全文获取类型
收费全文 | 904篇 |
免费 | 0篇 |
专业分类
耳鼻咽喉 | 1篇 |
儿科学 | 24篇 |
妇产科学 | 42篇 |
基础医学 | 36篇 |
口腔科学 | 30篇 |
临床医学 | 22篇 |
内科学 | 447篇 |
皮肤病学 | 13篇 |
神经病学 | 51篇 |
特种医学 | 7篇 |
外科学 | 133篇 |
综合类 | 2篇 |
预防医学 | 41篇 |
眼科学 | 7篇 |
药学 | 27篇 |
1篇 | |
肿瘤学 | 20篇 |
出版年
2023年 | 2篇 |
2022年 | 2篇 |
2021年 | 7篇 |
2020年 | 2篇 |
2019年 | 57篇 |
2018年 | 56篇 |
2017年 | 20篇 |
2016年 | 1篇 |
2015年 | 1篇 |
2014年 | 3篇 |
2013年 | 8篇 |
2012年 | 1篇 |
2011年 | 4篇 |
2009年 | 2篇 |
2007年 | 3篇 |
2006年 | 1篇 |
2005年 | 1篇 |
2003年 | 1篇 |
2001年 | 1篇 |
1998年 | 1篇 |
1993年 | 3篇 |
1990年 | 1篇 |
1989年 | 2篇 |
1985年 | 33篇 |
1984年 | 90篇 |
1983年 | 70篇 |
1982年 | 73篇 |
1981年 | 61篇 |
1980年 | 86篇 |
1979年 | 81篇 |
1978年 | 76篇 |
1977年 | 32篇 |
1976年 | 45篇 |
1975年 | 35篇 |
1974年 | 20篇 |
1973年 | 20篇 |
1972年 | 2篇 |
排序方式: 共有904条查询结果,搜索用时 15 毫秒
1.
Joseph F. Levy Rahul Khairnar Alexander V. Louie Timothy N. Showalter C. Daniel Mullins Mark V. Mishra 《Practical radiation oncology》2019,9(2):e172-e179
Purpose
A hydrogel rectal spacer (HRS) is a medical device that is approved by the U.S. Food and Drug Administration to increase the separation between the prostate and rectum. We conducted a cost-effectiveness analysis of HRS use for reduction in radiation therapy (RT) toxicities in patients with prostate cancer (PC) undergoing external beam RT (EBRT).Methods and Materials
A multistate Markov model was constructed from the U.S. payer perspective to examine the cost-effectiveness of HRS in men with localized PC receiving EBRT (EBRT alone vs EBRT + HRS). The subgroups analyzed included site of HRS placement (hospital outpatient, physician office, ambulatory surgery center) and proportion of patients with good baseline erectile function (EF). Data on EF, gastrointestinal and genitourinary toxicities incidence, and potential risks associated with HRS implantation were obtained from a recently published randomized clinical trial. Health utilities and costs were derived from the literature and the 2018 Physician Fee Schedule and were discounted 3% annually. Quality-adjusted life years (QALYs) and costs were modeled for a 5-year period from receipt of RT. Probabilistic sensitivity analysis and value-based threshold analyses were conducted.Results
The per-patient 5-year incremental cost for spacers administered in a hospital outpatient setting was $3578, and the incremental effectiveness was 0.0371 QALYs. The incremental cost-effectiveness ratio was $96,440/QALY for patients with PC undergoing HRS insertion in a hospital and $39,286/QALY for patients undergoing HRS insertion in an ambulatory facility. For men with good baseline EF, the incremental cost-effectiveness ratio was $35,548/QALY and $9627/QALY in hospital outpatient and ambulatory facility settings, respectively.Conclusions
Based on the current Medicare Physician Fee Schedule, HRS is cost-effective at a willingness to pay threshold of $100,000. These results contain substantial uncertainty, suggesting more evidence is needed to refine future decision-making. 相似文献2.
Albert Z. Kapikian Anthony R. Kalica J.Wai-Kuo Shih W.Lee Cline Thomas S. Thornhill Richard G. Wyatt Robert M. Chanock Hyun Wha Kim John L. Gerin 《Virology》1976,70(2):564-569
The buoyant density in cesium chloride of the human reoviruslike (HRVL) agent of infantile gastroenteritis was studied utilizing electron microscopy and complement fixation (CF) for the detection of reoviruslike particles in fractions of the density gradient. Three virus positive stool filtrates were studied. “Full” reoviruslike particles had a density of 1.35–1.37 g/cm3, whereas “empty” particles had a density of 1.29 g/cm3. Peak CF activity coincided with the peak fraction of both the “full” and “empty” reoviruslike particles. In addition, by differential centrifugation, CF activity was also associated with the virion and not a “soluble” antigen. 相似文献
3.
This retrospective review of seven patients with completely obstructing cancers of the left half of the colon, in addition to other reports in the literature, suggests that subtotal colectomy with primary ileal
proctostomy may be the treatment of choice for those lesions that are technically resectable and located high enough to permit an intraperitoneal ileal proctostomy. The morbidity and mortality is less than that seen with the staged approach and the length of hospitalization is shorter. By eliminating a second or third hospitalization and a temporary colostomy, palliation is better in those patients who ultimately die from recurrent cancer. Furthermore, those patients resected for cure may have increased rates of long-term survival. 相似文献
1 Clinical data on seven patients who underwent subtotal colectomy for obstructing carcinoma of the left colon: 1975–1982.
Patient | Age (yr) and Sex | Tumor Location | Hospital Stay | Comments |
1 | 68, F | Decending | 10 days | A and W 40 mo postop1 |
2 | 71, F | Sigmoid | 22 days | A and W 18 mo postop |
3 | 73, F | Sigmoid | … | A and W 5 yr postop |
4 | 66, F | Decending | 8 mo | Dead from complications |
5 | 72, M | Sigmoid | 11 days | Incidental cecal cancer; A and W 3 mo postop |
6 | 66, M | Sigmoid | 28 days | Alive with metastasis 16 mo postop |
7 | 78, M | Left transvers | 34 days | Many other polyps; A and W 9 mo postop |
- 1
- A and W = alive and well.
4.
5.
6.
Otto G. Thilenius MD PhD FACC Dolores Vitullo MD Saroja Bharati MD FACC Julia Luken MD John J. Lamberti MD FACC Constantine Tatooles MD FACC Maurice Lev MD FACC Ian Carr MD Rene A. Arcilla MD FACC 《The American journal of cardiology》1979,44(7):1339-1343
Clinical and angiographic or autopsy data, or both, on three children with a subdivided left atrium (cor triatriatum) and an associated endocardial cushion defect are reviewed. (One child had ostium primum defect, and two had complete atrioventricular [A-V] canal.) A fourth patient demonstrates the difficulties in differentiating subdivided left atrium from supravalve mitral stenosis in the presence of an endocardial cushion defect. The clinical findings are greatly influenced by the endocardial cushion defect. A pressure gradient between the pulmonary wedge and (left or right) ventricular end-diastolic pressures in patients with an endocardial cushion defect indicates pulmonary venous obstruction and should alert one to the possibility of these combined lesions. The exact diagnosis is made with injections of angiographic contrast medium into the proximal and distal left atrial chambers, to document the respective relations of the pulmonary veins, left atrial appendage and A-V valves to these atrial chambers. All three patients with an endocardial cushion defect and a subdivided left atrium had an associated patent ductus arteriosus. The common association of subdivided left atrium with intracardiac, pulmonary venous and aortic anomalies is again demonstrated. 相似文献
7.
To explore the possible influence of multiple myeloma on age-related amyloid accumulation, the frequency, extent and distribution of amyloid deposition in 35 patients who died of multiple myeloma was compared to that observed in 138 patients of comparable age but without myeloma (controls). The presence of multiple myeloma did not appear to enhance the development of age-related amyloid.Amyloid deposition in the patients with myeloma could be distinguished from that in the patients without myeloma by the occasional finding of amyloid in the bone marrow. In addition, material having the tinctorial and ultrastructural characteristics of amyloid was found in the renal tubular casts of 15 patients with myeloma but in none of the controls.The results suggest that although the appearance of amyloid in certain locations appears to be characteristic of multiple myeloma, the presence of amyloid in the heart or vascular system, even in considerable amounts, in a patient with multiple myeloma does not necessarily imply that the two conditions are related. 相似文献
8.
《Journal of neonatal nursing : JNN》2018,24(2):100-103
BackgroundCar Seat Tolerance Screening (CSTS) and Critical Congenital Heart Disease (CCHD) screens were both implemented to identify infants with cardiorespiratory distress. We hypothesized that the CCHD screen would be poorly sensitive to predict a failed CSTS for many reasons.MethodsRetrospective record review of infants in 2013 who qualified for CSTS. Calculated sensitivity, specificity, predictive value (PV) of a failed CCHD screen to identify those infants who failed their CSTS.Results270 subjects underwent both screens and 14 failed a CSTS (5.2%). Of these, 1 failed the CCHD and 1 had an equivocal result. None were diagnosed with CCHD. An abnormal CCHD (failed or equivocal) had a sensitivity = 14.3% and a PV = 40% for predicting CSTS failure.ConclusionsCCHD screening is poorly sensitive and has poor PV for identifying those infants who are at risk of failing a CSTS. We therefore cannot recommend replacement of the CSTS with routine CCHD screening. 相似文献
9.
Wenjun Kang Sabah Kadri Rutika Puranik Michelle N. Wurst Sushant A. Patil Ibro Mujacic Sonia Benhamed Nifang Niu Chao Jie Zhen Bekim Ameti Bradley C. Long Filipo Galbo David Montes Crystal Iracheta Venessa L. Gamboa Daisy Lopez Michael Yourshaw Carolyn A. Lawrence Jeremy P. Segal 《The Journal of molecular diagnostics : JMD》2018,20(4):522-532
10.
N L Capurro K M Kent H J Smith R Aamodt S E Epstein 《The American journal of cardiology》1977,39(5):679-683
Regional coronary blood flow was determined with the radioactive microsphere technique 10 an 70 minutes and 2 1/2 and 5 hours after abrupt occlusion of the left anterior descending coronary artery in 12 closed chest sedated dogs. In six dogs, nitroglycerin, 200 to 400 microng/min, was infused intravenously 10 to 70 minutes after occlusion. Methoxamine was administered to return blood pressure and heart rate to prenitroglycerin levels. Ten minutes after occlusion (before treatment) collateral flow values and ischemic zone endocardial/epicardial flow ratios were equivalent in untreated (0.11+/-0.03 ml/min per g; 0.31+/-0.05) and treated dogs (0.14+/-0.02 ml/min per g; 0.29+/-0.03). In untreated dogs, collateral flow did not change over 5 hours; the endocardial/epicardial flow ratio was decreased at 5 hours (0.21+/-0.05, P less than 0.05). In contrast, in treated dogs, collateral flow and the endocardial/epicardial flow ratio were increased at 70 minutes (0.27+/-0.04 ml/min per g, P less than 0.05; 0.53+/-0.10, P less than 0.05). Most importantly, collateral flow remained elevated 5 hours after occlusion (0.26+/-0.03 ml/min per g, P less than 0.05) although treatment was discontinued 70 minutes after occlusion. Hence, collateral flow was unchanged over 5 hours of occlusion in untreated dogs, but short-term treatment with nitroglycerin and methoxamine resulted in a sustained increase in collateral flow. These findings may be a result of stimulation by nitroglycerin and methoxamine of the spontaneous rate at which intrinsic collateral function increases after ischemia. Alternatively, nitroglycerin and methoxamine may maintain cell viability until collateral vessels develop spontaneously. 相似文献