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1.
内镜鼻窦术后鼻腔长期分泌物的合理用药局部冲洗治疗   总被引:24,自引:2,他引:22  
目的探讨慢性鼻窦炎伴鼻息肉鼻内镜鼻窦手术后鼻腔长期分泌物的治疗方法。方法符合要求的经鼻内镜术后的慢性鼻窦炎鼻息肉Ⅱ型Ⅱ期的病人42例,分成合理用药局部冲洗组(A)和未合理用药局部冲洗组(B)两组,治疗2周后比较两组的疗效。结果A组感染的细菌以G-杆菌为主,厌氧茵感染比例少,经验用药多耐药,A、B两组的有效率分别是89、47%和60.87%,经卡方检验,两组之间的差异有显著性(x^2=4.40,P=0.036)。结论慢性鼻窦炎伴鼻息肉鼻内镜鼻窦手术后鼻腔长期分泌物可以由于感染或感染以外的原因引起。合理用药局部冲洗是一种有效的治疗方法。  相似文献
2.
加味炙甘草汤注射液治疗病态窦房结综合征的电生理研究   总被引:18,自引:1,他引:17  
观察加味炙甘草汤注射液对窦房结功能损伤兔电生理的影响,探讨加味炙甘草汤注射液治疗病态窦房结综合征的临床疗效和机制。方法:应用经静脉和经食管心房调搏方法观察加味炙甘草汤注射液的窦房结电生理作用。结果:应用加味炙甘草汤注射液后,SND兔的窦房结恢复时间(SNRT)、校正SNRT(SNRTc)较对照组明显缩短,心脏固有心率(IHRo)明显上升,总窦房传导时间(TSACT)无改变。临床电生理结果与动物实验  相似文献
3.
目的观察鼻渊舒口服液对慢性鼻窦炎/鼻息肉鼻内窥镜手术(FESS)后临床症状和体征的改善情况以及对鼻窦粘膜创伤愈合时间的影响,并对其有效性做出评价.方法将340例临床确诊的慢性鼻窦炎、鼻息肉患者按单纯随机化方法分为试验组170例和对照组170例.试验组手术后除常规抗生素(喹诺酮类抗生素7 d)、局部类固醇激素等治疗外还给予鼻渊舒口服液治疗,每次10ml,每天3次,共20d;对照组手术后仅给予常规抗生紊和局部类固醇激素等治疗20d,而后比较两组疗效.结果试验组综合疗效的总有效率ITT人群为94.1%,即人群为96.4%;对照组综合疗效的总效率中,ITT人群为75.3%,PP人群为79.0%,经秩和检验,试验组和对照组综合疗效的总有效率有显著性差异(ITT:Z=5.635,P=0.018,Z=4.279,P=0.039).结论鼻渊舒口服液不仅可以提高鼻窦手术的疗效,而且可以减少抗生素、激素等药物的疗程,无毒副作用及不良反应.  相似文献
4.
目的:硬脑膜是颅内主要的伤害感受组织,在偏头痛的病理生理机制中起重要作用;c-fos的表达已被作为神经元激活的标记物用于痛觉传导的研究。本工作研究血管性头痛涉及的伤害觉信息的传递。方法:以猫为实验对象,在手术暴露其上矢状窦(SSS)后48h,8h,20h电刺激SSS区硬脑膜,应用免疫组化技术,观察延髓和上颈髓c-fos蛋白(Fos)表达的变化。结果:Fos免疫反应阳性神经元主要位于延髓三叉神经脊束核核尾侧部浅层,C1和后角的Ⅰ、Ⅱ层。在孤束的缝核和中央核及颈髓中央导周围X层也有Fos阳性神经元。4h,8h,20h各组中,假手术对照组动物Fos免疫反应阳性神经元随着手术后时间的延长而减少(P<0.05);8h刺激组和20h刺激组Fos阳性神经元较相应区且内假手术对照组明显增多(P<0.05和P<0.01),提示刺激SSS区硬脑膜可激活三叉神经二级神经元,后者与血管性头痛涉及的痛觉传入有关;延长手术和刺激间隔的时间可减少非特异刺激因素的影响。结论:猫SSS区硬脑膜刺激的c-fos表达模型可作为研究血管性头痛如偏头痛的病理生理机制及其治疗药物和方法的稳定可靠的动物模型。  相似文献
5.
In a phase IV, open-label study, 25 patients with clinically stable chronic sinusitis and persistent maxillary sinus inflammation were treated for 14 days with clarithromycin 500 mg twice daily. Biopsy specimens of the maxillary sinus mucosa were obtained pretreatment and evaluated for macrophages (CD68), eosinophils (MBP), elastase, interleukin-6 (IL-6), IL-8, tumor necrosis factoralpha (TNF-α), and activity of eosinophils (EG2), as well as edema score. Clinical signs and symptoms were assessed pretreatment, at the end of treatment, and 1 and 2 weeks later. Statistically significant reductions (P≤.05) from pretreatment were observed for all markers of sinus mucosal inflammation, including CD68, EG2, elastase, IL-6, IL-8, TNF-α, and edema score, with a trend to decreased total eosinophil count. Improvement was observed for all clinical signs and symptoms of chronic sinusitis—sinus pain, sinus headache, nasal congestion, nasal discharge, and mucopurulent discharge—up to 14 days after the end of treatment. Cultures to evaluate persistent infection withChlamydia pneumoniae showed negative results. Significant reductions in various markers of sinus mucosal inflammation support the role of clarithromycin in modulating immunologic responses. Improvement of clinical signs and symptoms in patients with chronic inflammatory sinusitis not meeting criteria for known or presumed bacterial infection was also noted up to 2 weeks after completion of a 14-day course of clarithromycin.  相似文献
6.
Angiographic Anatomy of the Coronary Sinus and Its Tributaries   总被引:16,自引:1,他引:15  
Permanent left ventricular pacing has been shown to imporve the hemodynamic and clinical status of patients with severe heart failure. To pace the left ventricle, the electrode is implanted in tributaries of the coronary sinus (CS). However, the anatomy of cardiac veins with this purpose in mind has not been described in detail. Methods: One hundred consecutive patients admitted for coronary angiography had a simultaneous coronary venography performed after the injection of 8 to 10 mL of contrast material into the left coronary artery. Cardiac veins were analyzed in antero-posterior, left anterior oblique 60±, and right anterior oblique 30± views by three different observers. The number, dimension, angulation, and position of the coronary sinus and of its tributaries were studied. Results: Two veins are consistently present: the middle cardiac vein (mean diameter 2.62 ± 1.26 mm) and the great cardiac vein (mean diameter 3.55 ± 1.24 mm). The left posterior vein(s) (LPV) (mean diameter 2.25 ± 1.2 mm) is (are) variable in number (ranging from 0 to 3), size, and angulation. The absence of LPV limits the ability to pace the left ventricle endovenously. The diameter of the vein (< 2 mm) and its angulation may also complicate the insertion of the lead. Conclusion: Angiographic analysis of dimensions, tortuosity, number, and angulation of venous tributaries of the CS seems to allow the insertion of commercially available pacing leads in approximately 85% of cases. An increase in this percentage hinges on the development of new, dedicated leads.  相似文献
7.
筛窦解剖变异的多排螺旋CT研究   总被引:13,自引:1,他引:12       下载免费PDF全文
目的 评价多排螺旋CT三维重建技术在显示筛窦解剖方面的作用,同时探讨筛窦解剖变异及其临床意义。方法 应用GE Lightspeed Plus多排螺旋机对250例进行筛窦横断面HQ或HS模式扫描,然后经工作站作冠状面、矢状面等切面三维重建。结果 筛窦的冠状面、矢状面多平面重建图像几乎与直接扫描相同,筛窦的解剖变异发生率较高,所见的解剖变异有5种,其中筛大泡104例,占总变异的56.5%;Onodi气房48例,占26%;眶下气房12例,占6.5%;筛凹低位8例,占4.3%;纸样板内移12例,占6.5%。结论 筛窦横断面HS或HQ模式的扫描,经三维重建可以得到冠状面及其他任何切面图像,完全能满足临床诊断的要求。它能如实反映筛窦的解剖变异,对鼻内镜外科有重要的临床指导意义。  相似文献
8.
慢性鼻炎鼻窦炎的CT表现及诊断   总被引:12,自引:1,他引:11  
目的 探讨慢性鼻炎及鼻窦炎的CT表现和诊断价值。方法 收集46例经临床证实为慢性鼻炎及鼻窦炎病人的CT影像资料,进行回顾分析。结果 中道阻塞是引发鼻部及鼻窦疾病的重要原因,其中慢性上颌窦炎,筛窦炎与中鼻道的阻塞有明显的相关关系。结论CT能清晰的显示鼻窦和中鼻道的解剖及变异,为术前诊断,确定治疗方案及预后估计提供了重要的解剖依据,是目前诊断鼻腔-鼻窦首选的影像学方法。  相似文献
9.
Permanent Left Atrial Pacing with a Specifically Designed Coronary Sinus Lead   总被引:12,自引:0,他引:12  
This article reports the original use of a specifically designed coronary sinus (CS) lead for permanent left atrial (LA) pacing. The device is characterized by its distal end shape featuring a double 45° angulation. which ensures very close contact with the CS upper wall. The device was successfully implanted in 39 out of 40 patients (97.5%). The tip electrode was eventually positioned in the distal CS in 9 patients, in the middle CS in 21 patients, and close to the ostium in the proximal CS in 9 patients. The mean acute pacing threshold voltage was 0.9 ± 0.5 V with a mean impedance of 578 ± 144 Ω as measured in unipolar distal configuration at 0.5 ms pulse width (PW). The mean A wave amplitude was 3.5 ± 2.1 mV. Early lead dislodgment occurred only once (3%) when the tip electrode was placed in the distal or middle CS, but more often (4/9 cases) when it was placed in the proximal CS. After a mean follow-up duration of 14 ± 8.5 months, 35 of the 39 successfully implanted leads (89.7%) were still functional in terms of LA pacing and sensing. The mean chronic pacing threshold voltage was 1.5 ± 0.8 V and the mean A wave amplitude was 2.7 ± 1.6 mV. There were no lead related complications. In conclusion, the device proved to be safe and highly effective for permanent LA pacing, provided the distal tip could be positioned in the distal or middle part of the CS.  相似文献
10.
内镜鼻窦手术620例临床疗效分析   总被引:12,自引:3,他引:9  
刘丽岱  许燕 《中国内镜杂志》2005,11(11):1185-1186,1188
目的探讨提高鼻内镜手术治疗慢性鼻窦炎、鼻息肉疗效的方法。方法对经鼻内镜手术治疗,术后随访6个月以上620例患者的临床资料进行回顾性分析。结果治愈464例(74.8%),好转125例(20.2%),无效31例(5.0%),总有效率95.0%。结论鼻内镜手术治疗慢性鼻窦炎,鼻息肉具有良好的疗效。认真的术前准备,准确熟练的手术操作和严格的术后随访是提高治愈率的重要保证。  相似文献
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