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71.
《The Foot》2021
BackgroundSeveral outcome scores are used to assess the outcome of ankle surgery, but many are not validated and there is currently no ‘gold-standard’. Consequently, there is demand to develop a new ‘gold-standard’ score to assess ankle surgery. The study aim was to review existing scores to develop and validate a new patient-reported outcome measure (PROM) to assess the outcome of operative ankle surgery.MethodsThe questionnaire items covered three areas: pain, symptoms and activity. The scale was reviewed by a patient group, resulting in the Oswestry Ankle score (Os-Ankle). The Os-Ankle was validated using a cohort of 206 patients at both pre-operative and post-operative stages of ankle surgery. Patients provided two other outcome scores, the scores currently used at our centre: the Manchester-Oxford Foot Questionnaire (MOxFQ) and the Veterans Rand-12 (VR-12). Factor analysis and Rasch were determined to assess the psychometric testing and design of the Os-Ankle score. A follow up paper assesses the validity of the Os-Ankle against two existing scores.ResultsResults of the factor and Rasch analysis suggested that 12-items should be removed. The remaining 18-items fitted the Rasch model well, suggesting good internal consistency.ConclusionA new ankle PROM, the Os-Ankle, was successfully developed and demonstrated good psychometric testing. The Os-Ankle evaluates pain, symptoms and activities and results in a single score. The Os-Ankle has been validated in our follow up paper, and is ready to be implemented by ankle clinicians to monitor clinical outcomes. With the publication of two back to back papers, it will allow for further engage with other clinicians and other centres.Level of evidenceLevel II, prospective comparative study. 相似文献
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目的 为提高人工种植天麻的质量,基于Group-Lasso变量筛选构建随机森林回归模型分析影响天麻品质形成的关键因子。方法 基于Group-Lasso法,对2007—2022年天麻质量研究文献中天麻素含量及产地环境变量等数据进行变量筛选,并在筛选出的变量基础上建立随机森林回归模型及计算变量重要性得分。结果 最终选择了产区、生长状况、种质类型、产地气候类型、产地土壤类型、最热月均温、产地年降水量、产地年日照时数和无霜期9个变量,基于被选变量与天麻素含量建立随机森林回归模型,模型的均方误差(mean square error,MSE)和平均绝对百分误差(mean absolute percentage error,MAPE)分别为0.103 2和14.08%,特征重要性排序显示天麻素含量的最大影响因素是产地年降水量,其次是产地土壤类型、无霜期和产地年日照时数。结论 随机森林回归模型有相对较低的误差和较高的预估精度,更适合用于对天麻种植环境的分析和天麻素含量的估算,为人工种植天麻提供参考。 相似文献
74.
Christopher Bush Joel J Gagnier James Carpenter Asheesh Bedi Bruce Miller 《World journal of orthopedics》2021,12(4):223-233
BACKGROUNDPrevious studies have shown that non-surgical management can be an effective treatment strategy for many patients with rotator cuff tears. Despite the prevalence of rotator cuff disease, few studies have examined the patient and tear related factors that predict outcomes of nonsurgical management in this cohort of patients.AIMTo identify factors that are associated with changes in patient reported outcomes over time in individuals with full-thickness rotator cuff tears treated without surgery. METHODSA cohort of 59 patients who underwent non-surgical management of full thickness rotator cuff tears with a minimum of 1-year follow-up were identified from our institutional registry. Patient demographics, comorbidities and tear characteristics were collected at initial presentation. Outcome measures were collected at baseline and at each clinical follow-up, which included Western Ontario Rotator Cuff (WORC) index, American Shoulder and Elbow Surgeons score, Visual Analog Scale for pain and Single Assessment Numerical Evaluation. Multi- and univariate regression analyses were used to determine the impact of each patient and tear related variable on final WORC scores and change in WORC scores throughout the study. RESULTSIn this non-surgical cohort, all patient-reported outcome measures significantly improved compared to baseline at 1 and 2-year follow-up. There was no significant difference in outcomes between 1 and 2 years. The average improvement surpassed the published minimal clinically important differences values for WORC, American Shoulder and Elbow Surgeons, Visual Analog Scale pain and Single Assessment Numerical Evaluation scores. Regression analysis identified female gender (β = - 19.88, P = 0.003), smoking (β = -29.98, P = 0.014) and significant subscapularis fatty infiltration (β = -15.35, P = 0.024) as predictors of less favorable WORC scores at 1 year, and female gender (β = -19.09, P = 0.015) alone as a predictor of lower WORC scores at 2 years. Patients with symptom duration greater than 1 year at presentation reported less improvement in WORC scores at 1-year follow-up (β = -14.63, P = 0.052) and patients with traumatic tears reported greater improvements in WORC scores at 2-year follow-up (β = 17.37, P = 0.031). CONCLUSIONPatients with full thickness rotator cuff tears can achieve and maintain clinically meaningful benefit from non-surgical management through 2-year follow-up. Female patients, smokers, and those with significant subscapularis fatty infiltration tend to have lower overall WORC scores at 1-year follow-up, and females also have lower WORC scores at 2-year follow-up. Patients presenting with symptoms greater than 1 year had less clinical improvement at 1-year follow-up, and those with traumatic tears had greater clinical improvement at 2-year follow-up. 相似文献
75.
Elissa M. Abrams 《Canadian journal of public health. Revue canadienne de santé publique》2021,112(2):289
There is now level one evidence based on randomized controlled trials that early ingestion of allergenic solids in infancy has a preventive effect against food allergy development. As a result, guidelines now recommend early ingestion of allergenic solids as a means of food allergy prevention. However, guidelines in Canada currently focus this intervention specifically on infants at risk, defined currently as an infant who has a history of atopy such as eczema or food allergy, or who has an immediate family history of atopy. However, this definition fails to account for studies supporting early ingestion as a preventive measure within the broader population. Not all of these risk factors (such as immediate family history of atopy) are consistently supported by the literature to date. Finally, a more universal approach to food allergy prevention simplifies the message, decreases stigmatization, and reduces medicalization of infant feeding. It also has the potential to reduce reticence to feed in infancy. The goal of this commentary is to argue that food allergy prevention guidelines should focus their interventions on the broader population and not just those defined as at higher risk. 相似文献
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乙型肝炎病毒基因重组(CHO)疫苗阻断母婴传播的研究 总被引:1,自引:0,他引:1
目的:研究乙型肝炎病毒基因重组(CHO)疫茵对HBsAg和HBeAg双阳性母亲所生婴儿的阻断效果。方法:选70例生于母亲为HBsAg和HBsAg双阳性的婴儿,随机分为A组(31例)和B组(39例),A组为单纯疫苗组,注射3次疫苗(0、1、6月,10μg/次);B组为疫苗加乙肝免疫球蛋自(HBIG)组,注射3次疫苗(同A组),并于出生时注射半支(50IU)HBIG。全程2~6个月采血,用固相放射免疫(RIA)法检测抗-HBs、HBsAg和抗-HBc。结果:抗抗-HBs阳转率为83.87%,阻断率为83.87%,疫苗加半量乙肝免疫球蛋白(50IU)组分别为93.10%和93.59%。结论:乙肝基因重组(CHO)疫苗有良好的阻断乙肝母婴传播的效果,如果出生时加注半支HBIG效果更好。 相似文献
79.
论数字化图书馆 总被引:2,自引:0,他引:2
王彤 《山东医科大学学报(社会科学版)》2000,(2)
数字化图书馆是 2 1世纪高速网络环境下图书馆发展的方向和主流。本文论述了数字化图书馆的概念、意义及其优越性 ,分析了当前我国数字图书馆发展存在的问题 ,并提出了我国数字图书馆建设的发展措施 相似文献
80.