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In patients undergoing external radiation therapy, bone marrow and cortical bone structures are all often neglected as organs at risk. Still, from increased febrile neutropenia risk in patients undergoing chemoradiation for a pelvic tumour to increased risk of vertebral fracture when undergoing hypofractioned stereotactic radiotherapy of a spinal metastasis, adverse effects are frequent and sometimes serious. This literature review first defines the rules for contouring these structures, then the dose constraints currently recommended. This article focuses first on conventional irradiation or intensity modulation radiotherapy considering classical fractionation. Secondly, it focuses on stereotactic radiotherapy. The considered organs will be haematopoietic structures, and bone cortical structures. Current recommendations are summarised in a table. 相似文献
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Mitchell M. Goodsitt PhD Emmanuel G. Christodoulou PhD Sandra C. Larson PhD Ella A. Kazerooni MD 《Academic radiology》2001,8(9):822-834
RATIONALE AND OBJECTIVES: Osteoporosis may contribute to the increased morbidity and mortality of elderly persons involved in motor vehicle accidents. Such patients commonly undergo whole-body computed tomographic (CT) studies that may be analyzed with quantitative CT. Various quantitative CT calibration techniques were investigated for use with patients who have suffered trauma, who are typically scanned on a backboard. MATERIALS AND METHODS: Lumbar simulator phantoms were used to simulate small and large patients. Vertebral spongiosa inserts with a wide range of bone and fat compositions were placed in the phantoms, and their bone mineral densities (BMDs) were measured by using calibration lines derived from the CT numbers of a calibration standard. Four calibration techniques were tested. In three the lumbar simulator and the calibration standard were scanned simultaneously, with the standard placed beneath the backboard (method 1), on top of the backboard adjacent to the lumbar simulator (method 2), or on top of the abdomen region of the lumbar simulator (method 3). The fourth technique employed a single calibration line derived from a separate scan of the calibration standard beneath the small lumbar simulator without the backboard, with correction for patient body size. RESULTS: The best overall results were obtained with the single calibration line method. The root mean square errors of the BMD values were 2.9-18.4, 2.5-7.5, 2.5-14.9, and 0.3-2.8 mg/cm3 for methods 1, 2, 3, and 4, respectively (ranges represent variations in the errors of the measured BMDs of the inserts due to changes in scanner table height and lumbar simulator phantom size). CONCLUSION: The single calibration line method is an accurate means of measuring BMD in trauma patients. 相似文献
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髋臼坐骨切迹周围骨盆截骨对儿童DDH的疗效探讨 总被引:1,自引:0,他引:1
目的介绍一种新的骨盆截骨即髋臼坐骨切迹周围骨盆截骨操作技术,并初步评价治疗儿童发育性髋关节脱位(Development Dysplsia of the Hip,DDH)的临床疗效。方法骨盆截骨线起自髂前上、下棘中点,与髋臼后上缘平行,并向髋臼后下方延长,止于距离坐骨切迹骨皮质3~5mm处,撑开截骨间隙时产生坐骨切迹皮质不完全性骨折,获得髋臼向前外方向的旋转,再用自体或异体楔形骨块嵌入截骨间隙,从而实现改变髋臼方向和增加对股骨头覆盖的目标。结果我院自2002年以来创用该术式治疗儿童发育性髋关节脱位64例(76髋)。对随访时间大于2年的12例14髋,按照McKay髋关节评定标准和Severin放射学分类评价标准评价其疗效,优12髋,良2髋。结论髋臼坐骨切迹周围骨盆截骨兼有Salter和Pemberton骨盆截骨的优点,但手术操作更为安全简便,适应征也比较宽泛。 相似文献
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David J. Sartoris M.D. Ralph E. Holmes M.D. Robert W. Bucholz M.D. Donald Resnick M.D. 《Skeletal radiology》1986,15(8):642-647
Radiographic and densitometric evaluation of a new type of bone graft substitute derived from reef-building sea coral via a hydrothermal chemical exchange process was undertaken in a canine diaphyseal defect model. Comparably sized blocks of this material and autogenous iliac cortical-cancellous graft were implanted into the respective radial diaphyses of seven dogs. Qualitative and quantitative radiographic assessment was performed during the immediate postoperative period and at 3 months following surgery. Significant complications were observed radiographically in over half of the coralline implanted limbs, including failed union, graft fracture, and loosening of internal fixation hardware. No significant difference was noted in degree of native osseous ingrowth between the implants and the autografts, and the latter exhibited a higher success rate. Radiographic film densitometry was found not to be reliably predictive of coralline implant behavior in the individual case. It is concluded that coralline hydroxyapatite bone graft substitutes appear to offer no particular advantage over autogenous grafts in the management of diaphyseal defects, although further investigation is warranted since other factors may be responsible for the unfavorable findings in this study.This work has been presented at the 34th Annual Meeting of The Association of University Radiologists. Hartford, Connecticut, May 4–9, 1986 相似文献
57.
S. Magnaldi R. Longo M. Ukmar M. Zanatta M. Bottega G. L. Sottocasa 《European radiology》1997,7(4):486-491
The aim of this work was to monitor the effectiveness of enzyme replacement therapy on the basis of the changes in T1 relaxation
times in Gaucher patients. A total of 26 patients underwent MR before enzyme replacement therapy; of them, 18 have been followed-up.
A total of 22 age-matched controls underwent the same MR study. Scans were focused on the femoral neck, and T1 relaxation
times were measured by means of a mixed spin-echo inversion recovery sequence. The T1 relaxation times in Gaucher patients
were significantly longer than normal (p < 0.05). After enzyme replacement therapy, T1 relaxation times gradually became closer to those of control subjects, and
there was also a significant decrease (p < 0.01) with respect to values before therapy, probably due to an increase in the fat/water ratio. Evaluation of T1 relaxation
time may supply a useful indication of Gaucher disease regression after enzyme replacement therapy particularly in those cases
in which a normal skeletal appearance corresponds to prolonged T1 relaxation times.
Received 28 February 1996; Revision received 20 May 1996; Accepted 21 August 1996 相似文献
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王自强吕晶邵泓夏瑞雪陈钢 《中国药师》2017,(5):813-816
摘 要 目的:建立一种基于限制性片段长度多态性技术鉴别梅花鹿骨粉的种属来源的方法。方法: 对脱钙后的动物骨粉样品进行核糖核酸提取,通过聚合酶链式反应对梅花鹿特征片段进行扩增,并通过限制性片段长度多态性分析进一步对其种属来源进行确证。结果: 通过对特征片段进行聚合酶链式反应扩增,可将梅花鹿及马鹿来源的骨粉样品与牛、猪、狗等动物骨粉样品进行区分。通过对限制性内切酶XbaI进行酶切后的片段长度进行分析,可进一步区分梅花鹿与马鹿来源的骨粉样品。结论:建立了一种基于限制性片段长度多态性技术的梅花鹿骨粉种属来源的鉴别方法。 相似文献
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