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101.
ELISA FAZZI MD PHD ; STEFANIA BOVA MD ; ALESSIA GIOVENZANA MD ; SABRINA SIGNORINI MD PHD ; CARLA UGGETTI MD ; PAOLO BIANCHI MD 《Developmental medicine and child neurology》2009,51(12):974-981
Aim Cognitive visual dysfunctions (CVDs) reflect an impairment of the capacity to process visual information. The question of whether CVDs might be classifiable according to the nature and distribution of the underlying brain damage is an intriguing one in child neuropsychology.
Method We studied 22 children born preterm (12 males, 10 females; mean age at examination 8y, range 6–15y; mean gestational age 30wks, range 28–36wks) with periventricular leukomalacia, spastic diplegia, normal intelligence (mean Full-scale IQ 84; mean Verbal IQ 97; mean Performance IQ 74), and normal visual acuity, focusing on higher visual functions. Brain magnetic resonance images (MRI) were analysed to establish the presence of lesions along the primary optic pathway, in the occipitoparietal and occipitotemporal regions.
Results Most children displayed an uneven cognitive profile, with deficits in visual object recognition, visual imagery, visual–spatial skills, and visual memory, and sparing of visual associative abilities, non-verbal intelligence, and face and letter recognition. Conventional brain MRI did not document major alterations of parietal and temporal white matter, or cortical alteration of areas involved in visual associative functions.
Interpretation We suggest a widespread involvement of higher visual processing systems, involving both the ventral and dorsal streams, in preterm children with periventricular leukomalacia. The lack of major alterations on conventional MRI does not exclude the possibility of malfunctioning of higher visual processing systems, expressing itself through discrete CVDs. Possible mechanisms underlying these neuropsychological deficits are discussed. 相似文献
Method We studied 22 children born preterm (12 males, 10 females; mean age at examination 8y, range 6–15y; mean gestational age 30wks, range 28–36wks) with periventricular leukomalacia, spastic diplegia, normal intelligence (mean Full-scale IQ 84; mean Verbal IQ 97; mean Performance IQ 74), and normal visual acuity, focusing on higher visual functions. Brain magnetic resonance images (MRI) were analysed to establish the presence of lesions along the primary optic pathway, in the occipitoparietal and occipitotemporal regions.
Results Most children displayed an uneven cognitive profile, with deficits in visual object recognition, visual imagery, visual–spatial skills, and visual memory, and sparing of visual associative abilities, non-verbal intelligence, and face and letter recognition. Conventional brain MRI did not document major alterations of parietal and temporal white matter, or cortical alteration of areas involved in visual associative functions.
Interpretation We suggest a widespread involvement of higher visual processing systems, involving both the ventral and dorsal streams, in preterm children with periventricular leukomalacia. The lack of major alterations on conventional MRI does not exclude the possibility of malfunctioning of higher visual processing systems, expressing itself through discrete CVDs. Possible mechanisms underlying these neuropsychological deficits are discussed. 相似文献
102.
103.
A. Papadias C. Miller W. L. Martin M. D. Kilby S. Sgouros 《Child's nervous system》2008,24(2):185-192
Aim To assess the diagnostic capability of fetal magnetic resonance imaging (MRI) in children suspected antenatally to harbor
central nervous system (CNS) defects that require immediate postnatal neurosurgical treatment.
Materials and methods Between 2003 and 2005, 13 fetal MRI scans were performed in mothers suspected to have fetuses with congenital CNS defects
that would require surgery soon after birth. Comparisons between antenatal and postnatal scans were made with emphasis on
diagnostic accuracy of antenatal examinations.
Results All mothers were scanned using heavily T2-weighted fat-saturated sequences, allowing rapid acquisitions to avoid movement
artefacts. Imaging quality was satisfactory in all patients. Diagnoses made antenatally were: myelomeningocele in seven, meningocele
in one, diastematomyelia in one, occipital meningocele in one, and isolated hydrocephalus in three children. Of the seven
children with antenatal diagnosis of myelomeningocele, one proved to have spinal lipoma postnatally. The patient who antenatally
was diagnosed with meningocele proved to have spinal lipoma postnatally. These two were early antenatal MR scans. Antenatal
diagnosis of hydrocephalus was made in five of the six confirmed myelomeningocele patients, which was verified postnatally.
Antenatal diagnosis of Chiari II malformation was made in all six confirmed myelomeningocele patients. The antenatal diagnoses
of occipital meningo-encephalocele and isolated hydrocephalus were verified postnatally. Antenatal diagnosis of diastematomyelia
was not verified postnatally.
Conclusion Fetal MRI scanning is an effective, noninvasive method of assessing in-utero CNS abnormalities. The diagnostic accuracy has
improved to allow prediction of clinical outcome and counseling for possible treatment, but is not perfect yet to allow counseling
for termination of pregnancy.
The material of this paper was presented at the 34th Annual Meeting of the International Society for Paediatric Neurosurgery,
Taipei, Taiwan, 10–14 September 2006. 相似文献
104.
105.
Spinal dysraphism: a review of neuroradiological features with embryological correlations and proposal for a new classification 总被引:5,自引:0,他引:5
Our purpose was to review the neuroradiological features of spinal dysraphism and to correlate them with clinical findings
and up-to-date embryological theory. We also aimed to formulate a working classification which might prove useful in clinical
practice. We reviewed series of 986 children referred to our Spina Bifida Centre in the past 24 years. There were 353 children
with open spinal (OSD) and 633 with closed (skin-covered) spinal (CSD) dysraphism. By far the most common open abnormality
was myelomeningocele, and all patients with OSD had a Chiari II malformation. CSD was categorised clinically, depending on
the presence of a subcutaneous mass in the back. CSD with a mass mainly consisted of lipomas with dural defects and meningoceles,
and accounted for 18.8 % of CSD. CSD without a mass were simple (tight filum terminale, intradural lipoma) or complex (split
cord malformations, caudal regression). Our suggested classification is easy to use and to remember and takes into account
clinical and MRI features; we have found it useful and reliable when making a preoperative neuroradiological diagnosis in
clinical practice.
Received: 6 December 1999 Accepted: 27 December 1999 相似文献
106.
Inborn errors of metabolism can affect the cerebellum during development, maturation and later during life. We have established
criteria for pattern recognition of cerebellar abnormalities in metabolic disorders. The abnormalities can be divided into
four major groups: cerebellar hypoplasia (CH), hyperplasia, cerebellar atrophy (CA), cerebellar white matter abnormalities
(WMA) or swelling, and involvement of the dentate nuclei (DN) or cerebellar cortex. CH can be an isolated typical finding,
as in adenylsuccinase deficiency, but is also occasionally seen in many other disorders. Differentiation from CH and CA is
often difficult, as in carbohydrate deficient glycoprotein syndrome or 2-l-hydroxyglutaric acidaemia. In cases of atrophy the relationship of cerebellar to cerebral atrophy is important. WMA may be
diffuse or patchy, frequently predominantly around the DN. Severe swelling of white matter is present during metabolic crisis
in maple syrup urine disease. The DN can be affected by metabolite deposition, necrosis, calcification or demyelination. Involvement
of cerebellar cortex is seen in infantile neuroaxonal dystrophy. Changes in DN and cerebellar cortex are rather typical and
therefore most helpful; additional features should be sought as they are useful in narrowing down the differential diagnosis.
Received: 17 September 1997 Accepted: 31 October 1997 相似文献
107.
Aldo Iannelli Nicola Pieracci Maria Cristina Bianchi Francesca Becherini Maura Castagna 《Child's nervous system》2008,24(1):7-11
Background Primary intra-diploic meningiomas are uncommon in childhood and, at the clinical onset, may be confused with other and more
frequent bone tumours because they lack specific clinical and radiological characteristics. Surgery is indicated not only
to remove the lesion but also to obtain an accurate histological diagnosis.
Case report We report the case of a young girl who presented with a recently developed subcutaneous hard mass in the left pterional region.
Neuroradiological investigations revealed an intra-osseous lytic mass with a sclerotic reaction. Diagnosis was possible only
after the total removal of the tumour and its histological examination. 相似文献
108.
Andrea Poretti Daniela Prayer Eugen Boltshauser 《European journal of paediatric neurology》2009,13(5):397-407
There is increasing evidence that the cerebellum is susceptible to both prenatal infections and haemorrhages as well as being vulnerable in extremely preterm babies, but not to perinatal and postnatal hypoxic-ischaemic injuries. Starting with the imaging appearance we describe and illustrate a spectrum of prenatal cerebellar disruptions: cerebellar agenesis; unilateral cerebellar hypoplasia; unilateral cerebellar cleft; global cerebellar hypoplasia; vanishing cerebellum in myelomeningocele; and disruption of cerebellar development in preterm infants. We discuss neuroradiological characteristics, possible disruptive events, and clinical findings in the different morphological patterns. Remarkably, the same disruptive agent can cause different neuroradiological patterns, which appear likely to represent a morphological spectrum. The analysis of imaging patterns is crucial in recognising cerebellar disruptions. Recognition of cerebellar disruptions and their differentiation from cerebellar malformations is important in terms of diagnosis, prognosis, and genetic counselling. 相似文献
109.
110.