全文获取类型
收费全文 | 4882篇 |
免费 | 418篇 |
国内免费 | 8篇 |
学科分类
医药卫生 | 5308篇 |
出版年
2023年 | 33篇 |
2022年 | 65篇 |
2021年 | 153篇 |
2020年 | 73篇 |
2019年 | 120篇 |
2018年 | 124篇 |
2017年 | 113篇 |
2016年 | 100篇 |
2015年 | 130篇 |
2014年 | 177篇 |
2013年 | 219篇 |
2012年 | 305篇 |
2011年 | 323篇 |
2010年 | 186篇 |
2009年 | 159篇 |
2008年 | 294篇 |
2007年 | 300篇 |
2006年 | 214篇 |
2005年 | 193篇 |
2004年 | 222篇 |
2003年 | 151篇 |
2002年 | 180篇 |
2001年 | 91篇 |
2000年 | 88篇 |
1999年 | 102篇 |
1998年 | 55篇 |
1997年 | 46篇 |
1996年 | 50篇 |
1995年 | 51篇 |
1994年 | 29篇 |
1993年 | 32篇 |
1992年 | 65篇 |
1991年 | 50篇 |
1990年 | 60篇 |
1989年 | 52篇 |
1988年 | 46篇 |
1987年 | 40篇 |
1986年 | 42篇 |
1985年 | 45篇 |
1984年 | 36篇 |
1983年 | 31篇 |
1982年 | 34篇 |
1981年 | 22篇 |
1980年 | 34篇 |
1979年 | 30篇 |
1978年 | 30篇 |
1977年 | 30篇 |
1976年 | 25篇 |
1974年 | 30篇 |
1973年 | 22篇 |
排序方式: 共有5308条查询结果,搜索用时 0 毫秒
1.
Anand Dayama Nikolaos Tsilimparis Stephen Kolakowski Nathaniel M. Matolo Misty D. Humphries 《Journal of vascular surgery》2019,69(1):156-163.e1
Background
Chronic limb-threatening ischemia (CLTI), defined as ischemic rest pain or tissue loss secondary to arterial insufficiency, is caused by multilevel arterial disease with frequent, severe infrageniculate disease. The rise in CLTI is in part the result of increasing worldwide prevalence of diabetes, renal insufficiency, and advanced aging of the population. The aim of this study was to compare a bypass-first with an endovascular-first revascularization strategy in patients with CLTI due to infrageniculate arterial disease.Methods
We reviewed the American College of Surgeons National Surgical Quality Improvement Program targeted lower extremity revascularization database from 2012 to 2015 to identify patients with CLTI and isolated infrageniculate arterial disease who underwent primary infrageniculate bypass or endovascular intervention. We excluded patients with a history of ipsilateral revascularization and proximal interventions. The end points were major adverse limb event (MALE), major adverse cardiovascular event (MACE), amputation at 30 days, reintervention, patency, and mortality. Multivariable logistic regression was used to determine the association of a bypass-first or an endovascular-first intervention with outcomes.Results
There were 1355 CLTI patients undergoing first-time revascularization to the infrageniculate arteries (821 endovascular-first revascularizations and 534 bypass-first revascularizations) identified. There was no significant difference in adjusted rate of 30-day MALE in the bypass-first vs endovascular-first revascularization cohort (9% vs 11.2%; odds ratio [OR], 0.73; 95% confidence interval [CI], 0.50-1.08). However, the incidence of transtibial or proximal amputation was lower in the bypass-first cohort (4.3% vs 7.4%; OR, 0.60; CI, 0.36-0.98). Patients with bypass-first revascularization had higher wound complication rates (9.7% vs 3.7%; OR, 2.75; CI, 1.71-4.42) compared with patients in the endovascular-first cohort. Compared with the endovascular-first cohort, the incidence of 30-day MACE was significantly higher in bypass-first patients (6.9% vs 2.6%; adjusted OR, 3.88; CI, 2.18-6.88), and 30-day mortality rates were 3.23% vs 1.8% (adjusted OR, 2.77; CI, 1.26-6.11). There was no difference in 30-day untreated loss of patency, reintervention of treated arterial segment, readmissions, and reoperations between the two cohorts. In subgroup analysis after exclusion of dialysis patients, there was also no significant difference in MALE or amputation between the bypass-first and endovascular-first cohorts.Conclusions
CLTI patients with isolated infrageniculate arterial disease treated by a bypass-first approach have a significantly lower 30-day amputation. However, this benefit was not observed when dialysis patients were excluded. The bypass-first cohort had a higher incidence of MACE compared with an endovascular-first strategy. These results reaffirm the need for randomized controlled trials, such as the Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL-2) trial and Best Endovascular vs Best Surgical Therapy in Patients with Critical Limb Ischemia (BEST-CLI), to provide level 1 evidence for the role of endovascular-first vs bypass-first revascularization strategies in the treatment of this population of challenging patients. 相似文献2.
3.
Prostatitis accounts for almost 2 million office visits to urologists and primary care physicians. The label “prostatitis” refers to a diverse constellation of symptoms and disease processes. The diagnosis and treatment of this disorder present numerous challenges for the physician, including a lack of abnormal findings on physical examination, laboratory tests, and radiographic images. In this article, we offer a review of the current literature and recommendations for the evaluation and diagnosis of the patient presenting with prostatitis. 相似文献
4.
5.
MD Charles D. Hummer III MD PhD Richard H. Rothman MD William J. Hozack 《The Journal of arthroplasty》1995,10(6)
Catastrophic failure of two zirconia—ceramic modular femoral heads occurred, despite the theoretical improved toughness of zirconia—ceramic relative to alumina—ceramic. This experience led the authors to return to cobalt—chromium as the metal of choice for articulation against polyethylene in total hip arthroplasty. 相似文献
6.
7.
8.
Robert A. Schnoll Ph.D. James Calvin B.A. Michael Malstrom B.S. Randi L. Rothman B.A. Hao Wang M.S. James Babb Ph.D. Suzanne M. Miller Ph.D. John A. Ridge M.D. Ph.D. Benjamin Movsas M.D. Corey Langer M.D. Michael Unger M.D. Melvyn Goldberg M.D. 《Annals of behavioral medicine》2003,25(3):214-221
Even though continued smoking by cancer patients adversely affects survival and quality of life, about one third of patients
who smoked prior to their diagnosis continue to smoke after their diagnosis. The implementation of smoking cessation treatments
for cancer patients has been slowed by the lack of data on correlates of tobacco use in this population. Thus, this longitudinal
study assessed demographic, medical, addiction, and psychological predictors of tobacco use among 74 head, neck, and lung
cancer patients. Multivariable binary logistic regression analyses, with outcome categorized as smoker or nonsmoker, indicated
that the likelihoodthat patients would be a smoker was associated with lower levels of perceived risk and a higher level of
quitting cons. Multivariable nominal logistic regression, with outcome classified as continuous smoker, continuous quitter,
relapser, or follow-up quitter, indicated that: (a) patients categorized as continuous smokers reported significantly lower
quitting self-efficacy than follow-up quitters and continuous quitters, (b) relapsers reported a significantly lower level
of quitting self-efficacy than either follow-up quitters or continuous quitters, and (c) continuous smokers exhibited a significantly
lower level of risk perceptions than continuous abstainers. These findings can be useful for the development and evaluation
of treatments to promote smoking cessation among cancer patients.
Support for this study was provided by National Institutes of Health Grants CA57708, CA06927, CA88610, CA95678, and CA76644. 相似文献
9.
10.