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   11078篇
  免费   1135篇
  国内免费   63篇
耳鼻咽喉   19篇
儿科学   2466篇
妇产科学   3124篇
基础医学   819篇
口腔科学   138篇
临床医学   852篇
内科学   518篇
皮肤病学   29篇
神经病学   330篇
特种医学   44篇
外科学   306篇
综合类   849篇
一般理论   3篇
预防医学   2116篇
眼科学   77篇
药学   404篇
  6篇
中国医学   42篇
肿瘤学   134篇
  2023年   226篇
  2022年   246篇
  2021年   446篇
  2020年   495篇
  2019年   592篇
  2018年   523篇
  2017年   604篇
  2016年   580篇
  2015年   512篇
  2014年   710篇
  2013年   1095篇
  2012年   540篇
  2011年   667篇
  2010年   550篇
  2009年   532篇
  2008年   514篇
  2007年   520篇
  2006年   449篇
  2005年   356篇
  2004年   314篇
  2003年   263篇
  2002年   186篇
  2001年   128篇
  2000年   128篇
  1999年   98篇
  1998年   75篇
  1997年   69篇
  1996年   69篇
  1995年   65篇
  1994年   72篇
  1993年   67篇
  1992年   49篇
  1991年   50篇
  1990年   41篇
  1989年   42篇
  1988年   44篇
  1987年   33篇
  1986年   38篇
  1985年   48篇
  1984年   46篇
  1983年   33篇
  1982年   35篇
  1981年   22篇
  1980年   24篇
  1979年   14篇
  1978年   11篇
  1977年   15篇
  1976年   10篇
  1975年   9篇
  1974年   6篇
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
1.
目的:探索体重指数(BMI)对不孕女性夫精宫腔内人工授精(IUI)周期妊娠结局的影响。方法:回顾性分析2015 年1 月—2020 年6 月于天津市中心妇产科医院生殖中心施行IUI 治疗的3 707 例患者的周期资料,按照BMI 分为3 组,A 组(正常 体质量组18.5 kg/m2≤BMI<23.0 kg/m2)、B 组(超重组23.0 kg/m2≤BMI<25.0 kg/m2)、C 组(肥胖组BMI≥25.0 kg/m2),比较各组间 一般资料以及妊娠结局。结果:在方案中,3 组间自然周期方案占比差异均有统计学意义(P<0.01),口服药物联合肌注促排药物 方案差异均有统计学意义(P<0.01);BMI 与活产率无关,B 组(OR=1.161,95% CI:0.861~1.565,P=0.328)以及C 组(OR=1.003, 95% CI=0.761~1.322,P=0.948)与A 组活产率差异无统计学意义;肌注促排药物(OR=1.425,95% CI:1.026~1.980,P=0.035) 以及口服药物联合肌注促排药物(OR=1.366,95% CI:1.038~1.796,P=0.026)是影响活产率的独立因素。肥胖(OR=2.784,95% CI:1.471~5.267,P=0.002)以及继发性不孕(OR=3.048,95% CI=1.454~6.389,P=0.003)是早期流产的危险因素。结论:肥胖以及继 发性不孕为早期流产的危险因素,促排药物可提高不孕患者IUI 活产率。  相似文献   
2.
The discussion paper will focus on continuity of care relating to previous NZ research, specifically to transitioning complex preterm infants from NICU to home based on parent experiences, and on the practice developments that have occurred, to ensure optimal health outcomes. Previous NZ research discovered parent desire a consistent service delivery for the entire transition journey from NICU and at home.An informative and comprehensive opportunity has occurred for reflective professional practice, evaluation, development and implementation which have transpired in positive change through innovative practice developments and support change implementation in Wellington, NZ. This has resulted in the articulation of a model of care that has both embraced and integrated parental desires for a continuity of care process for complex preterm infants. This has been achieved by having the same Discharge Facilitator/Key Case Manager present within the NICU and external to the NICU for Home-based infants for the entire transition journey.The paper will focus and emphasis additional practice development changes and furthermore, will present a real purpose, for other countries to learn of such practice developments that have exemplified a celebratory success for families of Wellington, NZ.  相似文献   
3.
随着医疗救治水平的不断提高,早产儿的存活率明显增加,但早产常易伴发脑性瘫痪、运动和认知障碍等一系列神经发育问题,给家庭、社会带来沉重负担。生命早期大脑发育迅速,可塑性强,是进行早期运动干预的良好时机。本文就早产儿早期神经运动干预进行综述,旨在为临床医护人员对早产儿进行适宜有效的运动干预提供参考。  相似文献   
4.
目的探究宫腔粘连分离术(TCRA)后患者接受IVF治疗的活产率及其影响因素。方法选择2014年1月至2019年12月于山东大学附属生殖医院行TCRA手术治疗后接受IVF助孕的635例宫腔粘连(IUA)患者。随访其妊娠结局,并分析可能影响活产率的因素。结果TCRA术后患者行鲜胚移植的活产率为36.7%。年龄(OR=0.930,P<0.001)、AFS评分(OR=0.898,P=0.035)、移植胚胎数(OR=1.875,P=0.001)、促性腺激素(Gn)启动量(OR=0.994,P=0.001)是活产率的独立影响因素。结论年龄、AFS评分、移植胚胎数、Gn启动量可能是活产率的独立影响因素。对于TCRA术后准备接受IVF鲜胚移植的患者,医生应根据以上因素制定个体化治疗方案。  相似文献   
5.
目的:探讨不同起始时间使用咖啡因防治极低出生体质量早产儿呼吸暂停的疗效和安全性。方法:检索PubMed、Cochrane Library、Embase、中国期刊全文数据库(CNKI)、万方数据、生物医学文献(CBM)及维普等数据库,收集各数据库从建库至2020年6月有关极低出生体质量早产儿早期应用咖啡因防治呼吸暂停的病例对照研究,并采用Cochrane系统评价手册5.1.0和Newcastle-Ottawa量表(NOS)对不同类型研究进行质量评价,采用RevMan 5.3进行系统评价。结果:10项文献中,包括5项随机临床对照研究(RCT)和5项回顾性队列研究,文献质量评价结果显示,5项RCT质量等级为B级,5项回顾性队列研究NOS评分为7~9分。共2 665例患儿,其中早期用药组1 515例,晚期用药1 150例。Meta分析结果显示,早期用药组呼吸暂停(AOP)发生率(RR=0.48,95%CI 0.38~0.60,P<0.01)、吸氧时间(SMD=-0.97,95%CI -1.13~-0.80,P<0.01)、机械通气时间(SMD=-0.82,95%CI -1.06~-0.58,P<0.01)、咖啡因用药时间(SMD=-0.42,95%CI -0.56~-0.28,P<0.01)、支气管肺发育不良(BPD)发生率(RR=0.50,95%CI 0.41~0.60,P<0.01)、动脉导管未封闭(PDA)发生率(RR=0.56,95%CI 0.44~0.70,P<0.01)、早产儿视网膜病(ROP)发生率(RR=0.59,95%CI 0.47~0.74,P<0.01)、脑室内出血(IVH)发生率(RR=0.66,95%CI 0.54~0.81,P<0.01)和坏死性小肠结肠炎(NEC)发生率(RR=0.70,95%CI 0.55~0.91,P<0.01)显著低于晚期用药组,而病死率(RR=1.15,95%CI 0.73~1.81,P=0.55)与晚期用药组比较差异无统计学意义。结论:极低出生体质量早产儿早期使用咖啡因能显著降低呼吸暂停发生率、BPD、ROP、PDA、IVH和NEC发生率,减少机械通气、吸氧和咖啡因用药时间,但对病死率无影响。  相似文献   
6.
目的分析中药加味催生饮对剖宫产术后再次阴道分娩引产成功率及分娩结局的影响。方法选取2018年10月至2020年11月在苏州市立医院本部产科收治的174例单胎头位的瘢痕子宫孕妇作为研究对象,根据处理方式的不同分为加味催生饮组50例,球囊组46例,以及未采用加味催生饮及球囊引产的对照组78例。比较3组间宫颈成熟度、分娩方式、产程、产后出血量以及新生儿结局的差异。结果加味催生饮组和球囊组剖宫产术后再次阴道分娩(vaginal birth after cesarean,VBAC)比例均高于对照组,差异有统计学意义(P<0.05)。加味催生饮组和球囊组引产后宫颈评分明显改善(P<0.001),并且加味催生饮组引产后宫颈评分高于球囊组(P<0.001)。与对照组比较,加味催生饮组VBAC产妇住院时间更短、住院费用更少,差异均有统计学意义(P<0.001)。加味催生饮组和球囊组胎儿窘迫发生率低于对照组(P<0.05),3组间产后出血、子宫破裂发生率、新生儿出生体重及Apgar评分比较,差异均无统计学意义(P>0.05)。结论对于剖宫产术后再次妊娠的孕妇,加味催生饮可有效促进产妇宫颈成熟,提高引产成功率,减少母婴不良结局。  相似文献   
7.
Acute myeloid leukaemia (AML) is one of the deadliest haematological malignancies. During pregnancy it is a rare comorbidity and can lead to adverse outcomes, such as death, without adequate treatment. The management of AML during pregnancy remains a challenge. We report the case of a primigravida 34-year-old, with 18 weeks of amenorrhoea, who attended the emergency department presenting with pain and hypertrophy of the oral mucosa, accompanied by intense asthenia. Acute myeloblastic leukaemia was diagnosed. The possibility of terminating the pregnancy was offered given the lack of evidence regarding the maternal-foetal outcome, but the patient rejected it, so chemotherapy treatment was started. In the ultrasound controls there was no evidence of teratogenic alterations nor foetal growth restriction, and there were no alterations in Doppler flow values. It was decided to end the pregnancy at 32 + 3 GW. A preterm male was born through eutocic delivery with a normal Apgar test and umbilical cord pH, and did not require resuscitation. The puerperium was favourable and 15 days following discharge she was admitted for a bone marrow transplant from her HLA identical sister. The patient died due to rejection of the transplant and the complications derived from this event.  相似文献   
8.
Preterm birth (PTB) is commonest cause of perinatal mortality and morbidity in multiple pregnancies with significant long-term sequelae. The etiology of PTB is multifactorial. Universal screening by a transvaginal assessment of cervical length (CL) at midtrimester scan is recommended for all women with twin pregnancies. Women with CL ≤ 25 mm should be offered prophylactic vaginal progesterone to mitigate the risk of PTB. Other modalities like home uterine activity monitoring, digital cervical examination, fetal fibronectin (FFN) assessment, and screening for infections are not recommended. History-indicated cerclage is not advised in unselected twin pregnancies, but a combination of physical examination-indicated cerclage, tocolytics, and antibiotics may be considered in twin pregnancies with a dilated cervix prior to 24 weeks’ gestation. Routine use of cervical pessary is not advised and should be limited to research settings. Neither transvaginal CL nor FFN assessment is supported by evidence to predict the risk of PTB in symptomatic women with multiple pregnancies. More research is warranted to develop and validate algorithms to predict PTB to provide individualized care to these high-risk pregnancies.  相似文献   
9.
《Value in health》2022,25(12):1947-1957
ObjectivesWe aimed to evaluate the cost-effectiveness of offering once-off birth cohort testing for hepatitis C virus (HCV) to people in Ireland born between 1965 and 1985, the cohort with the highest reported prevalence of undiagnosed chronic HCV infection.MethodsSystematic and opportunistic HCV birth cohort testing programs, implemented over a 4-year timeframe, were compared with the current practice of population risk-based testing only in a closed-cohort decision tree and Markov model hybrid over a lifetime time horizon. Outcomes were expressed in quality-adjusted life-years (QALYs). Costs were presented from the health system’s perspective in 2020 euro (€). Uncertainty was assessed via deterministic, probabilistic, scenario, and threshold analyses.ResultsIn the base case, systematic testing yielded the largest cost and health benefits, followed by opportunistic testing and risk-based testing. Compared with risk-based testing, the incremental cost-effectiveness ratio for opportunistic testing was €14 586 (95% confidence interval €4185-€33 527) per QALY gained. Compared with opportunistic testing, the incremental cost-effectiveness ratio for systematic testing was €16 827 (95% confidence interval €5106-€38 843) per QALY gained. These findings were robust across a range of sensitivity analyses.ConclusionsBoth systematic and opportunistic birth cohort testing would be considered an efficient use of resources, but systematic testing was the optimal strategy at willingness-to-pay threshold values typically used in Ireland. Although cost-effective, any decision to introduce birth cohort testing for HCV (in Ireland or elsewhere) must be balanced with considerations regarding the feasibility and budget impact of implementing a national testing program given high initial costs and resource use.  相似文献   
10.
目的探讨发展性照顾护理模式对低出生体重儿生长发育和神经行为发育的影响。方法选取2019年3月至2021年3月我院收治的86例低出生体重儿作为研究对象,随机分为对照组(n=43)和观察组(n=43)。对照组采用常规护理干预,观察组在对照组基础上采用发展性照顾护理模式干预。比较两组的生长发育和神经行为发育情况。结果出院时,观察组的身长、头围和体质量增长均显著优于对照组(P<0.05)。干预前,两组的MDI、PDI评分比较,差异无统计学意义(P>0.05);出院时,观察组的MDI、PDI评分均显著高于对照组(P<0.05)。结论发展性照顾护理模式在低出生体重儿中应用效果显著,可有效促进低出生体重儿的生长发育和神经行为发育。  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