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Lucio Lucchin Amleto D’Amicis Maria Gabriella Gentile Nino Carlo Battistini Maria Antonia Fusco Augusta Palmo Maurizio Muscaritoli Franco Contaldo Emanuele Cereda 《Mediterranean journal of nutrition and metabolism》2009,2(3):171-179
Aim and methods Nutrition, unhealthy lifestyles and cancer appear to be strictly related, but few authors have analysed the interest in dietary
information of cancer patients and their families. This survey was conducted in the Veneto area (Italy) to investigate the
concern of cancer patients and their family members about diet as a health tool before and after diagnosis of cancer.
Results Seven hundred and four questionnaires were collected: 380 from cancer patients and 324 from family members of cancer subjects.
Breast cancer (BC) was the most frequent disease for patients (61.8%) as well as families (26.5%). Generally, the importance
of having precise diet information after diagnosis is recognised by 40.3% of patients, with significant differences between
the various types of cancer: gastric and colon/rectum cancer (GCC) patients were more concerned than BC women about precise
information concerning a diet to follow immediately after diagnosis (p = 0.000, ODs = 3.10, CI 1.68–5.71) or during treatments (p = 0.001, ODs = 2.67, CI 1.46–4.89). The nutritional information is supplied to patients in 34% of cases and to relatives
in 30.3%, often from non-medical sources. In total healthcare workers (family doctor, oncologist, surgeon, dietician) represented
the exclusive source of dietary information for 24.9% of patients and 22.9% of family members. Diet after diagnosis changes
in 69.1% of GCC patients and in 39.2% of BC women. Relatives, particularly women, report difficulties preparing patients’
meals in 30.7% of cases, changes in the eating habits of the entire family in 29.9% and discontent connected with patients
diet in 13.9%. The concern about proper nutrition after diagnosis increases more in GCC subjects (p < 0.025) when compared to BC subjects and in patients with more recent diagnosis (p < 0.041) when compared with patients with diagnosis >5 years ago, while in family members the interest in diet after diagnosis
increases more in women than in men (p < 0.030) without other differences regarding the degree of relationship, type of cancer or diagnosis time. Relatives (92.7%)
have more interest in nutritional education than patients (74.9%). Cancer patients <65 years were more interested in educational
initiatives concerning nutrition (p = 0.000, ODs = 4.46, CI 2.6–7.4) than older patients (>65 years) and female subjects were more concerned than male patients
(p = 0.008, ODs = 2.11, CI 1.2–3.6).
Conclusions The interest in the dietary knowledge and in educational initiatives concerning nutrition is high in cancer patients and their
relatives, although it decreases with the age. The poor attention paid to nutrition of cancer patients by various healthcare
workers deserves consideration, since the psychophysical wellbeing and perhaps also survival of cancer patients can be improved
by correct dietary management, as well as, naturally, by the principal treatments themselves. 相似文献
3.
目的:探讨改进的内外括约肌在原位肛门整形重建术中的应用及其手术效果。方法:改进包括:①肛门内括约肌改进为双层双环肌套;②肛门外括约肌改进为股薄肌采用“围巾式”环绕结肠末端一周,其远端剖为两条,一条缝合固定于耻骨韧带;另一条缝合固定于骶尾韧带,即为肛门外括约肌重建和外括约肌浅部和深部的重建。结果:38例术后肛门外形及功能和远期生活质量、生存率均更为满意。术后随访总优良率达94.73%;远期生存率达76.32%。结论:低位直肠癌Miles术后,同时行改进的内外括约肌原位肛门整形重建的效果是可行的,更接近正常的肛门解剖结构和生理功能。 相似文献
4.
j. b. frøkjær † d. liao a. bergmann † b. p. mcmahon e. steffensen † a. m. drewes ‡ & h. gregersen ‡ 《Neurogastroenterology and motility》2005,17(4):531-540
A method to evaluate the three-dimensional (3-D) geometry of the human gastrointestinal wall may be valuable for understanding tissue biomechanics, mechano-sensation and function. In this paper we present a magnetic resonance imaging (MRI) based method to determine rectal geometry and validation of data obtained in three volunteers. A specially designed rectal bag was filled in a stepwise manner while MRI and bag pressure were recorded. 3-D models of curvatures, radii of curvature, tension and stress were generated and the circumferential and longitudinal strains were calculated. The computed bag volumes corresponded to the infused volumes. A pronounced bag elongation and decrease in wall thickness was observed during the bag filling. The spatial distributions of the biomechanical parameters were distinctly different between individuals and non-homogeneous throughout the rectal wall due to its complex geometry. The average tension and stress increased as a function of infused volume and circumferential strain. The present study provides a method for characterizing the complex in vivo 3-D geometry of the human rectum. The non-homogenous spatial curvature distribution suggests that simple estimates of tension based on pressure and volume do not reflect the true 3-D biomechanical properties of the rectum. 相似文献
5.
放射性125I粒子组织间植入或联合放化疗治疗复发直肠癌 总被引:5,自引:1,他引:4
目的探讨超声或CT引导下放射性125I粒子组织间植入治疗复发直肠癌的技术可行性、近期疗效和副反应.方法 15例直肠癌术后盆腔复发患者,女4例,男11例.硬膜外麻醉,2例经阴道超声引导,13例CT引导,行放射性125I粒子植入术.肿瘤匹配周边剂量为90~110 Gy,每颗粒子活度为0.50~0.70 mCi,植入33~70颗.术后24~48 h拍胸、盆腔X线片了解粒子是否发生移位.术后6例加三维适形放疗,4~6野/次,200~300 cGy/次,5次/周,总剂量为4 500~5 000 cGy,间隔4周.2例粒子治疗后加草酸铂、5-氟尿嘧啶和四氢叶酸化疗1个周期,随访3~15个月,根据CT扫描结果判断肿瘤大小. 结果术后平均7天疼痛缓解,其中12例完全缓解,2例部分缓解,1例无变化,有效率93%(14/15).9例肿瘤完全缓解,2例部分缓解,4例局部进展,局部控制率73%(11/15).2例术后6个月和12个月时死于肺转移.1例1颗粒子移位至盆壁,随访12个月无症状.无治疗相关并发症和副作用发生. 结论经超声或CT引导放射性125I粒子植入治疗复发直肠癌具有安全、微创、并发症发生率低和疗效肯定等优势,粒子治疗后应配合外放疗和全身化疗,有望进一步提高疗效. 相似文献
6.
大肠癌误诊误治较为普通。从总结经验教训出发,本文对确诊前曾发生过误诊误治的536例大肠癌进行详尽的分析。本组病例536例,曾719次先后被误诊为32种疾病,其中误诊为“痔”“痢疾”“肠炎”“肠梗阻”等最为常见,误诊为其它疾病也时有发生,严重的影响其预后。在误诊原因上,除病人自误外,与医生责任心不强,询问病史不细,本行或未认真行有关检查,特别是直肠指诊检查和结肠内窥镜检查是分不开的。文章就今后如何减少误诊,提高早期诊断率,提出了5点措施,强调了直肠指诊和结肠内窥镜检查的重要价值。 相似文献
7.
Seietsu Nyui Hiroyuki Osanai Hideji Masuoka Shigeri Ohba Toshiaki Ebata Yukinari Yoshida Hideki Hoshi Yoshifumi Shinohara 《Surgery today》1997,27(4):349-352
Primary extranodal malignant lymphoma frequently occurs in the gastrointestinal tract; however, it is rarely encountered in the rectum. We report herein the case of an 85-year-old man who underwent abdominoperineal resection for primary malignant lymphoma of the rectum, and 1 year later, developed hematemesis caused by gastric metastasis. To our knowledge this is the first case report of such distant metastasis developing from malignant lymphoma of the rectum. 相似文献
8.
大鼠直肠壁内淋巴管的微细分布和形态特征 总被引:4,自引:0,他引:4
目的观察大鼠直肠壁内淋巴管的分布和形态、结构特点,为探讨直肠癌淋巴道转移的机制,提供形态学依据。方法用半薄、超薄切片、光镜和电镜下观察大鼠淋巴管的微细分布。结果大鼠直肠壁的黏膜固有层深部可见毛细淋巴管,黏膜下层、肌层和浆膜层均有毛细淋巴管和淋巴管。结论直肠壁各层内均有毛细淋巴管,除黏膜层外,还存有淋巴管。 相似文献
9.
Akiomi Ogawa Masahiro Takano Kouichi Takagi Osamu Tokunaga Kohji Miyazaki 《Surgery today》1997,27(12):1167-1169
We describe herein a rare case of primary malignant melanoma of the rectum in an 85-year-old woman. The patient presented
with intermittent rectal bleeding, and a colonoscopy revealed an ulcerated polypoid mass in the rectum, located 5 cm from
the anal verge. The lesion was histologically characterized by solid growths of small round cells with scanty cytoplasm and
prominent nucleoli. Although no melanin pigment was found in the tumor cells, they were immunohistochemically positive for
HMB-45, a monoclonal antibody highly specific for malignant melanoma. Thus, HMB-45 proved very useful to establish a diagnosis
of amelanotic malignant melanoma of the rectum. 相似文献
10.
李诚 《中国煤炭工业医学杂志》2004,7(12):1147-1149
目的 探讨左半结直肠癌 (LCRC)临床病理特点及诊治对策。方法 采用直接结肠镜检查加病理活检的方法确诊LCRC 85例 ,其中 37例经手术治疗。结果 本组 50岁以上占 60 %。农民占 73 %。首发症状至确诊 <3个月占 56 .5 % ,<1年占 89.4%。便血、腹痛腹胀、排便习惯改变、肛门异常是LCRC常见症状 ,便血为主要表现占 83 .5 % ,始发便血 56例 ,占 56/ 71 (76 .87% )。本组临床误诊率 63 .5 %。活检符合率 88.57%。病理形态以隆起 (肿块型 85 .88% )管状腺癌 (98.36 % )为主。 37例手术DUKES分期DaDb1 7例为可切除可治愈癌 ,占 45 .95 %。病程 <3个月DaDb 47.4% ,DcDd 52 .6 %。手术率乙状结肠以上癌 2 0 / 2 6(76 .92 % ) ,肛直肠癌 1 7/59(2 8.81 % )。结论 >50岁属LCRC高发人群 ,为重点结肠镜检查对象。便血是LCRC始发主要表现和重要的结肠镜检查指征 ,应提高对便血的认识 ,放宽镜检范围。LCRC一经诊 ,应及早手术 ,这是切除或治愈LCRC的重要手段。 相似文献