全文获取类型
收费全文 | 1139篇 |
免费 | 53篇 |
国内免费 | 51篇 |
专业分类
耳鼻咽喉 | 1篇 |
儿科学 | 52篇 |
妇产科学 | 9篇 |
基础医学 | 42篇 |
临床医学 | 78篇 |
内科学 | 190篇 |
皮肤病学 | 3篇 |
神经病学 | 7篇 |
特种医学 | 22篇 |
外科学 | 591篇 |
综合类 | 144篇 |
预防医学 | 25篇 |
药学 | 50篇 |
中国医学 | 1篇 |
肿瘤学 | 28篇 |
出版年
2023年 | 12篇 |
2022年 | 20篇 |
2021年 | 27篇 |
2020年 | 22篇 |
2019年 | 23篇 |
2018年 | 18篇 |
2017年 | 37篇 |
2016年 | 31篇 |
2015年 | 33篇 |
2014年 | 80篇 |
2013年 | 78篇 |
2012年 | 62篇 |
2011年 | 82篇 |
2010年 | 80篇 |
2009年 | 72篇 |
2008年 | 77篇 |
2007年 | 58篇 |
2006年 | 73篇 |
2005年 | 46篇 |
2004年 | 32篇 |
2003年 | 35篇 |
2002年 | 35篇 |
2001年 | 26篇 |
2000年 | 25篇 |
1999年 | 24篇 |
1998年 | 14篇 |
1997年 | 12篇 |
1996年 | 11篇 |
1995年 | 12篇 |
1994年 | 11篇 |
1993年 | 6篇 |
1992年 | 6篇 |
1991年 | 2篇 |
1990年 | 4篇 |
1989年 | 8篇 |
1988年 | 10篇 |
1987年 | 4篇 |
1986年 | 5篇 |
1985年 | 6篇 |
1984年 | 3篇 |
1982年 | 4篇 |
1981年 | 2篇 |
1980年 | 3篇 |
1979年 | 4篇 |
1978年 | 4篇 |
1977年 | 1篇 |
1976年 | 2篇 |
1969年 | 1篇 |
排序方式: 共有1243条查询结果,搜索用时 15 毫秒
991.
A. Ismet K. Irfan K. Emin E. M. Al U. Ramazan B. Mustafa O. Onur 《International journal of laboratory hematology》2004,26(3):211-214
The standard treatment for immune thrombocytopenic purpura (ITP) is corticosteroid therapy. In patients who are refractory to this treatment, splenectomy is the most usual therapy. Between 1993 and 2003, 125 patients were diagnosed with ITP in the Inonu University School of Medicine, Department of Haematology. Twenty‐one of these patients who did not respond to steroids, underwent splenectomy. Of these 21 patients, 12 achieved complete and three achieved partial haematological responses, while the remaining six did not respond. Four of these six patients responded to drugs such as azathioprine and danazol, while the others were totally refractory. Only one of our patients showed fatal complications either during or after the surgery. Our results after 10 years experience demonstrate that splenectomy is an effective and safe treatment for ITP patients who are refractory to steroids. 相似文献
992.
993.
Juan Francisco Guerra Ignacio San Francisco Fernando Pimentel Luis Ibanez 《World journal of gastroenterology : WJG》2008,14(41):6410-6412
Colonoscopy is a safe and routinely performed diagnostic and therapeutic procedure for different colorectal diseases. Although the most common complications are bleeding and perforation, extracolonic or visceral injuries have also been described. Splenic rupture is a rare complication following colonoscopy, with few cases reported. We report a 60-year-old female who presented to surgical consultation 8 h after a diagnostic colonoscopy. Clinical, laboratory and imaging findings were suggestive for a massive hemoperitoneum. At surgery, an almost complete splenic disruption was evident, and an urgent splenectomy was performed. After an uneventful postoperative period, she was discharged home. Splenic injury following colonoscopy is considered infrequent. Direct trauma and excessive traction of the splenocolic ligament can explain the occurrence of this complication. Many times the diagnosis is delayed because the symptoms are due to colonic insufflation, so the most frequent treatment is an urgent splenectomy. A high index of suspicion needs an early diagnosis and adequate therapy. 相似文献
994.
Vassiliadis T Garipidou V Perifanis V Tziomalos K Giouleme O Patsiaoura K Avramidis M Nikolaidis N Vakalopoulou S Tsitouridis I Antoniadis A Semertzidis P Kioumi A Premetis E Eugenidis N 《World journal of gastroenterology : WJG》2006,12(5):818-821
The congenital dyserythropoietic anemias comprise a group of rare hereditary disorders of erythropoiesis, characterized by ineffective erythropoiesis as the predominant mechanism of anemia and by characteristic morphological aberrations of the majority of erythroblasts in the bone marrow. Congenital dyserythropoietic anemia type II is the most frequent type. All types of congenital dyserythropoietic anemias distinctly share a high incidence of iron loading. Iron accumulation occurs even in untransfused patients and can result in heart failure and liver cirrhosis. We have reported about a patient who presented with liver cirrhosis and intractable ascites caused by congenital dyserythropoietic anemia type II. Her clinical course was further complicated by the development of autoimmune hemolytic anemia. Splenectomy was eventually performed which achieved complete resolution of ascites, increase of hemoglobin concentration and abrogation of transfusion requirements. 相似文献
995.
区域性门静脉高压症的诊治 总被引:17,自引:2,他引:17
目的总结区域性门静脉高压症的诊治经验.方法回顾性分析16例区域性门静脉高压症的临床表现、诊断方法、治疗措施和疗效.结果16例区域性门静脉高压症中,合并胰腺疾病12例,未发现明确胰腺疾病4例.临床表现主要为脾肿大16例(100%)、腹痛10例(63%)、消化道出血7例(44%)、腹部肿块3例(19%).肝功能检查均正常.诊断方法主要为超声、CT和内镜.7例行彩色多普勒检查均提示脾静脉主干栓塞(7/7).增强CT可明确脾门周围及胃短静脉、胃网膜静脉扩张、迂曲(16/16).胃镜检查示孤立性胃底静脉曲张(4/5).脾脏切除对治疗消化道出血效果确切,发生门静脉栓塞1例.结论超声、CT和内镜检查联合特殊的临床特点,诊断区域性门静脉高压症并不困难.治疗上提倡个体化原则,但对有消化道出血者,应行脾脏切除术. 相似文献
996.
Mounir Ababou El Mehdi Mahtat Selim Jennane Hicham Elmaaroufi Mohammed Mikdame Kamal Doghmi 《Hematology/oncology and stem cell therapy》2021,14(2):153-155
We report the case of a patient diagnosed with a splenic marginal zone lymphoma with a simultaneous finding of hepatitis B virus infection, who responded to antiviral treatment and splenectomy. We highlighted this association described in the literature and its possible causal role, as well as the available therapeutic choices. 相似文献
997.
Background and AimsTo investigate the usefulness of inflammation biomarkers to serve as a predictors of portal vein thrombosis (PVT) postoperatively (post) in patients with portal hypertension after splenectomy and periesophagogastric devascularization.MethodsA total of 177 liver cirrhosis patients were recruited from January 2013 to December 2017. They were divided into a PVT group (n=71) and a non-PVT group (n=106), according to ultrasound examination findings at 7-day post. Inflammation biomarkers involving platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), red blood cell distribution width-to-platelet ratio(RPR), mean platelet volume-to-platelet ratio (MPR) preoperatively (pre) and at 1, 3, 7-days post were recorded.ResultsThe univariate logistic regression analysis indicated that PLR (pre) (odds ratio (OR)=3.963, 95% confidence interval (CI)=2.070–7.587, p<0.000), MLR (pre) (OR=2.760, 95% CI=1.386–5.497, p=0.004), PLR (post-day 7) (OR=3.345, 95% CI=1.767–6.332, p=0.000) were significantly associated with the presence of PVT. The multivariate logistic regression analysis results indicated that PLR (pre) (OR=3.037, 95% CI=1.463–6.305, p=0.003), MLR (pre) (OR=2.188, 95% CI=1.003–4.772, p=0.049), PLR(post-day 7) (OR=2.166, 95% CI=1.053–4.454, p=0.036) were independent factors for predicting PVT.ConclusionsThe PLR (pre), MLR (pre), and PLR (post-day 7) are predictors of portal vein thrombosis post in patients with portal hypertension after splenectomy and periesophagogastric devascularization. 相似文献
998.
999.
目的 探讨脾切除对原发性胆汁性肝硬化(PBC)小鼠的影响及其相关因素。方法 40只雌性C57BL/6小鼠被分为脾切除组(n=10)、假手术组(n=10)、模型组(n=10)和正常对照组(n=10)。在前三组,采用1%聚肌胞苷酸腹腔注射建立PBC模型,在正常对照组,给予等体积生理盐水腹腔注射。在实验20 w末,对动物分别行脾切除术,或在假手术组采取腹壁切开后仅轻微翻动脾脏,或在模型组和正常对照组不行任何处理。在实验32w,行血生化和肝组织病理学检查。采用RT-PCR法检测肝组织转化生长因子-β1(TGF-β1)及其I型受体(TβRI)和II型受体(TβRII)mRNA水平。取末端回肠组织,采用ELISA法检测其匀浆TNF-α水平。结果 在32w时,脾切除组、假手术组和模型组动物肝指数均显著低于对照组[(41.5±5.2)、(39.6±7.5)、(39.1±1.0)对(53.2±2.1),P值均<0.05];脾切除组血清ALT、AST和ALP水平分别为(43.5±6.4) U/L、(157.7±20.9) U/L和(178.1±38.0)U/L,显著低于模型组[(52.0±9.0) U/L、(183.4±12.4) U/L和(195.3±62.6) U/L,P值均<0.05];脾切除组肝组织纤维化程度明显轻于假手术组和模型组;脾切除组肝组织TGF-β1、TβRI和TβRII mRNA水平分别为(0.5±0.09)、(0.5±0.05)和(0.5±0.09),显著低于模型组[(1.0±0.10)、(1.0±0.08)和(1.0±0.09),P值均<0.05];脾切除组回肠末端匀浆TNF-α水平为(50.0±8.6) ng/L,显著低于模型组 [(106.8±19.8) ng/L,P<0.05]。结论 脾切除可缓解PBC小鼠肝组织纤维化进程,可能与抑制肝脏TGF-β1表达和抑制回肠末端TNF-α分泌有关。 相似文献
1000.
目的 探讨经皮经肝肝内门体分流术(PTIPS)治疗脾切除术后并发门静脉血栓形成的门静脉高压症患者的安全性和效果。方法 回顾性分析2011年1月~2015年12月在我院接受PTIPS治疗的30例脾切除术后并发门静脉血栓形成的门静脉高压症患者的病历资料,采用经皮经肝穿刺门静脉分支,采用球囊扩张术扩张闭塞的门静脉和肝内门体分流道,在分流道内植入8 mm的金属支架处理,使用320排CT机检查,随访(22.1±3.8)个月。结果 在30例接受PTIPS术患者中,27例(90.0%)手术成功,3例(10.0%)患者因术中未能开通门静脉闭塞而终止手术;27例手术成功患者术前门体静脉压力梯度为(21.5±3.4) mmHg,术后下降至(13.0±2.8) mmHg,差异具有统计学意义(t=10.0,P<0.05);术后CT检查,发现4例(13.3%)患者发生分流道支架闭塞,均及时给予球囊扩张并再次置入支架处理,血管再通,2例(6.7%)患者发生肝性脑病,给予降血氨药物和营养支持等治疗后好转;5例(16.7%)患者死亡,其中3例死于肝功能衰竭,2例死于脑出血。结论 采用PTIPS处理脾切除术后并发门静脉血栓形成的门静脉高压症患者疗效较好,创伤小、较安全,未来仍需进一步深入研究其应用适应证和并发症处理等问题。 相似文献