收费全文 | 1615篇 |
免费 | 129篇 |
国内免费 | 8篇 |
耳鼻咽喉 | 9篇 |
儿科学 | 15篇 |
妇产科学 | 8篇 |
基础医学 | 196篇 |
口腔科学 | 13篇 |
临床医学 | 187篇 |
内科学 | 558篇 |
皮肤病学 | 28篇 |
神经病学 | 156篇 |
特种医学 | 76篇 |
外科学 | 299篇 |
综合类 | 4篇 |
预防医学 | 44篇 |
眼科学 | 6篇 |
药学 | 61篇 |
中国医学 | 2篇 |
肿瘤学 | 90篇 |
2023年 | 16篇 |
2022年 | 51篇 |
2021年 | 111篇 |
2020年 | 62篇 |
2019年 | 107篇 |
2018年 | 111篇 |
2017年 | 53篇 |
2016年 | 62篇 |
2015年 | 61篇 |
2014年 | 97篇 |
2013年 | 88篇 |
2012年 | 161篇 |
2011年 | 148篇 |
2010年 | 62篇 |
2009年 | 58篇 |
2008年 | 74篇 |
2007年 | 89篇 |
2006年 | 71篇 |
2005年 | 64篇 |
2004年 | 46篇 |
2003年 | 39篇 |
2002年 | 35篇 |
2001年 | 12篇 |
2000年 | 6篇 |
1999年 | 2篇 |
1998年 | 4篇 |
1997年 | 3篇 |
1996年 | 4篇 |
1995年 | 6篇 |
1994年 | 2篇 |
1993年 | 2篇 |
1992年 | 3篇 |
1991年 | 5篇 |
1987年 | 3篇 |
1986年 | 3篇 |
1985年 | 1篇 |
1983年 | 2篇 |
1982年 | 4篇 |
1981年 | 3篇 |
1980年 | 1篇 |
1979年 | 2篇 |
1978年 | 1篇 |
1977年 | 2篇 |
1976年 | 3篇 |
1975年 | 2篇 |
1974年 | 1篇 |
1973年 | 2篇 |
1972年 | 1篇 |
1969年 | 1篇 |
1968年 | 1篇 |
The risk of ESKD is highly heterogeneous among renal diseases, and risk scores were developed to account for multiple progression factors. Kidney failure risk equation (KFRE) is the most widely accepted, although external validation is scarce. The objective of this study was to evaluate the usefulness of this score in a French case–control cohort and test the pertinence of the proposed thresholds.
MethodsA retrospective case–control study comparing a group of patients starting renal replacement therapy (RRT) to a group of patients with CKD stages 3–5. Multivariate analysis to assess the predictors of ESKD risk. Discrimination of 4-, 6- and 8-variable scores using ROC curves and compared with eGFR alone and albumin/creatinine ratio (ACR) alone.
Results314 patients with a ratio of 1 case for 1 control. In multivariate analysis, increasing age and higher eGFR were associated with a lower risk of ESKD (OR 0.62, 95% CI 0.48–0.79; and OR 0.72, 95% CI 0.59–0.86, respectively). The log-transformed ACR was associated with a higher risk of ESKD (OR 1.25 per log unit, 95% CI 1.02–1.55). The 4-variable score was significantly higher in the RRT group than in the CKD-ND group, and was more efficient than the eGFR (AUROC 0.66, 95% CI 0.60–0.72, p?=?0.018) and the log-transformed ACR (AUROC 0.63 95% CI 0.60–0.72, p?=?0.0087) to predict ESKD. The 6-variable score including BP metrics and diabetes was not more discriminant as the 4-variable score. The 8-variable score had similar performance compared with the 4-score (AUROC 8-variable score: 0.70, 95% CI 0.64–0.76, p?=?0.526). A 40% and 20% score thresholds were not superior to eGFR?<?15 and 20 mL/min/1.73 m2, respectively. A 10% threshold was more specific than an eGFR?<?30 mL/min/1.73 m2.
ConclusionKFRE was highly discriminant between patients progressing to ESKD vs those non-progressing. The 4-variable score may help stratify renal risk and referral in the numerous patients with stage 3 CKD. Conversely, the proposed thresholds for creating vascular access or preemptive transplantation were not superior to eGFR alone.
相似文献Background
For patients undergoing liver resection that leaves an empty intraparenchymal cavity, traditional topical agents might be inadequate to achieve additional hemostasis. A new hemostatic expanding topical foam (BioFoam®) has been designed to provide a mechanical seal. The objective of this study was to report our preliminary results regarding the safety and the efficacy using this foam.Methods
Between 2009 and 2011, BioFoam® was used to fill a three-dimensional defect following liver resection in 14 patients. The operative results and postoperative course of these patients were compared to those of 14 matched controls who underwent liver resection but did not receive BioFoam®.Results
The two groups were similar in terms of demographics, indications for liver resection, type of surgical procedure, and type and duration of clamping. BioFoam® patients experienced significantly less operative blood loss (275 vs. 630 ml, p = 0.032) but similar operative transfusion rates (28.6 vs. 35.7 %, p = 0.686) compared to no-BioFoam® patients. The postoperative mortality was nil and no patient developed postoperative hemorrhage. While the two groups shared similar overall (64.3 vs. 57.1 %, p = 0.599) and major (28.6 vs. 14.3 %, p = 0.357) complications rates, BioFoam® patients experienced significantly higher major vascular thrombosis compared to no-BioFoam® patients (29 vs. 0 %, p = 0.04). In the BioFoam® group, major vascular thrombosis was associated with exposure of the vessel along the transection plane.Conclusion
While the clinical benefit of BioFoam® in high-risk liver resections leaving a deep parenchymal defect remains to be proven, the associated risk of vascular thrombosis should preclude its use in contact with major veins. 相似文献Postoperative ilio-iliac arteriovenous fistula is an unusual but known complication after lumbar surgery.
Case reportWe report the case of a 74-year-old patient consulted at the emergency department for intense acute abdominal syndrome revealing a post-operative common ilio-iliac arteriovenous fistula 5 years after a lumbosacral arthrodesis L3–S1. The patient was treated with an endovascular arterial stent-graft with immediate vascular and clinical results.
ConclusionArteriovenous fistula is a possible etiology of acute abdominal syndrome in patients with lumbar or abdominopelvic surgery history.
相似文献