全文获取类型
收费全文 | 58895篇 |
免费 | 5814篇 |
国内免费 | 130篇 |
专业分类
耳鼻咽喉 | 555篇 |
儿科学 | 1606篇 |
妇产科学 | 1571篇 |
基础医学 | 8587篇 |
口腔科学 | 1201篇 |
临床医学 | 8187篇 |
内科学 | 10658篇 |
皮肤病学 | 794篇 |
神经病学 | 5553篇 |
特种医学 | 2004篇 |
外国民族医学 | 57篇 |
外科学 | 7027篇 |
综合类 | 1091篇 |
一般理论 | 60篇 |
预防医学 | 6794篇 |
眼科学 | 1237篇 |
药学 | 4267篇 |
中国医学 | 34篇 |
肿瘤学 | 3556篇 |
出版年
2021年 | 786篇 |
2020年 | 544篇 |
2019年 | 894篇 |
2018年 | 1010篇 |
2017年 | 734篇 |
2016年 | 833篇 |
2015年 | 908篇 |
2014年 | 1353篇 |
2013年 | 2175篇 |
2012年 | 3004篇 |
2011年 | 3127篇 |
2010年 | 1771篇 |
2009年 | 1556篇 |
2008年 | 2982篇 |
2007年 | 3008篇 |
2006年 | 3029篇 |
2005年 | 2913篇 |
2004年 | 2890篇 |
2003年 | 2594篇 |
2002年 | 2579篇 |
2001年 | 1592篇 |
2000年 | 1670篇 |
1999年 | 1468篇 |
1998年 | 706篇 |
1997年 | 566篇 |
1996年 | 498篇 |
1995年 | 569篇 |
1994年 | 524篇 |
1993年 | 480篇 |
1992年 | 1141篇 |
1991年 | 1169篇 |
1990年 | 1089篇 |
1989年 | 1060篇 |
1988年 | 1060篇 |
1987年 | 923篇 |
1986年 | 911篇 |
1985年 | 879篇 |
1984年 | 739篇 |
1983年 | 629篇 |
1982年 | 440篇 |
1981年 | 405篇 |
1980年 | 389篇 |
1979年 | 679篇 |
1978年 | 540篇 |
1977年 | 454篇 |
1976年 | 424篇 |
1975年 | 397篇 |
1974年 | 456篇 |
1973年 | 448篇 |
1972年 | 384篇 |
排序方式: 共有10000条查询结果,搜索用时 31 毫秒
1.
Diane Berish PhD Erica Husser PhD Jenny Knecht-Fredo MSN CRNP Jacqueline Sabol MEd George Garrow MD Judith Hupcey EdD CRNP FAAN Donna Fick RN GCNS-BC PhD FGSA FAAN 《Health services research》2023,58(Z1):78-88
Objective
To collaboratively implement the age-friendly health systems framework, known as the 4Ms: What Matters, Medication, Mentation, and Mobility, at The Primary Health Network (PHN), a federally qualified health center.Data Sources
Data were collected from PHN electronic medical records (EMRs) for individuals over age 65 from December 30, 2019 to December 24, 2021 and from Project ECHO© attendance and evaluation surveys.Study Design
The telementoring educational program, Project ECHO©, was used to engage PHN health care professionals working in rural areas of Pennsylvania to incorporate the 4Ms into their practice starting with the annual wellness visit (AWV). Project ECHO© was launched at three primary care sites. After 18 months, it was then disseminated to an additional 18 sites creating pilot and comparison groups. Outcomes included codesigned patient process metrics using EMR data and project ECHO© participant data.Data Collection Methods
EMR data were generated by system reports created by PHN's quality assurance program manager. Project ECHO© data were collected and managed using REDCap electronic data capture tools. Outcomes were aggregated, analyzed for trends over time, and compared between groups.Principal Findings
All nine process outcomes increased from baseline to follow-up at the three initial sites, ranging from 4% to 43% g. At year two, the three initial sites had higher rates on AWVs (pilot 24%, comparison 12%; p < 0.0001), Advance Care Planning (New on file, pilot 8%, comparison 2%; Discussed with patient, pilot 18%, comparison 13%; Patient declined, pilot 0%, comparison 0%; p = 0.0001), Dementia Screening (pilot 24%, comparison 12%; p < 0.0001), Fall Risk Management (pilot 43%, comparison 10%; p < 0.0001), and Mobility Goal (pilot 19%, comparison 9%; p < 0.0001); and lower rates on High-Risk Medication Elimination (pilot 54%, comparison, 63%, p < 0.02).Conclusions
Access to high-quality geriatric care for rural older adults can be improved by increasing health care professionals' knowledge of the 4Ms, beginning with its incorporation into the AWV. 相似文献2.
Cody M. Lebeck Lee MD Ioannis A. Ziogas MD Rajiv Agarwal MD Sophoclis P. Alexopoulos MD Kristen K. Ciombor MD Lea K. Matsuoka MD Daniel B. Brown MD Cathy Eng MD 《Cancer》2022,128(12):2243-2257
The 5-year overall survival rate of a patient with unresectable metastatic colorectal cancer is poor at approximately 14%. Similarly, historical data on liver transplantation (LT) in those with colorectal liver metastases (CRLM) showed poor outcomes, with 5-year survival rates between 12% and 21%. More recently, limited data have shown improved outcomes in select patients with 5-year overall survival rates of approximately 60%. Despite these reported survival improvements, there is no significant improvement in disease-free survival. Given the uncertain benefit with this therapeutic approach and a renewed investigational interest, we aimed to conduct a contemporary systematic review on LT for CRLM. A systematic review of the literature was performed according to the preferred reporting items for systematic reviews and meta-analysis statement. English articles reporting on data regarding LT for CRLM were identified through the MEDLINE (via PubMed), Cochrane Library, and ClinicalTrials.gov databases (last search date: December 16th, 2021) by 2 researchers independently. A total of 58 studies (45 published and 13 ongoing) were included. Although early retrospective studies suggest the possibility that some carefully selected patients may benefit from LT, there is minimal prospective data on the topic and LT remains exploratory in the setting of CRLM. Additionally, several other challenges, such as the limited availability of deceased donor organs and defining appropriate selection criteria, remain when considering the implementation of LT for these patients. Further evidence from ongoing prospective trials is needed to determine if and to what extent there is a role for LT in patients with surgically unresectable CRLM. 相似文献
3.
Loren Saulsberry PhD Ankur Bhargava MD MPH Sharon Zeng BA Jason B. Gibbons PhD Cody Brannan MS Diane S. Lauderdale PhD Robert D. Gibbons PhD 《Health services research》2023,58(4):873-881
Objective
To derive and validate a new ecological measure of the social determinants of health (SDoH), calculable at the zip code or county level.Data Sources and Study Setting
The most recent releases of secondary, publicly available data were collected from national U.S. health agencies as well as state and city public health departments.Study Design
The Social Vulnerability Metric (SVM) was constructed from U.S. zip-code level measures (2018) from survey data using multidimensional Item Response Theory and validated using outcomes including all-cause mortality (2016), COVID-19 vaccination (2021), and emergency department visits for asthma (2018). The SVM was also compared with the existing Centers for Disease Control and Prevention's Social Vulnerability Index (SVI) to determine convergent validity and differential predictive validity.Data Collection/Extraction Methods
The data were collected directly from published files available to the public online from national U.S. health agencies as well as state and city public health departments.Principal Findings
The correlation between SVM scores and national age-adjusted county all-cause mortality was r = 0.68. This correlation demonstrated the SVM's robust validity and outperformed the SVI with an almost four-fold increase in explained variance (46% vs. 12%). The SVM was also highly correlated (r ≥ 0.60) to zip-code level health outcomes for the state of California and city of Chicago.Conclusions
The SVM offers a measurement tool improving upon the performance of existing SDoH composite measures and has broad applicability to public health that may help in directing future policies and interventions. The SVM provides a single measure of SDoH that better quantifies associations with health outcomes. 相似文献4.
Cheryl L. Rock PhD RD Cynthia A. Thomson PhD RD Kristen R. Sullivan MS MPH Carol L. Howe MD MLS Lawrence H. Kushi ScD Bette J. Caan DrPH Marian L. Neuhouser PhD RD Elisa V. Bandera MD PhD Ying Wang PhD Kimberly Robien PhD RD Karen M. Basen-Engquist PhD MPH Justin C. Brown PhD Kerry S. Courneya PhD Tracy E. Crane PhD RDN David O. Garcia PhD FACSM Barbara L. Grant MS RDN CSO FAND Kathryn K. Hamilton MA RDN CSO CDN FAND Sheri J. Hartman PhD Stacey A. Kenfield ScD Maria Elena Martinez PhD Jeffrey A. Meyerhardt MD MPH Larissa Nekhlyudov MD MPH Linda Overholser MD Alpa V. Patel PhD Bernardine M. Pinto PhD Mary E. Platek PhD RD CDN Erika Rees-Punia PhD MPH Colleen K. Spees PhD MEd RD LD FAND Susan M. Gapstur PhD Marjorie L. McCullough ScD RD 《CA: a cancer journal for clinicians》2022,72(3):230-262
The overall 5-year relative survival rate for all cancers combined is now 68%, and there are over 16.9 million survivors in the United States. Evidence from laboratory and observational studies suggests that factors such as diet, physical activity, and obesity may affect risk for recurrence and overall survival after a cancer diagnosis. The purpose of this American Cancer Society guideline is to provide evidence-based, cancer-specific recommendations for anthropometric parameters, physical activity, diet, and alcohol intake for reducing recurrence and cancer-specific and overall mortality. The audiences for this guideline are health care providers caring for cancer survivors as well as cancer survivors and their families. The guideline is intended to serve as a resource for informing American Cancer Society programs, health policy, and the media. Sources of evidence that form the basis of this guideline are systematic literature reviews, meta-analyses, pooled analyses of cohort studies, and large randomized clinical trials published since 2012. Recommendations for nutrition and physical activity during cancer treatment, informed by current practice, large cancer care organizations, and reviews of other expert bodies, are also presented. To provide additional context for the guidelines, the authors also include information on the relationship between health-related behaviors and comorbidities, long-term sequelae and patient-reported outcomes, and health disparities, with attention to enabling survivors' ability to adhere to recommendations. Approaches to meet survivors' needs are addressed as well as clinical care coordination and resources for nutrition and physical activity counseling after a cancer diagnosis. 相似文献
5.
Naveen Pemmaraju MD Jacqueline S. Garcia MD Andrew Perkins MBBS PhD Jason G. Harb PhD Andrew J. Souers PhD Michael E. Werner PhD Christopher M. Brown PhD Francesco Passamonti MD 《Cancer》2023,129(22):3535-3545
Myelofibrosis is a heterogeneous myeloproliferative neoplasm characterized by chronic inflammation, progressive bone marrow failure, and hepatosplenic extramedullary hematopoiesis. Treatments like Janus kinase inhibitor monotherapy (e.g., ruxolitinib) provide significant spleen and symptom relief but demonstrate limited ability to lead to a durable disease modification. There is an urgent unmet medical need for treatments with a novel mechanism of action that can modify the underlying pathophysiology and affect the disease course of myelofibrosis. This review highlights the role of B-cell lymphoma (BCL) protein BCL-extra large (BCL-XL) in disease pathogenesis and the potential role that navitoclax, a BCL-extra large/BCL-2 inhibitor, may have in myelofibrosis treatment. 相似文献
6.
7.
8.
Renuka V. Iyer MD Bhavana Konda MD MPH Christos Fountzilas MD Sarbajit Mukherjee MD MS Dwight Owen MD MS Kristopher Attwood PhD Chong Wang MA Orla Maguire PhD Hans Minderman PhD Sheryl-Ann Suffren BA Karen Hicks BS John Wilton PhD Robert Bies PhD Danielle Casucci BA Diane Reidy-Lagunes MD Manisha Shah MD 《Cancer》2020,126(16):3689-3697
9.
10.