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   2385篇
  免费   114篇
  国内免费   50篇
耳鼻咽喉   3篇
儿科学   31篇
妇产科学   8篇
基础医学   253篇
口腔科学   11篇
临床医学   248篇
内科学   56篇
皮肤病学   4篇
神经病学   56篇
特种医学   155篇
外科学   700篇
综合类   472篇
预防医学   89篇
眼科学   1篇
药学   102篇
  2篇
中国医学   255篇
肿瘤学   103篇
  2024年   2篇
  2023年   30篇
  2022年   45篇
  2021年   63篇
  2020年   55篇
  2019年   41篇
  2018年   50篇
  2017年   66篇
  2016年   56篇
  2015年   61篇
  2014年   143篇
  2013年   105篇
  2012年   133篇
  2011年   184篇
  2010年   209篇
  2009年   131篇
  2008年   138篇
  2007年   141篇
  2006年   147篇
  2005年   126篇
  2004年   92篇
  2003年   84篇
  2002年   70篇
  2001年   57篇
  2000年   43篇
  1999年   47篇
  1998年   36篇
  1997年   30篇
  1996年   18篇
  1995年   25篇
  1994年   24篇
  1993年   14篇
  1992年   11篇
  1991年   8篇
  1990年   7篇
  1989年   9篇
  1988年   7篇
  1987年   7篇
  1986年   4篇
  1985年   3篇
  1984年   3篇
  1982年   6篇
  1981年   3篇
  1980年   4篇
  1978年   1篇
  1977年   2篇
  1976年   3篇
  1975年   2篇
  1974年   1篇
  1969年   1篇
排序方式: 共有2549条查询结果,搜索用时 15 毫秒
1.
《Australian critical care》2022,35(5):491-498
BackgroundAn activity to provide a tangible keepsake following the death of a loved one is termed ‘memory making’. However, limited evidence is available related to professionals' education and support to provide memory making opportunities in the adult intensive care unit (ICU). Having a greater understanding of healthcare professionals’ experiences can inform future patient/family care and support for professionals in end-of-life care.ObjectiveThe objective of this study was to describe what participants perceive memory making to be, if they have facilitated memory making activities as part of their practice, if they perceive it as part of their role, and if they have the necessary skills to do so.MethodsSeventy-five registered nurses (75% response rate), 19 medical doctors (76% response rate), and two social workers (66.7% response rate) completed a survey at a single tertiary referral centre in an adult ICU.ResultsParticipants reported memory making to include the creation of tangible keepsakes as well as nontangible activities. Overall, participants reported high agreement scores that the responsibility for initiating memory making predominately belonged to the nurse. Participants reported skills most needed involved the ability to interact with the family, being open to the concept, and integrating memory making into their standard of care. Having developed a rapport with families was considered an enabler, whereas lack of knowledge and clinical workload were reported as inhibitors to offering memory making.ConclusionsOverall, participants in this study reported positive experiences with offering memory making to families during end-of-life care in the adult ICU. Nurses are more likely to perceive professional responsibility for offering memory making, likely due to their increased time at the bedside and higher prominence and leadership in other end-of-life practices. To support professionals, education should include conceptual knowledge, procedural knowledge of keepsake creations, communication techniques using reflective practices, and organisational support to facilitate time requirements.  相似文献   
2.
Background:To explore the ideal trajectory of lumbar cortical bone trajectory screws and provide the optimal placement scheme in clinical applications.Methods:Lumbar computed tomography (CT) data of 40 patients in our hospital were selected, and the cortical vertebral bone contour model was reconstructed in three dimensions (3D). Depending on the different regions of the screw through the entrance and exit of the pedicle, 9 trajectories were obtained through combinational design: T-Aa, T-Ab, T-Ac, T-Ba, T-Bb, T-Bc, T-Ca, T-Cb, and T-Cc. Cortical bone trajectory (CBT) screws with appropriate diameters were selected to simulate screw placement and measure the parameters corresponding to each trajectory (screw path diameter, screw trajectory length, cephalad angle, and lateral angle), and then determine the optimal screw according to the screw parameters and screw safety. Then, 23 patients in our hospital were selected, and the navigation template was designed based on the ideal trajectory before operation, CBT screws were placed during the operation to further verify the safety and feasibility of the ideal trajectory.Results:T-Bc and T-Bb are the ideal screw trajectories for L1–L2 and L3–L5, respectively. The screw placement point is located at the intersection of the inner 1/3 vertical line of the superior facet joint and the bottom 1/3 horizontal line of the outer crest of the vertebral lamina (i.e., 2–4 mm inward at the bottom 1/3 of the outer crest of the vertebral lamina). CBT screws were successfully placed based on the ideal screw trajectory in clinical practice. During the operation or the follow-up period, there were no adverse events.Conclusion:CBT screw placement based on the ideal screw trajectory is a safe and reliable method for achieving effective fixation and satisfactory postoperative effects.  相似文献   
3.
Background/Objective: The feces sign has been reported as a possible predictive factor for non-operative treatment of small bowel obstruction. However, its relationship with prognosis of non-emergency adhesive small bowel obstruction remains unclear. This study aimed to clarify the relationship between the feces sign and prognosis of non-emergency adhesive small bowel obstruction.MethodsNinety-two patients with non-emergency adhesive small bowel obstruction with the transitional zone visible on computed tomography were included. Patients were categorized into two groups: feces sign positive (n = 40) and negative (n = 52). Clinical features and prognosis were compared between the two groups. Cox proportional hazards regression models incorporating the feces sign were used to analyze odds of diet resumption and discharge.ResultsPatients with feces sign were younger (p = 0.015), had a higher body mass index (p = 0.027), and a lower white blood cell count (p = 0.019) on admission. More patients with feces sign were successfully treated with fasting and/or nasogastric tube placement (p < 0.001), and no patient with feces sign suffered from recurrent obstruction after diet resumption. Kaplan–Meier analysis showed that patients with feces sign took less time for diet resumption (p = 0.007) and discharge (p = 0.004) than those without it. Using Cox proportional hazards regression model, the feces sign was reported as an independent predictor of diet resumption (odds ratio 1.685, p = 0.018) and discharge (odds ratio 1.861, p = 0.007).ConclusionsThe feces sign is associated with improved odds for diet resumption and discharge.  相似文献   
4.
5.
BackgroundAdverse drug reactions (ADRs) and adverse drug events (ADEs) in older people contribute to a significant proportion of hospital admissions and are common following discharge. Effective interventions are therefore required to combat the growing burden of preventable ADRs. The Prediction of Hospitalisation due to Adverse Drug Reactions in Elderly Community Dwelling Patients (PADR-EC) score is a validated risk score developed to assess the risk of ADRs in people aged 65 years and older and has the potential to be utilised as part of an intervention to reduce ADRs.ObjectivesThis trial was designed to investigate the effectiveness of an intervention to reduce ADR incidence in older people and to obtain further information about ADRs and ADEs in the 12–24 months following hospital discharge.MethodsThe study is an open-label randomised-controlled trial to be conducted at the Royal Hobart Hospital, a 500-bed public hospital in Tasmania, Australia. Community-dwelling patients aged 65 years and older with an unplanned overnight admission to a general medical ward will be recruited. Following admission, the PADR-EC ADR score will be calculated by a research pharmacist, with the risk communicated to clinicians and discussed with participants. Following discharge, nominated general practitioners and community pharmacists will receive the risk score and related medication management advice to guide their ongoing care of the patient. Follow-up with participants will occur at 3 and 12 and 18 and 24 months to identify ADRs and ADEs. The primary outcome is moderate-severe ADRs at 12 months post-discharge, and will be analysed using the cumulative incidence proportion, survival analysis and Poisson regression.SummaryIt is hypothesised that the trial will reduce ADRs and ADEs in the intervention population. The study will also provide valuable data on post-discharge ADRs and ADEs up to 24 months post-discharge.  相似文献   
6.
7.
目的 了解食管癌术后康复期患者营养状况及生命质量的变化趋势及相关关系。方法 以四川省肿瘤专科医院行食管癌手术治疗的75例患者为研究对象,在患者术后1个月、3个月和6个月时运用患者主观整体营养评估量表进行营养评估,采用肿瘤生命质量测评量表和食管癌患者补充量表进行生命质量评定。结果 食管癌患者术后随时间的延长营养不良发生率由73.4%下降至33.5%。生活质量各维度评分在各评估时间点差异均有统计学意义(P<0.05),功能领域和症状领域在术后1个月与术后3个月、术后6个月比较有统计学意义(P<0.05),术后3个月与术后6个月比较差异无统计学意义(P>0.05)。患者营养状态与躯体、角色、情绪及社会功能呈负相关(P<0.05),与吞咽困难、进食、反流、梗阻、食欲减退、咳嗽症状呈正相关(P<0.05)。结论 食管癌术后1个月患者营养状况及生命质量较差,随时间推移逐渐好转。医护人员应根据患者在不同时间点营养状况及生命质量的变化特点,制定规范化和个体化的延续护理方案,以促进患者术后康复、提高生命质量。  相似文献   
8.
目的探讨基于PDCA循环的过渡期护理对老年人瓣膜置换术后重症监护室(ICU)出科时期的干预效果。 方法选取2020年10月至2021年9月在遵义医科大学附属医院行瓣膜置换术的老年患者60例,其中30例在ICU出科过渡期采用常规护理(对照组),余30例采用基于PDCA循环的过渡期护理(观察组)。观察两组患者干预前后超声心动图相关指标左室射血分数(LVEF)和左心室舒张末期容积(LVEDV)、医院焦虑抑郁评分量表(HADS)评分、中文版Mishel疾病不确定感量表(MUIS)评分,以及日常生活能力评估量表(ADL)评分变化情况。计数资料的比较采用χ2检验,计量资料的比较采用t检验。 结果护理后,观察组LVEF和LVEDV指数均高于对照组(t=3.286、2.035,P<0.05),HADS-A、HADS-D和MUIS评分均低于对照组(t=3.873、3.873、6.076,P<0.01),ADL评分高于对照组(t=6.076,P<0.01)。 结论基于PDCA循环的过渡期护理可明显改善老年人瓣膜置换术后从ICU转入普通病房期间的焦虑情绪和疾病不确定感,促进心功能恢复,提高自理能力。  相似文献   
9.
[目的]比较复位棒辅助复位后伤椎置钉与常规复位前伤椎置钉短节段固定治疗Magerl A3型胸腰椎骨折的临床疗效。[方法]2018年12月一2020年6月收住本院的59例Magerl A3型胸腰椎骨折患者随机分为两组。所有患者均接受短节段椎弓根钉固定,其中,32例采用自制复位棒复位后,再行伤椎置钉(复位置钉组);27例采用常规技术,复位前伤椎置钉(常规组)。比较两组围手术期、随访和影像资料。[结果]两组患者均顺利完成手术,无严重术中并发症。两组手术时间、切口长度、术中失血量、术后引流量、下地行走时间及完全负重时间方面比较差异无统计学意义(P>0.05)。59例患者随访时间12?21个月,平均(14.42±2.04)个月。随时间推移,两组的VAS及0DI评分均显著减少(P<0.05),相应时间点,两组间VAS及0DI评分的差异均无统计学意义(P>0.05)。影像学方面,与术前相比,术后两组的伤椎前缘相对高度、后凸Cobb角和椎管占位率均显著改善(P<0.05)。相应时间点,两组间伤椎前缘相对高度和Cobb角的差异无统计学意义(P>0.05),但复位置钉组术后3d及末次随访椎管占位率改善显著优于常规组(P<0.05)。[结论]伤椎复位置钉与单纯置钉短节段固定治疗Mag-erl A3型胸腰椎骨折临床疗效无显著差异,但伤椎复位置钉椎管占位的改善优于单纯置钉。  相似文献   
10.
神经节细胞瘤是一种起源于交感神经节细胞的良性肿瘤,常发生于后纵隔、腹膜后、肾上腺髓质。椎管内神经节细胞瘤临床上较为罕见,好发于颈椎和胸腰椎,以手术治疗为主。河北省沧州市人民院收治1例以咳嗽为主要症状的患者,术前行胸椎核磁检查,手术行后正中入路肿瘤全切术,经病理诊断为位于胸3~4左侧椎间孔区、椎管内的神经节细胞瘤,HE染色可见基质内散在生长的成熟的神经节细胞,无核分裂像。术后3个月复查未见肿瘤复发。  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