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101.
Summary Lipid accumulation in muscular (pulmonary, coronary and tibial) arteries and elastic (aorta and pulmonary) arteries of streptozotocin diabetic (65 mg/kg) rats was studied with an electron microscope. Arterial tissue specimens taken 4 days after the induction of diabetes showed lipid deposits in smooth muscle cells in the muscular arteries of 9 out of 24 diabetic rats, but in none of the 17 control rats. Histochemically the lipid was identified as triacylglycerol. Lipid accumulation was not seen in the elastic arteries of either diabetic or control rats. The diabetic animals with lipid deposits had slightly but significantly higher plasma glucose concentrations (p<0.02), higher non-esterified fatty acids levels (p<0.01), and lower concentrations of plasma insulin (p<0.02) than those without arterial deposits. The amount of lipid deposited in the arteries was closely related to the plasma non-esterified fatty acid level, which was in the ranges 0.8–1.1 mmol/l in diabetic rats without deposits, and 1.1–2.4 mmol/l in those with deposits. The findings suggest that lipid accumulation in smooth muscle cells of muscular arteries during acute diabetes could result from the high plasma non-esterified fatty acid concentrations.  相似文献   
102.
The aim of this study was to evaluate the use of different fixatives on the reliability of histopathological changes in a rabbit model of proliferative vitreoretinopathy (PVR). Twenty eyes from 10 rabbits were divided into four groups. The right eyes were used in two experimental groups (each n = 5), and the left, in two control groups (each n = 5). Using a newly developed scleral incision marker, an oblique scleral incision was standardized in the experimental groups, followed by intravitreal injection of 0.4 ml autologous blood and the left for wound repair for four weeks. Eyes were enucleated at four weeks. The groups differed in the type of used fixative solution (formaldehyde 4% vs. 1% buffered formaldehyde and 1.25% glutaraldehyde). The eyes were evaluated for the development of fibrosis, retinal detachment (RD), and processed for histopathology. Fibrous ingrowth of a variable degree was present in the experimental groups originating from the trauma site. Experimental eyes fixed with formaldehyde 4% had RD extension that was greater than that fixed in formaldehyde/glutaraldehyde mixture; however, the difference did not reach statistical significance (P = 0.15). This difference was not fully explained by the fibrosis which developed. In addition, in control groups, formaldehyde 4% induced a fixative-dependent retinal separation that was absent in eyes fixed with formaldehyde/glutaraldehyde mixture (P = 0.03). In conclusion, a mixture of buffered formaldehyde 1% and glutaraldehyde 1.25% combined with standardized scleral incision resulted in consistent pathological changes. A reliable PVR model is a condition sine qua non to evaluate antifibrotic treatment strategies.  相似文献   
103.
104.
Dr. S. M. Virtanen  T. Saukkonen  E. Savilahti  K. Ylönen  L. Räsänen  A. Aro  M. Knip  J. Tuomilehto  H. K. Åkerblom  R. Lounamaa  L. Toivanen  E. A. Kaprio  J. Pitkäniemi  E. Virtala  A. Fagerlund  M. v. Flittner  B. Gustafsson  C. Häggqvist  A. Hakulinen  L. Herva  P. Hiltunen  T. Huhtamäki  N. -P. Huttunen  T. Huupponen  M. Hyttinen  T. Joki  R. Jokisalo  M. -L. Käär  S. Kallio  U. Kaski  L. Laine  J. Lappalainen  J. Mäenpää  A. -L. Mäkelä  K. Niemi  A. Niiranen  P. Ojajärvi  T. Otonkoski  K. Pihlajamäki  S. Pöntynen  J. Rajantie  J. Sankala  J. Schumacher  M. Sillanpää  M. -R. Ståhlberg  C. -H. Stråhlmann  T. Uotila  M. Väre  P. Varimo 《Diabetologia》1994,37(4):381-387
Summary Associations of infant feeding patterns and milk consumption with cow's milk protein antibody titres were studied in 697 newly-diagnosed diabetic children, 415 sibling-control children and 86 birth-date-and sex-matched population-based control children in the nationwide Childhood Diabetes in Finland study. IgA and IgG antibody titres to the proteins of cow's milk formula, BLG and BSA, and IgM antibody titres to cow's milk formula proteins were measured by ELISA. Several inverse correlations were observed between the duration of breast-feeding or age at introduction of dairy products and antibody titres, and positive correlations were observed between milk consumption and antibody titres in all three populations studied. Multivariate analyses which included the infant feeding variables, milk consumption and current age simultaneously showed that the earlier the introduction of dairy products and the greater the consumption of milk was, the higher several antibody titres were. High IgA antibody titres to cow's milk formula were associated with a greater risk of IDDM both among diabeticpopulation-control and diabetic-sibling-control pairs when adjusted for other cow's milk antibody titres, dietary variables and in diabetic-sibling-control pairs also for ICA. The results suggest that young age at introduction of dairy products and high milk consumption during childhood increase the levels of cow's milk antibodies and that high IgA antibodies to cow's milk formula are independently associated with increased risk of IDDM.Abbreviations IDDM Insulin-dependent diabetes mellitus - BLG betalactoglobulin - BSA bovine serum albumin - ICA islet cell antibodies - IAA insulin autoantibodies - OR odds ratio - CI confidence interval  相似文献   
105.
106.

Context

End-stage kidney disease (ESKD) is characterized by high physical and psychological burden, and therefore, more knowledge about the palliative care provided close to death is needed.

Objectives

To describe symptom prevalence, relief, and management during the last week of life, as well as end-of-life communication, in patients with ESKD.

Methods

This study was based on data from the Swedish Register of Palliative Care. Patients aged 18 or older who died from a chronic kidney disease, with or without dialysis treatment (International Classification of Diseases, Tenth Revision, Sweden; N18.5 or N18.9), during 2011 and 2012 were selected.

Results

About 472 patients were included. Of six predefined symptoms, pain was the most prevalent (69%), followed by respiratory secretion (46%), anxiety (41%), confusion (30%), shortness of breath (22%), and nausea (17%). Of patients with pain and/or anxiety, 32% and 44%, respectively, were only partly relieved or not relieved at all. Of patients with the other symptoms, a majority (55%–84%) were partly relieved or not relieved at all. End-of-life discussions were reported in 41% of patients and 71% of families. A minority died in specialized palliative care: 8% in hospice/inpatient palliative care and 5% in palliative home care. Of all patients, 19% died alone. Bereavement support was offered to 38% of families.

Conclusion

Even if death is expected, most patients dying with ESKD had unmet palliative care needs regarding symptom management, advance care planning, and bereavement support.  相似文献   
107.
Purpose: To deliver client-centered care, physiotherapists need to identify the patients’ individual treatment goals. However, practical tools for involving patients in goal setting are lacking. The purpose of this study was to improve the frequently used Patient-Specific Complaints instrument in Dutch physiotherapy, and to develop it into a feasible method to improve physiotherapy goal setting.

Methods: An iterative user-centered design was conducted in co-creation with the physiotherapists and patients, in three phases. Their needs and preferences were identified by means of group meetings and questionnaires. The new method was tested in several field tests in physiotherapy practices.

Results: Four main objectives for improvement were formulated: clear instructions for the administration procedure, targeted use across the physiotherapy process, client-activating communication skills, and a client-centered attitude of the physiotherapist. A theoretical goal-setting framework and elements of shared decision making were integrated into the new-called, Patient-Specific Goal-setting method, together with a practical training course.

Conclusions: The user-centered approach resulted in a goal-setting method that is fully integrated in the physiotherapy process. The new goal-setting method contributes to a more structured approach to goal setting and enables patient participation and goal-oriented physiotherapy. Before large-scale implementation, its feasibility in physiotherapy practice needs to be investigated.

  • Implications for rehabilitation
  • Involving patients and physiotherapists in the development and testing of a goal-setting method, increases the likelihood of its feasibility in practice.

  • The integration of a goal-setting method into the physiotherapy process offers the opportunity to focus more fully on the patient’s goals.

  • Patients should be informed about the aim of every step of the goal-setting process in order to increase their awareness and involvement.

  • Training physiotherapists to use a patient-specific method for goal setting is crucial for a correct application.

  相似文献   
108.
109.
<正>诺卡菌在自然界分布广泛,多为腐生寄生菌[1]。诺卡菌病是由诺卡菌引起的一种急性或慢性化脓性或肉芽肿性病变[2],多由呼吸道吸入病原菌或经外伤感染引起,常见于免疫缺陷患者。与人类疾病密切相关的是星形诺卡菌和巴西诺卡菌[3]。笔者就本例巴西诺卡菌感染患者的临床资料,结合近年来诺卡菌报道相关文献进行分析,对诺卡菌的实验室鉴定、诊断及治疗总结如下。1病历资料1.1病史患者,男性,50岁,2013年1月19日入  相似文献   
110.
肝脏疾病是影响人类健康的主要问题之一。超声在肝脏弥漫性和局灶性病变诊疗中发挥着重要作用,但传统超声评估存在主观性强且提供信息有限的问题。人工智能技术因能弥补传统超声的不足而被广泛应用于肝病超声领域,其在肝脏疾病诊断、疗效评估和预后预测等领域的应用取得了显著进展。本文对近年来国内外基于超声影像的人工智能技术在肝脏弥漫性和局灶性病变诊疗中的研究进展进行综述。  相似文献   
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