全文获取类型
收费全文 | 13226篇 |
免费 | 931篇 |
国内免费 | 29篇 |
专业分类
耳鼻咽喉 | 121篇 |
儿科学 | 415篇 |
妇产科学 | 483篇 |
基础医学 | 1737篇 |
口腔科学 | 131篇 |
临床医学 | 2561篇 |
内科学 | 2265篇 |
皮肤病学 | 240篇 |
神经病学 | 1156篇 |
特种医学 | 251篇 |
外科学 | 1112篇 |
综合类 | 106篇 |
一般理论 | 17篇 |
预防医学 | 1710篇 |
眼科学 | 116篇 |
药学 | 819篇 |
中国医学 | 11篇 |
肿瘤学 | 935篇 |
出版年
2023年 | 48篇 |
2022年 | 34篇 |
2021年 | 195篇 |
2020年 | 134篇 |
2019年 | 253篇 |
2018年 | 295篇 |
2017年 | 181篇 |
2016年 | 235篇 |
2015年 | 266篇 |
2014年 | 395篇 |
2013年 | 658篇 |
2012年 | 971篇 |
2011年 | 1042篇 |
2010年 | 539篇 |
2009年 | 488篇 |
2008年 | 1015篇 |
2007年 | 1040篇 |
2006年 | 1027篇 |
2005年 | 988篇 |
2004年 | 932篇 |
2003年 | 869篇 |
2002年 | 891篇 |
2001年 | 92篇 |
2000年 | 59篇 |
1999年 | 115篇 |
1998年 | 173篇 |
1997年 | 105篇 |
1996年 | 92篇 |
1995年 | 98篇 |
1994年 | 94篇 |
1993年 | 85篇 |
1992年 | 59篇 |
1991年 | 49篇 |
1990年 | 59篇 |
1989年 | 45篇 |
1988年 | 45篇 |
1987年 | 43篇 |
1986年 | 36篇 |
1985年 | 34篇 |
1984年 | 40篇 |
1983年 | 46篇 |
1982年 | 60篇 |
1981年 | 50篇 |
1980年 | 48篇 |
1979年 | 18篇 |
1978年 | 26篇 |
1977年 | 18篇 |
1976年 | 17篇 |
1975年 | 16篇 |
1974年 | 18篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
1.
Nicolas Penel Sylvie Bonvalot Marie-Cécile Le Deley Antoine Italiano Camille Tlemsani Diane Pannier Clémence Leguillette Jean-Emmanuel Kurtz Maud Toulmonde Julien Thery Daniel Orbach Pascale Dubray-Longeras Benjamin Verret François Bertucci Cécile Guillemet Lucie Laroche Armelle Dufresne Jean-Yves Blay Axel Le Cesne 《International journal of cancer. Journal international du cancer》2023,153(2):407-416
The aim of this study is to evaluate the prevalence, determinants and prognostic value of pain at diagnosis in patients with desmoid-type fibromatosis (DF). We selected patients from the ALTITUDES cohort (NCT02867033), managed by surgery, active surveillance or systemic treatments, with pain assessment at diagnosis. Patients were invited to fill QLQ-C30 questionnaire and Hospital Anxiety Depression Scale. Determinants were identified using logistic models. Prognostic value on event-free survival (EFS) was evaluated using the Cox model. Overall, 382 patients were included in the current study (median age: 40.2 years; 117 men). The prevalence of pain was 36%, without significant difference according to first-line treatment (P = .18). In the multivariate analysis, pain was significantly associated with tumor size >50 mm (P = .013) and tumor site (P < .001); pain was more frequent in the neck and shoulder locations (odds ratio: 3.05 [1.27-7.29]). Pain at baseline was significantly associated with poor quality of life (P < .001), depression (P = .02), lower performance status (P = .03) and functional impairment (P = .001); we also observed a nonsignificant association with anxiety (P = .10). In the univariate analysis, baseline pain was associated with poor EFS; the 3-year EFS was 54% in patients with pain compared to 72% in those without pain. After adjustment for sex, age, size and line of treatment, pain was still associated with poor EFS (hazard ratio: 1.82 [1.23-2.68], P = .003). One third of recently diagnosed patients with DF experienced pain, especially those with larger tumors and neck/shoulder locations. Pain was associated with unfavorable EFS after adjustment for the confounders. 相似文献
2.
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3.
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4.
Julia H. Vermylen Gordon J. Wood Elaine R. Cohen Jeffrey H. Barsuk William C. McGaghie Diane B. Wayne 《Journal of pain and symptom management》2019,57(3):682-687
Introduction
Physician communication impacts patient outcomes. However, communication skills, especially around difficult conversations, remain suboptimal, and there is no clear way to determine the validity of entrustment decisions. The aims of this study were to 1) describe the development of a simulation-based mastery learning (SBML) curriculum for breaking bad news (BBN) conversation skills and 2) set a defensible minimum passing standard (MPS) to ensure uniform skill acquisition among learners.Innovation
An SBML BBN curriculum was developed for fourth-year medical students. An assessment tool was created to evaluate the acquisition of skills involved in a BBN conversation. Pilot testing was completed to confirm improvement in skill acquisition and set the MPS.Outcomes
A BBN assessment tool containing a 15-item checklist and six scaled items was developed. Students' checklist performance improved significantly at post-test compared to baseline (mean 65.33%, SD = 12.09% vs mean 88.67%, SD = 9.45%, P < 0.001). Students were also significantly more likely to have at least a score of 4 (on a five-point scale) for the six scaled questions at post-test. The MPS was set at 80%, requiring a score of 12 items on the checklist and at least 4 of 5 for each scaled item. Using the MPS, 30% of students would require additional training after post-testing.Comments
We developed a SBML curriculum with a comprehensive assessment of BBN skills and a defensible competency standard. Future efforts will expand the mastery model to larger cohorts and assess the impact of rigorous education on patient care outcomes. 相似文献5.
6.
Erik C. von Rosenvinge Francis Palumbo Jacques Ravel Virginia Rowthorn Diane Hoffmann 《Gut microbes》2019,10(2):113-114
This is a reply to the commentary of Ossorio and Zhou. 相似文献
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.