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91.
Ran?HarelEmail authorView authors OrcID profile David?Schleifer Shmuel?Appel Moshe?Attia Zvi?R.?Cohen Nachshon?Knoller 《Neurosurgical review》2017,40(4):613-619
Nerve sheath tumors and meningiomas account for most intradural extramedullary (IDEM) tumors. These tumors are benign and amenable to complete surgical resection. In recent years, these surgeries are performed with intraoperative neurophysiologic monitoring (IONM) in order to minimize neurological injury, but the evidence for the statistical efficacy of this utility is lacking. This paper evaluates IONM benefits in IDEM tumor resection. Data of patients treated surgically for spinal intradural tumors from 1998 to 2003 was previously collected and analyzed. We retrospectively evaluated patients’ charts operated in the years 2011 to 2013. Patients’ medical files were reviewed including radiological examinations and electrophysiological reports. The data was collected and evaluated. Forty-one cases of meningioma or nerve sheath tumor resection surgery were performed in the study period. The surgical results were compared to 70 cases of historical controls. Demographic data was similar in these two groups. Sensitivity, specificity, and positive and negative predicted values of IONM were 75, 100, 100, and 97%, respectively. New neurological deficit rate was evident in 10 and 14% for the study and control groups, respectively (not significant). While IONM predicts neurological deficits with high accuracy level, this study does not suggest that there is a significant global benefit of IONM in these cases. As reported by others, in this series, the rate of new neurological deficits in non-monitored cases is similar to the monitored cases series; hence, IONM role in preventing new neurological deficits has yet to be proven. 相似文献
92.
Lim KJ; Odukoya OA; Ajjan RA; Li TC; Weetman AP; Cooke ID 《Molecular human reproduction》1998,4(1):77-81
93.
Apoptosis and expression of apoptotic regulators in the human testis following short- and long-term anti-androgen treatment 总被引:4,自引:0,他引:4
Woolveridge I; Bryden AA; Taylor MF; George NJ; Wu FC; Morris ID 《Molecular human reproduction》1998,4(7):701-707
Apoptosis and its augmentation by androgen withdrawal is an important event
in the testis. In other tissues apoptosis is regulated by genes belonging
to the bcl-2 family. However, little is known about these pathways in the
human testes. Human testes were obtained from patients with prostate
cancer, undergoing orchidectomy for permanent androgen ablative treatment.
The patients were either untreated or had previously received short- or
long-term anti-androgen therapy by cyproterone acetate or GnRH agonist
(goserelin). In comparison with untreated patients, testicular testosterone
concentrations were reduced by 83% in patients treated with cyproterone
acetate and by 99% in patients treated with goserelin. Apoptotic cells were
identified in tissue sections by in-situ end labelling of fragmented DNA.
The expression of Bcl-2, Bcl-xl, Bax, p53 and poly(ADP) ribose polymerase
(PARP) was demonstrated in tissue extracts by Western blotting. Apoptotic
germ cells were present in the spermatogenic epithelium of untreated
patients and patients who received short-term anti-androgen treatment.
There were few or no apoptotic cells in the seminiferous tubules following
long-term anti-androgen treatment. Following short- term treatment, the
concentrations of the apoptosis-related proteins examined did not change.
However, in the long-term treated testes, Bcl- xl and PARP expression
declined, Bax and p53 protein concentrations were unchanged, and Bcl-2 was
up-regulated. In conclusion, apoptosis occurs in spermatogenic cells of the
human testis and may contribute to the regulation of germ cell populations.
The apoptosis-related gene products which have been described in other
tissues are present in the human testis and are modulated by androgenic
stimuli.
相似文献
94.
Complications of laparoscopic pelvic surgery: recognition, management and prevention 总被引:2,自引:0,他引:2
Laparoscopic surgery has many advantages but it is not withoutcomplications. The complexity of the surgery, significantlyinfluences the complication rate. Laparoscopic surgeons oughtto be aware of the possible complications and how they couldbe prevented, recognized without delay, and managed safely andefficiently. Important complications include injuries to thevessels, bowel and urinary tract. Incisional hernia ought tobe reduced by careful closure of the facia whenever a trocar=" BORDER="0">10 mm is used at the extraumbilical site. Gasembolism is a rare but potentially life threatening complication.Shoulder pain is a minor complication but is exceedingly common;it is less likely to occur if as much gas as possible is removedat the endo of the operation while the patient is still in headdown Trendelenburg position. Rare complications include pneumothorax,subcutaneous and pre-peritoneal emphysema, cardiac arrhythmia,nerve injury and venous thrombosis. Laparoscopic surgeons shouldalso understand the principles of electrosurgery and how toavoid complications arising from the use of electrical energyincluding capacitative coupling, direct coupling and insulationfailure. 相似文献
95.
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97.
WJ Peterson ID Maya D Carlton E Estrada M Allon 《American journal of kidney diseases》2009,53(1):107-111
BACKGROUND: Catheter-related bacteremia (CRB) is a frequent complication of tunneled dialysis catheters, and Enterococcus is a common infecting organism. CRB may be treated by instilling an antibiotic lock into the catheter lumen in conjunction with systemic antibiotics. The efficacy of this approach in Enterococcus bacteremia is unknown. DESIGN: Quality improvement report. SETTING & PARTICIPANTS: 64 catheter-dependent hemodialysis outpatients with vancomycin-sensitive Enterococcus bacteremia treated with a uniform antibiotic lock protocol. Clinical outcomes were tracked prospectively. QUALITY IMPROVEMENT PLANS: Patients received intravenous vancomycin for 3 weeks in conjunction with a vancomycin lock instilled into both catheter lumens after each dialysis session. MEASURES: Treatment failure was defined as persistent fever 48 hours after initiation of antibiotic therapy or recurrent Enterococcus bacteremia within 90 days. A clinical cure was defined as fever resolution without recurrent bacteremia. Major infection-related complications within 6 months were documented. RESULTS: Treatment failure occurred in 25 patients (39%) because of persistent fever in 10 and recurrent bacteremia in 15. Treatment success occurred in 39 patients (61%). A serious complication of Enterococcus CRB occurred in 4 of 64 patients (6%); endocarditis in 1 and osteomyelitis in 3. The frequency of serious complications was 16% (4 of 25 patients) in those with treatment failure compared with 0% (0 of 39 patients) in those with treatment success (P = 0.01). LIMITATIONS: This was a single-center study. We did not measure serum vancomycin. CONCLUSIONS: An antibiotic lock protocol permits catheter salvage in 61% of hemodialysis patients with Enterococcus CRB. Serious complications occur in 6% of patients and are more common in those with treatment failure. 相似文献
98.
Alfgeir Logi Kristjansson Inga Dora Sigfusdottir Jack E. James John P. Allegrante Asgeir R. Helgason 《Addictive behaviors》2010
Cigarette smoking and alcohol use contribute substantially to the global burden of morbidity and premature mortality. Most use begins during adolescence, often with experimentation taking place between 11 and 15 years of age. This study examined the importance of perceived parental reactions to, and peer respect for, cigarette smoking and alcohol use. Particular attention was given to the relative importance of these variables compared with the more widely examined influences of perceived parental and peer support. Our final models explained 44% of the variance in cigarette smoking and 46% in alcohol use. Most of the explained variance in both cigarette smoking and alcohol use was accounted for by only three variables: peer use, perceived parental reaction to use, and perceived respect from peers if using. Our findings indicate that perceived parental reaction to use and peer respect for use may be important contributors to adolescent cigarette smoking and alcohol use. 相似文献
99.
Gudjonsson GH Sigurdsson JF Sigfusdottir ID Young S 《Journal of child psychology and psychiatry, and allied disciplines》2012,53(3):304-312
Background: This study investigates the relationship between attention deficit hyperactivity disorder (ADHD) symptoms and cigarette smoking, alcohol use and illicit drug use. Method: The participants were 10,987 pupils in the final three years of their compulsory education in Iceland (ages 14–16 years). The participants completed questionnaires in class relating to anxiety, depression and antiestablishment attitudes, ADHD symptoms, smoking, alcohol consumption and illicit drug use. Results: Of the total sample, 5.4% met screening criteria for ADHD. Smoking, alcohol and illicit drug use were significantly related to ADHD symptoms. In addition, the number of different illicit drugs consumed was significantly higher among the ADHD symptomatic than the nonsymptomatic participants, including the illicit use of sedatives. The main distinguishing illicit drug substances were lysergic acid diethylamide (odds ratio or OR = 8.0), cocaine (OR = 7.5), mushrooms (OR = 7.1) and amphetamines (OR = 6.5). Logistic multiple regressions showed that after controlling for gender and school grade, ADHD symptoms predicted smoking, alcohol use and illicit drug use independent of anxiety, depression and antiestablishment attitudes. In addition, poly‐substance use was linearly and incrementally related to ADHD symptoms with a large effect size. Conclusions: The findings underscore the vulnerability of young persons with ADHD symptoms to smoking, alcohol and illicit drug use, possibly as a means of self‐medication, and emphasize a need for early identification and treatment to reduce the risk of escalation. 相似文献
100.
PJ Needham KA Laughlan ID Botterill NS Ambrose 《Annals of the Royal College of Surgeons of England》2009,91(7):606-608