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卵巢甲状腺肿是具有高度特异性的单胚层分化的成熟畸胎瘤,其主要由甲状腺组织构成。良性卵巢甲状腺肿的恶变率低,为0.5%~5%。恶性卵巢甲状腺肿(MSO)与起源于甲状腺的恶性肿瘤具有相似的分子发病机制,如BRAF(B-Raf proto-oncogene)、RAS(retrovirus-associated DNA sequence)基因点突变,RET/PTC(RET proto-oncogen/papillary thyroid carcinoma)基因重排等。因MSO临床罕见,目前仍缺乏明确的诊断标准及处理原则。一些肿瘤专家主张用原发性甲状腺癌的病理标准作为MSO的诊断依据。MSO一旦确诊后,应行全面的手术分期和术后的辅助治疗,辅助治疗包括全甲状腺切除或甲状腺素抑制治疗、放射性碘治疗、体外照射等。临床观察发现MSO预后均较好,且术后辅助治疗起重要作用。术后需要长期随访,血清甲状腺球蛋白、131I全身扫描是检测肿瘤转移和复发的特异性指标。 相似文献
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目的 分析卵巢甲状腺肿的MRI、CT表现。方法 回顾性分析14例经手术病理证实的单发卵巢甲状腺肿患者的MRI及CT表现,观察其形态、大小、密度/信号、强化特点等。结果 14例病变均表现为包膜完整的囊实性肿块,其中分叶状11例,类圆形3例;多囊状13例,单囊1例;11例实性成分为明显厚壁或分隔,3例呈结节状。肿瘤最大径为3~34 cm,平均(11.34±2.24) cm。7例MR T2WI囊性部分均可见极低信号区,增强后无强化,实性成分明显强化。7例CT囊性部分均可见高密度区,CT值57~90 HU,增强扫描未见强化;实性成分明显强化,CT值为145~270 HU;4例囊壁或实性结节中见斑片状钙化。结论 卵巢甲状腺肿的MRI、CT表现具有一定特征性,有助于诊断及鉴别诊断。 相似文献
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G��lseren Y��cesoy Yigit Cakiroglu Bahar Muezzinoglu Birsen Besnili Izzet Yucesoy 《Journal of Korean medical science》2010,25(2):327-329
We present a case of a 40-yr-old woman diagnosed with a primary malignant struma ovarii. The patient was admitted with the complaint of pelvic pain and a large pelvic mass in the mid-portion of lower abdomen on gynecological examination. Pre-operative tumor markers and routine biochemistry were unremarkable. She was treated with total abdominal hysterectomy and right salpingo-oopherectomy. Post-operatively, she was diagnosed with a malignant struma ovarii through the usage of histopathological criteria similar to the guidelines for primary thyroid gland disease. The patient was subsequently performed left salpingo-oopherectomy and retroperitoneal pelvic lympadenectomy for re-staging. Although, left ovary and lymph nodes were histopathologically normal, she was offered thyroidectomy but she refused to accept the offer. Thyroglobulin level was monitored in the post-operative period. She is free of the disease for 18 months. 相似文献
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Struma ovarii, a rare germ cell tumor of the ovary composed of >50% thyroid tissue, is traditionally managed by gynecologic surgeons. Although struma ovarii is typically cured by simple excision, otolaryngology‐head and neck surgeons may play a critical role in caring for these patients. In this article, we present two cases of struma ovarii and discuss the role of the otolaryngologist. Laryngoscope, 2010 相似文献
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IntroductionStruma ovarii is a rare ovarian tumor, representing 0.5-1% of all ovarian tumors and 2–5% of ovarian teratomas. It is defined as an ovarian teratoma composed mostly of thyroid tissue. The symptoms are nonspecific, and the imaging studies can help in characterize the mass; however, the definitive diagnosis is usually given by the Pathologist. Classically, the treatment is the surgical resection of the ovarian mass, however there is no consensus regarding the follow-up.Presentation of caseAn asymptomatic malignant struma ovarii in a 43 year-old patient is presented. The diagnosis was postoperatively following a laparoscopic adnexectomy due to an apparently benign ovarian teratoma. The histopathology results revealed a mature ovarian cystic teratoma with papillary carcinoma with immunohistochemical characteristics suggesting a thyroid origin. Seeing that there was no thyroid affectation or metastatic disease, we decided a conservative management. A yearly follow-up with CT scan and tumor markers was performed. The endocrinologist also performed annual controls with thyroid ultrasound and serum tests. The patient has remained asymptomatic during these last four years.DiscussionThere is little evidence in literature on the conservative management in cases with evidence of malignancy. If fertility preservation is desired, an unilateral oophorectomy could be performed, along with levels of serum thyroglobulin as a marker of relapse. Other authors claim for aggressive ovarian cancer surgery followed by a total thyroidectomy. There is still no established management for struma ovarii patients and the choice for a conservative or radical approach depends only on the professional decision. 相似文献
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目的分析良、恶性卵巢甲状腺肿的临床和病理特征,为该瘤的病理诊断和治疗提供依据.方法对 9例卵巢甲状腺肿的临床和病理进行观察和分析.结果患者年龄 29~ 64岁,平均为 40.6岁.良性卵巢甲状腺肿 8例,大体呈实性、囊实性、囊性,有 3例可辨认出甲状腺组织.5例肿瘤全部由甲状腺组织组成, 3例含有其它畸胎瘤成份.组织学类型有:单纯型、腺瘤型、囊性变型.恶性卵巢甲状腺肿 1例,组织学类型为甲状腺乳头状癌,采用根治性手术和 131I放疗,随访 8个月无复发.结论卵巢甲状腺肿可出现发生于颈部甲状腺相似的任何病理改变.恶性卵巢甲状腺肿的病理诊断标准、临床处理与颈部甲状腺癌一致. 相似文献