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1.
The prevalence of infertility among the population of reproductive age continues to increase year after year in Western societies and the therapeutic resource in most cases will be assisted reproductive techniques, mainly in vitro fertilization. Although the advances made in vitro fertilization have had an undeniable impact on the chances of achieving pregnancy, the efficiency of the technique, in global terms, remains low. One of the factors with the greatest impact on in vitro fertilization results is embryo selection. That is why among the main future challenges that arise in the field of assisted human reproduction, is that of obtaining reliable embryo selection methods that allow the transfer of the embryo with greater competence to implant. In this article, the different embryo selection methods used in in vitro fertilization are reviewed.  相似文献   
2.
目的观察揿针耳穴贴压在体外受精-胚胎移植(IVF-ET)经阴道超声穿刺取卵术中的镇痛效果及不良反应,探讨其可能的镇痛机理。方法将2020年1月至2021年2月收治的210例行IVF-ET经阴道超声穿刺取卵术的患者按治疗方法分为3组:揿针组、耳穴压豆组、药物对照组,每组70例。揿针组和耳穴压豆组选穴均为双侧子宫、盆腔、神门、交感、皮质下、内分泌,分别予揿针和耳豆贴压,药物对照组选吲哚美辛0.1 g纳肛,比较3组患者取卵术中及术后1 h的疼痛分级指数(PRI)、现有疼痛强度(PPI)、目测类比定级法(VAS),术中及术后不良反应发生率、取卵手术时间及获卵数。结果3组的取卵时间、获卵数差异无统计学意义(P>0.05)。揿针组、耳穴压豆组及药物对照组的术中及术后1 h PRI、VAS、PPI评分呈增高趋势,差异有统计学意义(P<0.05)。揿针组(8.57%)、耳穴压豆组(10.00%)总不良反应发生率低于药物对照组(34.29%),差异有统计学意义(P<0.01)。结论揿针在IVF-ET经阴道取卵术中镇痛效果好,术中及术后不良反应发生率低,且效果优于耳穴压豆。  相似文献   
3.
Background: Familial adenomatous polyposis (FAP) is a hereditary disorder primarily caused by germline mutations in the APC gene. The most common type of mutation in the APC gene is point mutation, while deletion mutation is much less frequent. The current study was conducted to investigate the mutation spectrum of the APC gene in Vietnamese FAP patients. Methods: Patients with the clinical diagnosis of FAP on colorectal endoscopy were screened for mutations in the APC gene using Sanger sequencing. Those who exhibited no point mutation subsequently underwent MLPA assay to detect deletion and duplication mutations. Besides, the relatives of patients with mutated APC genes were recruited for detecting carrier status. Results: Sixty-three patients with clinical colorectal polyposis were recruited. Mutations in the APC gene were detected in 26/63 patients (41.3%). Genetic analysis of 105 asymptomatic relatives of these 26 patients found mutations in the APC gene in 55 individuals (52.4%). Conclusion: We successfully established the APC gene mutation spectrum in Vietnamese FAP patients for the first time. Of importance, we discovered two novel point mutations in the APC gene. The high prevalence of carrier status in asymptomatic family members of patients with mutation emphasizes the crucial role of appropriate genetic screening for early diagnosis, surveillance, and preventive measurements.  相似文献   
4.
Background: A new VMAT method called “Augmented Arc” (or simply Aug Arc) is proposed. The aim of this study is to demonstrate the validity of the proposed method in different clinical cases. Basically, Aug Arc refers to the portion(s) of the VMAT arc that is augmented with an additional arc to improve the plan quality. The Aug Arc portions in the Arc is determined using an objective function-based scoring method called “ψ – score”. Methods: To validate our approach, we have applied it in four clinical cases: Lung, Abdomen, Gynecologic (Gyn) and Pancreas. Basically, for Lung and Pancreas cases, four sets of plans were created, which are: (1) Single arc plan (S Arc), (2) Double arc plan (D Arc), (3) Partial Arc plan without Aug Arc (P Arc) and (4) Partial plan with Aug Arc (P+Aug Arc). For Abdomen and Gyn cases, three sets of plans were created, which are: (1) Single arc plan (S Arc), (2) Double arc plan (D Arc) and (3) Single Arc with Aug Arc (S+Aug Arc). To compute the “ψ – score”, an initial optimization was performed by using full Arc with 4-degree gantry spacing. Subsequently, Aug Arc portions were identified using the ψ – score plot in the single arc and partial arc scenarios. Results: The study finds that the proposed method is useful to improve the plan quality and plan deliverability for both centrically and non-centrically located tumors in terms of reducing the OAR dose, monitor units, beam on time and low dose volume without compromising the target coverage. Conclusion: The results indicate that the proposed approach could strike a balance between full double arc and single arc or partial arc in such a way that the planner can find a sweet spot of delivery parameters that result in optimal plan quality.  相似文献   
5.
6.
[目的] 通过梳理瘟疫病名的研究进展,获取古医籍中疫病文献的筛选思路。 [方法] 首先明确瘟疫的定义,阐述其主要分类方式,对温病、伤寒等相关名词进行考辨。而后将疫病文献分为笼统的瘟疫和具体的病种2大类,列举今人对相关术语的研究进展。[结果] 瘟疫指具有传染或流行特征而且伤亡较严重的一类疾病。按寒热性质分为温疫、寒疫和杂疫,温疫又可分为温热疫、湿热疫和暑热疫。瘟疫和温病的概念是交叉的,其交集部分为温疫。瘟疫本属广义伤寒,后逐渐脱离伤寒独立,其与传染病的关系仍存在争议。从文献中梳理出概述性瘟疫名称3种:(1)“疒”部的瘟疫全称;(2)以时令与流行命名的术语;(3)其他。制作“传染病中西医病名对照表”,涵盖传染病6类53种,包括病毒性传染病、立克次体病、细菌性传染病、螺旋体病、原虫病和蠕虫病。[结论] 本研究厘清了瘟疫的概念,找到了打开疫病文献宝库的钥匙,在相关研究中具有“破局”的效果。  相似文献   
7.
传统的体绘制光线投射算法虽然已成为医学影像三维重建的主流方法之一,但是其生成的三维模型质量与绘制速度仍不能满足临床医学诊断的要求。本研究提出一种基于反距离加权插值和改进采样点数据合成的医学影像三维重建算法,通过反距离加权插值方法提升绘制速度;通过增加采样点的个数提高三维重建的成像质量。实验结果表明,该算法在提高成像质量的同时可以提高绘制速度,可将圆锥绘制速度较传统方法提升20%,髋关节平均绘制速度提升18%,并且生成圆锥图像的MSE小于传统算法,SSIM大于传统算法。  相似文献   
8.
ObjectiveTo develop a prediction model for survival of patients with coronary artery disease (CAD) using health conditions beyond cardiovascular risk factors, including maximal exercise capacity, through the application of machine learning (ML) techniques.MethodsAnalysis of data from a retrospective cohort linking clinical, administrative, and vital status databases from 1995 to 2016 was performed. Inclusion criteria were age 18 years or older, diagnosis of CAD, referral to a cardiac rehabilitation program, and available baseline exercise test results. Primary outcome was death from any cause. Feature selection was performed using supervised and unsupervised ML techniques. The final prognostic model used the survival tree (ST) algorithm.ResultsFrom the cohort of 13,362 patients (60±11 years; 2400 [18%] women), 1577 died during a median follow-up of 8 years (interquartile range, 4 to 13 years), with an estimated survival of 67% up to 21 years. Feature selection revealed age and peak metabolic equivalents (METs) as the features with the greatest importance for mortality prediction. Using these 2 features, the ST generated a long-term prediction with a C-index of 0.729 by splitting patients in 8 clusters with different survival probabilities (P<.001). The ST root node was split by peak METs of 6.15 or less or more than 6.15, and each patient’s subgroup was further split by age or other peak METs cut points.ConclusionApplying ML techniques, age and maximal exercise capacity accurately predict mortality in patients with CAD and outperform variables commonly used for decision-making in clinical practice. A novel and simple prognostic model was established, and maximal exercise capacity was further suggested to be one of the most powerful predictors of mortality in CAD.  相似文献   
9.
张瑞珂  王玉秀 《护理学报》2022,29(22):20-25
目的 探索危害分析与关键控制点理论在边缘型人格障碍住院患者非自杀性自伤行为护理管理中的应用和效果。方法 以某三级甲等综合医院心身疾病科边缘型人格障碍住院患者为研究对象,制定纳入排除标准,选取2020年度182例边缘型人格障碍患者作为对照组,实施精神专科护理常规及风险管理;选取2021年度边缘型人格障碍患者175例作为观察组,在实施精神专科护理常规及风险管理基础上,借鉴危害分析与关键控制点的原理和步骤,组建危害分析与关键控制点项目小组,制定工作计划,对边缘型人格障碍患者非自杀性自伤行为进行危害分析和护理风险评估、防控关键控制点,实施住院全周期护理安全管理。比较2组边缘型人格障碍患者非自杀性自伤行为干预效果。结果 2组边缘型人格障碍患者一般人口学资料及住院前非自杀性自伤行为发生率比较,差异无统计学意义(P>0.05);与对照组比较,观察组患者非自杀性自伤行为发生率减少(P=0.001),非自杀性自伤行为对身体伤害严重程度降低(P=0.014),差异有统计学意义(P<0.05)。结论 运用危害分析与关键控制点原理和步骤组建项目小组,对边缘型人格障碍住院患者非自杀性自伤行为进行护理干预,有利于减少边缘型人格障碍患者非自杀性自伤行为发生率,降低非自杀性自伤行为对身体伤害严重程度,提高护理质量、保障患者安全。  相似文献   
10.
目的:探讨古代文献中针灸治疗闭经的选穴规律。方法:利用《中华医典》第5版数据库检索“不月”“月事不来”“闭经”“血枯”等30个关键词,筛选并提取针灸治疗闭经的处方条文,对数据进行整理。利用文献计量学的方法,借助古今医案云平台(V2.3)对针灸治疗闭经的选穴方案进行频次统计、社团分析、关联分析和复杂网络分析。结果:共筛选出符合要求的202条穴位处方条文,其中27条为复方,余为单穴方,共涉及38个腧穴,268频次。治疗闭经使用频次排前15位的腧穴:中极、血海、水泉、阴交、气海、关元、照海、带脉、腰俞、中髎、气冲、太冲、三阴交、合谷、会阴。复杂网络分析显示核心处方为:足三里、三阴交、肾俞、中极、血海、合谷、照海、气冲、气海、阴交。结论:针灸治疗闭经的取穴具有规律性,本研究结果可为临床提供一定的参考性,且通过数据挖掘技术探讨古籍针灸文献具有可行性。  相似文献   
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