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Thiago H Freitas Elias Andreoulakis Gilberto S Alves Hesley LL Miranda Lúcia LBC Braga Thomas Hyphantis André F Carvalho 《World journal of gastroenterology : WJG》2015,21(21):6713-6727
AIM: To investigate the relationship between sense of coherence, psychological distress and health related quality of life in inflammatory bowel disease (IBD).METHODS: This cross-sectional study enrolled a consecutive sample of 147 IBD (aged 45.1 ± 14.1 years; 57.1% female) patients recruited from a tertiary gastroenterology service. Sixty-four participants met diagnostic criteria for Crohn’s disease, while eighty-three patients had ulcerative colitis. Socio-demographic data (education, age, race, gender, gross monthly income and marital status), disease-related variables (illness activity, relapse rate in past 2 years, history of surgery and time since diagnosis), sense of coherence (Antonovsky’s SOC scale), psychological distress symptoms (Hospital Anxiety and Depression Scale) and health-related quality of life (HRQoL; WHOQOL-Bref) were assessed. Hierarchical multiple regression analyses were performed to identify factors that are independently associated with psychological distress and HRQoL in patients with IBD and to provide indications for possible moderating or mediating effects. In addition, formal moderation and mediation analyses (Sobel tests) were performed to confirm potential moderators/mediators of the relationship between SOC, psychological distress symptoms and HRQoL.RESULTS: Lower SOC scores (std beta= -0.504; P < 0.001), female gender (std beta = 0.176; P = 0.021) and White race (std beta = 0.164; P = 0.033) were independently associated with higher levels of depressive symptoms, while lower levels of SOC (std beta = -0.438; P < 0.001) and higher relapse rate (std beta = 0.161; P = 0.033) were independently associated with more severe anxiety symptoms. A significant interaction between time since diagnosis and SOC was found with regard to the severity of depressive or anxiety symptoms, as the interaction term (time since diagnosis X SOC) had beta coefficients of -0.191 (P = 0.009) and -0.172 (P = 0.026), respectively. Lower levels of anxiety symptoms (std beta = -0.369; P < 0.001), higher levels of SOC (std beta = 0.231; P = 0.016) and non-White race (std beta = -0.229; P = 0.006), i.e., mixed-race, which represented the reference category, were independently associated with higher levels of overall HRQoL. Anxiety symptoms were the most potent independent correlate of most aspects of HRQoL. In addition, anxiety mediated the association between SOC and satisfaction with health, as well as its relationship with physical, mental, and social relations HRQoL. Depressive symptoms also mediated the association between SOC and mental HRQoL.CONCLUSION: Our data indicated that SOC is an important construct, as it influences psychological distress and has significant albeit indirect effects on several HRQoL domains in IBD. 相似文献
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In the Canton Hospital there hangs a unique painting of Doctor
Peter Parker, the pioneer medical missionary to China. It shows him
with Kwan Ato, the young assistant whom he chose to teach as an
apprentice. The painting is far more than a portrait; it is a symbol of
the way in which, through these years of the century ending in 1935,
the medical missionary has conceived it to be his duty and his oppor-
tunity, not merely to dispense medicines for the relief of the sick, but
unceasingly to train workers who should be able to carry on the work
commenced by him. In a very real sense, therefore, the hundredth
anniversary of the beginning of hospital work in Canton is also the
centenary of moclern medical education in China. No other spirit
could possibly actuate the modern man who views his task on any
permanent basis. He must reproduce himself if his life and activity
are to last. It is natural, therefore, that, over and again through the
yeais, as one hospital cornerstone after another has been laid, the chief
address of the day has laid emphasis on the fact that this new building
was to be a place for healing, a place for teaching and, so far as pos-
sible, a place for inquiry into the causes of disease. The three go
hand in hand 相似文献
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Sheri Della Grotta Linda L. LaGasse Amelia M. Arria Chris Derauf Penny Grant Lynne M. Smith Rizwan Shah Marilyn Huestis Jing Liu Barry M. Lester 《Maternal and child health journal》2010,14(4):519-527
The objectives of this study are to characterize methamphetamine (MA) usage patterns during pregnancy, examine whether patterns
of MA use are associated with sociodemographic characteristics and prenatal care, and test the hypothesis that persistent
or increasing MA use during pregnancy is associated with greater use of other illicit drugs. The sample consisted of 191 MA-using
mothers who participated in a large-scale multi-site study of prenatal MA exposure. Patterns of substance use were assessed
by maternal self-report via the Substance Use Inventory (SUI), which included detailed information about MA use, including
frequency, quantity, and maximum use during each trimester of pregnancy. The study demostrated that on average, the prevalence
of MA use decreased over the three trimesters of pregnancy (84.3% vs. 56.0% vs. 42.4%), and decreased frequency was observed
among users from the first trimester to the third (3.1 vs. 2.4 vs. 1.5 days/week). Closer examination of the individual patterns
revealed that 29.3% of women maintained consistently high frequency, 9.4% increased frequency, 25.7% had a stable low/moderate
pattern, and 35.6% decreased their frequency of MA over the course of pregnancy. These four groups did not differ in sociodemographic
characteristics; women who decreased their use of MA had significantly more prenatal visits compared to the consistently high-use
group, but were the most likely to use alcohol during their pregnancy. In conclusion, this article elucidated the different
patterns of MA use in this community sample. Approximately, one third of MA-using mothers could be classified as consistently
high users with a profile of use with the greatest risk to themselves and potentially to their infants including high levels
of MA use throughout pregnancy and fewer prenatal care visits. Overall, we found that MA use declined across pregnancy; however,
a substantial proportion of users had consistently high or increasing MA use, while those who decreased their MA frequency
had a higher prevalence of polydrug use. Future research will investigate the association of these patterns with neonatal
outcomes. 相似文献
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