首页 | 本学科首页   官方微博 | 高级检索  
文章检索
  按 检索   检索词:      
出版年份:   被引次数:   他引次数: 提示:输入*表示无穷大
  收费全文   151196篇
  免费   11617篇
  国内免费   3616篇
耳鼻咽喉   1037篇
儿科学   3012篇
妇产科学   1987篇
基础医学   11017篇
口腔科学   3182篇
临床医学   17900篇
内科学   20712篇
皮肤病学   2381篇
神经病学   14130篇
特种医学   4318篇
外国民族医学   40篇
外科学   12791篇
综合类   20797篇
一般理论   3篇
预防医学   9601篇
眼科学   2054篇
药学   12762篇
  86篇
中国医学   11458篇
肿瘤学   17161篇
  2023年   2727篇
  2022年   3735篇
  2021年   6098篇
  2020年   6521篇
  2019年   5551篇
  2018年   5023篇
  2017年   6085篇
  2016年   6098篇
  2015年   5792篇
  2014年   10742篇
  2013年   13713篇
  2012年   8888篇
  2011年   9493篇
  2010年   7646篇
  2009年   7190篇
  2008年   7103篇
  2007年   7463篇
  2006年   6735篇
  2005年   5846篇
  2004年   4743篇
  2003年   4331篇
  2002年   3540篇
  2001年   3091篇
  2000年   2478篇
  1999年   1962篇
  1998年   1536篇
  1997年   1325篇
  1996年   1085篇
  1995年   1095篇
  1994年   896篇
  1993年   699篇
  1992年   657篇
  1991年   609篇
  1990年   519篇
  1989年   470篇
  1988年   454篇
  1987年   401篇
  1986年   386篇
  1985年   509篇
  1984年   473篇
  1983年   344篇
  1982年   382篇
  1981年   362篇
  1980年   332篇
  1979年   307篇
  1978年   194篇
  1977年   182篇
  1976年   177篇
  1975年   124篇
  1974年   90篇
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
1.
目的评价内镜套扎术和(或)硬化剂注射结合组织胶黏合剂联合普萘洛尔治疗食管胃底静脉曲张破裂出血患者的疗效。方法2017年10月—2019年10月同济大学附属第十人民医院崇明分院收治的食管胃静脉曲张破裂出血(esophagogastric variceal bleeding, EVB)患者共120例,将患者随机分为研究组和对照组,每组60例。两组患者在治疗前的年龄、性别、体质量指数、病因、Child-Pugh评分、静脉曲张严重程度、血液学检查(血红蛋白、C-反应蛋白(C-reactive protein, CRP)、肝酶水平、凝血酶原时间(prothrombin time, PT)、电解质)和影像学检查(静脉曲张直径、门静脉宽度、脾静脉宽度、门静脉流速)等基线资料均一致。研究组给予内镜下套扎术和(或)硬化剂注射结合组织胶黏合剂联合普奈洛尔治疗,而对照组长期口服普奈洛尔,根据最大耐受量调整剂量,术后随访24个月。评价患者的死亡率、再出血率以及实验室指标。结果研究组与对照组死亡率差异无统计学意义(P>0.05);研究组输血量、止血时间和住院日与对照组相比明显减少,差异具有统计学意义(P<0.05);研究组的Child-Pugh评分、PT、血钠水平、炎症指标CRP、静脉曲张直径、门静脉和脾静脉宽度改善较为明显,差异具有统计学意义(P<0.05);血红蛋白、肝酶、血钾水平和门静脉流速在两组间无明显差异(P>0.05);术后18个月和24个月,研究组再出血发生率显著低于对照组,差异具有统计学意义(P<0.05);治疗前Child-Pugh评分、PT、丙氨酸氨基转移酶(alanine aminotransferase, ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase, AST)、血钠水平、静脉曲径直径大小对预后具有重要意义,差异具有统计学意义(P<0.05);Chlid-Pugh评分、PT、血钠水平、静脉曲径直径大小可能是肝硬化静脉曲张预后不良的独立影响因素(OR>1,P<0.05)。结论内镜干预联合普萘洛尔治疗方案用于防治食管胃底静脉曲张再出血的效果确切,安全性较高,值得广泛推广。  相似文献   
2.
背景 音乐治疗作为新兴的治疗方法,在慢性疾病康复中的应用逐渐兴起,且日益得到重视。但音乐治疗对糖尿病康复的效果研究尚少见报道。 目的 观察音乐辅助阿格列汀对2型糖尿病患者糖脂代谢的影响。 方法 选取2019年10月至2021年2月在中国康复研究中心北京博爱医院内分泌科门诊就诊的口服药物血糖控制不佳的2型糖尿病患者65例。采用随机数字表法将患者分为A组(n=35)和B组(n=30),两组患者均保持原有饮食、运动习惯。A组在原治疗(药物种类、剂量不变)基础上联用阿格列汀片治疗,B组在A组基础上给予音乐辅助治疗。两组患者均连续治疗12周。比较治疗前及治疗12周后两组患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、尿酸(UA)、餐后2 h血糖(2 hPG)、超敏C反应蛋白(hs-CRP)、游离脂肪酸(FFA)、胰岛素抵抗指数(HOMA-IR)、β细胞功能分泌指数(HOMA-β);观察患者治疗过程中不良反应发生情况。 结果 两组试验过程中因药物不良反应均剔除1例患者,A组、B组最终分别有34、29例患者完成试验。B组患者治疗12周后2 hPG低于A组(P<0.05)。治疗12周后两组患者FPG、HbA1c、2 hPG均低于组内治疗前,HOMA-β高于组内治疗前(P<0.05);治疗12周后B组患者LDL-C、TC均低于组内治疗前(P<0.05)。两组均未发生低血糖事件。 结论 音乐辅助阿格列汀较无音乐辅助更能降低2型糖尿病患者的餐后血糖,改善血脂情况。需要强调的是,音乐治疗的效果一定是在饮食控制、适当运动、合理用药的基础上。  相似文献   
3.
认知障碍是指记忆、语言、理解和判断等一个或多个方面的功能障碍,包括轻度认知障碍和各种类型的痴呆症。痴呆症是认知障碍最严重的表现,是一种导致患者日常生活、社会交往和工作能力发生显著变化的综合征。阿尔茨海默病(AD)是最常见的痴呆症类型,其次是血管性痴呆(VD)和其他神经退行性痴呆[1]。已知年龄与认知功能的退化密切相关。  相似文献   
4.
目的探讨小儿肠胃康颗粒联合酪酸梭菌活菌散治疗小儿消化不良性腹泻的临床疗效及安全性。方法104例小儿消化不良性腹泻患儿,依据随机抽签法分为对照组与观察组,各52例。对照组采用小儿肠胃康颗粒治疗,观察组采用小儿肠胃康颗粒联合酪酸梭菌活菌散治疗。对比两组症状改善时间、治疗效果及不良反应发生情况。结果观察组腹泻、腹部疼痛及食欲下降改善时间分别为(1.93±1.05)、(2.05±1.06)、(2.47±1.04)d,均短于对照组的(4.88±1.49)、(3.62±1.55)、(3.63±1.15)d,差异有统计学意义(P<0.05)。观察组治疗总有效率为94.23%,高于对照组的76.92%,差异有统计学意义(P<0.05)。观察组不良反应发生率为1.92%,低于对照组的13.46%,差异有统计学意义(P<0.05)。结论小儿肠胃康颗粒联合酪酸梭菌活菌散治疗小儿消化不良性腹泻疗效显著,且安全性较高,值得临床合理推行实践。  相似文献   
5.
陈晓亮 《中国校医》2022,36(9):687-690
目的 探讨调强放射治疗对乳腺癌保乳术后患者的影响。方法 选取2015年3月—2019年10月在本院接受保乳术治疗的98例乳腺癌患者作为研究对象,按随机数字表法分为观察组与对照组,每组各49例。对照组采用常规放射治疗,观察组采用调强放射治疗。比较2组疗效、计划靶区剂量学、肌钙蛋白水平、预后情况。结果 观察组疗效总有效率为83.67%,高于对照组的65.31%,差异具有统计学意义(χ2=4.350,P=0.037);观察组计划靶区V100%、V105%分别为(9.68±0.65)%、(1.03±0.06)%,分别低于对照组的(42.02±4.87)%、(24.51±2.54)%,差异具有统计学意义(t=46.076、64.691,P值均<0.001);放疗后,观察组和对照组肌钙蛋白分别为(0.116±0.012)ng/mL、(0.260±0.019)ng/mL,分别高于放疗前的(0.059±0.010)ng/mL、(0.057±0.009)ng/mL,差异具有统计学意义(P<0.05),但观察组肌钙蛋白较对照组低,差异有统计学意义(t=44.855,P<0.001);观察组的无瘤生存率为97.96%,高于对照组的83.67%,差异具有统计学意义(χ2=4.405,P=0.036)。结论 对乳腺癌保乳术后患者辅以调强放射治疗,可提高临床疗效,调节靶区照射剂量均匀性、适应性,避免心肌及其他周围组织损伤,并提高无瘤生存率,改善预后。  相似文献   
6.
BackgroundStressors among nursing students arise from both academic activities and clinical placement. Understanding how nursing students perceive academic and clinical stressors and the clinical learning environment could help develop useful approaches to reducing levels of stress and contribute to the maintenance of a good learning environment. There is a paucity of studies that investigated associations between the clinical learning environment and the stress of nursing students.ObjectivesTo investigate the relationship between the perception of the clinical learning environment and stress in nursing students; to compare the perception of the clinical learning environment and stress in terms of the year and terms of the organization of supervision.DesignCross-sectional correlation studySettingsUniversityParticipantsThe sample consisted of 155 nursing students in the bachelor's degree program. During the four academic years, students of individual years of the bachelor's study program were included in the study after completing all clinical placements in a given academic year.MethodsThe following instruments were used for the data collection: Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale, Perceived Stress Scale; Physio-Psycho-Social Response Scale and Coping Behaviour Inventory. Correlation analysis and multiple linear regression analysis using stepwise methods were used to determine the relationships between the variables.ResultsThe clinical learning environment is a strong predictor of students' perceptions of stress related to teachers and nursing staff. Types and degrees of stressful events during clinical practice varied between years of study. The experience with supervision was related to the overall perception of the clinical learning environment, but not to the students' physio-psychosocial status, types of stressful events during clinical practice and coping behaviors. Also, the differences in the students' physio-psychosocial status were not significant in terms of individual years of study and method of supervision.ConclusionsThere is a significant relationship between the clinical learning environment and the perception of academic stress. The attitude of the teacher and the medical staff can thus be important in influencing the level of stress in nursing students.  相似文献   
7.
BackgroundIn transfusion-related iron overload, haem-derived iron accumulation in monocytes/macrophages is the initial event. When iron loading exceeds the ferritin storage capacity, iron is released into the plasma. When iron loading exceeds transferrin binding capacity, labile, non-transferrin-bound iron (NTBI) appears and causes organ injury. Haemin-induced cell death has already been investigated; however, whether NTBI induces cell death in monocytes/macrophages remains unclear.Material and MethodsHuman monocytic THP-1 cells were treated with haemin or NTBI, particularly ferric ammonium citrate (FAC) or ferrous ammonium sulfate (FAS). The intracellular labile iron pool (LIP) was measured using an iron-sensitive fluorescent probe. Ferritin expression was measured by western blotting.ResultsLIP was elevated after haemin treatment but not after FAC or FAS treatment. Reactive oxygen species (ROS) generation and cell death induction were remarkable after haemin treatment but not after FAC or FAS treatment. Ferritin expression was not different between the FAC and haemin treatments. The combination of an iron chelator and a ferroptosis inhibitor significantly augmented the suppression of haemin cytotoxicity (p = 0.011).DiscussionThe difference in LIP suggests the different iron traffic mechanisms for haem-derived iron and NTBI. The Combination of iron chelators and antioxidants is beneficial for iron overload therapy.  相似文献   
8.
目的分析血清脂质运载蛋白-2(lipocalin-2)在慢性阻塞性肺疾病(chronic obstructive pulmonary disease, COPD)稳定期伴认知障碍患者血清中的表达变化及其意义。 方法依据蒙特利尔认知评估量表(Montreal cognitive assessment, MoCA)评分,MoCA分值<26分者为认知受损,将43例COPD稳定期的患者分为认知障碍组23例及认知正常组20例,并选取20例健康体检者做对照组;采用酶联免疫吸附实验(ELISA)分别检测患者外周静脉血清脂质运载蛋白-2(lipocalin-2)水平;分析血清脂质运载蛋白-2与认知功能的相关性,根据血清lipocalin-2水平预测认知障碍的受试者工作特征(ROC)曲线。 结果与健康对照组相比(60.37±10.77)μg/ml,COPD稳定期伴认知障碍患者血清lipocalin-2水平(82.76±12.90)μg/ml显著增加(P<0.05);与COPD稳定期认知正常组(69.70±11.51)μg/ml相比,认知功能障碍组血清lipocalin-2水平显著升高,差别有统计学意义(P<0.05)。Pearson相关分析结果显示血清lipocalin-2水平与MoCA评分呈负相关(r=-0.749,P<0.001);血清lipocalin-2水平预测COPD稳定期患者认知功能障碍的ROC曲线下面积分别为0.804(95%CI 0.664~0.945,P<0.001)。 结论血清lipocalin-2表达水平与COPD稳定期患者认知功能障碍密切相关。血清lipocalin-2水平检测可能成为COPD患者出现认知功能障碍的一个重要诊断指标。  相似文献   
9.
BackgroundFindings on the usefulness of massage therapy (MT) in postoperative pain management are often inconsistent among studies.ObjectivesThis study’s aim is to conduct a meta-analysis of randomized controlled trials (RCT) to clarify the effects of massage therapy in the treatment of postoperative pain.MethodsThree databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) were searched for RCTs published from database inception through January 26, 2021. The primary outcome was pain relief. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The random-effect model was used to calculate the effect sizes and standardized mean difference (SMD) with 95 % confidential intervals (CIs) as a summary effect. The heterogeneity test was conducted through I2. Subgroup and sensitivity analyses were used to explore the source of heterogeneity. Possible publication bias was assessed using visual inspection of funnel plot asymmetry.ResultsThe analysis included 33 RCTs and showed that MT is effective in reducing postoperative pain (SMD, −1.32; 95 % CI, −2.01 to −0.63; p = 0.0002; I2 = 98.67 %). A similar significant effect was found for both short (immediate assessment) and long terms (assessment performed 4–6 weeks after the MT). Remarkably, we found neither the duration per session nor the dose had an impact on the effect of MT and there seemed to be no difference in the effects of different MT types. In addition, MT seemed to be more effective for adults. Furthermore, MT had better analgesic effects on cesarean section and heart surgery than orthopedic surgery.LimitationsPublication bias is possible due to the inclusion of studies in English only. Additionally, the included studies were extremely heterogeneous. Double-blind research on MT is difficult to implement, and none of the included studies is double-blind. There was some heterogeneity and publication bias in the included studies. In addition, there is no uniform evaluation standard for the operation level of massage practitioners, which may lead to research implementation bias.ConclusionsMT is effective in reducing postoperative pain in both short and long terms.  相似文献   
10.
目的:探讨血管内治疗(EVT)急性前循环大动脉闭塞性卒中(AC-LAO)患者血管再通后不良预后的影响因素。方法:回顾性分析行EVT且血管成功再通的145例AC-LAO患者临床资料,依据术后90 d改良Rankin量表(mRS)评分分为预后良好组(m RS≤2分)和预后不良组(m RS>3分)。单因素分析2组患者的基线资料、神经功能损伤状况、危险因素、Rapid软件和血管造影成像参数等资料,多因素Logistic回归探讨影响血管内再通治疗后预后不良的独立影响因素。结果:145例实现血管再通的患者中,65例患者术后90 d mRS评分>3分,预后不良率为44.83%。多因素Logistic回归显示入院时高NIHSS评分(OR 0.866,95%CI 0.794~0.943,P=0.001)、低Aspect评分(OR 1.607,95%CI 1.181~2.186,P=0.003)、不良侧支循环(OR 0.373,95%CI 0.163~0.856,P=0.020)是影响预后的独立危险因素。结论:入院NIHSS评分、Aspect评分、侧支循环状态是影响AC-LAO患者早期血管再通...  相似文献   
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号