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排序方式: 共有614条查询结果,搜索用时 31 毫秒
1.
Benoit J. M. Pirotte Alphonse Lubansu Michael Bruneau Chakir Loqa Nathalie Van Cutsem Jacques Brotchi 《Child's nervous system》2007,23(11):1251-1261
Objective The objective of this study was to evaluate whether the rigid application of a sterile protocol for shunt placement was applicable
on a routine basis and allowed the reduction of shunt infections (SI) in children.
Materials and methods Since 2001, a rigid sterile protocol for shunt placement in children using neither antibiotic-impregnated catheters nor laminar
airflow was prospectively applied at Erasme Hospital, Brussels, Belgium. For assessing the protocol efficacy before continuation,
we preliminarily analyzed the results of the first 100 operated children (43 females, 57 males, 49 aged <12 months; 115 consecutive
shunt placement/revision procedures). All procedures were performed by the same senior surgeon, one assistant, one circulating
nurse, one anesthesiologist. The sterile protocol was rigidly imposed to these four staff members: uniformed surgical technique;
limited implant and skin edge manipulation; minimized human circulation in the room; scheduling surgery as first morning operation;
avoiding postoperative cerebrospinal fluid (CSF) leak; double gloving; procedures of less than 30-min duration; systemic antibiotics
prophylaxis. We analyzed separately: (1) children carrying an increased risk of SI (n = 38) due to preoperative external ventricular drainage, CSF leak, meningitis, glucocorticoids, chemotherapy; (2) children
aged <12 months; (3) procedures for shunt revision.
Results Errors in protocol application were recorded in 71/115 procedures. They were mainly done by non-surgical staff, decreased
with time and were medically justified in some young children. Surprisingly, no SI occurred (follow-up, 4 to 70 months). One
child developed an appendicitis with peritonitis (Streptococcus faecalis) after 6 months. No SI was found. After peritonitis was cured, shunt reinsertion was uneventful.
Conclusion These preliminary results suggest that a uniform and drastic sterile surgical technique for shunt placement: (1) can be rigidly
applied on a routine basis; (2) can lower the early SI rate below 1%; (3) might have a stronger impact to reduce SI than using
antibiotic-impregnated catheters and optimizing the operative environment such as using laminar airflow and reducing the non-surgical
staff. This last issue will be evaluated further in the present ongoing protocol. 相似文献
2.
载银磷酸锆纱布对烧伤创面常见细菌作用的实验研究 总被引:1,自引:1,他引:0
目的 了解载银磷酸锆纱布对烧伤大鼠创面感染常见细菌的抗菌效力。方法制作Wistar大鼠烫伤(以下称烧伤)感染模型,采用试管双倍稀释法测定载银磷酸锆及磺胺嘧啶银的最低抑菌浓度(MIC)及最低杀菌浓度(MBC)。观察大鼠创面用磺胺嘧啶银纱布、普通尢菌纱布、载银磷酸锆纱布(小水洗及水洗20次)后痂下组织的细菌计数和对创面愈合的作用。结果载银磷酸锆对金黄色葡萄球菌、铜绿假单胞菌、大肠竹菌的MIC各为8、8、16mg/L,MBC各为16、8、32mg/L,为磺胺嘧啶银的2~8倍?大鼠创面用未水洗的载银磷酸锆纱布覆盖后,痂下细菌计数比用磺胺嘧啶银纱布低91%,比普通无菌纱布低99%未水洗的载银磷酸锆纱布对创面愈合的作用明显优于其他两种纱布,且其痂下组织细菌计数与水洗20次的效银磷酸锆纱布比较,差异无显著性意义(P>0.05)。结论载银磷酸锆埘烧伤创面感染常见细菌有较强的抑制和杀灭作用,其敷料可作为治疗措施中新的选择。 相似文献
3.
目的探讨不同方法治疗压疮的临床效果。方法将65例患者计Ⅱ~Ⅲ度溃疡84处按基本条件相当原则随机分成A、B、C三组,A组21例28处,伤口采用清创冲洗后,给予康惠尔水胶体敷料;B组23例30处,伤口采用湿润烧伤膏;C组21例26处,清创冲洗后,给予自制凡士林油纱敷料外敷溃疡面处。结果B组愈合率最高,且平均显效时间和愈合时间均较A、C两组明显缩短,且A、B组明显高于C组。结论采用清创冲洗后用湿润烧伤膏是治疗压疮较好的方法之一。 相似文献
4.
5.
In order to determine whether patients having pharyngeal packing experience more or less post-operative throat pain when tampons were used, 80 patients were randomized into two groups to receive either gauze or tampon pharyngeal packing. A third control group of 40 patients were intubated but did not have any throat packs. Post-operative throat pain was subjectively rated at both 6 hours and at 24 hours by an independent observer. Thirty-eight per cent of patients had moderate or severe throat pain in the gauze group, whilst in the tampon and control groups these amounted to only 15% and 1% respectively. A significantly higher proportion of patients also had a moderate or severe sore throat at 24 hours in the former group. Intubation alone resulted in a sore throat post-operatively in 50% of patients, but 85% of those had a mild sore throat only. No differences in pain ratings in any group could be shown between men or women or between age groupings. Endotracheal intubation often causes post-operative throat pain which is exacerbated by the use of pharyngeal packing. The results presented suggest that tampons are a safe, effective alternative to gauze and result in less severe post-operative throat pain. 相似文献
6.
采用纱球进行口腔护理的效果观察 总被引:5,自引:0,他引:5
目的探寻有效的口腔护理方法,取得更好的清洁口腔及洁牙效果。方法随机对53例有口腔护理适应症、意识清醒的患者,用纱球或棉球分别作左或右侧牙齿及口腔粘膜的清洁护理,并按同一标准进行效果评价。结果53例患者,以纱球擦洗侧,效果好的为42例,一般为11例,差为0例。以棉球擦洗侧,效果好为13例,效果一般为40例,差为0例,两组效果比较有显著性差异(P<0.01)。结论以纱球作口腔护理的清洁效果明显优于棉球的清洁效果。 相似文献
7.
Ruocco Fattori Romanelli Martelloni Casani Samolewska & Rezzonico 《Clinical and experimental allergy》1998,28(7):881-888
8.
王松 《辽宁中医药大学学报》2000,(1)
由于物理或化学因素引起皮肤创伤 ,皮肤创面形成以后 ,诸多原因(或感染 ,或异物 ,或血肿 ,或组织低流量血运不佳等 ) 使局部创面溃烂 ,创面增生和组织坏死液化交替、渗出 ,经久不愈。用中药制剂生肌膏制成膏剂药纱 ,外敷于皮肤疡面 ,收到满意的临床效果。 相似文献
9.
10.
G. Stühmer B. G. Weber R. Meierhans R. Janssen J. Brunner 《International orthopaedics》1977,1(2):95-99
Summary During the use of a vertical flow enclosure of our own design for almost five years, bacteriological studies and the infection rates in different groups of patients have taught us the following:1. In a clean room operating theatre, the use of a respired air exhaust system improves the sterility compared with the use of ordinary masks. In a vertical flow enclosure, the chest, the arms, and the hands of the team are contaminated from respired airborne bacteria if helmets, etc., are not worn.2. In our vertical flow enclosure with almost continuous absolute sterility of the air, the infection rate in primary total hip replacement is very low and less than 1%, including early and late infections. Antibiotics have not been used.In secondary surgery, i.e., total hip replacement in hip joints previously operated upon, the infection rate is markedly higher, probably because of a flare-up of latent infection.Clean room surgery therefore, can only prevent air borne contamination, and no more; but this is very valuable.3. Vertical flow enclosures of the Charnley-Howorth (1975) and Weber et al. (1971) type provide considerable improvement in sterility of the air compared with adaptations of more conventional theatres. We recommend that these facilities be made available for implant surgery. It is also necessary to have a stringent operational policy with cooperation and discipline on the part of all members of the theatre team.
Résumé Durant l'utilisation, depuis plus de 5 ans, de la serre stérile à flux laminaire vertical que nous avons construite, nous avons pratiqué des études bactériologiques et pu comparer les taux d'infection suivant les groupes de patients.1. Dans une salle d'opération propre, la stérilité est considérablement améliorée par le port de casques possédant un système d'aspiration de l'air expiré, ceci par rapport au port de masques ordinaires. De plus, si l'on ne porte pas le casque dans une serre à flux laminaire vertical, le tronc, les mains et les membres supérieurs de l'équipe chirurgicale sont contaminés par les microbes en suspension dans l'air expiré.2. Dans notre serre où l'air est pratiquement stérile, le taux d'infections précoces et tardives est inférieur à 1% dans les arthroplasties de la hanche, et cela sans utilisation d'antibiotiques.Lors d'interventions dites secondaires, c'est-à-dire dans les cas déjà opérés au préalable, par exemple par ostéotomie, ostéosynthèse, etc., le taux d'infection est plus élevé. On doit probablement en rechercher la cause dans une contamination de la plaie lors de la première intervention, l'infection alors à l'état latent pouvant se réveiller à la faveur d'une nouvelle opération.En opérant dans une serre stérile, on peut donc prévenir la contamination par l'air ambiant, mais pas plus. Cela est cependant déjà très appréciable.3. Comparées aux salles d'opération conventionnelles modernes, les serres stériles à flux laminaire vertical, comme celle de Charnley-Howorth (1975) et Weber-Meierhans (1971), améliorent considérablement la stérilité de l'air. Surtout pour la chirurgie prothétique de la hanche, dont les risques d'infection sont élevés, nous recommandons l'emploi de ce genre d'installation. Mais il est nécessaire que tous les membres de l'équipe chirurgicale adoptent des règles très strictes de discipline.相似文献