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《Seminars in Fetal & Neonatal Medicine》2017,22(3):176-185
Accurate and consistent classification of causes and associated conditions for perinatal deaths is essential to inform strategies to reduce the five million which occur globally each year. With the majority of deaths occurring in low- and middle-income countries (LMICs), their needs must be prioritised. The aim of this paper is to review the classification of perinatal death, the contemporary classification systems including the World Health Organization's International Classification of Diseases – Perinatal Mortality (ICD-PM), and next steps. During the period from 2009 to 2014, a total of 81 new or modified classification systems were identified with the majority developed in high-income countries (HICs). Structure, definitions and rules and therefore data on causes vary widely and implementation is suboptimal. Whereas system testing is limited, none appears ideal. Several systems result in a high proportion of unexplained stillbirths, prompting HICs to use more detailed systems that require data unavailable in low-income countries. Some systems appear to perform well across these different settings. ICD-PM addresses some shortcomings of ICD-10 for perinatal deaths, but important limitations remain, especially for stillbirths. A global approach to classification is needed and seems feasible. The new ICD-PM system is an important step forward and improvements will be enhanced by wide-scale use and evaluation. Implementation requires national-level support and dedicated resources. Future research should focus on implementation strategies and evaluation methods, defining placental pathologies, and ways to engage parents in the process. 相似文献
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AimAppraisal of cancer trends is essential for future cancer control, but relevant studies in China are scarce due to a lack of long-term data. With 40-years of cancer registry data, we sought to evaluate secular time trends in incidence and mortality of gynaecological cancers in an urban Chinese population.Materials and methodsData on incidence and mortality of invasive cervical, uterine and ovarian cancer were collected by the Shanghai Cancer Registry. Age-standardised incidence and mortality rates were calculated for women aged 20–84 in urban Shanghai between 1973 and 2012. Age-period-cohort Poisson regression models were used to evaluate age, period and cohort effects. Overall linear trends, interpreted as the estimated annual percentage change (EAPC), were derived from the net drift in age-drift models.ResultsOverall, cervical cancer incidence and mortality substantially decreased (EAPC = −4.5% and −5.5%, respectively); however, an upward trend was apparent among younger women (age <60). Uterine cancer incidence increased slightly (EAPC = 1.8%), while mortality decreased over time (EAPC = −2.4%). Ovarian cancer incidence and mortality both increased, although the increase in incidence (EAPC = 1.8%) was larger than mortality (EAPC = 0.6%). While cohort effects were most evident for cervical cancer incidence and mortality, significant age, period, and cohort effects were found for all three gynaecological cancers evaluated.ConclusionsThese secular trends in incidence and mortality of gynaecological cancers in Shanghai likely reflect changing risk factor profiles and improved cancer prognosis over time, and suggest new priorities and call for additional efforts for gynaecological cancer prevention and control for women in China. 相似文献
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《Vaccine》2016,34(20):2299-2304
BackgroundPertussis vaccination during pregnancy can prevent 91% of infant infections. In 2015, antenatal pertussis vaccination programs were introduced across Australia.MethodsTo monitor the safety of this program, pregnant women who received trivalent influenza vaccine (TIV) and/or diphtheria-tetanus-acellular pertussis vaccine (dTpa) were surveyed by text message seven days post-vaccination about possible adverse events following immunization (AEFI). Univariate logistic regression models were used to calculate the odds of reporting an AEFI following dTpa compared to TIV. Similar analyses were used to compare AEFI reported by women who received a previous dose of dTpa in 2011/2012 as part of a state-wide cocooning program.ResultsOf 5155 women, 4347 (84.3%) replied; 10.8% indicated they experienced an AEFI. There was no difference in the proportion of women who reported any reaction by vaccine; however, women who received dTpa were more likely to report a local reaction than women who received TIV (7.1% and 3.2%, respectively; OR: 2.29; 95% CI: 1.61–3.26). There was evidence suggesting local reactions were more common among women with a previous dose of dTpa (11.4%) compared to women with no previous dose (6.0%; OR: 2.00; 95% CI: 0.95–4.25); 11 (0.3%) women reported attending a hospital emergency department. Subsequent follow-up indicated symptoms resolved and mother and infant were healthy. There was no difference in the proportion of women attending hospital by vaccine (p > 0.05).DiscussionData on systemic and local reactions following receipt of TIV and dTpa during pregnancy support the safety of antenatal vaccination. 相似文献
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Wendy F. Davidson Donald Y.M. Leung Lisa A. Beck Cecilia M. Berin Mark Boguniewicz William W. Busse Talal A. Chatila Raif S. Geha James E. Gern Emma Guttman-Yassky Alan D. Irvine Brian S. Kim Heidi H. Kong Gideon Lack Kari C. Nadeau Julie Schwaninger Angela Simpson Eric L. Simpson Marshall Plaut 《The Journal of allergy and clinical immunology》2019,143(3):894-913
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Yasutoshi?KogaEmail authorView authors OrcID profile Nataliya?Povalko Eisuke?Inoue Hidefumi?Nakamura Akiko?Ishii Yasuhiro?Suzuki Makoto?Yoneda Fumio?Kanda Masaya?Kubota Hisashi?Okada Katsunori?Fujii 《Journal of neurology》2018,265(12):2861-2874