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Wonashi R. Tsanglao Sudha Chandelia Narendra Kumar Arya Anu Sharma 《The Journal of asthma》2019,56(7):791-798
Introduction: Tropical pulmonary eosinophilia (TPE) is a form of occult filariasis, clinically characterized by paroxysmal cough, wheezing and dyspnea which is often misdiagnosed and treated as asthma. These manifestations result from a host immune response to trapped antigens of the microfilarial parasites Wuchereria bancrofti or Brugia malayi in the pulmonary microcirculation. Case study: We describe three rare presentations of TPE (cor pumonale, cystic lung disease and respiratory distress mimicking acute severe asthma) in our series of 12 cases. All cases were from filaria endemic areas and presented with cough, wheezing and dyspnea, either alone or in combination. Subsequent work-up revealed peripheral eosinophilia, raised serum IgE levels and positive serum filarial antibody and/or antigen in all the cases. Results: All patients were treated with diethylcarbamazine (DEC), while few required inhaled/systemic corticosteroid. Prompt improvement in clinical symptoms with a decrease in eosinophil count was seen in all. Two cases relapsed requiring a second course of DEC. Long-term outcome was good, however, there was a persistence of restrictive lung function and echocardiographic feature of pulmonary hypertension in the patients with cystic lung disease and cor pulmonale, respectively. Conclusion: TPE should always be considered in patients from filaria endemic areas presenting with cough, dyspnea or wheezing. High eosinophil count (>3?×?109 cells) with raised IgE level (>1000?IU/mL) in such cases should alert the physician to look for TPE. Early diagnosis and treatment can prevent disease progression and complications. 相似文献
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以中国疾病预防控制中心寄生虫病预防控制所2016年8月至2017年4月举办的3次热带病预防控制主题会议(培训班)的参会人员为调查对象,采用自填式问卷调查的方法收集信息,使用SPSS 20.0软件对数据进行统计分析。共发放问卷256份,获得有效问卷241份。从未听说过全球卫生概念者占14.5%(35/241),虽听说过但不太了解者占82.6%(199/241),熟悉者仅2.9%(7/241)。调查对象对流行病学与卫生统计学知识的熟悉程度显著高于全球卫生(P<0.01)。全球卫生基本概念的正确理解占比为42.7%(103/241),≤35岁组的正确理解占比为53.8%(56/104),>35岁组为34.3%(47/137),二者差异有统计学意义(P<0.05)。97.1%(233/240)的调查对象表示有意愿参加全球卫生培训,培训内容需求排名前3的分别为疾病防控策略和技术,实验检测、诊断和研发技术,卫生管理知识;能力提升需求排名前3的分别为全球卫生视野、疾病防控经验和调查分析能力。培训方式以现场教学为主,采用教师学员互动教学模式,多聘用国外卫生系统师资。我国热带病防控人员对全球卫生知识的了解程度不容乐观,需要加强全球卫生培训和能力建设。 相似文献
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BackgroundPoor housing is detrimental to health. In England, around one in five homes fail decent homes criteria. The aims of this study were to map changes within English policy affecting housing for lower income households and explore the extent that health features in government housing documents.MethodsWe did an analysis of English housing policy documents between May 12, 2010, and Aug 1, 2019. English language UK Government publications on housing policy strategy, guidelines, consultations, and committee reports were included. The search was not comprehensive. Rather, we sought key policy documents by searching GOV.UK, consulting stakeholders, and checking citations. After identifying the main housing policies introduced during this period, we used thematic analysis to examine if and how health and health inequalities were considered in these policy documents.Findings71 documents were identified in our search. Each covered housing policies related to one or more of the following policy areas: social housing (n=34), supported housing for elderly and disabled people and people in housing crisis (n=35), private rented sector (n=8), home ownership (n=15), and healthy places (n=7). We identified the following health-related themes: focusing on vulnerable populations, temporary versus long-term health issues, health and housing welfare entitlement, environmental exposure to health and safety hazards, insecure housing, and the contribution of housing to healthy places and communities. Many policy documents distinguished between people requiring long-term sheltered or supported housing (typically focusing on elderly and disabled people) and people susceptible to acute housing crises requiring short-term interventions. Policy documents were less detailed on the health impacts housing policies could have on the wider population, including policy discussions of public expenditure constraints, welfare restrictions, and short-term tenancies. A few policy documents from 2017 onwards made some reference to the stress and harms of short-term and insecure housing—notably private rented homes—and the overall housing market has been described by the government as broken.InterpretationSince 2010, housing policy documents typically considered health in the context of public expenditure and social and supported housing. Wider population health impacts of housing policies received less attention. Recent changes in rhetoric should be monitored for their sustainability and health impacts.FundingNational Institute for Health Research (NIHR) School for Public Health Research (grant no PD-SPH-2015). 相似文献
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O.C. Durojaiye E.I. Kritsotakis P. Johnston T. Kenny F. Ntziora K. Cartwright 《Clinical microbiology and infection》2019,21(7):905.e1-905.e7
ObjectivesOutpatient parenteral antimicrobial therapy (OPAT) is increasingly used to treat a wide range of infections. However, there is risk of hospital readmissions. The study aim was to develop a prediction model for the risk of 30-day unplanned hospitalization in patients receiving OPAT.MethodsUsing a retrospective cohort design, we retrieved data on 1073 patients who received OPAT over 2 years (January 2015 to January 2017) at a large teaching hospital in Sheffield, UK. We developed a multivariable logistic regression model for 30-day unplanned hospitalization, assessed its discrimination and calibration abilities, and internally them validated using bootstrap resampling.ResultsThe 30-day unplanned hospitalization rate was 11% (123/1073). The main indication for hospitalization was worsening or nonresponse of infection (52/123, 42%). The final regression model consisted of age (adjusted odds ratio (aOR), 1.18 per decade; 95% confidence interval (CI), 1.04–1.34), Charlson comorbidity score (aOR, 1.11 per unit increase; 95% CI, 1.00–1.23), prior hospitalizations in past 12 months (aOR, 1.30 per admission; 95% CI, 1.17–1.45), concurrent intravenous antimicrobial therapy (aOR, 1.89; 95% CI, 1.03–3.47) and endovascular infection (aOR, 3.51; 95% CI, 1.49–8.28). Mode of OPAT treatment was retained in the model as a confounder. The model had adequate concordance (c-statistic 0.72; 95% CI 0.67–0.77) and calibration (Hosmer-Lemeshow p 0.546; calibration slope 0.99; 95% CI 0.78–1.21), and low degree of optimism (bootstrap optimism corrected c-statistic, 0.70).ConclusionsWe identified a set of six important predictors of unplanned hospitalization based on readily available data. The prediction model may help improve OPAT outcomes through better identification of high-risk patients and provision of tailored care. 相似文献
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I. Potters L. Van Duffel G. Broeckx E. Bottieau 《Clinical microbiology and infection》2019,21(6):696-698
We report a case of intestinal schistosomiasis in a patient who had not travelled outside Europe after migrating 20 years ago. Images of the Schistosoma mansoni eggs are shown that confirm the active nature of the infection. 相似文献
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<正>Asian Pacific Journal of Tropical Medicine(APJTM)is an international journal of tropical medicine that is edited by International Federation of Tropical Medicine(IFTM)and published by Elsevier.It is the only journal of tropical medicine included by SCI,Medline in China.It indicates APJTM has become one of the top international journals.Since the first issue in March 2008,it has been included by 12 international databases: 相似文献