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1.
The objective of this study was to analyze whether a meta‐analysis could allow us to draw useful conclusions about the risk factors for falls in the elderly. A systematic review was carried out of various databases and completed manually. To satisfy the inclusion criteria, an article had to examine a population of subjects aged over 60 years to pertain to falls occurring during daily living activities, and to involve observational or interventional studies. This review identified 4405 indexed articles published between 1981 and 2011. Of the 220 studies with available data that were included in the final study, just 4% were interventional. Among these 220 studies, just 45% offered a satisfactory level of scientific proof. In total, 88 meta‐analyses were carried out on the 156 potential protectors or risk factors that were identified. Our systematic review and meta‐analyses ensured that high‐quality results were obtained from this comprehensive literature search and included a detailed assessment of the quality of the included studies. Several factors appeared to be disproportionately represented in the literature, a fact that likely reflects the objective and precise assessment of these factors rather than their importance in the falls of the elderly. Thus, we cannot be certain that we obtained the most comprehensive analysis of the risk factors for falling with this method. Meta‐analyses can help to define the association between falls and various risk factors, but they have to be used complementary to systematic review for the assessment of risk factors. Geriatr Gerontol Int 2013; 13: 250–263.  相似文献   
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With the establishment of the new American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2010 criteria for rheumatoid arthritis (RA) to diagnose patients earlier and with the introduction of early and aggressive treatment, the current aim is remission resulting in less functional disability, halting of radiographic damage, less pain, less fatigue and no loss of employment. These outcomes can be related to the World Health Organization International Classification of Functioning, Disability and Health (the WHO ICF framework). This framework includes the component body functions, body structures, activities and participation related to the disease. These components are related to each other in a bidirectional way and can be influenced by contextual factors including environmental and personal factors. This framework can be used to describe trends in RA outcomes and the impact of contextual factors on these outcomes. Despite aggressive treatment strategies, patients with RA still experience loss of function, pain and fatigue, and a relatively high proportion of patients have to take sick leave or become work disabled within the first few years of the disease. There is evidence that more stringent definitions of remission lead to greater improvement of outcomes and that the aim should be sustained remission and not just remission. There is, however, a need for a better understanding of the relation between contextual factors and activity and participation outcomes to better guide therapy decisions by rheumatologists and provide information to patients, families and policymakers about the impact of RA on their lives and to the society. The overall aim of this overview is to highlight the important contextual factors and consequences that relate to outcomes typically measured in RA studies and to demonstrate the additional benefits that can be achieved with remission and sustained remission.  相似文献   
3.
Sensitive skin syndrome was first described in 1977; however, no robust study has been carried out to evaluate its prevalence in Japan. A national representative sample of the Japanese population over the age of 18 years was taken. Individuals were questioned by telephone and selected according to the quota method. When asked “Do you have a sensitive skin?”, 52.84% of men and 55.98% of women answered “rather sensitive” or “very sensitive”. There was no significant difference (P = 0.22) between the two sexes. The non‐response rate among respondents was zero, suggesting that the term “sensitive skin” held a meaning for the majority of the population. Concerning questions about the onset of a rash, tingling or irritation in the presence of various factors, such as emotional issues, cold, heat, sun, dry air, air‐conditioning, water, air pollution and temperature variations, respondents with rather sensitive or very sensitive skin responded “yes” more often than others: approximately three‐times more often for water (18.97%/6.15%), air pollution (39.29%/12.45%) and warm climatic conditions (29.74%/9.8%). To our knowledge, this epidemiological study is the first to focus on sensitive skin among Japanese people of this century. It is of particular interest for two reasons: (i) it was conducted on a representative sample of the Japanese population; and (ii) the methodology used was identical to that used for sensitive skin assessment studies conducted in Europe and the USA, making it possible to draw certain comparisons.  相似文献   
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Nuevo R, Van Os J, Arango C, Chatterji S, Ayuso‐Mateos JL. Evidence for the early clinical relevance of hallucinatory‐delusional states in the general population. Objective: To analyze, in a general population sample, clustering of delusional and hallucinatory experiences in relation to environmental exposures and clinical parameters. Method: General population‐based household surveys of randomly selected adults between 18 and 65 years of age were carried out. Setting: 52 countries participating in the World Health Organization’s World Health Survey were included. Participants: 225 842 subjects (55.6% women), from nationally representative samples, with an individual response rate of 98.5% within households participated. Results: Compared with isolated delusions and hallucinations, co‐occurrence of the two phenomena was associated with poorer outcome including worse general health and functioning status (OR = 0.93; 95% CI: 0.92–0.93), greater severity of symptoms (OR = 2.5 95% CI: 2.0–3.0), higher probability of lifetime diagnosis of psychotic disorder (OR = 12.9; 95% CI: 11.5–14.4), lifetime treatment for psychotic disorder (OR = 19.7; 95% CI: 17.3–22.5), and depression during the last 12 months (OR = 11.6; 95% CI: 10.9–12.4). Co‐occurrence was also associated with adversity and hearing problems (OR = 2.0; 95% CI: 1.8–2.3). Conclusion: The results suggest that the co‐occurrence of hallucinations and delusions in populations is not random but instead can be seen, compared with either phenomenon in isolation, as the result of more etiologic loading leading to a more severe clinical state.  相似文献   
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Epileptic seizures have been known from time immemorial. Throughout the ages, however, ideas concerning the aetiology and treatment of epilepsy have changed considerably. Epilepsy is mentioned many times in the Pentateuch, where it is portrayed as a mysterious condition, whose symptoms, course and contingencies evade rational laws and explanations. In the Middle Ages, the accepted view which prevailed in social consciousness was that patients with epilepsy were possessed by Satan and other impure spirits. One common method of treatment of epileptic seizures was to submit the patient to cruel exorcisms. Patients were frequently injured in the process and some of them even died. Our understanding of epilepsy and its social consequences has improved considerably within the last century. The most significant progress as far as diagnosis and treatment of epilepsy is concerned took place in the last four decades of the twentieth century. Although we now know much more about epilepsy than we used to, this knowledge is still insufficiently popularized.  相似文献   
10.
Objective: This study aimed to evaluate the effect of clustering of cardiovascular risk factors (CVRF) on stroke incidence and find some high predictive clusters among Inner Mongolians in China.

Methods: A prospective cohort study was conducted among 2589 participants aged 20 and older from Inner Mongolia, China. The participants were divided into four groups according to the number of CVRFs and followed up from June 2002 to July 2012. Cox proportional hazards model was used to evaluate the clustering of CVRFs on the incidence of stroke. Area under curve was used to compare the effect of every cluster on stroke and find those having higher predictive value.

Results: A total of 124 stroke occurred during the follow-up period. The incident stroke cases tended to be older and male; had higher prevalence of smoking, drinking, and family history of cardiovascular diseases (FHCVD); had greater waist circumference, higher systolic and diastolic blood pressure, and C-reactive protein levels at baseline compared with those who did not experience stroke. Unadjusted hazard ratio (HR) (95% confidence interval) of stroke in the participants with at least three CVRFs was 5.230 (2.646–10.336), compared with those without CVRF. After multiple adjustments, the result remained statistically significant (HR, 3.388; 95% confidence interval: 1.678–6.840). On the basis of FHCVD, clustering of hypertension with other CVRFs and clustering of diabetes with tachycardia had higher predictive value than other clustering.

Conclusion: The clustering of CVRFs increased the risk of stroke. On the basis of FHCVD, the clustering of hypertension with other CVRFs and the clustering of diabetes with tachycardia had higher predictive value for stroke than other cluster.  相似文献   
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