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1.
The development and implementation of school policies is considered a key strategy for the promotion of physical activity (PA) in children and adolescents. This study aimed to systematically review and synthesise existing literature focusing on the associations between formal written school-based PA policies and (a) school PA practices and (b) PA behaviours of school-aged children and adolescents. Fifty-one papers reporting on 52 studies met the eligibility criteria. All but two studies were from high income countries, most used cross-sectional designs and demonstrated fair methodological quality, and just over a third examined language aspects of policies. Findings predominantly indicated a lack of or inconclusive associations between the various characteristics examined and PA outcomes. Inconclusive associations were identified between both PA practice and behaviour outcomes and state level policies, policies focusing on PE and school-day PA, and in studies examining language aspects of policies. Inconclusive associations with both types of outcomes were more likely to be identified compared to a lack of associations in studies using self-report measures and in studies not providing information about the quality of exposure and outcome measures used. Overall, findings highlight the need for further research that acknowledges the complex relationship between school policies and PA outcomes and employs robust methodological approaches to enhance our understanding of this area.  相似文献   
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《Vaccine》2019,37(23):3002-3005
Despite global recommendations for influenza vaccination of high-risk, target populations, few low and middle-income countries have national influenza vaccination programs. Between 2012 and 2017, Lao PDR planned and conducted a series of activities to develop its national influenza vaccine program as a part of its overall national immunization program. In this paper, we review the underlying strategic planning for this process, and outline the sequence of activities, research studies, partnerships, and policy decisions that were required to build Laos’ influenza vaccine program. The successful development and sustainability of the program in Laos offers lessons for other low and middle-income countries interested in initiating or expanding influenza immunization.  相似文献   
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In 2013, a national inquiry into care failings at a large public hospital in England resulted in major healthcare reforms that included targeting policy aimed at ensuring the adequacy of nurse staffing levels on hospital wards within NHS England. This paper uses a review of publicly available documents to provide a contextual account of the evolution of nurse staffing policy development prior to and following the inquiry. We found that securing safe staffing policy has been impacted by caveats and competing policy, evidence gaps, lack of coordination, and the absence of readily implementable solutions. Consequently, five years on, safe staffing policy for NHS England is described in aspirational terms that ascribes accountability to providers, but fails to adequately address barriers to delivery. Kingdon’s ‘policy windows’ model is used to explain why policy, even when driven by strong public concern and with high inter-sector support, may struggle to gain traction when the conditions necessary for success are not present, and in the face of practical or political constraints. The progress and pitfalls encountered are not unique and the experience of safe staffing policy in England may have lessons for other countries grappling with policy development or implementation in this area.  相似文献   
4.
BackgroundDementia and cardiovascular disease generate enormous health and social-care costs and have shared risk factors. Following decades of cardiovascular disease mortality declines in England, improvements slowed after 2011. We investigated the potential economic implications of this slowdown.MethodsWe used the IMPACT better aging model—an open-cohort, stochastic Markov model. We synthesised trends in cardiovascular disease incidence and mortality, dementia, and disability (defined as reported diagnosis, functional impairment, or measured cognitive impairment) from the English Longitudinal Study of Ageing (ELSA) and Office for National Statistics data. We projected trends for adults aged 35–100 years in England and Wales from 2019–29. We modelled undiscounted health and social-care costs (primary outcome), and quality-adjusted life-years (QALYs) under the following two scenarios: age-specific cardiovascular disease incidence continues to decline, recommencing previous downward trends (scenario one); or age-specific cardiovascular disease incidence plateaus after 2006, continuing recent trends, assuming changes in mortality reflect incidence 5 years before (scenario two). We linked 85% of ELSA participants to their Hospital Episode Statistics (HES) data, which were costed and calibrated to national estimates. Age-related social-care costs were estimated by use of reported contact hours from ELSA combined with standard reference costs. Standard catalogues were used for QALY weights.FindingsIn scenario one, changes in population size and health were projected to increase health-care costs by around 12% between 2019 and 2029, from £93·0 billion to £104·6 billion per year (in 2019 prices). Social-care costs were projected to increase by around 27%, from £8·0 billion to £10·2 billion per year. In scenario two, health-care costs were projected to increase by around 15%, from £95·3 billion to £109·6 billion, and social-care costs by around 30%, from £8·2 billion to £10·7 billion, between 2019 and 2029. The overall net monetary cost of this slowdown in cardiovascular disease decline was £17·5 billion per year (made up of 200 000 QALYs and £5·5 billion in health and social-care costs).InterpretationWe predict social-care costs will grow twice as fast as health-care costs over the next decade, even if cardiovascular disease occurrence continues to decline. Understanding the scale of the future health and social-care funding challenge might support proactive policy making. This study represents the first time ELSA data have been linked with HES data. However, we did not assess changes in health and social-care efficiency over time or the effect of spending on improving health.FundingBritish Heart Foundation  相似文献   
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目的调查泸州市中老年男性艾滋病疫情高发的原因,为制订有针对性的干预策略提供依据。方法采用整群抽样的方法,2019年对473例新报告的泸州市50岁及以上中老年男性艾滋病感染者/病人展开性伴、安全套使用及商业性行为等主要内容的问卷调查,采用卡方检验进行差异性分析,检验水准α=0.05。结果分别有81.6%、62.8%和10.1%的人有商业性行为、固定性伴/配偶和临时性伴,除固定性伴比例随年龄增长呈下降趋势(χ2趋势=6.934,P=0.008)外,其余性伴类型没有统计学差异。与不同性伴发生性关系,近1年从未使用安全套比例均超过90%。无配偶(35.8%)、配偶不在身边(30.8%)、诱惑/好玩(22.4%)是寻找商业性伴的前3位原因;性交易对象以本地为主,本乡镇占56.0%。固定场所(46.3%)和接头拉客(43.7%)是最主要的寻找商业性伴方式。多数性交易价格低于50元,年龄越大,<50元的占比越大(50岁~59岁、60岁~69岁、≥70岁分别为52.1%、78.0%和80.0%),差异有统计学意义(χ2=22.061,P<0.001)。结论中老年男性通过寻找商业性伴满足其性需求,交易价格偏低。该群体存在多性伴行为、基本不使用安全套行为等现象,是其艾滋病疫情快速增长的重要原因。  相似文献   
7.
石少江 《当代医学》2022,28(2):75-77
目的探析全口义齿修复失败的原因及处理的方法。方法回顾性分析2017年1月至2020年1月本院收治的50例全口义齿修复失败患者的临床资料,分析全口义齿修复失败的原因,并据此制定具体的处理对策。结果50例全口义齿修复失败患者中,20例患者因义齿修复体松脱导致(占比40.00%),10例患者因基托折断、断裂导致(占比20.00%),8例患者因人工牙折断导致(占比16.00%),5例患者因颌位关系存在误差导致(占比10.00%),4例患者因美观原因导致(占比8.00%),3例患者因其他原因导致(占比6.00%)。经过处理、修复并且制作新义齿,43例患者非常满意(占比86.00%),6例患者基本满意(占比12.00%),1例不满意(占比2.00%)。结论全口义齿修复失败的原因较多,需根据患者适应证减少不良应激反应,提升全口义齿修复成功率。  相似文献   
8.
陈露  马芳  马蕊  马国芳 《现代预防医学》2022,(21):3944-3950
目的 评估我国疾病预防控制体系建设相关政策文件效力和实施效果,为我国疾病预防控制体系政策制定建言献策。方法 通过国家卫生健康委员会官网、“北大法宝”检索系统以“疾病预防控制”、“疾控体系”、“疾控”为主要检索词检索2003—2022年中央、国家及各部委发布的政策文件,经筛选后最终纳入52项疾病预防控制相关政策。将政策效力划分为政策力度、政策措施、政策目标3个维度,用疾病预防控制支出表示政策效果,通过构建多元线性回归模型对环境型、供给型、需求型三种不同政策工具疾病预防控制体系建设政策实施效果进行回归分析。结果 2003—2022年,我国疾控体系建设相关政策数量与总体效力值呈现平稳波动,且具有明显的正相关关系,政策平均效力值呈M型稳定变化趋势,整体水平偏低; 政策措施得分最高,政策目标次之,政策力度得分最低。相较于其他两种政策工具,环境型政策工具使用频率最高,需求型政策工具使用频率最低; 环境型(Coef.=0.732,P=0.015)、供给型(Coef.=0.64,P=0.010)、需求型(Coef.=0.523,P=0.035)三种政策工具对政策实施效果均具有促进作用,滞后期保持在1~2年; 上一年度的疾控支出对下一年度的政策效果具有促进作用(Coef.=0.74,P=0.032)。结论 我国疾病预防控制政策效力不断提高主要源于政策颁布数量的累计效应; 不同政策工具使用过程中存在不平衡、不充分问题; 三类政策工具均对我国疾病预防控制体系政策实施效果起到一定影响,且环境型政策工具最优; 疾病预防控制相关支出会强化政策实施效果,推动疾控体系建设快速发展。  相似文献   
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《Vaccine》2021,39(37):5240-5250
Given our global interconnectedness, the COVID-19 pandemic highlights the urgency of building a global system that can support both routine and pandemic/epidemic adult immunization. As such, a framework to recommend vaccines and build robust platforms to deliver them to protect the rapidly expanding demographic of older adults is needed. Adult immunization as a strategy has the broad potential to preserve and improve medical, social, and economic outcomes, including maintaining functional ability that benefits older adults, their families, communities, and countries. While we will soon have multiple vaccines against COVID-19, we must recognize that we already have a variety of vaccines against other pathogens that can keep adults healthier. They can prevent simultaneous co-infection with COVID-19, and may favorably impact- the outcome of a COVID-19 illness. Further, administering a vaccine against COVID-19 requires planning now to determine delivery strategies impacting how older adults will be immunized in a timely manner. A group of international experts with various backgrounds from health and aging disciplines met to discuss the evidence case for adult immunization and crucial knowledge gaps that must be filled in order to implement effective policies and programs for older adult immunization. This group, coming together as the International Council on Adult Immunization (ICAI), outlined a high-level roadmap to catalyze action, provide policy guidance, and envision a global adult immunization platform that can be adapted by countries to fit their local contexts. Further meetings centered around the value of adult immunization, particularly in the context of COVID-19. There was agreement that programs to deliver existing influenza, pneumococcal, herpes zoster vaccines, and future COVID-19 vaccines to over a billion older adults who are at substantially higher risk of death and disability due to vaccine-preventable diseases are more urgent than ever before. Here we present a proposed framework for delivering routine and pandemic vaccines. We call upon the global community and governments to prioritize action for integrating robust adult immunization programs into the public health agenda.  相似文献   
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