全文获取类型
收费全文 | 443篇 |
免费 | 15篇 |
国内免费 | 5篇 |
专业分类
耳鼻咽喉 | 4篇 |
儿科学 | 19篇 |
妇产科学 | 31篇 |
基础医学 | 21篇 |
临床医学 | 47篇 |
内科学 | 164篇 |
皮肤病学 | 29篇 |
神经病学 | 7篇 |
特种医学 | 9篇 |
外科学 | 78篇 |
综合类 | 7篇 |
预防医学 | 9篇 |
眼科学 | 3篇 |
药学 | 14篇 |
中国医学 | 2篇 |
肿瘤学 | 19篇 |
出版年
2023年 | 3篇 |
2022年 | 5篇 |
2021年 | 7篇 |
2020年 | 2篇 |
2019年 | 3篇 |
2018年 | 7篇 |
2017年 | 5篇 |
2016年 | 8篇 |
2015年 | 15篇 |
2014年 | 16篇 |
2013年 | 28篇 |
2012年 | 29篇 |
2011年 | 51篇 |
2010年 | 36篇 |
2009年 | 20篇 |
2008年 | 30篇 |
2007年 | 27篇 |
2006年 | 43篇 |
2005年 | 33篇 |
2004年 | 27篇 |
2003年 | 31篇 |
2002年 | 21篇 |
2001年 | 2篇 |
2000年 | 1篇 |
1999年 | 3篇 |
1998年 | 1篇 |
1997年 | 3篇 |
1996年 | 1篇 |
1994年 | 1篇 |
1993年 | 1篇 |
1991年 | 1篇 |
1984年 | 1篇 |
1983年 | 1篇 |
排序方式: 共有463条查询结果,搜索用时 797 毫秒
71.
72.
Complete mesocolic excision (CME) is being performed more frequently and has recently become an established oncologic surgical method for right hemicolectomy. Despite its advantages, such as its association with early mobilization, a short hospital stay, early bowel movement, mild postoperative pain, and good cosmesis, CME is technically demanding and carries the risk of severe complications. This study aims to compare the clinical, pathological, and oncological results of open and laparoscopic right hemicolectomy with CME.The data of 76 patients who underwent right hemicolectomy with CME and high vascular ligation were reviewed retrospectively. The patients were divided into 2 groups according to whether the open or laparoscopic technique was used.Thirty-two patients underwent open right hemicolectomy, and 44 patients underwent laparoscopic right hemicolectomy. The 2 groups were similar in age, sex, American Society of Anesthesiologists class, abdominal surgical history, tumor localization, and operation time. No significant differences were found regarding the specimen length, tumor size, harvested lymph nodes, number of metastatic lymph nodes, or tumor grade. According to the Clavien–Dindo classification system, the laparoscopic group had significantly fewer complications than did the open group (11.4% vs 31.2%; P = .04). The open group had a longer postoperative hospital stay than did the laparoscopic hemicolectomy group (9.9 ± 4.7 vs 7.2 ± 3.1 days; P = .002). In addition, the groups were similar with respect to disease-free survival (P = .14) and overall survival (P = .06).The data in this study demonstrated that no differences exist between the open and laparoscopic techniques concerning pathological and oncological results. However, significantly fewer complications and a shorter length of hospital stay were observed in the laparoscopic group than in the open group. Laparoscopic right hemicolectomy with CME and central vascular ligation is a safe and feasible surgical procedure and should be considered the standard technique for right-sided colon cancer. 相似文献
73.
74.
Adrenal ganglioneuromas are rare tumors originating from the neural crest tissue of the sympathetic nervous system. The clinical presentation for most patients is asymptomatic, and most of these tumors are hormone silent. We report a case of dopamine-secreting adrenal ganglioneuroma associated with paroxysmal hypertensive attacks in an adult patient. A 46-year-old woman was admitted to our hospital with a 2-month history of right flank pain, and a 2-year history of paroxysmal hypertensive attacks associated with headaches, palpitations, nervousness, and sweating. Abdominal CT and MRI revealed a solid round tumor approximately 4 cm in diameter on the upper pole of the right kidney. Urinary levels of dopamine and homovanillic acid were slightly elevated, although urinary levels of metanephrine and normetanephrine were suppressed. The urinary levels of epinephrine, norepinephrine, and vanillylmandelic acid were within normal limits. Right adrenalectomy was performed for treatment purposes. Histological diagnosis of the tumor was a ganglioneuroma originating from the adrenal medulla. In conclusion, this is a case of dopamine-secreting adrenal ganglioneuroma associated with paroxysmal hypertensive attacks in an adult patient. 相似文献
75.
Purnak Tugrul Efe Cumali Kav Taylan Wahlin Staffan Ozaslan Ersan 《Digestive diseases and sciences》2017,62(10):2900-2907
Digestive Diseases and Sciences - Beyond available guidelines, therapy of autoimmune hepatitis (AIH) shows wide variation among physicians. We compared two regimens for treatment naive AIH: one... 相似文献
76.
77.
Fidan E Onder Ersoz H Yilmaz M Yilmaz H Kocak M Karahan C Erem C 《Acta diabetologica》2011,48(4):297-302
Diabetic patients have a markedly increased risk of cardiovascular disease compared with non-diabetics. Two drug groups today
target insulin resistance; biguanides and thiazolidinediones. In addition, these may have other effects on cardiovascular
risk factors. The aim of this study was to evaluate the effects of metformin and rosiglitazone on non-traditional cardiovascular
risk factors. Forty type 2 diabetic patients were randomized into metformin and rosiglitazone groups. After receiving the
optimal doses, the patients were monitored for 12 weeks. Biochemical parameters, lipid parameters, CRP, insulin, c-peptide,
and HbA1c levels were analyzed. VWF, PAI-1, ICAM-1, TNF-α, IL-6, E-selectin, and fibrinogen levels were measured in order
to assess coagulation status and endothelial dysfunction. In the metformin group, body mass index, PPG, HbA1c, IL-6, ICAM-1,
and TNF-α levels were significantly decreased after 12 weeks compared with the basal levels. IL-6 levels decreased from 75 pg/ml ± 20
to 42 pg/ml ± 9 (P 0.023) and TNF- α levels from 61 pg/ml ± 31 to 39 pg/ml ± 10 (P 0.018). In the rosiglitazone group, FPG, PPG, HbA1c, insulin, HOMA-IR, IL-6, and TNF-α levels decreased significantly after
12 weeks compared with the basal levels. IL-6 levels decreased from 78 pg/ml ± 21 to 41 pg/ml ± 9 (P 0.028) and TNF-α levels from 62 pg/ml ± 19 to 37 pg/ml ± 10 (P 0.012). At the end of the study, no significant differences were determined between groups. Insulin resistance and type 2
diabetes are strongly associated with low grade inflammation. Both metformin and rosiglitazone were effective in controlling
inflammatory markers in addition to metabolic parameters. 相似文献
78.
Sinan Akbayram Murat Do?an Cihangir Akgün Erdal Peker Refah Sayιn Fesih Aktar Mehmet-Sel?uk Bekta? Hüseyin ?aksen 《Annals of Indian Academy of Neurology》2011,14(2):98-102
Background:
Guillain-Barré syndrome (GBS) is an acute inflammatory polyneuropathy commonly characterized by rapidly progressive, symmetric weakness and areflexia.Materials and Methods:
We retrospectively assessed the clinical manifestations, results of electrodiagnostic tests, functional status and prognosis of 36 children diagnosed with GBS.Results:
Based on clinical and electrophysiological findings, the patients were classified as having acute inflammatory demyelinating polyradiculoneuropathy (AIDP) (n = 25), acute motor axonal neuropathy (AMAN) (n = 10) and acute motor-sensory axonal neuropathy (AMSAN) (n = 1). Twenty (55.5%) patients were males and 16 (44.5%) patients were females. The mean age of the 36 patients was 68.1 ± 45.01 months (range, 6–180 months). Five (13.8%) patients were younger than 2 years. The most common initial symptoms were limb weakness, which was documented in 34 (94.4%) patients. In our study, 18 patients (51.4%) showed albuminocytological dissociation (raised protein concentration without pleocytosis) on cerebrospinal fluid (CSF) examination. Three patients (8.3%) required mechanical ventilation therapy during hospitalization. Unfortunately, three (8.3%) patients died; one patient had AIDP and two patients had axonal involvement (one case was AMAN and another case was AMSAN). When we compared the cases of residual sequel/dead and cases of complete recovery for neural involvement type including AIDP, AMAN and AMSAN, we did not find a statistically significant difference between the groups (P > 0.05).Conclusion:
Our findings showed that cases of GBS was not uncommon in children younger than 2 years of age, and CSF protein level might be found high in the first week of the disease in about one half of the patients, with a higher rate of morbidity and mortality in patients with axonal involvement than in those with AIDP. 相似文献79.
80.
Dogan L Gulcelik MA Karaman N Camlibel M Serdar GK Ozaslan C 《Clinical breast cancer》2012,12(3):194-198
BackgroundThe intraglandular flap is a volume replacement technique in which glandular tissue is used to close the tissue defect. We applied the intraglandular flap technique with racquet incision for tumors located in the upper outer quadrant of medium to small size breasts of 47 patients. In this report, we present our preliminary results of this technique.Patients and MethodsThe intraglandular flap technique using a racquet incision was used on 47 consecutive breast cancer patients with T1 and T2 tumors, and analyzed prospectively.ResultsThe median age of the patients was 46.5 (range, 24-63 years). The mean tumor size was 2.53 ± 0.8 cm. The volume of the resected specimen was 185 ± 29 cm3. The mean length of incision was 9.68 ± 1.8 cm. The mean distance from the tumor to the nearest surgical margin was 1.65 ± 0.4 cm. Fat necrosis was evident in 8 patients (17%) and hematoma in 2 patients (4.2%). The other complications like seroma, glandular, and flap necrosis were not observed.DiscussionIntraglandular flap technique with racquet incision used for tumors located in the upper outer quadrant of patients with medium and small breasts is an easy and safe technique with respect to cosmetic results, surgical margins and complications. The learning period of this technique is quite short. When used in patients with dense breasts the incidence of fat necrosis was found to be low. 相似文献