全文获取类型
收费全文 | 118篇 |
免费 | 2篇 |
专业分类
儿科学 | 1篇 |
基础医学 | 5篇 |
临床医学 | 9篇 |
内科学 | 14篇 |
神经病学 | 16篇 |
特种医学 | 5篇 |
外科学 | 68篇 |
肿瘤学 | 2篇 |
出版年
2022年 | 1篇 |
2021年 | 1篇 |
2019年 | 1篇 |
2018年 | 3篇 |
2017年 | 3篇 |
2016年 | 1篇 |
2015年 | 1篇 |
2014年 | 5篇 |
2013年 | 1篇 |
2012年 | 14篇 |
2011年 | 13篇 |
2010年 | 2篇 |
2009年 | 2篇 |
2008年 | 6篇 |
2007年 | 7篇 |
2006年 | 5篇 |
2005年 | 6篇 |
2004年 | 7篇 |
2003年 | 14篇 |
2002年 | 3篇 |
2001年 | 4篇 |
2000年 | 2篇 |
1999年 | 2篇 |
1998年 | 2篇 |
1997年 | 1篇 |
1995年 | 2篇 |
1994年 | 1篇 |
1992年 | 3篇 |
1991年 | 1篇 |
1987年 | 1篇 |
1985年 | 1篇 |
1984年 | 2篇 |
1978年 | 1篇 |
1973年 | 1篇 |
排序方式: 共有120条查询结果,搜索用时 31 毫秒
71.
72.
Ma J Mehrkens JH Holtmannspoetter M Linke R Schmid-Elsaesser R Steiger HJ Brueckmann H Bruening R 《Neuroradiology》2007,49(4):317-326
Introduction Impaired cerebral vascular reserve (CVR) in patients with symptomatic internal carotid artery (ICA) occlusion is regarded
as a possible indication for performing extra-/intracranial (EC/IC) bypass surgery. As perfusion MR imaging (MRI) can demonstrate
cerebral haemodynamics at capillary level, our hypothesis was that perfusion MRI could be used in these patients for the evaluation
of CVR following acetazolamide challenge in a similar way to single photon emission CT (SPECT) and might provide additional
information.
Methods Enrolled in the study were 12 patients (mean age 61.3 years; 11 male, 1 female) with symptomatic unilateral ICA occlusion
proven by angiography. Both perfusion MRI and 99m-technetium-ethyl-cysteinate dimer (99mTc-ECD) SPECT were performed before and after injection of acetazolamide (Diamox ,1000 mg i.v.). CVR parameters including
regional cerebral blood flow (rCBF) and volume (rCBV), and mean transit times (MTT) were measured by perfusion MRI.
Results The patients with impaired CVR proven by SPECT (n = 9) had a negative mean rCBF increment (−46.52%), negative rCBV increment (−13.5%) and delayed MTT (mean +2.98 s), respectively,
on the occluded side (Student’s t-test all P < 0.05). The patients with sufficient CVR (n = 3) had a mean rCBF increment of 1.2%, a decrement of rCBV of 10.46%, and a mean MTT shortening of 0.27 s following the
acetazolamide injection.
Conclusions Perfusion MRI before and after acetazolamide administration compares favourably with 99mTc-ECD SPECT for the detection of impaired CVR. The impact that perfusion MRI studies (before and after acetazolamide administration)
might have on the treatment decision in patients with ICA occlusion has yet to be determined by a prospective study.
The first and second author contributed equally to this study. 相似文献
73.
We report the rare case of an air gun pellet retained within the myocardium. The pellet passed through the right ventricle and the interventricular septum and was retained in the posterior left ventricular wall. The patient presented with cardiac tamponade requiring urgent surgical treatment. The case report is followed by a review of the pertinent literature. 相似文献
74.
P. Geiger MD H.H. Mehrkens MD 《Techniques in Regional Anesthesia and Pain Management》2003,7(2):67-71
Brachial plexus blockade is routinously performed by using the axillary route. From clinical experience and anatomical point of view it is known that the axillary approach is not the ideal technique to achieve efficient brachial plexus anesthesia. Regarding the anatomical conditions, it is clear that the mid-retrosubclavian region should be the most appropriate place to apply the local anesthetic agent due to the fact that all three fascicles of the plexus are lying close together. During the past several decades different supra- and infraclavicular approaches have been described but none of them are still in use to a great extent today. Since 1993 we routinely have used the vertical infraclavicular approach, a self developed technique based on detailed anatomic studies. This method of brachial plexus blockade has clearly defined guidelines using simple reproducible landmarks and is performed by applying a strongly vertical puncture at the center line between the ventral apophysis of acromion (lateral landmark) and the jugular notch (medial landmark) directly beneath the clavicula. The patient is lying in a supine position with his forearm relaxed on the chest and his head slightly turned to the contralateral side. The brachial plexus is met in 3 to 4 cm depth. Because of its advantages the vertical infraclavicular blockade has become the most applied technique in upper extremity regional anesthesia in our hospital. The method has a high success rate, low risks, and a high acceptance by both patients and anesthetists. © 2003 Elsevier Inc. All rights reserved. 相似文献
75.
Stefan Klotz Sina Stock Hans-Hinrich Sievers Michael Diwoky Michael Petersen Ulrich Stierle Doreen Richardt 《The Journal of thoracic and cardiovascular surgery》2018,155(4):1403-1411.e1
Objective
Remodeling or reimplantation are established operative techniques of aortic valve–sparing root replacement. Long-term follow-up is necessary comparing tricuspid and bicuspid aortic valves.Methods
A total of 315 patients (tricuspid, n = 225, bicuspid, n = 89, quadricuspid, n = 1; remodeling, n = 101, reimplantation, n = 214) were evaluated. Mean follow-up was 10.1 ± 5.6 and 6.4 ± 4.2 years for the remodeling and reimplantation group, respectively. Longest follow-up was 21.9 years with 99.2% completeness. Mean age of the patients was 55.9 ± 14.3 for the remodeling group and 48.9 ± 14.5 years for the reimplantation group.Results
There was no significant difference in survival between the remodeling and reimplantation group (P = .11). Survival was comparable with the normal population in the reimplantation group (P = .33). Risk factors for late death were age, diabetes, and a greater New York Heart Association classification. Cumulative incidence of reoperation at 10 years was 5.8% for the reimplantation and 11.7% for the remodeling group (P = .65). Overall, there was no difference in the cumulative incidence of reoperation between tricuspid and bicuspid aortic valve patients (P = .13); however, a landmark analysis showed that in the second decade, the cumulative incidence of reoperation was greater in bicuspid aortic valve patients (P < .001). A total of 10 of 11 reoperated bicuspid aortic valves were degenerated.Conclusions
The remodeling and reimplantation aortic valve–sparing root replacement techniques provided excellent long-term survival. Although the number of patients was relatively small, we provide some hints that in the second decade after the operation, especially in bicuspid aortic valve patients, the risk of reoperation may be increased, needing further evaluation. 相似文献76.
Bechtel JF Müller-Steinhardt M Schmidtke C Brunswik A Stierle U Sievers HH 《The Journal of heart valve disease》2003,12(6):734-9; discussion 739-40
BACKGROUND AND AIM OF THE STUDY: Rejection is thought to contribute to the degeneration of valved homografts. A novel cryopreserved decellularized homograft valve (SynerGraft; CryoLife, Inc.) offers the unique opportunity to gain new insight into the immunology of homograft implantation and its significance for valve function. METHODS: Twenty-four patients (group I; mean age 37 +/- 11 years) underwent implantation of a pulmonary SynerGraft and were examined at one and six months postoperatively; 22 patients (group II; mean age 41 +/- 17 years) with conventional homografts served as controls. Temperature, C-reactive protein (CRP) levels and white blood cell count (WBC) were studied perioperatively. Follow up included echocardiography and anti-human leukocyte antigen (HLA) class I antibody determination. RESULTS: Significantly lower temperatures were measured in group I (p = 0.019). CRP level and WBC each increased postoperatively, but did not differ between groups. During follow up, none of the SynerGraft patients became positive for anti-HLA antibodies, compared with 66% of controls (p = 0.011). Homograft diameter and valve orifice area were decreased significantly at one month after surgery in groups I and II (25 +/- 1 versus 18 +/- 3 mm; 25 +/- 1 versus 19 +/- 2 mm, respectively; p <0.001 both groups). Transvalvular pressure gradients significantly increased during follow up. CONCLUSION: Implantation of the SynerGraft pulmonary homograft appeared safe, and though evidence was found of a reduced immunologic response after SynerGraft implantation this (unexpectedly) did not translate into any hemodynamic advantage. Hence, factors other than rejection appear as the main contributions to the observed functional changes. 相似文献
77.
78.
79.
We report the case of a patient who developed acute transient psychosis after implantation, but not activation of pallidal
deep brain electrodes for generalised dystonia. Psychotic symptoms coincided temporally with postoperative motor improvement
induced by the microlesion effect after electode implantation. This finding suggests that the microlesion effect may not be
confined to motor improvement, but also comprises non-motor symptoms. In our case, affection of adjacent dopaminergic fibres
of passages has to be assumed. 相似文献