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1.
OBJECTIVE: The purpose of this study was to examine whether there is a bidirectional relationship between, on one hand, anxiety and depression and, on the other hand, insomnia over the course of a year. METHODS: A randomly selected sample of 3000 participants from the general population filled out a baseline survey (N=1812) and a 1-year follow-up survey (N=1498) on anxiety, depression, and insomnia. RESULTS: On cross-sectional analyses, bivariate correlations showed that anxiety, depression, and insomnia were significantly intercorrelated (varphi=.31-.54). On prospective analyses, logistic regression analyses demonstrated that anxiety at baseline [odds ratio (OR)=4.27 (8% of variance)] and depression at baseline [OR=2.28 (2% of variance)] were related to new cases of insomnia on follow-up. Furthermore, insomnia at baseline was related to new episodes of high anxiety and high depression on follow-up [OR=2.30 (2% of variance) and OR=3.51 (4% of variance), respectively]. CONCLUSION: Evidence suggests that there is a bidirectional relationship between, on one hand, anxiety and depression and, on the other hand, insomnia. This suggests that anxiety, depression, and insomnia are intertwined over time, implying implications for theoretical conceptualizations and interventions.  相似文献
2.
青年脑梗死与老年脑梗死的危险因素及临床特点对比分析   总被引:7,自引:0,他引:7  
目的分析青年和老年脑梗死患者的危险因素及临床特点,以提高预防和治疗效果。方法回顾性分析2006年1月~2008年12月在本科住院的103例青年脑梗死患者,127例老年脑梗死患者的临床资料,比较2组危险因素、梗死分型和临床表现。结果糖尿病、高同型半胱氨酸血症、吸烟和饮酒为青年脑梗死的重要危险因素,而高血压病、CRP和冠心病为老年脑梗死的重要危险因素,2组比较差别有显著性意义(P〈0.05)。结论青年与老年脑梗死患者的危险因素不同,应采取不同的预防措施。青年人脑梗死危险因素更为复杂多样,很多危险因素可以提前干预,健康的生活方式对预防本病非常重要,应加强脑血管疾病的一级预防。  相似文献
3.
不规则血肿形态的量化评价   总被引:7,自引:0,他引:7  
目的 不规则血肿形态是脑出血血肿扩大的危险因素之一,用数学方法推算出血肿的不规则指数(R),尝试用R值对血肿的不规则形态进行客观和量化的评价.方法 收集深圳市5家医院发病6 h内行第1次头颅CT检杏,48 h内复查头颅CT的非手术脑出血的病例资料,共120例,分为2组:血肿扩大组31例;血肿无扩大组89例.用图像测量软件测量脑出血患者头颅cT最大血肿平面的周长(L)、面积(s)、直径(A)、横径(B),计算周K/面积比值(L/S),设为X;以边缘光滑的椭圆形作为参照物,计算出以A、B为长、短轴线的椭圆周长/面积比值(L1/S1),设为X1.用测量得出实际血肿的x值除以参照物规则椭圆的xl值(X/X1),该比值称为R值,以R值来评价血肿不规则的程度.采用统计学方法分析R值与血肿扩大的关系.结果 120例脑出血患者中有31例患者发生血肿扩大,发生率为25.8%.R值越大,血肿的形态就越不规则,当R值≥1.3时,血肿的不规则形态渐显著.血肿扩大的发生率在R值≥1.3为36.7%,明显高于R值<1.3时的18.6%(χ2=4.62.P=0.032).结论 R值可作为不规则血肿的评价工具.R值≥1.3时患者更易发生血肿扩大.是血肿扩大的危险因素.  相似文献
4.
目的观察脑梗死初发、复发患者血浆同型半胱氨酸(Hcy)水平,探讨脑梗死复发与血浆Hcy的关系。方法用荧光偏振免疫法(FPIA)测定400例急性脑梗死患者及200例非急性脑卒中的对照组患者的血浆Hcy水平;将研究对象(400例)分为不同临床亚组各类型急性脑梗死组(动脉粥样硬化性脑血栓形成组、腔隙性脑梗死组、心源性脑栓塞组),初发组与复发组;比较各组患者血浆Hcy水平及高Hcy水平比率,对脑梗死复发进行多因素分析。结果(1)各类型急性脑梗死患者血浆Hcy水平均高于对照组患者(P〈0.01);各类型脑梗死患者之间血浆Hcy水平无显著差异;(2)脑梗死复发患者血浆Hcy水平高于初发患者,且高Hcy水平比率(49/97)亦高于初发患者(98/31)3)(P〈0.01);(3)1年内和1年后复发患者血浆Hcy水平无显著差异;(4)各类型脑梗死复发患者之间血浆Hcy水平无显著差异;(5)多因素分析显示脑梗死复发与高Hcy水平、糖尿病有关(P〈0.01)1、P〈0.05)。结论脑梗死复发与高血浆Hcy水平有一定关系,高血浆Hcy水平可能是脑梗死复发的独立性危险因素。  相似文献
5.
目的探讨颈动脉狭窄支架成形术后发生持续性低血压的危险因素。方法2006年7月至2008年1月,我科应用颈动脉狭窄支架成形术治疗颈动脉狭窄32例。采用单因素及Logistic多因素回归分析术后发生持续性低血压的危险因素。结果32例患者中,术后5例出现短暂性低血压(持续时间〈6h),15例出现持续性低血压(持续时间〉6h)。单因素分析结果提示,术前有低血压病史、颈动脉狭窄程度〉70%、血管狭窄长度〉15mm、支架置入前使用球囊预扩、支架直径稍大于颈动脉直径、手术操作时间超过1h与术后发生持续性低血压有关。多因素分析结果提示,术前有低血压病史、血管狭窄长度〉15mm、支架直径稍大于颈动脉直径、手术操作时间超过1h为术后发生持续性低血压的危险因素。结论术前有低血压病史、血管狭窄长度〉15mm、用直径稍大于颈动脉直径的支架行颈动脉成形的及介入治疗操作时间较长的患者.术后容易发生持续性低血压。  相似文献
6.
Risk Factors for a First Febrile Seizure: A Matched Case-Control Study   总被引:6,自引:6,他引:4  
Summary We conducted a matched casecontrol study to identify risk factors for first febrile seizures, with special emphasis on characteristics of the acute illness episode. Cases were identified through hospital emergency departments; controls were identified through outpatient clinics and emergency departments. Sixtynine children with first febrile seizures and no history of previous unprovoked seizures were matched for age (±6 months), site of routine pediatric care, and date of visit (±weeks) with 1 or 2 febrile controls who had no history of previous febrile or unprovoked seizures. Medical records for the index visit were reviewed, and parents were interviewed by telephone. Illness characteristics examined included height of temperature, type of underlying illness, contact with a physician during the illness but before the index visit, and use of acetaminophen or decongestants. Family history of febrile and of unprovoked seizures, sociodemographic characteristics, daycare use, and selected preand perinatal variables were also studied. On multivariable analysis, significant independent risk factors were height of temperature, history of febrile seizures in a firstor in a higher degree relative. Gastroenteritis as the underlying illness had a significant inverse (i.e., protective) association with febrile seizures. Maternal smoking during pregnancy was a marginally significant predictor of febrile seizures.  相似文献
7.
中青年脑梗死患者危险因素分析   总被引:6,自引:1,他引:5  
目的分析中青年脑梗死患者的病因、危险因素。方法回顾调查78例20岁~45岁年龄段的中青年脑梗死患者的临床资料,进行总结分析。结果78例中青年脑梗死患者中有明确病因者71例(91.0%),病因不明的7例(9.0%)。其中动脉硬化51例(65.4%),栓塞性疾病7例(9.0%),血液病4例(5.1%),烟雾病2例(2.6%),钩端螺旋体感染引起的脑动脉炎3例(3.8%),系统性红斑狼疮2例(2.6%),妊娠期1例(1.3%)。主要危险因素为高血压、高脂血症、高血糖、肥胖、心脏病、嗜烟酒。结论中青年脑梗死常见病因是动脉粥样硬化。危险因素主要是高血压、高脂血症、糖尿病、肥胖、心脏病、嗜烟酒。  相似文献
8.
Incidence of First Epileptic Seizures in the Canton of Geneva, Switzerland   总被引:5,自引:5,他引:1  
Summary: Purpose: We wished to determine the incidence of first provoked and nonprovoked epileptic seizures in the canton of Geneva, Switzerland.
Methods: Between June 1, 1990: and May 31, 1991, we collected all cases of suspected epileptic seizures referred to the two hospitals of the county of Geneva, Switzerland and to the private neurologists of the town. The diagnosis probability was based on clinical data from the patient chart and the EEG data. The classification of risk factors proposed by the International League Against Epilepsy (ILAE) Commission on Epidemiology and Prognosis was used.
Results: In all, 273 cases were collected. The age-adjusted incidence rate (U.S. population as standard) is 69.4 in 100.000. We observed a bimodal distribution of the cases with age (71 in the group aged 0–10 years and 107.5 in those aged >60 years). Ninety-seven cases were classified as having provoked seizures (incidence: 25.2 in 100,000). Alcohol consumption (29.8%) and cerebrovascular diseases were the most frequent causes (16.4%). One hundred seventy-six cases were classified as having unprovoked seizures (incidence: 45.6 in 100,000) with the following distribution: seizures in relation with a stable cerebral condition, 69 cases (incidence: 17.9); seizures in relation with an evolutive cerebral condition, 27 cases (incidence: 7); and seizures of unknown etiology, 80 cases (incidence: 20.8).
Conclusions: The incidence rate of first epileptic seizures in the canton of Geneva is quite similar to that reported in a French study ( Epilepsia 1990;31:391–394) in which the same methodology for case ascertainment was used. Our data clearly demonstrate that the classification of risk factors proposed by the ILAE Commission on Epidemiology and Prognosis is useful and particularly easy to use in epidemiological surveys.  相似文献
9.
Risk Factors for Sudden Unexpected Death in Epilepsy   总被引:5,自引:5,他引:1  
S. Shorvon 《Epilepsia》1997,38(S11):S20-S22
Summary: The exact mechanisms of sudden unexpected death in individuals with epilepsy (SUDEP) are unclear, and only an incomplete analysis of risk factors can be made. Clinical, epidemiologic, and electrophysiologic evidence suggests that most sudden deaths are related temporally to seizures, are unwitnessed, and that many occur during sleep. Individuals with generalized seizures, symptomatic epilepsy, severe or frequent seizures, and additional mental handicap or neurologic deficit are at greater risk, and the majority of cases probably occur in patients with chronic epilepsy. Young people are more at risk for SUDEP than older people with epilepsy, and risk factors in pediatric practice may differ from those in adult epileptology.  相似文献
10.
脑梗死与颈动脉粥样硬化斑块及其相关因素分析   总被引:5,自引:2,他引:3  
目的探讨脑梗死与颈动脉粥样硬化(CAS)斑块及血脂、纤维蛋白原(Fbg)水平的关系。方法对96例经头CT或MRI确诊的急性脑梗死患者和43例对照组进行颈动脉颅外段彩色多普勒检查,观察斑块情况。同时检测2组血脂、纤维蛋白原水平。结果(1)病例组96例,斑块检出率为78.13%(75/96)。对照组为18.60%(8/43)(P〈0.01);(2)血清总胆固醇(TC)、低密度脂蛋白(LDL)及Fbg水平脑梗死组明显高于对照组(P〈0.05);脑梗死组有斑块亚组明显高于无斑块亚组(P〈0.05)。结论颈动脉硬化斑块与脑梗死发生有密切关系,不稳定颈动脉硬化斑块是脑梗死发生的重要因素。LC,LDL,Fbg水平增高是脑梗死及颈动脉粥样硬化斑形成的危险因素。  相似文献
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