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351.
352.
We describe modifications and suggestions for safer percutaneous catheterization of the brachial artery based in part on the anatomy of the axillary-brachial artery and surrounding nerves of the brachial plexus. The brachial artery approach should be nearly as safe as the femoral artery approach for percutaneous catheterization and should not be avoided if the femoral arteries cannot be used. 相似文献
353.
Total intravenous anesthesia versus single breath technique and anesthesia maintenance with sevoflurane for bariatric operations 总被引:2,自引:0,他引:2
Background: The choice of anesthetic technique for general anesthesia in morbidly obese patients remains controversial. We
aimed to compare blood gases, recovery and hemodynamic parameters using TIVA and sevoflurane anesthesia in bariatric surgery.
Methods: The study was performed with permission of the ethics committee.We studied 40 morbidly obese patients allocated to
2 groups. The total I.V. anesthesia (TIVA) group was named Group T, and the sevoflurane group was named Group S. In Group
T, anesthesia induction was achieved with propofol. In Group S, anesthesia induction was achieved by sevoflurane with single
breath technique, with maintenance provided with 1-2% volume sevoflurane. Student t, Chi square and ANOVA tests were used
for data analysis; p-value <0.05 was considered statistically significant. Results: There was no significant difference between
the 2 groups in demographic data, blood gas values and recovery characteristic. Hemodynamic values were significantly lower
in Group T than Group S, during and after the operative period. Conclusion: While sevoflurane induction and maintenance is
a suitable anesthetic modality for obese patients, TIVA can be applied easily in those patients possessing no extra risk factors
other than morbid obesity. 相似文献
354.
Systemic Inflammatory Response after Laparoscopic and Open Application of Adjustable Banding for Morbidly Obese Patients 总被引:1,自引:0,他引:1
Background: Surgical injury induces a systemic inflammatory metabolic-endocrine response that is proportional to the severity
of the surgical stress. Compared with the conventional open method, laparoscopic surgery is mini-invasive and has decreased
postoperative pain and length of hospitalization. The aim of this study was to investigate the systemic inflammatory response,
after laparoscopic and open stoma-adjustable silicone band application, which is thought to be mediated by cytokines. Method:
30 morbidly obese patients underwent Swedish adjustable gastric banding (SAGB). 15 patients underwent laparoscopic (group
1) and 15 open SAGB (group 2). Mean operative time for the laparoscopic group was 70-110 min and for the laparotomy group
80-120 min. Gallbladders were not removed,and there were no systemic diseases in the patients.The intensity of surgical trauma
was evaluated by measurement of metabolic and hormonal responses to the surgery. Plasma levels of C-reactive (CRP), haptoglobin,
ceruloplasmin, albumin, transferrin, IL-6, malonic dialdehyde (MDA) and creatinine were measured before and after the operation.
Results: CRP and IL-6 levels increased during and after laparoscopic and open SAGB. However, postoperative responses were
significantly greater after open SAGB (group 2) (p<0.05). MDA level, an indicator of an oxidative trauma, was elevated in
group 1 at the 6th postoperative hour but was significantly higher in group 2 at the 6th and 12th postoperative hours. The
results were more significant in group 2 (p<0.05).There was no statistical difference between groups 1 and 2 in terms of albumin,
creatinine, and transferrin levels before and after surgery. Conclusion: The systemic inflammatory res ponses after laparoscopic
SAGB were significantly reduced compared with those after open SAGB. 相似文献
355.
Diaphragm rupture is an infrequently encountered but well-documented injury in the multiply injured patient. Only a few cases in which minimally invasive techniques were used for repair have been reported thus far. Herein we describe the repair of a diaphragm rupture in a 36-year-old man who was injured in a motor vehicle accident. In a 10-year review of the literature, we were able to locate seven journal articles reporting 10 patients. We conclude that in appropriate stable patients with diaphragm rupture, minimally invasive techniques offer a reasonable alternative to open laparotomy or thoracotomy. 相似文献
356.
Ozgur Yigit Mehmet Samancioglu Umit Taskin Serdar Ceylan Kadir Eltutar Murat Yener 《European archives of oto-rhino-laryngology》2007,264(8):879-885
To compare external and endoscopic dacryocystorhinostomy outcomes in patients with chronic dacryocystitis, a total of 103 patients with the complaint of epiphora and diagnosed as chronic dacryocystitis were included in the study. We performed external dacryocystorhinostomy on 55 patients under local anesthesia and endoscopic dacryocystorhinostomy on 48 patients under general anesthesia by means of drill and placed silicon stents to all the patients. The patients were examined endoscopically, at postoperative intervals of 1 week, first month, third month, sixth month and the first year. The patency of the tubes and nasolacrimal ducts were evaluated by irrigation and complaints of the patients were noted. Silicon stents were harvested at the sixth week postoperatively. Outcomes were classified as successful when epiphora diminished, no recurrent infection was noted and minimal or no reflux from the canaliculis during or after lacrimal irrigation was seen. A prospective endoscopic surgery group was compared to a prospective control group (external dacryocystorhinostomy). Full success was achieved in 69.9% of the patients with external dacryocystorhinostomy group whereas the full success rate of endoscopic dacryocystorhinostomy was 89.7%. Recently popularized endoscopic dacryocystorhinostomy is a safe and reliable procedure with high success rates. 相似文献
357.
Aslihan Kara Metin Kaya Gurgoze Mustafa Aydin Erdal Taskin Unal Bakal Aysen Orman 《Pediatrics and neonatology》2018,59(4):375-379
Background
The aim of present study was to evaluate the indications, complications and outcomes of acute peritoneal dialysis (APD) in neonates at a referral university hospital during the previous 8 years.Methods
This retrospective analysis included a total of 52 newborn infants who underwent APD in a neonatal intensive care unit between January 2008 and March 2016. Demographic, clinical, laboratory and microbiological data were extracted from patients' medical files.Results
The primary causes for requiring APD were acute tubular necrosis (n = 36, 69.2%), inborn error of metabolism (n = 10, 19.2%), congenital nephrotic syndrome (n = 2, 3.9%), bilateral polycystic kidney (n = 2, 3.9%), renal agenesis (n = 1, 1.9%), and obstructive uropathy (n = 1, 1.9%). The mean duration of APD was 8.7 ± 15.87 days (range: 1–90 days). Procedural complications were mainly hyperglycemia (n = 16, 47.1%), dialysate leakage (n = 7, 20.6%), peritonitis (n = 3, 8.8%), catheter obstruction (n = 3, 8.8%), bleeding at the time of catheter insertion (n = 2, 5.9%), catheter exit site infection (n = 2, 5.9%), and bowel perforation (n = 1 2.9%). There were 40 deaths (76.9%), mainly due to underlying causes. Ten of the 12 survivors showed full renal recovery, but mild chronic renal failure (n = 1) and proteinuria with hypertension were seen (n = 1) in each of remaining patients.Conclusion
Peritoneal dialysis is an effective route of renal replacement therapy in the neonatal period for management of metabolic disturbances as well as renal failure. Although major complications of the procedure are uncommon, these patients still have a high mortality rate due to serious nature of the underlying primary causes. 相似文献358.
359.
360.
Ibrahim Yalcin Mehmet Mutlu Meydanli Ahmet Taner Turan Salih Taskin Mustafa Erkan Sari Tayfun Gungor Ozgur Akbayir Ali Ayhan 《International journal of clinical oncology / Japan Society of Clinical Oncology》2018,23(2):329-337