全文获取类型
收费全文 | 19593篇 |
免费 | 884篇 |
国内免费 | 364篇 |
专业分类
耳鼻咽喉 | 309篇 |
儿科学 | 953篇 |
妇产科学 | 513篇 |
基础医学 | 710篇 |
口腔科学 | 120篇 |
临床医学 | 2474篇 |
内科学 | 2304篇 |
皮肤病学 | 67篇 |
神经病学 | 509篇 |
特种医学 | 988篇 |
外国民族医学 | 1篇 |
外科学 | 5841篇 |
综合类 | 2487篇 |
预防医学 | 1199篇 |
眼科学 | 86篇 |
药学 | 1259篇 |
14篇 | |
中国医学 | 458篇 |
肿瘤学 | 549篇 |
出版年
2024年 | 22篇 |
2023年 | 250篇 |
2022年 | 570篇 |
2021年 | 714篇 |
2020年 | 624篇 |
2019年 | 595篇 |
2018年 | 581篇 |
2017年 | 544篇 |
2016年 | 579篇 |
2015年 | 670篇 |
2014年 | 1439篇 |
2013年 | 1216篇 |
2012年 | 1165篇 |
2011年 | 1325篇 |
2010年 | 974篇 |
2009年 | 1034篇 |
2008年 | 971篇 |
2007年 | 995篇 |
2006年 | 862篇 |
2005年 | 739篇 |
2004年 | 672篇 |
2003年 | 477篇 |
2002年 | 465篇 |
2001年 | 390篇 |
2000年 | 294篇 |
1999年 | 261篇 |
1998年 | 240篇 |
1997年 | 185篇 |
1996年 | 210篇 |
1995年 | 180篇 |
1994年 | 143篇 |
1993年 | 148篇 |
1992年 | 124篇 |
1991年 | 117篇 |
1990年 | 130篇 |
1989年 | 101篇 |
1988年 | 94篇 |
1987年 | 88篇 |
1986年 | 69篇 |
1985年 | 80篇 |
1984年 | 63篇 |
1983年 | 29篇 |
1982年 | 67篇 |
1981年 | 54篇 |
1980年 | 44篇 |
1979年 | 46篇 |
1978年 | 58篇 |
1977年 | 40篇 |
1976年 | 32篇 |
1975年 | 18篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
1.
2.
Susumu Shibasaki Koichi Suda Masaya Nakauchi Kenichi Nakamura Kenji Kikuchi Kazuki Inaba Ichiro Uyama 《World journal of gastroenterology : WJG》2020,26(11):1172-1184
BACKGROUND Minimally invasive surgery for gastric cancer(GC) has gained widespread use as a safe curative procedure especially for early GC.AIM To determine risk factors for postoperative complications after minimally invasive gastrectomy for GC.METHODS Between January 2009 and June 2019, 1716 consecutive patients were referred to our division for primary GC. Among them, 1401 patients who were diagnosed with both clinical and pathological Stage Ⅲ or lower GC and underwent robotic gastrectomy(RG) or laparoscopic gastrectomy(LG) were enrolled. Retrospective chart review and multivariate analysis were performed for identifying risk factors for postoperative morbidity.RESULTS Morbidity following minimally invasive gastrectomy was observed in 7.5% of the patients. Multivariate analyses demonstrated that non-robotic minimally invasive surgery, male gender, and an operative time of ≥ 360 min were significant independent risk factors for morbidity. Therefore, morbidity was compared between RG and LG. Accordingly, propensity-matched cohort analysis revealed that the RG group had significantly fewer intra-abdominal infectious complications than the LG group(2.5% vs 5.9%, respectively; P = 0.038), while no significant differences were noted for other local or systemic complications.Multivariate analyses of the propensity-matched cohort revealed that non-robotic minimally invasive surgery [odds ratio = 2.463(1.070–5.682); P = 0.034] was a significant independent risk factor for intra-abdominal infectious complications.CONCLUSION The findings showed that robotic surgery might improve short-term outcomes following minimally invasive radical gastrectomy by reducing intra-abdominal infectious complications. 相似文献
3.
目的观察膀胱肿瘤切除术后患者尿路感染发生情况与病原学特征,分析诱发尿路感染的危险因素,并提出合理且具备针对性的冲洗对策,为未来膀胱肿瘤切除术后尿路感染的预防提供合理参考。方法回顾性分析连云港市第一人民医院2016年1月-2019年1月接受经尿道膀胱肿瘤切除术治疗的451例膀胱肿瘤患者的临床资料,收集患者病例资料,全部患者术后均定期取尿液标本进行细菌培养,参照相关标准判定患者尿路感染情况,记录患者一般情况,包括一般人口学资料(性别、年龄、体质量、受教育程度等),同时记录患者糖尿病的疾病合并情况,将术后尿路感染可能的危险因素纳入初步分析,Logistic多因素回归分析膀胱肿瘤切除术后发生尿路感染的危险因素。结果451例膀胱肿瘤切除术患者术后第3天尿液中细菌培养阳性例数为80例,阳性率为17.74%,在使用抗菌药物后,患者尿液中细菌培养阳性率逐渐降低,各时点尿液细菌阳性培养率比较,差异有统计学意义(P<0.05);经多因素Logistic回归分析检验证实,高龄、血糖水平控制不佳、术前留置导尿管、多发肿瘤是膀胱肿瘤切除术后尿路感染的危险因素(OR>1,P<0.05);80例术后尿液细菌培养阳性患者共分离出87株菌株,其中革兰阴性菌66株占75.86%,革兰阳性球菌21株占24.14%。结论膀胱肿瘤切除术后患者有较高的尿路感染风险,革兰阴性菌是主要的感染病原菌,年龄、基础疾病、肿瘤位点、术前导尿管留置等是影响因素,这类患者应引起临床高度重视。 相似文献
4.
5.
目的采用图像融合技术获得T2WI与T2WI-FS的融合图像,评估其在肛瘘及肛周结构显示中的优势。
方法2016年6月至2018年6月,前瞻性选择中山大学附属第一医院29例肛瘘患者进行肛管磁共振(MR)检查,采用图像融合技术获取T2WI与T2WI-FS的融合图像T2WI-Fusion,利用Fisher score算法计算瘘管及肛门括约肌的组织间分辨力Fisher值、脂肪与肛门括约肌间的Fisher值,评估融合图像中瘘管及肛周结构的显示情况。采用改进的双刺激连续质量量表(DSCQS)对T2WI-FS、T2WI、增强3D-VIBE和T2WI-Fusion序列图像进行主观图像质量评价。
结果29例患者均成功获得T2WI与T2WI-FS的融合图像T2WI-Fusion。T2WI-Fusion、T2WI瘘管与括约肌间Fisher均值分别为6.46、3.31,T2WI-Fusion图像对瘘管的显示优于T2WI序列图像(P<0.001)。T2WI-Fusion、T2WI-FS脂肪与括约肌间Fisher均值分别为10.61、2.45,T2WI-Fusion图像对括约肌的显示优于T2WI-FS序列图像(P<0.001)。T2WI-Fusion对瘘管与括约肌的图像质量评价总评分均高于T2WI-FS、T2WI、增强3D-VIBE序列(P<0.001)。
结论MRI图像融合技术同时具备T2WI及T2WI-FS的优势,无需增加扫描序列及扫描时间,且操作简单,花费时间短,显著提高病变及肛周解剖结构的对比度和图像质量。 相似文献
6.
Comparative outcomes of vascular access in patients older than 70 years with end-stage renal disease
Deokbi Hwang Sujin Park Hyung-Kee Kim Seung Huh 《Journal of vascular surgery》2019,69(4):1196-1206.e5
Objective
The advantage of arteriovenous fistulas (AVFs) in older patients requiring dialysis is controversial. We reviewed our vascular access experience in patients ≥70 years of age (older group) compared with younger patients.Methods
We analyzed consecutive patients who underwent access surgery between 2013 and 2016. Primary success (PS) and primary patency (PP) data were analyzed between the older and younger groups before and after propensity score matching of the patients' characteristics and access composition. PS was defined as the achievement of access function that was amenable to two sessions of successful cannulation without early occlusion or maturation failure requiring revision. PP was defined as the time with uninterrupted patency without intervention.Results
A total of 594 consecutive accesses were created among 563 patients, of whom 119 were allocated into each group after propensity score matching. In the whole cohort, 193 accesses (32.5%) were performed in older patients. AVFs were performed in 130 (67.4%) older patients and 293 (73.1%) younger patients. Regarding AVFs, the PS rate (83.6% in the older group vs 94.3% in the younger group; P = .001) and the overall PP at 6 and 12 months (73.1% and 57.1%, respectively, in the older group vs 86.7% and 77.7%, respectively, in the younger group; P = .009) were lower in the older group than in the younger group. However, no differences were found in the PS and PP rates for arteriovenous grafts between groups. Regarding the AVF location, the PS rate for forearm AVFs was significantly lower in the older group than in the younger group (76% vs 93%; P < .001); however, the PS rate of the upper arm was not different between the groups (94% vs 97%; P = .425). In the patients with PS, the PP rate of AVFs was similar between the two groups. In the older group with forearm AVFs, the median diameter of the radial artery was larger in the patients with PS than in the patients without PS (2.20 mm with PS vs 2.00 mm without PS; P = .008). The propensity score matching results demonstrated similar trends for the whole cohort, with lower PS (P = .042) and PP rates (P = .023) for AVF in the older group.Conclusions
The outcomes after AVF were poorer in the older group than in the younger group, which was primarily due to unsatisfactory outcomes in patients with forearm AVFs. Thus, stricter criteria, especially regarding the radial artery diameter, should be applied for forearm AVFs in older patients, and additional research is necessary to delineate the risk factors for primary failure. 相似文献7.
8.
9.
10.
目的 分析CSTB、A-FABP在膀胱癌诊断和预后的意义。方法 选取2014年1月至2016年7月在本院进行手术、病理证实的膀胱癌患者45例、良性膀胱病变患者88例,检测膀胱癌样本癌组织、癌旁组织、良性膀胱病变组织中CSTB、A-FABP表达水平。评价CSTB、A-FABP在鉴别诊断膀胱癌的效用。对比膀胱癌进展对象(2年内转移、复发、肿瘤死亡)以及未进展对象组织中CSTB、A-FABP表达水平。结果 癌组织、癌旁组织、良性病变对象组织中CSTB、A-FABP表达水平差异有统计学意义(P<0.05)。CSTB、A-FABP作为诊断标准(任意一项为阳性),鉴别诊断膀胱癌与良性病变的灵敏度为84.4%、特异度为90.9%、阳性预测值82.6%、阴性预测值92.0%、符合率88.7%。2年内转移、复发、肿瘤死亡的患者共30例,无转移、复发、死亡的患者共15例,膀胱癌进展对象CSTB、A FABP表达量高于未进展对象,差异有统计学意义(P<0.05)。结论 CSTB、A-FABP在膀胱癌诊断、预后预测中均有一定的临床价值。 相似文献