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排序方式: 共有601条查询结果,搜索用时 15 毫秒
41.
42.
Pawar M Mehta Y Kapoor P Sharma J Gupta A Trehan N 《Journal of cardiothoracic and vascular anesthesia》2004,18(3):304-308
OBJECTIVE: To determine the incidence, risk factors, outcome, and pathogens of central venous catheter-related bloodstream infections (CVC-BSIs). DESIGN: Prospective study. SETTING: Escorts Heart Institute and Research Centre, New Delhi, India. PARTICIPANTS: One thousand three hundred fourteen consecutive patients undergoing cardiac operations who were admitted to the intensive care unit with CVC. INTERVENTIONS: All patients were assigned into CVC-BSI (n = 35) and non-CVC-BSI (n = 1,279) groups. MEASUREMENT AND MAIN RESULTS: Of the 1,314 patients in the study, 35 (2.6%) had CVC-BSI. On univariate analysis, significant risk factors were use of multilumen catheters, coexistent infections, intra-aortic balloon counterpulsation (IABC), total ventilation hours, emergency surgery, acute physiology, age, chronic health evaluation score (APACHE II), and steroids. On multivariate analysis, duration of catheterization (24.5 +/- 10.9 v 6.1 +/- 3.2; p < 0.001), coexistent infections (57.11% v 2.61%; p < 0.001), IABC (77.1% v 4.1%; p = 0.005), and temperature (38.2 +/- 0.6 v 37.4 +/- 0.3; p < 0.001) were independent predictors of CVC-BSI. Pathogens isolated were Escherichia coli (47%), Acinetobacter species (11.7%), Enterobacter species (5.8%), Proteus species (5.8%), methicillin-resistant Staphylococcus species (11.7%), coagulase-negative Staphylococcus species (5.8%), and Candida (11.7%). The mortality rate in CVC-BSI was 22.9% as compared with 0.2% in non-CVC-BSI cases (p < 0.001). CONCLUSION: By univariate analysis, the risk factors for CVC-BSI were use of multilumen catheters, duration of catheterization, total ventilation hours, IABC, emergency surgery, APACHE II score, coexistent infections, and steroids. On multivariate analysis, duration of catheterization, IABC, coexistent infections, and temperature were independent predictors of CVC-BSI. The mortality was increased with CVC-BSI. 相似文献
43.
We report the learning curves of three eye surgeons converting from sutureless extracapsular cataract extraction to phacoemulsification using different teaching methods. Posterior capsule rupture (PCR) as a per-operative complication and visual outcome of the first 100 operations were analysed. The PCR rate was 4% and 15% in supervised and unsupervised surgery respectively. Likewise, an uncorrected visual acuity of > or = 6/18 on the first postoperative day was seen in 62 (62%) of patients and in 22 (22%) in supervised and unsupervised surgery respectively. 相似文献
44.
A prospective study was done to evaluate the incidence and microbiological trend of peritoneal infection in patients undergoing acute intermittent peritoneal dialysis (PD). Complete sterile procedure was ensured and at the completion of the procedure PD fluid was sent for bacteriological culture, sensitivity, and total and differential cell count. During the period September 2000 to February 2001 a total of 100 patients were evaluated. Male female ratio was 72:28. Mean age was 43.17 +/- 17.2 years. In 26 patients cyclers were used. Bacterial culture was positive in total of 30 cases (30%). Gram positive, Gram negative and mixed infection was found in 10%, 15%, and 5% respectively. Number of exchanges (31.61 +/- 7.7 vs. 31.3 +/- 6, p = 0.8) were similar and number of repositioning was significantly more in the infected group (23.3% vs. 11.4%, p < 0.01). Total cell count was significantly higher in infected group (274.3 +/- 502 vs. 31.25 +/- 79.34, p < 0.01). Among Gram +ve organisms Staphylococcus was found in 7, Enterococcus faecalis in 4 and Coryne bacterium sps. in 2 cases. Among Gram -ve organisms, E. coli was found in 4, Enterobacter in 3, Klebsiella 1, Pseudomonas 1, Acinetobacter arinatus 5, Acinetobacter baumani 3, and Citrobacter freundii 3. Mixed flora comprised of Enterococcus faecalis 3, Enterobacter 1, Staphlococcus 1, E. coli 3, Citrobacter 1, Acinobacter baumani 1. Although with the cyclers using collapsible bags, staphylococcus was not isolated, the total incidence of infection (11/26 cases) was not decreased with the use of cyclers. We conclude that in acute intermittent peritoneal dialysis the incidence of bacterial infection is 30% with preponderance of Gram -ve over Gram +ve organisms and organism of fecal origin being commoner than those of skin origin. Use of cycler-assisted over manual PD do not improve the incidence of infection. Repositioning of the stiff catheter significantly increases the incidence of infection. 相似文献
45.
Utkarsh Kohli Jitendra Sahu Rakesh Lodha Nidhi Agarwal Ruma Ray 《Pediatric critical care medicine》2007,8(4):389-391
OBJECTIVE: To report a case of invasive aspergillosis, associated with complete heart block and heart failure, in an immunocompetent child recovering from dengue shock syndrome. DESIGN: Case report and literature review. SETTING: Pediatric intensive care unit in a tertiary care center. PATIENT AND RESULTS: A 9-yr-old boy was admitted to our pediatric intensive care unit with dengue shock syndrome, for which he was successfully managed. During the recovery phase, the child developed recurrence of fever and signs of congestive heart failure. Thereafter, he developed complete heart block and died. Myocardial biopsy revealed myocarditis and invading fungal elements with branching septate hyphae suggestive of Aspergillus. A renal biopsy specimen also showed glomerular invasion with Aspergillus and patchy necrosis. This suggested the diagnosis of invasive aspergillosis. CONCLUSIONS: This case highlights an unusual manifestation of invasive aspergillosis in a critically ill immunocompetent child. 相似文献
46.
Naresh Kumar Baktavatsala Reddy Vikram Jitendra Mrinalini Kumar 《Indian Journal of Thoracic and Cardiovascular Surgery》2008,24(1):5-9
Background Despite several concerns involving patient status and care givers, the surgical management of cardiac diseases in patients
with Human Immunodeficiency Virus (HIV) positive status has evolved into a social reality which has good clinical outcome
and safety. We report here our clinical experience of seven patients with HIV positive status, on anti retroviral therapy,
undergoing cardiac surgery. Human resources, social and ethical problems faced in dealing with these patients are also discussed.
Methods This is a retrospective review of seven patients, all males, ranging in age from 33 to 60 years with HIV positive status and
undergoing anti retroviral therapy who have undergone cardiac surgical procedures. Their clinical presentation, management,
special precautions, pre and post operative medical therapies and follow up are discussed.
Results All 7 patients had good hospital course following their procedures. There was no hospital mortality. One patient was readmitted
for recurrent pleural effusion which was drained. All patients, except one lost to follow up are alive and well with no cardiac
symptom relapse between 6 months and 3 years.
Conclusion Cardiac surgery can be offered to patients with HIV positive status, with appropriate precautions, with safety to both patients
and care givers. Immediate and short term clinical outcomes in these patients are no different than for similar pathologies
in sero negative patients. 相似文献
47.
48.
Background
Most individuals who died of trauma were found to harbour microscopic primary cancers at autopsies. Surgical excision of the primary tumour, unfortunately, seems to disturb tumour dormancy in over half of all metastatic relapses. 相似文献49.
Anjana Trivedi Jitendra Patel 《Indian journal of otolaryngology and head and neck surgery》2006,58(4):408-409
Inflammatory pseudotumour (IPT), also known as inflammatory myofibroblastic tumour, is a rare cause of benign cervical lymphadenopathy.
In its acute clinical presentation it mimics malignant and infective causes of cervical lymphadenopathy. The combined clinical
history, histopathological findings, and imaging features of an infiltrating soft-tissue mass should lead to the possibility
of IPT. Radical surgery should be avoided before there is histological proof of a malignant tumor. 相似文献
50.
Jitendra D. Vaghasiya Navin R. Sheth Yagnik S. Bhalodia Nurudin P. Jivani 《Saudi Journal Of Gastroenterology》2010,16(3):174-180