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排序方式: 共有866条查询结果,搜索用时 14 毫秒
31.
Spinal cord ependymoma: radical surgical resection and outcome 总被引:22,自引:0,他引:22
Hanbali F Fourney DR Marmor E Suki D Rhines LD Weinberg JS McCutcheon IE Suk I Gokaslan ZL 《Neurosurgery》2002,51(5):1162-72; discussion 1172-4
OBJECTIVE: Several authors have noted increased neurological deficits and worsening dysesthesia in the postoperative period in patients with spinal cord ependymoma. We describe the neurological progression and pain evolution of these patients over the 1-year period after surgery. In addition, our favored method of en bloc tumor resection is illustrated, and the rate of complications, recurrence, and survival in this group of patients is addressed. METHODS: We operated on 26 patients (12 male and 14 female) with low-grade spinal cord ependymomas between 1975 and 2001. The median age at diagnosis was 42 years. Tumors extended into the cervical cord in 13 patients, the thoracic cord in 7 patients, and the conus medullaris in 6 patients. Eleven patients had previous surgery and/or radiation therapy. RESULTS: We achieved a gross total resection in 88% of patients, whereas 8% had a subtotal resection and 4% had a biopsy. Only 1 patient developed a recurrence over a mean follow-up period of 31 months. CONCLUSION: We conclude that radical surgical resection of spinal cord ependymomas can be safely achieved in the majority of patients. A trend toward neurological improvement from a postoperative deficit can be expected between 1 and 3 months after surgery and continues up to 1 year. Postoperative dysesthesias begin to improve within 1 month of surgery and are significantly better by 1 year after surgery. The best predictor of outcome is the preoperative neurological status. 相似文献
32.
The effect of pentoxifylline on the healing of intestinal anastomosis in rats with experimental obstructive jaundice 总被引:4,自引:0,他引:4
Cömert M Taneri F Tekin E Ersoy E Oktemer S Onuk E Düzgün E Ayoğlu F 《Surgery today》2000,30(10):896-902
The aims of this study were (1) to investigate the effect of experimental obstructive jaundice on the healing of intestinal
anastomosis, and (2) to investigate the effect of pentoxifylline on the healing of intestinal anastomosis in rats with obstructive
jaundice. Obstructive jaundice was induced in rats by the ligation and division of the common bile duct. Four days after this
operation, either pentoxifylline or isotonic saline solution was administered intraperitoneally to these jaundiced rats and
controls, and then intestinal anastomosis was performed. The concentrations of serum tumor necrosis factor α (TNF-α) and serum
triglyceride of jaundiced and nonjaundiced rats were measured, and the quality of healing was evaluated by measuring the bursting
preasure and hydroxyproline content of the anastomoses on the fifth and tenth days of anastomotic healing. Obstructive jaundice
resulted in an impaired wound healing of the intestinal anastomosis in the rats. The administration of pentoxifylline to the
jaundiced rats resulted in better anastomotic wound healing. The beneficial effects of pentoxifylline on anastomotic healing
in rats with obstructive jaundice was attributed to its inhibitor effect on the endotoxin-induced TNF-α release from macrophages
and monocytes, and the stabilizing effect on the neutrophils.
Received: March 29, 1999 / Accepted: March 24, 2000 相似文献
33.
卫生改革应在总结提高的基础上有所突破 总被引:1,自引:1,他引:0
从我国卫生改革的成就中,抓住几个关键因素分析.其一,对我国卫生事业性质总结的成果奠定了卫生改革的基础;其二,市场化手段在卫生经营战略上的巧用,创造了中国特色的经营之道;其三,指出了卫生投入和卫生资源配置改革是卫生改革的重点并总结其成功之处.卫生改革如何深化?如何对过去经验继承、发扬、突破?一是指出过去改革留下的"死角";二是通过分析卫生事业面临的形势和今后的发展趋势,阐明卫生经营战略的策略是更好地应用市场化手段. 相似文献
34.
Prognostic significance of estrogen receptor expression in superficial transitional cell carcinoma of the urinary bladder 总被引:1,自引:0,他引:1
OBJECTIVES: The role of estrogens in human bladder cancer still remains to be resolved. This study was undertaken to determine the estrogen receptor (ER) expression status and to elucidate the prognostic significance of ER in superficial transitional cell carcinoma (TCC) of the human bladder. METHODS: Tumor tissue blocks which were obtained by transurethral resection (TUR) from 121 patients with superficial TCC and 30 control subjects were investigated. Median follow-up was 40 months. The expression of nuclear ER was evaluated by immunohistochemistry using avidin-biotin-peroxidase method and a monoclonal ER antibody. ER staining intensity in samples was assessed semi-quantitatively. Staining characteristics were compared with the clinico-pathological results. RESULTS: ERs were detected in 12.4% of the superficial TCC patients and in 10% of the controls (P = 0.73). No association was found between ER immuno-reactive score and patients' age, sex, tumor multiplicity or tumor size. An association between the ER staining intensity and higher tumor grade was observed (P = 0.01). Grades I, II and III tumors showed 10.6, 8.7 and 44.4% staining, respectively. Survival was not affected by ER expression. In multivariate analysis ER expression was not an independent prognostic factor. CONCLUSION: Superficial TCC of the bladder shows low ER expression and it appears that ERs do not have any direct role on the prognosis of patients with superficial TCC. 相似文献
35.
Perigraft to right atrial shunt by using autologous pericardium for control of bleeding in acute type A dissections 总被引:2,自引:0,他引:2
Posacioglu H Apaydin AZ Calkavur T Yagdi T Islamoglu F 《The Annals of thoracic surgery》2002,74(4):1071-1074
BACKGROUND: We report our experience with creating a perigraft to right atrial fistula by using autologous pericardium to control the inaccessible bleeding after aortic root repair in patients with acute type A aortic dissection. METHODS: Between 1994 and 2001, perigraft to right atrial fistula was used in 7 of 109 patients (mean age; 55 years) who underwent emergency operation for acute type A dissections. A chamber around the aortic graft was created by suturing a patch of pericardium to the right ventricular wall inferiorly, to the pulmonary artery medially, to the Teflon felt at the distal aortic anastomosis or innominate vein superiorly, and to the superior vena cava and right atrium laterally. A large stab wound was created on the medial aspect of the right atrium. The perigraft space was then closed expeditiously. RESULTS: None of these patients required reexploration for bleeding and they were discharged from the hospital without complications. The average blood and fresh frozen plasma requirement was 3.4 +/- 0.9 and 2.7 +/- 0.7, respectively. All underwent echocardiographic examination before discharge and no perigraft to right atrial shunt was detected. CONCLUSIONS: If intractable bleeding is encountered after the administration of protamine and thrombotic agents and a discrete bleeding site can not be found, then a perigraft to right atrial fistula using autologous pericardium can be created as a last resort. It provides primary and definite sternal closure and avoids the detrimental effects of a second pump run and continued bleeding. 相似文献
36.
BENIGN ORGASMIC CEPHALGIA 总被引:3,自引:0,他引:3
GEORGE W. PAULSON M.D. Neurologist HAROLD L. KLAWANS JR. M.D. Associate Professor 《Headache》1974,13(4):181-187
37.
Akinci F Yildirim A Ogutman B Ates M Gozu H Deyneli O Aydar S Isci E Balcioglu L Sayhan OZ 《Evaluation & the health professions》2005,28(1):53-66
This article describes the adaptation of the Finnish 15D standardized measure of health-related quality of life (HRQoL) instrument for use in Turkey and assesses its psychometric properties. The HRQoL is measured in a sample of 75 patients with Type 2 diabetes using both 15D and Nottingham Health Profile (NHP) instruments. The internal consistency within the domains of 15D was high, with Cronbach's alpha values 0.89 for 15D scale and 0.89 for NHP. Significant correlations were observed between the scores of similar domains of 15D and the NHP in general health perception supporting the construct validity of the new 15D Turkish version. Overall, the results indicated that the adaptation of the 15D for use in Turkey was successful. The Turkish version was found to be a reliable and valid instrument. It is suitable and applicable to both clinical and population-based studies for the measurement of HRQoL in Turkey. 相似文献
38.
Kahraman S Rezai SM Dogu H Sayan MA Akar Z 《Anesthesia and analgesia》2005,100(5):1414-5, table of contents
In this case report we present a patient with a painful traumatic neuroma after a finger stick by lancet. The patient benefited from surgical excision of the lesion, and her symptoms were completely abolished with additional sympathetic nerve blocks. 相似文献
39.
Balbay MD Cimentepe E Unsal A Bayrak O Koç A Akbulut Z 《The Journal of urology》2005,174(6):2260-2263
PURPOSE: In this prospective study we evaluated the incidence of bladder perforation after transurethral bladder tumor resection. MATERIALS AND METHODS: A total of 36 patients (33 male, 3 female, mean age +/- SD 65.6 +/- 11.43 [range 26 to 81]) with a solid mass in the bladder (mean 20.3 +/- 8.7 mm, range 5 to 40) were included in the study. Transurethral resections were performed with a 24Fr resectoscope. After the procedure an 18Fr Foley catheter was inserted into the bladder and 400 ml of 1/4 saline diluted contrast solution was instilled under gravity from 60 cm above the bladder. Complete filling and post-drainage radiographs were taken and examined for any evidence of extravasation. Regular evaluations with cystoscopy and ultrasound/computerized tomography were done to detect possible tumor recurrence and perivesical seeding. RESULTS: Histopathological examination of the tumors showed transitional cell carcinoma in 35 patients and chronic eosinophilic cystitis in 1. Review of the cystograms revealed various degrees of extraperitoneal contrast extravasation around the resected area in 21 patients (58.3%). The only statistically significant difference between patients with and without extravasation was in tumor size (logistic stepwise regression p = 0.030,) among factors tested including patient age and localization, number of foci, tumor grade and stage. No apparent clinical problems requiring medical or surgical intervention other than urethral catheterization developed and no evidence of extravesical tumor seeding as per ultrasound and/or computerized tomography was seen during a mean followup of 21.9 months (range 7 to 40). CONCLUSIONS: The extravasation of urine (asymptomatic perforation) after transurethral bladder tumor resection may occur much more frequently than believed or reported. It seems that this extravasation does not impose a significant risk of extravesical tumor seeding. 相似文献
40.
PURPOSE: There is sparse population-based data on health factors related to medicinal herb use and use of medicinal herbs in children. For a sample of American adults, we estimated the prevalence and frequency of medicinal herb use, factors related to use, reasons for use, patient-physician discussion, and the proportion of respondents who gave herbs to their children. METHODS: The data used in this study was from the 2001 North Carolina Behavioral Risk Factor Surveillance System, a population-based telephone survey of English-speaking adults (n = 2982). RESULTS: Approximately 20% of respondents reported using medicinal herbs in the past year. Of these, 34% reported discussion of herb use with a physician; 69% reported taking herbs to maintain health, 20% to prevent illness, and 11% to treat illness. Of the total sample, 7% reported using herbs everyday and 5% of the respondents reported giving their children herbal medicines in the past year. CONCLUSIONS: Medicinal herb use is common in this population sample. The lack of discussion between users and their physicians highlights the importance of patient-physician communication to avoid possible herb-drug interactions and surgical complications. Herb use appears to be a popular strategy for maintaining health. Children may be vulnerable to herbal toxicity and therefore clinicians need to know about their medicinal herb use and counsel appropriately. 相似文献