首页 | 本学科首页   官方微博 | 高级检索  
文章检索
  按 检索   检索词:      
出版年份:   被引次数:   他引次数: 提示:输入*表示无穷大
  收费全文   3286篇
  免费   262篇
  国内免费   4篇
耳鼻咽喉   73篇
儿科学   93篇
妇产科学   71篇
基础医学   434篇
口腔科学   58篇
临床医学   265篇
内科学   580篇
皮肤病学   98篇
神经病学   336篇
特种医学   99篇
外科学   478篇
综合类   49篇
一般理论   2篇
预防医学   278篇
眼科学   103篇
药学   253篇
中国医学   11篇
肿瘤学   271篇
  2023年   32篇
  2022年   58篇
  2021年   100篇
  2020年   68篇
  2019年   77篇
  2018年   92篇
  2017年   62篇
  2016年   54篇
  2015年   77篇
  2014年   99篇
  2013年   130篇
  2012年   221篇
  2011年   217篇
  2010年   117篇
  2009年   84篇
  2008年   212篇
  2007年   200篇
  2006年   185篇
  2005年   162篇
  2004年   155篇
  2003年   151篇
  2002年   121篇
  2001年   76篇
  2000年   69篇
  1999年   45篇
  1998年   24篇
  1997年   24篇
  1996年   22篇
  1995年   25篇
  1994年   17篇
  1993年   16篇
  1992年   36篇
  1991年   56篇
  1990年   53篇
  1989年   38篇
  1988年   38篇
  1987年   40篇
  1986年   30篇
  1985年   22篇
  1984年   32篇
  1983年   16篇
  1981年   15篇
  1980年   15篇
  1979年   13篇
  1978年   17篇
  1977年   16篇
  1976年   11篇
  1975年   12篇
  1973年   11篇
  1970年   12篇
排序方式: 共有3552条查询结果,搜索用时 15 毫秒
121.
Vibrio fischeri belongs to the Vibrionaceae, a large family of marine gamma-proteobacteria that includes several dozen species known to engage in a diversity of beneficial or pathogenic interactions with animal tissue. Among the small number of pathogenic Vibrio species that cause human diseases are Vibrio cholerae, Vibrio parahaemolyticus, and Vibrio vulnificus, the only members of the Vibrionaceae that have had their genome sequences reported. Nonpathogenic members of the genus Vibrio, including a number of beneficial symbionts, make up the majority of the Vibrionaceae, but none of these species has been similarly examined. Here we report the genome sequence of V. fischeri ES114, which enters into a mutualistic symbiosis in the light organ of the bobtail squid, Euprymna scolopes. Analysis of this sequence has revealed surprising parallels with V. cholerae and other pathogens.  相似文献   
122.

Background

Approximately 359,400 out-of-hospital cardiac arrests occur in the United States every year, and around 60% of them are treated by emergency medical services (EMS) personnel. In order to alleviate the impact of this public health burden, some communities have trained police officers as first responders so that they can provide cardiopulmonary resuscitation and defibrillation to cardiac arrest patients. This paper is a review of the current literature on the impact of police automated external defibrillators (AEDs) programs in these communities.

Methods and results

A literature search of electronic journal databases was conducted to identify articles that evaluated police AED programs and quantified survival rates. The 10 articles that met the inclusion criteria were very heterogeneous in terms of study design, controlling for confounders, outcome definitions, and comparison groups. Two communities found a statistically significant difference in survival and 6 studies reported a statistically significant difference in time to defibrillation after the implementation of these programs. The weighted mean survival rate of the study groups was higher than that of the control groups (p < 0.001), as was the weighted mean survival rate of the group first shocked by police compared to those first shocked by EMS (39.4% vs. 28.6%, p < 0.001). The pooled relative risk of survival was 1.4 (95% CI: 1.3–1.6).

Conclusions

Though there are many challenges in initiating these programs, this literature review shows that time to defibrillation decreased and survival from out-of-hospital cardiac arrests increased with the implementation of police AED programs.  相似文献   
123.
OBJECTIVES: We sought to determine the level of angiographic stenosis at which reversible regional wall motion abnormalities (RWMA) are present on exercise stress technetium-99m (Tc-99m)- gated single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), and whether assessments of stress and rest RWMA add incremental diagnostic information. BACKGROUND: Stress and rest gated SPECT MPI enables the detection of post-exercise stunning. Although some studies have correlated RWMA to the severity of MPI defects, only one previous study correlated RWMA on gated MPI to angiographic findings. However, this correlation excluded patients with rest perfusion defects and did not involve gating of rest images. METHODS: One hundred patients undergoing angiography within six months of exercise stress Tc-99m (sestamibi)-gated SPECT MPI (in the absence of interim cardiac events or revascularization) were recruited. Images were acquired 15 to 30 min after stress and interpreted without knowledge of the Duke treadmill score, left ventricular ejection fraction and angiographic data. RESULTS: The sensitivity of reversible RWMA for angiographic stenoses >70% was 53%, with a specificity of 100%. The presence of reversible RWMA was able to stratify patients with angiographic stenoses of 50% to 79% and 80% to 99% with a high positive predictive value. A good correlation was noted between the presence of reversible RWMA and the coronary artery jeopardy score (R = 0.49, p < 0.0001). Multivariate analysis showed that the post-stress RWMA, Duke treadmill and reversible RWMA scores were significant predictors of angiographic severity. CONCLUSIONS: Post-stress and reversible RWMA, as shown by exercise stress Tc-99m-gated SPECT MPI, are significant predictors of angiographic disease and add incremental value to MPI for the assessment of angiographic severity.  相似文献   
124.
This study aimed to evaluate the color change of teeth bleached with light activation using two different objective color measurement approaches after two years of clinical follow-up. A cross-sectional retrospective clinical study according to STROBE was followed including 30 participants. The 25% hydrogen peroxide gel (Philips Zoom) was applied with a supplementary LED light for 15 min in four cycles. Tooth color was assessed based on CIEL*a*b* values using a spectrophotometer (Spectroshade) at different time points (baseline, post bleaching, 1 week, 1 year, and 2 years). Standardized digital photographs were taken at each time point. The L*, a*, and b* values were measured from the digital photographs using Adobe Photoshop software. The color difference (ΔE) was separately calculated using the L*, a*, and b* values obtained with spectrophotometric and photographic analyses at each evaluation time. Data were analyzed with non-parametric tests (p < 0.05). A color regression was detected by both measurement approaches after 1 and 2 years (p < 0.05). Greater ΔE values were acquired with the spectrophotometer compared to the digital photographic analysis (p < 0.05). Although a greater color change was observed with the spectrophotometer, both approaches were able to detect the color rebound using the 25% hydrogen peroxide light-activated in-office system. Digital photographic analysis might therefore be used to assess color change after bleaching.  相似文献   
125.
126.
We report a case of disseminated Trichosporon asahii in a patient on systemic antifungal therapy who presented with multiple cutaneous nodules suggestive of fungal infection. Histologic features resembled neutrophilic eccrine hidradenitis but staining with periodic acid‐Schiff and Gomori methenamine silver confirmed the clinical diagnosis. This case highlights the importance of maintaining suspicion for trichosporonosis and contextualizing histologic findings within the underlying clinical picture.  相似文献   
127.
AIMS--To compare the assessment of dyskaryosis in cervical smears made by specialist consultant cytopathologists and consultant general histopathologists. METHODS--One hundred and ten cervical smears were circulated to 10 observers from five district general hospital histopathology departments and five major departments of cytopathology. Their responses were analysed by five consultant general histopathologists and five consultant specialist cytopathologists. In 54 of the 110 cases, the histology of a corresponding cervical biopsy specimen was compared with the smear assessments. RESULTS--Specialist cytopathologists were more consistent than non-specialists when diagnosing and grading dyskaryosis. They chose the higher grades of dyskaryosis more frequently than the non-specialists. The cytopathologists recommended referral for colposcopy more frequently, but if they asked for a repeat smear, they wanted it done within three months more frequently than the histopathologists. The specialists were more frequently in agreement with the biopsy grade of intra-epithelial neoplasia than the non-specialists, whose smear diagnoses tended to underestimate the severity of the histopathological abnormality. CONCLUSIONS--This study has shown major differences between specialist and non-specialist cytopathologists in the diagnosis and grading of cervical smears and in the recommended management of patients with abnormal smears. These differences may result in uneven clinical management of women with smear abnormalities. It is therefore important to explore possible strategies for standardising the reporting of cervical smears, such as centralisation of screening services, accreditation in cytopathology for non-specialist consultants, and the value of participation in external quality assessment schemes.  相似文献   
128.
129.
High-fat diet-feeding increases body weight and adiposity in Syrian hamsters (Mesocricetus auratus), effects due in part to decreased energy expenditure. The effects of voluntary exercise- or cold exposure-induced increases in energy expenditure were examined in fat- or chow-fed, female Syrian hamsters. In Experiment 1, voluntary exercise (10 weeks) caused a moderate hyperphagia and actually increased body weight in both diet groups through increases in lean body mass. Carcass lipid was not affected by by exercise in chow-fed hamsters and only slightly reduced in fat-fed animals. In Experiment 2, chronic (8 weeks) cold exposure (5 degrees C) increased energy intake to the same extent in both dietary groups relative to the warm-exposed (23 degrees C) controls. High-fat diet-induced obesity was largely prevented by cold exposure. Cold exposure reduced lean body mass in chow-fed hamsters, but this carcass component was spared by fat-feeding. These results indicate that the increased metabolic demands of cold exposure were more effective in preventing this form of diet-induced obesity than those of voluntary exercise (80% and 17% reductions in carcass lipid, respectively). These results are discussed in terms of possible beneficial effects of eating a lipid-rich diet prior to winter.  相似文献   
130.
A large literature proposes that preferences for exaggerated sex typicality in human faces (masculinity/femininity) reflect a long evolutionary history of sexual and social selection. This proposal implies that dimorphism was important to judgments of attractiveness and personality in ancestral environments. It is difficult to evaluate, however, because most available data come from large-scale, industrialized, urban populations. Here, we report the results for 12 populations with very diverse levels of economic development. Surprisingly, preferences for exaggerated sex-specific traits are only found in the novel, highly developed environments. Similarly, perceptions that masculine males look aggressive increase strongly with development and, specifically, urbanization. These data challenge the hypothesis that facial dimorphism was an important ancestral signal of heritable mate value. One possibility is that highly developed environments provide novel opportunities to discern relationships between facial traits and behavior by exposing individuals to large numbers of unfamiliar faces, revealing patterns too subtle to detect with smaller samples.Inspired by evidence from nonhuman species indicating that exaggerated sex-typical traits (e.g., large antlers, peacock tails) are often attractive to mates or intimidating to rivals (1, 2), morphological sex typicality in humans (masculinity in men and femininity in women) has been the focus of considerable research into attractiveness judgments (3, 4). Facial attractiveness research has been revolutionized by this explanatory framework from the biological sciences, which proposes that attractive human faces honestly signaled mate value within ancestral environments.An influential proposal is that facial femininity is a signal of fertility in human female faces (49) because, within same-age women, it is associated with estrogens (10), which, in turn, are related to measures of reproductive health (11). Like ovarian function, facial femininity declines with age in adulthood (12, 13). The proposal that fertile women should be attractive to men is seemingly uncontroversial because males who discriminatively mate with fertile females should achieve a straightforward reproductive advantage over those males who do not, with all other factors being equal (6). Although direct associations between facial femininity and fertility have not been demonstrated, the consensus from Western preferences, and from the limited cross-cultural data available, is that femininity is attractive, as predicted by the fertility hypothesis (1417). In environments where fertility is high and variable, this relationship should be even more apparent.In male faces, masculinity has been variously proposed to signal heritable disease resistance (“good genes” or “immunocompetence”) (4, 15, 1822) and/or perceived as a cue of aggressiveness and, consequently, intrasexual competitiveness (22, 23). The “honesty” of face shape as an indicator of immunocompetence is proposed to be the result of an immunosuppressive effect of testosterone. Because testosterone influences the growth of sex-typical traits in many species (24, 25), masculine facial shape is proposed to be a costly, and thus honest, signal of male quality (22). The hypothesis that cues of heritable health should be attractive to females is widely accepted (26), although the evidence for a link between heritable health and masculinity in humans is tentative at best (22).Support for a link between masculinity and aggression is largely indirect, and it consists of an association between testosterone and both aggressive behavior (27, 28) and face shape (25), in addition to the fact that honest signaling of dominance is commonly observed in nonhuman species (3). Masculine faces are perceived as aggressive in those groups (i.e., urban, Western) where the relationship has been tested (29). Because masculinity may signal both (desirable) immunity and (potentially costly) aggression in humans, some authors have proposed that preferences for masculinity reflect women trading-off benefits of traits putatively associated with health against those traits associated with prosocial behaviors, such as parental investment (23, 30, 31).Consistent with both of these proposals, data indicate that preferences for masculinity are stronger in circumstances where indirect benefits (heritable quality) can be realized without accompanying direct costs (aggression and low paternal investment). Such circumstances include judging attractiveness in the context of a short-term (vs. a long-term) relationship (32) and in the follicular phase of the menstrual cycle when conception following intercourse is most likely (33). Masculinity is also reported to be more strongly preferred in environments with relatively high pathogen burdens (19, 30) and in environments with higher local homicide rates (23), which has been interpreted as a response to variation in the benefits of heritable disease resistance (19) and in the net benefits conferred by aggressive males under varying levels of male–male competition (23).All of this supporting evidence comes with a very important caveat; although there has been some cross-cultural work in this area (34), the majority of studies have been conducted in Western, often student, populations characterized by high levels of development and urbanization [Western, educated, industrialized, rich, and democratic; so-called WEIRD participants (35)]. Research on preferences in other groups is scant and methodologically inconsistent, using Internet-based designs or a limited cross-cultural component (7, 1518). Because there are differences between Western/non-Western and industrial/small-scale societies in many behaviors, including aspects of visual perception and mate choice (35), this over-representation greatly limits generalizability. Perhaps most importantly, large-scale (post)industrial societies present inhabitants with large numbers of unfamiliar faces and provide venues for the efficient exchange of (visual) social information (e.g., posters, television, Internet); these factors may be instrumental in the acquisition and reinforcement of preferences (3639). It is possible therefore that rather than being a legacy of ancestral selection pressures, preferences for dimorphism emerge in large urban groups as a byproduct of the information-processing strategies used to process large amounts of social information or in response to arbitrary cultural norms.Development also introduces an increased presence of highly differentiated social roles that arise from a greater division of labor, along with opportunities to acquire prestige without strength or aggression. Because partner preferences have been proposed to develop in response to sex-typical social roles (40, 41), it is possible that increasingly differentiated roles could influence masculinity preferences if desirable social roles not present in less developed groups are associated with facial appearance.We assessed preferences for, and trait attributions made to, faces varying in dimorphism in a cross-cultural sample of 12 groups, including non-Western, nonstudent, and small-scale societies (n = 962; Tables S1 and S2). We tested the predictions, derived from the immunocompetence handicapping hypothesis, that (i) preferences for dimorphism will be stronger in less developed groups and (ii) masculine faces would be perceived as aggressive in all populations, with perceptions in low-development groups at least as strong as in groups with high development. We estimated social development with the Human Development Index (HDI), which is a composite indicator compiled by the United Nations Development Program. To investigate which aspects of development were associated with variation in perception of our facial stimuli, we took the World Health Organization measures of years lost to disease and United Nations (UN) measures of homicide rates as proxy measures of disease burden and male intrasexual competition, respectively (both log-transformed), and UN measures of levels of urbanization. Using these national statistics almost certainly underestimates disease burden in the small-scale societies in our sample, which is a conservative estimate with regard to our hypotheses.

Table 1.

Summary information for the groups tested
GroupLocal regionCountrySubsistence moden malen femalen female after exclusions
Canadian studentsAlberta provinceCanadaMarket economy236018
UK studentsBristol cityUnited KingdomMarket economy80238134
Shanghai studentsShanghai municipalityChinaMarket economy413838
Hangzhou citizensZhejiang provinceChinaMarket economy435248
Cree CanadiansAlberta provinceCanadaMarket economy262813
TuvansTyva RepublicRussiaPastoralism, wages303018
Kadazan-DusunSabah regionMalaysiaPastoralism, agriculture252618
Fijian villagersCakaudrove provinceFijiForaging, agriculture, wages9105
ShuarMorona Santiago provinceEcuadorHorticulture, hunting, foraging, recent small-scale agropastoralism303119
MiskituRegión Autónoma del Atlántico SurNicaraguaHorticulture, fishing, hunting131715
TchimbaKunene regionNamibiaPastoralism352720
AkaSouthwest Central African RepublicCentral African RepublicForaging252511
Open in a separate windowParticipants were asked to choose the most attractive face from five sets (representing five different ethnicities, representing considerable phenotypic variation in human faces) of three opposite-sex photographs, with one 60% masculinized [i.e., with the shape differences between male and female faces caricatured by 60% (4)], one 60% feminized, and one unaltered face in each set (Fig. 1). Participants assessed attractiveness for long-term and short-term relationships. Participants were also asked to choose the most aggressive-looking face, and responses were scored in the same way. Custom randomization tests were used to test for nonrandomness of choice (e.g., Fig. S1), and ordinal generalized linear mixed models (GLMMs) were used to test for associations between choices and predictor variables.Open in a separate windowFig. 1.Examples of stimuli used. A European female composite (Upper) and an East Asian male composite (Lower) are shown. Masculinized stimuli (Left) and feminized stimuli (Right) are shown.Although the previous literature suggests that familiarity effects of ethnicity can subtly affect dimorphism preferences, this influence is small and inconsistent across cultures and is unlikely to bias results as a result of exposure to ethnic variation in facial appearance (4, 15).  相似文献   
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号