全文获取类型
收费全文 | 8053篇 |
免费 | 662篇 |
国内免费 | 23篇 |
专业分类
耳鼻咽喉 | 125篇 |
儿科学 | 329篇 |
妇产科学 | 156篇 |
基础医学 | 1024篇 |
口腔科学 | 67篇 |
临床医学 | 1297篇 |
内科学 | 1475篇 |
皮肤病学 | 183篇 |
神经病学 | 722篇 |
特种医学 | 132篇 |
外科学 | 925篇 |
综合类 | 177篇 |
一般理论 | 9篇 |
预防医学 | 864篇 |
眼科学 | 109篇 |
药学 | 502篇 |
中国医学 | 5篇 |
肿瘤学 | 637篇 |
出版年
2023年 | 62篇 |
2022年 | 50篇 |
2021年 | 223篇 |
2020年 | 99篇 |
2019年 | 207篇 |
2018年 | 245篇 |
2017年 | 168篇 |
2016年 | 191篇 |
2015年 | 200篇 |
2014年 | 262篇 |
2013年 | 421篇 |
2012年 | 564篇 |
2011年 | 589篇 |
2010年 | 298篇 |
2009年 | 270篇 |
2008年 | 463篇 |
2007年 | 485篇 |
2006年 | 442篇 |
2005年 | 503篇 |
2004年 | 439篇 |
2003年 | 437篇 |
2002年 | 362篇 |
2001年 | 131篇 |
2000年 | 115篇 |
1999年 | 113篇 |
1998年 | 83篇 |
1997年 | 71篇 |
1996年 | 56篇 |
1995年 | 72篇 |
1994年 | 53篇 |
1993年 | 41篇 |
1992年 | 81篇 |
1991年 | 65篇 |
1990年 | 69篇 |
1989年 | 50篇 |
1988年 | 50篇 |
1987年 | 47篇 |
1986年 | 44篇 |
1985年 | 46篇 |
1984年 | 33篇 |
1983年 | 26篇 |
1979年 | 23篇 |
1978年 | 23篇 |
1974年 | 26篇 |
1972年 | 22篇 |
1971年 | 22篇 |
1970年 | 29篇 |
1969年 | 30篇 |
1968年 | 23篇 |
1967年 | 26篇 |
排序方式: 共有8738条查询结果,搜索用时 31 毫秒
1.
2.
Pavan Brahmamdam Stephen L. Carveth Mary Smyth Brian S. Gendelman M. Jeffrey Maisels 《Journal of pediatric surgery》2019,54(9):1800-1803
PurposeTo examine what proportion of caregivers, if given a choice, would choose medical versus surgical treatment of appendicitis and what factors would be important in their decision.MethodsA survey was devised and given to the caregivers of children presenting to the pediatrician for a routine visit in community and academic pediatric clinics. The survey presented a summary of outcomes after medical (non-operative) and surgical treatment of uncomplicated appendicitis. Participants were then asked to choose medical versus surgical treatment if their child were to develop appendicitis. They were also asked to rate the importance of certain factors in their decision ? 1 being “not important” and 5 being “very important”.ResultsFour hundred surveys were distributed with an 86.2% (345/400) response rate. Six percent (21/342) of respondents reported a history of appendicitis and 49.4% (168/340) reported having known someone who had appendicitis. The majority of respondents, 85.3% (284/333), were mothers. A minority of respondents, 41.7% (95% CI: 36.7, 47.0), chose medical treatment over surgery for appendicitis. There was no statistical difference in the proportion of mothers (41.6%) versus fathers who chose medical treatment (41.3%). Caregivers who chose medical treatment were more likely to rate time in hospital (p = .008) and time out of school (p = 05) as important in decision making when compared with those who chose surgery. Those who chose surgical treatment were more likely to rate risk of recurrent appendicitis (p < .001) as important to decision making. In the multivariate analysis, those who rated time in hospital as very important had more than twice the odds of choosing medical therapy (OR 2.20, p = 0.02) when compared with those who rated it as less important. Not knowing someone who has had appendicitis was significantly associated with choosing medical therapy when compared with those who do know someone who has had appendicitis, OR 2.3, p = .002. Rating pain as very important was also significantly associated with choosing medical therapy, when compared to those rating pain 1–3, OR 3.38, p = .03.ConclusionsIn this survey of caregivers of children presenting for routine care, 41.7% would choose medical, or non-operative, therapy for their children with acute appendicitis. The risk of recurrence, time in hospital, and time out of school, pain, and knowing someone who has had appendicitis were all important factors that families may consider when making a decision. These data may be useful for surgeons counseling patients on which treatment to pursue. 相似文献
3.
4.
5.
Victoria A. Chang Dawn M. Meyer Brett C. Meyer 《Journal of stroke and cerebrovascular diseases》2019,28(1):163-166
Background
Acute stroke codes may be activated for anisocoria, but how often these codes lead to a final stroke diagnosis or alteplase treatment is unknown. The purpose of this study was to assess the frequency of anisocoria in stroke codes that ultimately resulted in alteplase administration.Methods
We retrospectively assessed consecutive alteplase-treated patients from a prospectively-collected stroke registry between February 2015 and July 2018. Based on the stroke code exam, patients were categorized as having isolated anisocoria [A+(only)], anisocoria with other findings [A+(other)], or no anisocoria [A?]. Baseline demographics, stroke severity, alteplase time metrics, and outcomes were also collected.Results
Ninety-six patients received alteplase during the study period. Of the 94 who met inclusion criteria, there were 0 cases of A+(only). There were 9 cases of A+(other) (9.6%). A+(other) exhibited higher baseline National Institutes of Health (NIH) Stroke Scale scores compared to A? (17 versus 7; P?=?.0003), and no additional differences in demographics or alteplase time metrics. Final stroke diagnosis and other outcome measures were no different between A+(other) and A?. Of the A+ patients without pre-existing anisocoria, 5 of 6 (83%) had posterior circulation events or diffuse subarachnoid hemorrhage.Conclusions
In this exploratory analysis, zero patients with isolated anisocoria received alteplase treatment. Anisocoria as a part of the neurologic presentation occurred in 10% of alteplase patients, and was strongly associated with a posterior circulation event. Therefore, we conclude that anisocoria has a higher likelihood of leading to alteplase treatment when identified in the presence of other neurologic deficits. 相似文献6.
Nirmanmoh Bhatia Buddhadeb Dawn Tariq S. Siddiqui Marcus F. Stoddard 《Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital》2015,42(1):16-24
Determining aortic stenosis (AS) severity is clinically important. Calculating aortic valve (AV) area by means of the continuity equation assumes a circular left ventricular outflow tract (LVOT). The full impact of this assumption in calculating AV area is unknown. Predictors of noncircular LVOT shape in patients with AS are undefined.In 109 adult patients with AS who underwent multiplanar transesophageal echocardiography, we calculated AV area by means of the standard continuity method and by a modified method involving planimetric LVOT area.We found 54 circular, 37 horizontal-oval, 8 vertical-oval, and 10 irregular LVOTs. Area derived by direct planimetry correlated better with the modified than the standard continuity method (r=0.89 vs r=0.85; both P=0.0001). Valve areas of patients with mild, moderate, or severe AS by planimetry were more often mischaracterized with use of the standard than modified method (29 vs 18; P <0.0001). Horizontal-oval AV area derived by planimetry (1.28 ± 0.55 cm2) was underestimated by the standard method (1.05 ± 0.47 cm2; P=0.001), but not by the modified method. Congenital AV morphology and low cardiac index were the only multivariate predictors of horizontal-oval shape. Low cardiac index was the only predictor of noncircular shape.More than half our patients with AS had noncircular LVOTs. Using the modified method reduces mischaracterizations of AS severity. Congenital AV morphology and low cardiac index predict horizontal-oval or noncircular shape. These data suggest the value of direct LVOT measurement to calculate AS severity in patients who have congenital AV or a low cardiac index. 相似文献
7.
8.
Dawn S. Milliner 《Acta paediatrica (Oslo, Norway : 1992)》2006,95(S452):27-30
Genetic disorders of mineral metabolism cause urolithiasis, renal disease, and osteodystrophy. Most are rare, such that the full spectrum of clinical expression is difficult to appreciate. Diagnosis is further complicated by overlap of clinical features. Dent's disease and primary hyperoxaluria, inherited causes of calcium urolithiasis, are both associated with nephrocalcinosis and urolithiasis in early childhood and renal failure that can occur at any age but is seen more often in adulthood. Bone disease is an inconsistent feature of each. Dent's disease is caused by mutations of the CLCN-5 gene with impaired kidney-specific CLC-5 chloride channel expression in the proximal tubule, thick ascending limb of Henle, and the collecting ducts. Resulting hypercalciuria and proximal tubule dysfunction, including phosphate wasting, are primarily responsible for the clinical manifestations. Low-molecular-weight proteinuria is characteristic. Definitive diagnosis is made by DNA mutation analysis. Primary hyperoxaluria, type I, is due to mutations of the AGXT gene leading to deficient hepatic alanine–glyoxylate aminotransferase activity. Marked overproduction of oxalate by hepatic cells results in the hyperoxaluria responsible for clinical features. Definitive diagnosis is by liver biopsy with measurement of enzyme activity, with DNA mutation analysis used increasingly as mutations and their frequency are defined.
These disorders of calcium urolithiasis illustrate the value of molecular medicine for diagnosis and the promise it provides for innovative and more effective future treatments. 相似文献
Conclusion
These disorders of calcium urolithiasis illustrate the value of molecular medicine for diagnosis and the promise it provides for innovative and more effective future treatments. 相似文献
9.
10.