全文获取类型
收费全文 | 596篇 |
免费 | 50篇 |
国内免费 | 1篇 |
专业分类
耳鼻咽喉 | 3篇 |
儿科学 | 17篇 |
妇产科学 | 12篇 |
基础医学 | 39篇 |
口腔科学 | 6篇 |
临床医学 | 40篇 |
内科学 | 214篇 |
皮肤病学 | 10篇 |
神经病学 | 16篇 |
特种医学 | 38篇 |
外科学 | 104篇 |
综合类 | 11篇 |
预防医学 | 59篇 |
眼科学 | 6篇 |
药学 | 38篇 |
中国医学 | 3篇 |
肿瘤学 | 31篇 |
出版年
2023年 | 2篇 |
2022年 | 9篇 |
2021年 | 16篇 |
2020年 | 7篇 |
2019年 | 13篇 |
2018年 | 26篇 |
2017年 | 18篇 |
2016年 | 19篇 |
2015年 | 15篇 |
2014年 | 21篇 |
2013年 | 33篇 |
2012年 | 35篇 |
2011年 | 55篇 |
2010年 | 23篇 |
2009年 | 19篇 |
2008年 | 28篇 |
2007年 | 32篇 |
2006年 | 24篇 |
2005年 | 26篇 |
2004年 | 22篇 |
2003年 | 16篇 |
2002年 | 9篇 |
2001年 | 8篇 |
2000年 | 4篇 |
1999年 | 12篇 |
1998年 | 1篇 |
1996年 | 5篇 |
1995年 | 2篇 |
1994年 | 2篇 |
1992年 | 4篇 |
1991年 | 2篇 |
1990年 | 2篇 |
1989年 | 6篇 |
1988年 | 11篇 |
1987年 | 10篇 |
1986年 | 19篇 |
1985年 | 20篇 |
1984年 | 16篇 |
1983年 | 11篇 |
1982年 | 2篇 |
1981年 | 3篇 |
1979年 | 4篇 |
1978年 | 2篇 |
1977年 | 1篇 |
1976年 | 5篇 |
1975年 | 5篇 |
1973年 | 11篇 |
1972年 | 6篇 |
1971年 | 4篇 |
1960年 | 1篇 |
排序方式: 共有647条查询结果,搜索用时 15 毫秒
51.
Ademmer Vanessa Agha Bishr Shajari Mehdi Kohnen Thomas Schmack Ingo 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2022,260(2):521-528
Graefe's Archive for Clinical and Experimental Ophthalmology - To investigate short-term (3 months follow-up) changes in visual quality following Descemet membrane endothelial... 相似文献
52.
Monica Poiani Myriam Labopin Giorgia Battipaglia Dietrich W. Beelen Johanna Tischer Jürgen Finke Arne Brecht Edouard Forcade Arnold Ganser Jakob R. Passweg Helene Labussiere‐Wallet Ibrahim Yakoub‐Agha Kerstin Schfer‐Eckart Nicolaus Kroeger Blandine Guffroy Annalisa Ruggeri Jordi Esteve Arnon Nagler Mohamad Mohty 《American journal of hematology》2021,96(1):40-50
Karyotypic analysis at time of diagnosis has an important value in determining initial response to treatment, remission duration and overall survival (OS) in acute myeloid leukemia (AML). Less is known about its value before allogeneic hematopoietic cell transplantation (allo‐HCT) in patients transplanted with active disease, either relapsed or primary refractory (Rel‐Ref) AML. We explored the impact of cytogenetic risk (stratification according to MRC‐UK) in 2089 patients with either Ref (n = 972) or Rel AML (n = 1117) transplanted during the period 2000‐2017. Overall, 154 patients had a favorable risk, 1283 had an intermediate risk and 652 had an adverse cytogenetic risk. Median follow‐up was 49 months. Compared to the favorable risk group, intermediate and adverse risk patients were associated with worse leukemia‐free survival and OS and also with a higher incidence of relapse. In a subgroup analysis of patients in the intermediate risk group harboring Fms‐like tyrosine kinase 3‐internal tandem duplication (FLT3‐ITD), this remained an important prognostic factor, being associated with worse outcomes. When analyzing patients according to the intensity of the conditioning regimen, no differences were observed for the main transplant outcomes. In conclusion, in patients diagnosed with AML and transplanted with active disease, karyotype remains an important prognostic factor, allowing splitting patients into different risk groups according to their cytogenetics. Similarly, FLT3‐ITD mutation also remains a negative prognostic factor in this population. 相似文献
53.
This report reviews the clinical and radiographic features of 40 patients who underwent visceral esophageal substitution with colon for benign or malignant lesions of the esophagus. The incidence and radiographic identification of complications are discussed. All patients were routinely examined with barium esophagrams on postoperative day 10. If an anastomotic leak was suspected clinically before this time, studies were performed using water-soluble iodinated contrast material. Follow-up barium esophagrams were obtained 1-96 months after operation (average, 60 months) in 24 patients. Eight patients (21%) demonstrated asymptomatic "jejunization" of the colonic mucosa with no attributable clinical manifestations; this finding resolved in 1-3 months, without sequelae, and has not been reported before. The spectrum of ischemic changes in the colonic segment included mucosal edema, spasm, ulceration, loss of haustration, and frank necrosis. Radiographically detectable early postoperative complications included anastomotic leak in six (three pharyngocolic, three cervical esophagocolic) and aspiration of barium into the tracheobronchial tree due to incoordinated swallowing in eight. Late postoperative complications included anastomotic narrowing (12) malfunctioning of the colon due to impaired emptying (five), recurrent aspiration pneumonia (three), small bowel obstruction (three), transhiatal herniation of small bowel through the diaphragmatic hiatus (one), and reflux into the retained bypassed esophagus (one). 相似文献
54.
M.?A.?SohnEmail author A.?Agha P.?Steiner A.?Hochrein M.?Komm R.?Ruppert P.?Ritschl F.?Aigner I.?Iesalnieks 《International journal of colorectal disease》2018,33(7):871-878
Purpose
Damage control strategy (DCS) is a two-staged procedure for the treatment of perforated diverticular disease complicated by generalized peritonitis. The aim of this retrospective multicenter cohort study was to evaluate the prognostic impact of an ongoing peritonitis at the time of second surgery.Methods
Consecutive patients who underwent DCS for perforated diverticular disease of the sigmoid colon with generalized peritonitis at four surgical centers were included. Damage control strategy is a two-stage emergency procedure: limited resection of the diseased colonic segment, closure of oral and aboral colon, and application of a negative pressure assisted abdominal closure system at the initial surgery followed by second laparotomy 48 h later. Therein, decision for definite reconstruction (anastomosis or Hartmann’s procedure (HP)) is made. An ongoing peritonitis at second surgery was defined as presence of visible fibrinous, purulent, or fecal peritoneal fluid. Microbiologic findings from peritoneal smear at first surgery were collected and analyzed.Results
Between 5/2011 and 7/2017, 74 patients underwent a DCS for perforated diverticular disease complicated by generalized peritonitis (female: 40, male: 34). At second surgery, 55% presented with ongoing peritonitis (OP). Patients with OP had higher rate of organ failure (32 vs. 9%, p =?0.024), higher Mannheim Peritonitis Index (25.2 vs. 18.9; p =?0.001), and increased operation time (105 vs. 84 min., p =?0.008) at first surgery. An anastomosis was constructed in all patients with no OP (nOP) at second surgery as opposed to 71% in the OP group (p <?0.001). Complication rate (44 vs. 24%, p =?0.092), mortality (12 vs. 0%, p =?0.061), overall number of surgeries (3.4 vs. 2.4, p =?0.017), enterostomy rate (76 vs. 36%, p =?0.001), and length of hospital stay (25 vs. 18.8 days, p =?0.03) were all increased in OP group. OP at second surgery occurred significantly more often in patients with Enterococcus infection (81 vs. 44%, p =?0.005) and with fungal infection (100 vs. 49%, p =?0.007). In a multivariate analysis, Enterococcus infection was associated with increased morbidity (67 vs. 21%, p <?0.001), enterostomy rate (81 vs. 48%, p =?0.017), and anastomotic leakage (29 vs. 6%, p =?0.042), whereas fungal peritonitis was associated with an increased mortality (43 vs. 4%, p =?0.014).Conclusion
Ongoing peritonitis after DCS is a predictor of a worse outcome in patients with perforated diverticulitis. Enterococcal and fungal infections have a negative impact on occurrence of OP and overall outcome.55.
Mahwish Khan Shah Jahan Saba Khaliq Bushra Ijaz Waqar Ahmad Baila Samreen Sajida Hassan 《Archives of virology》2010,155(11):1735-1753
Hepatitis C virus (HCV) has chronically infected a large number of patients, leading to the development of steatosis, cirrhosis and, ultimately, hepatocellular carcinoma. The pathogenesis of HCV has not been fully explained, although steatosis is considered to contribute greatly to liver fibrosis progression, modulating host-cell lipid metabolism. Suspected underlying molecular mechanisms include interactions between HCV proteins and intracellular lipid metabolic pathways. Recent studies have suggested that the nucleocapsid of HCV (core) acts as a pathogenic factor involved in lipid droplet accumulation, changes in lipogenic gene expression and/or the activity of lipogenic proteins in a genotype-specific manner. In this review, we have tried to summarize the current knowledge regarding HCV-induced steatosis and the regulation of expression of host genes and receptors that aid in the viral life cycle and promote liver diseases. 相似文献
56.
Ayman Agha Gabriel Glockzin Matthias Woenckhaus Wolfgang Dietmaier Igors Iesalnieks Hans J. Schlitt 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(6):671-677
Background Insular thyroid carcinoma was described as a tumor with aggressive behavior, and patients usually present themselves with
an advanced tumor stage. Whether the insular component is an independent factor for poor prognosis remains unclear. Therefore,
in the present study, we compared the survival of patients with advanced insular, follicular, and papillary thyroid cancer.
Materials and methods The clinical behavior of tumors in three groups of patients with T4 thyroid carcinoma—8 patients with insular, 11 patients
with follicular, and 21 patients with papillary thyroid carcinomas—was compared. Disease-free survival and disease-specific
death were analyzed statistically. Cox regression analysis was used to evaluate the influence of histotype and other prognostic
factors.
Results At 3 years, survival was 37.5% (mean 26 months) among patients with insular thyroid carcinoma, 80% (mean 59 months) among
those with follicular, and 89% (mean 126 months) among those with papillary thyroid carcinomas (p = 0.007). Disease-free survival in patients without initial distant metastasis was worst in patients with insular thyroid
carcinoma (20%) compared to those with follicular (75%) and those with papillary thyroid carcinomas (71%).
Conclusion Patients with advanced insular thyroid carcinoma have a poorer outcome in comparison to patients with similar advanced stage
who have follicular or papillary thyroid carcinoma. 相似文献
57.
Coletta Adriana M. Agha Nadia H. Baker Forrest L. Niemiro Grace M. Mylabathula Preteesh L. Brewster Abenaa M. Bevers Therese B. Fuentes-Mattei Enrique Basen-Engquist Karen Gilchrist Susan C. Simpson Richard J. 《Breast cancer research and treatment》2021,187(2):407-416
Breast Cancer Research and Treatment - Preclinical evidence suggests that natural killer cell (NK-cell) function and myokines facilitate the protective effects of exercise for breast cancer... 相似文献
58.
Gastric interposition was achieved in 138 patients following transhiatal esophagectomy without thoracotomy. Among these, 33 had benign and 105 malignant lesions. All patients were evaluated on the 10th postoperative day with a barium swallow examination. However, if an anastomotic leak was suspected clinically before this time, a water-soluble contrast study was initially obtained. Early postoperative complications included anastomotic leaks (15), cricopharyngeal incoordination with aspiration (6), and gastric perforation (2). Late postoperative complications included anastomotic strictures (12), pyloric stenosis (4), recurrence of tumor (3), and transhiatal visceral herniation (2). Our technique of postoperative radiographic evaluation, particularly when a leak is suspected clinically, is discussed. 相似文献
59.
BACKGROUND: The Veterans Affairs (VA) health system has been criticized for being inefficient based on comparisons of VA care with non-VA care. Whether such comparisons are biased by differences between the VA patient population and the non-VA patient population is not known. Our objective is to determine if VA patients are different from non-VA patients in terms of health status and medical resource use. METHOD: We analyzed 128,099 records from the National Health Interview Survey for the years 1993 and 1994. We compared the VA patient population with the general patient population for self report on health status, number of medical conditions, number of outpatient physician visits, number of hospital admissions, and number of hospital days each year. RESULTS: The VA patient population had poorer health status (odds ratio [OR], 14.7; 95% confidence interval [CI], 10.7-20.2), more medical conditions (OR, 14; 95% CI, 10.5-18.7), and higher medical resource use compared with the general patient population (OR, 3.7 for 3 or more physician visits per year; OR 5.4 for 3 or more hospital admissions per year; OR, 7.7 for 21 or more days spent in a hospital per year). However, after controlling for health and sociodemographic differences, VA patients had similar resource use compared with the general patient population. CONCLUSION: Large differences in sociodemographic status, health status, and subsequent resource use exist between the VA and the general patient population. Therefore, comparisons of VA care with non-VA care need to take these differences into account. Furthermore, health care planning and resource allocation within the VA should not be based on data extrapolated from non-VA patient populations. Arch Intern Med. 2000;160:3252-3257. 相似文献
60.
Hala Mounir Agha Rania Zakaria Fatma Alzahraa Mostafa Hala Hamza 《Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital》2015,42(2):184-187
Congenital hepatic arteriovenous malformations are rarely seen in association with persistent neonatal pulmonary hypertension. We report the case of a full-term female newborn who presented with heart failure and respiratory distress soon after birth. Echocardiographic investigation revealed severe persistent pulmonary hypertension and patent ductus arteriosus. Here we report spontaneous regression in size of both the feeder vessel and the vascular bed of the congenital hepatic arteriovenous malformation. We postulate that our conservative use of oral heart failure therapy, in the form of diuretic agents and captopril, decreased the congestion and diameter of the affected vessels. 相似文献