全文获取类型
收费全文 | 531篇 |
免费 | 11篇 |
国内免费 | 26篇 |
专业分类
耳鼻咽喉 | 1篇 |
儿科学 | 2篇 |
妇产科学 | 82篇 |
基础医学 | 4篇 |
临床医学 | 13篇 |
内科学 | 46篇 |
皮肤病学 | 4篇 |
特种医学 | 3篇 |
外科学 | 225篇 |
综合类 | 21篇 |
预防医学 | 2篇 |
药学 | 8篇 |
肿瘤学 | 157篇 |
出版年
2023年 | 10篇 |
2022年 | 16篇 |
2021年 | 26篇 |
2020年 | 19篇 |
2019年 | 24篇 |
2018年 | 27篇 |
2017年 | 16篇 |
2016年 | 17篇 |
2015年 | 15篇 |
2014年 | 42篇 |
2013年 | 32篇 |
2012年 | 31篇 |
2011年 | 46篇 |
2010年 | 27篇 |
2009年 | 34篇 |
2008年 | 31篇 |
2007年 | 36篇 |
2006年 | 23篇 |
2005年 | 12篇 |
2004年 | 16篇 |
2003年 | 9篇 |
2002年 | 9篇 |
2001年 | 8篇 |
2000年 | 8篇 |
1999年 | 11篇 |
1998年 | 6篇 |
1997年 | 3篇 |
1996年 | 2篇 |
1995年 | 1篇 |
1994年 | 1篇 |
1993年 | 2篇 |
1992年 | 3篇 |
1990年 | 1篇 |
1989年 | 1篇 |
1984年 | 3篇 |
排序方式: 共有568条查询结果,搜索用时 15 毫秒
31.
Challenges of laparoscopic resection of abdominal neuroblastoma with lymphadenectomy 总被引:2,自引:0,他引:2
BACKGROUND: The laparoscopic procedure involving total resection of abdominal neuroblastoma combined with lymphadenectomy has not been reviewed in English literature. The aim of this study was to evaluate the significance and accuracy of laparoscopic resection of abdominal neuroblastoma. METHODS: Since July 1997, five patients with abdominal neuroblastoma underwent laparoscopic resection combined with lymphadenectomy or sampling of the lymph nodes. The length of operation, intraoperative blood loss, resectability, and complications were retrospectively reviewed and evaluated. RESULTS: Four cases were managed laparoscopically, but one case was converted to open procedure because of poor visualization around large vessels. The mean operation time was 135 min and the intraoperative blood loss 52 ml. CONCLUSIONS: Good visualization of the primary tumor and large vessels is, arguably, the most important factor for successful completion of this procedure laparoscopically. Precise indicators for laparoscopic resection of abdominal neuroblastoma provide a better prognosis and a good quality of life for children with neuroblastoma. 相似文献
32.
J P Geisler G C Linnemeier K J Manahan 《International journal of gynaecology and obstetrics》2007,98(1):39-43
BACKGROUND: The purpose is to determine the rate of lymph node metastases in women with endometrioid adenocarcinoma of the endometrium (EAE) undergoing systematic lymphadenectomy. METHODS: Patients (349) underwent a complete pelvic and para-aortic lymphadenectomy from caudal to the median circumflex to the level of the renal vessels. RESULTS: Grade 1 tumors accounted for 32.7% of the tumors and 31.0% of the positive nodes, grade 2 accounted for 47.3% of the tumors (37.9% of positive nodes), and grade 3 accounted for 20.1% of the tumors and 31.0% of the positive nodes (P>0.05). Positive nodes were found in 15.8% of grade 1 tumors, 13.3% of grade 2 tumors and 25.7% of grade 3 tumors (P>0.05). Isolated para-aortic involvement without pelvic nodal involvement occurred in 29% of patients with positive nodes. CONCLUSIONS: When complete lymphadenectomies are performed in EAE, positive lymph nodes (including isolated para-aortic lymph nodes) are common in all grades. 相似文献
33.
34.
Thenappan Chandrasekar Hanan Goldberg Zachary Klaassen Rashid K. Sayyid Robert J. Hamilton Neil E. Fleshner Girish S. Kulkarni 《Urologic oncology》2018,36(1):13.e11-13.e18
Background
To examine usage trends, guideline adherence, and survival data for patients undergoing lymphadenectomy (LND) at the time of radical prostatectomy (RP) for Gleason 7 prostate cancer (PCa).Methods
The SEER database was queried for all patients with nonmetastatic biopsy Gleason 7 PCa from 2004 to 2013. Distribution and trends of LND were analyzed. The Memorial-Sloan Kettering Cancer Center nomogram was applied to stratify patients based on risk of nodal disease at time of RP (<5% risk or ≥5% risk). Analyses were performed to determine covariates associated with LND receipt at time of RP and cancer-specific mortality (CSM).Results
A total of 78,641 patients with either G34 or G43 PCa underwent RP (59,194 and 19,447, respectively). Of these patients, 61.2% of G34 and 73.5% of G43 patients underwent LND. During this 10-year period, the proportion of G43 patients undergoing LND remained relatively stable, whereas the proportion of G34 patients undergoing LND ranged between 55.9% and 67.9%. Regional differences were a predictor of LND receipt regardless of risk stratification, but did not translate to higher risk of CSM. Receipt of LND was not predictive of improved CSM in any of the cohorts analyzed.Conclusions
The role of LND for Gleason 7 prostate adenocarcinoma is not yet standardized, as indicated by the variability of LND dissection rates. Receipt of LND did not improve CSM, and in G43 patients, it predicted higher CSM. As the effect of LND on CSM is uncertain, further evaluation of oncologic benefit in this patient population is warranted. 相似文献35.
36.
Álvaro Jesús Bernal Martínez Nieves Fernández Letamendi Julio Delgado Martínez Lucía Gómez-Escolar Larrañaga Enara Reola Ramírez Javier Puertas Peña 《Cirugía espa?ola》2018,96(9):577-582
Introduction
It is unknown whether cervical lymphadenectomy as a treatment for cutaneous squamous cell carcinoma of the head and neck (cSCCh&n) increases survival in elderly patients. The aim of this study is to determine whether this procedure has an influence on the survival of these patients, and whether the Short-Form Charlson Comorbidity Index (CCI-SF) can be used as an alternative to age in the surgeon's estimation of elderly patient mortality.Methods
The study population included all patients diagnosed with cSCCh&n consecutively treated between 2006 and 2011. Non-invasive, non-cutaneous carcinomas were excluded. Patients were grouped according to their age (< 70, 70-79, 80-89, > 90), CCI-SF (< 3, ≥ 3) and presence (N1) or absence (N0) of cervical metastases. The dependent variable was the performance or not of cervical lymphadenectomy. A univariate survival analysis was performed according to the presence of metastases, a bivariate analysis for each of the independent variables according to the received treatment and a multivariate analysis.Results
416 cases were included. The mean survival time was greater in the N0 group. For each of the groups based on the presence of metastasis, the differences in the mean survival time according to age and CCI-SF were not significant, regardless of the treatment received. The multivariate analysis showed the influence of age (p = 0.0001, OR = 1.488, 95%CI = [1.318; 1.679]) and CCI-SF (p = 0.001, OR = 1.817, 95%CI = [1.257; 2.627]) in the N0 group. In the N1 group only regional treatment has a positive influence on survival (p = 0.048, OR = 0.15, 95%CI = [0.023; 0.981]).Conclusions
CCI-SF and age are good mortality indicators in cSCCh&n N0 patients, but not so in cSCCh&n N1 patients. In cSCCh&n N1 patients, regional treatment has a positive influence on survival. Differences cannot be affirmed in the mean survival time of patients with cSCCh&n, based on the development of metastases and the treatment given. New studies will be necessary. 相似文献37.
Thomas C. Tsai Jordan Miller Ciro Andolfi Brian Whang P. Marco Fisichella 《European journal of surgical oncology》2018,44(8):1177-1180
The extent of lymphadenectomy for esophageal adenocarcinoma remains controversial. Outstanding issues include the appropriate technical approach such as transthoracic versus transhiatal, or open versus minimally invasive, both of which have implications on overall lymph node harvest numbers and morbidity. Recent data on the relationship of total number of lymph nodes harvested and oncologic survival have been conflicting, due in part to a likely differential impact of lymphadenectomy on survival based on tumor stage and response to neoadjuvant therapy. While standardizing the extent of lymphadenectomy may be desirable, a more useful approach might be to tailor lymphadenectomy considering the multidimensional impact of surgical technique and multimodal treatment strategy. 相似文献
38.
39.
Pelvic lymph node metastases from bladder cancer occur in about 25% of patients undergoing radical cystectomy. While the majority
of patients with lymph node metastases will develop progressive disease, some patients do exhibit long-term survival with
and without adjuvant chemotherapy. The concept of lymph node density has been proposed as a means to stratify patient prognosis
since it takes into account two important factors—the number of positive nodes (tumor burden) and the total number of nodes
removed/examined (extent of dissection). Due to the lack of agreement on the extent of lymphadenectomy, lymph node density
facilitates standardization of lymph node staging, thus allowing for adjuvant therapies and clinical trials to be more uniformly
applied. Whether lymph node density provides improved prognostication over the standard nodal staging or absolute number of
positive lymph nodes remains controversial. We review the literature regarding the role of lymph node density in the prognostic
stratification of node-positive bladder cancer. 相似文献
40.
淋巴结转移是肺癌主要而常见的转移途径,也是术后癌残留而导致复发和转移的主要因素,肺癌手术中纵隔、肺门淋巴结清扫至关重要。但目前淋巴结的清扫方式尚不统一,有系统淋巴结清扫术(CMLND)、根治性淋巴结清扫术、淋巴结采样、系统淋巴结采样以及前哨淋巴结技术导航切除,并且随着微创外科的发展,胸腔镜下淋巴结清扫也日趋成熟。而寻求一个更规范、更完善的淋巴结清扫方式甚有必要。现就目前肺癌手术中纵隔、肺门淋巴结清扫的临床意义、清扫方式、清扫范围以及胸腔镜下淋巴结清扫的现状以及展望进行综述。 相似文献