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1.
轻度认知障碍患者记忆力的功能磁共振研究   总被引:19,自引:5,他引:14  
目的为探索早期诊断阿尔茨海默病 (AD)的方法 ,将神经心理测定和功能磁共振 (fMRI)检查相结合 ,了解轻度认知障碍 (MCI)患者在记忆方面的脑功能情况。方法 9例MCI患者和 9名正常对照在进行无意义图形记忆和再认时行fMRI检查 ,对反应时间、正确率和fMRI的脑激活图进行比较。结果患者的反应时间比正常对照明显延长 (P <0 0 1) ,正确率显著降低 (P <0 0 0 1)。脑激活图显示 ,与对照相比 ,在记忆编码时 ,患者主要在左侧前额叶背外侧和海马旁回、以及以右侧为主的后部脑区激活减弱 ,记忆提取时 ,在双侧前额叶背外侧 ,左侧海马旁回和前扣带回 ,以及后部脑区激活减弱。结论MCI患者的记忆功能已有损害。记忆功能的fMRI检查与认知神经心理学的联合研究能为早期诊断AD提供有力的参考依据。  相似文献
2.
目的:探讨肌电生物反馈疗法对急性脑梗死患者神经功能康复及认知障碍恢复的有效性。方法:发病〈14 d的脑梗死患者139例,分为研究组71例和对照组68例,均给予常规药物及康复治疗,研究组增加肌电生物反馈疗法。治疗前后均采用改良Rankin量表、中国脑卒中临床神经功能缺损程度评分量表(CSS)、ADL量表、老年认知筛查量表(ECAQ)、修订的长谷川简易智能量表(HDS-R)、简易精神状态检查法(MMSE)和临床记忆量表(MQ)检测。结果:经过平均1个月的治疗,与治疗前及对照组比较,研究组Rankin和CSS评分明显降低,ADL、ECAQ、HDS-R、MMSE和MQ评分明显提高(均P〈0.05)。结论:肌电生物反馈疗法结合常规康复训练能明显改善脑梗死患者的神经功能缺损,提高认知功能。  相似文献
3.
Mild cognitive impairment (MCI) comprises a heterogeneous group with a variety of clinical outcomes and they are at risk for developing Alzheimer's disease (AD). The prediction of conversion from MCI to AD using the initial neuroimaging studies is an important research topic. We investigated the initial regional cerebral blood flow (rCBF) measurements using single photon emission computed tomography (SPECT) in individuals with 76 amnesic MCI (52 subjects converted to AD and 24 subjects did not convert to AD at 3-year follow-up) and 57 age- and gender-matched controls. We sought functional profiles associated with conversion to AD, then evaluated the predictive value of the initial rCBF SPECT. As compared with controls, AD converters demonstrated reduced blood flow in the bilateral parahippocampal gyri, precunei, posterior cingulate cortices, bilateral parietal association areas, and the right middle temporal gyrus. Non-converters also demonstrated significant reduction of rCBF in the posterior cingulated cortices and the right caudate nucleus when compared to controls. As compared with non-converters, converters showed reductions of rCBF in the bilateral temporo-parietal areas and the precunei. The logistic regression model revealed that reduced rCBF in the inferior parietal lobule, angular gyrus, and precunei has high predictive value and discriminative ability. Although a cross-validation study is needed to conclude the usefulness of rCBF SPECT for the prediction of AD conversion in individuals with MCI, our data suggest that the initial rCBF SPECT studies of individuals with MCI may be useful in predicting who will convert to AD in the near future.  相似文献
4.
Pain in cognitively impaired nursing home patients   总被引:11,自引:0,他引:11  
Pain is an understudied problem in frail elderly patients, especially those with cognitive impairment, delirium, or dementia. The focus of this study was to describe the pain experienced by patients in skilled nursing homes, which have a high prevalence of cognitive impairment. A random sample of 325 subjects was selected from ten community skilled nursing homes. Subjects underwent a cross-sectional interview and chart review for the prevalence of pain complaints, etiology, and pain management strategies. Pain was assessed using the McGill Pain Questionnaire and four unidimensional scales previously utilized in younger adults. Thirty-three percent (33%) of subjects were excluded because they were either comatose (21%), non-English speaking (3.7%), temporarily away (sick in hospital) (4.3%), or refused to participate (3.7%). Of 217 subjects in the final analysis, the mean age was 84.9 years, 85% were women, and most were dependent in all activities of daily living. Subjects demonstrated substantial cognitive impairment (mean Folstein Mini-Mental State exam score was 12.1 ± 7.9), typically having deficits in memory, orientation, and visual spatial skills. Sixty-two percent reported pain complaints, mostly related to musculoskeletal and neuropathic causes. Pain was not consistently documented in records, and pain management strategies appeared to be limited in scope and only partially successful in controlling pain. None of the four unidimensional pain-intensity scales studied in this investigation had a higher completion rate than the Present Pain Intensity Scale of the McGill Pain Questionnaire (65% completion rate). However, 83% of subjects who had pain could complete at least one of the scales. We conclude that cognitive impairment among elderly nursing home residents presents a substantial barrier to pain assessment and management. Nonetheless, most patients with mild to moderate cognitive impairment can be assessed using at least one of the available bedside assessment scales.  相似文献
5.
轻度认知障碍患者计算能力的fMRI研究   总被引:11,自引:4,他引:7  
目的 探讨早期诊断A1zheimer病的方法,以及轻度认知障碍(MCI)患者计算能力损害的脑功能定位。方法 对8例MCI患者和9例正常对照使用神经心理测定和功能磁共振(fMRI)检查相结合的方法,比较两组反应时间、正确率和fMRI的脑激活图。结果 患者的反应时间比对照组延长(退位减法P>0.05,非退值减法P<0.05一0.01),正确率降低(P<0.01-0.001)。脑激活图显示:患者在左侧前额叶外下部,颞叶外侧和顶叶激活减弱(P<0.05),而右侧前额叶外下部激活代偿性增强(P<0.05)。结论MCI患者的计算功能已有损害。计算功能的fMRI与认知神经心理学的联合研究能为早期诊断AD提供有力的参考依据。  相似文献
6.
对102例大脑疾病患者测听觉P300,痴呆的P300潜伏期比年龄匹配的正常人和对照者分别延长77.17与60.10mS,波幅显著性降低。潜伏期与MMSE分呈显著性负相关,波幅与之呈显著性正相关。以P300潜伏期超过其年龄匹配的正常预期值2SD作为评定认知损害的阳性标准,P300测定与MMSE的符合率达90%。对31例病人的P300动态观察表明认知功能改善,MMSE分增加,P300潜伏期缩短;功能衰竭,MMSE分降低,潜伏期延长。研究认为P300测定对认知损害有客观,定量的评价作用,可用于临床诊断与康复疗效评定。  相似文献
7.
轻度认知功能损害患者汉语双词素词的语音编码研究   总被引:8,自引:3,他引:5  
目的探讨轻度认知功能损害 (MCI)患者汉语言语产生中双词素词语音激活的特点。方法对 10例MCI患者和 10例正常对照采用同音判断方法 ,选用以偏正结构的双词素词为名称的图片和与双词素词中首尾两个词素同音的两组探测字作为实验材料 ,探测字在图片呈现后 10 0ms出现 ,要求被试判断出现的探测字是否与图片名称中任何一个词素同音。对两组的反应时和错误率进行比较。结果正常老年人尾词素激活快于首词素激活 ,而MCI患者首尾词素激活时间无明显差异。首尾词素探测条件下正常老年人反应的错误率无明显差异 ,而MCI患者对尾词素探测条件的错误率低于首词素。结论正常老年人和MCI患者汉语言语产生中双词素词语音编码模式相同 ,均受词义和词素意义激活程度的影响 ;但激活的速度MCI患者慢于正常老年人。提示MCI患者语义记忆和语音提取的过程受损。  相似文献
8.
目的 探讨轻度认知损伤(MCI)患者海马,杏仁核萎缩在Alzheimer病(AD)发病中的作用,方法 MCI组11例,AD组15例,正常老年人14例,GE 1.5T MR机,3D-FSPGR序列采样,冠状位,层厚1.3mm,层数60,计算机三维重建并进行杏仁核海马体积测量,经标准化校正后进行比较,随访MCI患者进展为AD的情况,结果 AD组海马杏仁核体积萎缩25%(P<0.05),MCI组萎缩5-13%(P>0.05),27.3%的MCI患者经1年随访进展为AD。结论 伴海马 杏仁核萎缩的MCI患者更易于进展为AD。  相似文献
9.
目的了解轻度认知功能障碍 (MCI)和轻度阿尔茨海默病 (AD)患者的持续注意功能。方法采用持续作业任务(CPT) ,对 10例轻度AD患者、10例MCI患者和 10例正常老年人进行对照研究。结果轻度AD患者的反应时显著长于对照组 (P<0 0 0 1) ,漏报率高于对照组 (P <0 0 5 ) ,虚报率与对照组无显著性差异 (P =0 0 64 ) ,漏报率随时间延长增高。MCI组各指标与对照组无显著性差异。结论轻度AD患者存在持续注意功能障碍 ,MCI患者持续注意功能正常。  相似文献
10.
Hippocampal atrophy has been related to mild cognitive impairment (MCI) and early Alzheimer disease (AD), but the diagnostic significance of cross-sectionally determined hippocampal volumes is still ambiguous. Diffusion-Tensor-Imaging (DTI) in MCI patients revealed an association of microstructural changes in hippocampal areas with verbal memory decline. MRI volumetry and DTI were combined to investigate 18 MCI patients attending a memory clinic, and 18 carefully age- and gender-matched healthy controls. Neuropsychological testing, high resolution T1-weighted volume MRI scans, and DTI scans with regions-of-interest in hippocampal areas were applied. Left hippocampal volume was significantly lower (-11%, P = 0.02) in MCI patients than in control subjects. No significant differences were found for the right hippocampus (-4%). Mean diffusivity (MD) was significantly elevated in MCI patients vs. controls in left (+10%, P = 0.002) and right hippocampal areas (+13%, P = 0.02). Hippocampal volume and MD values were not significantly correlated. Combining left hippocampal volume and MD measures showed that lower left hippocampal volumes were associated with poor verbal memory performance particularly when co-occurring with high MD values. No comparable associations could be found regarding the right hippocampal formation and with respect to non-verbal memory function. The results demonstrate that microstructural abnormalities as revealed by DTI are very sensitive early indicators of hippocampal dysfunction. The combination of macro- and microstructural parameters in hippocampal areas could be promising in early detection of neurodegenerative processes.  相似文献
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