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1.
BackgroundPerianal abscesses and anal fistulas are common. The principle of intention-to-treat has not been considered in previous systemic reviews. Thus, the comparison between primary and post-recurrence management was confused, and the recommendation of primary treatment is obscure. The current study aims to identify the optimal initial treatment for pediatric patients.MethodsUsing PRISMA guidelines, studies were identified from MEDLINE, EMBASE, PubMed, Cochrane Library, and Google Scholar without any language or study design restriction. The inclusion criteria include original articles or articles with original data, studies of management for a perianal abscess with or without anal fistula, and patient age of <18 years. Patients with local malignancy, Crohn's disease, or other underlying predisposing conditions were excluded. Studies without analyzing recurrence, case series of <5, and irrelevant articles were excluded in the screening stage. Of the 124 screened articles, 14 articles had no full texts or detailed information. Articles written in a language other than English or Mandarin were translated by Google Translation first and confirmed with native speakers. After the eligibility process, studies that compared identified primary managements were then included in the qualitative synthesis.ResultsThirty-one studies involving 2507 pediatric patients met the inclusion criteria. The study design consisted of two prospective case series of 47 patients and retrospective cohort studies. No randomized control trials were identified. Meta-analyses for recurrence after initial management were performed with a random-effects model. Conservative treatment and drainage revealed no difference (Odds ratio [OR], 1.222; 95% Confidential interval [CI]: 0.615–2.427, p = 0.567). Conservative management had a higher risk of recurrence than surgery without statistical significance (OR 0.278, 95% CI: 0.109–0.707, p = 0.007). Compared with incision/drainage, surgery can prevent recurrence remarkably (OR 4.360, 95% CI: 1.761–10.792, p = 0.001). Subgroup analysis of different approaches within conservative treatment and operation was not performed for lacking information.ConclusionStrong recommendations cannot be made due to the lack of prospective or randomized controlled studies. However, the current study based on real primary management supports initial surgical intervention for pediatric patients with perianal abscesses and anal fistula to prevent recurrence.Level of evidenceType of study: Systemic review; Evidence level: Level II.  相似文献   
2.
收集2000年1月1日至2021年12月1日发表的以突发公共卫生事件中公众的信息需求为研究主题的中英文文献,探讨公众信息需求的动机、主题和特征,分析研究现状。在突发公共卫生事件中,信息需求的动机主要包括自我保护、缓解认知失调、缓解焦虑、维持社会关系;信息需求的主题为事件信息、疾病及治疗信息、健康防护知识、政府和专家权威信息;信息需求的特征表现为强烈而迫切,具有多样性和系统性。突发公共卫生事件中的公众信息需求相关研究主要针对普通群众和各种网络用户,关注老年人、高危工作人群等的信息需求是今后研究的重点。研究结果为突发公共卫生事件信息资源建设和科学决策提供了借鉴。  相似文献   
3.
调研“十四五”期间国内42所高校和加拿大15所高校图书馆的特色学习空间建设现状,对比分析国内外高校图书馆学习空间差异,并为我国高校图书馆特色学习空间建设提供发展思路,提出了建设特色化学习空间、深化空间服务内容、强化空间服务团队建设、建立完善的学习空间预约制度等特色学习空间建设途径。  相似文献   
4.
目的分析超长住院患者分布及影响因素,探讨减少超长住院日的措施。方法从江苏省某三甲医院病案管理系统中调取2020年1月1日-2020年12月31日134016例出院患者的住院病案首页资料,对住院时间≥30天的1401例超长住院患者的分布特征进行统计描述,采用Logistic回归模型分析超长住院日的影响因素。结果2020年全院平均住院日为7.13天,其中超长住院患者平均住院日为41.85天。超长住院患者以60岁以上年龄组最多(39.61%);出院科室主要分布在血液科(42.18%)、普通外科(11.85%)、骨科(7.49%)等;疾病类别主要为肿瘤(47.32%)、影响健康状态和与保健机构接触的因素(10.56%)、循环系统疾病(7.07%)等;多因素Logistic回归结果显示,男性(OR=1.188)、离院方式为非医嘱离院或其他(OR=2.046)和死亡病例(OR=3.362)是超长住院的危险因素。结论控制超长住院日对平均住院日影响显著,医院应加强重点人群、重点科室和重点病种管理提高诊疗管理水平,缩短平均住院日。  相似文献   
5.
目的分析看图对话工具在妊娠期糖尿病(GDM)患者健康教育中的应用效果。方法选取2018年1月—2019年12月广西中医药大学附属瑞康医院收治的80例GDM患者,随机分为对照组和观察组,每组40例。对照组开展常规健康教育,观察组采用看图对话工具开展健康教育。比较两组健康教育前后的血糖指标和自护行为能力评分、自然分娩率。结果健康教育后,对照组患者空腹血糖、餐后2 h血糖及糖化血红蛋白水平分别为(6.62±1.24)mmol/L、(7.25±1.32)mmol/L及(6.84±1.26)%,观察组患者空腹血糖、餐后2 h血糖及糖化血红蛋白水平分别为(6.12±2.41)mmol/L、(7.92±1.25)mmol/L及(6.26±1.31)%,两组比较差异均有统计学意义(t=5.135、5.032、5.121,均P<0.05)。健康教育后,观察组患者自护行为能力评分均显著高于对照组(均P<0.05)。观察组自然分娩率为95.00%(38例),显著高于对照组(82.50%,33例),差异有统计学意义(χ2=5.314,P<0.05)。结论在GDM患者健康教育中应用看图对话工具取得了显著效果,不仅能控制患者的血糖水平,而且在提高自护行为能力评分和自然分娩率方面有显著优势。  相似文献   
6.
目的 分析河南省老年人社会经济地位与精神健康的关系。方法 使用多阶段分层整群抽样方法,以河南省18个省辖市的5 570名60岁及以上老年人为研究对象,采用有序logistic回归模型分析社会经济地位对老年人精神健康的影响,探讨医疗保险和居住安排的中介效应。结果 河南省老年人精神健康受损1 999人,受损率35.89%。有序logistic回归分析显示社会经济地位的三个维度均对老年人精神健康有显著影响(均P<0.05),月收入水平(OR = 0.598,95%CI:0.446 ~ 0.801)和受教育程度(OR = 1.617,95%CI:1.004 ~ 2.604)越高,老年人精神健康水平越好;原来职业的层级越高(OR = 1.325,95%CI:1.155 ~ 1.520),老年人精神健康水平越差。影响路径分析显示,城镇职工医保对老年人精神健康有促进作用(低SES:OR = 0.609,95%CI:0.422 ~ 0.878;高SES:OR = 0.380,95%CI:0.248 ~ 0.582),城乡居民医保对高SES老年人精神健康有促进作用(OR = 0.285,95%CI:0.181 ~ 0.448);此外,与配偶/伴侣居住(OR = 0.610,95%CI:0.483 ~ 0.769)、与子女居住(OR = 0.646,95%CI:0.520 ~ 0.803)缓解了社会经济弱势地位对老年人精神健康的负面影响。结论 河南省老年人精神健康受损率较高,社会经济地位的三个维度影响老年人的精神健康水平,医疗保险和居住安排在社会经济地位与老年精神健康的关系中具有显著的中介效应。  相似文献   
7.
目的评估中小学校学生流感疫苗接种效果,开展疫苗接种的卫生经济学评价,为制定流感疫苗接种策略提供依据。方法采用易感者-潜伏者-显性感染者/隐性感染者-移出者/恢复者(susceptible-exposed-infectious/asymptomatic-removed/recovered,SEIARR)动力学模型对既往疫情数据进行模拟,计算累计罹患率评估疫苗接种效果,计算成本-效果和成本-效益进行卫生经济学评价。结果当流感疫苗接种率为0%、50%、70%和90%时,疫情平均累积罹患率为99.79%(99.75%,99.82%)、70.84%(70.58%,71.09%)、56.81%(56.17%,57.45%)和34.29%(32.46%,36.20%),流感疫苗接种率越高,累计罹患率越低;当疫苗接种率为50%、70%和90%时,疫苗的成本-效果比为:141.03(139.86,142.19)元、133.16(131.34,135.08)元和112.90(110.03,116.11)元,疫苗的成本-效益比为:6.27(6.22,6.32)元、6.65(6.56,6.74)元和7.88(7.66,8.09)元;流感疫苗接种率越高,疫苗的成本-效果越好,成本-效益越高。结论接种流感疫苗能有效降低疫情的累计罹患率,提高接种率能有效增加疫苗接种的卫生经济学效应。  相似文献   
8.
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   
9.
BackgroundPolypharmacy is commonly related to poor drug adherence, decreased quality of life and inappropriate prescribing in eldery. Furthermore, this condition also leads to a higher utilization of health services resources, due to the increased risk of adverse drug events, length of stays in hospitals and readmissions rates after discharge.ObjectiveThis Systematic Review aimed to synthesize the current evidence that evaluates pharmaceutical services on polymedicated patients, from an economic perspective.MethodsSystematic searches were conducted in MEDLINE, SCOPUS and Cochrane Library databases to identify studies that were published until January 2021. Experimental and observational studies were included in this review, using strict inclusion/exclusion criteria and were assessed for quality using the following tools: RoB and ROBINS-I. Two independent reviewers selected the articles and extracted the data.Results3,662 articles were retrieved from the databases. After the screening, 18 studies were included: 9 experimental and 9 observational studies. The studies reported that the integration of the pharmacist as a member of the healthcare team provides an optimized use of pharmacotherapy to polymedicated patients and contributes to health promotion, providing reduction of spending on medication, reduction of expenses related to emergency care and hospitalizations and other medical expenses. The ECRs made cost-effectiveness or cost-benefit analysis, and most of the Non Randomized studies had statistically significant cost savings even considering the expenses of pharmaceutical assistance. Experimental studies reported a cost reduction varying between US$ 193 to US$ 4,966 per patient per year. Furthermore, observational studies estimated a cost reduction of varying from US$ 3 to US$ 2,505 per patient per year. The cost savings are related to decrease in emergency visits and hospitalizations, through pharmacist intervention (medication review and pharmacotherapy follow-up).ConclusionsConsidering the set of studies included, pharmaceutical care services directed to polymedicated patients may cooperate to save financial resources. Most of the interventions showed positive economic trends and also contributed to improving clinical parameters and quality of life. However, due to the majority of the studies having exploratory or qualitative methodology, it is essential to carry out more robust studies, based on full economic evaluation.  相似文献   
10.
ObjectiveThe objective of this study was to reduce errors in a pathologic specimen with the help of a protocol systematizing the pathology specimen management process in the operating room.Materials and methodThis quasi-experimental study was carried out in the operating room unit of a research and training hospital. A protocol systematizing the process of specimen management in secure surgical pathology and prepared in light of the current literature was used as an intervention, and the effectiveness of the protocol was tested.ResultsIt was determined that the rate of adverse events decreased from .3226% (68 of 21,078) to .032% (6 of 18,706) after the protocol systematizing the surgical pathology specimen management process prepared by the researchers, and the protocol was found to be effective by 90% (P = .03).ConclusionBased on the data obtained in this study, we recommend the use of a pathologic specimen management protocol in the operating room.  相似文献   
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