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91.
The clinical and histopathologic characteristics of patients with ashy dermatosis (n = 20) and lichen planus pigmentosus (n = 11) were analyzed. We found significant clinical differences between both dermatoses, supporting our opinion that they are two separate conditions. Both dermatoses were histologically similar.  相似文献   
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BACKGROUND: Despite different telangiectasia treatments in the lower limbs, there is no method standardization for results assessment, making comparison between the existing treatments conflicting. OBJECTIVE: To compare the assessment carried out by a group of specialists with the assessment carried out by a computer program, according to clearance degree of telangiectasias during treatment by sclerotherapy. MATERIALS AND METHODS: Nineteen patients (21 studied areas) with telangiectasias of thighs and popliteal fossa were assessed, with a mean age of 37.5 (21-59) years old, all female. The pre- and posttreatment photos were standardized as per distance, light exposure, and aperture time. The sclerotherapy sessions were performed with 75% glucose. The clearance degree of telangiectasias was judged by a group of six doctors and by a computer program that analyzed the initial and final photos. The results of such assessment were compared according to concordance and correlation. RESULTS: There was no statistical difference between the assessments carried out by the specialists and the assessments carried out by the computer program according to the sclerotherapy results. CONCLUSION: The assessment carried out by the computer program was equivalent to the assessment carried out by the specialists in the judgment of clearance degree of telangiectasias of the lower limbs.  相似文献   
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The electrophysiological effects of RF ablation upon the areas in proximity to the lesioned zones have not yet been well characterized. An experimental model is used to investigate atrial conduction in the boundaries of RF damaged zones. In 11 isolated and perfused rabbit hearts, endocardial atrial electrograms were recorded using an 80-Iead multiple electrode positioned in the left atrium. Both before and after the RF application (5 W, 8 s, 1-mm diameter unipolar epicardial electrode) in the mid-portion of the free left atrial wall, measurements were made of conduction time from the pacing zone (posterior wall of the left atrium) to three points between 7.5 and 7.9 mm distal to the damaged zone. Conduction velocity and the direction of the activation propagation vector were determined in ten groups of four electrodes positioned around the damaged zone, and at the left atrial appendage. The mean diameter (± SEM) of the transmural lesions produced by RF ablation and defined by macroscopic examination was 4.2 ± 0.2 mm. The conduction times to the three points distal to the lesion site were significantly prolonged as a result of RF ablation: 7.6 ± 0.4, 7.4 ± 0.5, and 6.9 ± 1.0 ms (control); and 11.3 ± 1.0 (P ≤ 0.01), 11.1 ± 1.3 (P < 0.01), 10.6 ± 1.4 ms (P < 0.05) (post-RF). The differences between the conduction velocities determined in the areas surrounding the lesion, before and after RF application, failed to reach statistical significance: 86.2 ± 6.5 cm/s (control) versus 75.5 ± 5.7 cm/s (post-RF) (NS). After RF, significant variations were only observed in the direction of impulse propagation in the proximal-inferior quadrant adjacent to the lesion site, the difference being -61°± 18° (P < 0.02). In 2 of 4 experiments in which the lesion size was increased by a second RF application (5 W, 16 s), tachycardias with activation sequence around the lesion could be induced, with cycle lengths of 56 and 50 ms, respectively. In the atrial wall, the conduction times to the regions distal to the RF lesion are significantly prolonged. No significant changes are observed in conduction velocity in the areas in proximity to the lesion. Prolonged conduction to the areas distal to the ablation site is due to the lengthened pathway traveled by the impulses in reaching these areas. Tachycardias with activation patterns that suggest reentry around the RF damaged zone may be induced.  相似文献   
97.
ABSTRACT: idiopathic palmar and plantar hyperhidrosis is a relatively common disor-der of eccrine sweat gland function. Treat-ment with glufaraldehyde or formaldehyde, although successful, may cause undesirable side effects. Methenamine is a polycyclic organic compound which releases ammonia and formaldehyde at acid pH. Five per cent methenamine in a firm slick gel, applied daily to one palmar or plantar surface of 109 patients with hyperhidrosis, resulted in significantly less sweating after one month. No patients were sensitized to formaldehyde.  相似文献   
98.

Objectives

To assess the usefulness of a new approach to atrial septal puncture and septostomy in patients with end‐stage pulmonary hypertension.

Background

Atrial septostomy in end‐stage pulmonary hypertension has high mortality and morbidity rates mainly due to trans‐septal catheterization. New approaches to safety during this technical step are expected.

Methods

Twelve patients with end‐stage pulmonary arterial hypertension (5 males, 7 females, mean age 41, 9 ± 12, 0 years) underwent to balloon atrial septostomy. Intracardiac echography (ICE) was used to localize fossa ovalis while a radiofrequency wire was used to perforate the atrial septum. Then a septostomy was performed by progressive balloon dilatation of atrial septum. Septal perforation was successful at the first attempt in 4 patients and after 5 attempts in a single case, while Bas was successful in all.

Results

Pericardial effusion did not develop in any patient. Complications consisted in transient supraventricular tachyarrhythmia, transient cerebral ischemia and severe hypoxemia with ventricular tachycardia in 3 single patients. In‐procedure death rate was 0%. Systemic cardiac output increased immediately, while systemic O2 saturation decreased significantly in all. Mean follow‐up was 8, 2 ± 3, 8 months. Mortality was 16, 6% (2 patients). NYHA class improved in the rest of patients. Four patients (33, 2%) underwent to pulmonary transplant successfully.

Conclusions

This novel approach for trans‐septal catheterization has shown very low rate of major complication during atrial septostomy in patients with end‐stage pulmonary arterial hypertension. (J Interven Cardiol 2013;26:62–68)
  相似文献   
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Background: The right ventricular septum (RVS) and Hisian area (HA) are considered more “physiological” pacing sites than right ventricular apex (RVA). Studies comparing RVS to RVA sites have produced controversial results. There are no data about variability of electromechanical activation obtained by an approach using fluoroscopy and electrophysiological markers. This study compared the variability of left ventricular (LV) electromechanical activation in patients undergoing short‐term RVA and RVS with that measured during HA pacing based on fluoroscopy and electrophysiological markers. Methods: Tissue Doppler echocardiography was performed in 142 patients before and after RVA (54), RVS (44), and HA (44) pacing. Electromechanical activation was assessed by: (1) electromechanical latency (EML)‐interval between QRS onset and mechanical activation of basal LV; (2) intra‐LV dyssynchrony (intra‐LV)‐interval between earliest to the latest LV basal motion. The intra‐ and interpatients variability among pacing groups were assessed. Results: Pacing from RVA showed longer EML and higher degree of intra‐LV than RVS and HA pacing. RVA and RVS showed a higher variability than HA pacing with regard to intrapatient changes of EML (RVA vs RVS, P = 0.4; RVS vs HA, P = 0.01, RVA vs HA, P = 0.0002) and intra‐LV (RVA vs RVS, P = 0.2; RVS vs HA, P = 0.04; RVA vs HA, P = 0.005). Similar results were found in interpatients variability from paced‐values. Conclusions: RVA and RVS pacing produce a variable effect on LV electromechanical activation that is significantly more pronounced than HA pacing. A pacing site such as HA selected by fluoroscopic and electrophysiological markers maintains baseline and homogeneous LV activation pattern. (PACE 2010; 566–574)  相似文献   
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