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81.

Aim

The purpose of this study is to find out whether telephone referral from Primary Health Care to Internal Medicine Consult manages to reduce waiting days as compared to traditional referral. This study also aims to know how acceptable is the telephone referral to general practitioners and their patients.

Design

No blind randomized controlled clinical trial.

Setting

Northern Huelva Health District.

Participants

154 patients.

Interventions

Patients referrals from intervention clinicians were sent via telephone consultation, whereas patients referrals from control clinicians were sent by traditional via.

Measurements

Number of days from referral request to Internal Medicine Consult. Number of telephone and traditional referrals. Number of doctors and patients denied. Denial reasons.

Results

A statistically significant difference was found between groups, with an average of 27 (21-34) days. Among General Practitioners, 8 of the first 58 total doctors after randomization and, subsequently, 6 of the 20 doctors of the test group refused to engage in the trial because they considered “excessive time and effort consuming”. 50% of patients referred by the 14 General Practitioners finally randomized to the intervention group were denied referral by telephone due to patient's complexity.

Conclusions

Telephone referral significantly reduces waiting days for Internal Medicine consult. This type of referral did not mean an “excessive time and effort consuming” to General Practitioners and was not all that beneficial to complex patients  相似文献   
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Objective

To analyse and understand vaccination hesitancy discourses, particularly those of people who have decided not to vaccinate their sons and daughters.

Methods

Qualitative study of five individual interviews and two focus groups with people who chose not to vaccinate their children in the province of Granada (Spain).

Results

Mothers and fathers manifest a system of health beliefs different to the biomedical paradigm. From an ethical point of view, they justify their position based on the right to autonomy and responsibility for their decisions. Alleged specific reasons: they doubt administration of several vaccines simultaneously at an early age in a systematic way and without individualising each case; they fear adverse effects and do not understand the variations of the vaccination schedule.

Conclusions

These vaccination hesitancy discourses respond to the individual vs collective conflict; parents defend their right to bring up their children without any interference from the state and focus their responsibility on the individual welfare of their sons and daughters, regardless of the consequences that their actions might have on the collective. In their management of risks, they consider those derived from vaccination more relevant than the individual or collective consequences of not doing so. The vaccines generating most doubts are the more controversial ones within the scientific world. Transparency in communication of adverse effects; authorities respect for other health/disease concepts; banishment of the term “anti-vaccines” from the media and scientific vocabulary, and developing spaces for dialogue are bridges to be built.  相似文献   
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近代著名外交家、法学家伍廷芳撰写了一部养生学著作《延寿新法》,其版本众多,以南京中医药大学图书馆馆藏抄本为善。《延寿新法》一书从生理、饮食、睡眠、阳光、衣着、气象、风俗、烟酒、运动等方面详论养生延年之法。在“西学东渐”的时代背景下,《延寿新法》的养生思想折射出中西医交流的历史痕迹。  相似文献   
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刘秀芳  刘丽  周郁秋 《中国全科医学》2020,23(15):1916-1920
背景 痛风是一种代谢性疾病,可以并发肾、心脑血管等多器官疾病,目前痛风发病和预后的影响因素已经得到揭示,但鲜有通过质性研究方法全面评估痛风患者的疾病认知和健康素养状态。目的 探讨东北地区中青年痛风患者的健康素养,并了解痛风患者的一般感知能力及知识需求状况,为增强我国痛风患者的健康素养水平,改善其自身管理能力、提高痛风患者的生活质量提供理论依据。方法 招募2017年3月-2018年3月于大庆油田总医院、大庆市人民医院、大庆市第五医院3家医院确诊为痛风的中青年患者,信息饱和后停止招募,共招募13例患者。采用非结构式与半结构式访谈相结合的方式对患者资料进行收集,采用Colaizzi的现象学资料分析方法进行分析。结果 对访谈资料进行分析,提炼如下主题:痛风患者的疾病感知能力〔包括对痛风的认知及知晓情况较差;严重的疼痛可影响痛风患者的生活质量;自我感知导致疾病发作或加重的原因为饮食习惯及生活方式等〕、就诊状况及行为(包括首次发病对疾病认识缺乏;就医体验不良)、痛风药物管理计划(包括药物选择依从性低、治疗方案的知晓及应对差)、痛风非药物管理计划(包括生活方式的调整、社会资源互动、疾病信息挖掘)。结论 东北地区中青年痛风患者健康素养水平较低,对疾病相关信息获取途径单一,对疾病和治疗判断片面,因此不能有效进行疾病管理,阻碍医疗决策制定。提示根据需求状况、针对具体薄弱环节提升痛风患者的健康素养、提高知识水平对改善患者健康结局很有必要。  相似文献   
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BackgroundGrowing research documents associations between neighborhood social cohesion with better health and well-being. However, other work has identified social cohesion's “dark side” and its ability to promote negative outcomes. It remains unclear if such diverging findings are attributable to differences in study design, or other reasons. To better capture its potential heterogeneous effects, we took an outcome-wide analytic approach to examine perceived neighborhood social cohesion in relation to a range of health and well-being outcomes.MethodsData were from 12,998 participants in the Health and Retirement Study—a large, diverse, prospective, and nationally representative cohort of U.S. adults age >50. Multiple regression models evaluated if social cohesion was associated with physical health, health behavior, psychological well-being, psychological distress, and social well-being outcomes. All models adjusted for sociodemographics, personality, and numerous baseline health and well-being characteristics. To evaluate the effects of change in cohesion, we adjusted for prior social cohesion. Bonferroni correction was used to account for multiple testing.ResultsPerceived neighborhood social cohesion was not associated with most physical health outcomes (except for reduced risk of physical functioning limitations and better self-rated health) nor health behavior outcomes (except for more binge drinking). However, it was associated with numerous subsequent psychosocial well-being (i.e., higher: positive affect, life satisfaction, optimism, purpose in life, mastery, health mastery, financial mastery; reduced likelihood of infrequent contact with friends) and psychological distress outcomes (i.e., lower depression, hopelessness, negative affect, loneliness) over the 4-year follow-up period.ConclusionsWith further research, these results suggest that perceived neighborhood social cohesion might be a valuable target for innovative policies aimed at improving well-being.  相似文献   
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Disseminating research findings from global health collaborations is essential to advancing science. However, there are a number of ethical considerations and potential challenges to address to ensure thoughtful and non-exploitative reporting. The factors include the benefits and risks to publication, authorship criteria or values, and the accessibility of forums or journals in which to pursue publication. This paper provides commentary related to planning for writing, communicating intentions to publish, obtaining permissions to publish, risks in internationally collaborative work, authorship principles, and journal selection. Authors' and editors’ knowledge of experienced individuals from both pharmacy literature, medical fields, and general publications is incorporated to provide an assessment of risks and benefits of publication of international global health research.  相似文献   
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