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Objective
To present and evaluate the histological, anatomical and functional results of the McIndoe procedure, as modified by the application of oxidized cellulose (Surgicel™) in women with vaginal agenesis.Study design
Eleven patients with vaginal agenesis underwent vaginoplasty using a mould that had been wrapped with oxidized cellulose. The surgeries were performed between January 2009 and January 2010. Eight of the patients had been diagnosed with Mayer–Rokitansky–Kuster–Hauser (MRKH) syndrome, and the remaining three had been diagnosed with cervicovaginal agenesis (CVA). The mean follow-up time was 14 months (range, 6–24 months), and it included clinical examinations and evaluation of the Female Sexual Function Index (FSFI). Neovaginal biopsies were taken at the time of surgery and 1–12 months after surgery. The histology of the samples was evaluated to determine squamous epithelialization of the neovaginal tissue over time, and the total collagen content of the neovaginas were compared with normal control subjects. For statistical analysis we employed the ANOVA test and the t-test.Results
At 6 months, anatomical success was achieved in 100% of the MRKH syndrome patients (neovaginal length ≥ 6 cm), and functional success was achieved in 100% of the patients who started their sexual life (FSFI score ≥ 30). Biopsy results showed complete epithelialization of the neovagina after 5 months in all samples, and the collagen content was comparable to that of a normal vagina. One major postoperative complication occurred in a patient with CVA, which culminated in death. The uterovaginal canalization procedure was unsuccessful at creating an outflow tract for regular menses in all cases.Conclusions
The procedure described here offers patients a functional vagina by means of a simple and low-cost procedure that elicits squamous epithelialization of the neovaginal vault, with total collagen content similar to that of normal vaginal tissue. It is a potential alternative therapeutic approach for MRKH syndrome but not applicable to cases of CVA. 相似文献Statement of problem
Preparation of coronal dentin by using a diamond rotary instrument usually results in higher bond strength values than preparation with tungsten carbide burs, but information is lacking about the influence of rotary instruments on root canals before the bonding of fiber posts.Purpose
The purpose of this in vitro study was to evaluate the influence of the rotary instrument used to prepare the root canal and bonding strategies on the adhesion of fiber posts to root dentin with universal adhesive systems.Material and methods
Human premolars were used and divided into 8 groups according to the combination of the following factors: rotary instrument (tungsten carbide bur versus diamond rotary instrument), cementation system (single-bond versus prime and bond), and bonding method (etch-and-rinse versus self-etch). Eight teeth per group were evaluated by push-out bond strength, 4 teeth were evaluated for nanoleakage by using scanning electron microscopy (SEM), and 2 teeth were evaluated for shape by SEM. Data for bond strength and nanoleakage for each cementation system were subjected to 2-way ANOVA and Tukey honest significant differences tests (α=.05).Results
The highest bond strength values were observed for preparation using a diamond rotary instrument for both cementation systems. For prime and bond, the highest bond strength values were observed with the self-etch adhesion strategy, and the self-etch strategy was better for the single-bond; and the self-etch strategy was better than etch-and-rinse just after the use of a diamond instrument. In relation to nanoleakage for the cementation system, the prime and bond had the lowest values for groups using a diamond instrument and self-etch strategy. For the single bond, the adhesion strategy did not influence nanoleakage, but the rotary instrument did, with diamond rotary instruments resulting in lower values. SEM analyses showed a greater number of unobliterated tubules in the self-etch mode and a more regular surface when prepared with a diamond rotary.Conclusions
To improve the adhesion of fiber posts to root canal, a diamond rotary instrument should be used, and generally, universal adhesive systems must be used in self-etch mode. 相似文献Investigate the effect of erosive challenge with hydrochloric acid (HCl) on the surface of five different restorative materials.
Material and methodsTen plates of five restorative materials (Admira Fusion, Activa BioActive-Restorative, Charisma, Equia Forte HT Fil/EF, Filtek Universal Restorative/FU) were obtained. Half of the plate surfaces was covered with an adhesive tape, creating a control area, and the other side was submitted to the HCl (0.06 M HCl; pH 1.2; at 37 °C; for 30 h). Plates with control and HCl-treated areas were analyzed regarding the surface roughness (Sa), roughness profile (Rv), surface loss (SL), microhardness (MI), and gloss (GL) (n?=?10). Surface morphology was analyzed by SEM and chemical elements were identified by EDX (n?=?5). Data were evaluated by ANOVA and Tukey’s test (α?=?0.05).
ResultsMost materials were not affected by HCl. FU showed the lowest Sa and Rv, and the highest GL after HCl. On the other hand, EF presented the highest Sa, Rv, and SL, and the lowest GL. The MI of materials was not changed after HCl. Topographical and chemical alterations were observed after HCl only for EF.
ConclusionsThe composites showed minor surface changes after HCl, which was not observed for the glass ionomer cement (EF). FU presented the best performance regarding the parameters evaluated.
Clinical relevanceThe effects of erosive challenge with HCl on composites were minimal, while the glass ionomer cements might not be indicated as restorative material for patients with gastroesophageal reflux disease.
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