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Summary The frequency of diurnal clenching and/or grinding and nail‐biting habits was assessed in patients affected by temporomandibular disorders (TMDs) and in healthy controls in order to investigate the possible association between these oral parafunctions and different diagnostic subgroups of TMDs. The case group included 557 patients (127 men, mean age ± SD = 34·5 ± 15·4 years; 430 women, mean age ± SD = 32·9 ± 14·1 years) affected by myofascial pain or disc displacement or arthralgia/arthritis/arthrosis. The control group included 111 healthy subjects (55 men, mean age ± SD = 37 ± 15·2 years; 56 women, mean age ± SD = 38·2 ± 13·8 years). Multinomial logistic regression analysis was used to assess the association between oral parafunctions and TMDs, after adjusting for age and gender. Daytime clenching/grinding was a significant risk factor for myofascial pain (odds ratio (OR) = 4·9, 95% confidence interval (CI): 3·0–7·8) and for disc displacement (OR = 2·5, 95% CI: 1·4–4·3), nail biting was not associated to any of the subgroups investigated. Female gender was a significant risk factor for myofascial pain (OR = 3·8; 95% CI: 2·4–6·1), whereas the risk factor for developing disc displacement decreased with ageing. No association was found between gender, age and arthralgia/arthritis/arthrosis.  相似文献   
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Background: Automatic threshold measurement and output adjustment are used as default settings in modern pacemakers. The purpose of the study was to assess Atrial Capture Management (ACM) of Medtronic pacemakers in pediatric patients. Methods: Forty children were enrolled in two centers. Median age was 9.8 years (range 0.8–17.5 years). Half had undergone surgery for congenital heart defects; 45% of patients had an epicardial atrial lead. The pacing indication was atrioventricular block in 82% of patients and sinus node disease in 18%. Manually determined atrial thresholds and ACM measurements were compared. Results: ACM measurements were within the expected variation in 37/40 (93%) of the patients. In one patient the threshold was 0.625‐V lower manually than with ACM. One patient had too high an intrinsic atrial rate for ACM to be able to measure threshold. The mean threshold at 0.4 ms was 0.69 ± 0.32 V manually and 0.68 ± 0.35 V with ACM (two‐tailed paired t‐test, P = 0.52) in all patients. The mean difference was 0.012 V (95% confidence interval: ?0.027, 0.053). The mean endocardial threshold was 0.70 ± 0.36 V manually and 0.69 ± 0.38 V with ACM; epicardial threshold was 0.67 ± 0.27 V manually and 0.68 ± 0.32 V with ACM. The difference between the measurements was 0.012 V for endocardial and 0.014 V for epicardial leads. No atrial arrhythmias due to ACM measurements were observed. Conclusions: ACM measures atrial thresholds reliably in pediatric patients with both endocardial and epicardial leads, allowing its use in both. Constant high intrinsic atrial rate may prevent automatic threshold measurement in young children. (PACE 2010; 33:309–313)  相似文献   
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Although rate responsive pacing based on impedance minute ventilation (IMV) is now standard, there is almost no data confirming the relationship between IMV from an implanted pacemaker and measured minute ventilation (VE) during exercise. Nineteen completely paced adults implanted with Medtronic Kappa 400 pacemakers underwent symptom-limited maximal metabolic treadmill testing using a modified Minnesota Pacemaker Response Protocol. Minute ventilation (VE, L/min) was simultaneously measured using the flowmeter of a respiratory metabolic gas analysis system and the transthoracic impedance minute ventilation circuitry of the pacemaker. Correlation coefficients (r) were used to find the best fit line to describe the relationship between the two measurements. Mean (+/- SD) r values for the first, second, and third order polynomial equations and for log and exponential equations were: 0.92 +/- 0.08, 0.94 +/- 0.04, 0.95 +/- 0.04, 0.91 +/- 0.06, and 0.91 +/- 0.07, respectively. None of the r values were statistically different from the first order equation. Transthoracic IMV as measured by the Medtronic Kappa 400 is closely correlated to measured minute ventilation and is represented well by a first order (linear) equation.  相似文献   
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Clinical trials have demonstrated the efficacy of glycoprotein (GP) IIb/IIIa antagonists in preventing the thrombotic end points of death, myocardial infarction, and urgent revascularization when they are administered at the time of percutaneous coronary revascularization (PTCR). It has been postulated that prolongation of receptor blockade beyond acute intervention would extend the clinical benefit of these agents. The Evaluation of Oral Xemilofiban in Controlling Thrombotic Events (EXCITE) study was a multicenter, international, randomized placebo-controlled trial of the oral GP IIb/IIIa antagonist Xemilofiban administered prior to and after PTCR. The study was designed to assess the efficacy and safety of continuing oral xemilofiban for 6 months to prevent these primary thrombotic end points. More than 7,200 patients were randomized in 29 countries to receive placebo or one of two doses of xemilofiban. Stenting was performed at the discretion of the operator. All patients received aspirin and periprocedural heparin; all stented patients received continuous xemilofiban, or ticlopidine for 2–4 weeks followed by xemilofiban-placebo. Most patients were also evaluated 1 month after conclusion of the study drug treatment. Clinical data from up to 6 months of drug treatment and 1 month posttreatment were used to evaluate the acute and long-term efficacy and safety of xemilofiban. Secondary end points included the need for any revascularization, repeat hospitalization for unstable angina, and nonhemorrhagic stroke. The cumulative incidence of bleeding events and effects of xemilofiban in stented and nonstented patients were evaluated. The efficacy of continuing xemilofiban and aspirin therapy as the sole antithrombotic medications following stent deployment was assessed against a ticlopidine and aspirin control group. The incremental clinical benefit of long-term receptor blockade over acute receptor antagonism was evaluated.  相似文献   
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The Multi-Track System is a simplified double-balloon technique for percutaneous mitral valvuloplasty. Here we describe the technique and report the results obtained using it. The Multi-Track catheter has a short distal tip for connection to the guidewire. This leaves the rest of guidewire free to receive other catheters. Various catheters can be introduced over the same guidewire. The balloons are introduced one after the other allowing a smaller size of vascular access and transseptal passage. Furthermore, simultaneous pressure measurements in the left atrium and left ventricle are possible through a simple venous access, allowing avoidance of arterial puncture. We used this technique worldwide between June 1994 and February 2000 for the treatment of 153 patients with mitral stenosis worldwide. In 12 cases, the procedure was done using the exclusive venous approach. The mean mitral valve area increased from 0.75 ± 0.22 to 2 ± 0.33 cm2and the mean left atrial pressure dropped from 27 ± 8 to 11 ± 4 mmHg. Four patients had a significant increase in mitral regurgitation, requiring surgical treatment in two patients. There was no mortality. The Multi-Track system is a valid user-friendly and cost-effective alternative for the treatment of mitral stenosis. It is a rapid and effective procedure associated with low risks.  相似文献   
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