全文获取类型
收费全文 | 346篇 |
免费 | 11篇 |
国内免费 | 8篇 |
专业分类
耳鼻咽喉 | 3篇 |
儿科学 | 5篇 |
妇产科学 | 2篇 |
基础医学 | 31篇 |
口腔科学 | 1篇 |
临床医学 | 20篇 |
内科学 | 91篇 |
皮肤病学 | 26篇 |
神经病学 | 13篇 |
特种医学 | 6篇 |
外科学 | 73篇 |
综合类 | 7篇 |
预防医学 | 12篇 |
眼科学 | 25篇 |
药学 | 25篇 |
中国医学 | 2篇 |
肿瘤学 | 23篇 |
出版年
2023年 | 2篇 |
2022年 | 3篇 |
2021年 | 8篇 |
2020年 | 6篇 |
2019年 | 6篇 |
2018年 | 8篇 |
2017年 | 3篇 |
2016年 | 7篇 |
2015年 | 3篇 |
2014年 | 12篇 |
2013年 | 18篇 |
2012年 | 22篇 |
2011年 | 26篇 |
2010年 | 14篇 |
2009年 | 14篇 |
2008年 | 21篇 |
2007年 | 19篇 |
2006年 | 20篇 |
2005年 | 13篇 |
2004年 | 16篇 |
2003年 | 16篇 |
2002年 | 14篇 |
2001年 | 14篇 |
2000年 | 18篇 |
1999年 | 8篇 |
1998年 | 2篇 |
1997年 | 3篇 |
1992年 | 3篇 |
1991年 | 2篇 |
1990年 | 9篇 |
1987年 | 3篇 |
1976年 | 1篇 |
1975年 | 1篇 |
1969年 | 1篇 |
1967年 | 1篇 |
1966年 | 1篇 |
1963年 | 1篇 |
1961年 | 1篇 |
1943年 | 1篇 |
1935年 | 2篇 |
1930年 | 4篇 |
1929年 | 1篇 |
1927年 | 1篇 |
1925年 | 2篇 |
1924年 | 2篇 |
1923年 | 1篇 |
1918年 | 2篇 |
1912年 | 2篇 |
1910年 | 1篇 |
1907年 | 1篇 |
排序方式: 共有365条查询结果,搜索用时 46 毫秒
1.
The records of 54 consecutively treated patients with hepatic trauma were reviewed. Diagnosis, treatment and results were analyzed. Clinical features and ultra sonography were deciding for diagnosis. Frequent associated injuries are due to mechanism of injury 74% of road accident. 50% of lesions were major. Treatment were hemostasis, by suture and packing. Only 6 major hepatectomy were realised. Total mortality is 15% due to incomplete initial treatment or to extra-hepatic injury. Morbidity is important due to sepsis and hemorrhage. Therapeutic evolution showed decline of resection for conserving operation. 相似文献
2.
Hepatitis C virus (HCV) genotypes in the Caribbean island of Martinique: evidence for a large radiation of HCV-2 and for a recent introduction from Europe of HCV-4 下载免费PDF全文
Martial J Morice Y Abel S Cabié A Rat C Lombard F Edouard A Pierre-Louis S Garsaud P Béra O Chout R Gordien E Deny P Césaire R 《Journal of clinical microbiology》2004,42(2):784-791
Molecular epidemiological studies of hepatitis C virus (HCV) in the Caribbean may help to specify the origin and spread of HCV infection. Indeed, the Caribbean population is intermixed from European and African origins and geographically close to the American continent. We characterized HCV genotypes in the Caribbean island of Martinique. HCV genotypes were analyzed by sequencing or reverse hybridization in the 5' noncoding region (5'NC) in 250 HCV-monoinfected and 85 HCV-human immunodeficiency virus (HIV)-coinfected patients. In addition, sequencing in the nonstructural 5B (NS5B) gene was required to determine the subtype or to perform phylogenetic analysis in selected samples. Genotypes 1 to 6 were found, respectively, in 84.4, 6.8, 5.2, 2.8, 0.4, and 0.4% of 250 HCV-monoinfected patients and in 71.7, 7.1, 15.3, 5.9, 0, and 0% of 85 HCV-HIV-coinfected patients. HCV-1b was found in 66.4% of the HCV-monoinfected patients and was associated with blood transfusion, whereas HCV-1a was detected in 41.2% of the HCV-HIV-coinfected patients and was associated with intravenous drug use (IVDU). The HCV-3 strains belonged to subtype 3a and were linked to IVDU. Phylogenetic analyses were focused on HCV-2 and HCV-4, which are common in Africa. Two opposite patterns were evidenced. NS5B sequences from 19 HCV-2 isolates were affiliated with many different subtypes described either in Europe or in West Africa, suggesting an ancient radiation. In contrast, seven of the nine HCV-4 NS5B sequences ranged within HCV-4a and HCV-4d clusters spreading in continental France by the IVDU route. Epidemiological data demonstrate the recent introduction of HCV-4a and -4d subtypes into the Caribbean. 相似文献
3.
Fabrice Bonnet Anne-Christine Jouvencel Marie Parrens Magali Joblon Leon Emmanuelle Cotto Isabelle Garrigue Philippe Morlat Jacques Beylot Hervé Fleury Marie-Edith Lafon 《Journal of clinical virology》2006,36(4):258-263
BACKGROUND: Epstein-Barr virus (EBV) may be causally associated with non-Hodgkin Lymphoma (NHL) in HIV-infected patients. OBJECTIVES: To compare EBV load in whole blood in AIDS-NHL patients, HIV non-AIDS patients and non-HIV-infected persons, and to prospectively measure EBV load in whole blood in AIDS-NHL patients. STUDY DESIGN: Longitudinal and prospective study. RESULTS: We observed no statistical difference in EBV load between AIDS-NHL (3.69log(10) copies/mL [interquartile range (IQR): 2.89-4.27]) and HIV non-AIDS patients (3.08log(10) copies/mL [IQR: 1.29-3.57]) but AIDS-NHL patients had significantly higher EBV loads than HIV-negative controls (1.19log(10) copies/mL [IQR: 0.00-3.29]). We noticed an inverse correlation between CD4+ lymphocytes count and EBV load in patients with AIDS-NHL (r(2)=0.41, P=0.01). In the longitudinal study, the mean EBV load three months after NHL diagnosis decreased significantly (mean difference=-1.69log(10) copies/mL [95% confidence interval: -0.32; -3.04]; P=0.03) under chemotherapy but was still elevated in patients with relapses or no response to chemotherapy. CONCLUSION: Although EBV load seems a suboptimal marker for the diagnosis of AIDS-NHL, we observed a significant decrease of EBV load in patients treated with chemotherapy and a strong association between NHL outcome and EBV load in whole blood. 相似文献
4.
Adjunct effect of loratadine in the treatment of acute sinusitis in patients with allergic rhinitis 总被引:1,自引:2,他引:1
J. J. Braun J. P. Alabert F. B. Michel M. Quiniou C. Rat J. Cougnard W. Czarlewski J. Bousquet 《Allergy》1997,52(6):650-655
H1 -blockers are often added to the standard treatment of acute sinusitis, but this is not supported by a controlled study. A multicentric, randomized, double-blind, placebo-controlled, parallel-group study was done in 139 allergic patients (15–65 years) to assess the adjunct efficacy of loratadine in acute exacerbation of rhinosinusitis. Sinusitis was diagnosed by symptoms and confirmed by rhinoscopy and sinus radiograph. Allergy was characterized by skin tests, RAST, and history. Patients were treated with antibiotics (14 days), oral corticosteroids (10 days), and loratadine (10 mg OD) or placebo (28 days). Treatment efficacy was assessed over 28 days by symptom scores quoted daily by patients. Physicians also rated total symptom scores at entry and at day 28. At entry, both groups had similar symptoms. Placebo-treated patients improved significantly, but patients who received loratadine had a significantly greater improvement in sneezing ( P =0.003) after 14 days, and in nasal obstruction ( P =0.002) after 28 days. Physicians found that patients receiving loratadine were significantly improved compared to placebo patients ( P =0. 0125). Loratadine in addition to standard therapy was found to improve the control of some symptoms of sinusitis. 相似文献
5.
6.
Nicolas Santucci Olivier Facy Pablo Ortega-Deballon Jean-Baptiste Lequeu Paul Rat Patrick Rat 《Pancreatology》2018,18(6):666-670
Background
Surgical resection remains the only curative option for pancreatic adenocarcinoma. Despite recent improvements in medical imaging, unresectability is still often discovered at the time of surgery. It is essential to identify unresectable patients preoperatively to avoid unnecessary surgery. High serum CA 19-9 levels have been suggested as a marker of unresectability but considered inaccurate in patients with hyperbilirubinemia.Aim of the study
To evaluate CA 19-9 serum levels as a predictor of unresectability of pancreatic adenocarcinomas with a special focus on jaundiced patients.Methods
All patients presenting with histologically-confirmed pancreatic adenocarcinoma and having serum CA 19-9 levels available prior to any treatment were included in this retrospective study. The relationship between serum concentrations of CA 19–9 and resectability was studied by regression analysis and theROC curves obtained. A cut-off value of CA 19–9 was calculated. In jaundiced patients, a CA 19–9 adjusted for bilirubinemia was also evaluated.Results
Of the 171 patients included, 49 (29%) were deemed resectable and 122 (71%) unresectable. Altogether, 93 patients (54%) had jaundice. The area under the ROC curve for CA 19–9 as a predictor of resectability was 0.886 (95%CI:[0.832–0.932]); in jaundiced patients it was 0.880 (95% CI [0.798–0.934]. A cut-off in CA 19–9?at 178 UI/mlyielded 85% sensitivity, 81% specificity and 91% positive predictive value for resectability. There was no correlation between the levels of bilirubin and CA 19–9 (r?=?0.149).Conclusion
Serum CA 19–9 is a good predictive marker of unresectability of pancreatic adenocarcinoma, even in jaundiced patients. CA 19-9 levels over 178 UI/ml strongly suggest unresectable disease. 相似文献7.
8.
Wieczorek Maud Rotonda Christine Epstein Jonathan Guillemin Francis Rat Anne-Christine 《Quality of life research》2018,27(10):2731-2743
Quality of Life Research - To assess the validity of the e-OAKHQOL questionnaire and analyze whether the answers were affected by the form of administration (electronic vs. paper). Two samples of... 相似文献
9.
Cédric Rat Gaelle Quereux Christelle Riviere Sophie Clouet Rémy Senand Christelle Volteau Brigitte Dreno Jean-Michel Nguyen 《Annals of family medicine》2014,12(1):21-28
PURPOSE
Targeted interventions to reduce the risk and increase the early detection of melanoma have the potential to save lives. We aimed to assess the effect of such an intervention on patient prevention behavior.METHODS
We conducted a pilot clustered randomized controlled trial, comparing a targeted screening and education intervention with a conventional information-based campaign in 20 private surgeries in western France. In the intervention group, 10 general practitioners identified patients at elevated risk for melanoma with a validated assessment tool, the Self-Assessment Melanoma Risk Score (SAMScore), examined their skin, and counseled them using information leaflets. In the control group, 10 general practitioners displayed a poster and the leaflets in their waiting room and examined patients’ skin at their own discretion. The main outcome measures were sunbathing and skin self-examinations among patients at elevated risk, assessed 5 months later with a questionnaire.RESULTS
Analyses were based on 173 patients. Compared with control patients, intervention patients were more likely to remember the campaign (81.4% vs 50.0%, P = .0001) and to correctly identify their elevated risk of melanoma (71.1% vs 42.1%, P = .001). Furthermore, intervention patients had higher levels of prevention behaviors: they were less likely to sunbathe in the summer (24.7% vs 40.8%, P = .048) and more likely to have performed skin self-examinations in the past year (52.6% vs 36.8%, P = .029). The intervention was not associated with any clear adverse effects, although there were trends whereby intervention patients were more likely to worry about melanoma and to consult their general practitioner again about the disease.CONCLUSIONS
The combination of use of the SAMScore and general practitioner examination and counseling during consultations is an efficient way to promote patient behaviors that may reduce melanoma risk. Extending the duration of follow-up and demonstrating an impact on morbidity and mortality remain major issues for further research. 相似文献10.
Sandrine Hild MD MPH Marion Johanet MD Anna Valenza MD Maïna Thabaud MD Flore Laforest MD MPH Emilie Ferrat MD PhD Cédric Rat MD PhD for the DEDICACES Group the French National College of General Practitioners 《Cancer》2020,126(12):2765-2774
Mammographic screening contributes to a reduction in specific mortality, but it has disadvantages. Decision aids are tools designed to support people's decisions. Because these aids influence patient choice, their quality is crucial. The objective of the current study was to conduct a systematic review of decision aids developed for women eligible for mammographic screening who have an average breast cancer risk and to assess the quality of these aids. The systematic review included articles published between January 1, 1997, and August 1, 2019, in the PubMed, Embase, Cochrane, and PsycInfo databases. The studies were reviewed independently by 2 reviewers. Any study containing a decision aid for women eligible for mammographic screening with an average breast cancer risk was included. Two double-blind reviewers assessed the quality of the selected decision aids using the International Patient Decision Aid Standards instrument, version 3 (IPDASi). Twenty-three decision aids were extracted. Classification of decision aid quality using the IPDASi demonstrated large variations among the decision aids (maximum IPDASi score, 188; mean ± SD score, 132.6 ± 23.8; range, 85-172). Three decision aids had high overall scores. The 3 best-rated dimensions were disclosure (maximum score, 8; mean score, 6.8), focusing on transparency; information (maximum score, 32; mean score, 26.1), focusing on the provision of sufficient details; and probabilities (maximum score, 32; mean score 25), focusing on the presentation of probabilities. The 3 lowest-rated dimensions were decision support technology evaluation (maximum score, 8; mean score, 4.3), focusing on the effectiveness of the decision aid; development (maximum score, 24; mean score, 12.6), evaluating the development process; and plain language (maximum score, 4; mean score, 1.9), assessing appropriateness for patients with low literacy. The results of this review identified 3 high-quality decision aids for breast cancer screening. 相似文献