全文获取类型
收费全文 | 1256篇 |
免费 | 67篇 |
国内免费 | 50篇 |
专业分类
儿科学 | 51篇 |
妇产科学 | 10篇 |
基础医学 | 32篇 |
临床医学 | 130篇 |
内科学 | 180篇 |
皮肤病学 | 1篇 |
神经病学 | 60篇 |
特种医学 | 40篇 |
外科学 | 395篇 |
综合类 | 227篇 |
预防医学 | 58篇 |
药学 | 110篇 |
1篇 | |
中国医学 | 59篇 |
肿瘤学 | 19篇 |
出版年
2024年 | 1篇 |
2023年 | 12篇 |
2022年 | 28篇 |
2021年 | 44篇 |
2020年 | 30篇 |
2019年 | 23篇 |
2018年 | 31篇 |
2017年 | 28篇 |
2016年 | 32篇 |
2015年 | 39篇 |
2014年 | 84篇 |
2013年 | 92篇 |
2012年 | 73篇 |
2011年 | 71篇 |
2010年 | 72篇 |
2009年 | 76篇 |
2008年 | 57篇 |
2007年 | 71篇 |
2006年 | 71篇 |
2005年 | 57篇 |
2004年 | 34篇 |
2003年 | 34篇 |
2002年 | 25篇 |
2001年 | 32篇 |
2000年 | 27篇 |
1999年 | 31篇 |
1998年 | 19篇 |
1997年 | 21篇 |
1996年 | 17篇 |
1995年 | 16篇 |
1994年 | 23篇 |
1993年 | 10篇 |
1992年 | 11篇 |
1991年 | 10篇 |
1990年 | 9篇 |
1989年 | 6篇 |
1988年 | 9篇 |
1987年 | 6篇 |
1986年 | 5篇 |
1985年 | 9篇 |
1984年 | 4篇 |
1983年 | 1篇 |
1982年 | 3篇 |
1981年 | 4篇 |
1980年 | 6篇 |
1979年 | 4篇 |
1978年 | 2篇 |
1977年 | 1篇 |
1973年 | 1篇 |
1969年 | 1篇 |
排序方式: 共有1373条查询结果,搜索用时 15 毫秒
91.
Chen JY Wu GJ Mok MS Chou YH Sun WZ Chen PL Chan WS Yien HW Wen YR 《Acta anaesthesiologica Scandinavica》2005,49(4):546-551
BACKGROUND: Postoperative ileus (PI) is the transient impairment of bowel motility due to surgical trauma and the associated physiological responses. Postoperative ileus results in patient discomfort, increases gastrointestinal risks, prolongs hospital stay and increases medical expenses. In this study, we investigated the effect of patient-controlled analgesia (PCA) morphine with or without ketorolac on bowel functions in patients after colorectal surgeries. METHODS: A total of 79 patients who received elective colorectal resection were randomly allocated into two groups receiving either intravenous PCA morphine (M group) or intravenous PCA morphine plus ketorolac (K group). Recovery of bowel functions (bowel movement, passage of flatus, and soft diet intake), pain scores, morphine consumption, time for first ambulation, and opioid-related side-effects were recorded. RESULTS: Patients in the K group received 29% less morphine than patients in the M group with comparable pain scores. The first bowel movement (1.5 [0.7-1.9] vs. 1.7 [1.0-2.8] days, P < 0.05) and the first ambulation (2.2 +/- 1.0 vs. 2.8 +/- 1.2 days, P < 0.05) were significantly earlier in the K group than in the M group. The time of the first flatus passing, the first intake of soft diet, and duration of hospital stay were not significantly different between the two groups. CONCLUSIONS: The results of this study suggest that addition of ketorolac to intravenous morphine PCA provides an opioid-sparing effect but has limited benefit in shortening the duration of bowel immobility and time to first ambulation. These findings imply that postoperative ileus is attributable to multiple factors in addition to morphine consumption. 相似文献
92.
Vázquez-Lglesias JL González-Conde B López-Rosés L Estévez-Prieto E Alonso-Aguirre P Lancho A Suárez F F Nunes R 《Surgical endoscopy》2004,18(10):1442-1446
Background Endoscopic sphincterotomy without cholecystectomy is a therapeutic option in selected patients after acute biliary pancreatitis. We conducted a prospective evaluation of the long-term effects of sphincterotomy in terms of the need for of subsequent cholecystectomy and the recurrence of gallstone pancreatitis.Methods We studied 88 patients with acute biliary pancreatitis and an intact gallbladder who, underwent endoscopic sphincterotomy either because they were high-risk candidates for surgery or because they had refused of cholecystectomy. The median follow-up was 51 months (range, 5–86).Results Only two patients (2.2%) experienced recurrent pancreatitis. Subsequent cholecystectomy was performed in 10 patients because of acute cholecystitis in eight cases and biliary colic in two cases. Sixty-six patiens (75%) remained asymptomatic.Conclusions Endoscopic sphincterotomy is a safe and acceptable alternative to cholecystectomy for the prevention of recurring attacks of gallstone pancreatitis. As a result of this procedure, 75% of patients remained free of symptoms in the long term. 相似文献
93.
The most common complication during laparoscopic cholecystectomy is the spillage of stones into the abdominal cavity. Although spillage occurs in 30% of cases, the potential adverse effects of this event are rare and generally manifest within months. When complications do occur, however, they may cause significant morbidity for the patient. We report an unusual case in which an inflammatory mass mimicking a liver tumor developed 5 years after the stones had been lost during a laparoscopic cholecystectomy. We therefore urge all surgeons to make every attempt to retrieve gallstones from the abdominal cavity once they have been accidentally dropped. 相似文献
94.
Postoperative colonic motility in patients following laparoscopic-assisted and open sigmoid colectomy 总被引:4,自引:0,他引:4
Michael?S.?Kasparek Mario?H.?Müller J?rg?Glatzle Klaus?Manncke Horst?D.?Becker Tilman?T.?Zittel Martin?E.?KreisEmail author 《Journal of gastrointestinal surgery》2003,7(8):1073-1081
Clinical reports on laparoscopic-assisted sigmoid colectomy (LASC) suggest that the period of postoperative inhibition of
gastrointestinal motility is shortened as compared to open sigmoid colectomy (OSC). We aimed to specifically investigate whether
colonic motility increases more rapidly following LASC compared to OSC. LASC was performed in 11 patients and OSC in nine
patients for recurrent diverticulitis or carcinoma. During surgery a manometry catheter was inserted into the colon via the
anus, and the tip was placed in the splenic flexure. Continuous manometric recordings were performed from the day of surgery
until postoperative day 3 with a four-channel microtransducer manometry system combined with a portable data logger. The postoperative
colonic motility index was 101± 18, 199 ± 30, and 163 ±27 mm Hg/min on days 1,2, and 3 after LASC, respectively, which was
increased compared to indexes of 53 ± 15, 71 ± 18, and 76 ± 23 following OSC (mean ± standard error of the mean; P < 0.05). The amplitude but not the frequency of contractions was higher following LASC compared to OSC. Following LASC, patients
requested a similar amount of pain medication but resumed oral food more rapidly on postoperative days 2 and 3 (P < 0.05), and they were discharged from the hospital earlier (P < 0.05). Colonic motility in particular and the patient’s condition in general seem to improve more rapidly following LASC
compared to the open procedure.
Presented at the Forty-Fourth Annual Meeting of The Society for Surgery of the Alimentary Tract, Orlando, Florida, May 17–22,
2003 (oral presentation). 相似文献
95.
目的比较胆源性胰腺炎、胆囊结石及胆囊息肉患者胆囊CCK受体的改变,探讨胆囊收缩功能改变与胆源性胰腺炎发生的关系。方法免疫组化法分别检测胆囊结石、胆囊息肉、胆源性胰腺炎各20例患者的胆囊平滑肌标本中CCK受体含量。结果CCK—A受体表达强度胆囊结石组最强,胆囊息肉组次之,胆源性胰腺炎组最弱;胆源性胰腺炎组CCK—A受体数量明显减少。结论胆囊平滑肌细胞膜上的CCK受体改变与胆囊收缩功能减弱及胆源性胰腺炎的发生发展可能有一定关系。 相似文献
96.
97.
Sei Tomatsu 《Surgical endoscopy》1987,1(2):89-92
Summary The buoyancy of gallstones was observed by taking anterior-posterior scout X-ray films of two patients standing during endoscopic retrograde cholangiography. In case 1, the large and small gallstones differed in buoyancy, and ursodeoxycholic acid treatment dissolved the floating small stones while failing to dissolve the nonfloating large stone. In case 2, both the large and small stones floated and are being dissolved by ursodeoxycholic acid treatment. Since floating or nonfloating and the plane of flotation depend on the specific gravity of the gallstone, the above findings suggest that a gallstone with a low specific gravity is more readily dissolved than one with a high specific gravity. The present method of estimating the buoyancy of gallstones was therefore considered extremely useful in selecting patients for medical litholytic treatment. 相似文献
98.
We report a case of infant botulism presenting as primary colonic ileus—mimicking Hirschprung's megacolon. Infant botulism should be considered in any infant with constipation and neurologic abnormalities. 相似文献
99.
T Furukawa T Kubota A Suto T Takahara H Yamaguchi T Takeuchi S Kase S Kodaira K Ishibiki M Kitajima 《Journal of surgical oncology》1991,48(3):188-193
The results of in vitro chemosensitivity testing using the MTT assay of tumor cells from 140 patients were analyzed with reference to the clinical antitumor effects of the chemotherapy. One hundred and twenty-four (88.6%) of 140 specimens were successfully tested by the method of Mosmann (J Immunol Methods 65:55-63, 1983) with some modifications. When the results of the assay were compared with the clinical effects of chemotherapy in 22 patients with remaining measurable tumor lesions, the overall prediction rate was 86.4% (19/22). Among 31 patients with stage III-V gastric and colorectal carcinomas without remaining measurable tumor lesions, the survival rate of nine patients treated with drugs shown to be effective in the assay was significantly (P less than 0.05) better than that of 22 patients treated with drugs shown to be ineffective. 相似文献
100.
Kevin E. Behrns Stan W. Ashley John G. Hunter David Carr-Locke 《Journal of gastrointestinal surgery》2008,12(4):629-633
The indications for early endoscopic retrograde cholangiopancreatography (ERCP) in gallstone pancreatitis are unclear, and
the examination is often requested or performed without substantial supporting evidence. Several trials have been performed
to determine the benefit of early ERCP in pancreatitis, yet the results of these studies are inconsistent. To more closely
analyze these studies, we performed an evidence-based review of the outcomes of early ERCP in gallstone pancreatitis. To obtain
the best available evidence, a PubMed search using the MeSH terms “gallstones” and “pancreatitis” was performed and further
refined to identify appropriate studies. We included five randomized trials, a meta-analysis, and a Cochrane Database Systematic
Review in our detailed examination of the pertinent literature. Collectively, these studies suggest that early ERCP does not
alter mortality in gallstone pancreatitis. In addition, few patients with mild pancreatitis benefit from the procedure, whereas
some studies indicate that patients with severe pancreatitis or documented biliary obstruction may experience fewer complications
if ERCP is performed. The data in the studies are confounding because of heterogeneity of the patient population and the inability
to confirm gallstones in up to one third of patients. In conclusion, ERCP is not indicated for patients with mild pancreatitis.
In select patients with severe disease or biliary obstruction, ERCP may be indicated. A multicenter trial designed to study
the effect of early ERCP in severe pancreatitis only may provide additional useful information in patients with documented
gallstones.
Presented at the Postgraduate Course of the 48th Annual Meeting of The Society for Surgery of the Alimentary Tract (Digestive
Disease Week 2007), Washington DC, USA, May 20, 2007. 相似文献