全文获取类型
收费全文 | 53192篇 |
免费 | 3426篇 |
国内免费 | 156篇 |
专业分类
耳鼻咽喉 | 737篇 |
儿科学 | 1495篇 |
妇产科学 | 891篇 |
基础医学 | 6331篇 |
口腔科学 | 925篇 |
临床医学 | 5426篇 |
内科学 | 11349篇 |
皮肤病学 | 894篇 |
神经病学 | 4988篇 |
特种医学 | 2054篇 |
外国民族医学 | 1篇 |
外科学 | 9090篇 |
综合类 | 579篇 |
一般理论 | 49篇 |
预防医学 | 3596篇 |
眼科学 | 867篇 |
药学 | 3334篇 |
中国医学 | 54篇 |
肿瘤学 | 4114篇 |
出版年
2023年 | 273篇 |
2022年 | 435篇 |
2021年 | 1138篇 |
2020年 | 664篇 |
2019年 | 1152篇 |
2018年 | 1357篇 |
2017年 | 993篇 |
2016年 | 1039篇 |
2015年 | 1223篇 |
2014年 | 1878篇 |
2013年 | 2432篇 |
2012年 | 3900篇 |
2011年 | 4069篇 |
2010年 | 2257篇 |
2009年 | 1942篇 |
2008年 | 3535篇 |
2007年 | 3700篇 |
2006年 | 3736篇 |
2005年 | 3622篇 |
2004年 | 3485篇 |
2003年 | 3217篇 |
2002年 | 3006篇 |
2001年 | 513篇 |
2000年 | 398篇 |
1999年 | 506篇 |
1998年 | 608篇 |
1997年 | 492篇 |
1996年 | 375篇 |
1995年 | 371篇 |
1994年 | 342篇 |
1993年 | 287篇 |
1992年 | 286篇 |
1991年 | 285篇 |
1990年 | 266篇 |
1989年 | 236篇 |
1988年 | 238篇 |
1987年 | 211篇 |
1986年 | 197篇 |
1985年 | 205篇 |
1984年 | 222篇 |
1983年 | 212篇 |
1982年 | 221篇 |
1981年 | 198篇 |
1980年 | 146篇 |
1979年 | 132篇 |
1978年 | 122篇 |
1977年 | 93篇 |
1976年 | 61篇 |
1974年 | 76篇 |
1973年 | 59篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
991.
Wright A Poon EG Wald J Feblowitz J Pang JE Schnipper JL Grant RW Gandhi TK Volk LA Bloom A Williams DH Gardner K Epstein M Nelson L Businger A Li Q Bates DW Middleton B 《Journal of general internal medicine》2012,27(1):85-92
BACKGROUND
Provider and patient reminders can be effective in increasing rates of preventive screenings and vaccinations. However, the effect of patient-directed electronic reminders is understudied.OBJECTIVE
To determine whether providing reminders directly to patients via an electronic Personal Health Record (PHR) improved adherence to care recommendations.DESIGN
We conducted a cluster randomized trial without blinding from 2005 to 2007 at 11 primary care practices in the Partners HealthCare system.PARTICIPANTS
A total of 21,533 patients with access to a PHR were invited to the study, and 3,979 (18.5%) consented to enroll.INTERVENTIONS
Patients in the intervention arm received health maintenance (HM) reminders via a secure PHR “eJournal,” which allowed them to review and update HM and family history information. Patients in the active control arm received access to an eJournal that allowed them to input and review information related to medications, allergies and diabetes management.MAIN MEASURES
The primary outcome measure was adherence to guideline-based care recommendations.KEY RESULTS
Intention-to-treat analysis showed that patients in the intervention arm were significantly more likely to receive mammography (48.6% vs 29.5%, p = 0.006) and influenza vaccinations (22.0% vs 14.0%, p = 0.018). No significant improvement was observed in rates of other screenings. Although Pap smear completion rates were higher in the intervention arm (41.0% vs 10.4%, p < 0.001), this finding was no longer significant after excluding women’s health clinics. Additional on-treatment analysis showed significant increases in mammography (p = 0.019) and influenza vaccination (p = 0.015) for intervention arm patients who opened an eJournal compared to control arm patients, but no differences for any measure among patients who did not open an eJournal.CONCLUSIONS
Providing patients with HM reminders via a PHR may be effective in improving some elements of preventive care.Electronic supplementary material
The online version of this article (doi:10.1007/s11606-011-1859-6) contains supplementary material, which is available to authorized users.KEY WORDS: health maintenance reminders, personal health record, preventive care, clinical decision support, Patient Gateway 相似文献992.
Zuo J Suen J Wong A Lewis M Ayub A Belzer M Church J Yang OO Krogstad P 《AIDS research and human retroviruses》2012,28(5):486-492
Throughout the world, infants and children with HIV-1 infection are increasingly surviving into adolescence and adulthood. As HIV Nef is an important determinant of the pathogenic potential of the virus, we examined nef alleles in a cohort of extreme long-term survivors of HIV infection (average age of 16.6 years) to determine if Nef defects might have contributed to patient survival. HIV nef gene sequences were amplified for phylogenetic analysis from 15 adolescents and adults infected by mother-to-child transmission (n=10) or by blood transfusion (n=5). Functional analysis was performed by inserting patient-derived nef sequences into an HIV-derived vector that permits simultaneous evaluation of the impact of the Nef protein on MHC-I and CD4 cell surface expression. We found evidence of extensive nef gene diversity, including changes in known functional domains involved in the downregulation of cell surface MHC-I and CD4. Only 3 of 15 individuals (20%) had nef alleles with a loss of the ability to downregulate either CD4 or MHC-I. Survival into adulthood with HIV infection acquired in infancy is not uniformly linked to loss of function in nef. The Nef protein remains a potential target for immunization or pharmacologic intervention. 相似文献
993.
994.
995.
996.
997.
998.
Chan A Verma S Loibl S Crawford J Choi MR Dreiling L Vandenberg T 《Critical reviews in oncology/hematology》2012,81(2):136-150
In this article, we reviewed and quantified reporting of the risk of myelotoxicity, specifically febrile neutropenia (FN), and the related use of supportive care with colony-stimulating factor (CSF) or antibiotics in clinical trials published between January 2005 and June 2009, evaluating emerging regimens for the treatment of selected solid tumors. Our analysis showed that clinically significant neutropenia and neutropenia-related events were generally described in the studies evaluated (grade 3/4 neutropenia incidence, 72%; FN incidence, 53%). However, use of CSF and antibiotics was infrequently and inconsistently reported (trials reporting prophylactic CSF and antibiotics use: in the methods section, 38% and 10%, respectively; in the results section, 19% and 1%, respectively). These results highlight the need for a standardized approach to reporting neutropenic outcomes and use of supportive care measures. This can assist clinicians in prospectively managing relevant toxicities associated with these emerging regimens and thereby facilitate their safe and effective use in clinical practice. 相似文献
999.
Allensworth-Davies D Cheng DM Smith PC Samet JH Saitz R 《The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions》2012,21(3):257-262
Primary care physicians can help drug-dependent patients mitigate adverse drug use consequences; instruments validated in primary care to measure these consequences would aid in this effort. This study evaluated the validity of the Short Inventory of Problems-Alcohol and Drugs modified for Drug Use (SIP-DU) among subjects recruited from a primary care clinic (n= 106). SIP-DU internal consistency was evaluated using Cronbach's alphas, convergent validity by correlating the total SIP-DU score with the DAST-10, and construct validity by analyzing the factor structure. The SIP-DU demonstrated high internal consistency (Cronbach's alpha for overall scale .95, subscales .72-.90) comparable with other SIP versions and correlated well with the DAST-10 (r= .70). Confirmatory factor analysis suggested an unacceptable fit of previously proposed factors; exploratory factor analyses suggested a single factor of drug use consequences. The SIP-DU offers primary care clinicians a valid and practical assessment tool for drug use consequences. 相似文献
1000.
Refaat MM Tanaka T Kormos RL McNamara D Teuteberg J Winowich S London B Simon MA 《Journal of cardiac failure》2012,18(2):140-145
BackgroundImplantable cardioverter-defibrillators (ICDs) reduce mortality in heart failure (HF). In patients requiring a ventricular assist device (VAD), the benefit from ICD therapy is not well established. The aim of this study was to define the impact of ICD on outcomes in VAD-supported patients.Methods and ResultsWe reviewed data for consecutive adult HF patients receiving VAD as a bridge to transplantation from 1996 to 2003. The primary outcome was survival to transplantation. A total of 144 VADs were implanted [85 left ventricular (LVAD), 59 biventricular (BIVAD), mean age 50 ± 12 years, 77% male, left ventricular ejection fraction 18 ± 9%, 54% ischemic]. Mean length of support was 119 days (range 1–670); 103 patients (72%) survived to transplantation. Forty-five patients had an ICD (33 LVAD, 12 BIVAD). More LVAD patients had an appropriate ICD shock before implantation than after (16 vs 7; P = .02). There was a trend toward higher shock frequency before LVAD implant than after (3.3 ± 5.2 vs 1.1 ± 3.8 shocks/y; P = .06). Mean time to first shock after VAD implant was 129 ± 109 days. LVAD-supported patients with an ICD were significantly more likely to survive to transplantation [1-y actuarial survival to transplantation: LVAD: 91% with ICD vs 57% without ICD (log-rank P = .01); BIVAD: 54% vs 47% (log-rank P = NS)]. An ICD was associated with significantly increased survival in a multivariate model controlling for confounding variables (odds ratio 2.54, 95% confidence interval 1.04–6.21; P = .04).ConclusionsShock frequency decreases after VAD implantation, likely owing to ventricular unloading, but appropriate ICD shocks still occur in 21% of patients. An ICD is associated with improved survival in LVAD-supported HF patients. 相似文献