全文获取类型
| 收费全文 | 2768113篇 |
| 免费 | 216344篇 |
| 国内免费 | 5012篇 |
专业分类
| 耳鼻咽喉 | 39801篇 |
| 儿科学 | 85684篇 |
| 妇产科学 | 73148篇 |
| 基础医学 | 400226篇 |
| 口腔科学 | 79087篇 |
| 临床医学 | 251662篇 |
| 内科学 | 535030篇 |
| 皮肤病学 | 57226篇 |
| 神经病学 | 226020篇 |
| 特种医学 | 109466篇 |
| 外国民族医学 | 936篇 |
| 外科学 | 418652篇 |
| 综合类 | 63240篇 |
| 现状与发展 | 1篇 |
| 一般理论 | 1098篇 |
| 预防医学 | 221472篇 |
| 眼科学 | 65886篇 |
| 药学 | 209070篇 |
| 4篇 | |
| 中国医学 | 5320篇 |
| 肿瘤学 | 146440篇 |
出版年
| 2018年 | 28193篇 |
| 2016年 | 23969篇 |
| 2015年 | 27049篇 |
| 2014年 | 38708篇 |
| 2013年 | 58624篇 |
| 2012年 | 79315篇 |
| 2011年 | 84192篇 |
| 2010年 | 49480篇 |
| 2009年 | 47166篇 |
| 2008年 | 79593篇 |
| 2007年 | 84778篇 |
| 2006年 | 85758篇 |
| 2005年 | 83473篇 |
| 2004年 | 80385篇 |
| 2003年 | 77369篇 |
| 2002年 | 76532篇 |
| 2001年 | 127487篇 |
| 2000年 | 132131篇 |
| 1999年 | 111237篇 |
| 1998年 | 31726篇 |
| 1997年 | 28660篇 |
| 1996年 | 28805篇 |
| 1995年 | 27633篇 |
| 1994年 | 25925篇 |
| 1993年 | 24308篇 |
| 1992年 | 89791篇 |
| 1991年 | 87751篇 |
| 1990年 | 85184篇 |
| 1989年 | 82256篇 |
| 1988年 | 76444篇 |
| 1987年 | 75285篇 |
| 1986年 | 71328篇 |
| 1985年 | 68009篇 |
| 1984年 | 51319篇 |
| 1983年 | 43824篇 |
| 1982年 | 26257篇 |
| 1981年 | 23405篇 |
| 1980年 | 22033篇 |
| 1979年 | 48560篇 |
| 1978年 | 34326篇 |
| 1977年 | 28870篇 |
| 1976年 | 27303篇 |
| 1975年 | 29164篇 |
| 1974年 | 35900篇 |
| 1973年 | 33876篇 |
| 1972年 | 32035篇 |
| 1971年 | 29750篇 |
| 1970年 | 27923篇 |
| 1969年 | 26075篇 |
| 1968年 | 23861篇 |
排序方式： 共有10000条查询结果，搜索用时 31 毫秒
1.
2.
Methicillin‐resistant Staphylococcus aureus eradication in young infants should include the diaper area and treat housing contacts 
下载免费PDF全文
下载免费PDF全文 3.
4.
M. R. D. Maslin S. K. Lloyd S. Rutherford S. Freeman A. King D. R. Moore K. J. Munro 《Journal of the Association for Research in Otolaryngology》2015,16(5):631-640
Individuals with sudden unilateral deafness offer a unique opportunity to study plasticity of the binaural auditory system in adult humans. Stimulation of the intact ear results in increased activity in the auditory cortex. However, there are no reports of changes at sub-cortical levels in humans. Therefore, the aim of the present study was to investigate changes in sub-cortical activity immediately before and after the onset of surgically induced unilateral deafness in adult humans. Click-evoked auditory brainstem responses (ABRs) to stimulation of the healthy ear were recorded from ten adults during the course of translabyrinthine surgery for the removal of a unilateral acoustic neuroma. This surgical technique always results in abrupt deafferentation of the affected ear. The results revealed a rapid (within minutes) reduction in latency of wave V (mean pre = 6.55 ms; mean post = 6.15 ms; p < 0.001). A latency reduction was also observed for wave III (mean pre = 4.40 ms; mean post = 4.13 ms; p < 0.001). These reductions in response latency are consistent with functional changes including disinhibition or/and more rapid intra-cellular signalling affecting binaurally sensitive neurons in the central auditory system. The results are highly relevant for improved understanding of putative physiological mechanisms underlying perceptual disorders such as tinnitus and hyperacusis. 相似文献
5.
6.
Ngai-Yin Chan Chi-Chung Choy Ho-Chuen Yuen Hoi-Fan Chow Ho-Fai Fong 《The Canadian journal of cardiology》2019,35(4):396-404
Background
Persistent iatrogenic atrial septal defect (iASD) is a common but poorly characterized complication after cryoballoon (CB) pulmonary vein isolation (PVI) procedures. We therefore investigate its prevalence, evolution, risk factors, and clinical outcomes in a prospective longitudinal study.Methods
A total of 108 patients (41 women, mean age 57 ± 11.3) underwent CB PVI for AF. Serial transesophageal echocardiography (TEE) was performed 9 months and then annually until 6 years after the procedure to study the characteristics of persistent iASD.Results
Persistent iASD occurred in 33 (30.6%) patients 9 months after CB PVI. Spontaneous closure of iASD was found in 6 (22.2%) and 3 (15.8%) patients 2 and 3 years after the procedures, respectively. No spontaneous closure was observed on 4, 5, and 6-year TEE follow-up. The projected long-term persistence rate of iASD after CB PVI was therefore 20% (30.6% × 0.778 × 0.842). Using multivariate logistic regression, a higher number of cryoapplications (≥ 2 minutes) was the only independent predictor of persistent iASD 9 months after CB PVI (odds ratio [OR] 1.207; 95% confidence interval [CI], 1.033-1.411, P = 0.018). Two (1.9%) patients with significantly larger iASD size than the others (long diameter 12.6 ± 0.8 vs 3.7 ± 1.5 mm, P < 0.001; short diameter 10.9 ± 0.2 vs 3 ± 1.1 mm, P < 0.001) required percutaneous closure because of exertional dyspnea and right ventricular enlargement. Over 129.7 patient-years follow-up, during which iASD persisted, there was no occurrence of neurologic events.Conclusions
Approximately one fifth of patients undergoing CB PVI will have permanently persistent iASD. Patients with defect sizes of greater than 10 mm may need percutaneous closure due to significant left-to-right shunting. 相似文献7.
Accuracy and Precision of Acetabular Component Placement With Imageless Navigation in Obese Patients
Leonard T. Buller Alexander S. McLawhorn Jose A. Romero Peter K. Sculco David J. Mayman 《The Journal of arthroplasty》2019,34(4):693-699
Background
Obesity is a risk factor for acetabular component malposition when total hip arthroplasty is performed with manual techniques. The utility of imageless navigation in obese patients remains unknown. This study compared the accuracy and precision of imageless navigation for component orientation between obese and nonobese patients.Methods
A total of 459 total hip arthroplasties performed for osteoarthritis using imageless navigation were reviewed from a single surgeon’s institutional review board–approved database. Einzel-Bild-Roentgen Analyse determined component orientation on 6-week postoperative anteroposterior radiographs. Mean orientation error (accuracy) and precision were compared between obese (body mass index ≥ 30 kg/m2) and nonobese patients. Regression analysis evaluated the influence of obesity on component position.Results
The difference in mean inclination and anteversion between obese and nonobese groups was 1.1° (43.0° ± 3.5°; range, 35.8°-57.8° vs 41.9° ± 4.4°; range, 33.0°-57.1° and 24.9° ± 6.3°; range, 14.2°-44.3° vs 23.8° ± 6.6°; range, 7.0°-38.6°, respectively). Inclination precision was better for nonobese patients. No difference in inclination accuracy or anteversion accuracy or precision was detected between groups. And 83% of components were placed within the target range. There was no relationship between obesity (dichotomized) and component placement outside the target ranges for inclination, anteversion, or both. As a continuous variable, increased body mass index correlated with higher odds of inclination outside the target zone (odds ratio, 1.06; P = .001).Conclusion
Using imageless navigation, inclination orientation was less precise for obese patients, but the observed difference is likely not clinically relevant. Accurate superficial registration of landmarks in obese patients is achievable, and the use of imageless navigation similarly improves acetabular component positioning in obese and nonobese patients.Level of Evidence
Therapeutic Level IV. 相似文献8.
Stephan Koter Tina U. Cohnert Korbinian B. Hindermayr Jörg Lindenmann Maximilian Brückner Wolfgang K. Oswald Georg Werkgartner Doris Wagner 《Journal of vascular surgery》2019,69(4):1227-1232
Objective
Low psoas muscle area is shown to be an indicator for worse postoperative outcome in patients undergoing vascular surgical. Additionally, it has been associated with longer durations of hospital stay in patients with cancer who undergo surgery and subsequently greater health care costs in Europe and the United States. We sought to evaluate this effect on hospital expenditure for patients undergoing vascular repair in a health care system with universal access.Methods
Skeletal muscle mass was assessed on preoperative abdominal computed tomography scans of patients undergoing open aortic aneurysm repair in a retrospective fashion. The skeletal muscle index (SMI) was used to define low muscle mass. Health care costs were obtained for all patients and the relationship between a low SMI and higher costs was explored using linear regression and cross-sectional analysis.Results
We included 156 patients (81.5% male) with a median age of 72 years undergoing elective surgery for infrarenal abdominal aortic aneurysm in this analysis. The median SMI for patients with low skeletal muscle mass was 53.21 cm2/kg and for patients without, 70.07 cm2/kg. Hospital duration of stay was 2 days longer in patients with low skeletal muscle mass as compared with patients with normal (14 days vs 11 days; P = .001), as was duration of intensive care stay (3 days vs 1 day; P = .01). The median overall hospital costs were €10,460 higher for patients with a low SMI as compared with patients with a normal physical constitution (€53,739 [interquartile range, €45,007-€62,471] vs €43,279 [interquartile range, €39,509-€47,049]; P = .001). After confounder adjustment, a low SMI was associated with a 14.68% cost increase in overall hospital costs, for a cost increase of €6521.Conclusions
Low skeletal muscle mass is independently associated with higher hospital as well as intensive care costs in patients undergoing elective aortic aneurysm repair. Strategies to reduce this risk factor are warranted for these patients. 相似文献9.
Julia H. Vermylen Gordon J. Wood Elaine R. Cohen Jeffrey H. Barsuk William C. McGaghie Diane B. Wayne 《Journal of pain and symptom management》2019,57(3):682-687
Introduction
Physician communication impacts patient outcomes. However, communication skills, especially around difficult conversations, remain suboptimal, and there is no clear way to determine the validity of entrustment decisions. The aims of this study were to 1) describe the development of a simulation-based mastery learning (SBML) curriculum for breaking bad news (BBN) conversation skills and 2) set a defensible minimum passing standard (MPS) to ensure uniform skill acquisition among learners.Innovation
An SBML BBN curriculum was developed for fourth-year medical students. An assessment tool was created to evaluate the acquisition of skills involved in a BBN conversation. Pilot testing was completed to confirm improvement in skill acquisition and set the MPS.Outcomes
A BBN assessment tool containing a 15-item checklist and six scaled items was developed. Students' checklist performance improved significantly at post-test compared to baseline (mean 65.33%, SD = 12.09% vs mean 88.67%, SD = 9.45%, P < 0.001). Students were also significantly more likely to have at least a score of 4 (on a five-point scale) for the six scaled questions at post-test. The MPS was set at 80%, requiring a score of 12 items on the checklist and at least 4 of 5 for each scaled item. Using the MPS, 30% of students would require additional training after post-testing.Comments
We developed a SBML curriculum with a comprehensive assessment of BBN skills and a defensible competency standard. Future efforts will expand the mastery model to larger cohorts and assess the impact of rigorous education on patient care outcomes. 相似文献10.
M. Iachina P.M. Ljungdalh R.G. Sørensen L. Kaerlev J. Blaakær O. Trosko N. Qvist B.M. Nørgård 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(2):115-123