Cancer 8th edition staging guidelines for testicular cancer established a 3 cm cutoff to subclassify stage T1 seminomas (<3 cm = pT1a and ≥3 cm = pT1b). The efficacy of this cutoff in predicting metastatic disease and impact on treatment patterns have not been studied.MethodsWe retrospectively reviewed patients with pT1 testicular seminoma in the National Cancer Database from 2004 to 2016. Receiver operating curves were used to determine the efficacy of the 3 cm tumor cutoff in identifying metastatic disease, and multivariable regression was used to compute the effect of tumor size on the rate of adjuvant therapy among Stage I patients.ResultsA total of 10,134 patients with pT1 seminoma were evaluated. The current size cutoff of 3 cm for subclassification did not exhibit high discrimination in identifying metastatic disease (area under receiver operating curve: 0.546). Surveillance has grown as the preferred treatment after orchiectomy ?32.1% in 2004 to 81.2% in 2015. However, the rate of adjuvant therapy for pT1, Stage I seminomas associated positively with tumor size even with adjustment for year of diagnosis. For tumors above 3 cm, the odds ratio stabilized around 1.9. By using the 3 cm cutoff to guide adjuvant therapy, up to 85% of T1b patients may be overtreated.ConclusionThe 3 cm cutoff for subclassification of Stage I seminoma does not predict metastatic recurrence but is associated with increased receipt of adjuvant therapy. A 3 cm cutoff and the pT1a/b classification may therefore contribute to overtreatment in many young patients with a long life expectancy for whom minimizing adverse effects should be prioritized. 相似文献
9.
Elizabeth Zanley Neha D. Shah Colleen Craig James N. Lau Homero Rivas Tracey McLaughlin 《Surgery for obesity and related diseases》2021,17(2):456-465
BackgroundPostbariatric hypoglycemia (PBH) affects up to 38% of Roux-en-Y gastric bypass (RYGB) patients. Severe cases are refractory to diet and medications. Surgical treatments including bypass reversal and pancreatectomy are highly morbid and hypoglycemia often recurs. We have developed a highly effective method of treatment by which enteral nutrition administered through a gastrostomy (G) tube placed in the remnant stomach replaces oral diet: if done correctly this reverses hyperinsulinemia and hypoglycemia, yielding substantial health and quality of life benefits for severely affected patients.ObjectivesTo provide clinical guidelines for placement of a G-tube to treat postRYGB hypoglycemia, including candidate selection, preoperative evaluation, surgical considerations, and post-RYGB management.SettingStanford University Hospital and Clinics.MethodsBased on our relatively large experience with placing and managing G-tubes for PBH treatment, an interdisciplinary task force developed guidelines for practitioners.ResultsA team approach (endocrinologist, dietitian, surgeon, psychologist) is recommended. Appropriate candidates have a history of RYGB, severe hypoglycemia refractory to medical-nutrition therapy, and significantly affected quality of life. Preoperative requirements include education and expectation setting, determination of initial enteral feeding program, and establishing service with a home enteral provider. Close postoperative follow-up is needed to ensure success and may require adjustments in formula and mode/rate of delivery to optimize tolerance and meet nutritional goals. G-tube nutrition must fully replace oral nutrition to prevent hypoglycemia.ConclusionsG-tube placement in the remnant stomach represents a relatively well-tolerated and effective treatment for severe, refractory hypoglycemia after RYGB. 相似文献
10.
Akash Pramod Sali Priyal Motghare Munita Bal Neha Mittal Swapnil Rane Shubhada Kane Asawari Patil 《Head and neck pathology》2021,15(2):544
Parathyroid carcinoma (PC) is a rare malignancy that poses a diagnostic challenge on histologic examination. We analyzed various clinicopathologic features of PC. Pathology reports and slides were reviewed to evaluate the diagnostic histopathologic features of archived cases of PC from the years of 2004–2018. The study cohort comprised twenty cases of PC. The median age was 49 years (range 21–73 years) with equal gender distribution (M:F = 1:1). Most patients presented with symptoms of hypercalcemia (n = 7, 54%). Serum calcium and serum parathyroid hormone were elevated in all but one patient. The right inferior parathyroid was commonly involved (n = 8/14, 57%). The mean tumor size was 2.4 cm (range 0.8–3.5 cm). On frozen section examination, PC was diagnosed in 8 out of 9 cases. Vascular (n = 19/20, 95%) and soft tissue invasion (n = 10/20, 50%) were the most common characteristic histologic findings. Capsular invasion was identified in all cases. Perineural invasion or metastasis at presentation was absent in all cases. Other histological features noted were intratumoral fibrous bands (70%), nodular growth pattern (70%), moderate nuclear atypia (30%), prominent nucleoli (20%), and necrosis (20%). Regional lymph nodes were negative for metastatic disease in all cases (n = 10). Eight out of 16 patients received adjuvant radiotherapy. Follow-up was available in 16 cases (median 21.5 months). Two patients died of disease. Vascular and soft tissue invasion are the most common diagnostic histologic features of PC. Capsular invasion is important to distinguish PC from its benign counterparts. Intraoperative frozen section examination can be used for accurate diagnosis and surgical management. 相似文献