全文获取类型
收费全文 | 1010篇 |
免费 | 43篇 |
国内免费 | 38篇 |
专业分类
耳鼻咽喉 | 3篇 |
儿科学 | 65篇 |
妇产科学 | 42篇 |
基础医学 | 81篇 |
口腔科学 | 17篇 |
临床医学 | 102篇 |
内科学 | 223篇 |
皮肤病学 | 7篇 |
神经病学 | 23篇 |
特种医学 | 163篇 |
外科学 | 226篇 |
综合类 | 12篇 |
预防医学 | 32篇 |
眼科学 | 8篇 |
药学 | 50篇 |
肿瘤学 | 37篇 |
出版年
2024年 | 2篇 |
2023年 | 2篇 |
2022年 | 2篇 |
2021年 | 12篇 |
2020年 | 6篇 |
2019年 | 17篇 |
2018年 | 24篇 |
2017年 | 14篇 |
2016年 | 11篇 |
2015年 | 13篇 |
2014年 | 27篇 |
2013年 | 35篇 |
2012年 | 32篇 |
2011年 | 48篇 |
2010年 | 57篇 |
2009年 | 55篇 |
2008年 | 37篇 |
2007年 | 63篇 |
2006年 | 42篇 |
2005年 | 43篇 |
2004年 | 20篇 |
2003年 | 20篇 |
2002年 | 27篇 |
2001年 | 16篇 |
2000年 | 8篇 |
1999年 | 14篇 |
1998年 | 53篇 |
1997年 | 46篇 |
1996年 | 45篇 |
1995年 | 40篇 |
1994年 | 41篇 |
1993年 | 26篇 |
1992年 | 5篇 |
1991年 | 14篇 |
1990年 | 13篇 |
1989年 | 25篇 |
1988年 | 23篇 |
1987年 | 13篇 |
1986年 | 15篇 |
1985年 | 10篇 |
1984年 | 8篇 |
1983年 | 7篇 |
1982年 | 11篇 |
1981年 | 8篇 |
1980年 | 10篇 |
1979年 | 5篇 |
1978年 | 6篇 |
1977年 | 10篇 |
1976年 | 6篇 |
1975年 | 3篇 |
排序方式: 共有1091条查询结果,搜索用时 250 毫秒
1.
Tomoko Mizota Nicholas E. Anton Dimitrios Stefanidis 《American journal of surgery》2019,217(2):222-227
Background
This study aimed to identify differences in pattern recognition skill among individuals with varying surgical experience.Methods
Participants reviewed laparoscopic cholecystectomy videos of various difficulty, and paused them when the cystic duct or artery was identified to outline each structure on the monitor. Time taken to identify each structure, accuracy and work load, which was assessed using the NASA-Task Load Index (TLX), were compared among the three groups.Results
Ten students, ten residents and eight attendings participated in the study. Attendings identified the cystic duct and artery significantly faster and more accurately than students, and identified the cystic artery faster than residents. The NASA-TLX score of attendings was significantly lower than that of students and residents.Conclusions
Attendings identified anatomical structures faster, more accurately, and with less effort than students or residents. This platform may be valuable for the assessment and teaching of pattern recognition skill to novice surgeons.Short summary
Accurate anatomical recognition is paramount to proceeding safely in surgery. The assessment platform used in this study differentiated recognition skill among individuals with varing surgical experience. 相似文献2.
Nicholas E. Anton Tomoko Mizota Lava R. Timsina Jake A. Whiteside Erinn M. Myers Dimitrios Stefanidis 《American journal of surgery》2019,217(2):266-271
Introduction
Several studies demonstrated that simulator-acquired skill transfer to the operating room is incomplete. Our objective was to identify trainee characteristics that predict the transfer of simulator-acquired skill to the operating room.Methods
Trainees completed baseline assessments including intracorporeal suturing (IS) performance, attentional selectivity, self-reported use of mental skills, and self-reported prior clinical and simulated laparoscopic experience and confidence. Residents then followed proficiency-based laparoscopic skills training, and their skill transfer was assessed on a live-anesthetized porcine model. Predictive characteristics for transfer test performance were assessed using multiple linear regression.Results
Thirty-eight residents completed the study. Automaticity, attentional selectivity, resident perceived ability with laparoscopy and simulators, and post-training IS performance were predictive of IS performance during the transfer test.Conclusions
Promoting automaticity, self-efficacy, and attention selectivity may help improve the transfer of simulator-acquired skill. Mental skills training and training to automaticity may therefore be valuable interventions to achieve this goal. 相似文献3.
Tessa Timmers Rik Ossenkoppele Denise Visser Hayel Tuncel Emma E Wolters Sander CJ Verfaillie Wiesje M van der Flier Ronald Boellaard Sandeep SV Golla Bart NM van Berckel 《Journal of cerebral blood flow and metabolism》2020,40(12):2464
The aim of this study was to investigate the test–retest (TRT) repeatability of various parametric quantification methods for [18F]Flortaucipir positron emission tomography (PET). We included eight subjects with dementia or mild cognitive impairment due to Alzheimer’s disease and six cognitively normal subjects. All underwent two 130-min dynamic [18F]Flortaucipir PET scans within 3 ± 1 weeks. Data were analyzed using reference region models receptor parametric mapping (RPM), simplified reference tissue method 2 (SRTM2) and reference logan (RLogan), as well as standardized uptake value ratios (SUVr, time intervals 40–60, 80–100 and 110–130 min post-injection) with cerebellar gray matter as reference region. We obtained distribution volume ratio or SUVr, first for all brain regions and then in three tau-specific regions-of-interest (ROIs). TRT repeatability (%) was defined as |retest–test|/(average (test + retest)) × 100. For all methods and across ROIs, TRT repeatability ranged from (median (IQR)) 0.84% (0.68–2.15) to 6.84% (2.99–11.50). TRT repeatability was good for all reference methods used, although semi-quantitative models (i.e. SUVr) performed marginally worse than quantitative models, for instance TRT repeatability of RPM: 1.98% (0.78–3.58) vs. SUVr80–100: 3.05% (1.28–5.52), p < 0.001. Furthermore, for SUVr80–100 and SUVr110–130, with higher average SUVr, more variation was observed. In conclusion, while TRT repeatability was good for all models used, quantitative methods performed slightly better than semi-quantitative methods. 相似文献
4.
5.
Stephanie Dufek Tuula Holtta Michel Fischbach Gema Ariceta Augustina Jankauskiene Rimante Cerkauskiene Claus Peter Schmitt Betti Schaefer Christoph Aufricht Elizabeth Wright Constantinos J. Stefanidis Mesiha Ekim Sevcan Bakkaloglu Günter Klaus Aleksandra Zurowska Karel Vondrak Johan Vande Walle Alberto Edefonti Rukshana Shroff 《Pediatric nephrology (Berlin, Germany)》2015,30(11):2021-2027
6.
Vimal K. Narula Eleanor C. Fung D. Wayne Overby William Richardson Dimitrios Stefanidis 《Surgical endoscopy》2020,34(4):1482-1491
Choledocholithiasis is a common presentation of symptomatic cholelithiasis that can result in biliary obstruction, cholangitis, and pancreatitis. A systematic English literature search was conducted in PubMed to determine the appropriate management strategies for choledocholithiasis. The following clinical spotlight review is meant to critically review the available evidence and provide recommendations for the work-up, investigations as well as the endoscopic, surgical and percutaneous techniques in the management of choledocholithiasis. 相似文献
7.
目的:临床局部辐射条件下会造成非辐射区域组织及细胞功能损害,最为突出的是对造血功能的影响。实验建立60Coγ射线左半身辐射动物模型,观察局部电离辐射对其非辐射区域骨髓巨核细胞的影响。方法:实验于2003-10/2005-03在解放军第三军医大学辐照中心和全军复合伤研究所完成。①实验动物:6~8周龄SPF级雄性昆明小鼠180只,随机数字表法分为正常对照组、全身辐射组、左半身辐射组、全身屏蔽辐射组,45只/组。②实验方法:全身辐射组小鼠固定于辐射架内;左半身辐射组小鼠麻醉后固定体位,用铅砖屏蔽右半身;全身屏蔽辐射组小鼠麻醉固定体位,用铅砖屏蔽全身。以60Coγ射线一次性辐射,剂量率68.46cGy/min。正常对照组不作任何干预。③实验评估:辐射后不同时相检测小鼠血清丙二醛含量及超氧化物歧化酶活性变化,计数外周血血小板,检测骨髓巨核祖细胞集落形成单位,观察骨髓组织病理改变及CD41a、CD61的表达。结果:全身辐射组第8天死亡2只,第9天死亡4只,其余各组无脱失。①外周血血小板计数:辐射后第2,7天,左半身辐射组外周血血小板数量显著低于正常对照组(P<0.01),但高于全身辐射组(P<0.01)。②血清丙二醛含量及超氧化物歧化酶活性变化:辐射后第2,9天,左半身辐射组血清丙二醛含量显著高于正常对照组(P<0.01),低于全身辐射组(P<0.01);血清超氧化物歧化酶活性显著低于正常对照组(P<0.01),高于全身辐射组(P<0.01)。③骨髓巨核祖细胞集落形成单位的变化:与正常对照组比较,辐射后6h左半身辐射组非辐射侧的巨核祖细胞集落形成单位显著降低(P<0.01),高于全身辐射组及左半身辐射组(P<0.01)。④骨髓组织病理改变:正常对照组有核细胞比例较高,分布均匀,并见多量散在分布的细胞龛;辐射2d后,左半身辐射组非辐射侧骨髓有核细胞较正常对照组减少,但好于全身辐射组、左半身辐射组。⑤骨髓CD41a及CD61表达的变化:辐射后2d与正常对照组比较,左半身辐射组非辐射侧骨髓CD41a及CD61阳性细胞数和相对荧光强度均显著降低(P<0.01),但高于全身辐射组、左半身辐射组(P<0.01)。结论:局部电离辐射作用后,可导致小鼠非辐射区域骨髓巨核细胞增殖能力降低,血小板减少,产生功能障碍。氧自由基激活可能参与了该损伤过程。 相似文献
8.
D. Stefanidis K. Malireddy T. Kuwada R. Phillips E. Zoog K. S. Gersin 《Surgical endoscopy》2013,27(12):4504-4510
Background
Revisional bariatric procedures are on the rise. The higher complexity of these procedures has been reported to lead to increased risk of complications. The objective of our study was to compare the perioperative risk profile of revisional bariatric surgery with primary bariatric surgery in our experience.Methods
A prospectively maintained database of all patients undergoing bariatric surgery by three fellowship-trained bariatric surgeons from June 2005 to January 2013 at a center of excellence was reviewed. Patient demographics, type of initial and revisional operation, number of prior gastric surgeries, indications for revision, postoperative morbidity and mortality, length of stay, 30-day readmissions, and reoperations were recorded. These outcomes were compared between revisional and primary procedures by the Mann–Whitney or Chi square tests.Results
Of 1,556 patients undergoing bariatric surgery, 102 patients (6.5 %) underwent revisional procedures during the study period. Indications for revisions included inadequate weight loss in 67, failed fundoplications with recurrent gastroesophageal reflux disease in 29, and other in 6 cases. Revisional bariatric procedures belonged into four categories: band to sleeve gastrectomy (n = 23), band to Roux-en-Y gastric bypass (n = 25), fundoplication to bypass (n = 29), and other (n = 25). Revisional procedures were associated with higher rates of readmissions and overall morbidity but no differences in leak rates and mortality compared with primary procedures. Band revisions had similar length of stay with primary procedures and had fewer complications compared with other revisions. Patients undergoing fundoplication to bypass revisions were older, had a higher number of prior gastric procedures, and the highest morbidity (40 %) and reoperation (20 %) rates.Conclusions
In experienced hands, many revisional bariatric procedures can be accomplished safely, with excellent perioperative outcomes that are similar to primary procedures. As the complexity of the revisional procedure and number of prior surgeries increases, however, so does the perioperative morbidity, with fundoplication revisions to gastric bypass representing the highest risk group. 相似文献9.
Jessica C Fanzo Matthew M Graziose Klaus Kraemer Stuart Gillespie Jessica L Johnston Saskia de Pee Eva Monterrosa Jane Badham Martin W Bloem Alan D Dangour Richard Deckelbaum Achim Dobermann Patrizia Fracassi SM Moazzem Hossain John Ingram Johann C Jerling CJ Jones Stefanus Indrayana Jap Lynnda Kiess Quinn Marshall Keith Martin Anuradha Narayan Mary Amuyunzu-Nayamongo Fré Pepping Keith P West 《Advances in nutrition (Bethesda, Md.)》2015,6(6):639-647
Nearly all countries in the world today are burdened with malnutrition, manifesting as undernutrition, micronutrient deficiencies, and/or overweight and obesity. Despite some progress, efforts to alleviate malnutrition are hampered by a shortage in number, skills, and geographic coverage, of a workforce for nutrition. Here, we report the findings of the Castel Gandolfo workshop, a convening of experts from diverse fields in March 2014 to consider how to develop the capacity of a global cadre of nutrition professionals for the post-2015 development era. Workshop participants identified several requirements for developing a workforce for nutrition, including an ability to work as part of a multisectoral team; communication, advocacy, and leadership skills to engage decision makers; and a set of technical skills to address future challenges for nutrition. Other opportunities were highlighted that could immediately contribute to capacity development, including the creation of a consortium to link global North and South universities, online training modules for middle managers, and practical, hands-on experiences for frontline nutrition workers. Institutional and organizational support is needed to enable workshop recommendations on education and training to be effectively implemented and sustained. The findings from the Castel Gandolfo workshop can contribute to the delivery of successful nutrition-relevant actions in the face of mounting external pressures and informing and attaining the forthcoming Sustainable Development Goals. 相似文献
10.
Sebaceous carcinoma is a rare cutaneous malignancy, commonly affecting the eyelids. This case highlights a patient who presented with sebaceous carcinoma of the right upper lip with extensive involvement of the soft tissues of the head and neck. As part of the initial investigation, ultrasound was requested. This case demonstrates the ultrasound features of sebaceous carcinoma as well as revising the normal ultrasound anatomy of the upper lip and muscles of the cheek. 相似文献