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1.
目的探讨低分子量肝素在子痫前期患者中的应用效果。方法回顾性调查我院2019年1~4月290例子痫前期患者,根据产后1 d采用的治疗方法分为肝素组(190例)及对照组(100例),分析比较两组的一般资料和凝血指标差异。结果肝素组的新生儿体重和Apgar评分(1 min)低于对照组(P<0.05)。肝素组与对照组在产前仅凝血酶时间、D-二聚体、血小板体积分布宽度有差异,产后1 d肝素组纤维蛋白原含量、血小板计数、血小板压积低于对照组,凝血酶时间、D-二聚体、血小板体积分布宽度高于对照组(P<0.05)。产后3 d仅D-二聚体有差异。结论在产后1 d应用低分子量肝素有助于子痫前期患者产后凝血状态向正常恢复。  相似文献   
2.
Preeclampsia is a multifactorial vascular disease unique to human pregnancy. While genetic and antiangiogenic factors are important contributors to preeclampsia susceptibility, recent studies have shown that dysregulation and/or over-activation of the complement system has an integral role in disease etiology. Furthermore, the role of the coagulation cascade may be underappreciated in the development of the disease. Traditionally, for research purposes, the pool of preeclampsia cases has been divided into non-severe and severe disease depending on the onset and severity of the symptoms. However, of particular interest are a small but important minority of cases that present with symptoms likening to those of hemolysis, elevated liver enzymes and low platelets syndrome, atypical hemolytic uremic syndrome, or thrombotic thrombocytopenic purpura, all thrombotic microangiopathy (TMA) diseases, with the hallmark mechanisms of endothelial dysfunction and aberrant activation of complement and coagulation cascades. We therefore propose a third class, severe TMA-like preeclampsia to be included in the categorization of preeclampsia patients. Identifying these patients would target research, diagnostic differentiation, and novel treatment options to the subclass of patients with life-threatening disease that are most likely to benefit from next-generation drug development.  相似文献   
3.
Preeclampsia is a disease with a significant incidence worldwide that is directly associated with 15% of maternal deaths. This is usually characterized by the presence of hypertension and proteinuria, which manifests itself from the middle of pregnancy. MicroRNAs are single-stranded RNA molecules that act primarily by degrading transcribed messenger RNA or inhibiting microRNA translation. Placental microRNAs play a role in the growth and function of the placenta, their potential use as diagnostic biomarkers is considered feasible due to the ability to enter the maternal circulation and be detectable in maternal plasma.  相似文献   
4.
The Ostheimer lecture is given each year at the annual meeting of the Society for Obstetric Anesthesia and Perinatology. It summarizes “What’s New in Obstetric Anesthesia” based on a systematic evaluation of the relevant literature published in the previous calendar year. In this review I consider studies published in 2016 focused on the prevalence of, and risk factors for, maternal morbidity and mortality. I also discuss novel therapeutic approaches to the prevention and treatment of major sources of maternal morbidity and mortality.  相似文献   
5.
目的探讨体外受精与胚胎移植(in vitro fertilization-embryo transfer, IVF-ET)术后单胎妊娠与子痫前期的关系及临床特点。 方法回顾性分析2012年6月至2018年12月郑州大学第一附属医院产科收治的通过IVF-ET受孕的单胎子痫前期患者58例(IVF-ET组),同期自然受孕的单胎子痫前期患者100例(自然受孕组)的临床资料。比较两组孕妇的临床特点和妊娠结局。 结果IVF-ET组患者的平均住院日(8.74±4.98) d较自然受孕组(7.26±3.07) d长,t=-2.314,P<0.05;发病时间(28.6±5.63)周和诊断孕周(32.0±6.07)周均早于自然受孕组(28.6±5.63)周和(33.9±4.28)周,t=4.02和2.04,P<0.05;IVF-ET组尿蛋白(+++)的发生率34.5%、胸腹水发生率48.3%、胎儿宫内生长受限发生率41.4%均高于自然受孕组20%,29%和26%,P<0.05。 结论IVF-ET术后单胎子痫前期患者以严重尿蛋白和胸腹水为主要临床症状,胎儿不良结局主要为胎儿宫内生长受限。  相似文献   
6.
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7.
Introduction: Preeclampsia is a disease specific to pregnancy characterised by new onset hypertension with maternal organ dysfunction and/or fetal growth restriction. It remains a major cause of maternal and perinatal morbidity and mortality. For fifty years, antihypertensives have been the mainstay of treating preeclampsia, reducing maternal morbidity and mortality. With increased knowledge of the mechanisms underlying the disease has come opportunities for novel therapies that complement antihypertensives by protecting the maternal vasculature.

Areas covered: In this review, the authors consider, in detail, the antihypertensives commonly used today in the emergency care of women with severe preeclampsia. They also review less common anti-hypertensive agents and discuss the role of magnesium sulphate in the management of preeclampsia and the prevention of eclampsia. Finally, they explore novel therapeutics for the acute management of preeclampsia.

Expert opinion: The rapid control of maternal hypertension will, and must, remain the mainstay of emergency treatment for women with severe preeclampsia. The role of magnesium sulphate as a primary prevention for eclampsia is context dependant and should not displace a focus on correcting blood pressure safely. The exploration of novel adjuvant therapies will likely allow us to prolong pregnancy longer and improve perinatal outcomes safely for the mother.  相似文献   

8.
Introduction: Preeclampsia (PE) is a systemic inflammatory disease, and its effect on human milk immune components is poorly understood.

Objective: To investigate whether PE affects human milk cytokine levels.

Methods: This was a prospective observational study involving mothers diagnosed with PE and with singleton pregnancy with no fetal malformation. The following cases were excluded: diabetes, chorioamnionitis, use of illicit drugs and alcohol, mastitis and congenital infection. In total, 228 mothers were studied and divided into two groups matched by gestational age: PE (n?=?114) and normotensive (control, n?=?114). Colostrum was collected from 24–72?hours postpartum, and mature milk was collected at the end of the first month. Cytokines (IL-1β, IL-6, IL-8, IL-10, IL-12, and TNF-α) were measured using flow cytometry. A generalized linear model with a gamma distribution was used to analyze the differences between groups versus time interaction.

Results: The mean gestational age was 36 weeks. Increased IL-1 and IL-6 levels and reduced IL-12 levels in the colostrum were detected in PE, while in the mature milk, the IL-6 and IL-8 levels were lower than those of the control group.

Conclusions: PE is associated with increased levels of inflammatory cytokines in colostrum and decreased levels in mature milk.  相似文献   
9.
The role of angiogenic factors in the onset of clinical manifestations of preeclampsia was demonstrated in 2003 by the implication of sFlt-1, PlGF and VEGF, and in 2006 by the implication of soluble endoglin. Placental ischemia and inflammation observed in preeclampsia alter both the production and progression of angiogenic factors during pregnancy. During the first trimester, the combination of PlGF with clinical, biophysical and biological factors results in a better test than the conventional one. However, the clinical value of this method remains to be confirmed. During the second and third trimesters, the sFlt-1/PlGF ratio may be used, with or without pre-existing renal disease, for short-term prediction, diagnosis, and prognosis, and to evaluate the effectiveness of preeclampsia treatment. While a sFlt-1/PlGF ratio < 38 and ≤ 33, respectively, rules out the short-term onset and diagnosis of preeclampsia, a sFlt-1/PlGF ratio ≥ 85 between 20 and 34 weeks of pregnancy and ≥ 110 beyond 34 weeks of pregnancy confirms a diagnosis of preeclampsia. Angiogenic and non-angiogenic preeclampsia are identified by a sFlt-1PlGF ≥ 85 and < 85, respectively, with the risk of maternal and fetal complications at two weeks differing between the two. Similarly, a sFlt-1/PlGF ratio > 665 and > 205, respectively, is a good short-term predictor of adverse outcomes of early and late-onset preeclampsia. These values could be incorporated into future guidelines for better clinical management of preeclampsia.  相似文献   
10.
目的分析妊娠期脂代谢异常与子痫前期发生的关系。方法回顾性选取2019年1月至2020年1月于新疆医科大学第一附属医院产检并分娩的53例子痫前期产妇作为观察组,并选取同期医院产检并分娩的53例正常产妇作为对照组。记录两组产妇妊娠早、中、晚期的脂代谢指标,分析其与子痫前期发生的关系。结果两组早、中、晚期的甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平比较,差异具有统计学意义(P<0.001);进一步两两比较发现,两组晚期TG、HDL-C、LDL-C分别与两组早期及中期比较,差异具有统计学意义(P<0.001),两组中期TC与观察组早期及对照组晚期比较,差异具有统计学意义(P<0.001),但观察组中期与晚期TC及对照组早期与中期TC比较,差异无统计学意义(P>0.05)。经Logistic回归分析结果显示,不同妊娠期脂代谢水平与子痫前期的发生有关,妊娠早、中、晚期TG、TC、LDL-C升高及HDL-C降低可能是子痫前期发生的风险因子(P<0.05);绘制受试者工作特征(ROC)曲线结果显示,妊娠早、中、晚期TG、TC、HDL-C、LDL-C水平预测子痫前期发生风险的AUC均>0.80。结论妊娠期血脂代谢水平异常与子痫前期的发生有关,可能是产妇发生子痫前期的风险因子。  相似文献   
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