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排序方式: 共有634条查询结果,搜索用时 109 毫秒
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Kristin Alvsåker Rolf Hanoa Theresa M. Olasveengen 《Acta anaesthesiologica Scandinavica》2023,67(8):1069-1078
Background
Early interdisciplinary rehabilitation (EIR) in neurointensive care is a limited resource reserved for patients with moderate to severe traumatic brain injury (TBI) believed to profit from treatment. We evaluated how key parameters related to injury severity and patient characteristics were predictive of receiving EIR, and whether these parameters changed over time.Methods
Among 1003 adult patients with moderate to severe TBI admitted over 72 h to neurointensive care unit during four time periods between 2005 and 2020, EIR was given to 578 and standard care to 425 patients. Ten selection criteria thought to best represent injury severity and patient benefit were evaluated (Glasgow Coma Scale, Head Abbreviated Injury Scale, New-Injury-Severity-Scale, intracranial pressure monitoring, neurosurgery, age, employment, Charlson Comorbidity Index, severe psychiatric disease, and chronic substance abuse).Results
In multivariate regression analysis, patients who were employed (adjOR 1.99 [95% CI 1.41, 2.80]), had no/mild comorbidity (adjOR 3.15 [95% CI 1.72, 5.79]), needed neurosurgery, had increasing injury severity and were admitted by increasing time period were more likely to receive EIR, whereas receiving EIR was less likely with increasing age (adjOR 0.97 [95% CI 0.96, 0.98]) and chronic substance abuse. Overall predictive ability of the model was 71%. Median age and comorbidity increased while employment decreased from 2005 to 2020, indicating patient selection became less restrictive with time.Conclusion
Injury severity and need for neurosurgery remain important predictors for receiving EIR, but the importance of age, employment, and comorbidity have changed over time. Moderate prediction accuracy using current clinical criteria suggest unrecognized factors are important for patient selection. 相似文献3.
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Rasa Giniūnaitė Rebecca McLennan Mary C McKinney Ruth E Baker Paul M Kulesa Philip K Maini 《Developmental dynamics》2020,249(3):270-280
The neural crest serves as a powerful and tractable model paradigm for understanding collective cell migration. The neural crest cell populations are well-known for their long-distance collective migration and contribution to diverse cell lineages during vertebrate development. If neural crest cells fail to reach a target or populate an incorrect location, then improper cell differentiation or uncontrolled cell proliferation can result. A wide range of interdisciplinary studies has been carried out to understand the response of neural crest cells to different stimuli and their ability to migrate to distant targets. In this critical commentary, we illustrate how an interdisciplinary collaboration involving experimental and mathematical modeling has led to a deeper understanding of cranial neural crest cell migration. We identify open questions and propose possible ways to start answering some of the challenges arising. 相似文献
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Angela Steineck Lori Wiener Jennifer W. Mack Nirali N. Shah Corinne Summers Abby R. Rosenberg 《Pediatric blood & cancer》2020,67(5)
Chimeric antigen receptor (CAR) T‐cell therapy has transformed the treatment of relapsed/refractory B‐cell acute lymphoblastic leukemia (ALL). However, this new paradigm has introduced unique considerations specific to the patients receiving CAR T‐cell therapy, including prognostic uncertainty, symptom management, and psychosocial support. With increasing availability, there is a growing need for evidence‐based recommendations that address the specific psychosocial needs of the children who receive CAR T‐cell therapy and their families. To guide and standardize the psychosocial care offered for patients receiving CAR T‐cell therapy, we propose the following recommendations for addressing psychosocial support. 相似文献
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Michael E. J. Stouthandel Liv Veldeman Tom Van Hoof 《Anatomical record (Hoboken, N.J. : 2007)》2019,302(10):1681-1695
This review intends to rekindle efforts to map the lymphatic system by using a more modern approach, based on medical imaging. The structure, function, and pathologies associated with the lymphatic system are first discussed to highlight the need for more accurately mapping the lymphatic system. Next, the need for an interdisciplinary approach, with a central role for the anatomist, to come up with better maps of the lymphatic system is emphasized. The current approaches on lymphatic system research involving medical imaging will be discussed and suggestions will be made for an all-encompassing effort to thoroughly map the entire lymphatic system. A first-hand account of our integration as anatomists in the radiotherapy department is given as an example of interdisciplinary collaboration. From this account, it will become clear that the interdisciplinary collaboration of anatomists in the clinical disciplines involved in lymphatic system research/treatment still holds great promise in terms of improving clinical regimens that are currently being employed. As such, we hope that our fellow anatomists will join us in an interdisciplinary effort to map the lymphatic system, because this could, in a relatively short timeframe, provide improved treatment options for patients with cancer or lymphatic pathologies all over the world. Anat Rec, 302:1681–1695, 2019. © 2019 American Association for Anatomy 相似文献
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Jane Mohler Karen D’Huyvetter Lisa O’Neill Conrad Clemens Amy Waer Victoria Began 《Gerontology & geriatrics education》2014,35(4):354-368
Using interprofessional faculty, the authors reviewed and enhanced the nationally renowned Chief Resident Immersion Training (CRIT) in the Care of Older Adults Program to include Triple Aim objectives and interprofessional competency-based content and developed the Interprofessional CRIT. Evaluations were positive and sustained. The authors educated chief residents about value-based care, linking them to key interprofessional staff to build team-based care. The authors addressed quality improvement issues identified by the Institute of Medicine and our health network. Chief residents are now better prepared to train medical students and residents using a team-based, patient-centered approach, and a culture of continual quality improvement toward improved care of older patients. 相似文献
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Asha Vas Robin Abellera Sarah Taylor Emily Rich Jennifer Burns Alisa Woods 《Journal of Applied Biobehavioral Research》2018,23(3)
Cognitive and functional impairments are common sequelae following stroke, often resulting in significant disabilities that persist years post‐stroke. While the degree of impairments varies with pathology and location of stroke, it is widely understood that executive dysfunction including disturbances of attention, complex information processing, inhibition, reasoning, and flexible thinking underlie a majority of the impairments. Existing rehabilitation approaches predominantly focus on mitigating targeted cognitive deficits (e.g., language disturbance, neglect of one side of the body, memory). Remediation approaches to address executive dysfunction in chronic stages of recovery post‐stroke are limited. The Strategic Memory Advanced Reasoning Training (SMART) that teaches strategies to improve higher order reasoning skills has proven to enhance executive functions, strengthen brain networks and improve participation in daily life activities in adults with traumatic brain injury. The current case example, part of an ongoing larger study, discusses post‐SMART performance of a 57‐year‐old female stroke survivor, who sustained a left middle cerebral artery infarct in July 2015. The participant showed gains in executive functions and participation in leisure pursuits following 10 SMART sessions. These preliminary findings prove feasibility of the training approach and offer promise of neuroplasticity during chronic stages of recovery. 相似文献