全文获取类型
收费全文 | 188篇 |
免费 | 7篇 |
国内免费 | 3篇 |
专业分类
儿科学 | 3篇 |
妇产科学 | 1篇 |
基础医学 | 10篇 |
口腔科学 | 2篇 |
临床医学 | 8篇 |
内科学 | 81篇 |
皮肤病学 | 2篇 |
神经病学 | 1篇 |
特种医学 | 26篇 |
外科学 | 27篇 |
综合类 | 3篇 |
预防医学 | 7篇 |
眼科学 | 8篇 |
药学 | 12篇 |
肿瘤学 | 7篇 |
出版年
2023年 | 1篇 |
2022年 | 8篇 |
2021年 | 8篇 |
2020年 | 2篇 |
2019年 | 6篇 |
2018年 | 12篇 |
2017年 | 7篇 |
2016年 | 7篇 |
2015年 | 12篇 |
2014年 | 15篇 |
2013年 | 7篇 |
2012年 | 16篇 |
2011年 | 9篇 |
2010年 | 11篇 |
2009年 | 12篇 |
2008年 | 8篇 |
2007年 | 14篇 |
2006年 | 4篇 |
2005年 | 4篇 |
2004年 | 7篇 |
2003年 | 10篇 |
2002年 | 7篇 |
2001年 | 5篇 |
1992年 | 2篇 |
1986年 | 1篇 |
1981年 | 1篇 |
1977年 | 1篇 |
1966年 | 1篇 |
排序方式: 共有198条查询结果,搜索用时 15 毫秒
71.
Sanaka MR Shah N Mullen KD Ferguson DR Thomas C McCullough AJ 《The American journal of gastroenterology》2006,101(12):2726-2730
BACKGROUND: There are several known predictors of an incomplete colonoscopy or difficult colonoscopy. In addition, inadequate bowel preparation has been reported in procedures scheduled later in the day. Operator fatigue, which tends to be higher as the day passes on, may also impact colonoscopy completion rate. AIMS: To determine the influence of performing outpatient colonoscopies in the afternoon versus morning on the completion rates of colonoscopy and adequacy of bowel preparation. METHODS: Retrospective chart review of all outpatient colonoscopies performed between November 2003 and October 2004 in the Division of Gastroenterology at MetroHealth Medical Center in Cleveland, Ohio. Patient demographics, indications for procedure, and colonoscopic findings were reviewed. Patients received polyethylene glycol electrolyte-based bowel preparation in the evening prior to the day of the scheduled colonoscopy. RESULTS: A total of 2,087 colonoscopies was performed, of which 1,084 were in the morning and 999 were in the afternoon. Patients in the morning and afternoon were similar in regards to the known risk factors predictive of an incomplete colonoscopy. The incompletion rate was significantly higher in the afternoon compared to the morning (6.5% vs 4.1%, P= 0.013, OR for incompletion was 1.64, CI 1.11-2.44). Inadequate bowel preparation was found in 167 out of 1,084 (15.4%) colonoscopies in the morning and 197 out of 999 (19.7%) colonoscopies in the afternoon (P= 0.011). Even after excluding incomplete colonoscopies due to poor bowel preparation precluding examination, the incompletion rate was still higher in the afternoon (5% vs 3.2%, P= 0.043, OR 1.60, CI 1.03-2.51). CONCLUSIONS: Scheduling of colonoscopies in the afternoon compared to the morning may be an independent predictor of an incomplete colonoscopy and inadequate bowel preparation. According to our study findings, scheduling of all outpatient colonoscopies preferentially in the morning would avoid suboptimal procedures in 5% of patients and the need for unnecessary repeat colonoscopy or an alternative imaging study in 2.4% of patients. 相似文献
72.
Vipin Gupta Saurabh Kedia Ujjwal Sonika Kumble Seetharama Madhusudhan Sujoy Pal Pramod Garg 《Clinical journal of gastroenterology》2018,11(3):212-216
A 60-year-old man presented with recurrent abdominal pain and weight loss for 6 months. Abdominal imaging showed a large vascular lesion in the head and neck of pancreas suggestive of arteriovenous malformation (AV malformation). Endoscopic ultrasound was done which showed features of AV malformation with no evidence of pancreatic malignancy. Surgery was planned for definitive treatment of malformation. Digital subtraction angiography with angioembolization was done prior to surgery to reduce vascularity of the lesion. He recovered after a pylorus preserving pancreaticoduodenectomy. Histopathology of the resected specimen confirmed the pancreatic AV malformation. There has been no recurrence at 2 years of follow-up. 相似文献
73.
Arora Umang Kedia Saurabh Garg Prerna Bopanna Sawan Jain Saransh Yadav Dawesh P. Goyal Sandeep Gupta Vipin Sahni Peush Pal Sujoy Dash Nihar Ranjan Madhusudhan Kumble Seetharama Sharma Raju Makharia Govind Ahuja Vineet 《Digestive diseases and sciences》2018,63(6):1592-1599
Digestive Diseases and Sciences - The literature on disease characteristics of colonic Crohn’s disease (CD) is sparse, especially from Asia, where the burden of inflammatory bowel disease is... 相似文献
74.
Vedha Sanghi Hina Amin Madhusudhan R Sanaka Prashanthi N Thota 《World journal of gastrointestinal endoscopy》2019,11(10):491-503
Esophageal cancer is a highly lethal disease and is the sixth leading cause of cancer related mortality in the world. The standard treatment is esophagectomy which is associated with significant morbidity and mortality. This led to development of minimally invasive, organ sparing endoscopic therapies which have comparable outcomes to esophagectomy in early cancer. These include endoscopic mucosal resection and endoscopic submucosal dissection. In early squamous cell cancer, endoscopic submucosal dissection is preferred as it is associated with cause specific 5-year survival rates of 100% for M1 and M2 tumors and 85% for M3 and SM1 tumors and low recurrence rates. In early adenocarcinoma, endoscopic resection of visible abnormalities is followed by ablation of the remaining flat Barrett's mucosa to prevent recurrences.Radiofrequency ablation is the most widely used ablation modality with others being cryotherapy and argon plasma coagulation. Focal endoscopic mucosal resection followed by radiofrequency ablation leads to eradication of neoplasia in93.4% of patients and eradication of intestinal metaplasia in 73.1% of patients.Innovative techniques such as submucosal tunneling with endoscopic resection are developed for management of submucosal tumors of the esophagus. This review includes a discussion of various endoscopic techniques and their clinical outcomes in early squamous cell cancer, adenocarcinoma and submucosal tumors. An overview of comparison between esophagectomy and endoscopic therapy are also presented. 相似文献
75.
KS Madhusudhan S Sharma DN Srivastava S Thulkar SN Mehta G Prasad V Seenu S Agarwal 《Journal of Medical Imaging and Radiation Oncology》2009,53(1):40-49
To prospectively compare the feasibility, safety and diagnostic role of carbon dioxide (CO2) digital subtraction angiography (DSA) using a ‘home made’ delivery system with iodinated contrast medium (ICM) DSA in the evaluation of peripheral arterial occlusive diseases (PAOD) of lower limbs. Twenty‐one patients (27 limbs; all men; mean age, 47.6 years) who presented with PAOD of lower limbs underwent DSA using both intra‐arterial CO2 and ICM. Conventional ICM DSA was performed first and used as gold standard. Carbon dioxide was then injected by hand using a locally improvised home made plastic bag delivery system. Patient tolerance was assessed subjectively. Arteries from aortic bifurcation to the ankle were independently evaluated by two radiologists and graded for stenosis using a five‐point scale. For each patient, the quality of CO2 DSA images were compared with the corresponding images of ICM DSA and an overall grade of ‘good’, ‘acceptable’ or ‘poor’ was assigned. Cohen’s kappa coefficient was used to determine inter‐observer agreement. Carbon dioxide opacified 86.2% (188/195) of major arteries and depicted stenosis adequately in 84.5% (191/226) of arterial segments. A good or acceptable image quality of CO2 DSA was obtained in over 95% of patients. Infrapopliteal arteries were inadequately visualized. Mild pain was seen in six (28.6%) patients with both contrast agents; one patient developed severe pain during CO2 DSA. Inter‐observer agreement was good (k > 0.75) at 70% of the segments. Administration of CO2 into lower limb arteries is well tolerated. Carbon dioxide DSA using the locally improvised home made delivery system is a feasible and safe alternative to ICM DSA in the evaluation of PAOD. It provides adequate imaging of arteries of lower extremities except infrapopliteal segments. 相似文献
76.
Manoharan Dinesh Srivastava Deep Narayan Gupta Arun Kumar Madhusudhan Kumble Seetharama 《Abdominal imaging》2019,44(6):2205-2216
Abdominal Radiology - Endoscopic retrograde cholangiopancreatography (ERCP) has currently become an inseparable tool in the gastroenterologist’s armamentarium for treatment of... 相似文献
77.
78.
Madhusudhan TR Rangan A Gregg PJ 《Annals of the Royal College of Surgeons of England》2008,90(4):332-335
INTRODUCTION
Upper gastrointestinal (GI) bleeding in patients who undergo hip and knee arthroplasty tends to be associated with non-steroidal anti-inflammatory drug use, steroid intake, pre-existing peptic ulcers and smoking. The use of aspirin for thromboprophylaxis is an added risk for the occurrence of GI bleed. The aim of this study was to determine the incidence of upper GI bleeding and whether the use of peri-operative oral ranitidine reduces the incidence of upper GI bleeding when aspirin thromboprophylaxis is used for hip and knee arthroplasty.PATIENTS AND METHODS
Data from 1491 and 886 patients who underwent hip and knee replacements at the James Cook University Hospital (group 1) and at Friarage Hospital, Northallerton (group 2), respectively, were analysed in retrospect. All patients received 150 mg of aspirin per day for a period of 6 weeks from the day of surgery. Additionally, patients operated at the Friarage Hospital received 300 mg of oral ranitidine per day, for three postoperative days.RESULTS
We observed that patients in group 1 had a higher incidence of overt upper GI haemorrhage, which was statistically significant (P <0.014) compared to patients in group 2.CONCLUSIONS
Based on this experience, we recommend the use of peri-operative gastric protection with ranitidine when aspirin is used for thromboprophylaxis in hip and knee arthroplasty. 相似文献79.
Madhusudhan KS Shad PS Sharma S Goel A Mahajan H 《International urology and nephrology》2012,44(4):1285-1287
Metastatic pulmonary calcification can be caused by a number of diseases, most common being end-stage renal disease. Most of the patients are asymptomatic, and imaging with computed tomography is useful in making a diagnosis. Demonstration of pulmonary and chest wall vessel calcification is characteristic. We report a case of a 60-year-old patient with chronic renal failure on dialysis, presenting with gradual onset dyspnea, who showed metastatic pulmonary calcification on chest imaging. 相似文献
80.
Development and validation of visceral fat quantification as a surrogate marker for differentiation of Crohn's disease and intestinal tuberculosis 下载免费PDF全文