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A. Drake‐Lee 《Clinical otolaryngology》2002,27(5):396-402
The aims of this paper are to evaluate the training in out‐patients and in theatre after the recent changes in SpR training. A postal questionnaire was sent to 191 Specialist Registrars (SpRs) in England and Wales and 57 were returned (30%). There were temporal bone facilities within the hospital for 53 SpRs but only three used them because there were no temporal bones. Surgical training was more satisfactory than out‐patient training. Fewer general clinics and more specialized clinics are required, and consultant supervision is still patchy and needs attention. 相似文献
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运动训练联合基因治疗对肾性高血压大鼠肾功能的影响 总被引:1,自引:0,他引:1
目的观察运动训练联合β1肾上腺素能受体基因治疗对肾性高血压大鼠血压、肾功能、肾脏前肾素原mRNA、肾脏β1受体mRNA和蛋白的影响,探讨其改善肾功能的机制。方法两肾一夹法制作肾性高血压模型,基因治疗采用经鼠尾静脉注射阳离子脂质体与β1反义寡核苷酸方法。检测大鼠血压、肾功能变化。半定量RT—PCR测定肾脏β1受体mRNA、前肾素原mRNA水平。Western印迹法测检肾脏β1受体的蛋白水平。结果与模型组比较,运动联合基因治疗可使血压下降并维持4周,血压下降最高达41mmHg;尿蛋白量[(45.82±6.56)比(29.12±5.22)mg/L,P〈0.01】、BUN[(13.10±2.62)比(9.05±1.84)mmol/L,P〈0.05]显著降低(P〈0.01,P〈0.05);内生肌酐清除率显著升高(P〈0.01);前肾素原mRNA、β1受体mRNA、蛋白表达水平显著降低(P〈0.05)。结论运动训练联合β1受体反义基因治疗可以明显地降低血压,改善肾功能;且运动训练可以增强基因治疗对β1受体mRNA和蛋白的抑制作用,在转录和翻译水平抑制过度激活的β1受体的表达。 相似文献
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Aaron R Jensen Richard Milner John Gaughan Harsh Grewal 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2005,9(3):322-327
BACKGROUND: We recently implemented the use of an ex-vivo porcine model to teach residents the fundamentals of performing a laparoscopic Nissen fundoplication. METHODS: Residents were trained using intact porcine esophagus, stomach, and spleen placed in a standard video-trainer. They were later asked to complete a survey containing a course evaluation. RESULTS: Sixteen residents (R1-R4) completed the survey. They agreed that (1) the exercise was a valuable use of their limited time, (2) repeating the exercise will be of additional benefit, (3) it will improve their ability to perform or assist in an actual case in the OR, and (4) the surgical principles learned using the model will transfer to other laparoscopic cases. Significant subjective improvements were reported in resident comfort level in assisting in or performing a laparoscopic Nissen fundoplication. CONCLUSIONS: The use of an inexpensive ex-vivo porcine training model increases resident comfort level in performing a Nissen fundoplication in the operating room. 相似文献
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This paper describes a response directed stress management intervention (SMI) in the form of a Jungian based preference awareness education (PAE). It uses the Insights System of personality types to increase awareness of behaviour and communication preferences of self and different others. Eighteen self‐recruited academic employees participated for 7 weeks and received feedback about work preferences and personality type. The aim was to reduce perceptions of stress and interpersonal stress and to increase feelings of job satisfaction and interpersonal satisfaction. The data were analysed using two‐tailed t‐tests. No significant findings were observed for the total sample after training, however, interesting results were found for certain sub‐sample groups. Extravert‐thinking types, reported decreased stress levels (p > 0.018), and participants suffering high stress/interpersonal stress pre‐PAE, reported decreased stress levels (p > 0.010–0.018). Participants suffering low job/interpersonal satisfaction pre‐PAE, reported increased job satisfaction (p > 0.015–0.016). These results suggest that individuals who report high levels of stress and dissatisfaction are most likely to benefit from this type of intervention. Future PAE research might: (a) use pilot studies to meet the intervention preferences of employees that are reluctant to participate in SMIs; (b) include a wait‐list control group; use: (c) a follow up education/measures; (d) and organizational level (stressor directed) SMIs at the same time as response directed initiatives. Copyright © 2005 John Wiley & Sons, Ltd. 相似文献
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Background and objectives: To determine improvement in hand dexterity with targeted laparoscopic skill exercises desirable for use in the operating rooms among in-training laparoscopic gynaecological surgeons and medical students. Design: Cross-sectional study with paired analysis. Setting: Kiel School of Gynaecological Endoscopy and Reproductive Medicine, Germany, between February and April 2005. Subjects: Twenty third-year medical students and 20 in-training gynaecological endoscopic surgeons from various parts of the world. Interventions: Demonstration and explanation of a set of five laparoscopic skill exercises desirable for use in the operating rooms before administering a pretest. This was followed by voluntary practice of these exercises for at least 10 times over 1 day. The posttest was performed the next day once the participant was comfortable performing the skill. Pre- and posttest assessments were conducted by independent supervisors. Main outcome measures: Time to completion of tasks with minimal errors. Results: There was significant reduction in mean time for all the laparoscopic skill exercises performed with dominant, nondominant, and both hands, before and after the training and practice (p-value <0.01; paired t-test). Moderate to high correlation (0.617–0.901) was seen with the intermediate and complex/difficult tasks, whereas low correlation was seen with the simple/easy task (0.200–0.336). Medical students and gynaecologists both showed improvement in performance from pretest to posttest in terms of reduction in mean time taken to perform all the tasks with minimal errors. Conclusions: Simple laparoscopic training devices can substantially help an individual hand’s improvement and acquisition of laparoscopic skills. Simple laparoscopic training devices along with animal models will continue to provide an efficient and effective environment for learning and teaching laparoscopic surgical skills. With this training, performance improves progressively with practice. 相似文献
60.
舰艇部队军事训练伤分布特点与干预效果研究 总被引:1,自引:0,他引:1
目的:查明海军舰艇部队特殊军事训练伤的发生率和分布特征,以及施加干预措施后军事训练伤发生率的变化。方法:以整群抽样方式选取海军某舰艇部队官兵1648人,对全年军事训练伤进行前瞻性流行病学调查;以每个参试支队各抽2艘舰艇为干预试验单位,设同期对照组和历史对照组。结果:全年军事训练伤累积发生率为14.62%,时间分布以7月份为高峰;46.53%的伤者为机电部门人员;损伤部位以下肢为主,占32.64%;受伤类型以急性创伤性损伤为主;干预试验的军事训练伤发生率为8.96%,低于同期对照组(12.21%,P<0、05)和历史对照组(14.62%,P<0.01)。结论:舰艇部队军事训练伤发生情况与其它军兵种有较大的区别。施加干预措施可显著降低舰艇部队的军事训练伤。 相似文献