全文获取类型
收费全文 | 88176篇 |
免费 | 6557篇 |
国内免费 | 2526篇 |
专业分类
耳鼻咽喉 | 853篇 |
儿科学 | 1643篇 |
妇产科学 | 1593篇 |
基础医学 | 8899篇 |
口腔科学 | 1728篇 |
临床医学 | 9170篇 |
内科学 | 7871篇 |
皮肤病学 | 1086篇 |
神经病学 | 3073篇 |
特种医学 | 3887篇 |
外国民族医学 | 319篇 |
外科学 | 9994篇 |
综合类 | 15699篇 |
预防医学 | 4782篇 |
眼科学 | 761篇 |
药学 | 7501篇 |
44篇 | |
中国医学 | 3717篇 |
肿瘤学 | 14639篇 |
出版年
2024年 | 29篇 |
2023年 | 1152篇 |
2022年 | 1973篇 |
2021年 | 2961篇 |
2020年 | 2875篇 |
2019年 | 2637篇 |
2018年 | 2539篇 |
2017年 | 2662篇 |
2016年 | 2629篇 |
2015年 | 2704篇 |
2014年 | 8419篇 |
2013年 | 7154篇 |
2012年 | 6034篇 |
2011年 | 6185篇 |
2010年 | 6743篇 |
2009年 | 6446篇 |
2008年 | 4596篇 |
2007年 | 3907篇 |
2006年 | 3407篇 |
2005年 | 2952篇 |
2004年 | 2550篇 |
2003年 | 2185篇 |
2002年 | 2010篇 |
2001年 | 1793篇 |
2000年 | 1453篇 |
1999年 | 1298篇 |
1998年 | 1035篇 |
1997年 | 906篇 |
1996年 | 781篇 |
1995年 | 783篇 |
1994年 | 670篇 |
1993年 | 531篇 |
1992年 | 437篇 |
1991年 | 366篇 |
1990年 | 288篇 |
1989年 | 269篇 |
1988年 | 265篇 |
1987年 | 223篇 |
1986年 | 171篇 |
1985年 | 240篇 |
1984年 | 198篇 |
1983年 | 122篇 |
1982年 | 161篇 |
1981年 | 137篇 |
1980年 | 91篇 |
1979年 | 93篇 |
1978年 | 65篇 |
1977年 | 50篇 |
1976年 | 39篇 |
1975年 | 17篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
1.
Association of Multimodal Pain Control with Patient-Reported Outcomes in Children Undergoing Surgery
《Journal of pediatric surgery》2023,58(6):1206-1212
IntroductionOur aim was to describe practices in multimodal pain management at US children's hospitals and evaluate the association between non-opioid pain management strategies and pediatric patient-reported outcomes (PROs).MethodsData were collected as part of the 18-hospital ENhanced Recovery In CHildren Undergoing Surgery (ENRICH-US) clinical trial. Non-opioid pain management strategies included use of preoperative and postoperative non-opioid analgesics, regional anesthetic blocks, and a biobehavioral intervention. PROs included perioperative nervousness, pain-related functional disability, health-related quality of life (HRQoL). Associations were analyzed using multinomial logistic regression models.ResultsAmong 186 patients, 62 (33%) received preoperative analgesics, 186 (100%) postoperative analgesics, 81 (44%) regional anesthetic block, and 135 (73%) used a biobehavioral intervention. Patients were less likely to report worsened as compared to stable nervousness following regional anesthetic block (relative risk ratio [RRR]:0.31, 95% confidence interval [CI]:0.11–0.85), use of a biobehavioral technique (RRR:0.26, 95% CI:0.10–0.70), and both in combination (RRR:0.08, 95% CI:0.02–0.34). There were no associations of non-opioid pain control modalities with pain-related functional disability or HRQoL.ConclusionUse of postoperative non-opioid analgesics have been largely adopted, while preoperative non-opioid analgesics and regional anesthetic blocks are used less frequently. Regional anesthetic blocks and biobehavioral interventions may mitigate postoperative nervousness in children.Level of evidenceIII. 相似文献
2.
《Saudi Pharmaceutical Journal》2022,30(9):1327-1344
Effective communication between pharmacists and patients is essential for therapeutic success. The pharmacist's perspective may differ from that of the patient in terms of effective communication. Our study aimed to assess the communication efficiency in the pharmacist-patient relationship from the pharmacists’ perspective. We hypothesize that the community pharmacist's perspective can lead to relevant aspects of patient-centred communication and their profession. A cross-sectional study was conducted through an online questionnaire addressed to pharmacists. A number of 506 questionnaires were collected, evaluated, analyzed and interpreted. The questionnaire focused on the following main issues: degree of job satisfaction, essential skills of a pharmacist working in a community pharmacy, different aspects of pharmacist-patient communication, shared decision-making, patient monitoring plan and other elements related to a patient under treatment (healthy lifestyle, receptivity to counselling, loyalty and appreciation of pharmaceutical services). The pharmacist's efficiency in communication with the patient and professional education were also targeted in the study. There are no significant differences between job satisfaction in women compared to men. However, the job satisfaction increases with the average age. Caregiver, communicator and life-long learner were identified as essential skills of a pharmacist. Pharmacists participating in the study generally perceive themselves as good communicators with the patient. Nevertheless, many particular aspects of communication with patients can be greatly improved. The lack of training in the spirit of the ?patient-centred communication” concept has been identified. Still, more than a third of the respondents are missing the need for professional training. A periodic evaluation of the efficiency of pharmacist-patient communication in the community pharmacy is necessary. The degree of subjectivity of the pharmacist from this perspective and self-sufficiency would be significantly diminished if the pharmacists had access to the results of the periodic evaluations. 相似文献
3.
4.
目的 从患者视角深入了解已完成新辅助免疫治疗临床试验患者在其参与过程中的角色感知和体验,为新辅助免疫治疗方案临床试验设计中增加患者视角,进一步促进新辅助免疫治疗用药的发展及提升我国肿瘤患者的整体诊治水平提供参考和依据。方法 采用现象学研究方法,以目的抽样选取13例已完成新辅助免疫治疗临床试验患者,进行半结构式访谈,并运用Colaizzi7步分析法对资料进行分析。结果 患者参与新辅助免疫治疗临床试验的角色感知归纳为4个主题,分别为药物发展的“试验品”、新药实践的志愿者与促进者、新药方案的参与者与评价者、医学进步的受益者。患者在新辅助免疫治疗临床试验中的参与体验归纳为3个主题,分别为来自研究团队的关怀,新辅助免疫临床试验过程中的担心与困扰(免疫不良反应的不确定性、医疗资源的不便捷性、随访检查的频繁性),医院、社会缺少对临床试验的相关宣传(试验获取途径受限、积极与支持环境的欠缺、尊重与理解的需求)。结论 患者在新辅助免疫治疗临床试验参与中尚需改善其“试验品”的负性感知,参与体验也反映了目前新辅助免疫治疗临床试验中存在的相关问题,护理人员需要重视患者在试验参与中的体验,针对患者需求完善健康教育方案,提升社会支持,进而提高我国新辅助免疫治疗临床试验的质量。 相似文献
5.
6.
目的探讨胸部孤立性纤维性肿瘤(SFT)的多层螺旋CT影像学表现与组织标本人表皮生长因子受体2(CerbB-2)表达的相关性。方法收集手术治疗的SFT的34例患者临床资料,术前均行多层螺旋CT检查,切除肿瘤组织标本采用免疫组织化学SP法对CerbB-2表达进行检测,分析结果。结果在多层螺旋CT下肿瘤形态13例(38.24%)为圆形或椭圆形、18例(52.94%)为不规则形、3例(8.82%)为分叶状,30例(88.24%)肿瘤组织边缘清晰、4例(11.76%)边缘不清,12例(35.29%)CT平扫及强化扫描肿瘤密度均均匀,22例(64.71%)平扫和强化扫描不均匀有不规则钙化或病灶坏死。肿瘤最大直径4.72~22 cm,平均为(13.34±4.36)cm,肿瘤实质平扫CT值(35.79±8.33)HU,肿瘤实质增强CT值(66.47±21.56)HU,静脉期最大强化率(vCER)(155.24±45.72)%。26患者切除肿瘤组织中CerbB-2表达阳性,阳性率为76.47%,其中弱阳性7例、中等阳性11例、强阳性8例。瘤细胞密度(438.95±103.47)个,肿瘤实质血管数(2.41±0.74)条。患者多层螺旋CT检查所示的肿瘤直径、肿瘤平扫及增强扫描CT值、静脉期vCER不同时CerbB-2表达阳性率明显不同,比较差异有统计学意义(P<0.05)。Spearman相关分析显示患者多层螺旋CT检查所示肿瘤直径、肿瘤平扫及增强扫描CT值、静脉期vCER值与肿瘤组织中CerbB-2表达阳性率之间有正相关性(P<0.05)。结论胸部SFT在多层螺旋CT下主要表现为边缘清晰、不均匀强化的圆形或椭圆形包块,组织CerbB-2表达阳性率高。多层螺旋CT影像学指标与肿瘤组织CerbB-2蛋白有密切相关性。 相似文献
7.
8.
Biaoming Xu Yu Chen Mingjing Peng Jin Hai Zheng Chaohui Zuo 《International journal of cancer. Journal international du cancer》2023,152(2):110-122
Pancreatic cancer (PC) is a cancer of the digestive system, and pancreatic ductal adenocarcinoma (PDAC) accounts for approximately 90% of all PC cases. Exosomes derived from PDAC (PDAC-exosomes) promote PDAC development and metastasis. Exosomes are nanoscale vesicles secreted by most cells, which can carry biologically active molecules and mediate communication and cargo transportation among cells. Recent studies have focused on transforming exosomes into good drug delivery systems (DDSs) to improve the clinical treatment of PDAC. This review considers PDAC as the main research object to introduce the role of PDAC-exosomes in PDAC development and metastasis. This review focuses on the following two themes: (a) the great potential of PDAC-exosomes as new diagnostic markers for PDAC, and (b) the transformation of exosomes into potential DDSs. 相似文献
9.
10.
住院患者睡眠不良是一个长期被忽视的重要问题,主要表现为睡眠时间缩短、睡眠质量下降。影响患者睡眠的因
素是多方面的,主要为噪音、医疗护理行为及灯光,而疼痛是影响手术后患者睡眠的主要因素。住院患者睡眠不良绝大多数情
况下可防可治。解决住院患者睡眠不良问题需要多管齐下,包括提高对睡眠问题的认识、强化睡眠诊断、常规评估睡眠情况、
营造良好睡眠环境、降低医院中位声级水平、优化病房护理管理、减少医疗护理行为对睡眠的干扰以及增加必要的非药物和药
物干预。住院患者睡眠不良事关医疗质量和患者安全,需要全社会、卫生行政管理部门、医院管理部门,尤其是医护人员的高
度重视。 相似文献