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BACKGROUNDGastric cancer (GC) is characterized by a low 5-year survival rate. The prognosis is still not satisfactory although it has significantly improved due to developments in medicine. Thus, the identification of more efficient indices for the evaluation of GC prognosis is required. We propose, for the first time, that the alkaline phosphatase (ALP) to prealbumin (PA) ratio (APR) can be used as an independent prognostic factor in GC.AIMTo evaluate the prognostic value the APR in GC.METHODSAccording to the exclusion strategy, we collected the preoperative serologic examination results and clinical information of 409 GC patients treated in Shandong Provincial Hospital from January to December, 2016. By calculating the APR, the neutrophil and lymphocyte ratio (NLR), C-reactive protein (CRP) and albumin (ALB) ratio, platelet and lymphocyte ratio, lymphocyte and monocyte ratio, and the relationship with clinical information, we verified the role of preoperative APR ratio in the prognosis of GC. In addition, we used a Cox model combined with the APR and tumor stage to demonstrate its efficacy in assessing the prognosis of GC patients.RESULTSPreoperative APR was an independent prognostic factor for GC. The median age of patients in the APR-high group was greater compared with that in the APR-low group. Patients with a higher APR had a more advanced clinical stage, higher neutrophil to lymphocyte, CRP to ALB, and platelet to lymphocyte ratios, but a lower lymphocyte to monocyte ratio (P < 0.05). The APR-high group also had higher glycoprotein antigen 199 and carbohydrate antigen 125 levels than the APR-low group (P < 0.05). Median overall survival and disease-free survival were significantly longer in the APR-low group than in the APR-high group. In addition, a Cox model based on the APR and tumor stage was more effective in evaluating the prognosis of patients than models based on stage alone or stage plus the NLR.CONCLUSIONA higher APR is an independent and negative prognostic factor for GC. The prognosis of GC can be better evaluated using a Cox model based on the APR and stage.  相似文献   
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刘倩  范晓晨 《安徽医学》2020,41(4):389-392
目的 探讨血浆前清蛋白(PA)水平对川崎病(KD)患儿合并冠状动脉病变(CAL)的预测意义。方法 回顾性分析2014年1月至2018年12月安徽医科大学第一附属医院儿科收治的128例KD患儿(KD组)的临床资料和50例同期健康体检儿童(对照组)的体检资料。KD组根据临床特点分为典型KD组98例和不典型KD组30例,根据是否合并CAL分为CAL组23例和nCAL组105例,记录各组患者PA、中性粒细胞绝对值(NEUT)、血小板计数(PLT)、清蛋白(Alb)、谷丙转氨酶(ALT)、C反应蛋白(CRP)、血沉(ESR)及心脏多普勒超声心动图结果,对各组间以上指标进行相关性分析,并绘制受试者工作特征(ROC)曲线,得出PA的最佳截断值,计算PA判断KD合并CAL的敏感度和特异度。结果 治疗前KD组PA水平为(68.91±40.65)mg/L,低于对照组的(180.20±31.81)mg/L,差异有统计学意义(P<0.05);典型KD组PA水平(67.19±41.29)mg/L低于不典型KD组的(74.53±38.60)mg/L,但差异无统计学意义(P>0.05);CAL组PA水平(53.30±24.73)mg/L低于nCAL组的(72.33±42.69)mg/L,差异有统计学意义(P>0.05);根据ROC曲线,PA的截断值选为82.5 mg/L时,敏感度为87.0%,特异度为69.5%。结论 血浆PA水平有望作为KD患儿合并CAL的预测指标之一。  相似文献   
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目的 探讨维持性血液透析患者透析初始血尿酸水平与预后的相关性。方法 纳入2013年7月~2018年7月于我院透析的309例患者为研究对象,按照尿酸是否升高分为尿酸升高组和尿酸正常组。收集患者临床资料,用二元logistic回归法分析尿酸升高的独立危险因素;Kaplan-Meier生存曲线法分析患者生存预后的影响因素;Log-rank法进行显著性检验。结果 ①共309例患者纳入本研究,男性178例(57.6%),女性131例(42.4%)。其中,158例(51.1%)患者尿酸升高,151例(48.9%)患者尿酸正常。与尿酸正常组比较,尿酸升高组透析龄更长,但年龄、二氧化碳结合力较低,尿素、前白蛋白较高(均P<0.05)。②相关性分析结果提示,尿酸与透析龄、尿素、肌酐、甘油三酯、血磷和前白蛋白呈正相关,与年龄、直接胆红素、eGFR、高密度脂蛋白、二氧化碳结合力呈负相关均(均P<0.05)。③二元logistic逐步回归分析结果显示,男性较女性患者尿酸风险降低(OR=0.086)。随着年龄、二氧化碳结合力和高密度脂蛋白的增加,尿酸的风险减少,但随着前白蛋白和尿素的升高,尿酸风险增加(均P<0.05)。④全因死亡患者的生存分析结果提示,尿酸升高组患者生存时间高于尿酸正常组(P<0.05)。结论 前白蛋白和尿素是尿酸升高的危险因素,高尿酸可能是维持性血液透析患者死亡的保护因素。  相似文献   
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Background

Familial amyloidotic polyneuropathy (FAP) is a rare disease diagnosed in Brazil and worldwide. The frequency of cardiovascular involvement in Brazilian FAP patients is unknown.

Objective

Detect the frequency of cardiovascular involvement and correlate the cardiovascular findings with the modified polyneuropathy disability (PND) score.

Methods

In a national reference center, 51 patients were evaluated with clinical examination, electrocardiography (ECG), echocardiography (ECHO), and 24-hour Holter. Patients were classified according to the modified PND score and divided into groups: PND 0, PND I, PND II, and PND > II (which included PND IIIa, IIIb, and IV). We chose the classification tree as the statistical method to analyze the association between findings in cardiac tests with the neurological classification (PND).

Results

ECG abnormalities were present in almost 2/3 of the FAP patients, whereas ECHO abnormalities occurred in around 1/3 of them. All patients with abnormal ECHO also had abnormal ECG, but the opposite did not apply. The classification tree identified ECG and ECHO as relevant variables (p < 0.001 and p = 0.08, respectively). The probability of a patient to be allocated to the PND 0 group when having a normal ECG was over 80%. When both ECG and ECHO were abnormal, this probability was null.

Conclusions

Brazilian patients with FAP have frequent ECG abnormalities. ECG is an appropriate test to discriminate asymptomatic carriers of the mutation from those who develop the disease, whereas ECHO contributes to this discrimination.  相似文献   
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背景 血清前白蛋白是营养和炎性状态的标志物,血清前白蛋白水平低与冠心病预后不良有关。然而,血清前白蛋白水平对急性心力衰竭(AHF)患者的预后价值尚未确定。目的 探讨入院时血清前白蛋白水平与心脏重症监护病房内AHF患者长期预后之间的关联。方法 回顾性纳入2014年1月-2017年2月在海南省人民医院心脏重症监护病房的AHF患者186例,入院后24 h内检测其血清前白蛋白水平,再进行随访,随访截止日期为2019年2月。根据血清前白蛋白参考值,将患者分为血清前白蛋白>14.0 mg/dl组(119例)和血清前白蛋白≤14.0 mg/dl组(67例),比较两组患者一般资料及全因死亡、复合终点(由AHF发作引起的全因死亡或再入院)发生率,比较两组患者全因死亡和复合终点的生存曲线,分析全因死亡和复合终点的影响因素。结果 血清前白蛋白≤14.0 mg/dl组患者全因死亡、复合终点发生率高于血清前白蛋白>14.0 mg/dl组(P<0.05)。两组患者全因死亡和复合终点的生存曲线比较,差异有统计学意义(P<0.05)。多因素Cox回归分析显示:血清前白蛋白≤14.0 mg/dl与全因死亡和复合终点有关(P=0.002、<0.001)。结论 检测入院时的血清前白蛋白水平可能有助于监护环境下AHF患者的风险分层,且较低的血清前白蛋白水平可能与心脏重症监护病房接受治疗的AHF患者的长期不良预后有关。  相似文献   
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目的     探讨急性缺血性卒中血管内治疗术后低血清前白蛋白血症的发生情况及其与预后的相关性。  相似文献   
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BackgroundHypoalbuminemia has now emerged as a powerful prognosticator in heart failure regardless of age, clinical presentation, left ventricular ejection fraction and usual prognostic markers. Growing evidence is that this prognostic value persists after adjusting for causative factors for hypoalbuminemia such as malnutrition, inflammation and liver dysfunction.ObjectiveTo address the prognostic relevance of hypoalbuminemia in frail elderly patients with well-characterized cardiogenic pulmonary edema at high risk for adverse outcome, beyond causative factors for low serum albumin levels. Serum albumin was measured after clinical stabilization to avoid hypervolemia.ResultsIn all, 67 patients with a mean age of 86 years were included. Hospital mortality was 30%. Patients who died and who survived were similar in age, ejection fraction, BNP concentration, serum creatinine, serum hemoglobin, total bilirubin and prealbumin. Patients who died had lower serum albumin levels (P < 0.001), higher blood urea nitrogen (P = 0.03) and higher C-reactive protein (P = 0.02). In multivariate analysis, serum albumin was the sole independent predictor of hospital death (P < 0.01), after adjusting for malnutrition (prealbumin P = ns), inflammation (C-reactive protein P = ns) and liver dysfunction (total bilirubin P = ns).ConclusionSerum albumin is a powerful prognosticator in frail elderly patients with acute cardiogenic pulmonary edema even after adjusting for main causative factors. These results suggest that hypoalbuminemia may contribute to the worsening of heart failure given the physiological properties of serum albumin that includes antioxidant activity and plasma colloid osmotic pressure action. Further studies are critically needed to address the relevance of prevention and correction of hypoalbuminemia in heart failure.  相似文献   
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[目的]探讨急性心肌梗死(AMI)患者血清前白蛋白(PAB)水平与冠脉病变程度的相关性.[方法]选择2012年6月至2015年6月本院收治的194例AMI患者作为观察组,以同期于本院行常规体检无心血管疾病的58例健康者为对照组.观察两组以及观察组内不同程度血管病变患者血清PAB水平,并分析血清PAB水平与AMI冠脉病变的相关性.[结果]与对照组相比,观察组患者入院时PAB水平明显降低,GRACE评分明显提高,组间比较差异均具有统计学意义(P<0.05).观察组不同程度血管的病变的PAB水平单支组>双支组>三支组,而GRACE评分为单支组<双支组<三支组,组间比较均具有统计学意义(P<0.05).观察组中发生心血管事件136例,与未发生心血管事件患者相比其入院时PAB水平较高,GRACE评分较低,差异具有统计学意义(P<0.05).经spearman相关分析,PAB水平与AMI病变程度(r=-0.202,P<0.05)、GRACE危险评分(r=-0.236,P<0.05)以及心血管事件的发生均呈负相关(r=-0.211,P<0.05).[结论]AMI患者血清PAB水平与冠脉病变程度及其预后均具有相关性,可作为早期诊断治疗和判断预后的参考指标.  相似文献   
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