全文获取类型
收费全文 | 914篇 |
免费 | 49篇 |
国内免费 | 3篇 |
专业分类
耳鼻咽喉 | 3篇 |
儿科学 | 18篇 |
妇产科学 | 7篇 |
基础医学 | 102篇 |
口腔科学 | 24篇 |
临床医学 | 77篇 |
内科学 | 166篇 |
皮肤病学 | 9篇 |
神经病学 | 70篇 |
特种医学 | 85篇 |
外科学 | 249篇 |
综合类 | 13篇 |
预防医学 | 26篇 |
眼科学 | 7篇 |
药学 | 22篇 |
肿瘤学 | 88篇 |
出版年
2023年 | 2篇 |
2021年 | 1篇 |
2020年 | 2篇 |
2019年 | 6篇 |
2018年 | 10篇 |
2017年 | 4篇 |
2016年 | 12篇 |
2015年 | 19篇 |
2014年 | 18篇 |
2013年 | 41篇 |
2012年 | 33篇 |
2011年 | 37篇 |
2010年 | 36篇 |
2009年 | 42篇 |
2008年 | 46篇 |
2007年 | 62篇 |
2006年 | 47篇 |
2005年 | 55篇 |
2004年 | 36篇 |
2003年 | 34篇 |
2002年 | 42篇 |
2001年 | 34篇 |
2000年 | 46篇 |
1999年 | 26篇 |
1998年 | 30篇 |
1997年 | 26篇 |
1996年 | 26篇 |
1995年 | 18篇 |
1994年 | 15篇 |
1993年 | 13篇 |
1992年 | 10篇 |
1991年 | 5篇 |
1990年 | 9篇 |
1989年 | 20篇 |
1988年 | 13篇 |
1987年 | 6篇 |
1986年 | 8篇 |
1985年 | 7篇 |
1984年 | 6篇 |
1983年 | 9篇 |
1982年 | 6篇 |
1981年 | 10篇 |
1980年 | 6篇 |
1979年 | 4篇 |
1978年 | 5篇 |
1977年 | 7篇 |
1976年 | 5篇 |
1975年 | 7篇 |
1974年 | 1篇 |
1973年 | 2篇 |
排序方式: 共有966条查询结果,搜索用时 31 毫秒
1.
Both vascular surgery and endovascular interventions traumatise the arterial wall, especially the endothelium. The vessel responds with neointimal hyperplasia and/or constrictive remodelling, and this is still the limiting factor in curative interventions. Stent placement prevents constrictive remodelling but is the main trigger for in-stent restenosis. Hyperproliferation of neointimal tissue is the main response to arterial thrombosis, local inflammation or medio-intimal injury such as occurs, for example, after balloon dilatation in the region of arterial anastomoses or of a thrombectomy (Fogarty-manoeuvre). At present, research on prevention of restenosis is focused on inhibiting neointimal hyperproliferation by using drug-eluting stents, and especially sirolimus- or paclitaxel-eluting stents. In addition, further experimental research work is in progress, with the aim of esablishing new treatment regimens and solving the problem of neointimal formation, thrombosis and constrictive remodelling. These include both local and systemic pharmacological therapy, brachy- and laser therapy, and many genetic treatment options, some of which are currently the subjects of experimental studies and early-stage clinical trials. Gene therapy seems like a promising way of preventing restenosis, but has not yet been tested in clinical trials. In the near future, selective, simultaneous, and perhaps even polyphasic regulation for gene silencing of two or more genes involved in the development of restenosis could improve the long-term patency rate. 相似文献
2.
Hendrik Seeliger Alois Fürst Carl Zülke Karl-Walter Jauch 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2002,387(7-8):286-293
BACKGROUND: Biliary tract lesions pose a dreaded complication of laparoscopic cholecystectomy. In a retrospective study we analyzed the clinical presentation, diagnostic and therapeutic management and outcome of 28 patients presenting with iatrogenic bile duct injuries. PATIENTS AND METHODS: Between 1994 and 2001 we treated 28 patients with bile duct lesions following laparoscopic cholecystectomy at our center. Operation notes and charts of all patients were reviewed systematically. A follow-up examination of each patient was performed after a median of 12 months (range 1-90). RESULTS: Twenty-two patients presented with major circumferential bile duct defect lesions. Less severe injuries (n=6) were two minor bile leaks, one bile duct stricture and three tangential lesions. Twenty-six patients were referred to our institution within 16 days (range 0-226 days). Six patients were treated by nonsurgical procedures: endoscopic stenting in four and percutaneous intervention in two. In one of the remaining patients a cystic duct leak was closed via laparotomy, and in 21 a hepaticojejunostomy was performed. Reconstruction of a hepaticojenunostomy was performed in two of these patients. Patients were dismissed from the hospital after a median of 13 days (range 4-156). Four patients presenting with generalized biliary peritonitis required prolonged intensive care. One or more episodes of cholangitis were seen in five patients during follow-up examinations. CONCLUSIONS: Major iatrogenic bile duct injuries are associated with high morbidity and prolonged hospitalization. Interdisciplinary cooperation and early referral to an experienced center is crucial in the management of patients suffering from this affliction. Cholangitis is a marked problem in the follow-up. 相似文献
3.
G Gaitanis K Nomikos E Vava EC Alexopoulos ID Bassukas 《Journal of the European Academy of Dermatology and Venereology》2009,23(12):1427-1431
Background/aim Theoretical considerations support the combination of cryosurgery and topical imiquimod to treat basal cell carcinomas (BCC). The aim of the present study was to test the feasibility and efficacy of 'cryosurgery during continued imiquimod application' ('immunocryosurgery') to treat 'high-risk-for-recurrence' BCCs.
Methods Thirteen patients with 21 biopsy-proven tumours (4 of 21 relapses after prior surgery) were included. After 2–5 weeks (median, 3) of daily 5% imiquimod cream application, the tumours were treated by liquid N2 cryosurgery (spray, two cycles, 10–20 s) and imiquimod was continued for additional 2–12 weeks (median, 4). The outcome after at least 18 months of follow-up (18–24 months) is currently reported.
Results Nineteen of 21 tumours responded promptly to immunocryosurgery; two tumours required additional treatment cycles to clear. Thus, the clinical clearance rate was 100%. Only 1 of 21(5%) tumour relapsed after at least 18 months of follow-up (cumulative efficacy: 95%).
Conclusions 'Immunocryosurgery' is a promising non-surgical combination modality to treat 'high-risk-for-recurrence BCCs'. Initial evidence is suggestive of an at least additive effect of the two combined modalities. Further studies comparing immunocryosurgery directly with cryosurgery and imiquimod monotherapies will confirm the reported results. 相似文献
Methods Thirteen patients with 21 biopsy-proven tumours (4 of 21 relapses after prior surgery) were included. After 2–5 weeks (median, 3) of daily 5% imiquimod cream application, the tumours were treated by liquid N
Results Nineteen of 21 tumours responded promptly to immunocryosurgery; two tumours required additional treatment cycles to clear. Thus, the clinical clearance rate was 100%. Only 1 of 21(5%) tumour relapsed after at least 18 months of follow-up (cumulative efficacy: 95%).
Conclusions 'Immunocryosurgery' is a promising non-surgical combination modality to treat 'high-risk-for-recurrence BCCs'. Initial evidence is suggestive of an at least additive effect of the two combined modalities. Further studies comparing immunocryosurgery directly with cryosurgery and imiquimod monotherapies will confirm the reported results. 相似文献
4.
5.
6.
K.-W. Jauch 《Der Chirurg》1997,68(6):551-558
Summary. Trauma, operative interventions, infection and other disturbances of homeostasis lead to a uniform reaction of the body,
namely release and activation of hormones and cytokines. Profound alterations of substrate flow result, with mobilization
of energy stores and degradation of structural and functional proteins of vital organs like the gut mucosa. Due to these reactions
the energy demands of the organs are met and energy-consuming synthesis of substrates is indicated. Clinically, hypermetabolism,
hyperglycemia, lipolysis and increased urea production with negative nitrogen balance can be observed. The metabolic reactivity
is reached by an increased substrate cycling. To avoid negative consequences such as organ dysfunction, a rational situation-adapted
substrate supply is warranted as well as reduction of catabolic stimuli and stimulation of anabolic factors. The metabolic
care of the surgical patient is still a basic and important task.
相似文献
7.
Mulkerrin EC; Clark BA; Epstein FH 《QJM : monthly journal of the Association of Physicians》1997,90(6):411-415
We studied blood pressure and natriuretic responses to acute salt loading,
and the effect of non-steroidal anti-inflammatory agents on these
responses, in five healthy normotensive women aged 65 to 71 years. Five
women aged 25 to 31 years acted as controls. Intravenous saline loading,
with and without prior ingestion of ibuprofen, was 15 ml/kg/h for 3 h.
Baseline blood pressures were higher in the elderly. Saline infusion
without ibuprofen raised systolic blood pressure (SBP) by about 25 mmHg in
the older group only. Ibuprofen increased baseline SBP in the elderly (129
+/- 6 vs. 116 +/- 5 mmHg, p < 0.05). Saline loading after ibuprofen
again raised blood pressure by about 25 mmHg in the elderly only. The
elderly group showed markedly increased sodium excretion during saline
loading, but this was reduced by ibuprofen. Ibuprofen had no effect on SBP
or sodium excretion in controls. Ageing appears to increase susceptibility
to salt retention and hypertension from non-steroidal anti-inflammatory
agents.
相似文献
8.
Laparoscopic mesh repair of incisional hernia: an alternative to the conventional open repair? 总被引:1,自引:0,他引:1
M. Stickel M. Rentsch D.-A. Clevert T. Hernandez-Richter K. W. Jauch F. Löhe M. K. Angele 《Hernia》2007,11(3):217-222
Background Tension-free incisional hernia repair using alloplastic material increasingly replaces conventional repair techniques. This
change resulted in a decreased recurrence rate (50% vs. 10%, respectively). Recently, laparoscopic approaches for the intraperitoneal
tension-free mesh application have been introduced. The decreased trauma at the incision site and the reduction in wound infections
appear to be the main advantages. The aim of the present study was to evaluate the early and long-term complications as well
as patients’ contentment.
Methods Laparoscopic hernia repair with intraperitoneal polytetrafluroethylene (PTFE) mesh implantation was performed on 62 patients
at the Klinikum Grosshadern between 2000 and 2005 (29 males, 33 females age 60.7). Intra- and postoperative complications
were registered prospectively and retrospectively analyzed. In addition, 57 patients were evaluated for recurrence, postoperative
pain and patient contentment (median follow-up 409 days).
Results A low complication rate was observed in our patient collective. One trocar bleeding occurred. Three patients presented with
wound hematoma. The recurrence rate was 8% (2/25). Sixty-two percent of the patients were free of complaints postoperatively.
Eighty-five percent would once again choose the laparoscopic approach for incisional hernia repair.
Conclusion The laparoscopic technique was associated with a low recurrence rate, a small rate of wound infections and high patient comfort.
Thus, the laparoscopic approach for mesh implantation appears to be a safe and effective method for the treatment of incisional
hernias. The efficiency for laparoscopic intraperitoneal mesh implantation, however, should be further evaluated within a
prospectively randomized multicenter trial.
M. Stickel and M. Rentsch contributed equally. 相似文献
9.
10.
Uroscopy in the 21st century: high-field NMR spectroscopy 总被引:1,自引:1,他引:0
Neild GH; Foxall PJ; Lindon JC; Holmes EC; Nicholson JK 《Nephrology, dialysis, transplantation》1997,12(3):404-417
From the experiments described, it can be seen that there are different
research approaches that can be taken and these are summarized in Table 1.
Whereas much scientific research is principally hypothesis led, there
remains, nevertheless, an important place for exploratory research. High
resolution NMR can measure, directly and simultaneously, a wide range of
endogenous metabolites in biological fluids and has the unique capability
of providing structural information on the metabolites detected. It has
proved to be a powerful research tool with which to study inherited
metabolic diseases, renal disease, drug metabolism, and toxicity, and can
be used to monitor the effects of drug therapy. For instance, by using a
library of experimental toxins one can map the metabolic profile of
site-specific nephron injury. With this approach in man one could
eventually take an unknown disease such as Balkan nephropathy and predict
the initial site of tubular injury, the mode of injury and therefore the
kind of toxin capable of producing that injury. NMR spectroscopic
techniques are still advancing rapidly, with ever increasing sensitivity
and sophistication of NMR pulse sequences to enhance structural elucidation
in complex mixtures. Given the advances in directly coupled HPLC-NMR and
even HPLC-NMR-mass spectroscopy it is likely that these technologies in
conjunction with pattern recognition will make major contribution to our
understanding of renal processes and provide new diagnostic insights in the
21st century.
相似文献