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1.
目的 探讨饮酒与慢性阻塞性肺疾病风险(chronic obstructive pulmonary disease, COPD)的关系。 方法 计算机检索PubMed、Web of Science、Embase、中国知网、万方数据库和维普数据库,搜集各数据库建库至2021年11月公开发表的有关饮酒与COPD风险的观察性研究。由2位研究者根据文献纳入及排除标准独立筛选文献并提取数据。采用Stata 12.0软件进行统计学分析。 结果 共纳入8篇文献(2篇队列研究文献和6篇横断面研究文献),共纳入209 489例研究对象。meta分析结果显示,与最低饮酒量组相比,最高饮酒量组发生COPD的风险无显著变化(RR=0.97, 95%CI:0.87~1.08);与不饮酒组相比,少量或中度饮酒组发生COPD的风险降低(RR=0.87, 95%CI:0.81~0.94);与少量或中度饮酒组相比,过量饮酒组发生COPD的风险无显著变化(RR=1.26, 95%CI:0.98~1.63)。 结论 meta分析结果提示少量或中度饮酒可降低COPD的风险。过量饮酒是否会增加COPD的风险尚需进一步研究。  相似文献   
2.
《Vaccine》2022,40(19):2679-2695
Vaccinations are essential for preventing infectious diseases in children with chronic diseases as they have increased risk of infection from frequent use of biologics. Response to immunizations in this group is not well known.ObjectiveA systematic review was performed to evaluate three primary outcomes: efficacy; immunogenicity; and safety of vaccines in children with chronic conditions treated with biologics.MethodsThe protocol for our systematic review and meta-analysis was registered and published with PROSPERO. We searched electronic bibliographic databases for studies published from 2009 to 2019, focusing on vaccinations in children with chronic conditions treated with biologics.ResultsWe retrieved 532 records. Thirty-one full-text articles were selected, and 14 were included in the meta-analysis. No significant publication bias was found. Efficacy: limited data are available regarding the efficacy of vaccination, as most studies have focused on immunogenicity as surrogate outcome for efficacy. Immunogenicity: patients receiving anti-TNF-alpha therapy had a statistically significant risk of poor seroconversion (p = 0.028) and seroprotection by the serotype B influenza vaccine [inflammatory bowel disease (IBD) p = 0.013; juvenile idiopathic arthritis (JIA) p = 0.004]. We found adequate responses with H1N1 and H3N2 serotypes. Few studies existed for pneumococcal, hepatitis A virus, hepatitis B virus, varicella-zoster virus, Measles Mumps Rubella virus, and multiple vaccine administration. Safety: vaccine administration was not associated with serious side effects, but JIA patients on anti-TNF alpha therapy had a statistically significant risk of presenting with myalgia or arthralgia postinfluenza vaccine (p = 0.014).ConclusionsMore evidence concerning efficacy, immunogenicity, and safety of vaccinations is needed to guide physicians in the vaccine decision process for this pediatric population.  相似文献   
3.
BackgroundVulvovaginal candidiasis (VVC) is the second most common infection of the genital tract affecting millions of women worldwide. Data concerning the distribution and antifungal resistance of Candida species responsible of VVC vary among countries and population studied. Objectives: The aim of this work was to determine the prevalence, species distribution and antifungal susceptibility patterns of Candida species among symptomatic women over a 20-year period.MethodsA total of 5,820 unique samples were retrospectively identified. Out of them, 1,046 (18%) were diagnosed with VVC.ResultsWomen between 18 and 30 years had the highest prevalence rate of VVC (21%). Women aged less than 18 years and greater than 51 years had the highest prevalence rates of vaginal bacterial infections. Thirty-five (3.3%) women presented recurrent VVC. The most common yeast isolated was C. albicans, followed by C. glabrata, C. krusei, and C. parapsilosis. Non-Candida albicans species (NAC) were more significantly isolated among women aged 51 or above, than in women included in other groups (p < 0.01). Resistance to fluconazole and amphotericin B was infrequent in C. albicans strains. Resistance to fluconazole and amphotericin B was infrequent in C. albicans strains. NAC species presented higher resistance rates against fluconazole (30%) and voriconazole (25%). C. krusei and C. glabrata isolates showed lower MICs than most of the strains against amphotericin B (1 mg/L) and flucytosine (1 mg/L).ConclusionsOur findings indicated that continued surveillance on Candida species distribution and non-susceptibility rates to antifungals should be routinely reported to help the selection of the most appropriate drug, to avoid the emergence of resistant strains, and to improve the patient's outcomes.  相似文献   
4.
Defects of the cystic fibrosis (CF) transmembrane conductance regulator (CFTR) protein affect the homeostasis of chloride, bicarbonate, sodium, and water in the airway surface liquid, influencing the mucus composition and viscosity, which induces a severe condition of infection and inflammation along the whole life of CF patients. The introduction of CFTR modulators, novel drugs directly intervening to rescue the function of CFTR protein, opens a new era of experimental research. The review summarizes the most recent advancements to understand the characteristics of the infective and inflammatory pathology of CF lungs.  相似文献   
5.
目的:建立HPLC一测多评法同时测定胃疡灵颗粒中肉桂酸、桂皮醛、毛蕊异黄酮葡萄糖苷、芒柄花苷、芒柄花素、6-姜辣素、8-姜酚和10-姜酚的含量。方法:采用HPLC法,以Agilent SB-C18柱(250 mm×4.6 mm,5μm)为色谱柱,流动相A为乙腈-甲醇(9∶1),流动相B为0.1%磷酸溶液,梯度洗脱(0~13 min,28%A;13~24 min,28%→35%A;24~39 min,35%→56%A;39~53 min,56%→85%A;53~60 min,85%→28%A),流速为1.1 ml/min,检测波长为280 nm,柱温为25℃。以毛蕊异黄酮葡萄糖苷为内参物,建立其他7个成分的相对校正因子,计算各成分含量。结果:肉桂酸、桂皮醛、毛蕊异黄酮葡萄糖苷、芒柄花苷、芒柄花素、6-姜辣素、8-姜酚和10-姜酚分别在0.59~11.80、7.47~149.40、2.18~43.60、1.91~38.20、4.49~89.80、3.87~77.40、0.94~18.80、1.46~29.20μg/ml(r≥0.9991)范围内线性关系良好;平均加样回收率分别为(96.89±1.04)%、(100.05±0.64)%、(99.52±1.18)%、(98.51±1.30)%、(99.38±0.77)%、(98.29±0.88)%、(97.72±1.26)%和(97.93±1.01)%(n=9);肉桂酸、桂皮醛、芒柄花苷、芒柄花素、6-姜辣素、8-姜酚和10-姜酚的相对校正因子分别为0.8263、0.8490、0.9720、1.2005、1.2766、0.7202和0.8749,一测多评法计算值和外标法实测值无明显差异。结论:本研究建立的HPLC一测多评法操作便捷、结果准确,可用于胃疡灵颗粒的质量控制。  相似文献   
6.
ObjectiveTo assess the association between adherence to a Mediterranean lifestyle and changes in pain, and its characteristics over time in older adults.Patients and MethodsWe analyzed data from 864 and 862 community-dwelling individuals aged 65+ years from the Study on Cardiovascular Health, Nutrition and Frailty in Older Adults in Spain (Seniors-ENRICA) Seniors-ENRICA-1 (2008–2010 to 2012) and Seniors-ENRICA-2 (2015–2017 to 2019) cohorts, with a median follow-up of 2.8 and 2.4 years, respectively. Adherence to a Mediterranean lifestyle was assessed at baseline with the 27-item Mediterranean lifestyle (MEDLIFE) index. Pain changes over time were calculated with a pain scale that assessed the frequency, severity, and the number of pain locations both at baseline and follow-up. Multivariable-adjusted relative risk ratios (RRRs) were obtained using multinomial logistic regression.ResultsIn the pooled cohorts, after a median follow-up of 2.6 years, pain worsened for 697 participants, improved for 734, and did not change for 295. Compared with the lowest category of MEDLIFE adherence, those in the highest category showed an RRR of improvement vs worsening of overall pain of 1.85 (95% CI, 1.28 to 2.67; P-trend<.001). MEDLIFE adherence was also linked to improvement in pain frequency (RRR, 1.98; 95% CI, 1.31 to 3.01; P-trend=.001), pain severity (RRR, 2.00; 95% CI, 1.33 to 3.00; P-trend=.001), and a reduction in the number of pain locations (RRR, 1.68; 95% CI, 1.13 to 2.50; P-trend=.004). Limitations of this study are the use of self-reported lifestyle data.ConclusionA Mediterranean lifestyle was associated with improvement of pain characteristics in older adults. Experimental studies should assess the efficacy of an integral lifestyle approach for the management of pain in older adults.  相似文献   
7.
《Value in health》2022,25(9):1480-1488
ObjectivesInvolvement of patients and medical professionals in assessment of relative effectiveness (relative effectiveness assessment) contributes to an efficient and effective health technology assessment (HTA) process and supports acceptance and implementation of the outcome. This study aimed to analyze stakeholder involvement in assessing relative effectiveness and how the parties involved value this collaboration.MethodsThis is a document analysis of all drug assessments completed in 2019 (20) by the public HTA agency of The Netherlands, enriched with semistructured interviews with employees of the HTA agency (18) and representatives of patient (5) and medical (11) associations involved in these assessments. Data were analyzed, coded, and categorized.ResultsIn almost half of the assessments, there was no coordination with the medical associations at the start of the relative effectiveness assessment and no patient associations involved in this phase. During the assessment procedure, patient and medical associations were always asked to comment on the draft report. Nevertheless, the strict 5-day deadline that the HTA agency uses as a response period often hampered a proper response and involvement. According to interviewees of the HTA agency, this leads to a great diversity in the substantive quality of their input. Patient and medical associations indicated that the HTA agency relies too much on “paper knowledge,” which leads to a (perceived) lack of alignment with clinical practice.ConclusionsThe limited involvement results in a lack of coordination and mutual trust. Optimizing involvement of patients and medical professionals in HTA practice requires effort from all parties involved. Procedural adjustments and better coordination, especially at the start of the assessment, would probably improve cooperation.  相似文献   
8.
摘要:抗菌药物的滥用加速了细菌耐药的产生与传播,每年因耐药细菌导致的人口死亡和医疗成本耗费都极为惊人。针对 耐药细菌的新型抗生素研制十分缓慢,自1987年以来没有一类新型抗生素上市。研究抗生素杀菌机制以开发新药或抗生素佐剂 是一种应对耐药细菌的良好策略。目前普遍认同活性氧(ROS)介导细胞死亡是抗生素杀菌的共享途径,抗生素作用于靶标介导 产生原发初级损伤,诱使ROS生成,ROS造成次级细胞损伤并刺激更多ROS生成,形成一种恶性循环,最终ROS累积超过细胞 氧化应激极限、致使细菌死亡。细菌胞内具有用以消除氧化应激压力的专能系统,针对性抑制这些系统可能是快速杀伤细菌的 一个好策略。然而,设计靶向细菌某些代谢节点的新型抗生素或相关佐剂很可能更为简单、有效,生物体代谢是一个巨大的相 互协作网络,关键节点的扰动很容易引起代谢通路的剧烈波动,能引发细菌整体氧化应激状态改变的代谢节点有望成为潜在新 抗生素或抗生素增效剂的靶标。  相似文献   
9.
《Value in health》2022,25(6):992-1001
ObjectivesWith complex health technologies entering the market, methods for health technology assessment (HTA) may require changes. This study aimed to identify challenges in HTA of complex health technologies.MethodsA survey was sent to European HTA organizations participating in European Network for HTA (EUnetHTA). The survey contained open questions and used predefined potentially complex health technologies and 7 case studies to identify types of complex health technologies and challenges faced during HTA. The survey was validated, tested for reliability by an expert panel, and pilot tested before dissemination.ResultsA total of 22 HTA organizations completed the survey (67%). Advanced therapeutic medicinal products (ATMPs) and histology-independent therapies were considered most challenging based on the predefined complex health technologies and case studies. For the case studies, more than half of the reported challenges were “methodological,” equal in relative effectiveness assessments as in cost-effectiveness assessments. Through the open questions, we found that most of these challenges actually rooted in data unavailability. Data were reported as “absent,” “insufficient,” “immature,” or “low quality” by 18 of 20 organizations (90%), in particular data on quality of life. Policy and organizational challenges and challenges because of societal or political pressure were reported by 8 (40%) and 4 organizations (20%), respectively. Modeling issues were reported least often (n = 2, 4%).ConclusionsMost challenges in HTA of complex health technologies root in data insufficiencies rather than in the complexity of health technologies itself. As the number of complex technologies grows, the urgency for new methods and policies to guide HTA decision making increases.  相似文献   
10.
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