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21.
Retention: An unresolved workforce issue affecting rural occupational therapy services 总被引:1,自引:0,他引:1
Failure to retain health professionals in rural areas contributes to the poor health status of these communities through an inability to deliver reliable and consistent services. Considerable attention has been focused on factors affecting recruitment of health professionals. Far less is known about factors affecting the retention of occupational therapists. This was the focus of this study. Ethnographic interviews were used to explore the experiences of 10 occupational therapists who had left rural practice. Six themes emerged from the participants' experiences, from when they first considered rural practice to reflections following their departure from it. These themes were initial appeal, facing the challenge, rural practice issues, the social sphere, reasons for leaving and the value of rural experience. These factors gave rise to a proposed Model of Retention Equilibrium, which suggests that retention can be improved by addressing the imbalance between incentives to leave and incentives to stay. The model provides a useful framework for occupational therapists contemplating rural practice, as well as for health services managers responsible for service delivery in rural areas. 相似文献
22.
OBJECTIVE: The aim of this study was to assess the severity of epilepsy and
its effect on patients lives, and to describe patients' use of and
attitudes to health care. METHOD: A questionnaire was sent to 595 people
with epilepsy identified from 14 general practices in north-west Bristol.
All patients aged 16 years and over receiving anti-epileptic medication for
their epilepsy were included in the study. Areas investigated included
severity of epilepsy and its effect on quality of life, anti-epileptic
medication and its perceived effect, health care utilization and
preferences for health care. RESULTS: Seizure frequency was strongly
associated with adverse effects of epilepsy. Attacks of epilepsy were
experienced at least monthly by 20.4% (95% confidence intervals (Cl)
17.0-23.7%) of patients, 29.4% (25.4-33.4%) took more than one
anti-epileptic drug, 56.1% (50.1-62.2%) reported drug side effects, 74.1%
(70.3-77.8%) would prefer to receive all or most of their epilepsy care in
a general practice setting, and 69.8% (63.5- 76.2%) would like contact with
a primary care-based epilepsy specialist nurse. During the previous year
42.4% (35.9-48.8%) of patients had not seen a doctor about their epilepsy.
Of patients who had attended the general practice only 13.4% (9.6-17.2%)
had regular arrangements to see their GP about epilepsy. Patients receiving
both primary and secondary care had the greatest needs and wants for
improved care. CONCLUSIONS: Structured care, including regular
appointments, co-ordination of primary and secondary care, and increased
monitoring and discussion, may improve the quality of life of people with
epilepsy, but requires evaluation.
相似文献
23.
Atul K. Sharma Moira S. Mills Vijay L. Grey Keith N. Drummond 《Pediatric nephrology (Berlin, Germany)》1997,11(6):711-713
Accurate, timed urine collections for the measurement of glomerular filtration rate (GFR) may be impractical in infants or
in patients with urological abnormalities. GFR may be measured without urine collection using a constant subcutaneous infusion
of iothalamate. We compare the infusion clearance with conventional renal clearance in 14 children and young adults. The mean
clearance ratio (infusion clearance/renal clearance ± 1 SD) was 0.99±0.1 and the mean discrepancy between the two methods
was 8.5%±4.7%. The 95% limits of agreement for the ratio of the two methods are 0.83–1.23. These data indicate that subcutaneous
infusion of iothalamate is a practical method for measuring GFR in children without a urine collection.
Received March 18, 1996; received in revised form February 12, 1997; accepted March 26, 1997 相似文献
24.
目的 探索LDH实验检测细胞活力的可行性。方法 原代培养骨髓细胞和软骨细胞,用LDH实验测定上述两组细胞的活力,并与镜下活体观察到细胞的生长状况相比较。与目前比较成熟的测定细胞活力的MTS实验的测得的值相比较。结果 LDH实验对上述两组细胞的活力的测定结果与镜下活体观察到的结果相符合。与MTS实验的测得的结果经统计学处理无显著差异。结论 LDH实验可用于细胞活力的直接测定,而对活细胞的生存、繁殖无影响。 相似文献
25.
Annals of Behavioral Medicine - 相似文献
26.
Increased sensitivity of virus-infected cells to inhibitors of protein synthesis does not correlate with changes in plasma membrane permeability 总被引:3,自引:0,他引:3
J M Cameron M J Clemens M A Gray D E Menzies B J Mills A P Warren C A Pasternak 《Virology》1986,155(2):534-544
Semliki Forest virus-infected BHK cells or herpes simplex virus-infected Vero cells were incubated with the protein synthesis inhibitors hygromycin B and gougerotin. Infected cells take up no more [3H]hygromycin or [3H]gougerotin than do mock-infected cells, at a time p.i. at which either compound is more inhibitory to protein synthesis in infected, than in mock-infected cells. The concentrations of hygromycin and gougerotin required to inhibit protein synthesis in intact cells (irrespective of whether they are infected or not) are several orders of magnitude higher than those required in either permeabilized cells or in cell-free systems. Infected cells take up 86Rb+ at the same rate as mock-infected cells, their intracellular content of K+ is the same, and the activity of the Na+ pump is the same. It is concluded that the increased efficacy of hygromycin and gougerotin in virus-infected cells is a consequence of altered intracellular compartmentation and that increases in permeability of the plasma membrane, if any, are so small as to be undetectable by direct methods. 相似文献
27.
Two fast magnetic resonance (MR) imaging techniques, advanced Fourier and partial-flip imaging, were used at 0.35 T to examine 21 patients with suspected intracranial lesions; the results were quantitatively compared with a conventional spin-echo study. Both of the fast MR techniques yielded a fourfold reduction in imaging time per section. The advanced Fourier sequence showed contrast that was identical to the conventional spin-echo study with signal-to-noise ratios of 58% and 57% for the first and second echoes, respectively. The partial-flip sequence showed a contrast of 109% and 57% for lesions versus substantia alba, and 107% and 78% for substantia grisea versus substantia alba relative to the first and second echoes of the conventional spin-echo study. The partial-flip sequence was particularly sensitive to magnetic susceptibility; this produced artifacts that may undermine the usefulness of partial flip for routine screening in certain parts of the brain. However, this susceptibility significantly improved the detection of intracranial hemorrhage when compared with the spin-echo sequence, particularly when combined with phase mapping of the partial-flip study. 相似文献
28.
Alcoholism and dental management 总被引:1,自引:0,他引:1
A H Friedlander M J Mills D A Gorelick 《Oral surgery, oral medicine, and oral pathology》1987,63(1):42-46
Alcohol is widely used and abused in the United States. Because alcohol affects all parts of the body, it is important for dentists as well as all other medical practitioners to be aware of the signs of alcoholism. Some dental problems occur more frequently in alcoholic patients, and often general dental care for these patients must be modified. 相似文献
29.
Human osteoclasts are well characterized multinucleated cells whose function is the directed resorption of normal bone (NB).
Osteoclastic bone destruction accompanies lytic solid tumors and myeloma as well as Paget's disease (PD) of bone and giant
cell tumors of bone (GCTB). The mechanism of this stimulation of osteoclastic bone resorption is unknown. This study was designed
to detect cytokines present in the multinucleated cells of PD and GCTB in order to determine whether cytokine abnormalities
exist to account for bone lysis. Nine cytokines, representing the functions of bone resorption, angiogenesis, tumor necrosis,
bone cell proliferation, and osteoblast–osteoclast coupling, were examined by immunohistochemistry using tissue samples from
15 NB, 17 PD, and 19 GCTB patients. Standard nonparametric statistical analysis showed a significant increase (P < 0.01 to 0.05) in immunostaining between osteoclasts of PD and NB for interleukin-6 (Il-6), tumor necrosis factor beta (TNFβ),
epidermal growth factor (EGF), platelet derived growth factor (PDGF), and basic fibroblast growth factor (bFGF). There was
a statistically significant decrease in immunostaining of giant cells of GCTB as compared with NB for transforming growth
factor beta (TGFβ), but no other differences from normal osteoclasts. The increase in staining of PD osteoclasts over the
giant cells of GCTB was significant (P < 0.01) for Il-6, TNFβ, PDGF, bFGF and insulin growth factor-1 (IGF-1), and (P < 0.05) for Il-1 and EGF. It was concluded that marked cytokine differences exist in vivo between osteoclasts of NB and PD lesions consistent with stimulated resorption. Alternatively, ``osteoclastoma' cells in
the center of the tumor did not overexpress the cytokines associated with bone lysis, suggesting some other mechanism for
stimulated resorption.
Received: 12 February 1996 / Accepted 31 December 1996 相似文献
30.