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1.
Introduction
The Advisory Committee on Immunization Practices (ACIP) has focused on maternal Tdap immunization as an important means to protect neonates from pertussis infections. There is little published data on provider and/or clinic characteristics as predictors of maternal Tdap uptake. This study examined differences in maternal Tdap coverage in women delivering at a single academic institution, but cared for prenatally in different clinical settings, in 2013, 2014, and 2015. Additionally, the accuracy and utilization of Vermont's immunization information system (IIS) was assessed.Methods
This was a retrospective, multiple time-point cross-sectional analysis of annual maternal Tdap coverage in women delivering at a single academic institution in the 3?years following a fundamental change in national maternal Tdap vaccination guidelines. Tdap administration was examined across different obstetric groups using chart review and data from the state's IIS.Results
All obstetric care groups except the resident-staffed clinic significantly increased maternal Tdap coverage in 2014, compared to 2013 coverage, with no further increase in 2015. In contrast, there was no increase in maternal Tdap coverage in 2014 in the resident-staffed clinics, but then a statistically significant increase in 2015. Overall Tdap coverage in 2014 was 80.4%, with variation in Tdap coverage between clinics types. In the subset of women who were cared for by the University-based groups, there was significant variation in Tdap coverage between clinics, despite racial homogeneity, which persisted after adjustment for maternal age and insurance type. The state's IIS was found to be highly accurate, using individual chart review as the “gold standard.”Discussion
While we demonstrated high maternal Tdap coverage in women delivering at our institution, differences in clinic type and provider training appeared to impact immunization rates, as well as how quickly evolving national recommendations were adopted. Additionally, the fidelity of the state's IIS data was verified. 相似文献2.
L. Hulshof D.P. Hack Q.C.J. Hasnoe B. Dontje I. Jakasa C. Riethmüller W.H.I. McLean W.M.C. van Aalderen B. van't Land S. Kezic A.B. Sprikkelman M.A. Middelkamp-Hup 《The British journal of dermatology》2019,180(3):621-630
Atopic dermatitis (AD, atopic eczema) is a very common skin condition affecting 10-20% of children. It affects children of all skin colours and seems to occur more often in Asian children and children with dark skin types. However, most research is performed on children with light skin types. This study, performed in Amsterdam, the Netherlands, aimed to investigate differences between AD in children with dark and light skin types. To study this, the investigators took tape strips from 53 AD children aged 0-12 years and 50 healthy children as control (comparison). Tape stripping is a painless procedure which is ideal to perform in children, in which a small round sticker is attached to the skin. When removing this special sticker, a thin layer of skin cells remains attached to the sticker, allowing the investigators to study several aspects of skin inflammation and skin barrier. The authors found that AD skin from children with light and dark skin have similar levels and types of skin inflammation. However, they found differences in skin barrier markers between these two groups. In light skinned children, markers of good skin barrier were lower in AD skin when compared to healthy children's skin, while in dark AD skin these skin barrier markers were not significantly different from healthy dark skin. This study showed that dark-skinned and light-skinned AD children are similar when it concerns skin inflammation, but in light skinned AD children the skin barrier dysfunction may play an additional role in the development of AD. This suggests that AD in light and dark skin has different mechanisms of development. 相似文献
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Derek J. Roebuck Emma Stockton Susanna N. Ritchie‐McLean Clare A. McLaren 《Paediatric anaesthesia》2020,30(3):311-318
Interventional procedures in the airway can be performed in interventional radiology suites or the operating room, by radiologists or other specialists. The most common therapeutic interventions carried out by radiologists are balloon dilatation, stenting, and the treatment of certain airway fistulas. These operations can be very challenging for anesthetists in terms of planning, airway management, the identification and treatment of procedural complications and postoperative care. In particular, a multidisciplinary approach to decision‐making and planning is important to obtain the best results. 相似文献
5.
AbstractIn this commentary, we discuss health professions’ education (HPE) leadership in relation to planetary health emergencies, suggesting that an ‘eco-ethical leadership’ approach is highly relevant. Building on both traditional and more contemporary leadership approaches and the need for HPE to be socially and environmentally accountable, we define the key features of eco-ethical leadership and its underpinning beliefs and values, then expand on these features in terms of leadership at intrapersonal, interpersonal, team, organisational and system levels. Eco-ethical leadership is needed to tackle a range of ‘wicked’ problems – a changing climate, environmental pollution, deforestation, all of which threaten global biodiversity and human civilisation. Such leadership requires passionate individuals to role model the behaviours and actions that are required to bring people along with them, not least the learners, many of whom are already concerned about their future. Eco-ethical leadership (and followership) offers an integrated approach for HPE, centred around sustainability, values, collaboration, justice, advocacy and, if need be, activism. The environment cannot not wait. Eco-ethical leaders already exist but their numbers are small. They are required in key positions in academia and healthcare to drive the agenda in partnership with learners, many of whom are already environmental advocates and activists. 相似文献
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Cranial nerve outcomes in regionally recurrent head & neck melanoma after sentinel lymph node biopsy
8.
Zainul A Rajion Grant C Townsend David J Netherway Peter J Anderson Toby Hughes Ibrahim L Shuaib Ahmad Sukari Halim Abdul Rani Samsudin Neil R McLean David J David 《The Cleft palate-craniofacial journal》2006,43(5):532-538
OBJECTIVE: To compare morphological and positional variations of the hyoid bone in unoperated infants with cleft lip and palate (CL/P) with those in noncleft infants. DESIGN: Retrospective, cross sectional. PATIENTS AND METHODS: Three-dimensional computed tomography scans were obtained from 29 unoperated CL/P infants of Malay origin aged between 0 and 12 months and from 12 noncleft infants in the same age range. Observations were made and measurements were obtained with a software package developed at the Australian Craniofacial Unit. The sizes of the hyoid bones and the position of the hyoid body and epiglottis in relation to the cervical spine were measured. Anatomical anomalies of the hyoid and prevalence of aspiration pneumonia were also documented. RESULTS: The hyoid bones and epiglottis were found to be located more inferiorly in CL/P infants compared with the noncleft infants. Also, 17% (5/29) of the CL/P infants had nonossified hyoid bodies. CONCLUSION: The results suggest that there are differences in the location and genesis of the hyoid bone in infants with CL/P that warrant further investigation. 相似文献
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