全文获取类型
收费全文 | 399篇 |
免费 | 9篇 |
国内免费 | 7篇 |
专业分类
儿科学 | 1篇 |
基础医学 | 20篇 |
临床医学 | 14篇 |
内科学 | 16篇 |
神经病学 | 27篇 |
特种医学 | 8篇 |
外科学 | 283篇 |
综合类 | 18篇 |
预防医学 | 2篇 |
药学 | 19篇 |
中国医学 | 3篇 |
肿瘤学 | 4篇 |
出版年
2023年 | 21篇 |
2022年 | 26篇 |
2021年 | 35篇 |
2020年 | 33篇 |
2019年 | 16篇 |
2018年 | 26篇 |
2017年 | 31篇 |
2016年 | 12篇 |
2015年 | 7篇 |
2014年 | 24篇 |
2013年 | 24篇 |
2012年 | 20篇 |
2011年 | 18篇 |
2010年 | 20篇 |
2009年 | 22篇 |
2008年 | 22篇 |
2007年 | 8篇 |
2006年 | 6篇 |
2005年 | 3篇 |
2004年 | 5篇 |
2003年 | 3篇 |
2002年 | 6篇 |
2000年 | 2篇 |
1999年 | 3篇 |
1998年 | 2篇 |
1997年 | 3篇 |
1996年 | 1篇 |
1994年 | 1篇 |
1993年 | 6篇 |
1991年 | 3篇 |
1990年 | 4篇 |
1988年 | 1篇 |
1987年 | 1篇 |
排序方式: 共有415条查询结果,搜索用时 15 毫秒
21.
《The Journal of arthroplasty》2020,35(5):1179-1185
BackgroundThe Patient-Reported Outcomes Measurement Information System (PROMIS) is increasingly used to assess patient health. The Bundled Payment for Care Improvement (BPCI) initiative for total hip arthroplasty (THA) was introduced to decrease costs and improve clinical care. We investigated differences between BPCI and non-BPCI THA patients and their PROMIS scores, along with its feasibility and responsiveness in these populations.MethodsWe included all consecutive patients receiving unilateral primary THA who also had preoperative and one-year postoperative PROMIS physical function (PF), PROMIS pain interference (PI), and PROMIS depression (DEP) scores. Demographics and PROMIS scores were compared. Test burden was assessed using the number of questions and time required for PROMIS completion. The minimum clinically important difference was defined as 5. Floor and ceiling effects were noted if more than 15% of patients responded with the lowest or highest possible score, respectively. Wilcoxon rank-sum test was used to compare categorical data. ANOVA was used for PROMIS comparisons.Results290 hips (86 BPCI, 30%) were included. The BPCI cohort was older (P < .001) with a higher American Society of Anesthesiologists physical status classification system (P = .0045). There were significant differences in baseline scores of PF and DEP between BPCI and non-BPCI (P = .046 and P = .048, respectively). Both groups showed significant improvement at follow-up in all scores (all P < .001). Significantly more non-BPCI patients achieved minimum clinically important difference at follow-up in PI and PF (P = .047 and P = .023, respectively). Floor effects were identified for DEP at baseline and follow-up and for PI at follow-up only.ConclusionPROMIS is feasible and time-efficient in BPCI patients undergoing primary THA. There were significant differences between BPCI and non-BPCI hips.Level of EvidenceLevel III. 相似文献
22.
《The Journal of arthroplasty》2020,35(8):2188-2194
BackgroundUnconstrained tripolar articulations have been theorized to increase hip stability. The purpose of this study is to report the performance of tripolar articulations in revision THA and identify factors associated with success and failure.MethodsBetween 1994 and 2016, 67 revision THAs were performed with an unconstrained tripolar articulation. Mean follow-up was 5.4 years. Patient charts were retrospectively reviewed emphasizing factors associated with risk of instability. There were 21 patients with neither a history of instability (HI) nor abductor insufficiency (AI), 20 patients with HI alone, 13 with AI alone, and 13 had both HI and AI.ResultsTwelve THAs sustained at least one postrevision dislocation at an average of 2.1 years. One bipolar dissociation occurred early (1.2 y). Nine hips had a re-revision to address these complications. Survival free from dislocation at 2, 5, and 10 years was 88%, 85%, and 74%, respectively. Survival free from re-revision at 2, 5, and 10 years was 91%, 84%, and 65%, respectively. Patients with combined AI and HI had the worst survivorship free from dislocation at 2, 5, and 10 years (77%, 68%, and 55%), respectively. In contrast, patients with neither HI nor AI experienced zero dislocations. There were no failures associated with bearing wear.ConclusionOff-the-shelf tripolar articulations were associated with reasonable survival at midterm follow-up. In patients with both AI and HI, the risks and benefits of alternative options such as dual mobility or constrained liners should be explored as the risk of dislocation at 10 years approached 50%. 相似文献
23.
24.
目的比较老年股骨颈骨折行人工股骨头置换术与全髋关节置换术的临床疗效。方法将82例老年股骨颈骨折患者分成两组,A组52例,采用人工股骨头置换,B组30例,采用全髋关节置换。随访6年,按Harris评分标准评定手术疗效并将结果进行比较。结果术后1年两组疗效没有明显差别,手术4年以后B组疗效优于A组,两组差别具有显著性意义。结论老年股骨颈骨折行人工股骨头置换或全髋关节置换手术的早期临床效果基本相同,但全髋关节置换手术的后期疗效优于人工股骨头置换。 相似文献
25.
Automatic measurement of polyethylene modification in metal-backed artificial hip joints using three-dimensional CT 总被引:1,自引:0,他引:1
Shigeru Mitsuhashi Yoshitada Harada Noriyuki Yanagawa Koya Kamikawa Hiroshi Kitahara Hideshige Moriya 《Journal of orthopaedic science》2004,9(1):10-15
A new method has been developed for automatic measurement of polyethylene linear modification using three-dimensional CT in total hip arthroplasty (THA) and bipolar hemiarthroplasty (BHP). We obtained a three-dimensional digital image of the metal components by widening the maximum window width, adjusting the proper cutoff threshold level, and removing the metal artifact. The centric coordinates of both the metal-backed cup and the femoral head were calculated from this image. Modification was defined as a change in distance between those two points from their original interval. Phantom studies of the accuracy and reproducibility of the method indicated that the average error ranged from 0.02 to 0.12mm and the standard deviation ranged from 0.01 to 0.05mm. Clinical in vivo measurement was performed without error of computer software on 19 hips in which modification of highly cross-linked polyethylene components was significantly large. 相似文献
26.
Andres Troelsen Jens K. Møller Lars Bolvig Thomas Prynø Lisbeth N. Pedersen Kjeld Søballe 《The Journal of arthroplasty》2010
Invasive infection with animal-associated bacteria, Erysipelotrix rhusiopathiae, is unusual and has, to our knowledge, never been described as the cause of infected total hip arthroplasty. We describe how an infected total hip arthroplasty caused by these bacteria is eradicated using standard surgical and antibiotic treatment. Before 2-stage revision surgery, the patient had persistent groin pain, elevated C-reactive protein, radiographic periprosthetic osteolysis, excessive intra-articular fluid, and periprosthetic activity accumulation on the white cell scan. The patient was treated with benzylpenicillin after confirmed sensitivity of E rhusiopathiae diagnosed by culture of five tissue samples and polymerase chain reaction of the prosthetic sonicate sample. Sixteen weeks after the last stage of revision surgery, there were no signs of reoccurring infection. 相似文献
27.
Brian Elmengaard Joan E. Bechtold Xinqian Chen Kjeld Søballe 《Journal of orthopaedic research》2009,27(8):996-1001
Revision joint replacement has poorer outcomes that have been associated with poorer mechanical fixation. We investigate a new bone‐sparing surgical technique that locally cracks the sclerotic bone rim formed during aseptic loosening. We inserted 16 hydroxyapatite‐coated implants bilaterally in the distal femur of eight dogs, using a controlled weight‐bearing experimental model that replicates important features of a typical revision setting. At 8 weeks, a control revision procedure and a crack revision procedure were performed on contralateral implants. The crack procedure used a splined tool to perform a systematic local perforation of the sclerotic bone rim of the revision cavity. After 4 weeks, the hydroxyapatite‐coated implants were evaluated for mechanical fixation by a push‐out test and for tissue distribution by histomorphometry. The cracking revision procedure resulted in significantly improved mechanical fixation, significantly more bone ongrowth and bone volume in the gap, and reduced fibrous tissue compared to the control revision procedure. The study demonstrates that the sclerotic bone rim prevents bone ingrowth and promotes fixation by fibrous tissue. The effect of the cracking technique may be due to improved access to the vascular compartment of the bone. The cracking technique is a simple surgical method that potentially can improve the fixation of revision implants in sclerotic regions important for obtaining the fixation critical for overall implant stability. © 2009 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27: 996–1001, 2009 相似文献
28.
29.
Shai S. Shemesh Calin S. Moucha Aakash Keswani Nolan A. Maher Darwin Chen Michael J. Bronson 《The Journal of arthroplasty》2018,33(4):1205-1209
Background
Trochanteric bursitis (TB) remains a common complication after total hip arthroplasty (THA), with an incidence between 3% and 17%, depending on the surgical approach, with the posterior approach (PA) being relatively protective compared to the lateral approach. The purposes of this study were to determine the incidence of TB after primary THA, identify potential risk factors for TB, and examine the utility of different modes of treatment.Methods
Retrospective cohort data of 990 primary THAs performed in a single institution, including 613 PAs and 377 direct anterior approaches (DAAs), were analyzed. Data abstracted included demographic data, operative diagnosis, comorbidities, radiographic assessment, and other specific predictors of interest that were compared between patients diagnosed with TB following THA and controls.Results
The incidence of TB following primary THA was 5.4% (54/990) for the entire cohort. The incidence did not differ significantly between the PA and DAA (5% vs 6.1%, respectively; P = .47). Charlson comorbidity index and American Society of Anesthesiology did not differ significantly in the TB group. Lumbar spinal stenosis and history of past smoking were significantly more common in patients who developed TB (P = .03, P = .01, respectively), but did not continue to be significant risk factors on multivariate analysis. All patients were treated nonoperatively by the time of final follow-up. Seventy-four percent required a local steroid injection and 30% required treatment with more than one modality.Conclusion
The occurrence of TB is not influenced by the surgical approach (PA or DAA), and could not be predicted by specific comorbidities or radiographic measurements. However, it can be effectively treated conservatively in most cases. 相似文献30.
Elizabeth B. Gausden Harman S. Parhar Joseph E. Popper Peter K. Sculco Barret N.M. Rush 《The Journal of arthroplasty》2018,33(5):1567-1571.e2