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1.
《Vaccine》2022,40(52):7515-7519
The recent wave of COVID-19 cases has led to the potential need for booster doses. We surveyed 6,294 people and found that 87.6% reported willingness to take a booster dose, with vaccine efficacy rate being the most common reason cited to accept booster dose. Differences in acceptance rates were noted among those working in non-health related sectors, different ethnic groups as well as those who had taken viral vector vaccines.  相似文献   
2.
《Radiography》2022,28(1):162-167
IntroductionThe choice of career and speciality can be a complex process. It is unclear what influences career decisions within undergraduate radiographers and whether the curriculum provides sufficient support.MethodsAn online cross-sectional survey was undertaken. All undergraduate diagnostic radiography students within one UK higher education institution were invited to participate. Questions were related to anticipated career choice, motivational factors and influences.ResultsThe response rate was 67.6% (90/133). The most popular specialist area for career preference was general radiography. The top three motivational factors were work life balance, career development and job satisfaction. The most influential factors on career choice were clinical placements, radiographers on placements and formal teaching. Career guidance was predominantly sourced from the personal academic tutor and was informed by role models.ConclusionRadiography academic teams and clinical placement providers must work together to ensure that students have access to high quality placements across specialities. The experiences received during undergraduate training are important in specialty choice.Implications for practiceCareer guidance is essential and should begin as early as possible. Clinical and academic radiographers need to appreciate the influence they have on students future career plans.  相似文献   
3.
BackgroundAlthough recent advances have been made in the treatment of acute stroke, only a few patients have received reperfusion therapy. Studies on prehospital delay in patients with stroke have revealed a wide range of associated factors in different countries. However, a unified risk management system for stroke remains unavailable. There are no published risk management systems to manage prehospital delay in stroke patients across China.AimThis study aimed to identify key risk factors that affect the prehospital delay risk prediction of acute ischemic stroke (AIS) patients and develop a crux of recommendations using the identified risk factors.MethodsPrehospital delay predictors were collected through literature and expert interviews. We also developed a risk assessment questionnaire via two rounds of expert inquiry. From October 2017 to July 2019, 447 patients admitted for AIS and 202 relevant medical personnel from the Heilongjiang province of China were recruited. The risk factors were analyzed using the Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) to extract those that significantly impacted prehospital delay.ResultsA total of seven key risk factors were extracted from the 22 factors that were evaluated. Of these factors, five were associated with the patient delay stage and two with the transportation delay stage.ConclusionsA multi-dimensional and whole-process risk management mechanism should be established for AIS patients. These patients should be advised to improve their risk coping ability and relevant departments should formulate complete medical treatment procedures and medical systems to ameliorate prehospital delay effectively.  相似文献   
4.

Background

To estimate patient acceptable symptom state (PASS) and minimal clinically important difference (MCID) for patient-reported outcomes in systemic sclerosis (SSc).

Methods

We conducted a secondary analysis of the SCLEREDUC trial, a 12-month randomized controlled trial comparing the efficacy of physical therapy to usual care in 220 SSc patients followed-up from September 2005 to October 2010. Self-rated state and change in patient health at 12 months were assessed by using 2 external anchors extracted from the Medical Outcomes Study 36-Item Short-Form. Patients who self-rated their health as “excellent”, “very good” or “good” were the PASS group and those who self-rated their health change as “somewhat better” were the MCID group. Main outcomes were the estimates of PASS by using the 75th percentile method and of MCID by using the mean change in scores method for pain and activity limitation.

Results

PASS (95% confidence interval) and mean (SD) MCID estimates at 12 months were 53.75 (34.00 to 68.00) and ?6.74 (32.02) for the joint-pain visual analog scale (range 0–100), 1.41 (1.13 to 1.63) and ?0.21 (0.48) for the Health Assessment Questionnaire (HAQ, range 0–3), 1.27 (1.07 to 1.62) and ?0.13 (0.45) for the scleroderma HAQ (range 0–3), 26.00 (17.00 to 37.00) and -3.38 (9.87) for the Cochin Hand Function Scale (range 0–90), and 19.40 (17.20 to 21.90) and ?5.69 (6.79) for the McMaster-Toronto Arthritis Patient Preference Disability Questionnaire (range 0–30), respectively.

Conclusions

We provide, for the first time, the PASS and MCID estimates for pain and activity limitation in SSc.

Trial registration

ClinicalTrials.gov Identifier: NCT00318188. First Posted: April 26, 2006.  相似文献   
5.

BACKGROUND:

The cost of liver biopsy (LB) is publicly funded in British Columbia, while the cost of transient elastography (FibroScan [FS], Echosens, France) is not. Consequently, there is regional variation regarding FS access and monitoring of liver disease progression.

OBJECTIVE:

To evaluate patient preference for FS versus LB and to assess the willingness to self-pay for FS.

METHODS:

Questionnaires were distributed in clinic and via mail to LB-experienced and LB-naive patients who underwent FS at Vancouver General Hospital, Vancouver, British Columbia.

RESULTS:

The overall response rate was 76%. Of the 422 respondents, 205 were LB-experienced. The mean age was 53.5 years, 50.2% were male, 54.7% were Caucasian, 38.2% had hepatitis C and 26.3% had an annual household income >$75,000. Overall, 95.4% of patients preferred FS to LB. FS was associated with greater comfort than LB, with the majority reporting no discomfort during FS (84.1% versus 7.8% for LB), no discomfort after (96.2% versus 14.6% LB) and no feelings of anxiety after FS explanation (78.2% versus 12.7% LB). FS was also associated with greater speed, with the majority reporting short test duration (97.2% versus 48.3% LB) and short wait for the test result (95.5% versus 30.2% LB). Most (75.3%) respondents were willing to self-pay for FS, with 26.3% willing to pay $25 to $49. Patients with unknown liver disease preferred LB (OR [FS preference] 0.20 [95% CI 0.07 to 0.53]).

CONCLUSIONS:

FS was the preferred method of assessing liver fibrosis among patients, with the majority willing to self-pay. To ensure consistency in access, provincial funding for FS is needed. However, LB remains the procedure of choice for individuals with an unknown diagnosis.  相似文献   
6.
IntroductionA systematic meta-analysis was conducted of the association between preference and popularity across childhood and adolescence. The role of development, sex, and region of the world were examined.MethodThe analysis was conducted on 135 samples including 136,014 participants. The samples were divided by age (upper grades primary school, k = 41; lower grades secondary school, k = 72; upper grades secondary school, k = 22) and region (North America, k = 54; Europe, k = 66; China, k = 10).ResultsAcross all samples, a moderate positive association between preference and popularity was found (r = 0.45). The association was significantly weaker in the upper grades of secondary school (r = 0.37) than in the lower grades of secondary school (r = 0.47) or the upper grades of primary school (r = 0.47). The association was weaker for girls (r = 0.26) than for boys (r = 0.38) in the upper grades of secondary school. The association was weaker in European samples (r = 0.41) than in those from North America (r = 0.50) and China (r = 0.57).ConclusionsThe results confirmed that preference and popularity are related but distinct dimensions of adolescent peer status. The association differed significantly by age, sex, and region of the world. Further research should examine additional factors that explain the variability in the association between preference and popularity.  相似文献   
7.
《Value in health》2022,25(5):824-834
ObjectivesThe Patient-Reported Outcome Measurement Information System (PROMIS) Preference score (PROPr) can be used to assess health state utility (HSU) and estimate quality-adjusted life-years in cost-effectiveness analyses. It is based on item response theory and promises to overcome limitations of existing HSU scores such as ceiling effects. The PROPr contains 7 PROMIS domains: cognitive abilities, depression, fatigue, pain, physical function, sleep disturbance, and ability to participate in social roles and activities. We aimed to compare the PROPr with the 5-level EQ-5D (EQ-5D-5L) in terms of psychometric properties using data from 3 countries.MethodsWe collected PROMIS-29 profile and EQ-5D-5L data from 3 general population samples (United Kingdom = 1509, France = 1501, Germany = 1502). Given that cognition is not assessed by the PROMIS-29, it was predicted by the recommended linear regression model. We compared the convergent validity, known-groups construct validity, and ceiling and floor effects of the PROPr and EQ-5D-5L.ResultsThe mean PROPr (0.48, 0.53, 0.48; P<.01) and EQ-5D-5L scores (0.82, 0.85, 0.83; P<.01) showed significant differences of similar magnitudes (d = 0.34; d = 0.32; d = 0.35; P<.01) across all samples. The differences were invariant to sex, income, occupation, education, and most conditions but not for age. The Pearson correlation coefficients between both scores were r = 0.74, r = 0.69, and r = 0.72. PROPr’s ceiling and floor effects both were minor to moderate. The EQ-5D-5L’s ceiling (floor) effects were major (negligible).ConclusionsBoth the EQ-5D-5L and the PROPr assessed by the PROMIS-29 show high validity. The PROPr yields considerably lower HSU values than the EQ-5D-5L. Consequences for quality-adjusted life-year measurements should be investigated in future research.  相似文献   
8.
IntroductionThe World Health Organization's general assembly, in its last meeting of May 2019, has approved the suggested changes to the International Classification of Diseases manual, 11th version (ICD-11). Some of the proposed recommendations include the revision of “Disorders of Sexual Preference”, now called Paraphilic Disorders, currently listed under the International Classification of Diseases-10 Mental and Behavioural Disorders.AimThis article presents findings on the analysis of the existing laws and policies that are relevant to paraphilic disorders in Lebanon.MethodsA literature review of all official and unofficial documents, reports, and articles published on laws and health policies relevant to paraphilic disorders in Lebanon was conducted, including a thorough review on Lebanese laws on that matter. Moreover, interviews with government representatives, including the Ministry of Public Health, the Ministry of Justice, the Ministry of Social Affairs, representatives of Non-Governmental Organizations working in child protection, and mental health professionals from the private and public sector, were conducted.Main Outcome MeasureCovered are (i) the health system in Lebanon including policies and laws related to mental health care provision and relevance to paraphilic disorders, (ii) the legal framework and the mental health evaluation and treatment in the Lebanese criminal justice system: the case of paraphilic disorders, (iii) adjudication of sex offenders in Lebanon, (iv) criminal responsibility relevant to paraphilic disorders, and (v) the relationship between legal and clinical issues for non–forensic health professionals.ResultsThe treatment of paraphilic disorders would follow the treatment of all mental health conditions in Lebanon as no specific services for paraphilic disorders are available within these health-care systems. Legally, sexual crimes in Lebanon are not judged according to the individual's urges, fantasies, or state of mind, rather are assessed according to the acts committed by the individual. Therefore, an individual diagnosed with a paraphilic disorder is not culpable of any crime should he not act on this disorder by committing acts that fall under the scope of the penal code. An analysis of sexual acts that qualify as crimes reveals that the element of consent is rarely taken into consideration as most sexual crimes are defined as such with reference to violation of social norms, primarily “morals and public morality.” Therefore, a change in the diagnostic classification of mental and behavioral disorders (ICD or Diagnostic and Statistical Manual of Mental Disorders) should not be a factor in their definition. Furthermore, in the course of enforcing criminal sanctions on individuals diagnosed with a mental disorder, the determining factor will be the individual's state of awareness at the time of the act. Psychiatric expertise initiated in that context lacks standardized criteria for diagnosis and is not bound by law to rely on international classifications; it is usually based on nonstructured interviews. Should it be assessed that the individual was fully aware of the consequences of his or her act, the paraphilic disorder diagnosis should not play any role in the sentencing.Clinical implicationsClinicians in Lebanon can now be aware of the legal sanctions that patients with paraphilic disorders may fall under, should criminal acts be committed. Clinicians can also be familiar with the role of mental health disorders in the legal system, specifically with relevance to “awareness” at the time of the criminal act. Moreover, clinicians can freely use the updated diagnoses of paraphilic disorders in the ICD-11, as they form no legal detriments in Lebanon.Strength & LimitationsThe interviewing technique used in this study ensured that participants spoke about issues pertinent to their experience and expertise and helped achieve data saturation. Nonetheless, although this is a review, a quality and bias screening tool was not used because of the search mostly pertaining to legal laws and cases instead of research articles. furthermore, no software was used to analyze the qualitative data from the interviews. In addition, some of the documents reviewed were in Arabic, and therefore, some nuances, while translating the essential findings to English, might have been lost in translation.ConclusionCompared with the ICD-10, the categories and definitions in ICD-11 should not create any additional obstacles nor offer any direct positive consideration, as the diagnostic classifications of mental disorders (ICD or Diagnostic and Statistical Manual of Mental Disorders) are not relevant to the definition of criminal sexual acts in Lebanon.Makhlouf Y, Kerbage H, Khauli N, et al. Legal and Policy Considerations in Lebanon Related to Proposals for Paraphilic Disorders in World Health Organization's International Classification of Diseases Manual, 11th Version. J Sex Med 2020;17:491–504.  相似文献   
9.
目前,我国学术论文出现明显向SCI等数据库收录期刊及核心期刊的现象。本文探究了这种流向的原因,指出发表论文的客观要求、科研人员的自利性因素、科研评价的导向与推动、科研人员的投稿偏好性等是影响学术论文发表的重要因素,并提出有效完善科研评价制度、客观分析科研人员自利性因素,制定学术道德的相应规范、提高期刊质量和完善学术出版规范是吸引高质量论文的措施。  相似文献   
10.
Objectives: To pilot the feasibility of using a discrete choice experiment (DCE) design to investigate individual preferences from the decision-maker perspective regarding the use of public funding for orphan drugs and generate prior information for future experimental designs.Methods: A DCE was used on a convenience sample of participants from five European countries (England, France, Germany, Italy and Spain), exploring their preferences in distinct healthcare scenarios involving orphan drugs. A preliminary review of the empirical literature on distributive preferences informed the selection of attributes and their levels in the design. An online questionnaire was used to conduct the DCE survey.Results: A total of 199 questionnaires were completed. The five country model showed relative preference for some attributes over others: cost of treatment, improvement in health, value for money and availability of treatment alternatives received the greatest attention. However, disease severity, beginning of life, waiting times and side effects were also shown to be important social values that should not be ignored.Conclusions: The ?ndings presented in this study provide insight about the preferences that can influence decisions on orphan drugs in different countries. This study also provides valuable prior information that could inform future DCE designs in this area.  相似文献   
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