全文获取类型
收费全文 | 3121篇 |
免费 | 156篇 |
国内免费 | 19篇 |
专业分类
耳鼻咽喉 | 11篇 |
儿科学 | 38篇 |
妇产科学 | 31篇 |
基础医学 | 389篇 |
口腔科学 | 72篇 |
临床医学 | 265篇 |
内科学 | 537篇 |
皮肤病学 | 35篇 |
神经病学 | 197篇 |
特种医学 | 480篇 |
外科学 | 811篇 |
综合类 | 7篇 |
预防医学 | 65篇 |
眼科学 | 41篇 |
药学 | 94篇 |
中国医学 | 1篇 |
肿瘤学 | 222篇 |
出版年
2024年 | 8篇 |
2023年 | 62篇 |
2022年 | 104篇 |
2021年 | 166篇 |
2020年 | 80篇 |
2019年 | 103篇 |
2018年 | 140篇 |
2017年 | 101篇 |
2016年 | 123篇 |
2015年 | 116篇 |
2014年 | 144篇 |
2013年 | 165篇 |
2012年 | 259篇 |
2011年 | 240篇 |
2010年 | 130篇 |
2009年 | 107篇 |
2008年 | 163篇 |
2007年 | 169篇 |
2006年 | 126篇 |
2005年 | 102篇 |
2004年 | 80篇 |
2003年 | 75篇 |
2002年 | 95篇 |
2001年 | 20篇 |
2000年 | 14篇 |
1999年 | 11篇 |
1998年 | 17篇 |
1997年 | 11篇 |
1996年 | 17篇 |
1995年 | 9篇 |
1992年 | 12篇 |
1991年 | 12篇 |
1990年 | 10篇 |
1989年 | 8篇 |
1988年 | 7篇 |
1987年 | 14篇 |
1984年 | 13篇 |
1983年 | 14篇 |
1982年 | 8篇 |
1980年 | 17篇 |
1979年 | 15篇 |
1978年 | 9篇 |
1977年 | 9篇 |
1975年 | 7篇 |
1974年 | 8篇 |
1973年 | 8篇 |
1972年 | 8篇 |
1971年 | 11篇 |
1970年 | 6篇 |
1928年 | 6篇 |
排序方式: 共有3296条查询结果,搜索用时 15 毫秒
1.
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2.
3.
4.
Injuries to the heart and the intrathoracic vessels involve a high mortality rate. The outcome depends on the concomitant injuries sustained and the quality of primary care, and also on the options available in the care centre. Aetiology, incidence, diagnostic and therapeutic algorithms, and surgical approaches and methods, including endovascular repair of aortic ruptures, are described. At the Hanover Medical School 41 patients (39 male, 2 female) aged 8–83 (mean 38) years were treated for penetrating heart or vascular injuries from 1997 to 2004. The 30-day mortality was 9.8%. 相似文献
5.
Karl Lehner M.D. Maximilian Reiser Ulrich Gebhardt Andreas Heuck Jürgen Schaff 《Cardiovascular and interventional radiology》1987,10(2):71-74
In contrast to conventional film angiography, the perfusion pattern of hepatic arterial chemotherapy was consistently visualized
by DSA in 40 patients with implanted Infusaid pump or Port-A devices. Incomplete perfusion of a liver region by the cytotoxic
agent was recognized by DSA as accurately as by nuclide scintigraphy. Furthermore, DSA appeared to be more sensitive in determining
aberrantly perfused extrahepatic regions; this was especially true when there was a nonligated right hepatic artery. Specific
details of vascular lesions and associated complicating events also could be satisfactorily analyzed by DSA only. 相似文献
6.
7.
Richard Werner Karsten Alfke Tobias Schaeffter Arya Nabavi H Maximilian Mehdorn Olav Jansen 《Magnetic resonance in medicine》2004,52(6):1443-1447
A new method for the selective spin labeling of left- or right-sided supplying arteries of the brain without the need for additional RF coils is demonstrated. A clinical 1.5 T scanner was used. The spatial selectivity of the labeling process is based on the limited coverage of the excitation field of a standard send/receive head coil together with an oblique positioning of the labeling plane. A computer simulation was used to optimize key labeling parameters under the condition of laminar flow. The validity of the computer model results was confirmed by MRI measurements with a flow model. For human studies, a double-inversion continuous arterial spin labeling (CASL) sequence was modified to allow for arbitrary positioning of the labeling plane. The obtained perfusion-weighted images showed a clear delineation of the perfusion territories of the selected arteries in the anterior circulation of the brain and good gray/white matter contrast. 相似文献
8.
Th. Junginger W. Wahl H. Pichlmaier 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1989,374(3):175-180
Zusammenfassung An der Chirurgischen Klinik Köln-Lindenthal wurden zwischen 1968 and 1983 94 Patienten, an der Klinik and Poliklinik für Allgemein- and Abdominalchirurgie Mainz zwischen 1972 and 1986 74 Patienten wegen eines Magenfrühcarcinoms operiert. Überlebensraten und Rezidivverhalten wurden abhängig von der operativen Therapie untersucht. In beiden Kollektiven war die Prognose des Mucosacarcinoms unabhängig von der durchgeführten Therapie günstig. Beim Submucosacarcinom war nach radikalchirurgischem Vorgehen die Häufigkeit von Rezidiven geringer und die Überlebensraten signifikant günstiger als nach alleiniger 2/3-Resektion. Die Ergebnisse sprechen für die Notwendigkeit eines radikalchirurgischen Vorgehens mit Dissektion der N2-Lymphknoten zumindest beim Submucosacarcinom des Magens.
Surgical treatment of early gastric carcinoma
Summary At the department of surgery at the university hospital in Cologne 94 patients suffering from early gastric cancer of the stomach were operated in the years between 1968 and 1983. From 1972 till 1987 the department of surgery at the university hospital Mainz has had 74 patients. Survival rates and times without recurrence were calculated dependent on the surgical treatment carried out. In both collectives the prognosis for the patients with mucosal carcinoma was good no matter which operation was carried out. In the case of submucosal infiltration the frequency of recurrence was smaller and the survival rates significantly higher in those patients who subjected to a cancer operation than in those on whom only a resection of two third of the stomach was performed. The results indicate a radical approach in the treatment of early gastric cancer. At least in the case of submucosal carcinoma a dissection of the N2 lymph nodes is advisable.相似文献
9.
Grundmann R. Weber F. Pichlmaier H. 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1987,372(1):861-862
Zusammenfassung Über 52 Monate wurden 4747 allgemeinchirurgische Planeingriffe prospektiv erfasst. Postoperative Komplikationen (Wundinfektion, Pneumonie, Revision, Letalität) wurden mit einem Punktescore bewertet, der die konkrete Zahl der zu erwartenden Komplikationen auf 10 Operationen der gleichen Art wiedergibt. Der Wert einer solchen Erfassung des Komplikationsrisikos zeigte sich in Verlaufsuntersuchungen, bei denen die postoperativen Komplikationen im 4-Monatsrhythmus aufgetragen wurden: Ursachen von Komplikationen konnten erforscht und beseitigt werden. 相似文献
10.
Th. Junginger S. Walgenbach H. Pichlmaier 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》1989,374(6):323-328
Zusammenfassung Experimentelle Untersuchungen haben für den maschinellen Bronchusverschluß nach Lobektomie und Pneumonektomie im Vergleich zu anderen Nahtmaterialien die geringste Entzündungsrate und die höchste Zugfestigkeit ergeben. In einer konsekutiven Serie von 233 Lungenresektionen der Chirurgischen Kliniken Köln-Lindenthal und der Klinik für Allgemein- und Abdominalchirurgie der Johannes Gutenberg-Universität Mainz ging die Häufigkeit einer Bronchus-stumpfinsuffizienz von 7,1% nach manuellem Bronchusverschluß auf 2,0% und die insuffizienzbedingte Letalität auf 0,7% bei Anwendung des Klammergeräts zurück. Die wesentlichen Vorteile des maschinellen Bronchusverschlusses sind die Einfachheit der Anwendung, die Schnelligkeit und die Gleichmäßigkeit des Verschlusses. Damit stellen die Klammernahtgeräte bei Lungenresektionen eine wertvolle Ergänzung der Operationstechnik dar.
Mechanical and manual bronchial closure —results of a consecutive trial
Summary After lobectomy and pneumonectomy in experimental evaluations stapled bronchial closures showed the lowest incidence of inflammatory reaction and the highest strength determined by leakage pressure compared with other suture material. A total of 233 lung resections - performed at Surgical University Clinic Köln-Lindenthal and the Clinic for General and Abdominal Surgery of the Johannes-Gutenberg-Universität Mainz — were reviewed. Mechanical stapling reduced the rate of bronchopleural fistulas to 2.0% compared with 7.1 % after manual suturing. In parallel, mortality related to bronchial stump leakage decreased to 0.7%. Main advantages of bronchial closure with staplers are the simplicity of their use, the speed and the uniformity of the closure. Thereby stapling devices are valuable completions in pulmonary surgery.相似文献