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1.
Though cerebrovascular complications of pregnancy remain relatively rare, they represent a potentially devastating event that necessitates prompt identification and treatment. Eighteen percent of strokes occurring in young women are linked to pregnancy. They occur mostly in the third trimester or during the post-partum period. Their biggest risk factors are hypertension, preeclampsia/eclampsia and migraine. Cerebrovascular events occurring during this period may involve specific pathophysiological processes that include embolic phenomena or endothelial dysfunction, but can also have common etiologies that are simply favored by the context of pregnancy. Thus, posterior encephalopathy and vasoconstriction cerebral syndrome are relatively frequently involved in cerebrovascular complications of pregnancy. Other very specific causes like amniotic fluid embolism or postpartum cardiomyopathy can also be responsible for such events. The management of stroke during pregnancy must be multidisciplinary and include a neurovascular expertise. Some conditions can lead to a long-life follow-up and modify the management of a future pregnancy.  相似文献   
2.
卒中相关性肺炎(Stroke Associated Pneumonia,SAP)是指人院时无肺部感染的卒中患者于卒中发病后发生感染性肺部炎症.SAP是卒中患者极为常见并发症之一,发生率为7%~22%,严重影响了患者的康复进程,延长了住院时间,显著增加脑卒中患者的病死率.综合相关临床研究和文献表明,引起SAP的危险因素[1]有很多,从而导致其病理学改变[2]也较其他原因导致的肺炎复杂多样.病因主要包括以下两方面:一为患者发病时的自身状况,如年龄偏大、意识障碍、吞咽障碍、脑血管病的类型及位置、呕吐或误吸、长期卧床、房颤、心功能下降、低白蛋白血症、其他基础疾病等;二为医源性因素,包括气管插管、呼吸机应用、不适宜的留置鼻饲管或留置时间较久、不合理使用抑酸剂和脱水药物、不良卧姿、口腔清洁护理不到位、不合理的应用抗生素预防或治疗等.关键词:卒中相关性肺炎;预防;预后  相似文献   
3.
Our goals were to explore whether performing computerized tomography angiography (CTA) prior to administration of tissue plasminogen activator (tPA) delays treatment and impacts outcome in patients with proximal middle cerebral artery occlusions (pMCAO). Patients with pMCAO with a National Institutes of Health Stroke scale (NIHSS) score >10 were identified from a prospective Stroke Registry. Patients underwent multi-parametric imaging studies whenever possible. Patients who underwent CTA were compared to those who only had non-contrast CT scan. Disability was measured with the modified Rankin Scale. Logistic regression was used to determine outcome modifiers. We included 73 patients (median age 73 years, 52% men) with moderate-severe stroke (median admission NIHSS 14). Of those, 44 underwent CTA and 29 did not. There were no differences between the groups in risk factor profile or baseline characteristics including stroke severity and door to needle, door to imaging or imaging to treatment times. At 90 days post-stroke there were no statistically significant differences in outcomes between the groups. On multivariate analysis, performing CTA had no impact on the chance of obtaining favorable outcome. In conclusion, CTA does not have a major impact on outcome in patients with pMCAO treated with tPA. Therefore, performing CTA should be considered on an individual basis prior to administration of tPA.  相似文献   
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5.
《Sleep medicine》2014,15(4):410-414
ObjectivePatients with sleep apnea syndrome (SAS) carry a higher stroke risk. The differential stroke risk between sex and among different age groups has not yet been specifically addressed in previous studies.MethodsUsing a universal insurance claims database, we identified a large cohort of SAS patients from 1997 to 2010 and assessed the sex- and age-specific stroke risk compared with a control cohort matched for age, sex, and index date. Cox regression analyses were performed to assess the hazard ratio (HR) of stroke and the corresponding 95% confidence interval (CI). Stroke-free probabilities were computed using the Kaplan–Meier method and differences between both cohorts were examined using the log-rank test.ResultsWe identified 29,961 patients with SAS and a control cohort of 119,844 subjects without SAS. The overall incidence of stroke in the SAS cohort was 37% higher compared to the non-SAS cohort (54.6 per 10,000 individual-years vs 39.8 per 10,000 individual-years). After controlling for sex and comorbidities, the SAS cohort exhibited a 19% higher risk for stroke compared to the control cohort (adjusted HR, 1.19 [95% CI, 1.09–1.30]). Women with SAS ages 35 years or younger had the highest stroke risk compared to older age groups of the same sex and their risk for stroke was relatively higher compared to their male counterparts.ConclusionWomen aged 35 years or younger with SAS have a higher stroke risk.  相似文献   
6.
采用FIM量表对68例急性脑卒中患者功能活动能力进行临床对照研究。两组患者在病后3月时的功能活动能力均有不同程度的改善,但康复组优于对照组(P<0.001),在恢复独立功能活动者中,康复组16例(47.06%),对照组4例(11.76%)。研究结果表明,早期康复干预有助于脑卒中患者独立功能活动能力的恢复;患者在病后1月内,FIM评定为72.25±20.96分考,经早期康复治疗有可能达到功能活动独立。  相似文献   
7.
Abstract

Numerous acute ischemic stroke trials have recently published detailed results, providing an opportunity to consider the role of collaterals in stroke pathophysiology and their influential effect on patient outcomes. Safety and Efficacy of NeuroFlo Technology in Ischemic Stroke (SENTIS), the largest randomized controlled trial of device therapy to date, tested the potential augmentation of collateral perfusion. SYNTHESIS Expansion, Mechanical Retrieval and Recanalization of Stroke Clots Using Embolectomy (MR RESCUE), and Interventional Management of Stroke (IMS) III chronicled the saga of endovascular therapy trialed against medical treatment for acute ischemic stroke. These recent randomized studies, however, largely neglect current device technology available for endovascular therapy as advanced by the TREVO2 and SOLITAIRE?TM FR With the Intention For Thrombectomy (SWIFT) studies. Such exhaustive efforts in recent trials have failed to introduce a new treatment for stroke that unequivocally improves patient outcomes. Collateral perfusion is widely recognized to vary across individuals in any population and exerts a dramatic effect on baseline variables including the time course of ischemic injury, stroke severity, imaging findings, and therapeutic opportunities. Similarly, collaterals have been recognized to influence recanalization, reperfusion, hemorrhagic transformation, and subsequent neurological outcomes after stroke. Collateral lessons may be gleaned from these trials, to expand consideration of overall study results and perhaps most importantly, alter ongoing and new trials in development. Detailed analyses of available information on collaterals from these trials demonstrate that collaterals may be more influential than the choice of treatment modality or intervention.  相似文献   
8.
老年脑卒中偏瘫患者的平衡训练   总被引:11,自引:4,他引:11  
对109例老年脑卒中偏瘫患者平衡训练进行观察,发现患者经训练后,各项能力都有明显改善。与老年前期组相比无差别。训练对恢复运动及日常生活活动很有价值。观察还表明,平衡能力由高到低呈规律性变化,对指导平衡训练及判断预后有参考作用。  相似文献   
9.
脑卒中患者步行功能的恢复   总被引:12,自引:0,他引:12  
目的:探讨康复治疗对脑卒中患者行步功能恢复的影响,方法:采用以Bobath和Brunnstrom方法为主的康复治疗技术,并配合传统按摩疗法和功能性电刺激,对急性脑卒中患者进行了临床对照性研究,对恢复期患者进行了临床观察。结果康复治疗后,病程在1个月的患者的独立步行恢复率为72.00%,与对照组(14.71%)相比差异显著(P〈0.001);恢复早期(病后1~3月)患者的独立步行恢复率为77.78%  相似文献   
10.
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