首页 | 本学科首页   官方微博 | 高级检索  
文章检索
  按 检索   检索词:      
出版年份:   被引次数:   他引次数: 提示:输入*表示无穷大
  收费全文   22106篇
  免费   1691篇
  国内免费   596篇
耳鼻咽喉   244篇
儿科学   1073篇
妇产科学   348篇
基础医学   1975篇
口腔科学   217篇
临床医学   1956篇
内科学   5147篇
皮肤病学   237篇
神经病学   2540篇
特种医学   440篇
外科学   949篇
综合类   3170篇
一般理论   2篇
预防医学   2986篇
眼科学   382篇
药学   1137篇
  7篇
中国医学   1241篇
肿瘤学   342篇
  2023年   502篇
  2022年   1012篇
  2021年   1279篇
  2020年   1310篇
  2019年   978篇
  2018年   882篇
  2017年   935篇
  2016年   916篇
  2015年   935篇
  2014年   1724篇
  2013年   1872篇
  2012年   1321篇
  2011年   1447篇
  2010年   1137篇
  2009年   1035篇
  2008年   950篇
  2007年   876篇
  2006年   666篇
  2005年   600篇
  2004年   468篇
  2003年   511篇
  2002年   383篇
  2001年   327篇
  2000年   242篇
  1999年   201篇
  1998年   154篇
  1997年   186篇
  1996年   148篇
  1995年   123篇
  1994年   122篇
  1993年   80篇
  1992年   87篇
  1991年   80篇
  1990年   59篇
  1989年   55篇
  1988年   41篇
  1987年   53篇
  1986年   34篇
  1985年   64篇
  1984年   72篇
  1983年   52篇
  1982年   46篇
  1981年   51篇
  1980年   64篇
  1979年   52篇
  1978年   36篇
  1976年   32篇
  1973年   33篇
  1972年   25篇
  1971年   25篇
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
1.
目的分析某儿童专科医院住院患儿年龄、性别分布、各系统疾病谱顺位及其各年龄段变化趋势,为医院临床研究及疾病预防提供依据。方法回顾性分析2010年1月1日-2019年12月31日收治的743517例患儿病例资料,按年度、年龄段、性别对疾病构成进行χ2检验及构成比分析。结果住院患儿男性多于女性,男女性别比为1.99:1;2015年-2019年收治的患儿人数较2010年-2014年增长16.71%;2010年-2019年收治的住院患儿疾病谱首位为呼吸系统疾病(28%),2015年-2019年内分泌、营养和代谢疾病的疾病构成比较2010年-2014年明显增加(P<0.001);各年龄段疾病谱顺位不同;女童内分泌、营养和代谢疾病的发生率高于男童(P<0.001)。结论呼吸系统疾病仍为儿童常见病、多发病,在提高对呼吸系统疾病诊疗水平的同时,应加强对内分泌、营养和代谢疾病的防治。  相似文献   
2.
目的研究免疫学检验联合检测诊断类风湿关节炎(RA)的临床价值。方法40例进行体检的健康人员作为参照组,同期40例类风湿关节炎患者作为研究组。两组受检者均接受免疫学检验联合检测,分析检验结果。比较两组类风湿因子(RF)、抗环瓜氨酸多肽抗体(抗CCP)、抗角蛋白抗体(AKA)阳性检出率,免疫球蛋白G(IgG)、补体C3、补体C4水平。结果研究组的RF、抗CCP、AKA阳性检出率分别为85.00%、62.50%、85.00%,均高于参照组的2.50%、5.00%、0,差异具有统计学意义(P<0.05)。研究组的IgG为(15.64±4.71)g/L、补体C3为(0.68±0.25)g/L、补体C4为(0.14±0.05)g/L,参照组的IgG为(10.47±3.08)g/L、补体C3为(1.23±0.31)g/L、补体C4为(0.29±0.17)g/L。研究组的IgG高于参照组,补体C3、补体C4低于参照组,差异具有统计学意义(P<0.05)。结论采用免疫学检验联合检测诊断类风湿关节炎的准确率较高,临床可以将其作为类风湿关节炎诊断的有效方案,为患者的疾病治疗提供参考。  相似文献   
3.
In this paper, we argue that understanding and addressing the problem of poor-quality medical products requires a more interdisciplinary approach than has been evident to date. While prospective studies based on rigorous standardized methodologies are the gold standard for measuring the prevalence of poor-quality medical products and understanding their distribution nationally and internationally, they should be complemented by social science research to unpack the complex set of social, economic, and governance factors that underlie these patterns. In the following sections, we discuss specific examples of prospective quality surveys and of social science studies, highlighting the value of cross-sector partnerships in driving high-quality, policy-relevant research in this area.  相似文献   
4.
周平  陈立 《中国儿童保健杂志》2022,30(11):1208-1211
孤独症谱系障碍(ASD)是一组以不同临床表现为主要特征的神经发育性障碍。近年来,ASD儿童的发育倒退(DR)受到越来越多的关注,并被认为可能是ASD的一种特殊亚型。目前关于ASD儿童DR的影响因素尚不清楚,综合文献分析主要是由遗传、环境及其交互作用共同引起。本文拟从遗传和环境两方面对目前报道的ASD儿童DR影响因素进行总结,为该部分ASD患儿的临床早期识别和干预提供参考。  相似文献   
5.
目的 比较孤独症谱系障碍(ASD)儿童与典型发育(TD)儿童母亲的焦虑状况,探索ASD儿童情绪行为问题与其母亲焦虑水平间的关系。方法 通过临床诊断招募55名6~12岁智商≥70的ASD儿童及74名TD儿童,采用状态-特质焦虑问卷(STAI)评估入组儿童母亲的焦虑情况,采用长处与困难问卷(SDQ)评估两组儿童情绪行为问题及表现。结果 ASD儿童组母亲状态焦虑得分与特质焦虑得分高于TD组母亲(t=5.272、4.484、P<0.05),ASD儿童SDQ困难总分及多动/注意力缺陷、情绪症状、同伴交往问题及品行问题因子得分高于TD组儿童(t=10.791、7.482、4.295、12.925、3.544),亲社会行为因子分(t=5.084)低于TD组儿童,差异均有统计学意义(P<0.01)。校正混杂因素后,ASD组母亲状态、特质焦虑得分与儿童困难总分 [S-AI: β=0.83 (95%CI: 0.19~1.46); T-AI: β=0.60 (95%CI: 0.05~1.14)]、情绪症状 [S-AI: β=2.28 (95%CI:0.72~3.84); T-AI: β=2.04 (95%CI: 0.74~3.33)]存在正相关关系(P<0.05)。TD组母亲状态焦虑得分与儿童困难总分 [β=0.50 (95%CI: 0.03~0.96)]、品行问题 [β=1.74 (95%CI: 0.19~3.30)]存在正相关关系;特质焦虑得分与品行问题 [β=1.54 (95%CI: 0.09~3.00)]存在正相关关系(P<0.05)。结论 ASD儿童母亲比TD儿童母亲更容易出现焦虑。其中ASD儿童母亲的焦虑水平与儿童情绪问题有关,TD儿童母亲的焦虑水平与儿童品行问题有关。  相似文献   
6.
目的 了解稳定期慢性阻塞性肺疾病 (chronic obstructive pulmonary disease,COPD) 患者报告结局现状,分析其影响因素及与炎症指标的相关性,为开展以患者为中心的早期护理干预提供依据。 方法 采用便利抽样法,选取2020年10月—2021年7月于南宁市某三级甲等医院呼吸内科门诊就诊的稳定期COPD患者作为调查对象,采用一般资料调查表、COPD患者报告结局量表修订版 (the Modified Patient-Reported Outcome Scale for COPD,mCOPD-PRO) 进行调查,并收集患者就诊时炎症指标的结果。采用多元线性回归分析稳定期COPD患者报告结局的影响因素,采用相关性分析探讨患者报告结局与炎症指标的关系。结果 该研究共纳入204例稳定期COPD患者,mCOPD-PRO得分为 (1.75±0.58) 分。多元线性回归分析显示,性别、合并疾病数量、病程、肺功能分级是稳定期COPD患者报告结局的影响因素 (P<0.05),可解释稳定期COPD患者报告结局10.8%的总变异。相关性分析显示,白细胞计数、中性粒细胞计数、嗜酸性粒细胞计数与稳定期COPD患者的mCOPD-PRO得分呈正相关 (P<0.05) ;总白蛋白浓度与其呈负相关 (P<0.05) 。结论 稳定期COPD患者报告结局有待改善,女性、合并疾病数量>3种、病程较长、肺功能分级较高的COPD患者报告的结局较差。COPD患者报告结局与白细胞计数、中性粒细胞计数、嗜酸性粒细胞计数、总白蛋白浓度相关。护理人员应关注稳定期COPD患者报告结局及炎症指标,在早期采取针对性的干预措施,以改善患者的生活质量。  相似文献   
7.
ObjectiveTo determine the long-term cardiovascular disease risk of astronauts with spaceflight exposure compared with a well-matched cohort.MethodsNational Aeronautics and Space Administration (NASA) astronauts are selected into their profession based upon education, unique skills, and health and are exposed to cardiovascular disease risk factors during spaceflight. The Cooper Center Longitudinal Study (CCLS) is a generally healthy cohort from a preventive medicine clinic in Dallas, Texas. Using a matched cohort design, astronauts who were selected beginning April 1, 1959, (and each subsequent selection class through 2009) and exposed to spaceflight were matched to CCLS participants who met astronaut selection criteria; 1514 CCLS participants matched to 303 astronauts in a 5-to-1 ratio on sex, date of birth, and age. The outcome of cardiovascular mortality through December 31, 2016, was determined by death certificate or National Death Index.ResultsThere were 11 deaths caused by cardiovascular disease (CVD) among astronauts and 46 among CCLS participants. There was no evidence of increased mortality risk in astronauts (hazard ratio [HR]=1.10; 95% confidence interval [CI], 0.50 to 2.45) with adjustment for baseline cardiovascular covariates. However, the secondary outcome of CVD events showed an increased adjusted risk in astronauts (HR=2.41; 95% CI, 1.26 to 4.63).ConclusionNo increased risk of CVD mortality was observed in astronauts with spaceflight exposure compared with a well-matched cohort, but there was evidence of increased total CVD events. Given that the duration of spaceflight will increase, particularly on missions to Mars, continued surveillance and mitigation of CVD risk is needed to ensure the safety of those who venture into space.  相似文献   
8.
Background/PurposeA small number of Hirschsprung disease (HD) patients develop inflammatory bowel disease (IBD)-like symptoms after pullthrough surgery. The etiology and pathophysiology of Hirschsprung-associated IBD (HD-IBD) remains unknown. This study aims to further characterize HD-IBD, to identify potential risk factors and to evaluate response to treatment in a large group of patients.MethodsRetrospective study of patients diagnosed with IBD after pullthrough surgery between 2000 and 2021 at 17 institutions. Data regarding clinical presentation and course of HD and IBD were reviewed. Effectiveness of medical therapy for IBD was recorded using a Likert scale.ResultsThere were 55 patients (78% male). 50% (n = 28) had long segment disease. Hirschsprung-associated enterocolitis (HAEC) was reported in 68% (n = 36). Ten patients (18%) had Trisomy 21. IBD was diagnosed after age 5 in 63% (n = 34). IBD presentation consisted of colonic or small bowel inflammation resembling IBD in 69% (n = 38), unexplained or persistent fistula in 18% (n = 10) and unexplained HAEC >5 years old or unresponsive to standard treatment in 13% (n = 7). Biological agents were the most effective (80%) medications. A third of patients required a surgical procedure for IBD.ConclusionMore than half of the patients were diagnosed with HD-IBD after 5 years old. Long segment disease, HAEC after pull through operation and trisomy 21 may represent risk factors for this condition. Investigation for possible IBD should be considered in children with unexplained fistulae, HAEC beyond the age of 5 or unresponsive to standard therapy, and symptoms suggestive of IBD. Biological agents were the most effective medical treatment.Level of EvidenceLevel 4  相似文献   
9.
目的探讨基于Heider平衡理论的健康教育在肝癌根治术患者中的应用效果。方法采用便利抽样法,于2019年7月—2020年10月选取在山西医科大学第一医院行根治手术治疗的肝癌患者为研究对象。按照随机数字表将患者分为观察组(n=51)和对照组(n=52)。对照组给予常规护理,观察组在对照组基础上给予基于Heider平衡理论的健康教育。采用压力感知量表(PSS)、抑郁-焦虑-压力自评量表(DASS)、Mishel疾病不确定感量表评估干预的效果。结果干预2个月后观察患者PSS、DASS评分均低于对照组,差异有统计学意义(P<0.01)。干预2个月后观察组患者Mishel疾病不确定感量表总分及各维度评分均低于对照组,差异有统计学意义(P<0.01)。结论基于Heider平衡理论的健康教育可降低患者感知压力,改善患者疾病不确定感,值得临床推广应用。  相似文献   
10.
BackgroundWhile studies have demonstrated favorable outcomes in utilization of primary total shoulder arthroplasty (TSA) for the treatment of glenohumeral osteoarthritis (OA), adverse events such as infections can still occur. Periprosthetic joint infections (PJIs) are associated with worse outcomes and patient morbidity. The purpose of this study was to: (1) compare patient demographics amongst TSA patients with and without PJIs following primary TSA; and (2) identify patient-related risk factors for PJIs following primary TSA.MethodsPatients undergoing primary TSA for the treatment of glenohumeral OA were identified using the Mariner administrative claims database by CPT code 23,472. Laterality modifiers were utilized to ensure PJIs were developing in the correct laterality as those patients undergoing primary TSA. Inclusion for the study group consisted of patients who developed PJIs within 2-years after the index procedure, whereas patients who did not develop PJIs served as the comparison cohort. Primary outcomes analyzed included patient demographics and patient-related risk factors for PJIs following primary TSA. A stepwise backwards elimination multivariate binomial logistic regression analyses was performed to determine the odds (OR) of PJIs in patients undergoing primary TSA. A P value less than .05 was considered statistically significant.ResultsThe query yielded 15,396 patients who underwent primary TSA for glenohumeral OA, of which 191 patients developed PJIs and 15,205 did not develop PJIs. The study found statistically significant differences amongst patients who did and did not develop PJIs following primary TSA with respect to age, sex, and presence of comorbid conditions. Risk factors associated with developing PJIs following primary TSA included: pathologic weight loss (OR: 2.06, P < .0001), obesity (OR: 1.56, P = .0001), male sex (OR: 1.52, P = .007), and peripheral vascular disease (OR: 1.46, P = .022).ConclusionAs the number of primary TSAs for the treatment of glenohumeral OA increase worldwide, identifying modifiable risk-factors to reduce the incidence of infection is critical. The study found various modifiable and non-modifiable risk factors associated with developing PJIs following primary TSA. This study is valuable to orthopedists in order to identify and risk-stratify patients with regard to PJI in the setting of primary TSA for OA.Level of EvidenceLevel III; Case-Control Study  相似文献   
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号