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排序方式: 共有2352条查询结果,搜索用时 15 毫秒
1.
目的 检索、评价并整合国内外早产儿体位管理的相关证据,为临床实践提供参考。方法 计算机检索国际指南网、英国国家健康与临床优化研究所网站、苏格兰学院指南网、美国指南网、加拿大安大略注册护士协会网站、乔安娜布里格斯研究所循证卫生保健中心数据库、BMJ Best Practice、PubMed、Embase、OVID、万方数据库、中国知网、医脉通等网站或数据库中关于早产儿体位管理的所有证据,包括指南、证据总结、最佳临床实践手册、临床决策及系统评价,检索时限为建库至2020年8月31日。结果 共纳入10篇文献,其中指南3篇、系统评价5篇、技术报告1篇、临床决策1篇。从体位评估、体位摆放、体位辅助工具及使用、特殊疾病或情境下的体位管理4个方面总结了21条证据。结论 该研究总结了早产儿体位管理的最佳证据,为规范早产儿体位管理提供了循证依据,建议护理人员在应用证据时综合考虑临床实际情况选择性应用最佳证据,促进早产儿健康。  相似文献   
2.
《Vaccine》2022,40(40):5828-5834
BackgroundTyphoid fever is a common disease in developing countries especially in the Indian subcontinent and Africa. The available typhoid conjugate vaccines (TCV) have been found to be highly immunogenic in infants and children less than 2 years of age. Many countries are planning to adopt TCV in their routine EPI programs around 9 months of age when measles containing vaccines are given. Therefore, Vi-DT TCV was tested in 9–15 months aged healthy infants in Nepal to demonstrate non-interference with a measles containing vaccine.MethodsThis was a randomized, open label, phase III study to assess the immune non-interference, safety, and reactogenicity of Vi-DT typhoid conjugate vaccine when given concomitantly with measles, mumps and rubella (MMR) vaccine. A total of 360 participants aged 9–15 months were enrolled and randomized equally into Vi-DT + MMR (180 participants) or MMR alone (180 participants) group and were evaluated for immunogenicity and safety 28 days post vaccination.ResultsUsing the immunogenicity set, difference between proportions (95% CI) of the Vi-DT + MMR group vs MMR alone group were ?2.73% (-8.85, 3.38), ?3.19% (-11.25, 4.88) and 2.91% (-3.36, 9.18) for sero-positivity rate of anti-measles, anti-mumps and anti- rubella, respectively. Only the lower bound of the range in difference of the proportions for sero-positivity rate of anti-mumps did not satisfy the non-inferiority criteria as it was above the ?10% limit, which may not be of clinical significance. These results were confirmed in the per protocol set. There were no safety concerns reported from the study and both Vi-DT + MMR and MMR alone groups were comparable in terms of solicited and unsolicited adverse events .ConclusionsResults indicated that there is non-interference of MMR vaccine with Vi-DT and Vi-DT conjugate vaccine could be considered as an addition to the EPI schedule among children at risk of contracting typhoid.  相似文献   
3.
BackgroundCurrent dietary guidelines recommend avoiding foods and beverages with added sugars and higher sodium before age 2 years.ObjectiveThe aim was to describe daily snack food intake (frequency and total energy) and the associations with overconsumed nutrients (added sugars, sodium, and saturated fats) and child weight-for-length z scores.DesignA cross-sectional, secondary analysis of baseline data from an ongoing longitudinal intervention was conducted.Participants and settingA sample of 141 caregivers with infants (aged 9 to 11 months) and toddlers (aged 12 to 15 months) was recruited in Buffalo, NY, between 2017 and 2019.Main outcome measuresThree 24-hour dietary recalls were used to categorize 'sweet and salty snack foods' or 'commercial baby snack foods' based on the US Department of Agriculture What We Eat in America food group classifications and estimate nutrient intakes. Child recumbent length and weight were measured by trained researchers.Statistical analysisDaily frequency (times/day), energy (kcal/day), and overconsumed nutrients from snack food intake were calculated. Multivariable regression models examined associations between the frequency of and energy from snack food intake with overconsumed nutrients and child weight-for-length z scores.ResultsInfants consumed snack foods on average 1.2 times/day contributing 5.6% of total daily energy, 19.6% of added sugars, and 6.8% of sodium. Toddlers consumed snack foods on average 1.4 times/day contributing 8.9% of total daily energy, 40.0% of added sugars, and 7.2% of sodium. In adjusted models including all children, greater frequency of sweet and salty snack food intake, but not commercial baby snack foods, was associated with higher weight-for-length z scores.ConclusionsSnack foods are frequently consumed by infants and toddlers and contribute to the intake of overconsumed nutrients such as added sugars and sodium. Given the current guidelines to avoid added sugars and higher sodium before age 2 years, additional recommendations related to nutrient-dense snack intake may be beneficial.  相似文献   
4.
目的研究喘息婴幼儿潮气肺功能和呼出气一氧化氮(FeNO)的变化,着重探讨过敏体质在其中的潜在作用。方法纳入成都市妇女儿童中心医院呼吸科2018年2月至2019年1月收治的急性下呼吸道感染婴幼儿285例,回顾性分析患儿的一般资料,喘息的危险因素,喘息与潮气肺功能及FeNO的关系,并通过亚组分析探究过敏因素在其中的作用。结果Logistic回归分析发现男性(χ2=13.071,P<0.001)及过敏体质(χ2=8.889,P=0.003)是喘息的危险因素。在纳入的总体人群中,喘息者较非喘息者达峰时间比(TPTEF/TE)及达峰容积比(VPEF/VE)降低,FeNO增高,差异均有统计学意义(P值均<0.05);在喘息患儿中,过敏体质不影响潮气肺功能,但与FeNO增高有关(Z=-2.109,P<0.05)。按过敏体质亚组分析,非过敏体质患儿喘息者较非喘息者TPTEF/TE及VPEF/VE降低,差异均有统计学意义(P值均<0.05),而FeNO差异无统计学意义(Z=-1.264,P>0.05);按过敏原种类分组,吸入过敏原及混合过敏原阳性者较过敏原阴性者FeNO增高,差异均有统计学意义(P值均<0.05),但各组间潮气肺功能差异无统计学意义(P>0.05)。结论喘息婴幼儿潮气肺功能受损,FeNO增高;且潮气肺功能改变不依赖过敏状态,而FeNO增高与吸入过敏原阳性有关。进一步探讨吸入过敏原亚类对喘息婴幼儿FeNO的影响可能为临床上精准治疗提供理论依据。  相似文献   
5.
BackgroundPain assessment is essential for the administration of appropriate analgesia. Currently, clinicians use surrogate methods, such as heart rate or behavioural pain scales, to estimate pain in neonates and infants. The Newborn and Infant Parasympathetic Evaluation (NIPE™) monitor aims to provide an objective numeric value (NIPE index) of pain through a continuous assessment of the patient's parasympathetic activity. The aim of this study was to determine if the intraoperative NIPE index monitoring could predict postoperative pain in neonates and infants.MethodsThis prospective observational pilot study included neonates and infants undergoing elective day-surgical procedures (n = 50). Intraoperatively, NIPE indices at 0 (NIPE0), 10 (NIPE10), 20 (NIPE20), 30 (NIPE30) minutes and at completion of surgery (NIPEe), were recorded; the median NIPE index (NIPEm) was calculated for the entire procedure. Postoperative Face, Legs, Activity, Cry, Consolability (FLACC) scale scores were calculated by the nursing staff blinded to the intraoperative NIPE indices.ResultsLinear regression documented an association between the NIPEm and postoperative FLACC score at 0 (r = 0.31, p = 0.03) and 10 min (r = 0.36, p = 0.01). No significant associations were observed for FLACC scores at 20 (r = 0.21, p = 0.2) and 30 min (r = 0.36, p > 0.9). Multiple regression analysis revealed that intraoperative NIPE10, NIPE20, NIPE30 and NIPEe also predicted the FLACC score at 0 min (p = 0.003).ConclusionThe intraoperative NIPE index is predictive of pain in the immediate postoperative period. This association was lost at 20 min likely due to nursing intervention to administer analgesia. NIPE monitoring could be useful in facilitating postoperative pain management in infants.Level of evidenceII.Type of studyStudy of Diagnostic Test.  相似文献   
6.
目的 研究机械通气下使用密闭式吸痰的婴幼儿吸痰前不常规提高吸氧浓度对患儿氧合的影响。 方法 通过对64例婴幼儿(192次吸痰操作),吸痰前不进行提高氧浓度的操作进行观察,分别记录患儿吸痰前平静时、吸痰中、吸痰后1min时患儿SpO2的值和SpO2恢复至平静时所需的时间。 结果 吸痰前不提高氧浓度,患儿在吸痰时及吸痰后SpO2相对于吸痰前变化不明显。吸痰后SpO2恢复至平静时的时间为18.00(5.25-30.00)s。 结论 吸痰前SpO2稳定,并排除痉咳、心脏分流等原因的患儿,密闭式吸痰前没有必要常规给予提高吸氧浓度的操作。  相似文献   
7.
《Vaccine》2019,37(32):4587-4593
ObjectiveThe objective of the present study was to investigate the risk factors for intussusception (IS) among infants, including vaccination against rotavirus.MethodsCase-control study with systematic inclusion of all infants aged <1 year with suspected IS admitted to emergency departments in the eastern region of France between 1 April 2008 and 31 March 2012. All cases classed level 1 according to the Brighton classification were matched to 4 hospital controls. Two exposure windows were examined; exposure to the first dose of rotavirus vaccine in the 7 and in the 14 days prior to the occurrence of IS.ResultsA total of 115 cases were matched with 457 controls. The average vaccination coverage rate over the 4 years of study was 8.6%. Rotavirus vaccine was not found to be significantly associated with the occurrence of IS in the 7 days (odds ratio (OR) not calculated; p = 0.99) and in the 14 days after administration of one dose vaccine (OR 1.33, 95% confidence interval (CI) 0.14–12.82). Infant formula alone or combined with breastfeeding was associated with an excess risk of IS (OR 2.74, 95% CI 1.10–6.79). A history of gastroenteritis within 2 weeks prior to hospitalisation was also associated with an increased risk (OR 2.24, 95% CI 1.07–4.67).ConclusionOur study indicates that infant formula alone or combined with breastfeeding is a risk factor for IS. A small, non-significant increase in the risk of IS was observed after rotavirus vaccination, although the low vaccine coverage rate likely precluded detection of a significant increase in risk.  相似文献   
8.
目的探讨术前留置输尿管支架管在输尿管导引鞘下输尿管软镜治疗婴幼儿肾结石的临床疗效。 方法我院2015年6月至2018年6月收治24例肾结石婴幼儿(观察组),行输尿管软镜下激光碎石,术前留置输尿管支架,被动扩张输尿管2周后再置入输尿管软镜导引鞘完成输尿管软镜下激光碎石术,并对比分析同期17例未置入输尿管软镜导引鞘行输尿管软镜下激光碎石术(对照组)的患者资料。 结果观察组结石清除率为87.5%,手术时间(56±14) min,术后发热1例,较对照组结石清除率76.5%明显提高,术后泌尿系感染发生率降低。 结论术前行输尿管支架被动扩张后置入输尿管软镜导引鞘提高输尿管软镜下碎石治疗婴幼儿肾结石手术的成功率及安全性。  相似文献   
9.
目的分析临床结合超声检查对婴儿发育性髋关节发育不良(developmental dysplasia of the hip,DDH)进行早期筛查的结果,为DDH早期干预提供科学依据,降低DDH的致残率。方法对我院筛选DDH体征阳性4896例患儿行超声进一步检查。结果体格检查可疑阳性婴儿4896例,经过超声检查,正常髋关节3591例,占73.3%(3591/4896),可疑异常髋关节1196例,占24.5%(1196/4896),异常髋关节109例,占2.2%(109/4896),其中脱位型髋关节7例,占0.14%(7/4896)。对确诊患儿进行临床治疗,106例异常髋关节转为Graf I型髋关节,治愈率达97.2%(106/109)。结论对婴儿髋关节进行早期筛查对提高婴儿DDH检出率有重要意义,对确诊患儿给予早期干预可促使发育异常的髋关节结构向正常的髋关节转化,改善婴儿髋关节功能,具有重要的经济意义与社会意义。  相似文献   
10.
《Vaccine》2016,34(41):4979-4984
BackgroundAmong the three poliovirus serotypes, the lowest responses after vaccination with trivalent oral polio vaccine (tOPV) are to serotype 3. Although improvements in routine immunisation and supplementary immunisation activities have greatly increased vaccine coverage, there are limited data on antibody prevalence in Indian infants.MethodsChildren aged 5–11 months with a history of not having received inactivated polio vaccine were screened for serum antibodies to poliovirus serotype 3 (PV3) by a micro-neutralisation assay according to a modified World Health Organization (WHO) protocol. Limited demographic information was collected to assess risk-factors for a lack of protective antibodies. Student’s t-test, logistic regression and multilevel logistic regression (MLR) model were used to estimate model parameters.ResultsOf 8454 children screened at a mean age of 8.3 (standard deviation [SD]-1.8) months, 88.1% (95% confidence interval (CI): 87.4–88.8) had protective antibodies to PV3. The number of tOPV doses received was the main determinant of seroprevalence; the maximum likelihood estimate yields a 37.7% (95% CI: 36.2–38.3) increase in seroprevalence per dose of tOPV. In multivariable logistic regression analysis increasing age, male sex, and urban residence were also independently associated with seropositivity (Odds Ratios (OR): 1.17 (95% CI: 1.12–1.23) per month of age, 1.27 (1.11–1.46) and 1.24 (1.05–1.45) respectively).ConclusionSeroprevalence of antibodies to PV3 is associated with age, gender and place of residence, in addition to the number of tOPV doses received. Ensuring high coverage and monitoring of response are essential as long as oral vaccines are used in polio eradication.  相似文献   
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