全文获取类型
收费全文 | 1269篇 |
免费 | 50篇 |
国内免费 | 8篇 |
专业分类
耳鼻咽喉 | 28篇 |
儿科学 | 30篇 |
妇产科学 | 76篇 |
基础医学 | 62篇 |
口腔科学 | 45篇 |
临床医学 | 99篇 |
内科学 | 291篇 |
皮肤病学 | 59篇 |
神经病学 | 84篇 |
特种医学 | 29篇 |
外科学 | 313篇 |
综合类 | 13篇 |
预防医学 | 69篇 |
眼科学 | 42篇 |
药学 | 54篇 |
肿瘤学 | 33篇 |
出版年
2023年 | 4篇 |
2022年 | 2篇 |
2021年 | 25篇 |
2020年 | 12篇 |
2019年 | 21篇 |
2018年 | 38篇 |
2017年 | 22篇 |
2016年 | 42篇 |
2015年 | 27篇 |
2014年 | 28篇 |
2013年 | 55篇 |
2012年 | 97篇 |
2011年 | 81篇 |
2010年 | 47篇 |
2009年 | 70篇 |
2008年 | 121篇 |
2007年 | 128篇 |
2006年 | 103篇 |
2005年 | 118篇 |
2004年 | 95篇 |
2003年 | 75篇 |
2002年 | 56篇 |
2001年 | 24篇 |
2000年 | 17篇 |
1999年 | 9篇 |
1998年 | 1篇 |
1997年 | 4篇 |
1996年 | 1篇 |
1990年 | 1篇 |
1979年 | 2篇 |
1974年 | 1篇 |
排序方式: 共有1327条查询结果,搜索用时 46 毫秒
1.
A. Caldern‐Larraaga D. L. Vetrano L. Ferrucci S. W. Mercer A. Marengoni G. Onder M. Eriksdotter L. Fratiglioni 《Journal of internal medicine》2019,285(3):255-271
This review discusses the interplay between multimorbidity (i.e. co‐occurrence of more than one chronic health condition in an individual) and functional impairment (i.e. limitations in mobility, strength or cognition that may eventually hamper a person's ability to perform everyday tasks). On the one hand, diseases belonging to common patterns of multimorbidity may interact, curtailing compensatory mechanisms and resulting in physical and cognitive decline. On the other hand, physical and cognitive impairment impact the severity and burden of multimorbidity, contributing to the establishment of a vicious circle. The circle may be further exacerbated by people's reduced ability to cope with treatment and care burden and physicians’ fragmented view of health problems, which cause suboptimal use of health services and reduced quality of life and survival. Thus, the synergistic effects of medical diagnoses and functional status in adults, particularly older adults, emerge as central to assessing their health and care needs. Furthermore, common pathways seem to underlie multimorbidity, functional impairment and their interplay. For example, older age, obesity, involuntary weight loss and sedentarism can accelerate damage accumulation in organs and physiological systems by fostering inflammatory status. Inappropriate use or overuse of specific medications and drug–drug and drug–disease interactions also contribute to the bidirectional association between multimorbidity and functional impairment. Additionally, psychosocial factors such as low socioeconomic status and the direct or indirect effects of negative life events, weak social networks and an external locus of control may underlie the complex interactions between multimorbidity, functional decline and negative outcomes. Identifying modifiable risk factors and pathways common to multimorbidity and functional impairment could aid in the design of interventions to delay, prevent or alleviate age‐related health deterioration; this review provides an overview of knowledge gaps and future directions. 相似文献
2.
Haluk Agus Burak ?nvural Cemal Kazimoglu Ali Reisoglu Onder Kalenderer 《Acta orthopaedica》2015,86(4):506-510
Background and purpose
Avascular necrosis (AVN) is a major cause of disability after treatment of developmental dysplasia of the hip (DDH), leading to femoral head deformity, acetabular dysplasia, and osteoarthritis in adult life. Type-II AVN is characterized by retarded growth in the lateral aspect of the physis or by premature lateral fusion, which produces a valgus deformity of the head on the neck of the femur. We investigated the effect of medial percutaneous hemi-epiphysiodesis as a novel technique in the treatment of late-diagnosed type-II AVN.Patients and methods
9 patients (11 hips) with a diagnosis of type-II AVN who underwent medial percutaneous hemi-epiphysiodesis after the surgical treatment for DDH were included in the study. 10 patients (12 hips) with the same diagnosis but who did not undergo hemi-epiphysodesis were chosen as a control group. Preoperative and postoperative articulotrochanteric distances, head-shaft angles, CE (center-edge) angles, and physeal inclination angles were measured. The treatment group underwent medial hemi-epiphysodesis at a mean age of 8 years. The mean ages of the treatment group and the control group at final follow-up were 14 and 12 years respectively. The mean duration of follow-up was 5.7 years in the treatment group and 8.3 years in the control group.Results
Preoperative articulotrochanteric distance, head-shaft angle, and functional outcome at the final follow-up assessment were similar in the 2 groups. However, preoperative and postoperative CE angles and physeal inclination angles differed significantly in the treatment group (p < 0.05). The final epiphyseal valgus angles were better in the treatment group than in the control group (p = 0.05). The treatment group improved after the operation.Interpretation
Medial percutaneous epiphysiodesis performed through a mini-incision under fluoroscopic control is a worthwhile modality in terms of changing the valgus tilt of the femoral head.Avascular necrosis (AVN) of the proximal femoral epiphysis is an iatrogenic complication of treatment for developmental dysplasia of the hip (DDH) (Danielsson 2000, Dhar 2003, Domalzki and Synder 2004, Roposch et al.2013). A late abnormality that may be the manifestation of the lateral portion of the capital femoral growth plate in type-II AVN alters the morphology of hip joint (Kalamchi and MacEwen 1980). When a progressive valgus deformity occurs in a patient with type-II AVN, problems associated with hip dysplasia may follow (Siffert 1981, Campbell and Tarlos 1990, Kim et al. 2000, Wu et al. 2010, Herring 2014). Due to inadequate coverage, reduced contact area between acetabulum and femoral head leads to early secondary osteoarthritis (Aronson 1986, Inoue et al. 2000, Herring 2014).The treatment decision for type-II AVN is challenging. Procedures such as varus femoral osteotomy and redirectional acetabular osteotomy have been used with a view to preventing future degenerative disease. However, these procedures are technically difficult and may result in serious complications (Siebenrock et al. 2013). On the other hand, as the main pathology is the growth disturbance at the lateral aspect of the femoral head, some form of arrest of the medial portion of the growth plate may be more logical in the treatment of type-II AVN (Herring 2014). We analyzed the radiographic and clinical outcomes of 11 hips in 9 patients with late-diagnosed type-II AVN who underwent percutaneous hemi-epiphysiodesis of the femoral head. 相似文献3.
Tan O Kantarci M Parmaksizoglu D Uyanik U Durur I 《The Journal of craniofacial surgery》2007,18(6):1284-1289
Preoperative assessment of the recipient vessels in free flap surgery directly affects the success rate of the operation by determining the flap type, pedicle length, orientation to the recipient site, and need for a vein graft. For this purpose, conventional angiographic methods are still being used with some disadvantages. The aims of this study were to evaluate the potential success of multislice computed tomography angiography in assessment of the recipient vessels before free flap surgery and to reveal if this may be an alternative to conventional angiography. The study was bilaterally carried out in 33 outpatients using a 16-detector spiral computed tomography scanner. In images of multiplanar reconstructions, maximum intensity projections, and three-dimensional volume renderings, the external carotid artery and its main branches were evaluated in terms of availability; patency, stenosis, or occlusion; maximal and minimal external diameters through their traces; variations involving ramification from another main vessel; and abnormal course. The superior thyroid artery was absent bilaterally in two patients (6.06%). The external carotid artery was stenotic on one side in two patients (6.06%) and on each side in one (3.03%). All the remaining vessels appeared without stenosis, occlusion, or variation. We think that multislice computed tomography angiography can provide detailed information about vascular structures and the remaining anatomic structures and their relationships with the recipient vessels. Therefore, multislice computed tomography angiography, as a less invasive vascular imaging method, can be a useful tool before planning free flap surgery. 相似文献
4.
Evaluation of osteogenic and chondrogenic activities of prefabricated periallografts 总被引:2,自引:0,他引:2
Ozdemir R Ulusoy MG Kocer U Karaaslan O Sahin B Culha E Bayiz U 《The Journal of craniofacial surgery》2005,16(6):1015-1022
Reconstruction of cartilage and bone defects has always been a challenging problem for the surgeon. Basic elements that are responsible for the repair process of these tissues are periost and perichondrium. Although several methods for the use of periost and perichondrium are proposed in the literature, the osteogenic and chondrogenic capacities of these tissues were shown to be the most important factor for a successful outcome. Bone and cartilage formation in acellular dermal matrix (ADM) prefabricated with periost and perichondrium was studied in 20 New Zealand rabbits. Morphologic and histologic evaluation and comparison of the newly formed tissues were evaluated. Four rabbits were excluded from the study because of infection, and specimens were obtained at 4, 6, 8, and 12 weeks after the study began from the remaining 16 rabbits. A gradual increase in bone and cartilage tissue formation through the 4th to 12th weeks was documented by reason of perichondrium and periost activation infiltrating into acellular dermal allografts. In view of the data obtained, it was concluded that periost or perichondrium prefabricated over ADM may be an alternative technique of cartilage and bone formation that may provide adequate tissue with elastic and osteo- and chondroconductive properties for the reconstruction of challenging defects. 相似文献
5.
Teke Kerem Yaprak Bayrak Busra Yuksekkaya Mustafa Uslubas Ali Kemal Kosem Mehmet Esat Yilmaz Hasan Kara Onder Dillioglugil Ozdal 《International urology and nephrology》2020,52(12):2289-2299
International Urology and Nephrology - We aimed to assess an “Immunological Profile (IP)” including CD8+ and FoxP3+ T lymphocytes for renal cell carcinoma (RCC) to evaluate its effects... 相似文献
6.
Ahmet Sahan Alkan Cubuk Orkunt Ozkaptan Tuncay Toprak Tolga Ozcan Kasım Ertas Onder Canguven Fatih Tarhan 《Andrologia》2020,52(11):e13854
This study compared the safety and efficacy of the on-demand (OD) use of sertraline (50 mg), sertraline (100 mg) and dapoxetine (30 mg), and the daily use of sertraline (50 mg) in the treatment of patients with premature ejaculation (PE). This prospective randomised study involved 120 lifelong PE patients (intravaginal ejaculatory latency time [IELT]: <1 min; Arabic Index of Premature Ejaculation [AIPE] score: < 30) without secondary causes of PE, identified between March 2018 and May 2020. Patients were divided into 4 groups (30 patients per group) and treated for 8 weeks. Assessments were conducted using the AIPE form as a diagnostic tool. Sertraline (50 mg, daily; 196.7 ± 115.5 s) and sertraline (100 mg, OD; 173.3 ± 97.0 s) had similar IELT and AIPE scores. The latter groups had better results in comparison with sertraline (50 mg, OD; 100.5 ± 54.4 s) and dapoxetine (93.7 ± 53.5 s; p < 0.01). Sertraline (100 mg, OD) had a similar efficacy to that of sertraline (50 mg, daily) and was more effective than sertraline (50 mg, OD) and dapoxetine (30 mg, OD). Sertraline (100 mg, OD) can be considered in the treatment of lifelong PE treatment, having tolerable side effects. 相似文献
7.
Landi F Tua E Onder G Carrara B Sgadari A Rinaldi C Gambassi G Lattanzio F Bernabei R;SILVERNET-HC Study Group of Bergamo 《Medical care》2000,38(12):1184-1190
BACKGROUND: Optimal care for frail elderly patients depends on comprehensive assessment. This is especially true in the complex setting of interdisciplinary home care programs. To facilitate comprehensive assessment, as well as to generate a useful, policy-relevant patient database, standardized, multidimensional, and validated instruments are very helpful. OBJECTIVES: The aim of the present study was to demonstrate that the Minimum Data Set assessment instrument for Home Care (MDS-HC) can be used to detect functional and cognitive impairment as defined by analogous research instruments. RESEARCH DESIGN: This was a cross-sectional correlation study. SUBJECTS: We studied 95 patients admitted to home care services of the Health Care Agency of Bergamo (Italy). MEASURES: The MDS-HC form was completed for all patients by well-trained nurses, independently of and with nurses blinded to the results from the research rating scales. The Barthel Activities of Daily Living (ADL) Index, the Instrumental Activities of Daily Living of Lawton (IADL), and the Mini Mental State Examination (MMSE) were considered the gold standard. RESULTS: Agreement between the MDS-HC scales and the research rating scales was assessed with Pearson's correlation coefficient. This coefficient was 0.74 for MDS-ADL versus Barthel Index, 0.81 for MDS-IADL versus Lawton Index, and 0.81 for Cognitive Performance Scale versus MMSE, indicating an excellent agreement. CONCLUSIONS: The MDS-HC scales, when performed by trained nurses using recommended protocols, provide a valid measure of function and cognitive status in frail home care patients. These findings point out the overall validity of the functional and clinical data contained in the MDS-HC assessment. Use of the MDS-HC gives the unique opportunity of setting up a database, a prerequisite for all epidemiological evidence-based medicine studies. 相似文献
8.
Muslumanoglu L Aki S Turkdogan D Us O Akyuz G 《Archives of physical medicine and rehabilitation》2004,85(3):470-473
OBJECTIVE: To investigate sympathetic nervous system functions in patients with acute and chronic phase of stroke by measuring sympathetic skin reflex (SSR) and the relationship between sympathetic dysfunction and motor function capacity. DESIGN: Cross-sectional, case-control study. SETTING: A physical medicine and rehabilitation department in a research hospital of a university referral center in Turkey. PARTICIPANTS: Fifty-six patients with stroke-13 in the acute phase and 43 in the chronic phase-and 42 age- and sex-matched healthy volunteers were included. INTERVENTION: SSR was recorded with electric stimulation of the bilateral median nerves. MAIN OUTCOME MEASURES: SSR was recorded to assess sympathetic reflex activity in patients in the acute and chronic phase of stroke and in controls. Motor functions was classified using the Brunnstrom stages. RESULTS: The mean SSR latency in the acute phase was significantly prolonged and the amplitudes were decreased compared with controls. In the chronic phase, the mean amplitudes were significantly attenuated compared with controls, whereas the mean latency did not change. The mean latency of SSR in patients in Brunnstrom groups 1 and 2 was longer, and the mean amplitude was smaller than in controls (P<.05). The mean amplitude was significantly reduced in patients classified as Brunnstrom groups 3 and 4 compared with controls (P<.05), but the mean latency was not affected. CONCLUSIONS: Depression of sympathetic reflex activity was more prominent in the acute phase of stroke and was associated with moderate or highly limited motor function capacity. Improvement of motor dysfunction may parallel recovery of sympathetic reflex activity. 相似文献
9.
H Gümüş M Gümüş G Tekbaş H Onder F Ekici MG Cetinçakmak A Bilici 《Clinical imaging》2012,36(5):522-525
ObjectivesThe present study aimed to present the clinical and multidetector computed tomography (MDCT) findings of patients who were diagnosed with the median arcuate ligament (MAL) syndrome on MDCT retrospectively.MethodsSeven hundred forty-four patients in whom MDCT angiography was performed were retrospectively analyzed for investigating incidental MAL syndrome.ResultsTwenty-one patients were shown to have MAL syndrome. Of 21 patients, 18 with MAL syndrome were asymptomatic. Three patients had some symptoms. On MDCT angiography, proximal narrowing of the arteries was observed in 21 patients.ConclusionsMDCT is a minimally invasive and useful tool for the diagnosis of MAL syndrome. 相似文献
10.
Arikanoglu Z Taskesen F Gumus H Onder A Aliosmanoglu I Gul M Akgul OL Keles C 《Journal of gastrointestinal surgery》2012,16(6):1189-1193