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1.
OBJECTIVE. The accuracy of CT in the detection of injuries of the solid viscera after blunt trauma is well established, but the value of CT in diagnosing bowel rupture resulting from blunt trauma is controversial. This study was conducted to determine the sensitivity of CT in diagnosing posttraumatic bowel rupture. SUBJECTS AND METHODS. During a 51-month period, 17 preoperative CT scans were obtained in 16 patients who subsequently had bowel ruptures verified surgically. Both preoperative (prospective) and retrospective CT findings were analyzed in these patients. Retrospective interpretation was made by consensus of two radiologists. RESULTS. Surgically confirmed bowel ruptures occurred in the duodenum (five), ileum (four), jejunum (four), colon (four), and stomach (two). CT findings considered diagnostic of bowel perforation were detected prospectively on 10 (59%) of 17 scans; these included pneumoperitoneum without prior peritoneal lavage (six), mesenteric, intramural, or retroperitoneal free air (six), or direct visualization of discontinuity of the bowel wall or extravasation of luminal contents (four). Prospective CT findings considered suggestive of bowel rupture were present on five (29%) of the 17 scans; these included intraperitoneal fluid of unknown source (three), thickened (> 4-5 mm) bowel wall (two), gross anterior pararenal fluid without a recognized source (one), and a mesenteric-bowel wall hematoma (one). On two of 17 scans, findings were seen in retrospect only; these included free intraperitoneal blood without a source (findings on a second CT scan were diagnostic) and pneumoperitoneum. CT findings diagnostic or suggestive of bowel injury were detected prospectively on 15 (88%) of 17 scans and were noted in all retrospectively. CONCLUSION. CT is sensitive for the diagnosis of bowel rupture resulting from blunt trauma, but careful inspection and technique are required to detect often subtle findings. 相似文献
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Using CT to diagnose traumatic lumbar hernia 总被引:4,自引:0,他引:4
Killeen KL Girard S DeMeo JH Shanmuganathan K Mirvis SE 《AJR. American journal of roentgenology》2000,174(5):1413-1415
OBJECTIVE: The objective of this study was to determine the CT findings of traumatic lumbar hernia in 15 patients and to discuss the mechanism and treatment of injury. CONCLUSION: CT can reveal traumatic lumbar hernia and show both the anatomy of disrupted muscular layers and the presence of herniated intraabdominal viscera or retroperitoneal fat. 相似文献
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Shamriz Oded Kumar Deepak Shim Jenny Briones Michael Quarmyne Maa-Ohui Chonat Satheesh Lucas Laura Edington Holly White Michael H. Mahajan Advay Park Sunita Chandrakasan Shanmuganathan 《Journal of clinical immunology》2021,41(7):1582-1596
Journal of Clinical Immunology - T cell-Epstein-Barr virus–associated hemophagocytic lymphohistiocytosis (T cell-EBV-HLH) is prevalent in East Asia and has poor prognosis. Understanding of... 相似文献
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The present study evaluates the glycosaminoglycans (GAGs) pattern associated with transplantable rat fibrosarcoma induced by 3-methylcholanthrene. The quantitative analysis of fractionation of GAGs in fibrosarcoma and fetal tissues was performed by enzymatic digestion. The average value of total GAGs in fibrosarcoma and fetal tissue was found to be 4 times higher than its value in the tissue of origin. GAG content showed a steady increase from 7th day onward to 25th day. Hyaluronic acid content in tumor tissue was observed to increase markedly (8-fold) against that of the normal tissue and was equivalent to that of the fetal tissue. Chondroitin sulfate level was also increased in the tumor as well as fetal tissue. The increase in the chondroitin sulfate and hyaluronic acid contents might possibly be due to the abnormal GAG metabolism in the increased production of both sulfated and nonsulfated GAGs. 相似文献
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Shanmuganathan Chandrakasan Saurabh Chiwane Matthew Adams Basil M. Fathalla 《Journal of clinical immunology》2014,34(1):104-113
Objective
To report a cohort of children with periodic fever syndromes (PFS) from Southeast Michigan.Methods
A retrospective review of medical records for patients referred for periodic fever over 5 years.Results
Sixty-six patients including 21 FMF, 15 PFAPA, four TRAPS and one patient with combined HIDS and FMF were included. In addition, 25 patients were categorized as clinical PFS (cPFS) based on their clinical features however their genetic workup was either negative or inconclusive. Majority of the patients with FMF were from Middle Eastern background (88 %), but positive family history was noted in only 55 % of cases. Mean age at diagnosis was 40.8 months with a mean delay in diagnosis of 24 months. Most common MEFV mutations were p.M694V and p.M694I. Four patients with TRAPS were from mixed European descent and age at onset of symptoms was 6, 12, 12, and 84 months respectively. TNFRSF1A sequence variants in the TRAPS patients included p.R121Q (R92Q) and p.C99G (C70G); one patient had a rare occurrence of a concurrent p.V726A/-MEFV mutation. One patient with HIDS and FMF presented with atypical overlapping PFS clinical manifestations and genetic evaluation showed a unique combination of p.I268T/p.V377I MVK mutations and p.E230K/-MEFV variant. All patients with PFAPA group were from mixed European descent, symptoms started at a mean age of 34.6 months with a mean delay in diagnosis of 23.3 months. Symptoms started during infancy in six patients. All patients fulfilled the diagnostic criteria for PFAPA. The mean age of onset of symptoms in cPFS group was 17.2 months. Empiric colchicine and glucocorticosteroids controlled flares in majority of patients with cPFS. No evidence of amyloidosis was found in this entire cohort of 66 patients after a mean of 29.2 months of follow-up.Conclusion
PFS can present with atypical manifestations and should not be excluded based on a negative family history. Concomitant mutations in different autoinflammatory disorders genes can be present and possibly explain atypical manifestations. Various therapies may be considered even if genetic testing is inconclusive or negative. 相似文献10.
N. Shanmuganathan M. Uma Maheswari V. Anandkumar T. V. Padmanabhan Shailee Swarup Ahmed Hasan Jibran 《Journal of Indian Prosthodontic Society》2011,11(4):232-237
Complete or partial fingers are the most commonly encountered forms of partial hand losses. Though finger amputations are commonly due to traumatic injuries, digit loss may also be attributed to congenital malformations and disease. Irrespective of the etiology, the loss of a finger has a considerable functional and psychological impact on an individual. In order to alleviate these problems, partial or complete finger prosthesis may be fabricated. This clinical report portrays a method to fabricate silicone rubber prosthesis for a patient who has a partial finger loss caused due to trauma. 相似文献