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961.
Background
providing opportunities for students to participate in midwifery continuity of care experiences is a challenge in many midwifery education programmes. The ‘follow-through experience’ was a deliberate strategy introduced into midwifery education programmes in Australia to ensure that students experienced midwifery continuity of care. The follow through experience provides an opportunity for midwifery students to follow a pre-determined number of women through pregnancy, labour and birth and into the early parenting period.Aim
the aim of this study was to explore the follow-through experience in the 3 year Bachelor of Midwifery (direct entry) in Australia to better understand its impact on midwifery students and to identify the learning that is associated with this experience.Methods
a qualitative methodology was used. Data were collected from former and current Bachelor of Midwifery students through a survey and telephone interviews. Students from all 3-year pre-registration Bachelor of Midwifery programmes in Australia were invited to participate. A thematic analysis was undertaken. Constructivist learning theories were used to identify whether learning occurred in the context of the follow-through experience.Findings
students do learn from their engagement in midwifery continuity of care experiences. Learning was characterised by the primacy of the relationship with the women. Students also identified the challenges they faced which included recruitment of women and finding the time to fully engage with the follow-through experience. Difficulties were identified around the different requirements of the follow-through experience, the lack of support at times for students and the incongruence with the existing maternity system. These issues impacted on students' ability to engage in and maximise their learning.Conclusions
the follow-through experience is an innovative midwifery education strategy that facilitates learning for midwifery students. Challenges need to be addressed at a systematic level and new strategies developed to support the learning opportunities presented by the follow-through experience. 相似文献962.
Beatriz Marcheco Teruel Juan J Llibre Rodríguez Paul McKeigue Teresa Collazo Mesa T Evelyn Fuentes Adolfo Valhuerdi Cepero A Milagros A Guerra Hernandez John RM Copeland JRM Cleusa P Ferri Martin J Prince 《BMC medical genetics》2011,12(1):43
Background
The prevalence and incidence of dementia are low in Nigeria, but high among African-Americans. In these populations there is a high frequency of the risk-conferring APOE-e4 allele, but the risk ratio is less than in Europeans. In an admixed population of older Cubans we explored the effects of ethnic identity and genetic admixture on APOE genotype, its association with dementia, and dementia prevalence. 相似文献963.
Brain or lung injury or both are frequent causes of admission to intensive care units and are associated with high morbidity
and mortality rates. Mechanical ventilation, which is commonly used in the management of these critically ill patients, can
induce an inflammatory response, which may be involved in distal organ failure. Thus, there may be a complex crosstalk between
the lungs and other organs, including the brain. Interestingly, survivors from acute lung injury/acute respiratory distress
syndrome frequently have some cognitive deterioration at hospital discharge. Such neurologic dysfunction might be a secondary
marker of injury and the neuroanatomical substrate for downstream impairment of other organs. Brainlung interactions have
received little attention in the literature, but recent evidence suggests that both the lungs and brain can promote inflammation
through common mediators. The present commentary discusses the main physiological issues related to brain-lung interactions. 相似文献
964.
Julie Considine RN RM BN GDipNurs GCertHigherEd MNurs PhD FRCNA Mari Botti RN BA GDCAP PhD Shane Thomas BA DipPubPol PhD 《Australasian emergency nursing journal : AENJ》2011,14(3):180-188
Background
Streamlining emergency department (ED) care of patients with chronic obstructive pulmonary disease (COPD) may be an important strategy in managing the increasing burden of this disease.Study objectives
The aim of this study was to identify factors predictive of hospital admission in ED patients with COPD, specifically factors that can be used early in the ED episode of care.Methods
Using retrospective regression analysis, case data from 321 randomly selected medical records from five Australian EDs were analysed. Patient characteristics, triage and ED system features, physiological status, and ED treatment during the first four hours of ED care were compared between discharged and admitted patients.Results
Factors available on ED arrival associated with increased likelihood of admission were: age (OR = 1.04, p = 0.008) respiratory symptoms affecting activities of daily living (OR = 1.8, p = 0.043) and signs of respiratory dysfunction (OR = 2.5, p = 0.005). Factors available from the first four hours of ED care associated with increased likelihood of admission were: age (OR = 1.04, p = 0.021), oxygen use at four hours (OR = 3.5, p = 0.002) and IV antibiotic administration (OR = 2.6, p = 0.026). There were conflicting findings regarding the association between ambulance transport and admission.Conclusion
There were significant differences in the characteristics of patients who were admitted or not admitted to hospital. Knowledge of these differences may be used to tailor care directed at anticipated outcome (home or hospital admission). 相似文献965.
966.
van den Berg Jolice P Westerbeek Elisabeth AM Berbers Guy AM van der Klis Fiona RM Lafeber Harrie N van Elburg Ruurd M 《Tijdschrift voor kindergeneeskunde》2013,81(1):23-24
Tijdschrift voor Kindergeneeskunde - 相似文献
967.
Yvonne L. Hauck BScN RM MSc PhD Professor Catherine Graham-Smith RN RM BNsg Staff Development Educator Justine McInerney BN PG Dip PG Dip Coordinator Performance Analysis & Clinical Midwife Sue Kay RN RM Clinical Midwife 《Midwifery》2011,27(5):486
Objective
to explore women’s perceptions of conflicting advice around breast feeding from formal support networks, specifically health professionals involved in postnatal support.Design, setting and participants
a qualitative exploratory design was employed using the critical incident technique. Data were obtained from 62 Western Australian women who responded to an invitation to share incidents of receiving conflicting advice. Women who had breast fed a child within the past 12 months shared their experience through a telephone interview (n=50) or completing a brief questionnaire (n=12) addressing the following questions: Describe a situation in detail where you felt you received conflicting advice about breast feeding from a health professional. How did this situation affect you and/or your breast feeding?Findings
a modified constant comparison method was used to analyse the critical incidents revealing commonalities under who offered conflicting advice; what contributed to advice being perceived as conflicting; topic areas more inclined to being regarded as conflicting; what protected against advice being perceived as conflicting; the consequences of receiving conflicting advice; and strategies that women used to manage these incidents.Key conclusions and implications for practice
advice that was viewed as conflicting extended beyond the provision of information that was inconsistent or directly contradictory, and included issues around information overload and disparities between the mother’s and health professional’s expectations. The manner of presenting information or advice, the skills of using effective communication, demonstration of a caring attitude with an empathic approach and focusing upon the woman as an individual were seen to be important to minimise these incidents. Attention to women’s perceptions and the consequences of conflicting advice must be addressed, otherwise the credibility and confidence in health professionals’ knowledge and ability to support breast feeding is questioned, resulting in a valuable support network being selectively ignored. 相似文献968.
Jane Warland RN RM Dip Appl Sc PhD Lecturer in Nursing Midwifery Joann O’Leary MPH MS PhD Field faculty Helen McCutcheon RN RM BA MPH PhD Professor Head of School 《Midwifery》2011,27(5):628-633
Objective
to gain an in-depth understanding of subsequent children’s experiences of being born into and raised in a family following an infant death.Design
an exploratory qualitative study.Setting
semi-structured interview in the participants’ homes. Data were collected over a five-month period in 2009 and analysed using thematic analysis.Participants
a purposive sample of 10 subsequent children (five boys and five girls) was used. Children whose parents had accessed the support services offered by two bereavement support agencies were recruited. Participants were asked to describe their experiences of being a subsequent child. Interviews were conducted when the subsequent child was at least 13 years of age.Findings
all participants spent time describing how they felt about being a subsequent child. They described how they had experienced life as a subsequent child, how they considered others felt about them (especially their mother), and finally how they felt about their deceased sibling.Key conclusions and implications for practice
all participants in this study provided a picture of emotional well-being. They were aware of their family history, and all appreciated the grief and loss which their parents had suffered. However, they did not believe that this had impacted negatively on them; rather, most talked about positive effects including feeling loved and special because of the circumstances resulting in their birth. Even those who recognised that they may not have been born had their sibling lived accepted this and appeared to be emotionally secure and well adjusted. These findings suggest that intervention with bereaved parents at the time of the perinatal/infant death and soon after is beneficial to the experiences of the subsequent child. Further research to determine the nature and extent of this benefit is warranted. 相似文献969.
Destructive deformation of the digits with auto-amputation: a review of pseudo-ainhum 总被引:1,自引:0,他引:1
RM Rashid† E Cowan† SA Abbasi‡ J Brieva§ M Alam§ 《Journal of the European Academy of Dermatology and Venereology》2007,21(6):732-737
Pseudo-ainhum is an auto-amputation of the digits. Although extremely rare, it is a traumatic and painful experience that can be alleviated with early recognition and intervention. The scientific literature is filled with reports of this interesting but unfortunate phenomenon. To date, a firm causative aetiology has not yet been established. Although reports on this phenomenon have attempted to further our understanding of pseudo-ainhum, a clear understanding has been complicated by the interchangeable use of terms describing this auto-amputation. In this review, we discuss the current understanding, diagnostic criteria, and management of pseudo-ainhum. Furthermore, the nomenclature of pseudo-ainhum is clarified. Ideally, this will allow for more efficient exploration of pseudo-ainhum, its causes, and therapeutic approaches. 相似文献
970.
M Akhyani AH Ehsani RM Robati AM Robati 《Journal of the European Academy of Dermatology and Venereology》2007,21(10):1330-1332
BACKGROUND: Psoriasis is an inflammatory dermatosis that is characterized with hyperproliferation of keratinocytes and inflammatory infiltration in the epidermis and dermis. The high prevalence of atherosclerosis has been reported in psoriatic patients. High serum lipid level has been suggested in the pathogenesis of this phenomenon. In this study, our purpose was to compare the lipid profile in psoriatic patients with non-affected persons. METHODS: This study was designed and conducted as a case-control assay with 50 cases in the patient and control groups, respectively. The lipid profile, including serum level of triglyceride, cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL), were assessed in both groups. RESULTS: The patient and control groups each consisted of 50 cases (39 male and 11 female). The serum triglyceride, cholesterol, and LDL was significantly higher in psoriatic patients (P < 0.05) but not for HDL (P = 0.29). CONCLUSION: This study, like previous assays, shows that high serum lipid level is significantly more common in psoriasis. This fact may be responsible for higher prevalence of cardiovascular accident in psoriatic patients. It may be useful to do early screening and treatment of hyperlipidaemia in psoriasis to prevent the atherosclerosis and its complications. 相似文献