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1.
Rammurti T Kamble George B Selby Martha Mims Mohamed A Kharfan-Dabaja Howard Ozer James N George 《Biology of blood and marrow transplantation》2006,12(5):506-510
Iron overload presenting as exacerbation of hepatic graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation has not been previously described. We report 6 patients with established hepatic GVHD in whom iron overload (median serum ferritin, 7231 mug/dL; median transferrin saturation, 77%) resulting from a lifetime median of 20 units of packed red blood cell transfusions was manifested by worsening of liver function. Liver biopsies performed in 4 patients confirmed severe iron overload and also hepatic GVHD. Analysis for the C282Y and H63D hemochromatosis gene mutation was negative for the homozygous state in all 6 patients. Erythropoietin-assisted phlebotomy resulted in normalization of liver function at a median of 7 months and of serum ferritin at a median of 11 months. Immunosuppressive therapy was successfully tapered in all 4 patients who completed the phlebotomy program, and this supported the impression that iron overload, rather than GVHD, was the principal cause of liver dysfunction. At a median follow-up of 50 months (range, 18-76 months) from the transplantation and 25 months (range, 5-36 months) from ferritin normalization, all 4 patients require maintenance phlebotomy. We conclude that iron overload can mimic GVHD exacerbation, thus resulting in unnecessary continuation or intensification of immunosuppressive therapy for GVHD, and that maintenance phlebotomy is necessary after successful iron-reduction therapy. 相似文献
2.
Okan Bilge Yelda Pinar Mehmet Asim Ozer Figen Govsa 《Journal of plastic, reconstructive & aesthetic surgery》2007,60(10):1120-1126
The lumbrical muscles are located in the midpalm, dorsal to the palmar aponeurosis. The main function of these muscles is an indirect contribution to interphalangeal joint extension by decreasing the flexor effect of the flexor digitorum profundus muscle. Due to their minor biomechanical functions and suitable constructions, these muscles have been preferred in reconstructive surgery as local transposition flaps or pedicled flaps. Despite the surgical and clinical importance, vascular anatomical studies of these muscles are not well represented in the current literature. This study was performed in the Department of Anatomy of the Faculty of Medicine of the Ege University. Thirty-four cadaver hands, injected with red-coloured latex were used, and we aimed to describe the morphometry and vascular anatomy of the lumbrical muscles. We measured the length and width of the muscles, after removing their epimisium, and the diameter and length of the arteries to the muscles. The outcomes of our study determined that the length and width of the lumbrical muscles were reduced significantly from radial towards ulnar sides. The lumbrical muscles were supplied from both their palmar and dorsal surfaces by both superficial and deep palmar arches and/or their branches. We also described the level of entry of the dominant arteries for each lumbrical muscle and measured the size of the vessels and muscles to guide some surgical approaches. This anatomical study could guide for some surgical approaches and reduce the deficiency about the vascular anatomical patterns of the lumbrical muscles in the literature. 相似文献
3.
4.
Erythraea centaurium is a plant which is used in the treatment of various inflammatory conditions in popular medicine. The aqueous extract of the plant has been examined for its antiinflammatory, analgesic, and antipyretic effects in several animal models. The extract exhibited antiinflammatory and antipyretic activity although no analgesic activity was observed. 相似文献
5.
Lumbar intraradicular disc herniation: report of a rare and preoperatively unpredictable case and review of the literature. 总被引:1,自引:0,他引:1
BACKGROUND CONTEXT: Intraradicular lumbar disc herniation is rare, having been reported to date in only three postoperative patients. The diagnosis is typically made intraoperatively. PURPOSE: To report a fourth case of intraradicular disc herniation, to emphasize its radiological characteristics and operative findings. STUDY DESIGN: Case report. PATIENT SAMPLE: A 41-year-old female. METHODS: Retrospective case review. RESULTS: The patient underwent a second operation and intraradicular disc fragment was removed. She was completely well at her 9-month check up. CONCLUSIONS: The diagnosis, mechanism, and surgical treatment of intraradicular lumbar disc herniation are reviewed. The round shape of the sequestrated fragment, as seen on magnetic resonance imaging, may help to establish the correct diagnosis. 相似文献
6.
Burcin Ozer Muserref Tatman-Otkun Dilek Memis Metin Otkun 《Central European Journal of Medicine》2010,5(2):203-208
The aim of this study was to determine the types nosocomial infections (NIs) and the risk factors for NIs in the central intensive
care unit (ICU) of Trakya University Hospital. The patients admitted to the ICU were observed prospectively by the unit-directed
active surveillance method based on patient and the laboratory over a 9-month-period. The samples of urine, blood, sputum
or tracheal aspirate were taken from the patients on the first and the third days of their hospitalization in ICU; the patients
were cultured routinely. Other samples were taken and cultured if there was suspicion of an infection. Infections were considered
as ICU-associated if they developed after 48 hours of hospitalization in the unit and 5 days after discharge from the unit
if the patients had been sent to a different ward in the hospital. The rate of NIs in 135 patients assigned was found to be
68%. The most common infection sites were lower respiratory tract, urinary tract, bloodstream, catheter site and surgical
wound. Hospitalization in ICU for more than 6 days and colonization was found to be the main risk factor for NIs. Prolonged
mechanical ventilation and tracheostomy, as well as frequently changed nasogastric catheterization, were found to be risk
factors for lower respiratory tract infections. For bloodstream infections, both prolonged insertion of and frequent change
of arterial catheters, and for urinary tract infections, female gender, period and repeating of urinary catheterization were
risk factors. A high prevalence rate of nosocomial infections was found in this study. Invasive device use and duration of
use continue to greatly influence the development of nosocomial infection in ICU. Important factors to prevent nosocomial
infections are to avoid long hospitalization and unnecessary device application. Control and prevention strategies based on
continuing education of healthcare workers will decrease the nosocomial infections in the intensive care unit. 相似文献
7.
Yazicioglu M Oner N Celtik C Okutan O Pala O 《Asian Pacific journal of allergy and immunology / launched by the Allergy and Immunology Society of Thailand》2004,22(4):183-190
Asthma and allergic rhinitis are common problems in children and the causative pollen allergens vary according to the geographical area. The aim of this study was to investigate patterns of sensitization to common inhalant allergens, especially pollens, in Turkish children living in the Trakya region and to determine differences between rural and urban areas. Allergen skin testing was prospectively performed on 539 children aged between 4 and 17 years with respiratory allergy. The reaction was considered to be positive if the mean wheal diameter was at least 3 mm greater than that of the negative controls. We detected positive skin reactions in 420 (77.9%) children. Two hundred and eighty-one (52.1%) mite, 277 (51.4%) pollen, 174 (32.3%) mold, 65 (12.1%) animal dander, 12 (2.2%) cockroach and 6 (1.1%) latex skin sensitivities were detected. Among the pollen allergies 173 were cereal pollen (32.1%), 170 grass pollen (31.5%) and 144 tree pollen allergies (26.7%). The most common positive skin test among the pollens was to cultivated wheat (Titicum vulgare) (n = 116, 21,5%), followed by rye grass (Lolium perenne) and orchard grass (Dactylis glomerata). Positive skin reactions to Alternaria, to Candida albicans, and to all pollens except Ulmus competris, Pinus sylvetris, Platanus vulgaris and Tilia platyphyllos, were higher in children with allergic rhinitis than in those with asthma. In children from rural areas, allergic skin reactivity was found to be more common against Candida albicans, sheep dander and all pollens except Corylus avellana, Fraxinus excelsior, Populus alba, Pinus sylvetris, Platanus vulgaris and Chenopodium album, than in urban children. Although Trakya is close to Greece and other Mediterranean countries, this study suggests that the pollens, which sensitize children, are not similar. 相似文献
8.
A randomized controlled trial of goserelin and medroxyprogesterone acetate in the treatment of pelvic congestion 总被引:3,自引:0,他引:3
Following identification of the proportion of pelvic congestion among symptomatic patients complaining of chronic pelvic pain, and in a totally asymptomatic group of patients requesting tubal ligation, the efficiency of goserelin acetate versus medroxyprogesterone acetate was compared objectively using pelvic venogram scores, and subjectively by symptom resolution, improvement of psychological status and sexual functioning in a prospective randomized trial in 47 patients with pure pelvic congestion syndrome. Patients received either goserelin acetate (3.6 mg/month for 6 months) or medroxyprogesterone acetate (MPA; 30 mg/day for 6 months). Among patients with chronic pelvic pain, those with pure pelvic congestion were mostly parous, had the most severe pelvic signs and symptom scores, lowest rates of sexual functioning, and higher states of anxiety and depression as compared with others. At 1 year after treatment, goserelin remained superior to MPA in terms of pelvic venographic improvement as an objective measure. In alleviation of signs and symptomatology, improvement of sexual functioning and reduction of anxiety and depressive states as subjective measures, goserelin acetate achieved a statistically significant advantage (P = 0.0001) compared with MPA. 相似文献
9.
BACKGROUND: Some patients with endometriosis are candidates for sympathectomy of the superior hypogastric plexus. The objective of this paper is to describe our technique of laparoscopic presacral neurolysis for sympathectomy and to report 1 year results of the first 15 cases. METHODS: To achieve this objective in a prospective observational study of 1 year follow-up; we performed laparoscopic presacral chemical neurolysis with phenol in 15 patients with pelvic pain and minimal-moderate endometriosis. The main outcome measures were: the impact of treatment on pelvic symptom resolution, non-opioid analgesic consumption during menses, sexual performance and observed complications and side effects during 1 year follow-up. RESULTS: We noted a significant reduction in total pelvic symptom score as compared with baseline mean (SD) of 9.04 (1.2). The mean difference [95% confidence interval (CI)] of reduction was 5.7 (4.9-6.5), 5.8 (5.0-6.6) and 5.8 (4.9-6.6) from the baseline at the 3rd, 6th and 12th postoperative month (P < 0.001). We observed a significant improvement in Sabbatberg Sexual Rating Scale as compared with baseline mean (SD) of 30.9 (4.3). The mean difference (95% CI) of increase was 33.4 (30.3-36.4), 33.2 (30.1-36.2) and 33.2 (30.1-36.3) from the baseline at the 3rd, 6th and 12th postoperative month. We observed a significant reduction in analgesic consumption during menses in terms of total naproxen sodium tablets as compared with baseline mean (SD) of 8.9 (1.1). The mean difference (95% CI) of reduction in the total number of naproxen sodium 250 mg tablets was 6.5 (5.5-7.5), 6.7 (5.7-7.7) and 6.6 (5.6-7.6) from the baseline at the 3rd, 6th and 12th postoperative month. The most common side effect was constipation. CONCLUSION: Laparoscopic presacral neurolysis is feasible and simple. More data is needed to support its efficacy and safety. 相似文献
10.
Ozer E Sengül AM Gedik S Salman S Salman F Sargin M Işsever H Satman I Yilmaz T 《Patient education and counseling》2003,51(1):39-44
To examine the influence of diabetes education on well-being, 255 patients with type 2 diabetes were recruited according to whether they attended a diabetes education program (n=126) or not (n=129). In patients who had participated in the program, the mean anxiety score was significantly lower, whereas positive well-being and general well-being scores were significantly higher than for patients who had not participated. Factors related to lower well-being included: being female, taking insulin, not attending a diabetes education program and having HbA(1c) level greater than 8%. The odds of having better well-being were two-fold higher in patients participating the diabetes education program compared with those who had not. Diabetes education has a crucial role in improving the well-being of patients with type 2 diabetes. All patients with diabetes should be encouraged to attend a diabetes education program. 相似文献