全文获取类型
收费全文 | 342篇 |
免费 | 16篇 |
专业分类
耳鼻咽喉 | 6篇 |
儿科学 | 11篇 |
妇产科学 | 6篇 |
基础医学 | 35篇 |
口腔科学 | 9篇 |
临床医学 | 32篇 |
内科学 | 72篇 |
皮肤病学 | 4篇 |
神经病学 | 15篇 |
特种医学 | 5篇 |
外科学 | 16篇 |
综合类 | 14篇 |
预防医学 | 38篇 |
眼科学 | 42篇 |
药学 | 30篇 |
肿瘤学 | 23篇 |
出版年
2024年 | 3篇 |
2023年 | 7篇 |
2022年 | 16篇 |
2021年 | 28篇 |
2020年 | 15篇 |
2019年 | 24篇 |
2018年 | 19篇 |
2017年 | 13篇 |
2016年 | 18篇 |
2015年 | 12篇 |
2014年 | 19篇 |
2013年 | 17篇 |
2012年 | 32篇 |
2011年 | 31篇 |
2010年 | 23篇 |
2009年 | 14篇 |
2008年 | 16篇 |
2007年 | 12篇 |
2006年 | 13篇 |
2005年 | 5篇 |
2004年 | 8篇 |
2003年 | 3篇 |
2002年 | 6篇 |
1995年 | 1篇 |
1994年 | 2篇 |
1992年 | 1篇 |
排序方式: 共有358条查询结果,搜索用时 15 毫秒
1.
2.
Yin Wan Shelby Corman Xin Gao Sizhu Liu Haridarshan Patel Reema Mody 《American Health & Drug Benefits》2015,8(2):93-102
Background
Opioid-induced constipation (OIC) can be a debilitating side effect of opioid therapy and may result in increased medical costs. The published data on the economic burden of OIC among long-term opioid users are limited.Objective
To assess the economic burden of OIC in patients with noncancer pain in a managed care population in the United States.Methods
This retrospective study used 2007–2011 data from the Truven Health MarketScan Commercial and Medicare databases. The study included adults with ≥12 months of insurance enrollment before and after starting long-term (≥90 days) use of opioids. Patients were excluded if they had cancer or a diagnosis of drug abuse or drug dependence during the study period, or if they had constipation or bowel obstruction within 90 days before starting opioid therapy during the study period. OIC was identified by International Classification of Diseases, Ninth Edition codes for constipation (564.0) or bowel obstruction (560.x) within 12 months of the initiation of an opioid. Patients with OIC were identified in the nonelderly, elderly (age ≥65 years), and long-term care populations. Differences in costs and healthcare resource utilization were calculated using propensity scoring.Results
A total of 13,808 nonelderly (age, 48.6 ± 10.4 years; female, 50%) and 2958 elderly patients (age, 78.7 ± 8.1 years; female, 70%) met the study inclusion criteria. Of 401 nonelderly and 194 elderly patients with OIC, 85 patients initiated opioid therapy in a long-term care facility (age, 80.7 ± 11.6 years; female, 77%). After matching by key covariates, patients with OIC had significantly more hospital admissions than patients without OIC (nonelderly, 33% vs 22%, respectively; P <.001; elderly, 51% vs 31%, respectively; P <.001) and longer inpatient stays (nonelderly, 3.0 ± 8.4 days vs 1.0 ± 3.0 days, respectively; P <.001; elderly, 5.2 ± 12.2 days vs 2.1 ± 4.0 days, respectively; P <.001). The group with OIC had significantly higher total healthcare costs than the group without OIC in all 3 study cohorts (nonelderly, $23,631 ± $67,209 vs $12,652 ± $19,717, respectively; elderly, $16,923 ± $38,191 vs $11,117 ± $19,525, respectively; long-term care, $16,000 ± $22,897 vs $14,437 ± $25,690, respectively; all P <.05).Conclusion
To the best of our knowledge, this is the first study to analyze the economic impact of long-term use of opioids among patients with OIC, using real-world data. The findings underscore the significant economic burden associated with long-term opioid use for noncancer pain in a managed care population. Effective therapies for OIC may reduce the associated economic burden and improve quality of life for long-term opioid users. 相似文献3.
4.
Jain R von Hurst PR Stonehouse W Love DR Higgins CM Coad J 《Metabolism: clinical and experimental》2012,61(3):293-301
The objectives of the study were to determine associations between single nucleotide polymorphisms (SNPs) of the vitamin D receptor (VDR) gene and insulin resistance and the effects of these SNPs on changes in insulin sensitivity in response to vitamin D supplementation. The research described here was an extension of the Surya study. Genotyping of the Cdx-2, FokI, BsmI, ApaI, and TaqI SNPs was carried out on 239 South Asian women in New Zealand using polymerase chain reaction-based techniques. Associations of these genotypes and 3' end haplotypes with insulin resistance were determined using multiple regression analysis. Associations between SNP genotypes and responses in insulin sensitivity to vitamin D supplementation (4000 IU vitamin D(3) per day) were also determined for a subset (81) of these women. BsmI BB, ApaI AA, and TaqI tt genotypes were significantly associated with lower insulin resistance compared with BsmI bb, ApaI aa, and TaqI TT, respectively, in the cohort of 239 women. Furthermore, homozygosity of the haplotypes baT and BAt was associated with higher and lower insulin resistance, respectively, compared with no copies of their respective alleles. Of the 81 subjects who were supplemented with vitamin D, women with the FokI Ff genotype showed a significantly greater improvement in insulin sensitivity (increase of 29.4 [2.9, 38.1]) compared with women with the FokI FF genotype (increase of 2.3 [-11.5, 10.1]). This study has highlighted the association of vitamin D responsiveness and insulin resistance with VDR gene polymorphisms. This is the first study to determine associations between all three. Genotyping of the VDR gene may provide a predictive measure for insulin resistance in response to vitamin D intervention. 相似文献
5.
Singh BP Pradhan KN Tripathi A Tua R Tripathi S 《The journal of advanced prosthodontics》2012,4(1):43-51
PURPOSE
The objective of this study was to evaluate the effect of sociodemographic factors on quality of satisfaction towards denture treatment.MATERIALS AND METHODS
One hundred subjects (filling inclusion criteria) who were wearing a denture for at least two months were enrolled and divided into five groups on the basis of sociodemographic variables (age, gender, literacy level, socio-economic and marital status). Questionnaires consisting of 38 questions (positive and negative attitude towards denture satisfaction) related to patients'' perception of clinical outcome in different domains such as mastication, appearance, speech, comfort, health, denture care and social status were scored by the subjects. Questions reflecting positive attitude were scored as 2, 1, or 0 (yes, uncertain and no, respectively) and reversely for the negative questions. Statistical analysis was done by using Statistical Package for Social Sciences (α = .05).RESULTS
Level of denture satisfaction was higher in age subgroup belonging to 45 - 65 years of age in relation to comfort, health and denture care. Female and male showed significant priority for denture treatment because of esthetic and function respectively. Level of satisfaction was statistically significant with literacy level. Upper high income group showed significantly higher level of satisfaction only in case of social status. Married group showed significantly higher satisfaction level only with comfort.CONCLUSION
Patients'' sociodemographic variables were influential factors on denture satisfaction. 相似文献6.
7.
8.
Saad Akhtar Khan Hussain Shallwani Muhammad Shahzad Shamim Ghulam Murtaza Syed Ather Enam Reema Obaid Qureshi Muhammad Zubair Tahir 《Child's nervous system》2014,30(2):277-281
Objective
This study aimed to determine the risk factors associated with poor outcome of decompressive craniectomy (DC) for severe traumatic brain injury (TBI) in pediatric patients.Methods
This retrospective study is conducted on pediatric population (age 1–15 years) presenting with TBI who underwent DC at our institute between January 2000 and 2010. Based on Glasgow outcome score (GOS) at a minimum follow-up of 5 months, patients were divided into two groups, namely poor outcome (GOS 1, 2, and 3) and good outcome (GOS 4 and 5). Records were reviewed and analyzed for preoperative and intraoperative predictors.Results
We found 25 patients who were eligible as per selection criteria. Mean age at presentation was 6?±?4 years and there was male preponderance (84 %). Fall (60 %) was the most common mechanism of injury followed by gunshots and road traffic accident. On univariate analysis, presenting GCS ≤5 (p value?=?0.009), delay in presentation of more than 150 min (p value?=?0.010), DC performed after more than 4 h of arrival in hospital (p value?=?0.042), and intraoperative blood loss exceeding 300 ml (p value?=?0.001) were significant predictors of poor outcome.Conclusion
Our study suggests that DC in children is not only a life-saving procedure, but also leads to a good functional outcome after severe injury. However, patient selection still remains an important aspect, and the above-mentioned factors should be considered while deciding for DC to improve survival. Further prospective studies on larger sample size are warranted to validate our results. 相似文献9.
10.