收费全文 | 956篇 |
免费 | 61篇 |
国内免费 | 3篇 |
耳鼻咽喉 | 20篇 |
儿科学 | 35篇 |
妇产科学 | 9篇 |
基础医学 | 176篇 |
口腔科学 | 2篇 |
临床医学 | 76篇 |
内科学 | 188篇 |
皮肤病学 | 6篇 |
神经病学 | 167篇 |
特种医学 | 39篇 |
外科学 | 135篇 |
综合类 | 1篇 |
预防医学 | 82篇 |
眼科学 | 18篇 |
药学 | 34篇 |
中国医学 | 2篇 |
肿瘤学 | 30篇 |
2023年 | 8篇 |
2022年 | 31篇 |
2021年 | 31篇 |
2020年 | 16篇 |
2019年 | 18篇 |
2018年 | 27篇 |
2017年 | 24篇 |
2016年 | 28篇 |
2015年 | 40篇 |
2014年 | 31篇 |
2013年 | 38篇 |
2012年 | 65篇 |
2011年 | 65篇 |
2010年 | 51篇 |
2009年 | 36篇 |
2008年 | 63篇 |
2007年 | 50篇 |
2006年 | 51篇 |
2005年 | 57篇 |
2004年 | 45篇 |
2003年 | 31篇 |
2002年 | 35篇 |
2001年 | 15篇 |
2000年 | 18篇 |
1999年 | 19篇 |
1998年 | 9篇 |
1997年 | 9篇 |
1996年 | 7篇 |
1995年 | 6篇 |
1994年 | 5篇 |
1993年 | 7篇 |
1992年 | 6篇 |
1991年 | 13篇 |
1990年 | 4篇 |
1989年 | 4篇 |
1988年 | 2篇 |
1987年 | 2篇 |
1986年 | 6篇 |
1985年 | 4篇 |
1984年 | 2篇 |
1981年 | 3篇 |
1980年 | 4篇 |
1975年 | 2篇 |
1974年 | 4篇 |
1969年 | 3篇 |
1968年 | 4篇 |
1922年 | 2篇 |
1908年 | 2篇 |
1887年 | 1篇 |
1858年 | 1篇 |
Transscleral controlled cyclophotocoagulation (COCO) is a transscleral 810-nm diode laser cyclophotocoagulation that automatically adjusts the applied laser energy utilizing an optical feedback loop. The present study investigates the influence of pseudoexfoliation (PEX) on the efficacy of COCO in a Caucasian study population.
MethodsRetrospective data from 130 consecutive eyes were analyzed during a 2-year follow-up. Baseline characteristics, intraocular pressure (IOP), number of IOP-lowering medications, visual field, best-corrected visual acuity (BCVA), and secondary surgical interventions (SSI) were analyzed. The primary endpoint was IOP reduction at M24 compared to baseline, and the secondary endpoints were IOP course, reduction of IOP-lowering medications, surgical success, and IOP-lowering SSIs stratified by PEX and baseline IOP.
ResultsIOP reductions of −35, −39, −25, −25, −23, −34, and −36% could be achieved from baseline to D1, W1, M1, M3, M6, M12, and M24 (all p < 0.001), respectively, while there was a significant overall reduction over time (p < 0.001) in the number of topical IOP-lowering medications postoperatively. The proportion of eyes requiring additional systemic IOP-lowering medication reduced from 31 to 0% at M24 (p = 0.025). Eyes without PEX and IOP < 30 mmHg at baseline had the lowest risk for IOP-lowering SSIs (p < 0.03). BCVA dropped at M12 (0.25 [95% CI: 0.12–0.38]), and the drop persisted during the following 12 months.
ConclusionThe present study demonstrates a midterm IOP-lowering effect after COCO while reducing the burden for topical and systemic IOP-lowering medications. Patients without PEX and IOP < 30 mmHg have a lower risk of SSI. The procedure per se cannot be excluded as causative for the decreased postoperative BCVA. Further prospective investigations are suggested.
相似文献Diagnosis
The case of an assumed major trauma after a traffic accident which turned out to be a stroke due to embolic occlusion of the middle cerebral artery is presented. Prehospital and inhospital diagnostic steps and management were conducted with awareness of possible bleeding complications due to thrombolytic treatment.Therapy
A goal-directed interdisciplinary approach led to a good outcome after weighing up the risks of intervention. 相似文献Objective
Decompressive hemicraniectomy (DC) and duroplasty after malignant brain infarction or traumatic brain injury is a common surgical procedure. Usually, preserved bone flaps are being reimplanted after resolution of brain swelling. Alloplast cranioplasties are seldom directly implanted due to the risk of wound healing disorders. While numerous studies deal with DC, little is known about the encountered problems of bone flap reimplantation. Thus, aim of the study was to identify surgery-associated complications after bone flap reimplantation.Methods
We performed a retrospective chart analysis of patients that underwent DC and subsequent bone flap reimplantation between 2001 and 2011 at our institution. We registered demographic data, initial clinical diagnosis and surgery-associated complications.Results
We identified 136 patients that underwent DC and subsequent reimplantation. Forty-one patients (30.1%) had early or late surgery-associated complications after bone flap reimplantation. Most often, bone flap resorption and postoperative wound infections were the underlying causes (73%, n = 30/41). Multivariate analysis identified age (p = 0.045; OR = 16.30), GOS prior to cranioplasty (p = 0.03; OR = 2.38) and nicotine abuse as a prognostic factor for surgery-associated complications (p = 0.043; OR = 4.02). Furthermore, patients with early cranioplasty had a better functional outcome than patients with late cranioplasty (p < 0.05).Conclusions
Almost one-third of the patients that are operated on for bone flap reimplantation after DC suffer from surgery-associated complications. Most often, wound healing disorders as well as bone flap resorption lead to a second or even third operation with the need for artificial bone implantation. These results might raise the question, if subsequent operations can be avoided, if an artificial bone is initially chosen for cranioplasty. 相似文献During monitoring of motor evoked potentials (MEP) elicited by transcranial electrical stimulation (TES) for prognostication of postoperative motor deficit, significant MEP changes without postoperative deterioration of motor function represent false-positive results. We aimed to investigate this phenomenon in a large series of patients who underwent resection of supratentorial lesions. TES was applied in 264 patients during resection of motor-eloquent supratentorial lesions. MEP were recorded bilaterally from arm, leg, and/ or facial muscles. The threshold criterion was applied assessing percentage increase in threshold level, which was considered significant if being?>?20% higher on affected side than on the unaffected side. Subcortical stimulation was additionally applied to estimate the distance to corticospinal tract. Motor function was evaluated at 24 h after surgery and at 3-month follow-up. Patients with false-positive results were analyzed regarding tumor location, tumor volume, and characteristics of the monitoring. MEP were recorded from 399 muscles (264 arm muscles, 75 leg muscles, and 60 facial muscles). Motor function was unchanged postoperatively in 359 muscles in 228 patients. Among these cases, the threshold level did not change significantly in 354 muscles in 224 patients, while it increased significantly in the remaining 5 muscles in 4 patients (abductor pollicis brevis in all four patients and orbicularis oris in one patient), leading to a false-positive rate of 1.1%. Tumor volume, opening the ventricle, and negative subcortical stimulation did not significantly correlate with false-positive results, while the tumor location in the parietal lobe dorsal to the postcentral gyrus correlated significantly (p?=?0.012, odds ratio 11.2, 95% CI 1.8 to 69.8). False-negative results took place in 1.1% of cases in a large series of TES-MEP monitoring using the threshold criterion. Tumor location in the parietal lobe dorsal to the postcentral gyrus was the only predictor of false-positive results.
相似文献