全文获取类型
收费全文 | 204篇 |
免费 | 7篇 |
国内免费 | 1篇 |
专业分类
儿科学 | 8篇 |
基础医学 | 13篇 |
口腔科学 | 1篇 |
临床医学 | 15篇 |
内科学 | 12篇 |
皮肤病学 | 1篇 |
神经病学 | 6篇 |
特种医学 | 65篇 |
外科学 | 56篇 |
综合类 | 1篇 |
预防医学 | 5篇 |
眼科学 | 18篇 |
药学 | 8篇 |
肿瘤学 | 3篇 |
出版年
2023年 | 1篇 |
2022年 | 7篇 |
2021年 | 13篇 |
2020年 | 6篇 |
2019年 | 6篇 |
2018年 | 5篇 |
2017年 | 5篇 |
2016年 | 8篇 |
2015年 | 5篇 |
2014年 | 6篇 |
2013年 | 9篇 |
2012年 | 10篇 |
2011年 | 19篇 |
2009年 | 7篇 |
2008年 | 7篇 |
2007年 | 11篇 |
2006年 | 5篇 |
2005年 | 12篇 |
2004年 | 10篇 |
2003年 | 1篇 |
2002年 | 4篇 |
2001年 | 7篇 |
2000年 | 8篇 |
1999年 | 7篇 |
1998年 | 4篇 |
1997年 | 5篇 |
1996年 | 5篇 |
1995年 | 2篇 |
1994年 | 6篇 |
1993年 | 1篇 |
1992年 | 5篇 |
1991年 | 1篇 |
1971年 | 2篇 |
1968年 | 1篇 |
1967年 | 1篇 |
排序方式: 共有212条查询结果,搜索用时 0 毫秒
1.
The purpose of this retrospective study was to determine the CT findings diagnostic of cardiac and pericardial injury, including
signs of pericardial tamponade, in patients suffering from blunt and penetrating trauma. A search of the CT radiology database
at a level I trauma center was performed to identify cases in which injury to the heart or pericardium was diagnosed, as well
as to identify cases of pericardial tamponade. All cases were reviewed to ascertain the specific CT findings, and medical
records were reviewed to assess the influence of CT findings on management and to assess for clinical evidence of pericardial
tamponade. Eighteen patients had direct CT evidence of cardiac or pericardial injury, including nine cases of pneumopericardium,
eight cases of hemopericardium, and one case of intrapericardial gastric herniation. Four of these patients were found to
have direct cardiac injuries. Three additional cases with CT evidence of pericardial tamponade were identified, two secondary
to cardiac compression by an anterior mediastinal hematoma and one following repair of left ventricular rupture. Of 11 patients
with CT evidence of tamponade, only three were suspected clinically. Cardiac and pericardial injuries are usually diagnosed
surgically and are often clinically unsuspected, particularly in blunt trauma. As CT is increasingly utilized as a general
screening test for thoracic/abdominal trauma, these injuries may be first suspected on the basis of CT findings, and knowledge
of the CT findings of cardiac injury or tamponade is crucial. 相似文献
2.
Diffusion tensor imaging (DTI) has recently emerged as a useful tool for assessing traumatic brain injury (TBI). In this study, the prognostic value of the relationship between DTI measures and the clinical status of severe TBI patients, both at the time of magnetic resonance imaging (MRI), and their discharge to acute TBI rehabilitation, was assessed. Patients (n=59) admitted to the trauma center with severe closed head injuries were retrospectively evaluated after approval from the institution's institutional review board, to determine the prognostic value of DTI measures. The relationship of DTI measures, including apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial (λ‖) and radial diffusivity (λ⊥) from the whole brain white matter, internal capsule, genu, splenium, and body of the corpus callosum, were compared with neurological status at MRI and at discharge to acute TBI rehabilitation. Whole brain white matter averages of ADC, λ‖, and λ⊥, and their coefficient of variation (CV) were significantly correlated with the Glasgow Coma Scale (GCS) score on the day of MRI. The average λ‖ was significantly correlated with GCS scores on the day of MRI in all measured brain regions. Outcomes were associated with whole brain white matter averages of ADC and λ‖, and the CVs of FA, ADC, λ‖, and λ⊥; and the averages and CVs of FA and λ‖ in all corpus callosum regions. The inclusion of regional and global DTI measures improved the accuracy of prognostic models, when adjusted for admission GCS score and age (p<0.05). Whole brain white matter and regional DTI measures are sensitive markers of TBI, and correlate with neurological status both at MRI and discharge to rehabilitation. The addition of DTI measures adjusted for age, gender, and admission GCS score significantly improved prognostic models. 相似文献
3.
Silvampatty R. Sundararajan Kanchana P. Srikanth Handenahally S. Nagaraja Shanmuganathan Rajasekaran 《The Journal of foot and ankle surgery》2017,56(2):282-286
The optimal time to treat neuropathic (Charcot) arthropathy of the ankle and peritalar joint is controversial because of the various treatment options available and the variable results reported in published studies. We sought to determine the outcome of hind foot arthrodesis with stable internal fixation in patients with different Eichenholtz stages of arthropathy. We prospectively studied patients with substantial disabilities caused by neuropathic arthropathy in deformed, unstable ankle and peritalar joints, with or without ulcerations, who had undergone treatment from July 2007 to December 2012. All patients underwent ankle arthrodesis, autologous iliac crest bone grafting, and subtalar joint arthrodesis, with or without talonavicular joint arthrodesis, fixed internally with an intramedullary hindfoot nail, with or without an additional plate or cancellous screws. Of the 33 enrolled patients, 9 (27.3%) had stage I, 13 (39.4%) had stage II, and 11 (33.3%) had stage III Charcot arthropathy. The cause of arthropathy was diabetes mellitus in 25 (75.8%) patients. The duration of symptoms ranged from 1 to 120 (median 7) months. The mean follow-up period was 40 (range 12 to 76) months and did not differ markedly among the groups. The hindfoot scores, rate of salvage or amputation, or complication rates did not differ significantly across Eichenholtz stage. For the patients with stage I, II, and III, the preoperative hindfoot score was 50, 49, and 48, respectively (p = .9). The corresponding postoperative scores were 68, 68, and 70 (p = .5). We found no evidence that the effectiveness of hindfoot arthrodesis by stable fixation varied across the Eichenholtz stage of Charcot arthropathy involving ankle and peritalar joint. Furthermore, we found that stable internal fixation and bone grafting using a hindfoot nail results in an 84.84% union rate and salvages the unstable and disabled foot in 90.9% of patients with ankle and peritalar Charcot arthropathy. 相似文献
4.
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
5.
6.
7.
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8.
Rajkumar Natesan Soundarrajan Dhanasekaran Dhanasekararaja Palanisami Rajasekaran Shanmuganathan 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2020,30(5):923-929
European Journal of Orthopaedic Surgery & Traumatology - Alkaptonuria is a rare metabolic disorder, and only a few case reports of total joint arthroplasty (TJA) for ochronotic arthropathy are... 相似文献
9.
Ramesh Perumal Vijay Shankar Rizwan Basha Dheenadayalan Jayaramaraju Shanmuganathan Rajasekaran 《Journal of Clinical Orthopaedics and Trauma》2018,9(4):322-326
Purpose
Although nail dynamization in femoral and tibial fractures is an effective method of promoting healing, its role beyond twelve weeks is still not clear. It is usually done two to three months following interlocking nailing. This study was done to evaluate the efficacy of late dynamization (after 12 weeks) and factors affecting union.Materials and methods
In this retrospective study, thirty seven patients who underwent dynamization for reamed intramedullary interlocking nails of femur (18) and tibia (20) after twelve weeks from index surgery and with a minimum followup of six months were included. Fracture healing index was calculated using predynamization radiographs. Radiographic union was defined as osseous bridging of three cortices on followup radiographs. Dynamization failure was defined as fractures not showing progressive increase in callus on followup radiographs and those that required secondary intervention.Results
Mean age of patients at time of injury was 35.92 years (range: 16–63) with males (86.8%) predominating. Mean time to dynamization from index surgery was 19.11 weeks (range-12–36). Thirty one fractures (81.5%) went onto union after dynamization of which twelve were femoral and nineteen were tibial fractures. Mean time to union after dynamization was 6 months. Communited fractures (6–21) showed poor results with delayed dynamization compared to other anatomical types which was statistically significant (P?=?0.05). Predynamization FHI of more than 1.18 had 83% sensitivity and 72% specificity in predicting fracture healing after dynamization.Conclusion
Late dynamization is still beneficial in promoting healing in femoral and tibial fractures. Communited fractures showed poor results with dynamization. Predynamization FHI was an important predictor of fracture healing. 相似文献10.
Canadian Journal of Anesthesia/Journal canadien d'anesthésie - 相似文献