全文获取类型
收费全文 | 36325篇 |
免费 | 2218篇 |
国内免费 | 874篇 |
学科分类
医药卫生 | 39417篇 |
出版年
2024年 | 98篇 |
2023年 | 854篇 |
2022年 | 1669篇 |
2021年 | 2193篇 |
2020年 | 2146篇 |
2019年 | 1779篇 |
2018年 | 1726篇 |
2017年 | 1555篇 |
2016年 | 1273篇 |
2015年 | 1223篇 |
2014年 | 2766篇 |
2013年 | 2679篇 |
2012年 | 2045篇 |
2011年 | 2304篇 |
2010年 | 1782篇 |
2009年 | 1691篇 |
2008年 | 1579篇 |
2007年 | 1606篇 |
2006年 | 1309篇 |
2005年 | 1089篇 |
2004年 | 926篇 |
2003年 | 748篇 |
2002年 | 612篇 |
2001年 | 503篇 |
2000年 | 460篇 |
1999年 | 366篇 |
1998年 | 324篇 |
1997年 | 259篇 |
1996年 | 229篇 |
1995年 | 211篇 |
1994年 | 159篇 |
1993年 | 140篇 |
1992年 | 142篇 |
1991年 | 101篇 |
1990年 | 80篇 |
1989年 | 73篇 |
1988年 | 92篇 |
1987年 | 83篇 |
1986年 | 55篇 |
1985年 | 63篇 |
1984年 | 62篇 |
1983年 | 73篇 |
1982年 | 62篇 |
1981年 | 49篇 |
1980年 | 40篇 |
1979年 | 39篇 |
1978年 | 20篇 |
1977年 | 19篇 |
1976年 | 15篇 |
1975年 | 22篇 |
排序方式: 共有10000条查询结果,搜索用时 0 毫秒
31.
完全性肺静脉异位引流的手术治疗经验 总被引:15,自引:1,他引:14
为评估影响完全性肺静脉异位引流(TAPVD)手术纠治的因素,本组纳入了28例在中度低温体外循环和15例在深低温停循环下手术纠治者。结果手术死亡4例,死亡率9.3%。随访32例,2例肺静脉回流梗阻分别于术后5个月和2年3个月死亡。结论认为,TAPVD必须早期手术防止肺血管阻塞性病变;术后定期随访;改进手术方法,防止心房内补片粘连所致肺静脉回流梗阻。 相似文献
32.
33.
34.
Gabriel Mircescu Dimitrie Capsa Maria Covic Mirela Gherman Caprioara Gheorghe Gluhovschi Ovidiu Golea Nicolae Ursea Liliana Garneata Vasile Cepoi Nicolae Constantinovici Adrian Covic 《Nephrology, dialysis, transplantation》2004,19(12):2971-2980
INTRODUCTION. This report describes the current status of nephrology and renal replacement therapy (RRT) in Romania, a country with previously limited facilities, highlighting national changes in the European context. METHODS: Trends in RRT development were analysed in 2003, on a national basis, using the same questionnaires as in previous surveys (1991, 1995). Survival data and prognostic risk factors were calculated retrospectively from a large representative sample of 2284 patients starting RRT between January 1, 1995 and December 31, 2001 (44% of the total RRT population investigated). RESULTS: In 2003, RRT incidence [128 per million population (p.m.p.)] and prevalence (250 p.m.p.) were six and five times higher, respectively, than in 1995. The annual rate of increase in the stock of RRT patients (11%) was supported mainly by an exponential development of the continuous ambulatory peritoneal dialysis (CAPD) population (+600%), while the haemodialysis (HD) growth rate was stable (+33%) and renal transplantation made a marginal contribution. Renal care infrastructure followed the same trend: nephrology departments (+100%) and nephrologists (+205%). The characteristics of RRT incident patients changed accordingly to current European epidemiology (increasing age and prevalence of diabetes and nephroangiosclerosis). The estimated overall survival of RRT patients in Romania was 90.6% at 1 year [confidence interval (CI) 89.4-91.8] and 62.2% at 5 years (CI 59.4-65.0). Patients' survival was negatively influenced (Cox regression analysis) by age >65 years (P < 0.001), lack of pre-dialysis monitoring by a nephrologist [P = 0.01, hazards ratio (HR) = 0.8], severe anaemia, lack of erythropoetin treatment (P < 0.001, HR = 0.6), and co-morbidity, e.g. cardiovascular diseases (P < 0.001, HR = 1.8) and diabetes mellitus (P < 0.001, HR = 2.2). CONCLUSIONS: Although the rate of increase in RRT patient stock in 1996-2003 in Romania was the highest in Europe, the prevalence remained below the European mean. As CAPD had the greatest expansion, followed by HD, an effective transplantation programme must be set up to overcome the imbalance. The quality of RRT appears to be good and survival was similar to that in other registries. Further evolution implies strategies of prevention, based on national surveys, supported by the Romanian Renal Registry. 相似文献
35.
36.
Summary A randomised, comparative study is reported of single intravenous doses of cephradine 2 g or cefuroxime 1.5 g given as prophylactic cover for total hip replacements in 40 patients. The serum and bone levels of cephalosporin achieved were higher in the cephradine treated group in proportion to the higher dose employed. Both agents provided adequate bone levels on average, cephradine 25.34 mcg/g, cefuroxime 17.39 mcg/g, although bone penetration was more variable with cefuroxime.
Résumé Dans cette étude comparative randomisée, 40 patients ont reçu une dose intraveineuse unique de 2 g de céphradine ou de 1,5 g de céfuroxime en tant que couverture prophylactique d'arthroplastie totale de hanche. Les concentrations sériques et osseuses de céphalosporine ont été plus élevées dans le groupe traité par la céphradine, en rapport avec l'utilisation d'une dose plus importante. Des concentrations osseuses adéquates ont été obtenues en moyenne avec les deux produits (25,34 mcg/g avec la céphradine et 17,39 mcg/g avec le céfuroxime) bien que la pénétration osseuse ait été plus variable avec le céfuroxime.相似文献
37.
38.
U. Böhling H. Schamberger U. Grittner J. Scholz 《Journal of orthopaedics and traumatology》2005,6(2):69-75
Abstract The objective of the study was to evaluate the precision, concordance, practicability and the early clinical outcome of the use of a computerised navigation system in a comparative study with a group of 100 patients. Two groups of 50 patients each underwent implantation of a bicondylar knee prosthesis either by means of the freehand navigation system or by means of technical instrumentation. We found that the computerised navigation system provided a higher precision than the technically instrumented implantation: 94% of the prostheses implanted with the navigation system have an alignment within a range of -3° to 3° on of the Mikulicz line. Only 46% of the patients operated by means of the technical instrumentation reached this aspired result. Furthermore, the navigation system showed smaller ranges in the deviation of the aspired alignment. The radiological and computer-modeled alignment values differed both pre- and postoperatively, but to a larger extent before surgery. The varus or valgus deviations of the axis were more distinct radiologically under the weight of the patient’s body than in the computer model. The clinical outcome examined by the use of the HSS score after a mean followup of 7 months is good in both groups, and without significant differences. On average, the duration of surgery was 13 minutes longer in the computerised navigation group. We conclude that the benefit of the computerised navigation system is represented by the high improvement of precision. Achieving early clinical results identical to those in the technical instrumentation group, we expect a reduction of aseptic loosening in the computerised navigation group. 相似文献
39.
The patella and tibial condyle position after combined and after closing wedge high tibial osteotomy
Miklós Papp Zoltán Csernátony Sándor Kazai Zoltán Károlyi László Róde 《Knee surgery, sports traumatology, arthroscopy》2007,15(6):769-780
High tibial osteotomy changes the patella and tibial condyle position, which makes the subsequent total knee replacement technically
demanding. From 1 January 1993 to 31 December 2000, combined osteotomy [After the first osteotomy made 2 cm distally to the
joint line, a bone wedge is removed based laterally. Its tip ends at the center of the tibial condyle (half bone wedge). The
distal part of the tibia is placed into the valgus position and the half bone wedge is placed into the gap opened medially.]
was performed on 103 knees and closing wedge osteotomy was performed on 47 consecutive knees. Eighty combined (group A) and
41 closing wedge (group B) osteotomy were studied. All knees were assessed radiologically before surgery, in the 10th postoperative
week, in the 12th postoperative month and at the time of the final follow-up (in group A—66.15 months, in group B—66.61 months).
We examined the change of the femorotibial angle, of the patellar height according to the method of Insall and Salvati, of
the tibial slope angle according to the method of Bonnin, of the tibial condylar offset according to the method of Yoshida
and of the distance between the lateral tibial plateau and the top of the fibular head. In group A and B, the recurrence of
the varus deformity was not noted and valgus alignment did not increase in any case. In group-A, the Insall–Salvati ratio
remained unchanged in 65% of knees. The tibial slope angle decreased in both groups. There was correlation between the change
of the tibial condylar offset and the angle of the correction in both groups. There was correlation between the change of
the distance between the lateral tibial plateau and the top of the fibular head. After combined osteotomy, the transposition
of the tibial condyle and the decrease of the distance between the lateral tibial plateau and the top of the fibular head
was less than after closing wedge osteotomy, although the average angle of correction was more after combined osteotomy (11.835°),
than after closing wedge osteotomy (9.465°). Theoretically, the recurrence of the varus deformity, the increase of the valgus
alignment and (in majority of cases) the shortening of the patellar tendon do not compromise the likelihood of successful
conversion to the subsequent total knee replacement, either after combined or after closing wedge osteotomy. The combined
osteotomy does not lead to considerable transposition of the tibial condyle and to considerable lateral tibial bone loss;
therefore, theoretically, the combined osteotomy does not impair the subsequent total knee replacement. 相似文献
40.
Diabetic control after total pancreatectomy 总被引:3,自引:0,他引:3
BACKGROUND: Diabetes after total pancreatectomy is commonly described as 'brittle' with most series reporting outcomes after resection for pancreatitis alone. The aim of this study was to determine glycaemic control in patients resected for benign and malignant disease. METHODS: A retrospective analysis of all patients undergoing total pancreatectomy (1989-2003) from a single institution was done. Data of diabetic control were obtained from case notes, general practitioners and telephonic consultation. Comparison was made against a matched type 1 diabetic population. RESULTS: Forty-seven patients with a median age of 59 years (range 17-85 years) and median follow-up of 50 months (range 5-136 months) were identified. Thirty-five underwent primary resection with 11 receiving completion procedures. Thirty were for malignancy (19 deceased) and 17 for benign/indeterminate histology (2 deceased). Thirty-three patients were available for detailed follow-up. There was no significant difference between median HbA(1c) of the study group and the control (8.2% versus 8.1%). The majority of patients reported diabetic control and daily performance as excellent or good. Resection for pancreatitis gave poorer subjective control (p < 0.05) than those resected for malignancy. Two patients required in-patient treatment for diabetic complications, with no deaths related to diabetes observed. CONCLUSION: Diabetes after total pancreatectomy is not necessarily associated with poor glycaemic control and in the majority results in equivalent biochemical control compared to a normal type 1 diabetic population. 相似文献