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1.
《Journal of Radiology Nursing》2022,41(3):170-179
BackgroundDespite indications for the removal of temporary inferior vena cava (IVC) filters, many filters are unintentionally left in place, predisposing patients to adverse outcomes.ObjectiveThis quality improvement study set out to determine the impact of an IVC filter retrieval protocol on filter retrieval rates and patients lost to follow-up for patients who had undergone placement of a temporary IVC filter.MethodsFollowing a quasi-experimental design, data of all consecutive patients who underwent insertion of a temporary IVC filter for a period of 24-month preprotocol and 12-month postprotocol were compared.ResultsFilter retrieval rates of eligible filters increased from 64.2% to 100%; patients lost to follow-up decreased from 35.9% to 0% (p < .01, both outcomes).ConclusionAdoption of a comprehensive IVC filter protocol by the service that implants these devices can improve filter retrieval rates and decrease patients being lost to follow-up. 相似文献
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《Australian critical care》2019,32(6):540-559
ObjectivesThe objective of this review was to describe cardiovascular risk (CVR) assessment methods and to identify evidence-based practice recommendations when dealing with population at risk of developing cardiovascular diseases.Review methods and data sourcesA literature review following the Arksey and O'Malley scoping review methodology was conducted. By using appropriate key terms, literature searches were conducted in PubMed, SciELO, Cochrane Library, Dialnet, ENFISPO, Medigraphic, ScienceDirect, Cuiden, and Lilacs databases. A complementary search on websites related to the area of interest was conducted. Articles published in English or Spanish in peer-review journals between 2010 and 2017. Critical appraisal for methodological quality was conducted. Data was extracted using ad-hoc tables and qualitatively synthesized.ResultsAfter eliminating duplicates, 55 325 records remained, and 1432 records were selected for screening. Out of these, 88 full-text articles were selected for eligibility criteria, and finally, 67 studies were selected for this review, and 25 studies were selected for evidence synthesis. In total, 23 CVR assessment tools have been identified, pioneered by the Framingham study. Qualitative findings were grouped into four thematic areas: assessment tools and scores, CVR indicators, comparative models, and evidence-based recommendations.ConclusionsIt is necessary to adapt the instruments to the epidemiological reality of the population. The most appropriate way to estimate CVR is to choose the assessment tool that best suits individual conditions, accompanied by a comprehensive assessment of the patient. More research is required to determine a single, adequate, and reliable tool. 相似文献
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Nurse perceptions of the Nursing Delirium Screening Scale in two palliative care inpatient units: a focus group study 下载免费PDF全文
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《Paediatrics & Child Health》2019,29(8):339-344
Von Willebrand Disease is a common cause of excessive bruising and bleeding in children. This short article gives advice on diagnosis and management for paediatricians. Given its prevalence and presenting symptoms, VWD should always be considered in the assessment of children suspected of non-accidental injury. Its diagnosis can be challenging, not only because of the various subtypes of the disorder but because of the considerable overlap between VWD and normal individuals. Laboratory diagnosis requires a range of quantitative and qualitative tests of the VWF protein, with targeted gene analysis increasingly used to confirm the diagnosis of type 2 and type 3 VWD. Bleeding Assessment Tools may be helpful in directed laboratory testing but are often less so in young children who have had limited haemostatic challenges. Treatment for VWD includes the use of antifibrinolytic drugs, vasopressin or VWF-containing clotting factor concentrates. Treatment is often on-demand for individual bleeding episodes but there are specific indications for the use of prophylactic treatment in children. 相似文献
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OBJECTIVES: To test the variability in estimating cancer risk and demonstrate the consequences that subjectivity has on patient care. SUBJECTS AND METHODS: Forty-three clinicians were each asked to assess 40 symptomatic colorectal referrals. Each clinician was provided with a comprehensive history on the 40 patients. The clinicians graded the referral according to a malignancy risk score, decided on the required first line investigation and the priority of that investigation. The main outcome measures used was accuracy in cancer detection and appropriateness of investigations selected. RESULTS: There was a wide degree of variation among all clinicians grading both benign and malignant disease with the overall correct classification of 54% (P-value of <0.001). On average, the clinicians correctly diagnosed 71.3% of the cancer patients as compared to 44% of the benign patients. Of the cancer patients, 47% were correctly classified as an urgent referral whilst 52% of the benign patients were over classified and graded as an urgent referral. The mean number chosen by clinicians to have a flexible sigmoidoscopy as the appropriate first investigation was 13 (of 40 patients); this was despite the diagnosis being possible in all cases with a flexible sigmoidoscopy. The choice to use full colonic investigation was seen throughout all disciplines. Junior doctors demonstrated the highest tendency choosing full colonic investigation in 92.3%. Consultants and senior grades showed the least tendency to choose full colonic imaging although even here colonoscopy or barium enema represented 48.5%. CONCLUSION: Subjective assessment of cancer referrals is a significant problem that needs to be confronted. Improvements are needed to resolve the inherent problems of subjectivity and operator bias if uniform quality of patient care and best use of resources is to be achieved. 相似文献
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《Disability and health journal》2021,14(4):101122
BackgroundDisability faced by a young person can impact the school-to-work transition and shape health and well-being over the life course. Unique barriers to entry and advancement within the labor market that are relevant to young people with disabilities underscore the need for tailored policy-level supports.ObjectivesTo examine and describe policies that support the school-to-work transition of young people with disabilities in Canada.MethodsA scan of policies which focused on the school-to-work transition of young people with disabilities across Canada was conducted between June 2019 and January 2020. Searches were completed within federal, provincial and territorial policy portals. Each policy relating to employment participation of people with disabilities was summarized. Policies that focused on the school-to-work-specific were synthesized using Bemelmans-Vidic, Rist and Vedung's policy tool framework.ResultsA total of 36 policies were identified by our scan that focused on the employment of people with disabilities. Only five policies explicitly addressed the school-to-work transition. All existing policies were implemented at the provincial level and aimed to promote entry into employment. The synthesis of policies revealed that financial policy tools were primarily used to incentivize employment, provision of workplace accommodations, or the development and implementation of job readiness programs.ConclusionOur analysis of federal, provincial and territorial policies in Canada uncovered a limited number of policies that specifically support the school-to-work transition. Addressing these policy gaps can increase the inclusion of young people with disabilities in the labor market. 相似文献
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《Health & place》2021
The distribution of food outlets within towns and cities and the provision of active travel infrastructure have been associated with health behaviours that can contribute to obesity risk. Decision-makers describe a lack of local data and research evidence as a barrier to policy adoption to improve the public's health. Online spatial data visualisation tools created by researchers can help to bridge this gap. We explored stakeholder experiences of using such tools for decision-support, with a focus on facilitators and barriers to use. We conducted 16 qualitative interviews with Public Health, Planning and Transport Planning professionals, who had used two recently-developed tools. Participants described the importance of tools being open access; their use in “story-telling”, particularly to non-experts; and more broadly their use even when imperfect. They expressed that ‘robustness’ of underpinning data was important, however this was not easily defined. Participants employed personal heuristics, principally based on endorsement and developer credibility, to determine suitability for use. We present key learning points for future developers to maximise engagement and impact. 相似文献
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医学信息化的快速发展带来了医疗健康数据的井喷式增长,虽然其创造了丰富的临床数据资源,但也存在着管理不当和应用不足的问题,其核心在于现有采集模式不能适用真实世界数据采集的需要。通过梳理目前临床研究信息采集的现状,发现其存在着采集场景较局限,采集角色较单一,数据采集的丰富性和客观性较欠缺,跨场景医疗健康数据之间的连贯性和共享性较差以及个体健康数据采集的时间范围较短的问题,针对这些问题从扩展数据场景和采集角色,丰富数据采集的工具及建立个体健康信息的全生命周期采集4个方向探讨了中医多场景、多角色、全时空的临床信息采集模式的构建,以期为中医临床研究提供一些参考和借鉴。 相似文献