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71.

Objective

To evaluate the efficacy of neurodynamic techniques used as the sole therapeutic component compared with sham therapy in the treatment of mild and moderate carpal tunnel syndromes (CTS).

Design

Single-blinded, randomized placebo-controlled trial.

Setting

Several medical clinics.

Participants

Volunteer sample of patients (N=250) diagnosed with CTS (n=150).

Interventions

Neurodynamic techniques were used in the neurodynamic techniques group, and sham therapy was used in the sham therapy group. In the neurodynamic techniques group, neurodynamic sequences were used, and sliding and tension techniques were also used. In the sham therapy group, no neurodynamic sequences were used, and therapeutic procedures were performed in an intermediate position. Therapy was conducted twice weekly for a total of 20 therapy sessions.

Main Outcome Measures

Symptom severity (symptom severity scale) and functional status (functional status scale) of the Boston Carpal Tunnel Questionnaire.

Results

A baseline assessment revealed no intergroup differences in all examined parameters (P>.05). After therapy, there was statistically significant intragroup improvement in nerve conduction study (sensory and motor conduction velocity and motor latency) only for the neurodynamic techniques group (P<.01). After therapy, intragroup statistically significant changes also occurred for the neurodynamic techniques group in pain assessment, 2-point discrimination sense, symptom severity scale, and functional status scale (in all cases P<.01). There were no group differences in assessment of grip and pinch strength (P>.05).

Conclusions

The use of neurodynamic techniques has a better therapeutic effect than sham therapy in the treatment of mild and moderate forms of CTS.  相似文献   
72.
A clinically feasible method to reliably estimate muscle–tendon unit (MTU) lengths could provide essential diagnostic and treatment planning information. A 3-D freehand ultrasound (3-DfUS) method was previously validated for extracting in vivo medial gastrocnemius (MG) lengths, although the processing time can be considered substantial for the clinical environment. This investigation analyzed a quicker and simpler method using the US transducer as a spatial pointer (US-PaP), where the within-session reliability of extracting the muscle–tendon unit (MTU) and tendon lengths are estimated. MG MTU lengths were extracted in a group of 14 healthy adults using both 3-DfUS and US-PaP. Two consecutive acquisitions were performed per participant, and the data processed by two researchers independently. The intra-class correlation coefficients were above 0.97, and the standard error of measurements below 3.6?mm (1.5%). This investigation proposes that the simplified US-PaP method is a viable alternative for estimating MG MTU lengths.  相似文献   
73.

Objective

The purpose of this review was to compare oblique pulling spinal manipulation with other treatments for lumbar disc herniation.

Methods

Randomized controlled trials of oblique pulling manipulation versus other treatment for lumbar disc herniation were identified using the following databases: China National Knowledge Infrastructure, Wanfang Data, Chinese Science and Technology Periodical Database, PubMed, the Cochrane Library, Embase, Chinese Biological Medicine, and Web of Science. Data extraction was carried out based on inclusion and exclusion criteria, and meta-analysis were performed using RevMan 5.3 software.

Results

Nine relevant randomized controlled trials with a total of 887 patients were included. Meta-analysis revealed that oblique pulling manipulation was superior in effective rate to lumbar traction (risk ratio = 1.12; 95% confidence interval [CI]: 1.06-1.19; P < .01) and acupuncture (risk ratio = 1.22; 95% CI: 1.06-1.39; P < .01) and more effective in Visual Analog Scale score (mean difference = - 1.03, 95% CI: -1.32 to -0.74; P < .01) when compared to lumbar traction. It also demonstrated a favorable effect of modified oblique pulling manipulation in Japanese Orthopedic Association scores when compared with lumbar traction (mean difference = 1.66, 95% CI: 0.89 to 2.43; P < .01).

Conclusion

In the treatment of lumbar disc herniation, oblique pulling spinal manipulation presented with a higher effective rate than acupuncture and lumbar traction. Manipulation had a favorable effect in alleviating pain, and modified oblique pulling manipulation had significant superiority in improving lumbar function when compared with lumbar traction. However, considering the low methodological quality of included studies, more rigorously designed trials should be performed in the future.  相似文献   
74.

Objective

The purpose of the study was to determine the association between trapezius muscle tenderness and tension-type headache among female office workers.

Methods

Through a questionnaire survey, 256 female office workers with tension-type headaches reported the level of palpable tenderness (“no,” “some,” or “severe tenderness”) in the trapezius muscle. The number of days with headache (“0-7,” “8-14,” or “>14”), intensity (“low,” “moderate,” or “high”), duration of headache (“<8 hours per day,” “>8 hours per day,” and “all day”), and use of analgesic medications were reported. Odds ratio (OR) for tenderness in the trapezius muscle (“no/some” vs “severe tenderness”) as a function of days with headache, intensity of headache, duration of headache, and use of analgesic medications were calculated using a binary logistic regression controlling for age and body mass index.

Results

After adjustments for confounders, a strong association was found between the level of trapezius muscle tenderness and intensity of headache (moderate intensity, OR 2.45; 95% confidence interval [CI] 1.08-5.54; high intensity, OR 7.51 [95% CI 2.65-21.29]) and days with headache (>14 days, OR 4.75 [95% CI 1.41-15.89]). No association was observed for duration of headache or use of analgesic medications.

Conclusions

For the participants studied, there was a strong association between trapezius muscle tenderness and the level of intensity and the number of days with a headache among female office workers. No association was seen for duration of headaches or use of analgesic medications.  相似文献   
75.

Objective

The purpose of this study was to compare vertebral displacements (absolute and relative) and muscle responses induced by spinal manipulative therapy of short (spinal manipulation) and long (spinal mobilization) impulse duration.

Methods

Twenty-five healthy adults (without thoracic pain) were recruited for this crossover study. Six spinal manipulative therapies (255 N peak force) of different impulse durations (100, 125, 200, 500, 1000, and 1500 ms) were delivered to each participant’s T7 transverse process using a mechanical device. Impulse duration effect on the vertebral displacement (absolute displacement of T6, T7, and T8 and relative displacement between T7 and T6 and between T7 and T8) and the thoracic muscle response (surface electromyography) were assessed using mixed-model analyses of variance and predefined linear trend analyses.

Results

Results showed a linear increase in the absolute vertebral displacement for T8 (P = .002) and a linear decrease in the T7/T6 and T7/T8 relative displacement (P < .0001) when impulse duration was increased. The data of 24 participants were available for electromyography analysis. A significant main effect of impulse duration on surface electromyography response was observed (P < .0001, ?p2=0.43). Planned comparisons for a linear trend between these variables revealed a negative relationship (P < .0001). Only 13 of the 24 participants with available data presented a muscle response at every impulse duration.

Conclusion

These results support the assumption that spinal manipulation and spinal mobilization might operate under distinct mechanisms.  相似文献   
76.

Objective

The purpose of this study was to determine the prevalence of musculoskeletal disorders among Iranian physical therapists.

Methods

A cross-sectional study was carried out. An online survey was completed by Iranian physiotherapists from June 2017 to August 2017. A total of 333 online questionnaires were sent, and 319 questionnaires were fully completed and used for data analysis. The Persian version of the Nordic Questionnaire was the main outcome measurement. This questionnaire identified work-related pain or discomfort in 9 parts of the body, including: (1) neck, (2) shoulder, (3) elbow, (4) wrists, (5) upper back, (6) lumbar, (7) thighs, (8) knee, and (9) ankle.

Results

The findings of this study showed the prevalence of musculoskeletal disorders was 94% in Iranian physiotherapists. Lumbar (65%), neck (57.4%), shoulder (50.2%), upper back (49%), and knee (45.5%) were the most prevalent regions of these disorders. While ankle (19.7%) and elbow (21.6%) disorders showed the lowest prevalence.

Conclusion

The prevalence of work-related musculoskeletal disorders was high in Iranian physiotherapists, especially in the lumbar, neck, shoulder, and upper back regions.  相似文献   
77.
目的了解某化工企业工人MSDs患病情况及其影响因素。方法采用整群抽样方法,在某化工企业采用经修改的北欧国家MSDs标准调查表对593名化工工人进行横断面调查,得到有效问卷538份。结果该化工企业工人腰部MSDs患病最为严重,年患病率达67.60%,其次为肩(62.41%)和颈(61.87%)部,多部位发生MSDs构成比为76.64%。不同年龄、学历、婚姻、休息状况、工作环境、工作满意、工作疲劳程度、工种、工龄(除踝外)、以及人员是否短缺(除颈、髋臀外)、是否有加班(除颈、腰外)组间,各部位MSDs年患病率差异均有统计学意义(P0.01或P0.05);患病部位数女性大于男性,差异有统计学意义(t=-4.066,P﹤0.01),女性颈、肩、腰、髋臀、膝部患病率高于男性。对MSDs患病率最高的腰部进行危险因素回归分析表明,工作时弯腰转身同时存在、长时间统一姿势工作、短时间做大力气动作、用手或胳膊做出很大的力气、推拉5kg重物、工作时大幅度弯腰、手保持在肩及以下、用手捏住物体均可增加腰部MSDs患病率(P﹤0.01),前4项以及性别、工作疲劳和工作不满意OR值均2,可认为是化工工人腰部MSDs危险因素。对工作不满意者多部位MSDs患病风险是满意者10.86倍,50岁以上是30岁以下10.64倍,女性是男性6.81倍,长时间统一姿势工作对多部位MSDs患病影响也较明显,OR值达5.98。结论化工工人MSDs患病率较高,并以腰、肩、颈部为主,年龄、学历、婚姻、性别等个体因素,工作不满意、疲劳等心理因素,工龄、工种、工作环境等职业因素以及休息状况、人员短缺、加班等工作组织因素是导致化工工人各部位MSDs患病的危险因素。性别、工作时弯腰转身同时存在、长时间同一姿势工作、短时间做大力气动作等是影响腰部MSDs患病的危险因素。工作不满意、年龄、性别以及长时间统一姿势是导致多部位患病的危险因素。  相似文献   
78.
《Radiologia》2022,64(6):566-572
Elastography is a novel imaging technique based on ultrasound that evaluates the deformability of tissues to help characterize lesions. It is widely used and has been validated in many tissues (e.g., liver, breast, thyroid). It is also used in the study of musculoskeletal disease. Although the use of elastography in musculoskeletal radiology is limited by the variability and heterogeneity of tissues, it is a very promising technique. In this article, we aim to review the usefulness, possible indications, limitations, and future perspectives of this technique in musculoskeletal radiology.  相似文献   
79.
Evidence for electrogenic Na+ pumping in human atrial myocardium   总被引:1,自引:0,他引:1  
The resting potential of "sodium-loaded' cardiac cells can transiently hyperpolarize to levels negative to the steady state resting potential [3,5,6]. Hyperpolarization is associated with the coupled efflux of Na+ and influx of K+ driven by an active transport process and may result from an increased K+ equilibrium potential (EK), an outward pump current or both. Using conventional microelectrode techniques, we found that Na+-loaded human atrial myocardium can also transiently hyperpolarize. Na+ loading was induced by cooling to 2 degrees to 3 degrees C. Upon rewarming to 37 degrees C in a 20 mM K+ solution, the resting potential transiently hyperpolarized to levels at least 11 mV negative to the calculated EK and 29 +/- 2 mV (mean +/- S.E.) negative to the steady state level (- 33 +/- 2 mV) recorded some 15-20 minutes later. An increase in K+ conductance induced by acetylcholine exposure [2,7,10] during the transient hyperpolarization caused a depolarization, indicating that the resting potential was indeed negative to EK. These findings cannot be explained by either conductance changes or electroneutral Na+ pumping and concomitant extracellular K+ depletion. We conclude that the Na+-loaded human atrium can generate net pump current.  相似文献   
80.
The Disrupted-in-Schizophrenia 1 (DISC1) gene plays a role in the regulation of neural development. Previous evidence from genetic association and biological studies implicates the DISC1 gene as having a role in the pathophysiology of schizophrenia. In the present study, we explored the association between DISC1 missense mutation rs821616 (Ser704Cys) single nucleotide polymorphism (SNP) and four other SNPs (rs1772702, rs1754603, rs821621, rs821624) in the related haplotype block and schizophrenia in the Japanese population. We could not find a significant association of selected SNPs with schizophrenia after correction for multiple testing. We performed a meta-analysis of the Ser704Cys variant in schizophrenia using data from the present study and five previous Japanese population studies, and found no association with schizophrenia. We also examined DISC1 immunoreactivity in postmortem prefrontal cortex specimens of schizophrenia patients compared to control samples. The immunoreactivity revealed a significant decrease of DISC1 protein expression in the schizophrenia samples after ruling out potential confounding factors. However, the Ser704Cys variant did not show effects on DISC1 immunoreactivity. These results provide evidence that this functional genetic variation of DISC1 do not underlie the pathophysiology of schizophrenia in the Japanese population.  相似文献   
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