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91.
Michael K. Rakotz Bernard G. Ewigman Menaka Sarav Ruth E. Ross Ari Robicsek Chad W. Konchak Thomas F. Gavagan David W. Baker David J. Hyman Kenneth P. Anderson Christopher M. Masi 《Annals of family medicine》2014,12(4):352-358
PURPOSE
The goal of this study was to develop a technology-based strategy to identify patients with undiagnosed hypertension in 23 primary care practices and integrate this innovation into a continuous quality improvement initiative in a large, integrated health system.METHODS
In phase 1, we reviewed electronic health records (EHRs) using algorithms designed to identify patients at risk for undiagnosed hypertension. We then invited each at-risk patient to complete an automated office blood pressure (AOBP) protocol. In phase 2, we instituted a quality improvement process that included regular physician feedback and office-based computer alerts to evaluate at-risk patients not screened in phase 1. Study patients were observed for 24 additional months to determine rates of diagnostic resolution.RESULTS
Of the 1,432 patients targeted for inclusion in the study, 475 completed the AOBP protocol during the 6 months of phase 1. Of the 1,033 at-risk patients who remained active during phase 2, 740 (72%) were classified by the end of the follow-up period: 361 had hypertension diagnosed, 290 had either white-coat hypertension, prehypertension, or elevated blood pressure diagnosed, and 89 had normal blood pressure. By the end of the follow-up period, 293 patients (28%) had not been classified and remained at risk for undiagnosed hypertension.CONCLUSIONS
Our technology-based innovation identified a large number of patients at risk for undiagnosed hypertension and successfully classified the majority, including many with hypertension. This innovation has been implemented as an ongoing quality improvement initiative in our medical group and continues to improve the accuracy of diagnosis of hypertension among primary care patients. 相似文献92.
93.
J. Baron E. Fishbourne E. Couacy‐Hyman M. Abubakar B. A. Jones L. Frost R. Herbert T. R. Chibssa G. van't Klooster M. Afzal C. Ayebazibwe P. Toye J. Bashiruddin M. D. Baron 《Transboundary and Emerging Diseases》2014,61(5):390-396
We have developed an immunochromatographic test for the diagnosis of peste des petits ruminants (PPR) under field conditions. The diagnostic assay has been tested in the laboratory and also under field conditions in Ivory Coast, Pakistan, Ethiopia and Uganda. The test is carried out on a superficial swab sample (ocular or nasal) and showed a sensitivity of 84% relative to PCR. The specificity was 95% over all nasal and ocular samples. The test detected as little as 103 TCID50 (50% tissue culture infectious doses) of cell culture‐grown virus, and detected virus isolates representing all four known genetic lineages of peste des petits ruminants virus. Virus could be detected in swabs from animals as early as 4 days post‐infection, at a time when clinical signs were minimal. Feedback from field trials was uniformly positive, suggesting that this diagnostic tool may be useful for current efforts to control the spread of PPR. 相似文献
94.
95.
96.
Smith Giri Nabiel Mir Mustafa Al-Obaidi Deanna Clark Kelly M Kenzik Andrew McDonald Crystal Young-Smith Ravi Paluri Lakshmin Nandagopal Olumide Gbolahan Kirsten A Nyrop Hyman B Muss Mackenzi Pergolotti Smita Bhatia Grant R Williams 《The oncologist》2022,27(1):e45
BackgroundPoor self-rated health (SRH) is a known predictor of frailty and mortality in the general population; however, its role among older adults with cancer is unknown. We evaluated the role of SRH as a potential screening tool to identify frailty and geriatric assessment (GA)-identified impairments.Materials and MethodsAdults ≥60 years diagnosed with cancer in the UAB Cancer & Aging Resilience Evaluation (CARE) registry underwent a GA at the time of initial consultation. We measured SRH using a single-item from the Patient-Reported Outcomes Measurement Information System global health scale and dichotomized responses as poor (poor, fair) and good (good, very good, and excellent). We evaluated the diagnostic performance of SRH in measuring frailty, and GA impairment (≥2 deficits among a set of seven GA domains). We examined the impact of SRH with survival using a Cox model adjusting for confounders, exploring the mediating role of frailty.ResultsSix hundred and three older adults with cancer were included, with a median age of 69 years. Overall, 45% (n = 274) reported poor SRH. Poor SRH demonstrated high sensitivity and specificity for identifying frailty (85% and 78%, respectively) and GA impairment (75% and 78%, respectively). In a Cox regression model, poor SRH was associated with inferior survival (HR = 2.26; 95% CI 1.60-3.18) after adjusting for confounders; frailty mediated 69% of this observed relationship.ConclusionSelf-rated health may be used as a screening tool to identify older adults with cancer with frailty and GA impairments. Poor SRH is associated with inferior survival, which is mediated by frailty. 相似文献
97.
Daneng Li Can-Lan Sun Rebecca Allen Christiana J Crook Abrahm Levi Richard Ballena Heidi D Klepin Rawad Elias Supriya G Mohile William P Tew Cynthia Owusu Hyman B Muss Stuart M Lichtman Cary P Gross Andrew E Chapman Ajeet Gajra Harvey J Cohen Vani Katheria Arti Hurria William Dale 《The oncologist》2022,27(1):e37
BackgroundOlder adults (≥65 years) with gastrointestinal (GI) cancers who receive chemotherapy are at increased risk of hospitalization caused by treatment-related toxicity. Geriatric assessment (GA) has been previously shown to predict risk of toxicity in older adults undergoing chemotherapy. However, studies incorporating the GA specifically in older adults with GI cancers have been limited. This study sought to identify GA-based risk factors for chemotherapy toxicity–related hospitalization among older adults with GI cancers.Patients and MethodsWe performed a secondary post hoc subgroup analysis of two prospective studies used to develop and validate a GA-based chemotherapy toxicity score. The incidence of unplanned hospitalizations during the course of chemotherapy treatment was determined.ResultsThis analysis included 199 patients aged ≥65 years with a diagnosis of GI cancer (85 colorectal, 51 gastric/esophageal, and 63 pancreatic/hepatobiliary). Sixty-five (32.7%) patients had ≥1 hospitalization. Univariate analysis identified sex (female), cardiac comorbidity, stage IV disease, low serum albumin, cancer type (gastric/esophageal), hearing deficits, and polypharmacy as risk factors for hospitalization. Multivariable analyses found that patients who had cardiac comorbidity (OR 2.48, 95% CI 1.13-5.42) were significantly more likely to be hospitalized.ConclusionCardiac comorbidity may be a risk factor for hospitalization in older adults with GI cancers receiving chemotherapy. Further studies with larger sample sizes are warranted to examine the relationship between GA measures and hospitalization in this vulnerable population. 相似文献
98.
Maria M. Rubinstein MD David M. Hyman MD Imogen Caird BA Helen Won MS Krysten Soldan BSN Kenneth Seier MS Alexia Iasonos PhD William P. Tew MD Roisin E. O’Cearbhaill MD Rachel N. Grisham MD Martee L. Hensley MD Tiffany Troso-Sandoval MD Paul Sabbatini MD Joyce Guillen BS S. Duygu Selcuklu PhD Catherine Zimel BS Jean Torrisi MD Carol Aghajanian MD Vicky Makker MD 《Cancer》2020,126(6):1274-1282
99.
Sebastian P. Mondaca MD Dazhi Liu PharmD BCOP Jessica R. Flynn Sandy Badson Stefan Hamaway BS Mrinal M. Gounder MD Danny N. Khalil MD PhD Alexander E. Drilon MD Bob T. Li MD MPH Komal L. Jhaveri MD Alison M. Schram MD Katherine E. Kargus RN Mary Kate Kasler DNP MSN Natalie M. Blauvelt Neil H. Segal MD PhD Marinela Capanu PhD Margaret K. Callahan MD PhD David M. Hyman MD Maya Gambarin-Gelwan MD James J. Harding MD 《Cancer》2020,126(22):4967-4974
100.
Jared M. Weiss MD Nathan Pennell MD PhD Allison M. Deal MS Daniel Morgensztern MD Daniel S. Bradford MD Jeffrey Crane MD Howard Jack West MD Carrie Lee MD Chad Pecot MD James P. Stevenson MD William Irvin MD Mark Socinski MD Tom Stinchcombe MD Liza C. Villaruz MD Hyman B. Muss MD 《Cancer》2020,126(5):1060-1067