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In 2005, the elderly generation comprised 20% of the Japanese population. This percentage will grow to approximately 30% in 2030, meaning that nearly one in three people in Japan will be 65 years of age or older. Japan is the first nation in the world to face this situation. This article uses the context of Japanese society to give an overview of the elderly and people with disabilities; the International Classification of Functioning, Disability, and Health model; rehabilitation engineering-related policy; and education. In addition, we examine how governmental programs and Japanese law regarding technical aids may evolve by 2030. Partner robots, intelligent powered wheelchairs, nursing robots, and other technologies are introduced as examples of rehabilitation engineering and assistive technology. We also discuss the volunteer activities of the Rehabilitation Engineering Society of Japan (RESJA) in response to the Asian tsunami disaster and the achievements of a group of students from a Japanese senior high school of industry.  相似文献   
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汪婷  陈任  闵源  舒守宏  章秋 《安徽医学》2022,43(12):1402-1407
目的 通过对老年住院共病患者开展生活质量评估和影响因素分析,为老年共病人群的综合治疗和健康干预提供理论依据。方法 回顾性分析铜陵市人民医院全医学科2019年6月至2021年9月住院治疗的89例老年住院共病患者临床资料,采用改良老年疾病累计评分表(MCIRS-G)、微型营养评估量表(MNA)、欧洲五维度健康评定量表(EQ-5D-3L)评估老年住院共病患者的共病严重程度、营养状况和生活质量,并运用多元线性回归分析方法分析老年住院共病患者生活质量的影响因素。结果 老年共病患者中患病率较高的为高血压(57.3%)、脑血管疾病(50.6%)和呼吸系统疾病(41.6%),而共病种类上以患3种慢性病者居多(50.6%)。单因素分析显示,不同年龄、总胆固醇、肌酐、共病严重程度和营养状况的共病患者生活质量(VAS)评分比较,差异有统计学意义(t=3.676、3.438、2.160、4.251、-4.256,P<0.05);多元线性回归分析显示,总胆固醇异常、肌酐异常和重度共病是老年共病患者生活质量的主要危险因素(P<0.05),而较好营养状况则可能是其生活质量的保护因素。结论 老年住院共病患者的整体生活质量不容乐观,应通过积极治疗,重点减缓疾病严重程度和改善其营养状况来提高此类患者生活质量。  相似文献   
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目的探讨低钙血症在老年创伤性凝血病(trauma-induced coagulopathy,TIC)早期诊断中的预警价值。方法回顾性分析2015年1月至2020年9月浙江大学医学院附属第二医院急诊ICU中老年创伤患者临床资料,包括年龄、性别、损伤部位、创伤严重度评分(injury severity score,ISS)、格拉斯哥昏迷评分、入院24 h内首次动脉血气分析(Ca^(2+)、K^(+))、静脉血生化电解质(Ca^(2+)、K^(+)、Na^(+))、凝血谱[国际标准化比值、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶原时间(prothrombin time,PT)、纤维蛋白原水平(fibrinogen,FIB)]、血制品使用、临床预后、ICU住院时间、总住院时间、总费用。采用多因素Logistic回归分析和ROC曲线评价血钙水平等相关风险因素在老年TIC早期诊断中效能。结果371例老年创伤患者年龄(72.5±6.8)岁,其中男性248例(66.8%)。TIC组ISS评分高于非TIC组[25(20,34)分vs.21(16,29)分];TIC组中胸部损伤、腹部损伤和四肢损伤发生率均高于非TIC组,而头颈部损伤发生率低于非TIC组;差异均具有统计学意义(均P<0.05)。TIC组静脉血生化血钙水平低于非TIC组[(1.97±0.19)mmol/L vs.(2.15±0.16)mmol/L,P<0.001],而动脉血气分析中钙离子水平差异无统计学意义。TIC组凝血谱中APTT值[(47.6±21.8)s vs.(33.8±4.1)s]、PT值[(18.0±3.9)s vs.(13.7±0.8)s]明显高于非TIC组,FIB值则明显低于非TIC组[(1.7±0.8)g/L vs.(2.8±0.9)g/L];差异均具有统计学意义(均P<0.01)。TIC组血制品使用率、总费用高于非TIC组,而预后好转率低于非TIC组(69.8%vs.86.4%,P<0.001)。多因素logistics回归分析显示低钙血症是老年创伤TIC的独立危险因素(OR=5.830,95%CI:3.295~10.314)。生化血钙与老年创伤TIC相关性的ROC曲线下面积为0.779(95%CI:0.728~0.831),最佳截断值为2.06 mmol/L。结论老年严重创伤早期生化血钙水平降低是发生TIC的独立危险因素。积极纠正老年TIC有助于不断改善临床预后。  相似文献   
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The need to improve the nutrition of the elderly living in long term care has long been recognised, but how this can best be achieved, and whether (and which) intervention is successful in reducing morbidity is less well understood. The aim of this systematic review was to determine the effectiveness of mealtime interventions for the elderly living in residential care. Mealtime interventions were considered as those that aimed to change/improve the mealtime routine, practice, experience or environment. Following comprehensive searches, review and appraisal, 37 articles were included. Inadequate reporting in over half of the articles limited data quality appraisal. Mealtime interventions were categorised into five types: changes to food service, food improvement, dining environment alteration, staff training and feeding assistance. Meta-analysis found inconsistent evidence of effects on body weight of changes to food service (0.5 kg; 95% CI: ?1.1 to 2.2; p = 0.51), food improvement interventions (0.4 kg; 95% CI: ?0.8 to 1.7; p = 0.50) or alterations to dining environment (1.5 kg; 95% CI: ?0.7 to 2.8; p = 0.23). Findings from observational studies within these intervention types were mixed, but generally positive. Observational studies also found positive effects on food/caloric intake across all intervention types, though meta-analyses of randomised studies showed little evidence of any effects on food/caloric intake in food improvement studies (?5 kcal; 95% CI: ?36 to 26; p = 0.74). There was some evidence of an effect on daily energy intakes within dining environment studies (181 kcal/day, 95% CI: ?5 to 367, p = 0.06). The need to improve the nutrition of the elderly living in residential long term care is well recognised. This review found some evidence that simple intervention around various aspects of mealtime practices and the mealtime environment can result in favourable nutritional outcomes. Further large scale pragmatic trials, however, are still required to establish full efficacy of such interventions.  相似文献   
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This study examined the relationship between loneliness, health, and mortality using a U.S. nationally representative sample of 2101 adults aged 50 years and over from the 2002 to 2008 waves of the Health and Retirement Study. We estimated the effect of loneliness at one point on mortality over the subsequent six years, and investigated social relationships, health behaviors, and health outcomes as potential mechanisms through which loneliness affects mortality risk among older Americans. We operationalized health outcomes as depressive symptoms, self-rated health, and functional limitations, and we conceptualized the relationships between loneliness and each health outcome as reciprocal and dynamic. We found that feelings of loneliness were associated with increased mortality risk over a 6-year period, and that this effect was not explained by social relationships or health behaviors but was modestly explained by health outcomes. In cross-lagged panel models that tested the reciprocal prospective effects of loneliness and health, loneliness both affected and was affected by depressive symptoms and functional limitations over time, and had marginal effects on later self-rated health. These population-based data contribute to a growing literature indicating that loneliness is a risk factor for morbidity and mortality and point to potential mechanisms through which this process works.  相似文献   
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许明 《安徽医学》2013,34(11):1626-1628
目的探讨老年隐匿型冠心病患者采取12导动态心电图检查效果,并分析其临床特点,为临床认识及诊断该病提供参考价值。方法将我院2012年1月至2012年12月收治的6l例老年冠心病患者,依据其病史状况分为有临床症状组(30例)和无临床症状组(3l例)。并进行12导动态心电图检查,对比分析ST-T变化。结果无临床症状心肌缺血组患者发生缺血性sT段改变阵次数和白天缺血发作时间均明显多于有临床症状心肌缺血组,数据比较差异有统计学意义(P〈0.05)。无临床症状心肌缺血组的sT段压低幅度〉1.0mm的比例和持续时间〉1.0min的比例均高于有临床症状心肌缺血组,数据比较差异有统计学意义(P〈0.05)。结论12导动态心电图能够对老年冠心病无临床症状心肌缺血患者进行诊断,能够反应出无症状组患者心肌缺血的情况。  相似文献   
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