首页 | 本学科首页   官方微博 | 高级检索  
文章检索
  按 检索   检索词:      
出版年份:   被引次数:   他引次数: 提示:输入*表示无穷大
  收费全文   361篇
  免费   18篇
  国内免费   4篇
耳鼻咽喉   23篇
儿科学   3篇
妇产科学   5篇
基础医学   9篇
口腔科学   10篇
临床医学   20篇
内科学   15篇
皮肤病学   8篇
神经病学   2篇
特种医学   3篇
外科学   211篇
综合类   21篇
预防医学   21篇
眼科学   6篇
药学   5篇
中国医学   1篇
肿瘤学   20篇
  2024年   3篇
  2023年   12篇
  2022年   17篇
  2021年   20篇
  2020年   21篇
  2019年   25篇
  2018年   23篇
  2017年   22篇
  2016年   17篇
  2015年   10篇
  2014年   36篇
  2013年   26篇
  2012年   21篇
  2011年   18篇
  2010年   17篇
  2009年   13篇
  2008年   8篇
  2007年   15篇
  2006年   8篇
  2005年   8篇
  2004年   12篇
  2003年   4篇
  2002年   3篇
  2001年   3篇
  2000年   3篇
  1999年   2篇
  1998年   1篇
  1996年   2篇
  1994年   2篇
  1992年   1篇
  1991年   2篇
  1989年   2篇
  1988年   1篇
  1985年   1篇
  1984年   1篇
  1982年   1篇
  1977年   1篇
  1976年   1篇
排序方式: 共有383条查询结果,搜索用时 15 毫秒
1.

Background

Thyroid surgery can cause postoperative hypocalcemia (POH) and permanent hypoparathyroidism (PEH). Surgeons implicitly assess the risk and adapt their surgical strategy accordingly.

Methods

The outcome of this intraoperative decision-making process (the surgeons' ability to predict the risk of POH and PEH on a numerical rating scale and their actual incidence) was studied prospectively in 2,558 consecutive thyroid operations.

Results

POH and PEH occurred in 723 and 64 patients, respectively. In multivariate analysis, the surgeons' risk assessment score was an independent predictive factor for both complications (P < .05). Surgeons' differed significantly (P = .015) in their rates of POH but not of PEH (P = .062). Six and 3 (of 9) surgeons correctly predicted an increased risk of PEH and POH (adjusted odds ratios 1.67 to 2.21 and 1.47 to 12.73), respectively.

Conclusion

The risk for hypoparathyroidism can be estimated, but surgeons differ substantially in this ability and in the extent to which this implicit knowledge is translated into lower complication rates.  相似文献   
2.

BACKGROUND

Online physician rating websites are increasingly used by patients to evaluate their doctors. The purpose of this investigation was to evaluate factors associated with better spine surgeon ratings.

METHODS

Orthopedic spine surgeons were randomly selected from the North American Spine Society directory utilizing a random number generator. Surgeon profiles on three physician rating websites, namely, www.HealthGrades.com, www.Vitals.com, and www.RateMDs.com, were analyzed to gather qualitative and quantitative data on patients’ perceptions of the surgeons. Independent variables from the websites were analyzed in relation to overall physician or patient satisfaction rating. Comments were coded by subject into following three categories: professional competence, bedside manner, and practice characteristics.

RESULTS

A total of 250 surgeons were evaluated, and 92% (n=230) of these doctors had at least one rating among the three websites. The surgeons with a higher average rating had significantly better trust (p<.01), scheduling (p<.01), staff (p<.01), helpfulness (p<.01), and punctuality (p<.01) scores but significantly less experience (p<.05). A linear regression model for the average rating of each surgeon (R2 value=0.754) yielded only following three significant variables: trustworthiness (p<.01), experience match (p<.05), and the average number of negative comments on surgeon's professional competence (p<.05). Trustworthiness (β=0.749) was the strongest predictor variable of physician rating, followed by the number of negative professional competence comments (β=?0.132) and experience match (β=?0.112).

CONCLUSIONS

This investigation assessed spine surgeon online patient ratings and categorized factors that patients associate with quality care. Trustworthiness was the most significant predictor of positive ratings, whereas ease of scheduling, quality of staff, helpfulness, and punctuality were also associated with higher patient ratings. Understanding what patients value may help optimize care of spine surgery patients.  相似文献   
3.

Background:

Over the years, there has been a tremendous increase in the use of fluoroscopy in orthopaedics. The risk of contracting cancer is significantly higher for an orthopedic surgeon. Hip and spine surgeries account for 99% of the total radiation dose. The amount of radiation to patients and operating surgeon depends on the position of the patient and the type of protection used during the surgery. A retrospective study to assess the influence of the radiation exposure of the operating surgeon during fluoroscopically assisted fixation of fractures of neck of femur (dynamic hip screw) and ankle (Weber B) was performed at a district general hospital in the United Kingdom.

Materials and Methods:

Sixty patients with undisplaced intertrochanteric fracture were included in the hip group, and 60 patients with isolated fracture of lateral malleolus without communition were included in the ankle group. The hip and ankle groups were further divided into subgroups of 20 patients each depending on the operative experience of the operating surgeon. All patients had fluoroscopically assisted fixation of fracture by the same approach and technique. The radiation dose and screening time of each group were recorded and analyzed.

Results:

The radiation dose and screening time during fluoroscopically assisted fixation of fracture neck of femur were significantly high with surgeons and trainees with less than 3 years of surgical experience in comparison with surgeons with more than 10 years of experience. The radiation dose and screening time during fluoroscopically assisted fixation of Weber B fracture of ankle were relatively independent of operating surgeon''s surgical experience.

Conclusion:

The experience of operating surgeon is one of the important factors affecting screening time and radiation dose during fluoroscopically assisted fixation of fracture neck of femur. The use of snapshot pulsed fluoroscopy and involvement of senior surgeons could significantly reduce the radiation dose and screening time.  相似文献   
4.
5.
6.
7.
8.
The surgical workforce is ageing. This will impact on future workforce supply and planning, as well as the professional performance and welfare of surgeons themselves. This paper is a ‘call to arms’ to surgeons to consider the complex problem of advancing years and surgical performance. We aim to promote discussion about the issue of ageing as it relates to surgeons, while exploring ways in which successful ageing in surgeons may be promoted. The task‐specific aspects of surgical practice suggest that it is a physically and cognitively demanding task, reliant on a range of fine motor, sensory, visuospatial, reasoning, memory and processing skills. Many of these skills potentially decline with age, although there is great inter‐individual variation, particularly in cognitive performance. Nevertheless, there is some consensus in the literature that age‐related cognitive changes exist in a proportion of surgeons, and there is an increase in operative mortality rates for certain surgical procedures performed by older and more experienced surgeons. In the absence of mandatory retirement, guidance is needed in regard to individualizing the timing of retirement and encouraging reflective and adaptive practice based on insight into how one's skills and performance may change with age. This may be best facilitated by some form of informed and guided self‐monitoring or ‘self‐screening’. It should be emphasized that self‐screening is not a form of self‐treatment but aims to enhance insight, using a tool kit of resources to promote adaptive ageing. Moreover, self‐screening should not be restricted to cognition, which is only part of the picture of ageing, but extended to emphasize the maintenance of mental and physical wellness, and the acceptance of independent professional treatment and support when required.  相似文献   
9.
10.

Background

This study evaluates the rates of immediate breast reconstruction (IBR) among racial and insurance status subgroups, in the setting of a changing plastic surgeon workforce.

Methods

Using state level inpatient and ambulatory surgery data, we identified discharges for adult women who underwent mastectomy for breast cancer. This information was supplemented with plastic surgeon workforce data and aggregated to the health service area-level (HSA). Hierarchical linear models were used to risk standardized IBR rates for 8 race-payer subgroups.

Results

The final cohort included 65,246 women treated across 67 HSAs. The plastic surgeon density per 100,000 population directly related to the IBR rate. While all subgroups saw a modest increase in IBR rates, Caucasian women with private insurance realized the largest absolute increase (46%) while African-American and Asian women with public insurance saw the smallest increase (6%).

Conclusion

Significant disparities persist in the provision of IBR according to the form of insurance a patient possesses. Of heightened concern is the novel finding that even within privately insured patients, women of color have significantly lower IBR rates compared to Caucasian women.  相似文献   
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号