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991.

Objective

To characterize the mechanical properties of different coating methods of DLC (diamond-like carbon) onto dental implant abutment screws, and their effect on the probability of survival (reliability).

Methods

Seventy-five abutment screws were allocated into three groups according to the coating method: control (no coating); UMS – DLC applied through unbalanced magnetron sputtering; RFPA-DLC applied through radio frequency plasma-activated (n = 25/group). Twelve screws (n = 4) were used to determine the hardness and Young’s modulus (YM). A 3D finite element model composed of titanium substrate, DLC-layer and a counterpart were constructed. The deformation (μm) and shear stress (MPa) were calculated. The remaining screws of each group were torqued into external hexagon abutments and subjected to step-stress accelerated life-testing (SSALT) (n = 21/group). The probability Weibull curves and reliability (probability survival) were calculated considering the mission of 100, 150 and 200 N at 50,000 and 100,000 cycles.

Results

DLC-coated experimental groups evidenced higher hardness than control (p < 0.05). In silico analysis depicted that the higher the surface Young’s modulus, the higher the shear stress. Control and RFPA showed β < 1, indicating that failures were attributed to materials strength; UMS showed β > 1 indicating that fatigue contributed to failure. High reliability was depicted at a mission of 100 N. At 200 N a significant decrease in reliability was detected for all groups (ranging from 39% to 66%). No significant difference was observed among groups regardless of mission. Screw fracture was the chief failure mode.

Significance

DLC-coating have been used to improve titanium’s mechanical properties and increase the reliability of dental implant-supported restorations.  相似文献   
992.

Background

Promising results of initial clinical trials with yttria-stabilized zirconia have led to more extensive use of zirconia in dental implant superstructures. The applications have extended to abutments and complex individually designed crown-abutment one-piece structures. Little is known about their clinical success and the primary cause of failures.

Purpose

The aim of this study was to identify the cause of fracture of retrieved implant-retained one-piece prostheses that failed during clinical use.

Methods

Nine fractured restorations were analyzed with fractographic methods and their fracture origins were identified.

Results

All but two of the fractures originated in an area of tight contact between the implant or titanium screw and the abutment base. Results of the evaluation showed that zirconia-based implant restorations with very thin walls in the region connecting the prosthesis to the implant are vulnerable to damage from the screw retaining process and fracture from non-axial loads. Two restorations failed due to veneer fractures.

Significance

The findings suggest that large crowns on narrow implants or implants with internal fixation should preferably not be made with zirconia abutments, or that a new design approach should be considered.  相似文献   
993.

Objectives

The purpose of this study was to estimate the fatigue life of premolars restored with two dental ceramics, lithium disilicate (LD) and polymer infiltrated ceramic (PIC) using the numerical method and compare it with the published in vitro data.

Methods

A premolar restored with full-coverage crown was digitized. The volumetric shape of tooth tissues and crowns were created in Mimics®. They were transferred to IA-FEMesh for mesh generation and the model was analyzed with Abaqus. By combining the stress distribution results with fatigue stress–life (S–N) approach, the lifetime of restored premolars was predicted.

Results

The predicted lifetime was 1,231,318 cycles for LD with fatigue load of 1400 N, while the one for PIC was 475,063 cycles with the load of 870 N. The peak value of maximum principal stress occurred at the contact area (LD: 172 MPa and PIC: 96 MPa) and central fossa (LD: 100 MPa and PIC: 64 MPa) for both ceramics which were the most seen failure areas in the experiment. In the adhesive layer, the maximum shear stress was observed at the shoulder area (LD: 53.6 MPa and PIC: 29 MPa).

Significance

The fatigue life and failure modes of all-ceramic crown determined by the numerical method seem to correlate well with the previous experimental study.  相似文献   
994.

Objective

Clasps of removable partial dentures (RPDs) often suffer from plastic deformation and failure by fatigue; a common complication of RPDs. A new technology for processing metal frameworks for dental prostheses based on laser-sintering, which allows for precise fabrication of clasp geometry, has been recently developed. This study sought to propose a novel method for designing circumferential clasps for laser-sintered RPDs to avoid plastic deformation or fatigue failure.

Methods

An analytical model for designing clasps with semicircular cross-sections was derived based on mechanics. The Euler–Bernoulli elastic curved beam theory and Castigliano’s energy method were used to relate the stress and undercut with the clasp length, cross-sectional radius, alloy properties, tooth type, and retention force. Finite element analysis (FEA) was conducted on a case study and the resultant tensile stress and undercut were compared with the analytical model predictions. Pull-out experiments were conducted on laser-sintered cobalt–chromium (Co–Cr) dental prostheses to validate the analytical model results.

Results

The proposed circumferential clasp design model yields results in good agreement with FEA and experiments. The results indicate that Co–Cr circumferential clasps in molars that are 13 mm long engaging undercuts of 0.25 mm should have a cross-section radius of 1.2 mm to provide a retention of 10 N and to avoid plastic deformation or fatigue failure. However, shorter circumferential clasps such as those in premolars present high stresses and cannot avoid plastic deformation or fatigue failure.

Significance

Laser-sintered Co–Cr circumferential clasps in molars are safe, whereas they are susceptible to failure in premolars.  相似文献   
995.

Objective

To compare mechanical performance and enamel-crack propensity of direct, semi-direct, and CAD/CAM approaches for large MOD composite-resin restorations.

Methods

45 extracted maxillary molars underwent standardized slot-type preparation (5-mm depth and bucco-palatal width) including immediate dentin sealing (Optibond FL) for the inlays (30 teeth). Short-fiber reinforced composite-resin (EverX Posterior covered by Gradia Direct Posterior) was used for the direct approach, Gradia Direct Posterior for the semi-direct, and Cerasmart composite resin blocks for CAD/CAM inlays. All inlays were adhesively luted with light-curing composite-resin (preheated Gradia Direct Posterior). Shrinkage-induced enamel cracks were tracked by transillumination photography. Cyclic axial isometric chewing (5-Hz) was simulated, starting with a load of 200 N (5000 cycles), followed by stages of 400, 600, 800, 1000, 1200, and 1400 N (maximum 30,000 cycles each) until fracture or to a maximum of 185,000 cycles. Survived specimens were subjected to cyclic-load-to-failure test at 30-degree angle on the palatal cusp.

Results

Only small shrinkage-induced cracks were found in 47% of the direct restorations compared to 7% and 13% of semi-direct and CAD/CAM inlays, respectively. Survival to accelerated fatigue was similar for all three groups (Kaplan–Meier p > .05) and ranged between 87% (direct) and 93% (semi-direct and CAD/CAM). Cyclic-load-to-failure tests did not yield significant differences either (Life Table analysis, p > .05) with median values of 1675 N for CAD/CAM inlays, 1775 N for fiber-reinforced direct restorations and 1900 N for semi-direct inlays.

Significance

All three restorative techniques yielded excellent mechanical performance above physiological masticatory loads. Direct restorations performed as good as inlays when a short-fiber reinforced composite-resin base was used.  相似文献   
996.

Objectives

To evaluate the effect of different glass-ceramic surface treatments and aging on the fatigue failure load of a lithium disilicate glass-ceramic adhesively cemented to a dentin analogue material.

Methods

One hundred and twenty (120) disc-shaped lithium disilicate specimens (Ø = 10 mm, thickness = 1.5 mm) were produced and randomly allocated (n = 20) into 6 groups, considering 2 study factors: “surface treatment” in 3 levels (SIL—silane application only; HF5+SIL—5% hydrofluoric acid etching and silane application; ME&P—etching with an one-step ceramic primer), and “storage” in 2 levels (baseline—storage for 7 days; aging—storage for 90 days + 12,000 thermal cycles). Ceramic discs were adhesively cemented to discs of a dentin analogue material (Ø = 10 mm, thickness = 2.0 mm) following the manufacturers’ instructions. The fatigue failure load was determined by the staircase approach (250,000 cycles; 20 Hz; initial load = 1050 N [~70% of mean load-to-failure]; step size = 52.5 N [5% of initial load]). Micro-morphologic, fractographic, and atomic force microscope analysis were also performed. Fatigue failure load data were evaluated by one-way ANOVA, Bonferroni and t-tests for independent samples.

Results

HF5+SIL presented higher fatigue failure load in both conditions (baseline and aging); ME&P presented intermediary mean values, while the SIL group presented the worst performance. All groups had a statistically significant decrease in the fatigue performance after aging.

Significance

Hydrofluoric acid followed by silane application showed the best fatigue performance for an adhesively-cemented lithium disilicate ceramic. Aging negatively influenced the fatigue performance for all tested groups.  相似文献   
997.
BackgroundEvidence suggests that individuals with human immunodeficiency virus (HIV) often exhibit poor physical and mental health, which contributes to a reduced Quality of Life (QoL). Yoga is a form of alternative therapy that has positive influences on general health and QoL.ObjectivesThis study examined the effects of yoga on i) anxiety, depression, and psychological well-being and ii) QoL among individuals with an HIV positive status.MethodologySixty individuals with HIV-positive (aged 30–50 years) from rehabilitation centres across Bangalore were randomly assigned to the yoga intervention group (n = 30; 11 men) or the wait-listed control group (n = 30; 10 men). Participants in the yoga group underwent 8 weeks of intense yoga practice performed an hour a day for 5 days a week. The yoga practice consisted of physical postures, breathing practices, relaxation techniques, and meditation. Participants in the wait-listed control group followed their normal routine. Anxiety, fatigue, depression, and QoL were assessed twice for all subjects in each group – once at the start of the study to establish a baseline and once more at the end of the 2-month study period to assess any changes. Data analysis was performed on the assessments using SPSS software version 10.ResultsBetween group analysis demonstrated that a significantly different reduction in anxiety (p < 0.001), depression (p < 0.001), and fatigue (p < 0.001) was observed in the yoga group compared to the control group, as well as significant improvements in well-being (p < 0.001) and all domains of QoL (p < 0.001) in the yoga group compared to the control group.ConclusionThis study indicates that yoga intervention appears to improve the psychological health and QoL of individuals who are HIV-positive. Therefore, based on these findings, yoga may be recommended as a complementary therapy to enhance conventional HIV care.  相似文献   
998.
目的:了解手术室护士的疲劳程度、个体特征对其疲劳的影响,为手术室护理管理,缓解护士职业疲劳提供理论依据。方法以随机整群抽样方式,调查长春市4所三级甲等综合医院手术室护士279人,采用一般状况调查表、疲劳评定量表收集资料。结果手术室护士职业疲劳程度处于高水平。不同性别、收入、婚姻状况、受教育情况、学历、年龄的护士所经历的疲劳差异具有统计学意义( P<0.05)。结论手术室护士是易感疲劳的群体,应根据其个体特征,有针对性地进行人员管理,缓解职业疲劳。  相似文献   
999.

OBJECTIVES:

This study was designed to assess cardiopulmonary resuscitation quality and rescuer fatigue when rescuers perform one or two minutes of continuous chest compressions.

METHODS:

This prospective crossover study included 148 lay rescuers who were continuously trained in a cardiopulmonary resuscitation course. The subjects underwent a 120-min training program comprising continuous chest compressions. After the course, half of the volunteers performed one minute of continuous chest compressions, and the others performed two minutes, both on a manikin model. After 30 minutes, the volunteers who had previously performed one minute now performed two minutes on the same manikin and vice versa.

RESULTS:

A comparison of continuous chest compressions performed for one and two minutes, respectively, showed that there were significant differences in the average rate of compressions per minute (121 vs. 124), the percentage of compressions of appropriate depth (76% vs. 54%), the average depth (53 vs. 47 mm), and the number of compressions with no errors (62 vs. 47%). No parameters were significantly different when comparing participants who performed regular physical activity with those who did not and participants who had a normal body mass index with overweight/obese participants.

CONCLUSION:

The quality of continuous chest compressions by lay rescuers is superior when it is performed for one minute rather than for two minutes, independent of the body mass index or regular physical activity, even if they are continuously trained in cardiopulmonary resuscitation. It is beneficial to rotate rescuers every minute when performing continuous chest compressions to provide higher quality and to achieve greater success in assisting a victim of cardiac arrest.  相似文献   
1000.
Alcohol consumption (quantity, frequency, and pattern) and alcoholrelated problems were determined in endometriosis patients ( n = 137), patients with other gynecological disorders ( n = 91), and normal control subjects ( n = 98). Participants completed a self-administered questionnaire, including the Michigan Alcoholism Screening Test (MAST), questions to determine the quantity and frequency of alcohol use, and questions regarding the relationship between gynecological symptoms and alcohol intake. The percentage of endometriosis patients with MAST scores greater than five or seven was significantly greater than that of normal control subjects ( p = 0.045 and p = 0.009, respectively), but did not differ from that for patients with other gynecological disorders. Endometriosis patients with high MAST scores (≥5) tended to consume more alcohol on a yearly basis than normal control subjects with high MAST scores ( p = 0.07). Among participants who experienced gynecological symptoms and were not abstainers, 31% of endometriosis patients, 9.5% of normal control subjects, and 14.3% of patients with other gynecological disorders reported increasing their alcohol consumption when experiencing gynecological symptoms. Endometriosis patients tended to differ in this regard from normal control subjects ( p = 0.058) and were significantly different from patients with other gynecological disorders ( p = 0.039). The evidence suggests that the gynecological problems of endometriosis may be a major medical correlative of alcoholism in women.  相似文献   
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