全文获取类型
收费全文 | 10708篇 |
免费 | 502篇 |
国内免费 | 253篇 |
专业分类
耳鼻咽喉 | 23篇 |
儿科学 | 192篇 |
妇产科学 | 29篇 |
基础医学 | 521篇 |
口腔科学 | 11篇 |
临床医学 | 1240篇 |
内科学 | 1757篇 |
皮肤病学 | 8篇 |
神经病学 | 1724篇 |
特种医学 | 1120篇 |
外科学 | 2853篇 |
综合类 | 1269篇 |
预防医学 | 196篇 |
眼科学 | 61篇 |
药学 | 328篇 |
4篇 | |
中国医学 | 41篇 |
肿瘤学 | 86篇 |
出版年
2024年 | 16篇 |
2023年 | 173篇 |
2022年 | 342篇 |
2021年 | 474篇 |
2020年 | 435篇 |
2019年 | 369篇 |
2018年 | 273篇 |
2017年 | 285篇 |
2016年 | 277篇 |
2015年 | 372篇 |
2014年 | 602篇 |
2013年 | 691篇 |
2012年 | 522篇 |
2011年 | 636篇 |
2010年 | 511篇 |
2009年 | 537篇 |
2008年 | 607篇 |
2007年 | 499篇 |
2006年 | 518篇 |
2005年 | 439篇 |
2004年 | 411篇 |
2003年 | 312篇 |
2002年 | 263篇 |
2001年 | 232篇 |
2000年 | 172篇 |
1999年 | 132篇 |
1998年 | 140篇 |
1997年 | 129篇 |
1996年 | 123篇 |
1995年 | 96篇 |
1994年 | 94篇 |
1993年 | 79篇 |
1992年 | 86篇 |
1991年 | 74篇 |
1990年 | 68篇 |
1989年 | 51篇 |
1988年 | 42篇 |
1987年 | 52篇 |
1986年 | 39篇 |
1985年 | 45篇 |
1984年 | 51篇 |
1983年 | 27篇 |
1982年 | 40篇 |
1981年 | 44篇 |
1980年 | 19篇 |
1979年 | 21篇 |
1978年 | 15篇 |
1977年 | 5篇 |
1976年 | 8篇 |
1973年 | 4篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
1.
2.
3.
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4.
《The surgeon》2015,13(5):286-291
BackgroundCure of aneurysms which involve the aorta at the level of the visceral arteries and the thoracoabdominal segment remains a considerable surgical enterprise with a relatively high mortality and morbidity despite improvements of the surgical procedure and anesthetic technique. Fenestrated and branched endovascular stent grafts are currently available offering an attractive less invasive option especially for most frail patients. These grafts are relatively recent, technically more demanding to insert than the current stent graft for infrarenal aneurysm and besides, given the relative low frequency of the disease, they are much less used by practitioners. Thus, unconditional widespread of this sophisticated technique may not necessarily benefit patients.MethodsWe reviewed our experiences and articles regarding this concern, 1) who should perform this new technique and 2) in what kind of setting.ConclusionBased on the combined complexities of 1) patients selection, 2) proper planning and manufacturing of the graft, 3) the need for outstanding imaging and operating facilities, 4) and the required endovascular skill of physicians involved in the procedure, we feel that only highly specialized centers should be allowed to perform this complex procedure. 相似文献
5.
6.
目的探讨应用电解可脱性弹簧圈(GDC)栓塞治疗颅内动脉瘤的临床效果。方法2002年6月-2004年6月我们采用GDC栓塞颅内动脉瘤126例(其中4例有2个动脉瘤,共130个)。前交通动脉瘤42个,后交通动脉瘤53个,颈内动脉瘤6个,大脑中动脉瘤10个,大脑后动脉瘤8个,大脑前动脉瘤6个,小脑后下动脉瘤2个;基底动脉瘤3个。按Hunt-Hess分级:Ⅰ级38例,Ⅱ级54例,Ⅲ级23例,Ⅳ级11例。必要时辅以篮筐技术、重塑技术、支架技术、双微导管或连环技术、蚕食技术。结果成功栓塞126例动脉瘤,其中103例为100%栓塞,21例为95%,2例为90%。12例在栓塞后6~18个月进行造影随访,所栓塞动脉瘤均未见复发征象。结论GDC栓塞颅内动脉瘤是安全、有效和微创的治疗手段。联合运用多种栓塞技术有助于减少术后并发症,提高治愈率。 相似文献
7.
D.A. Legemate P.M. Bossuyt 《European journal of vascular and endovascular surgery》2006,32(6):620-623
There is insufficient evidence that the surgical treatment of asymptomatic infrarenal aneurysms > 5.5 cm. is beneficial to patients. This is the result of serious complications of aneurysm surgery and the dearth of information from randomized trials. Based on evidence from the literature we defined scenarios and translated data into natural frequency trees to improve understanding of the uncertainty of help versus harm due to treatment of aneurysms. Our analysis shows that the majority of patients can expect little on longevity from surgery while they are at risk of dying from surgery or suffering from serious morbidity. We conclude that, as long as uncertainty persist, patients should be treated in hospitals that can show very low surgical mortality and major morbidity rates. To further resolve the problem of uncertainty randomized trials for larger aneurysms should be performed. Important issues to discuss are the lower and upper limits of the diameter of the aneurysms and the age and risk profiles of the patients to be included in such trials. 相似文献
8.
Mohammad-Reza Movahed John Vu Paul Lizotte 《Cardiovascular Revascularization Medicine》2006,7(4):250-254
We present a patient with a history of coronary artery disease and exertional angina after an acute anterior myocardial infarction. Angiography and ventriculography revealed multivessel coronary artery disease and a large apical aneurysm. Echocardiography and gated SPECT studies were performed for further evaluation of ischemia and assessment of left ventricular function. Gated SPECT and echocardiography failed to detect a large apical aneurysm due to a hyperdynamic left ventricular wall at the neck of the aneurysm. This case demonstrates the importance of using multiple imaging modalities in the evaluation of ventricular function in the setting of coronary artery disease. 相似文献
9.
本文报告113例脑前循环系统动脉管其中包括颈内动脉后交通动脉瘤75例.前交通动脉瘤17例,大脑中动脉瘤10例,人脑前动脉-胼周动脉瘤3例,颈内动脉-眼动脉瘤2例,颈内动脉海绵窦段动脉瘤1例.多发动脉瘤5例.共118个动脉瘤在显微镜下直视手术,动脉瘤直接夹闭术108例.孤立或包裹术5例:5例多发动脉瘤行同期手术3例,分期手术2例.术中发生动脉瘤破裂18次.Hunt和HessⅠ~Ⅱ级病人中有例行早期手术.全组术后死亡率为7.9%.着重讨论手术时机.术中动脉瘤破裂处理及多发动脉瘤的治疗. 相似文献
10.
目的总结和探讨脑血管造影和载瘤动脉闭塞在治疗颅内巨大动脉瘤上的作用及特点。方法60例颅内巨大动脉瘤患者,根据其脑血管造影的特点采取血管内介入方法[可脱式球囊和(或)弹簧圈]闭塞载瘤动脉近端53例、闭塞载瘤动脉两端后孤立动脉瘤7例;其中23例闭塞前先行颅内-外血管搭桥术。结果出院时Rankin评分分级:单纯血管内介入治疗组37例中轻残3例,合并颅内-外血管搭桥术组23例中死亡1例、重残2例。1-6年的影像学随访动脉瘤无复发。结论血管内介入结合颅内-外血管搭桥术闭塞载瘤动脉是治疗颅内巨大动脉瘤的方法之一。 相似文献