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1.
AIDS and Behavior - This study describes the acceptability of a rectal microbicide gel formulation using dapivirine (DPV) among men and women from two countries (United States and Thailand)...  相似文献   
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The purpose of this study was to provide an evidence base for colorectal cancer research activity that might influence policy, mainly at the national level. Improvements in healthcare delivery have lengthened life expectancy, but within a situation of increased cancer incidence. The disease burden of CRC has risen significantly, particularly in Africa, Asia and Latin America. Research is key to its control and reduction, but few studies have delineated the volume and funding of global research on CRC. We identified research papers in the Web of Science (WoS) from 2007 to 2021, and determined the contributions of the leading countries, the research domains studied, and their sources of funding. We identified 62 716 papers, representing 5.7% of all cancer papers. This percentage was somewhat disproportionate to the disease burden (7.7% in 2015), especially in Eastern Europe. International collaboration increased over the time period in almost all countries except in China. Genetics, surgery and prognosis were the leading research domains. However, research on palliative care and quality-of-life in CRC was lacking. In Western Europe, the main funding source was the charity sector, particularly in the UK, but in most other countries government played the leading role, especially in China and the USA. There was little support from industry. Several Asian countries provided minimal contestable funding, which may have reduced the impact of their CRC research. Certain countries must perform more CRC research overall, especially in domains such as screening, palliative care and quality-of-life. The private-non-profit sector should be an alternative source of support.  相似文献   
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Acute skin toxicity in adjuvant breast radiation can be reduced with modern radiotherapy (RT) techniques. However, having reviewed the literature, we found no dosimetric constraint for acute skin toxicity that would be applicable to modern RT planning. This study aimed to identify dosimetric factors that are associated with higher rates of acute skin toxicity. A retrospective review was carried out including women who received adjuvant forward-planned intensity-modulated radiotherapy (IMRT) after breast-conserving surgery. Acute skin toxicity grade was prospectively recorded. A total of 131 patients were analyzed. On multivariate analysis, the V105%?>?30?cc (p?=?0.013) and the use of conventional fractionation (CF) (p?=?0.001) were statistically significant for acute skin toxicity. On literature review, current quantitative dosimetric parameters that have shown statistical significance include a V107%?>?3?cc in hypofractionation (HF), V107%?>?9?cc in CF, treated volume 110%?>?5.13%, and V107%?>?28.6%. There is little evidence on the predictive value of clinically applicable dosimetric factors in acute skin toxicity. Given the recent improvements in RT planning, we would consider a V107% or a V110% too high a dosimetric value to be useful for the majority of patients. We have shown that a V105% of greater than 30?cc is significantly associated with acute skin toxicity, controlling for other variables. We suggest that this is currently the most useful modifiable parameter available to reduce skin toxicity and is applicable to modern RT planning. We also suggest that consideration be given to hypofractionated schedules to further reduce acute skin toxicity.  相似文献   
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The terrestrial biosphere is currently a strong carbon (C) sink but may switch to a source in the 21st century as climate-driven losses exceed CO2-driven C gains, thereby accelerating global warming. Although it has long been recognized that tropical climate plays a critical role in regulating interannual climate variability, the causal link between changes in temperature and precipitation and terrestrial processes remains uncertain. Here, we combine atmospheric mass balance, remote sensing-modeled datasets of vegetation C uptake, and climate datasets to characterize the temporal variability of the terrestrial C sink and determine the dominant climate drivers of this variability. We show that the interannual variability of global land C sink has grown by 50–100% over the past 50 y. We further find that interannual land C sink variability is most strongly linked to tropical nighttime warming, likely through respiration. This apparent sensitivity of respiration to nighttime temperatures, which are projected to increase faster than global average temperatures, suggests that C stored in tropical forests may be vulnerable to future warming.Terrestrial ecosystems have been a substantial net sink of anthropogenic carbon (C) emissions since the 1960s (14), but the terrestrial C sink could switch to a C source in the 21st century, resulting in a positive C cycle-climate feedback that would accelerate global surface warming with potentially major consequences for the biosphere (57). The interannual variability of the terrestrial C sink can help constrain our understanding of C/climate feedbacks and identify regions and mechanisms of the terrestrial C cycle that are most sensitive to climate parameters, shedding light on the future of the sink and its possible transition to a source (8). Currently, several major drivers have been shown to be correlated with the interannual variability of the terrestrial C sink, including (i) tropical temperature, which is tightly coupled to interannual variability in the atmospheric growth rate (AGR) of CO2 (8, 9); (ii) tropical drought stress, including major droughts in the Amazon (1012), which has been suggested to underlie increasing sensitivity of the AGR to tropical temperature over the period from 1959–2010 (13); (iii) temperature and precipitation variability in semiarid regions (14, 15); and (iv) average minimum daily (hereafter “nighttime”) temperatures, which studies of several local field sites in the tropics have found play a major role in interannual productivity (1618).Determining the mechanism underlying the interannual variability of the terrestrial C sink, including the relative roles of precipitation vs. temperature stress and their effects on gross primary productivity (GPP) vs. total respiration (both autotrophic and heterotrophic; R), is critical to predict the sink’s future and to improve Earth system models. Here, we quantify changes in the interannual variability of the terrestrial C sink over the past half-century and then statistically evaluate four hypotheses that the variability of the terrestrial sink is most strongly influenced by (i) tropical mean temperature, (ii) tropical precipitation, (iii) precipitation and temperature in semiarid regions, and (iv) nighttime tropical temperatures. We combine multiple simulations from an atmospheric mass balance of the land C sink [net ecosystem exchange (NEE)] from 1959 to 2010, remote sensing-modeled datasets of vegetation greenness and GPP from 1982 to 2010, and global gridded climate datasets to constrain globally the fundamental equation NEE = GPP − R and the relative sensitivities of each component to temperature and precipitation. We draw on a combination of model selection and partial correlation analysis to provide relative likelihood estimates of each driver and to account for covariation between predictor variables (e.g., tropical mean temperature vs. nighttime temperature).  相似文献   
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HIV risk in vulnerable groups such as itinerant male street labourers is often examined via a focus on individual determinants. This study provides a test of a modified Information-Motivation-Behavioral Skills (IMB) model to predict condom use behaviour among male street workers in urban Vietnam. In a cross-sectional survey using a social mapping technique, 450 male street labourers from 13 districts of Hanoi, Vietnam were recruited and interviewed. Collected data were first examined for completeness; structural equation modelling was then employed to test the model fit. Condoms were used inconsistently by many of these men, and usage varied in relation to a number of factors. A modified IMB model had a better fit than the original IMB model in predicting condom use behaviour. This modified model accounted for 49% of the variance, versus 10% by the original version. In the modified model, the influence of psychosocial factors was moderately high, whilst the influence of HIV prevention information, motivation and perceived behavioural skills was moderately low, explaining in part the limited level of condom use behaviour. This study provides insights into social factors that should be taken into account in public health planning to promote safer sexual behaviour among Asian male street labourers.  相似文献   
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AIDS and Behavior - People living with HIV (PLWH) experience higher rates of comorbid chronic pain conditions compared to the general population. Managing HIV and chronic pain, two stigmatized...  相似文献   
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