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Bruno Fautrel Thao Pham Gaël Mouterde Xavier Le Loët Philippe Goupille Francis Guillemin Philippe Ravaud Alain Cantagrel Maxime Dougados Xavier Puchal Jean Sibilia Martin Soubrier Xavier Mariette Bernard Combe pour le Club rhumatismes et inflammation pour la Socit franaise de rhumatologie 《Revue du Rhumatisme》2007,74(12):1301-1311
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Ganne-Carrié N Chevret S Barbare JC Chaffaud C Grando V Vogt AM Beaugrand M Trinchet JC;Association Française pour l'Etude du Foie 《Gastroentérologie clinique et biologique》2002,26(6-7):570-577
AIM: To describe French practices for screening hepatocellular carcinoma. METHODS: A standardized questionnaire was mailed to all French hospital hepato-gastroenterologists in June 1999. RESULTS: 411 out of 623 practitioners responded (66%). 394 (96%) routinely screen hepatocellular carcinoma, mainly with ultrasound (98%) and mainly at 6-month intervals (77%). Screening was performed in cirrhosis (100%) or extensive fibrosis (54%), independent of the etiology (21%) or the Child-Pugh score of the chronic liver disease (41%), but based on age and treatment feasibility. If of a small hypoechogenic nodule was detected in a young patient with compensated HCV-cirrhosis, 59% of practitioners performed a histological examination. In case of non biopsy-proven hepatocellular carcinoma, a second biopsy (49%), treatment (either percutaneous alcohol injection, resection or transplantation) (24%) or an ultrasonographic follow-up (23%) was proposed. In case of biopsy-proven hepatocellular carcinoma, resection (49%), transplantation (30%) or percutaneous alcohol injection (16%) was proposed. CONCLUSION: Almost all French specialists routinely screen cirrhotic patients for hepatocellular carcinoma, but use somewhat different modalities. In case of small HCC without contraindications to curative treatment, surgical resection is performed in half the patients. 相似文献
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European AIDS Clinical Society;European Association for the Study of the Liver;Société de Pathologie Infectieuse de Langue Française;Agence national de recherches sur le sida et les hépatites virales;European AIDS Treatment Group;International AIDS Society;European Society of Clinical Microbiology Infectious Diseases;European Federation of Internal Medicine;Association française pour l'étude du foie;Société national française de médecine interne;Ministère des Solidarités 《Médecine et maladies infectieuses》2005,35(3):109-120
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Fontaine H Petitprez K Roudot-Thoraval F Trinchet JC;Association francaise pour l'etude du foie;Club de reflexion des cabinets et groupes d'hepato-gastro-enterologue;College national des generalistes enseignants;Groupe francophone d'hepatologie gastro-enterologie et nutrition pediatriques;Societe francaise de biologie clinique;Societe francaise de radiologie;Societe nationale francaise de gastro-enterologie 《Gastroentérologie clinique et biologique》2007,31(5):504-509
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B. Quentin O. Grim H. Moine N. H. Bui B. Eon O. Noizet J. Pillot A. Boyer C. Daubin R. Robert pour la commission d’éthique de la Société de réanimation de langue française 《Réanimation》2017,26(4):261-267
Three cases involving patients with severe septic shock and disseminated intravascular coagulation inducing major skin lesions raising the question of urgent multiple amputaion decision during ICU stay are reported. Different decisions were taken in these three patients. These three observations question the prospects of accepting a life with a major handicap. This problem is illustrated by a double anthropological and philosophical analysis. 相似文献
10.
Chantry AA Deneux-Tharaux C Bal G Zeitlin J Quantin C Bouvier-Colle MH;pour le groupe GRACE 《Revue d'épidémiologie et de santé publique》2012,60(3):177-188
BackgroundThe organization of obstetric care in France brings all women in contact with the hospital system. Thus, hospital discharge data from the Program of Medicalization of the Information System (PMSI) constitute a potentially valuable source of information, particularly regarding rare events such as severe maternal morbidity. These data cover a large population but their quality has not been assessed in that field. Our objectives were to study the processes of production and the validity of PMSI data related to severe maternal morbidity.MethodsThe study was conducted in four French tertiary teaching hospitals (Caen, Cochin [AP–HP, Paris], Grenoble and Lille). First, the organization of each step of the medical information process -production, formatting, verification and processing- was detailed in each center with a standardized form. Second, the validation study was based on the comparison of data related to severe maternal morbid events in the PMSI from these centers for 2006 and 2007, with the content of medical records which constituted the gold standard. Indicators of sensitivities and positive predictive values of PMSI were calculated.ResultsThe processes of PMSI data production showed major differences between the four centers. In hospital discharge data, diagnoses (eclampsia and pulmonary embolism) had a high proportion of false-positives (68%). Inversely, procedures (four procedures for management of severe haemorrhage) had less than 1% of false-positives, but a low sensitivity with 37% false-negatives which could be corrected in 95%. Regarding intensive care provision, all indicators of hospital data quality were very high. In addition, the validity of hospital data in centers 1 and 2 was higher for all events.ConclusionThe heterogeneity of the process of PMSI data production is associated with a variable quality of these data. Intensive care provision can be used in the PMSI, as well as procedures after correction. For diagnoses, the quality of the PMSI data is better in centers having both computerized medical records and steps for verification of medical information. 相似文献