全文获取类型
收费全文 | 20447篇 |
免费 | 993篇 |
国内免费 | 605篇 |
专业分类
耳鼻咽喉 | 36篇 |
儿科学 | 128篇 |
妇产科学 | 20篇 |
基础医学 | 1217篇 |
口腔科学 | 500篇 |
临床医学 | 1807篇 |
内科学 | 748篇 |
皮肤病学 | 11篇 |
神经病学 | 228篇 |
特种医学 | 1390篇 |
外科学 | 9729篇 |
综合类 | 3535篇 |
现状与发展 | 1篇 |
预防医学 | 596篇 |
眼科学 | 71篇 |
药学 | 1196篇 |
21篇 | |
中国医学 | 684篇 |
肿瘤学 | 127篇 |
出版年
2024年 | 57篇 |
2023年 | 274篇 |
2022年 | 625篇 |
2021年 | 814篇 |
2020年 | 758篇 |
2019年 | 601篇 |
2018年 | 573篇 |
2017年 | 710篇 |
2016年 | 804篇 |
2015年 | 751篇 |
2014年 | 1722篇 |
2013年 | 1677篇 |
2012年 | 1531篇 |
2011年 | 1591篇 |
2010年 | 1258篇 |
2009年 | 1266篇 |
2008年 | 985篇 |
2007年 | 958篇 |
2006年 | 924篇 |
2005年 | 823篇 |
2004年 | 626篇 |
2003年 | 483篇 |
2002年 | 376篇 |
2001年 | 310篇 |
2000年 | 267篇 |
1999年 | 194篇 |
1998年 | 158篇 |
1997年 | 122篇 |
1996年 | 78篇 |
1995年 | 66篇 |
1994年 | 75篇 |
1993年 | 68篇 |
1992年 | 53篇 |
1991年 | 46篇 |
1990年 | 36篇 |
1989年 | 32篇 |
1988年 | 47篇 |
1987年 | 32篇 |
1986年 | 20篇 |
1985年 | 28篇 |
1984年 | 23篇 |
1983年 | 24篇 |
1982年 | 36篇 |
1981年 | 32篇 |
1980年 | 26篇 |
1979年 | 17篇 |
1978年 | 20篇 |
1977年 | 13篇 |
1976年 | 15篇 |
1975年 | 15篇 |
排序方式: 共有10000条查询结果,搜索用时 10 毫秒
1.
2.
目的::研究股骨近端空心锁定板内固定治疗股骨颈骨折的临床效果。方法:对2008年2月至2010年4月我院入院治疗的108例股骨颈骨折患者进行了研究,随机分为两组,对照组给与空心钉进行治疗,观察组采用股骨近端空心锁定板内固定治疗,比较两组治疗方案的手术时间、出血量、住院时间以及下床时间,比较两组治疗方案的手术并发症发生率,并比较两组患者三年期临床疗效。结果:观察组患者手术出血量明显少于对照组,手术时间、住院时间以及下床时间明显短于对照组,两组比较差异明显,有统计学意义( P<0.05);两组患者手术并发症均以疼痛、骨不连以及感染为主,其中观察组上述并发症的发生率为13.0%,明显低于对照组33.3%,两组比较差异有统计学意义( P<0.05);观察组患者三年临床总有效率为79.6%,对照组患者三年期临床总有效率为51.9%,两组比较差异明显,有统计学意义( P<0.05)。结论:股骨近端空心锁定板内固定治疗股骨颈骨折临床效果显著,可以明显缩短手术时间以及住院时间,降低手术并发症,并且三年临床总有效率更高,值得临床推广应用。 相似文献
3.
文题释义:股骨头坏死中日友好医院分型的有限元分析:根据李子荣等提出的中日友好医院分型,建立股骨头坏死三维模型,分为 M型(内侧型)、C型(中央型)和 L型(外侧型),其中 L型包括L1型(次外侧型)、L2型(极外侧型)和 L3型(全头型)。通过对建立的模型进行有限元分析,为该分型的保髋治疗提供了一定力学依据,显示外侧柱的存留是精准预防塌陷的重要因素,为进一步实现个体化治疗提供力学基础。
腓骨支撑坏死股骨头保髋手术:是对于早中期股骨头坏死需要保留股骨头患者进行的一种手术方式。首先需对股骨头进行髓芯减压,清除一定坏死骨,空腔填塞松质骨(髂骨为主),打压结实后植入腓骨(异体或自体)支撑,给坏死区的提供力学支撑及生物学修复,预防股骨头进一步坏死及塌陷。
背景:研究报道股骨头坏死的保髋疗效与外侧柱存留密切相关,中日友好医院分型是根据三柱结构确立的,对股骨头塌陷的预测准确性高。
目的:建立股骨头坏死中日友好医院分型各分型仿真的三维有限元模型,通过有限元分析各分型腓骨植入的力学变化,探讨外侧柱存留对保髋疗效的意义,为该分型的塌陷精准预测提供基础。
方法:建立正常股骨头、中日友好医院分型(M型、C型、L1型、L2型、L3型)股骨头坏死及其腓骨植入3组11种三维有限元模型,运用ANSYS软件进行有限元分析计算,观察各组模型的最大应力值、最大位移值及股骨头内部载荷传递模式。
结果与结论:①坏死组位移最大,应变最大,且因坏死分型不同而位移不同,位移变化如下:M型相似文献
4.
《Journal of Clinical Orthopaedics and Trauma》2019,10(5):884-889
IntroductionAcetabulum fractures, though relatively uncommon, are associated with significant morbidity and mortality. These involve high energy trauma and due to their complex nature, the management requires understanding the relevant surgical anatomy, defining the injury via appropriate radiographic assessment and determining a suitable treatment plan. Literature is scarce for the demographic data, fracture patterns, associated injuries, management and early complications in the Indian scenario. These factors play a pivotal role in the ultimate recovery of the patients. Therefore this study was conceptualised to assess the epidemiology and evaluate the complications of these fractures. Furthermore the effects of various factors determining the quality of reduction in surgically treated patients were also assessed.MethodologyThis was a prospective observational study in which patients presenting to the advance trauma centre of our institute with acetabulum fractures were included. Demographical data of the patients, mechanisms of injuries, fractures morphologies, complications and radiological outcomes were recorded prospectively.Results116 patients with acetabular fractures were included in the study. 81% of these were males, with average age of 39.95 ± 15.87 years; with road traffic accidents being the predominant mode of injuries. Mortality was reported in 5 patients; 4 patients had deep venous thrombosis and sciatic nerve injuries were seen in 12 patients of which 4 were iatrogenic. 8 patients had some form of infection, out of which 4 required multiple debridements. 4 cases developed heterotrophic ossification while 2 cases had loss of reduction. The timing of surgery and other associated fractures had significant effect on the quality of reduction (p < 0.05); while age, gender, mode of injury or individual fracture patterns had no such effect.ConclusionsProper radiological assessment and evaluation of fracture configuration is important for management of acetabulum fractures. When indicated, this should be followed by early open reduction and internal fixation to achieve anatomical reduction, with management of associated injuries for better outcomes. 相似文献
5.
IntroductionDespite advancements in surgical techniques complications like implant failure is very common after the fixation of intertrochanteric fractures. Classifying these complex fractures based on plain radiographs underestimates the complexity of these fractures which in turn leads to complications. We propose a comprehensive classification of the intertrochanteric fractures based on 3D Non Contrast Computed Tomography (3D NCCT) scan.Material and methodsA total of 102 patients (51 males and 51 females) with intertrochanteric fractures were included in this study conducted over a time period of 22 months in a Tertiary care center in North India. NCCT proximal femur of the intertrochanteric fracture patients was done to formulate a new CT classification system and classify all fractures. Intra and inter-observer reliability was tested using kappa variance.ResultsNew classification system was proposed which included 3 main and a total of 6 groups. All the fractures were classifiable into the new system. Kappa variance of the study showed a good intra and interobserver reliability (0.95 and 0.90) proving clinical agreement of the classification.ConclusionThis new 3D-CT based classification has the advantages of being easy, comprehensible with high intra and inter-observer reliability. This 3DCT based classification can prove to be useful to detect occult intertrochanteric fractures undetectable in plain radiographs as well as choosing the optimum treatment plan. 相似文献
6.
《The Foot》2020
PurposeOptimum management of displaced intra-articular calcaneal fractures (DIACF) still controversial. Open surgery carries the risk of wound complications, while non-operative management has a high incidence of arthrosis. To avoid these complications, minimally invasive and percutaneous fixation was introduced. The purpose of this study was to prospectively evaluate the short term clinical and radiological outcomes after closed reduction and percutaneous fixation of DIACF using K-wires.Patients and methodsOutcomes of twenty patients were evaluated at the final follow up. A functional assessment using the AOFAS scoring system. Radiological parameters recorded included three angles (Böhler’s, Gissane and posterior facet inclination angles) and three distances (calcaneal length, height and width). Any complications were reported at any follow-up.ResultsThe mean patient’s age was 33 ± 15.2 years, 8 (40%) patients with type II fractures, 10 (50%) patients with type III fractures, and 2 (10%) with type IV fracture according to Sanders classification. After a mean follow-up of 9 months, the mean AOFAS score was 84, excellent in 9 patients (45%), good in 9 (45%), and fair in 2 (10%). At the final follow-up the Böhler’s angle, Gissane angle and PFIA was 25.1° ± (5.2), 119.9° ± (9.4) and 51.7° ± (5.9) respectively and the calcaneal height, length and width was 41.8 mm ± (2.1), 75.1 mm ± (3.01) and 40.9 mm ± (2.6) respectively. We had no cases of deep infection, 20% had significant subtalar arthritis.ConclusionThe closed reduction and percutaneous fixation technique for DIACF management offered acceptable clinical and radiographic outcomes, with fewer complications when compared to other management options. 相似文献
7.
目的研究续筋接骨方治疗骨折的临床疗效。方法选取2018年1月—2018年6月在辽宁中医药大学附属第三医院就诊的骨折患者60例,所有患者按照随机数字表法分为对照组与观察组,每组30例。观察组口服续筋接骨方联合正骨后小夹板固定治疗,对照组患者采用正骨后小夹板固定治疗。分析2组患者干预3个月后的血清骨代谢指标、骨密度、生活质量改善情况以及疗效判定。结果干预前,2组的血清Ⅰ型前胶原羧基端肽β特殊序列(β-CTX)、血清Ⅰ型前胶原氨端肽原(PINP)、骨特异性碱性磷酸酶(ALP)水平、钙、磷及骨密度比较,差异无统计学意义(P>0.05);干预后,2组的β-CTX、PINP、骨特异性ALP水平、钙、磷及骨密度较干预前改善,观察组的改善效果优于对照组,差异均有统计学意义(P<0.05)。干预前,2组的物质生活、社会功能、躯体健康以及心理健康评分比较,差异无统计学意义(P>0.05);干预后,2组的物质生活、社会功能、躯体健康以及心理健康评分较干预前升高,观察组的各项生活质量评分高于对照组,差异均有统计学意义(P<0.05)。观察组的治疗恢复率高于对照组,差异有统计学意义(P<0.05)。结论续筋接骨方可以改善骨折患者骨代谢功能及生活质量。 相似文献
8.
《Journal of Clinical Orthopaedics and Trauma》2021,12(6):976-982
ObjectiveMultiple treatment options for acetabular fractures in geriatric patients exist. However, no large-scale studies have reported the outcomes of acute total hip arthroplasty (THA) in this patient population. We systematically evaluated all available evidence to characterize clinical outcomes, complications, and revisions of acute THA for acetabular fractures in geriatric patients.MethodsMeta-analysis of 21 studies of 430 acetabular fractures with mean follow-up of 44 months (range, 17−97 months). Two independent researchers searched and evaluated the databases of Ovid, Embase, and United States National Library of Medicine using a Boolean search string up to December 2019. Population demographics and complications, including presence of heterotopic ossification (HO), dislocation, infection, revision rate, neurological deficits, and venous thromboembolic event (VTE), were recorded and analyzed.ResultsWeighted mean Harris Hip Score was 83.3 points, and 20% of the patients had reported complications. The most common complication was HO, with a rate of 19.5%. Brooker grade III and IV HO rates were lower at 6.8%. Hip dislocation occurred at a rate of 6.1%, 4.1% of patients developed VTE, deep infection occurred in 3.8%, and neurological complications occurred in 1.9%. Although the revision rate was described in most studies, we were unable to perform a survival analysis because the time to each revision was described in only a few studies. The revision rate was 4.3%.ConclusionsAcute THA is a viable option for treatment of acetabular fracture and can result in acceptable clinical outcomes and survivorship rates in older patients but with an associated complication rate of approximately 20%. Considering the limited treatment options, THA might be a viable alternative for appropriately selected patients. 相似文献
9.
前后挤压型骶骨Ⅱ区骨折与骶丛神经损伤的关系 总被引:1,自引:0,他引:1
目的 探讨前后挤压致骶骨Ⅱ区骨折造成骶丛神经损伤的机制。方法 经甲醛短期(1年内)浸泡固定的国人尸体6具,12侧。解剖保护骶丛神经,制成前后挤压型暴力致骶Ⅱ区骨折模型,定量测量不同骨折移位时骶丛神经被拉长的距离。另外,利用X线片观察骶从神经受压情况。结果 随耻骨联合分离逐渐增大,骶丛神经张应变呈直线相关逐渐加大,以S1,S4为最显著,且可造成神经的刺伤,多见于L5和S1,X线未发现骶丛神经受压表现。结论 前后挤压型暴力致骶骨Ⅱ区骨折神经损伤以牵拉伤为丰,以S1,S4为主,且与骨折移位程度成正相关关系。神经的刺伤,多见于骨折移位较大的L5和S1。 相似文献
10.