全文获取类型
收费全文 | 372篇 |
免费 | 1篇 |
专业分类
耳鼻咽喉 | 2篇 |
儿科学 | 6篇 |
妇产科学 | 36篇 |
内科学 | 172篇 |
皮肤病学 | 44篇 |
神经病学 | 19篇 |
特种医学 | 4篇 |
外科学 | 78篇 |
预防医学 | 10篇 |
眼科学 | 2篇 |
出版年
2023年 | 13篇 |
2022年 | 14篇 |
2021年 | 12篇 |
2020年 | 17篇 |
2019年 | 44篇 |
2018年 | 76篇 |
2017年 | 7篇 |
2016年 | 1篇 |
2014年 | 27篇 |
2013年 | 25篇 |
2012年 | 21篇 |
2011年 | 24篇 |
2010年 | 16篇 |
2009年 | 21篇 |
2008年 | 11篇 |
2007年 | 19篇 |
2006年 | 8篇 |
2005年 | 9篇 |
2004年 | 2篇 |
1999年 | 5篇 |
1981年 | 1篇 |
排序方式: 共有373条查询结果,搜索用时 10 毫秒
1.
C. Moctezuma-Velázquez 《Revista de gastroenterologia de Mexico》2018,83(2):125-133
Non-alcoholic fatty liver disease is the most prevalent hepatopathy, estimated at 30% in the general population. In the coming years, it will likely be the most common indication for liver transplantation and the most frequent cause of hepatocellular carcinoma. Current treatment for non-alcoholic fatty liver disease is based on dietary and exercise interventions that have been shown to be efficacious, even for reverting fibrosis. Unfortunately, compliance with general measures involving lifestyle modifications is very poor, making pharmacologic strategies a necessary option. At present, there are no treatments for non-alcoholic fatty liver disease approved by regulatory agencies, and the only ones with sufficient evidence and recommended by international societies are treatments with pioglitazone and vitamin E, which are not exempt from adverse effects. We review herein the current management of non-alcoholic fatty liver disease, including dietary and physical activity interventions, available treatments, equivocal therapies, emerging treatments, and treatments presently in clinical trials. 相似文献
2.
Iñigo Royo Crespo Juan José Rivas de Andrés Raúl Embún Flor Severiano Cortés Franco 《Archivos de bronconeumología》2013
Chondroid chordoma is an extremely rare tumour with an annual incidence of around 0.1 cases per 100,000 population. Involvement of the thoracic vertebrae may be present in 2-5% of cases. 相似文献
3.
Carlos A. Jiménez Ruiz Daniel Buljubasich Juan Antonio Riesco Miranda Agustín Acuña Izcaray José Ignacio de Granda Orive José Miguel Chatkin Gustavo Zabert Alfredo Guerreros Benavides Nelson Paez Espinel Valeri Noé Efraín Sánchez-Angarita Ingrid Núñez-Sánchez Raúl H. Sansores Alejandro Casas Andrés Palomar Lever Inmaculada Alfageme Michavila 《Archivos de bronconeumología》2017,53(11):622-628
The ALAT and SEPAR Treatment and Control of Smoking Groups have collaborated in the preparation of this document which attempts to answer, by way of PICO methodology, different questions on health interventions for helping COPD patients to stop smoking.The main recommendations are: (i) moderate-quality evidence and strong recommendation for performing spirometry in COPD patients and in smokers with a high risk of developing the disease, as a motivational tool (particularly for showing evidence of lung age), a diagnostic tool, and for active case-finding; (ii) high-quality evidence and strong recommendation for using intensive dedicated behavioral counselling and drug treatment for helping COPD patients to stop smoking; (iii) high-quality evidence and strong recommendation for initiating interventions for helping COPD patients to stop smoking during hospitalization with improvement when the intervention is prolonged after discharge, and (iv) high-quality evidence and strong recommendation for funding treatment of smoking in COPD patients, in view of the impact on health and health economics. 相似文献
4.
Ten years after the publication of the first GOLD strategy (Global Strategy for the Diagnosis, Management, and Prevention of COPD) for chronic obstructive pulmonary disease (COPD), the new revision published on the GOLD website at the end of 2011 represents a significant change in the diagnostic approach, clinical evaluation and therapeutic treatment of the disease. This revision debates not only the most significant aspects, which remain relatively intact, but also, and in particular, those that have been substantially modified compared with the GOLD revision from 2006. 相似文献
5.
Reactive arthritis (ReA) is sterile arthritis occurring after extra articular bacterial infection. The aim of this study was to analyze, over 30 years, clinical, biological and imaging characteristics as well as therapeutic management of new cases of ReA, comparing two periods.
Methods
retrospective monocentric study, data of all the patients followed in our unit between January 1st 1984 and April 2014 with the diagnosis or ReA were analyzed (clinical and biological features, management and outcome), and compared between two periods: from January 1984 to December 1993, and from January 2004 to December 2013.Results
Sixty two patients fulfilling international diagnosis criteria were analyzed. There was no significant difference between the two periods in number of new cases, clinical presentation, biological data or outcome. Changes in therapeutic management were obvious with occurrence of anti TNF in the recent period.Conclusion
Reactive arthritis is still a current rheumatologic problem in a developed country, with a need of early and tailored rheumatologic management. 相似文献6.
Javier Lucas Ramos Cristina Suárez Ferrer Joaquín Poza Cordón María Sánchez Azofra Jose Luis Rueda García Eduardo Martin Arranz Jorge Yebra Carmona Irene Andaluz García Maria Dolores Martín Arranz 《Gastroenterologia y hepatologia》2021,44(5):337-345
IntroductionThe dose of thiopurine drugs in combined treatments with anti-TNF in inflammatory bowel disease (IBD) has not been clearly established. The purpose of this study is to assess whether the dose of azathioprine influences clinical and biochemical response/remission rates, and anti-TNF drug levels/antibody formation.Material and methodsPatients with IBD on combined maintenance treatment with azathioprine and infliximab or adalimumab were selected. Based on the dose of azathioprine, two groups were defined (standard: 2–2.5 mg/kg/day; and decreased: less than 2 mg/kg/day).ResultsIn the IFX group, there were no statistically significant differences (p = 0.204) in the rates of remission (39% vs 41.3%), response (10% vs 21.7%) or failure (51.5% vs 37%) depending on the dose of thiopurine drugs. No differences were found between AZA-dose dependent IFX levels (2.46 vs 3.21 μg/mL; p = 0.211). In the adalimumab group, there were no statistically significant differences (p = 0.83) in the rates of remission (66% vs 56%), response without remission (15.38% vs 25%) or failure (18% vs 18%) depending on the dose of thiopurines. With respect to ADA-levels, no differences were found in both groups (7.69 vs 8.23 μg/mL; p = 0.37).ConclusionIn our experience, no statistically significant differences were found in either anti-TNF levels or clinical-biological response/remission rates based on doses of azathioprine. 相似文献
7.
《Archivos de bronconeumología》2021,57(3):205-213
BackgroundRecent data from real world clinical practices on the use of Triple Therapy (TT) in patients with COPD are scarce.MethodsObservational population-based study with longitudinal follow-up in patients with COPD identified in a primary care electronic medical records database in Catalonia, covering 80% of the general population. The aims were to characterize COPD patients who initiated TT and to describe treatment pathways before and after TT initiation. Time to and probability of step down or complete discontinuation of TT was described using restricted mean survival time and Kaplan–Meier analysis.ResultsA total of 34,018 COPD patients initiated TT during the study period. Of them, 23,867 (70.1%) were GOLD A/B. 18,453 (54.2%) were non-exacerbators, 9931 (29.2%) infrequent exacerbators, 5634 (16.5%) frequent exacerbators and 1923 (5.6%) had asthma-COPD overlap. Drugs most frequently used prior to initiation of TT were long-acting antimuscarinics (22.5%) and combination of long-acting beta2 agonists/inhaled corticosteroids (15.2%). A total of 11,666 (34.3%) stepped down and 1091 (3.2%) discontinued TT during follow-up. Step down following TT was more likely in patients with severe COPD, especially during the first year; however, discontinuation was more common among patients with mild COPD.ConclusionMost patients initiating treatment with TT were non exacerbators and continued on the same treatment over time regardless severity of disease. Stepping down was more frequent in severe patients, while discontinuation was more common among mild patients. Overall, it appears that TT is extensively used in primary care for treatment of patients with COPD. 相似文献
8.
The term phenotype in the field of COPD is defined as "a single or combination of disease attributes that describe differences between individuals with COPD as they relate to clinically meaningful outcomes". Among all phenotypes described, there are three that are associated with prognosis and especially are associated with a different response to currently available therapies. There phenotypes are: the exacerbator, the overlap COPD-asthma and the emphysema-hyperinflation. The exacerbator is characterised by the presence of, at least, two exacerbations the previous year, and on top of long-acting bronchodilators, may require the use of antiinflammatory drugs. The overlap phenotype presents symptoms of increased variability of airflow and incompletely reversible airflow obstruction. Due to the underlying inflammatory profile, it uses to have a good therapeutic response to inhaled corticosteroids in addition to bronchodilators. Lastly, the emphysema phenotype presents a poor therapeutic response to the existing antiinflammatory drugs and long-acting bronchodilators together with rehabilitation are the treatments of choice. Identifying the peculiarities of the different phenotypes of COPD will allow us to implement a more personalised treatment, in which the characteristics of the patients, together with their severity will be key to choose the best treatment option. 相似文献
9.
Juan José Soler-Cataluña Borja Cosío José Luis Izquierdo José Luis López-Campos José M. Marín Ramón Agüero Adolfo Baloira Santiago Carrizo Cristóbal Esteban Juan B. Galdiz M. Cruz González Marc Miravitlles Eduard Monsó Teodoro Montemayor Josep Morera Francisco Ortega Germán Peces-Barba Luis Puente José Miguel Rodríguez Ernest Sala Jaume Sauleda Joan B. Soriano José Luis Viejo 《Archivos de bronconeumología》2012
Introduction
Although asthma and COPD are different pathologies, many patients share characteristics from both entities. These cases can have different evolutions and responses to treatment. Nevertheless, the evidence available is limited, and it is necessary to evaluate whether they represent a differential phenotype and provide recommendations about diagnosis and treatment, in addition to identifying possible gaps in our understanding of asthma and COPD.Methods
A nation-wide consensus of experts in COPD in two stages: 1) during an initial meeting, the topics to be dealt with were established and a first draft of statements was elaborated with a structured «brainstorming» method; 2) consensus was reached with two rounds of e-mails, using a Likert-type scale.Results
Consensus was reached about the existence of a differential clinical phenotype known as «Overlap Phenotype COPD-Asthma», whose diagnosis is made when 2 major criteria and 2 minor criteria are met. The major criteria include very positive bronchodilator test (increase in FEV1 ≥ 15% and ≥ 400 ml), eosinophilia in sputum and personal history of asthma. Minor criteria include high total IgE, personal history of atopy and positive bronchodilator test (increase in FEV1 ≥ 12% and ≥ 200 ml) on two or more occasions. The early use of individually-adjusted inhaled corticosteroids is recommended, and caution must be taken with their abrupt withdrawal. Meanwhile, in severe cases the use of triple therapy should be evaluated. Finally, there is an obvious lack of specific studies about the natural history and the treatment of these patients.Conclusions
It is necessary to expand our knowledge about this phenotype in order to establish adequate guidelines and recommendations for its diagnosis and treatment. 相似文献10.
Clara Isabel Bayarri Lara Sebastián Sevilla López Abel Sánchez-Palencia Ramos Amira Alkourdi Martínez Francisco Hernández Escobar Florencio Quero Valenzuela Francisco Javier Ruiz Zafra Antonio Cueto Ladrón de Guevara 《Cirugía espa?ola》2013