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91.
目的:探讨对头颈部动脉狭窄使用CTA与MRA诊断的效果。方法:对2019年1月-2019年12月一年时间内进行回顾性分析,选择63例我院收治的手术病理确诊为头颈部动脉狭窄的患者,对所有患者进行CTA与MRA诊断,分析CTA诊断、MRA诊断以及CTA联合MRA诊断的准确率,动脉狭窄程度检出率,以及图像的质量。结果:CTA联合MRA诊断头颈部动脉狭窄的准确率比CTA诊断、MRA诊断均较高(P<0.05),且CTA与MRA诊断没有差异(P>0.05),CTA联合MRA诊断头颈部动脉狭窄程度的准确率比CTA诊断、MRA诊断均较高(P<0.05),且CTA与MRA诊断没有差异(P>0.05),CTA与MRA诊断的图像质量没有差异(P>0.05)。结论:对头颈部动脉狭窄使用CTA与MRA诊断,可明确判断狭窄程度,诊断准确率高,图像清晰,为临床治疗提供依据,具有较高的临床诊断价值。  相似文献   
92.
MRA和CTA应用于颅内动脉瘤诊断中的比较   总被引:3,自引:0,他引:3  
目的 通过与CTA的对比研究,初步探讨MRA对颅内动脉瘤的显示能力和诊断价值。方法 对14例临床怀疑颅内动脉瘤患者进行MRA和CTA检查,后处理使用最大密度投影(MIP)和容积重建(VR)。以DSA和动脉瘤夹闭术作为参考标准,比较MRA和CTA对颅内动脉瘤的显示情况。结果 在14例中,经选择性DSA和动脉瘤夹闭术证实21个动脉瘤,其中17个动脉瘤CTA和MRA均显示良好,两种检查方法所得瘤颈宽度、瘤体最长径数值比较无显著性差异(P〉0.05)。MRA发现的颅内动脉瘤敏感性为90.5%。CTA为95.2%。结论 MRA具有无创、费用低、无并发症、无放射性损害、空间分辨率高、不用造影剂即可明确诊断的优点,在评估动脉瘤及帮助确定治疗方案等方面能满足临床的需求,可以成为临床筛查大部分颅内动脉瘤的首选方法。  相似文献   
93.
CTA、2D-DSA和3D-DSA对颅内动脉瘤的诊断价值   总被引:1,自引:0,他引:1  
徐宁  佟丹  王宏磊  王柏 《中国老年学杂志》2008,28(21):2156-2157
颅内动脉瘤是常见的一种脑血管病,致死率和病残率较高,早期诊断并处理动脉瘤是防止动脉瘤再次破裂出血的有效手段.以往对动脉瘤的诊断多通过2D-DSA来进行,近年来,随着计算机技术和设备的不断发展,CTA和3D-DSA逐渐应用于临床,在动脉瘤的诊断中发挥了巨大的作用.本文对2D-DSA、CTA和3D-DSA诊断颅内动脉瘤价值进行探讨.  相似文献   
94.
64层CT平扫及CTA对烟雾病诊断价值的探讨   总被引:1,自引:0,他引:1  
目的探讨64层CT平扫及CTA对烟雾病的诊断价值。方法回顾性分析18例烟雾病患者的临床和影像资料,全部行64层CT平扫和CTA检查,其中7例进行了DSA检查。结果CT平扫大部分脑实质出现异常密度,其中有10例表现为脑梗死,6例为脑出血及蛛网膜下腔出血,合并脑萎缩3例,合并脑软化4例,只有2例脑实质未见异常。CTA均能显示病变血管狭窄和闭塞,呈多支受累,也可见烟雾升腾的血管,与DSA所见相似。结论64层CT平扫及CTA可作为此病首选检查方法,必要时再做DSA检查。  相似文献   
95.
目的对主动脉夹层CTA的诊断及介入治疗进行探讨与分析。方法本研究共纳入研究对象60例,均为2012年6月到2014年1月我院收治的主动脉夹层患者,所有患者均经DSA抑或MR T1-FS确诊。对患者的内膜瓣、管壁增厚、夹层动脉瘤和双腔征等影像学征象进行回顾性分析。结果 60例患者中出现主动脉夹层病变的70处,其中30例前循环,40例后循环。在70处主动脉夹层病变当中,有27处内膜瓣,7处双腔征,36处血管狭窄。相比DSA诊断,通过CTA可以把23处内膜瓣显示出来,占85.2%(23/27),可把5处双腔征显示出来,占71.4%(5/7),可把34处血管狭窄显示出来,占94.4%(34/36)。而在显示主动脉夹层脉瘤和血管闭塞上差异不显著。CTA比MR T1-FS更容易把血管内膜增厚给显示出来。结论通过CTA诊断主动脉夹层,能够把多种影像学征象给清晰显示出来,包括管壁和血管腔在内的主动脉夹层,是一种有效的影像学方式,对临床上运用适当的介入治疗有着重要的指导作用。  相似文献   
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98.

Background/Objectives

Due to its rarity, epidermoid cyst in intrapancreatic accessory spleen (ECIPAS) is still a diagnostic dilemma during clinical practice. The aim of this review was to summarize the epidemiologic features and management of ECIPAS.

Methods

MEDLINE and EMBASE were searched for English articles reporting on ECIPAS up to April 30th, 2018 following the methodology suggested by the PRISMA guidelines. Categorical variables were reported as frequency and percentage. Continuous variables were reported as median (range).

Results

A total of 56 patients from 47 full articles were included for the final data synthesis. More than half of the ECIPASs (59%) were found incidentally. The female/male ratio was 1.33. ECIPAS is typically a single mono-/multi-lobular cystic lesions in the pancreatic tail with thickened cystic wall or various amount of solid component which had identical density/signal to the spleen on imaging examinations. The cyst is filled with serous or non-serous fluid. Recognition of the surrounding ectopic splenic tissue is the key point to diagnose ECIPAS. However, no preoperative examination was able to make a definite diagnosis. Almost all the patients (96%) received surgical treatment, due to the suspicion of pancreatic malignant or potentially malignant cystic tumor, especially mucinous cystic neoplasm (MCN).

Conclusions

Although seldom encountered, ECIPAS should be considered as a differential diagnosis for pancreatic cystic lesions, especially when solid component was detected. As a benign disease, unnecessary surgery should be avoided. Because it is difficult to make a definite diagnosis preoperatively by one single examination, multiple modalities may be required.  相似文献   
99.
ObjectivesThis study sought to assess the ability of a novel virtual coronary intervention (VCI) tool based on invasive angiography to predict the patient’s physiological response to stenting.BackgroundFractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) is associated with improved clinical and economic outcomes compared with angiographic guidance alone. Virtual (v)FFR can be calculated based upon a 3-dimensional (3D) reconstruction of the coronary anatomy from the angiogram, using computational fluid dynamics (CFD) modeling. This technology can be used to perform virtual stenting, with a predicted post-PCI FFR, and the prospect of optimized treatment planning.MethodsPatients undergoing elective PCI had pressure-wire–based FFR measurements pre- and post-PCI. A 3D reconstruction of the diseased artery was generated from the angiogram and imported into the VIRTUheart workflow, without the need for any invasive physiological measurements. VCI was performed using a radius correction tool replicating the dimensions of the stent deployed during PCI. Virtual FFR (vFFR) was calculated pre- and post-VCI, using CFD analysis. vFFR pre- and post-VCI were compared with measured (m)FFR pre- and post-PCI, respectively.ResultsFifty-four patients and 59 vessels underwent PCI. The mFFR and vFFR pre-PCI were 0.66 ± 0.14 and 0.68 ± 0.13, respectively. Pre-PCI vFFR deviated from mFFR by ±0.05 (mean Δ = ?0.02; SD = 0.07). The mean mFFR and vFFR post-PCI/VCI were 0.90 ± 0.05 and 0.92 ± 0.05, respectively. Post-VCI vFFR deviated from post-PCI mFFR by ±0.02 (mean Δ = ?0.01; SD = 0.03). Mean CFD processing time was 95 s per case.ConclusionsThe authors have developed a novel VCI tool, based upon the angiogram, that predicts the physiological response to stenting with a high degree of accuracy.  相似文献   
100.

Objectives

The authors sought to evaluate the plaque-modifying effects of low-dose colchicine therapy plus optimal medical therapy (OMT) in patients post-acute coronary syndrome (ACS), as assessed by coronary computed tomography angiography (coronary CTA).

Background

Colchicine therapy has been postulated to have beneficial anti-inflammatory effects in patients with ACS, translating into reduction in future adverse cardiovascular events. However, whether favorable plaque modification underpins this is yet unproven.

Methods

In this prospective nonrandomized observational study of 80 patients with recent ACS (<1 month), patients received either 0.5 mg/day colchicine plus OMT or OMT alone and were followed for 1 year. Our primary outcome was change in low attenuation plaque volume (LAPV), a marker of plaque instability on coronary CTA and robust predictor of adverse cardiovascular events. Secondary outcomes were changes in other coronary CTA measures and in high-sensitivity C-reactive protein (hsCRP).

Results

Mean duration of follow-up was 12.6 months; mean age was 57.4 years. Colchicine therapy significantly reduced LAPV (mean 15.9 mm3 [?40.9%] vs. 6.6 mm3 [?17.0%]; p = 0.008) and hsCRP (mean 1.10 mg/l [?37.3%] vs. 0.38 mg/l [?14.6%]; p < 0.001) versus controls. Reductions in total atheroma volume (mean 42.3 mm3 vs. 26.4 mm3; p = 0.28) and low-density lipoprotein levels (mean 0.44 mmol/l vs. 0.49 mmol/l; p = 0.21) were comparable in both groups. With multivariate linear regression, colchicine therapy remained significantly associated with greater reduction in LAPV (p = 0.039) and hsCRP (p = 0.004). There was also a significant linear association (p < 0.001) and strong positive correlation (r = 0.578) between change in LAPV and hsCRP.

Conclusions

Our findings suggest, for the first time, that low-dose colchicine therapy favorably modifies coronary plaque, independent of high-dose statin intensification therapy and substantial low-density lipoprotein reduction. The improvements in plaque morphology are likely driven by the anti-inflammatory properties of colchicine, as demonstrated by reductions in hsCRP, rather than changes in lipoproteins. Colchicine may be beneficial as an additional secondary prevention agent in patients post-ACS if validated in future studies.  相似文献   
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