首页 | 本学科首页   官方微博 | 高级检索  
文章检索
  按 检索   检索词:      
出版年份:   被引次数:   他引次数: 提示:输入*表示无穷大
  收费全文   941篇
  免费   150篇
  国内免费   11篇
耳鼻咽喉   1篇
儿科学   45篇
妇产科学   10篇
基础医学   43篇
口腔科学   6篇
临床医学   301篇
内科学   187篇
皮肤病学   6篇
神经病学   5篇
特种医学   21篇
外科学   50篇
综合类   227篇
预防医学   89篇
眼科学   1篇
药学   75篇
  2篇
中国医学   17篇
肿瘤学   16篇
  2024年   7篇
  2023年   11篇
  2022年   57篇
  2021年   63篇
  2020年   56篇
  2019年   42篇
  2018年   43篇
  2017年   79篇
  2016年   108篇
  2015年   115篇
  2014年   156篇
  2013年   107篇
  2012年   53篇
  2011年   46篇
  2010年   24篇
  2009年   19篇
  2008年   14篇
  2007年   16篇
  2006年   19篇
  2005年   16篇
  2004年   20篇
  2003年   11篇
  2002年   6篇
  2001年   5篇
  2000年   6篇
  1998年   1篇
  1997年   2篇
排序方式: 共有1102条查询结果,搜索用时 15 毫秒
21.
目的评估血清C反应蛋白(CRP)和降钙素原(PCT)联合检测对创伤后脓毒症患者的预警价值。方法纳入严重创伤患者235例,其中110例脓毒症患者和125例非脓毒症患者。采集入院24 h内血样,检测血清中CRP和PCT。采用ROC曲线比较CRP和PCT对创伤后脓毒症的预警价值,同时采用NRI和IDI分析联合使用后的提高能力。结果脓毒症患者血清CRP和PCT水平均显著高于非脓毒症患者(P<0.001),ROC分析显示血清CRP和PCT的AUC分别为0.766(0.707~0.819)和0.744(0.684~0.799);将CRP和PCT联合较单指标预警创伤脓毒症的AUC提高了5.1%,7.3%。NRI和IDI分析结果证实PCT和CPR的联合使用较单独使用的预警效能显著提高(P<0.001)。结论CRP和PCT对严重创伤后脓毒症发生风险具有早期预警作用,二者联合能够显著提高早期预警能力。  相似文献   
22.
目的拟用辛伐他汀干预脓毒症,观察辛伐他汀对脓毒症患者降钙素原(PCT)、C反应蛋白(CRP)及预后的影响,以探索辛伐他汀调节炎症反应的相关机制。方法采用前瞻性随机对照研究,以2013年10月-2016年12月ICU收治的82例脓毒症患者为研究对象并随机分组。测定两组患者入院后体温,血PCT、CRP水平,白细胞计数以及28 d病死率情况;在使用辛伐他汀(40 mg/d)第10天随访患者的肝功能指标丙氨酸转氨酶(ALT)和肌红蛋白(Myo),以评估辛伐他汀对相关脏器功能的影响。结果42例干预组和40例对照组患者年龄、性别、APACHEⅡ评分、入院最高体温、合并心力衰竭、肾功能等均无显著差异。干预组与对照组患者的炎症指标(PCT、CRP)在第3天开始都出现明显的下降,PCT第5天为(4.76±1.58)μg/L与(8.62±2.92)μg/L,P=0.038;第7天为(1.35±0.36)μg/L与(2.79±0.98)μg/L,P=0.017;第10天为(0.45±0.07)μg/L与(1.61±0.48)μg/L,P<0.001。CRP第3天为(81.95±7.63)mg/L与(123.17±12.29)mg/L,P=0.003;第5天为(45.12±4.17)mg/L与(67.93±7.15)mg/L,P=0.006;第7天为(21.73±2.55)mg/L与(34.72±4.81)mg/L,P=0.007等。两组患者28 d病死率无显著差异。两组患者的ALT和Myo随访数据无显著差异。结论辛伐他汀能显著降低脓毒症患者的PCT、CRP等炎症指标,两组患者全因死亡率无差异,希望对临床上干预脓毒症提供新思路。  相似文献   
23.
24.
该文报道了1例患登革热脑炎的年轻女性患者。收集了患者的临床症状和体征、生化标志物、影像学表现、宏基因检测等资料,并查阅相关文献。该患者以“发热、头痛4 d,腹泻、呕吐3 d,全身抽搐伴意识障碍3 h”为主诉被陆军军医大学第一附属医院收入院。入院第2天脑脊液宏基因组学检测(RNA)结果显示,登革热病毒1型,且伴有降钙素原升高,明确了登革热脑炎的诊断。临床上遇到发热、头痛、腹泻、呕吐,伴随降钙素原水平升高的患者,应怀疑登革热脑炎,并进行登革热血清学检查和脑脊液登革热RNA检测。 [国际神经病学神经外科学杂志, 2024, 51(2): 69-72]  相似文献   
25.
IntroductionInflammation is associated with the development and progression of ischemic stroke. In this study, we tested the diagnostic ability of procalcitonin (PCT) to C-reactive protein (CRP) ratio (PC ratio; ×10–6) to predict 90-day mortality in ischemic stroke patients.Material and methodsWe retrospectively collected the medical records of patients with a diagnosis of ischemic stroke from February 2008 to January 2018. We analyzed the data of study patients with both PCT and CRP results, and evaluated the relationship between PC ratio and 90-day mortality. Logistic regression was adjusted for confounders and survival analysis was conducted using the Kaplan-Meier estimation.ResultsA total of 333 patients were analyzed in this study. As compared with the lowest PC ratio quartile (0–2.1), the odds ratios for 90-day mortality were; 1.47 (95% CI: 0.62–4.20) for the 2nd quartile (2.2–6.3, p = 0.440), 2.54 (95% CI: 0.95–5.91) for the 3rd quartile (6.4–19.6, p = 0.048), and 4.10 (95% CI: 1.73–9.80) for the 4th quartile (≥ 19.7, p = 0.002), after adjusting for age, sex, medical history, and laboratory results. A higher PC ratio (≥ 2.2) was associated with higher mortality (p < 0.05) in ischemic stroke patients in Kaplan-Meier estimation, and this was confirmed by the log-rank test (p < 0.001).ConclusionsProcalcitonin to C-reactive protein ratio was found to be positively associated with 90-day mortality in ischemic stroke patients. Our findings indicate that PC ratio may be a useful marker for predicting mortality after ischemic stroke. Further prospective studies are required to investigate and validate the use of PC ratio in clinical practice.  相似文献   
26.
Disseminated herpes simplex virus infection is a potentially fatal condition which may be difficult to differentiate from bacterial sepsis. We report the case of a neonate with overwhelming herpes simplex (type 2) viraemia who presented with `septic shock'. Conclusion A low procalcitonin level (1.6 ng/ml), inconsistent with bacteraemia, suggests an alternative aetiology and may strengthen the case for antiviral therapy. Received: 28 March 1999 / Accepted: 10 August 1999  相似文献   
27.
目的 探讨利福平耐药实时荧光定量核酸扩增技术 ( rifampicin resistant real-time fluorescent quantitative nucleic acid amplification, GeneXpert MTB/ RIF) 联合基因芯片技术在涂阴结核分支杆菌 (Mycobacterium tuberculosis, MTB) 诊断中的价值及血清可溶性髓系细胞触发受体-1 ( serum soluble triggering receptor-1, sTREM-1)、 降钙素原 (procalcitonin, PCT) 水平的意义。 方法 选取 2019 年 1 月至 2021 年 1 月在聊城市 人民医院就诊的疑似涂阴肺结核患者130 例, 采集肺泡灌洗液, 给予 GeneXpert MTB/ RIF、 基因芯片及药敏 试验检查, 同时检查肺结核患者血清 sTREM-1、 PCT 水平。 以肺泡灌洗液结核菌培养及药敏试验为金标准 评价 GeneXpert MTB/ RIF 联合基因芯片检测对涂阴肺结核的诊断价值。 采用 ROC 评价血清 sTREM-1、 PCT 对涂阴肺结核的诊断价值。 结果 以肺泡灌洗液结核菌培养诊断出非涂阴肺结核患者 58 例, 涂阴肺结核患 者 72 例。 GeneXpert MTB/ RIF 联合基因芯片诊断肺结核的灵敏性为 68. 06 % , 高于基因芯片单独诊断 (P< 0. 05), GeneXpert MTB/ RIF 联合基因芯片诊断肺结核的特异性、 准确性、 阳性预测值和阴性预测值分别为 91. 38 % 、 78. 46 % 、 90. 74 % 和 69. 74 % , 与 GeneXpert MTB/ RIF 诊断、 基因芯片单独诊断比较差异无统 计学意义 (P> 0. 05); GeneXpert MTB/ RIF 联合基因芯片诊断 MDR-TB 的灵敏性、 特异性、 准确性、 阳性 预测值和阴性预测值分别为 94. 12 % 、 85. 45 % 、 87. 50 % 、 66. 67 % 和 97. 92 % , 与 GeneXpert MTB/ RIF 诊断基因芯片单独诊断比较差异无统计学意义 (P> 0. 05); 重症肺结核患者血清 sTREM-1、 PCT 分别为 (18. 04 ± 2. 07) ng / ml 和 (2. 09 ± 0. 19) ng / ml, 明显高于轻症肺结核患者 ( P< 0. 05); 血清 sTREM-1、 PCT 预测重症肺结核的 ROC 曲线下面积分别为 0. 811 和 0. 844, 截断值分别为 16. 32 ng / ml 和 2. 00 ng / ml, 灵敏性分别为 89. 30 % 和 82. 00 % , 特异性分别为 61. 40 % 和 79. 60 % 。 结论 GeneXpert 联合基因芯片技 术可提高涂阴 MTB 诊断灵敏性, 且两种手段对 MDR-TB 均有较好的诊断价值。 重症肺结核患者 sTREM-1、 PCT 水平明显高于轻症肺结核, 血清 sTREM-1、 PCT 对重症肺结核诊断灵敏性、 特异性较高, 可作为早期 诊断的手段加以应用。  相似文献   
28.
The worldwide yearly mortality from sepsis is substantial, greater than that of cancer of the lung and breast combined. Moreover, its incidence is increasing, and its response to therapy has not appreciably improved. In this condition, the secretion of procalcitonin (ProCT), the prohormone of calcitonin, is augmented greatly, attaining levels up to thousands of fold of normal. This hypersecretion emanates from multiple tissues throughout the body that are not traditionally viewed as being endocrine. The serum values of ProCT correlate with the severity of sepsis; they recede with its improvement and worsen with exacerbation. Accordingly, as highlighted in this review, serum ProCT has become useful as a biomarker to assist in the diagnosis of sepsis, as well as related infectious or inflammatory conditions. It is also a useful monitor of the clinical course and prognosis, and sensitive and specific assays have been developed for its measurement. Moreover, it has been demonstrated that the administration of ProCT to septic animals greatly increases mortality, and several toxic effects of ProCT have been elucidated by in vitro experimental studies. Antibodies have been developed that neutralize the harmful effects of ProCT, and their use markedly decreases the symptomatology and mortality of animals that harbour a highly virulent sepsis analogous to that occurring in humans. This therapy is facilitated by the long duration of serum ProCT elevation, which allows for a broad window of therapeutic opportunity. An experimental groundwork has been established that suggests a potential applicability of such therapy in septic humans.  相似文献   
29.
李刚  向芳  陈卓 《武警医学》2016,27(3):250-252
 目的 研究重度感染患者降钙素原(procalcitonin,PCT)浓度与抗生素应用的关系。方法 通过系统性回顾Meta分析的方法,检索Pubmed,Embase,Cochrane中心对照试验数据库,纳入2015年6月以前有关降钙素原指导重度感染患者抗生素应用的研究文献,并用Revman 5软件进行分析。结果 纳入文献8篇,其中PCT指导治疗患者总计783例,传统方案治疗患者744例。Meta分析结果表明,PCT指导组抗生素使用时间少于传统治疗组(Z=1.08,P=0.28),且应用PCT指导治疗重度感染患者不会增加病死率(Z=0.37,P=0.71)。结论 根据PCT浓度指导重度感染患者抗生素治疗可以有效、安全地减少抗生素的应用。
  相似文献   
30.
Abstract

Purpose: Surgical site infections (SSIs) after cesarean section cause maternal morbidity and economic and emotional burdens on society. Our aim is to measure procalcitonin (PCT) levels in patients who developed incisional SSIs after cesarean section while also comparing PCT concentrations between patients who underwent a secondary suture and who did not require a secondary suture.

Methods: Ninety-four patients who developed incisional SSI after cesarean section were enrolled in our study. At the time of admission, serum PCT, C-reactive protein (CRP), and white blood cell (WBC) counts were measured. The study population was grouped into two, based on the need of a secondary suture and the patients baseline blood tests were compared.

Results: The mean serum CRP level was not significant among the groups; however, the median serum PCT level was significantly higher in patients who required a secondary suture (0.21 vs. 0.05?ng/ml, p?≤?.0001). Serum PCT levels were positively correlated with the length of hospital stay (r?=?0.72, p?=?.0001). Area under the curve (AUC) for PCT in predicting the need of a secondary suture was 0.85 (95% CI: 0.772–0.922) and the cutoff point was 0.142?ng/ml with a sensitivity of 75% and specificity of 97.8% (p?=?.0001).

Conclusion: Serum PCT is a promising marker for both diagnosing and predicting the severity of SSIs after cesarean sections.

Trial registration: ClinicalTrials.gov identifier: NCT03223233.  相似文献   
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号