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北京协和医院1990~2000年副肿瘤综合征住院病例总结   总被引:31,自引:1,他引:30  
目的 了解副肿瘤综合征 2 6例患者的临床基本特征。方法 回顾性分析 1990~ 2 0 0 0年北京协和医院副肿瘤综合征患者的临床资料并加以总结。结果 副肿瘤综合征平均发病年龄 4 8.6± 2 6岁 ,男性占 6 9.2 % ,女性占 30 .8%。 3.8%患者在发现肿瘤后才出现神经症状 ;96 .2 %在出现副肿瘤症状后才发现肿瘤。诊断出副肿瘤综合征时 ,2 6 .9%肿瘤已出现转移。从出现神经症状至发现肿瘤平均时间为 18± 6个月 ,患者多为慢性隐袭或亚急性起病 ,症状进行性加重 ,对治疗无明显缓解。结论 副肿瘤综合征出现明显的临床症状可发生在肿瘤发现之前、之后或与之同时发生 ,它们的出现几乎均预示预后不良。临床早期诊断对于及时发现和治疗癌肿至关重要  相似文献
3.
脑卒中与卒中后抑郁的关系研究   总被引:22,自引:0,他引:22  
目的 通过调查脑卒中患者抑郁的发生率和抑郁与病灶部位、认知功能、日常生活能力及神经功能缺损程度之间的关系,探讨脑卒中后早期抑郁发生的情况及危险因素。方法 运用问卷调查的方法评估抑郁状态及认知功能状态,并根据临床体检结果判定日常生活能力及神经功能缺损程度。结果 脑卒中后早期抑郁的发生率为31.43%;抑郁与认知功能障碍之间有明显关系。抑郁与日常生活能力及神经功能缺损程度之间有明显关系。结论 脑卒中后早期即存在较普遍的抑郁情绪,抑郁与认知功能、日常生活能力及神经功能缺损程度之间存在显著关系。  相似文献
4.
Ictal Clinical Electroencephalographic Findings of Spasms in West Syndrome   总被引:20,自引:14,他引:6  
Summary: The electroencephalographic/video recordings of 955 spasms in children with cryptogenic and symptomatic West syndrome (WS) were reviewed to define the relation between a clinical manifestation of a spasm and its EEG pattern, and to examine whether these features reflect the etiology and prognosis of WS. The review confirmed the spasm to be a distinct type of seizure, with a unique clinical and EEG pattern unlike that of all other recognized seizures. Symmetric spasms were present in cryptogenic and symptomatic patients. In contrast, asymmetric spasms, or focal signs recognizable during a spasm, strongly indicated the existence of a cerebral lesion. In both etiological groups, the characteristic ictal EEG pattern of the spasms consisted of a positive-vertex slow wave. The other two patterns apparently correlated to a spasm, were fast activity, here called spindle-like, and decremental activity. The fast activity corresponded to a clinical stare, and the decremental activity, when present, represented a postictal event. Although it was independent from the etiology of the spasms, persisting hypsarrhythmia during a cluster of spasms appeared to be an EEG pattern that correlated with a favorable outcome.  相似文献
5.
Landau-Kleffner Syndrome: A Clinical and EEG Study of Five Cases   总被引:19,自引:4,他引:15  
In five children with normal initial psychomotor development, a Landau-Kleffner syndrome appeared at age 3-7 years. No neuroanatomic lesions were noted. Aphasia and hyperkinesia were isolated in three patients and associated with global regression of higher cortical functions in one patient. Massive intellectual deterioration and psychotic behavior were associated with transient aphasia in one patient. The epilepsy (focal motor and generalized tonic-clonic seizures, subclinical EEG focal seizures during sleep, and atypical absences) always regressed spontaneously or with antiepileptic drug (AED) treatment. The EEG in waking patients showed focal and generalized spike-wave discharges on a normal background rhythm. Discharge topography and pattern changed frequently. During sleep, discharges always increased. At some time during syndrome development, all patients had bilateral spike-waves for greater than 85% of the sleep period, while at other times the discharges were discontinuous or continuous but focal or unilaterally hemispheric. Discharge topography and abundance changed from night to night. The abnormal EEG and the impaired higher functions developed and regressed together, but not with strict temporal correlation. Our own experience suggests that the Landau-Kleffner syndrome and epilepsy with continuous spike-wave activity in slow-wave sleep cannot be clearly differentiated. They may be different points on the spectrum of a single syndrome.  相似文献
6.
大鼠杏仁核快速点燃癫痫模型   总被引:19,自引:0,他引:19  
建立一种新型、实用的快速点燃癫痫动物模型。方法用频率16Hz、波宽1.0ms、串长10秒、串隔7分钟、强度0.4mA的恒流脉冲电流刺激32只6~8周龄雄性Wistar大鼠的杏仁核。结果动物在0.5~4.0小时内就被点燃。模型稳定性好,致癫痫效应相对持久保留且向对侧杏仁核转移。其癫痫性行为规范,可控性和重复性好,易于判别与定量研究。动物对刺激反应性好,不易死亡。结论该模型满足了作为一种较理想的癫痫动物模型应具有的绝大多数先决条件。  相似文献
7.
改善血肿周围缺血对高血压性脑出血预后的初步报告   总被引:19,自引:0,他引:19  
目的:观察改善血肿周围缺血对脑出血血肿和水肿及神经功能的影响。方法:21例脑出血患者随机分组,观察血肿、水肿体积和神经功能缺失评分。结果:(1)低右、血栓通组第10天血肿体积明显缩小;(2)低右组第4、10、21天水肿体积缩小;(3)ESS/CSS评分与血肿体积显著相关,与水肿体积中度相关;(4)低右组改善治疗后第4、10、21天的ESS/CSS;血栓通组的第21天ESS/CSS改善。结论:低右和血栓通能改善血肿周围缺血、促进血肿吸收、促进水肿的消退,改善临床神经功能。  相似文献
8.
脑卒中患者临床神经功能缺损评分标准的信度和效度研究   总被引:19,自引:0,他引:19  
目的;研究脑卒中患者临床神经功能缺损评分标准的信度和效度。方法:100例连续住院的急性脑卒中患者,按照“评分标准”和美国国立卫生研究院卒中量表的评分规则进行评定。重测信度,评定者间信度检验用Kappa相关;内容一致性检验用Cronbachα相关;共同效度用Spearman相关;预测效度用协方差分析和logistic回归。  相似文献
9.
Electroencephalographic (EEG) studies were performed to examine the effects of several antiepileptic drugs (AEDS) on absence-like and tonic seizures in the spontaneously epileptic rat (SER: zi(zi), tm/tm,), a double mutant rat, which was obtained by mating the tremor heterozygous animals (tm/ +) with the zitter homozygous animals (zi/zi), and to determine whether the seizures in the SER correspond to human absence and tonic seizures. Spontaneous EEG was continuously recorded from the frontal cortex and hippocampus using implanted electrodes. The SER showed paroxysmal and synchronized 5-7-Hz spike-wave-like complexes in both cortical and hippocampal EEG during the absence-like state, which was characterized by immobility and staring. The animal also exhibited tonic convulsion without external stimulation concomitant with low-voltage fast waves on cortical and hippocampal EEG. In some animals, sporadic low-amplitude spikes appeared in the low-voltage fast waves during tonic convulsion. the absence-like seizures were inhibited by trimethadione (100 mg/kg intraperitoneally, i.p.) and ethosuximide 100 mg/kg i.p.), whereas the tonic convulsion was not affected by these drugs. In contrast, phenytoin (20 mg/kg i.p.) inhibited the tonic seizures without affecting the absence-like seizures. Phenobarbital (10 mg/kg i.p.) and valproate (200 mg/kg i.p.) inhibited both seizures to a similar degree. These results suggest that the SER, with both absence-like and tonic seizures, is a useful model for evaluation of AEDS.  相似文献
10.
Eleven patients had seizures with unilateral temporal lobe onset recorded with simultaneous bilateral medial temporal depth electrodes and neocortical (subdural) electrodes at least on the side of seizure onset. Of a total of 55 seizures, four had simultaneous onset in neocortex and hippocampus, and 51 had onset in unilateral hippocampus. None originated solely in temporal neocortex. Three reproducible patterns of seizure spread from hippocampus were defined in which seizures spread initially to ipsilateral neocortex (32 seizures), spread first to contralateral hippocampus (13 seizures), or spread simultaneously to ipsilateral neocortex and contralateral hippocampus. Although the region of hippocampus in which seizures arose was constant, patterns of spread sometimes varied in the same patient. When contralateral neocortical involvement occurred, it was after or with contralateral hippocampus but never before. These results suggest the existence of an operational hippocampal commissure in humans.  相似文献
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