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Norma Terrin Angie Mae Rodday Hocine Tighiouart Grace Chang Susan K. Parsons 《Supportive care in cancer》2013,21(3):687-695
Purpose
Parents’ stress levels are high prior to their child’s hematopoietic stem cell transplant (HSCT) and during transplant hospitalization, usually abating after discharge. Nevertheless, a subgroup of parents continues to experience frequent anxiety and mood disruption, the causes of which are not well understood. The purpose of this study was to assess whether clinical complications of HSCT could explain variation in parents’ recovery of emotional functioning.Methods
Pediatric HSCT recipients (n?=?165) aged 5–18 and their parents were followed over the first year post-transplant. Health-related quality of life assessments and medical chart reviews were performed at each time period (baseline, 45 days, 3, 6, and 12 months). We tested the association between clinical complications [acute and chronic graft versus host disease (aGVHD and cGVHD), organ toxicity, and infection] and longitudinally measured parental emotional functioning, as assessed by the Child Health-Ratings Inventories. The models used maximum likelihood estimation with repeated measures.Results
In adjusted analyses covering the early time period (45 days and 3 months), aGVHD grade ≥2, intermediate or poor organ toxicity, and systemic infection were associated with decreases in mean parental emotional functioning of 5.2 (p?=?0.086), 5.8 (p?=?0.052), and 5.1 (p?=?0.023) points, respectively. In the later time period (6 and 12 months), systemic infection was associated with a decrease of 20 points (p?<?0.0001). cGVHD was not significantly associated.Conclusions
When children experience clinical complications after HSCT, parental emotional functioning can be impacted. Intervening at critical junctures could mitigate potential negative consequences for parents and their children. 相似文献34.
J. Allali 《Archives de pédiatrie》2010,17(11):1609-1616
Tearing and lacrimal pathologies are very frequent motives of consultation. The pediatrician must know the congenital dacryocele, and nasolacrimal duct obstruction by the Hasner valve imperforation, which represents the main reason of tearing of the infant. Nasolacrimal duct obstruction is treated by probing by the ophthalmologist from the third month and by probing with silicone intubation in case of failure, or in the children of more than one year old. 相似文献
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Hind Sahli Jihad Boularab Jihane El Mandour Nazik Allali Latifa Chat Siham El Haddad 《Radiology Case Reports》2022,17(7):2315
Extramedullary hematopoiesis is a rare disorder in which hematopoietic cells proliferate in tissues other than the bone marrow as a result of a range of hematologic illnesses. Our case is unique in that it covers a number of extramedullary hematopoiesis sites in a 15-year-old girl, some of which are uncommon. 相似文献
36.
A study was conducted to identify neural elements in the posterior ligaments of the lumbar spine by using a modified gold-chloride method. Three morphologic types of mechanoreceptors were identified: Ruffini corpuscles, Ruffini end organs, and pacinian corpuscles. Free nerve endings, which are thought to be responsible for pain production, were also demonstrated within the ligaments. 相似文献
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Amyopathic dermatomyositis 总被引:2,自引:0,他引:2
Amyopathic dermatomyositis (ADM) is a rare condition characterized by skin lesions suggestive of dermatomyositis (DM) without detectable muscle abnormalities after at least 2 years of follow-up. Pulmonary fibrosis is uncommon in patients with ADM. CASE REPORT: A 64-year-old woman presented with a 2 years and 6 months history of nondestructive polyarthritis. She had skin changes suggestive of DM, including a pink rash over the face, neck, and forearms; Gottron's papules over the metacarpophalangeal joints; and heliotrope edema of the eyelids. She reported no muscle symptoms. Findings were normal from muscle enzyme assays, electromyography, and muscle biopsies. A diagnosis of ADM was given. Early lung fibrosis was found. Investigations for a tumor were negative. DISCUSSION: ADM is a rare condition that may be an abortive form of DM with a favorable outcome and a lower risk of malignancy compared to classic DM. However, the development of pulmonary fibrosis may cloud the prognosis. 相似文献
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Tangri N Tighiouart H Meyer KB Miskulin DC 《Journal of the American Society of Nephrology : JASN》2011,22(12):2296-2302
The Centers for Medicare and Medicaid Services (CMS) designated the achieved urea reduction ratio (URR) as a pay-for-performance measure, but to what extent this measure reflects patient characteristics and adherence instead of its intent to reflect facility performance is unknown. Here, we quantified the contributions of patient case-mix and adherence to the variability in achieving URR targets across dialysis facilities. We found that 92% of 10,069 hemodialysis patients treated at 173 facilities during the last quarter of 2004 achieved the target URR ≥65%. Mixed-effect models with random intercept for dialysis facility revealed a significant facility effect: 11.5% of the variation in achievement of target URR was attributable to the facility level. Adjusting for patient case-mix reduced the proportion of variation attributable to the facility level to 6.7%. Patient gender, body surface area, dialysis access, and adherence with treatment strongly associated with achievement of the URR target. We could not identify specific facility characteristics that explained the remaining variation between facilities. These data suggest that if adherence is not a modifiable patient characteristic, providers could be unfairly penalized for caring for these patients under current CMS policy. These penalties may have unintended consequences. 相似文献
40.
Beauchet O Freiberger E Annweiler C Kressig RW Herrmann FR Allali G 《Journal of neuroengineering and rehabilitation》2011,8(1):37-5