全文获取类型
收费全文 | 1740篇 |
免费 | 61篇 |
国内免费 | 9篇 |
专业分类
耳鼻咽喉 | 4篇 |
儿科学 | 55篇 |
妇产科学 | 46篇 |
基础医学 | 287篇 |
口腔科学 | 19篇 |
临床医学 | 207篇 |
内科学 | 401篇 |
皮肤病学 | 9篇 |
神经病学 | 184篇 |
特种医学 | 34篇 |
外科学 | 226篇 |
综合类 | 5篇 |
一般理论 | 1篇 |
预防医学 | 69篇 |
眼科学 | 6篇 |
药学 | 126篇 |
中国医学 | 2篇 |
肿瘤学 | 129篇 |
出版年
2024年 | 1篇 |
2023年 | 12篇 |
2022年 | 25篇 |
2021年 | 65篇 |
2020年 | 14篇 |
2019年 | 30篇 |
2018年 | 38篇 |
2017年 | 20篇 |
2016年 | 35篇 |
2015年 | 46篇 |
2014年 | 56篇 |
2013年 | 85篇 |
2012年 | 151篇 |
2011年 | 162篇 |
2010年 | 88篇 |
2009年 | 78篇 |
2008年 | 139篇 |
2007年 | 122篇 |
2006年 | 117篇 |
2005年 | 96篇 |
2004年 | 109篇 |
2003年 | 81篇 |
2002年 | 107篇 |
2001年 | 14篇 |
2000年 | 14篇 |
1999年 | 14篇 |
1998年 | 20篇 |
1997年 | 15篇 |
1996年 | 10篇 |
1995年 | 7篇 |
1994年 | 14篇 |
1993年 | 9篇 |
1992年 | 5篇 |
1991年 | 5篇 |
1988年 | 3篇 |
1987年 | 1篇 |
1986年 | 1篇 |
1977年 | 1篇 |
排序方式: 共有1810条查询结果,搜索用时 15 毫秒
51.
52.
Jean-Christophe Lifante Claire Blanchard Eric Mirallié Albert David Jean-Louis Peix 《World journal of surgery》2014,38(3):576-581
Background
The American Thyroid Association (ATA) published recommendations for the timing of prophylactic surgery for medullary thyroid carcinoma based on the specific mutation, patient age, family history, and serum calcitonin levels. The aim of this study was to assess the role of preoperative basal calcitonin (prebCt) levels in predicting the presence of medullary carcinoma of the thyroid in patients with RET mutations.Methods
We conducted a retrospective study in two endocrine surgery departments. Between 1986 and 2012, a total of 32 patients with RET mutations underwent prophylactic thyroidectomy. The patients were stratified into four ATA risk levels: A, B, C, and D.Results
All of the patients were biologically cured. Microcarcinoma was observed in the final pathology report for four of the 20 patients with normal prebCt (25 %) and for nine of the 12 patients with elevated prebCt (75 %). In the level A group, four patients with normal prebCt and one patient with elevated prebCt presented with microcarcinoma. In the level C group, one patient with normal prebCt and six of the seven patients with elevated prebCt (86 %) presented with microcarcinoma.Conclusions
PrebCt can predict the presence of microcarcinoma according to surgical pathological analysis. Patients with microcarcinoma can be biochemically and clinically cured using prophylactic thyroidectomy. 相似文献53.
54.
Géraldine Pignot Pierre Bigot Jean-Christophe Bernhard Fabien Bouliere Thomas Bessede Karim Bensalah Laurent Salomon Nicolas Mottet Laurent Bellec Michel Soulié Jean-Marie Ferrière Christian Pfister Julien Drai Marc Colombel Arnauld Villers Jerome Rigaud Olivier Bouchot Francesco Montorsi Jean-Jacques Patard 《Urologic oncology》2014,32(7):1024-1030
ObjectivesTo analyze to what extent partial nephrectomy (PN) is superior to radical nephrectomy (RN) in preserving renal function outcome in relation to tumor size indication.Methods and materialsClinical data from 973 patients operated at 9 academic institutions were retrospectively analyzed. Glomerular filtration rate (GFR) before and after surgery was calculated with the abbreviated Modification of the Diet in Renal Disease equation. For a fair comparison between the 2 techniques, all imperative indications for PN were excluded. A shift to a less favorable GFR group following surgery was considered clinically significant.ResultsMedian age at diagnosis was 60 years (19–91). Tumor size was smaller than 4 cm in 665 (68.3%) cases and larger than 4 cm in 308 (31.7%) cases. PN and RN were performed in 663 (68.1%) and 310 (31.9%) patients, respectively. In univariate analysis, patients undergoing PN had a smaller risk for developing significant GFR change following surgery than those undergoing RN did. This was true for tumors≤4 cm (P = 0.0001) and for tumors>4 cm (P = 0.0001). In multivariate analysis, the following criteria were independent predictive factors for developing significant postoperative GFR loss: the use of RN (P = 0.0001), preoperative GFR<60 ml/min (P = 0.0001), tumor size≥4 cm (P = 0.0001), and older age at diagnosis (P = 0.0001).ConclusionsThe renal function benefit carried out by elective PN over RN persists even when expanding nephron-sparing surgery indications beyond the traditional 4-cm cutoff. 相似文献
55.
Michel Drancourt Sbastien Cortaredona Cla Melenotte Sophie Amrane Carole Eldin Bernard La Scola Philippe Parola Matthieu Million Jean-Christophe Lagier Didier Raoult Philippe Colson 《Viruses》2021,13(5)
SARS-CoV-2 nasopharyngeal shedding contributes to the spread of the COVID-19 epidemic. Among 3271 COVID-19 patients treated at the Hospital University Institute Méditerranée Infection, Marseille, France from 3 March to 27 April 2020, tested at least twice by qRT-PCR, the median SARS-CoV-2 nasopharyngeal shedding duration was 6 days (range 2–54 days). Compared with short shedders (qRT-PCR positivity < 10 days), 34 (1.04%) persistent shedders (qRT-PCR positivity ≥ 17 days; mean ± SD: 23.3 ± 3.8 days) were significantly older, with associated comorbidities, exhibiting lymphopenia, eosinopenia, increased D-dimer and increased troponin (p < 0.05), and were hospitalized in intensive care unit in 17.7% vs. 1.1% of cases (p < 0.0001). Viral culture was positive in six persistent shedders after day 10, including in one patient after day 17, and no viral co-pathogen was detected in 33 tested patients. Persistent shedders received azithromycin plus hydroxychloroquine ≥ 3 days in 26/34 (76.5%) patients, a figure significantly lower than in short shedders (86.6%) (p = 0.042). Accordingly, mortality was 14.7% vs. 0.5% (p < 0.0001). Persistent shedding was significantly associated with persistent dyspnea and anosmia/ageusia (p < 0.05). In the context of COVID-19 treatment, including treatment with azithromycin plus hydroxychloroquine, the persistence of SARS-CoV-2 nasopharyngeal shedding was a rare event, most frequently encountered in elderly patients with comorbidities and lacking azithromycin plus hydroxychloroquine treatment. 相似文献
56.
57.
El Khaddari S Gaudin JL Abidi H Picaud G Rode A Souquet JC 《Gastroentérologie clinique et biologique》2002,26(8-9):728-734
AIM: The aim of the study was to determine whether simple routine parameters evaluating the first session of transarterial chemoembolization (variation in alfa-fetoprotein concentration, tumor lipiodol uptake, and post-embolization syndrome) can predict survival of patients treated for hepatocellular carcinoma. METHODS: Seventy-two patients treated with transarterial chemoembolization and evaluated one month after the first sessions with CT scan were included. Transarterial chemoembolization session included hepatic arteriography, lipiodol and doxorubicin (50 mg) emulsion injection, followed by gelatin sponge embolization. The following variables were studied in univariate and multivariate analysis: 6 recorded at the first session (age, cirrhosis etiology, Child-Pugh class, tumor number, largest lesion size, and alpha-fetoprotein concentration), and 5 recorded after the first session (variation in alfa-fetoprotein concentration, tumor lipiodol uptake, post-embolization syndrome, mean interval between each session, and associated treatment). RESULTS: Mean follow-up was 22.7 months (4-106). Mean survival was 30.4 months (95% CI: 23. 3-37.5). Actuarial survival at 1, 2, 3 and 5 years was respectively 65.5%, 44%, 29.5%, and 18%. The only independent prognostic factors in multivariate analysis were the Child Pugh class and the mean interval between sessions (P<0.001 and<0.01 respectively). None of our criteria evaluating the first TACE session significantly influenced survival. CONCLUSION: The 3 parameters (variation in alpha-fetoprotein concentration, tumor lipiodol uptake and post-embolization syndrome) after the first transarterial chemoembolization did not predict survival. They could not be used to determine which patient could benefit from repeated transarterial chemoembolization sessions. 相似文献
58.
59.
60.
Accuracy of multislice computed tomography in the preoperative assessment of coronary disease in patients with aortic valve stenosis. 总被引:4,自引:0,他引:4
Martine Gilard Jean-Christophe Cornily Pierre-Yves Pennec Cedric Joret Grégoire Le Gal Jacques Mansourati Jean-Jacques Blanc Jacques Boschat 《Journal of the American College of Cardiology》2006,47(10):2020-2024
OBJECTIVES: To evaluate multislice computed tomography (MSCT) as an alternative to coronary angiography, we prospectively studied its diagnostic accuracy for the detection of significant coronary artery lesions in patients with significant aortic valve stenosis undergoing valve surgery. BACKGROUND: In patients with aortic valve stenosis, coronary angiography is still recommended before surgery. Multislice computed tomography is a promising noninvasive technique for the detection of significant coronary artery lesions. METHODS: Fifty-five consecutive patients scheduled for coronary angiography in the preoperative assessment of aortic valve stenosis underwent 16-slice MSCT 24 h before coronary angiography. We analyzed coronary lesions, image quality, and arterial calcium score. RESULTS: The sensitivity of the MSCT-based strategy in detecting significant stenosis was 100%, and its specificity 80%. The positive and negative predictive values were respectively 55% and 100%. For calcium scores <1,000 (77% of patients), MSCT detected all patients without coronary artery disease, enabling conventional coronary angiography to be avoided in 35 of 55 cases (80%). For calcium scores >1,000, MSCT enabled conventional coronary angiography to be avoided in only 6% of cases, either because significant stenosis was found with a possible indication of revascularization, or because the examination was not interpretable. CONCLUSIONS: The results of this initial experience in relatively few patients suggest that MSCT-based coronary angiography may serve as an alternative to invasive coronary angiography to rule out significant coronary artery disease in patients scheduled for elective aortic valve replacement. Larger studies are necessary to fully explore the potential of coronary MSCT to improve preoperative risk stratification. 相似文献