全文获取类型
收费全文 | 2371篇 |
免费 | 102篇 |
国内免费 | 68篇 |
专业分类
耳鼻咽喉 | 43篇 |
儿科学 | 19篇 |
妇产科学 | 40篇 |
基础医学 | 71篇 |
口腔科学 | 27篇 |
临床医学 | 287篇 |
内科学 | 289篇 |
皮肤病学 | 9篇 |
神经病学 | 65篇 |
特种医学 | 96篇 |
外科学 | 683篇 |
综合类 | 313篇 |
预防医学 | 95篇 |
眼科学 | 10篇 |
药学 | 124篇 |
1篇 | |
中国医学 | 12篇 |
肿瘤学 | 357篇 |
出版年
2024年 | 7篇 |
2023年 | 41篇 |
2022年 | 110篇 |
2021年 | 120篇 |
2020年 | 109篇 |
2019年 | 99篇 |
2018年 | 119篇 |
2017年 | 86篇 |
2016年 | 90篇 |
2015年 | 101篇 |
2014年 | 211篇 |
2013年 | 156篇 |
2012年 | 165篇 |
2011年 | 150篇 |
2010年 | 103篇 |
2009年 | 129篇 |
2008年 | 112篇 |
2007年 | 113篇 |
2006年 | 103篇 |
2005年 | 50篇 |
2004年 | 53篇 |
2003年 | 33篇 |
2002年 | 34篇 |
2001年 | 35篇 |
2000年 | 26篇 |
1999年 | 18篇 |
1998年 | 29篇 |
1997年 | 16篇 |
1996年 | 18篇 |
1995年 | 9篇 |
1994年 | 6篇 |
1993年 | 9篇 |
1992年 | 8篇 |
1991年 | 4篇 |
1990年 | 8篇 |
1989年 | 7篇 |
1988年 | 5篇 |
1987年 | 6篇 |
1986年 | 4篇 |
1985年 | 5篇 |
1984年 | 2篇 |
1983年 | 2篇 |
1982年 | 3篇 |
1981年 | 5篇 |
1980年 | 6篇 |
1979年 | 6篇 |
1978年 | 6篇 |
1976年 | 2篇 |
1975年 | 2篇 |
排序方式: 共有2541条查询结果,搜索用时 15 毫秒
1.
2.
《Clinics in plastic surgery》2019,46(4):625-639
3.
4.
Mohammad K. Jamal M.D. Eric J. DeMaria M.D. Jason M. Johnson D.O. Brennan J. Carmody M.D. Luke G. Wolfe M.S. John M. Kellum M.D. Jill G. Meador R.N. 《Surgery for obesity and related diseases》2006,2(2):417-127
BACKGROUND: Preoperative dietary counseling (PDC) before bariatric surgery is mandated by a growing number of insurance payers. Their claim is that PDC improves outcomes and postoperative compliance. We compared outcomes of GBP patients undergoing a mandatory 13 weeks of PDC (n = 72) to a contemporaneous group of patients with no such requirement (no-PDC; n = 252) who underwent operation between January 2000 and December 2002. METHODS: The PDC and no-PDC groups were characterized by similar male:female ratios (1:4 vs 1:4.6), mean age (42 years), mean body weight (324 lb vs 309 lb), and mean body mass index (BMI) (52 kg/m2 vs 50 kg/m2). The PDC group had a higher incidence of obstructive sleep apnea compared with the no-PDC group (41% vs 28%; P < .04) but otherwise the two groups had similar incidences of obesity-related comorbidities. The presurgery dropout rate was 50% higher in the PDC group than in the no-PDC group (28% vs 19%; P < .05). RESULTS: At 1 year follow-up, the no-PDC patients had a statistically greater percentage excess weight loss (67% vs 60%; P < .0001), lower BMI (32 vs 35; P < .015), and lower body weight (197 vs 218; P < .01). Resolution of major comorbidities, complication rates, 30-day postoperative mortality, and postoperative compliance with follow-up were similar in the two groups. CONCLUSIONS: The data demonstrate that insurance-mandated PDC is an obstacle to patient access for surgical treatment of severe obesity and has no impact on weight loss outcome or postsurgical compliance. PDC should be abandoned by the insurance industry. 相似文献
5.
Summary Intracavitary application of ultrasound was first performed for diagnostic purposes in 1967; since that time, it has been
more and more widely used. As far as the gastrointestinal tract is concerned, endoscopically controlled ultrasonic probes
provide visualization of the various layers of the intestinal wall. It is therefore possible to describe lesions of the esophagus,
stomach, and the rectum with regard to their nature and depth of infiltration. Furthermore, periesophageal and perigastric
organs can be visualized. It has become evident that endosonography is particularly important for pretherapeutic staging of
tumors of the esophagus, stomach, and rectum. Here prospective comparative studies confirm the superiority of this new diagnostic
procedure when compared to the methods available to date. 相似文献
6.
Timothy M. Pawlik Kelly Olino Ana Luiza Gleisner Michael Torbenson Richard Schulick Michael A. Choti 《Journal of gastrointestinal surgery》2007,11(7):860-868
Some investigators have suggested that preoperative chemotherapy for hepatic colorectal metastases may cause hepatic injury
and increase perioperative morbidity and mortality. The objective of the current study was to examine whether treatment with
preoperative chemotherapy was associated with hepatic injury of the nontumorous liver and whether such injury, if present,
was associated with increased morbidity or mortality after hepatic resection. Two-hundred and twelve eligible patients who
underwent hepatic resection for colorectal liver metastases between January 1999 and December 2005 were identified. Data on
demographics, clinicopathologic characteristics, and preoperative chemotherapy details were collected and analyzed. The majority
of patients received preoperative chemotherapy (n = 153; 72.2%). Chemotherapy consisted of fluoropyrimidine-based regimens: 5-FU monotherapy, 31.6%; irinotecan, 25.9%; and
oxaliplatin, 14.6%. Among those patients who received chemotherapy, the type of chemotherapy regimen predicted distinct patterns
of liver injury. Oxaliplatin was associated with increased likelihood of grade 3 sinusoidal dilatation (p = 0.017). Steatosis >30% was associated with irinotecan (27.3%) compared with no chemotherapy, 5-FU monotherapy, and oxaliplatin
(all p < 0.05). Irinotecan also was associated with steatohepatitis, as two of the three patients with steatohepatitis had received
irinotecan preoperatively. Overall, the perioperative complication rate was similar between the no-chemotherapy group (30.5%)
and the chemotherapy group (35.3%) (p = 0.79). Preoperative chemotherapy was also not associated with 60-day mortality. In patients with hepatic colorectal metastases,
preoperative chemotherapy is associated with hepatic injury in about 20 to 30% of patients. Furthermore, the type of hepatic
injury after preoperative chemotherapy was regimen-specific.
Presented at the American Hepato-Pancreato-Biliary Association 2006 Annual Meeting, March 11, Miami, Florida. 相似文献
7.
Retrospective review of the preoperative biliary and gastrointestinal evaluation for gastric bypass surgery 总被引:1,自引:0,他引:1
Vincent W. Vanek M.D. C.N.S.P. F.A.C.S. Michele Catania R.N. B.S.N. Kimberly Triveri R.D. L.D. Robert W. Woodruff Jr M.D. 《Surgery for obesity and related diseases》2006,2(1):839-22
BACKGROUND: The purpose of this study was to analyze the frequency and results of preoperative biliary and gastrointestinal (GI) evaluation of patients undergoing Roux-en-Y gastric bypass (RYGB). METHODS: Retrospective review of the preoperative evaluation of 144 consecutive RYGB patients. RESULTS: Cholecystectomy had already been performed in 43 (30%) patients; 22% of those patients with an intact gallbladder had cholelithiasis. Ten patients (7%) had an upper GI x-ray (UGI), and 94 patients (65%) had an esophagogastroduodenoscopy (EGD). Abnormalities were found in 40% of the UGIs and 84% of the EGDs. A total of 96 patients (67%) were tested for Helicobacter pylori; 11% were positive. Twenty-one patients (15%) underwent preoperative colonoscopy; 48% were abnormal, but most of the abnormalities were not clinically significant. Three patients had barium enema x-ray, which was normal in all cases. CONCLUSIONS: The preoperative biliary and GI evaluation of bariatric surgery patients should include a routine ultrasound of the gallbladder. Routine preoperative EGD will detect a significant number of abnormalities that should be treated, but should rarely alter the bariatric surgical procedure or result in denial of bariatric surgery. Many abnormalities will be asymptomatic. Patients should be routinely screened for H. pylori and, if positive, treated before bariatric surgery. Lower GI evaluation should be performed selectively based on the patient's symptoms, physical findings, and guidelines for colorectal cancer and polyp screening. 相似文献
8.
9.
Claudia Ehringer Mikulaninec 《Patient education and counseling》1987,10(3):253-265
This study sought to contrast mailing a booklet to accomplish preoperative instruction with teaching performed by nurses after hospital admission. Sixty-six patients were studied in a 700-bed medical center and were assigned to three teaching groups and a control group which did not receive teaching. The researcher compared the four groups preoperatively after admission to determine the patients' knowledge and ability to perform surgical exercises, as well as their anxiety levels.
Findings were that patients who received a booklet by mail preadmission learned surgical exercises equally well compared to patients taught postadmission, and mastered significantly more exercise behaviors than those receiving no instruction. No statistical difference in anxiety level was found among groups. One may infer that mailing preadmission material should be considered as an effective teaching mode and alternative to postadmission instruction. 相似文献
10.
目的:改变脊柱转移瘤治疗长期以来采用的姑息、保守的治疗方法。手术切除脊柱肿瘤后,给予坚强的内固定,辅以术后放化疗,可延长病人的生命,使病人无痛生存,提高了病人的生活质量。但由于脊柱转移瘤切除术中出血异常多,使手术切除肿瘤椎管减压内固定较难进行,为解决这一问题我们于1991年始用下述方法治疗脊柱转移瘤。方法:应用术前选择性脊柱血管栓塞,肿瘤切除椎管减压,内固定器材固定治疗脊柱转移瘤16例,取得了满意的效果。16例病人均为胸腰段转移瘤,均在术前48h行相应脊柱血管,胸段选择相应肋间动脉,腰段选择相应腰动脉进行栓塞,然后行胸段、胸腰段、腰段前路或后路肿瘤切除,椎管减压、内固定术。结果:16例病人术中出血平均900ml,出血量最少者仅600ml,出血量较未行血管栓塞病例明显减少,术野更为清晰、使术者更易操作;术后病人脊髓及神经根受压症状明显减轻,16例脊髓及脊神经根受压症状明显减轻,16例病人中8例脊髓及脊神经受压症状完全解除。结论:术前脊柱血管栓塞,手术切除肿瘤椎管减压内固定明显减少了术中出血、降低了手术风险、缩短了手术时间,是治疗脊柱转移瘤的安全有效的方法。 相似文献