全文获取类型
收费全文 | 1475篇 |
免费 | 103篇 |
国内免费 | 25篇 |
专业分类
儿科学 | 145篇 |
妇产科学 | 14篇 |
基础医学 | 135篇 |
口腔科学 | 66篇 |
临床医学 | 143篇 |
内科学 | 342篇 |
皮肤病学 | 49篇 |
神经病学 | 25篇 |
特种医学 | 328篇 |
外科学 | 80篇 |
综合类 | 21篇 |
预防医学 | 61篇 |
眼科学 | 16篇 |
药学 | 87篇 |
1篇 | |
中国医学 | 1篇 |
肿瘤学 | 89篇 |
出版年
2023年 | 3篇 |
2022年 | 4篇 |
2021年 | 13篇 |
2020年 | 10篇 |
2019年 | 12篇 |
2018年 | 23篇 |
2017年 | 20篇 |
2016年 | 27篇 |
2015年 | 32篇 |
2014年 | 26篇 |
2013年 | 48篇 |
2012年 | 10篇 |
2011年 | 12篇 |
2010年 | 40篇 |
2009年 | 79篇 |
2008年 | 19篇 |
2007年 | 39篇 |
2006年 | 38篇 |
2005年 | 30篇 |
2004年 | 21篇 |
2003年 | 25篇 |
2002年 | 20篇 |
2001年 | 20篇 |
2000年 | 21篇 |
1999年 | 32篇 |
1998年 | 101篇 |
1997年 | 117篇 |
1996年 | 112篇 |
1995年 | 77篇 |
1994年 | 82篇 |
1993年 | 98篇 |
1992年 | 17篇 |
1991年 | 17篇 |
1990年 | 18篇 |
1989年 | 44篇 |
1988年 | 39篇 |
1987年 | 26篇 |
1986年 | 32篇 |
1985年 | 31篇 |
1984年 | 17篇 |
1983年 | 15篇 |
1982年 | 19篇 |
1981年 | 34篇 |
1980年 | 20篇 |
1979年 | 8篇 |
1978年 | 8篇 |
1977年 | 21篇 |
1976年 | 19篇 |
1975年 | 6篇 |
1970年 | 1篇 |
排序方式: 共有1603条查询结果,搜索用时 11 毫秒
991.
Rajman I; Lip GY; Cramb R; Maxwell SR; Zarifis J; Beevers DG; Kendall MJ 《QJM : monthly journal of the Association of Physicians》1996,89(10):771-778
In a prospective longitudinal study in 17 women, we investigated the
effects of surgical menopause and subsequent oestrogen-only hormone
replacement therapy (HRT) on plasma concentrations of total cholesterol,
HDL cholesterol, LDL cholesterol, triglyceride and LDL subfractions
profile. Plasma LDL is a heterogeneous population of particles of varying
size, density and chemical composition. The predominance of small LDL
particles is a newly-recognized risk factor for coronary artery disease.
The LDL score is used to describe LDL subfractions profile and the greater
the score, the higher the proportion of small LDL particles. Six weeks
after hysterectomy and bilateral oopherectomy, total cholesterol and
triglyceride concentrations were significantly increased (p < 0.01) as
well as the LDL score (p < 0.05). After 6 weeks of oestrogen-only HRT,
total cholesterol concentration was significantly lower and HDL cholesterol
concentration significantly higher than before the treatment (p < 0.05).
At the same time, mean LDL score significantly increased and in none of the
women did LDL subfractions profile change favourably.
相似文献
992.
van der Vorst MM den Hartigh J Wildschut E Tibboel D Burggraaf J 《Critical care (London, England)》2007,11(5):R111
Introduction
The objective of the present study was to explore a continuous intravenous furosemide regimen that adapts to urine output in neonates treated with extracorporeal membrane oxygenation (ECMO). 相似文献993.
994.
BACKGROUND: To avoid the need, in serial apheresis donors, either to delay plateletpheresis until a predonation platelet count is completed or to obtain a postdonation count after each procedure, a statistical model has been developed to predict the postdonation platelet count from the donor predonation platelet count, weight, and hematocrit. STUDY DESIGN AND METHODS: Predonation and postdonation platelet counts were measured in two groups of approximately 100 consecutive donors (Group A to test the model and Group B to validate it), and the postdonation counts were calculated with the model. Using stepwise multiple linear regression from donor data, estimated postdonation platelet counts were found to be comparable to the postdonation platelet counts actually measured. RESULTS: Estimated postdonation platelet counts × 10(9) per L (mean +/− SD) for each group, respectively, were Group A, 195 +/− 35, versus actual platelet counts of 195 +/− 39 (p = 0.43), and Group B, 183 +/− 36, versus actual platelet counts of 189 +/− 34 (p = 0.14). Sensitivity and specificity, respectively, were Group A, 57 and 99 percent and Group B, 62 and 99 percent. CONCLUSION: For most serial apheresis donors, application of this predictor model should preclude the need to obtain an extra postdonation platelet count. 相似文献
995.
Nurse middle managers are in an ideal position to facilitate patient‐centred care. However, their contribution is underexposed in literature due to difficulties to articulate this in practice. This paper explores how nurse middle managers contribute to patient‐centred care in hospitals. A combination of time‐use analysis and ethnographic work was used to disclose their contribution to patient‐centred care at a micro level. Sixteen nurse managers were shadowed for over 560 hours in four hospitals. Some nurse middle managers seldom contribute to patient‐centred care. Others are involved in direct patient care, but this does not result in patient‐centred practices. At one hospital, the nurse middle managers did contribute to patient‐centred care. Here balancing between “organizing work” and “caring work” is seen as a precondition for their patient‐centeredness. Other important themes are feedback mechanisms; place matters; with whom to talk and how to frame the issues at stake; and behavioral style. Both “hands‐on” and “heads‐on” caring work of nurse middle managers enhances their patient‐centeredness. This study is the first of its kind to obtain insight in the often difficult to articulate “doings” of nurse middle managers with regard to patient‐centred care through combining time‐use analysis with ethnographic work. 相似文献
996.
MH Elvey H Pugh G Schaller G Dhotar B Patel MJ Oddy 《Annals of the Royal College of Surgeons of England》2014,96(5):381-385
Introduction
The cost of fragility fractures to the UK economy is predicted to reach £2.2 billion by 2025. We studied our hip fracture population to establish whether national guidelines on fragility fracture prevention were being followed, and whether high risk patients were identified and treated by local care services.Methods
Data on a consecutive series of trauma hip fracture admissions were collected prospectively over 14 months. National Institute for Health and Care Excellence (NICE) and National Osteoporosis Guideline Group (NOGG) recommendations and FRAX® risk calculations were applied to patients prior to their admission with a new hip fracture.Results
Overall, 94 patients were assessed against national guidelines. The mean population age was 77 years. Almost a quarter (22%) of patients had suffered a previous fragility fracture. The mean FRAX® ten-year probability of hip fracture was 7%. According to guidelines, 45% of the study population required treatment, 35% fulfilled criteria for investigation and reassessment, and 20% needed no further management. In practice, 27% received treatment, 4% had undergone dual energy x-ray absorptiometry and were untreated, and 69% had not been investigated and were untreated. In patients meeting intervention thresholds, only 33% of those who required treatment were receiving treatment in practice.Conclusions
In conjunction with NICE and NOGG recommendations, FRAX® was able to identify 80% of our fracture population as intermediate or high risk on the day of fracture. Correct management was evident in a third of cases with a pattern of inferior guideline compliance seen in a London population. There remains a lack of clarity over the duty of care in fragility fracture prevention. 相似文献997.
Candida species (spp) are commensal yeast that can only instigate oral infection (oral candidosis – OC) when there is an underlying predisposing condition in the host. We investigated four controversial topics on OC: (i) How can a microbiological determination of OC be made as Candida spp. are commensal yeasts and not all of them form hyphae or pseudohyphae during infection? (ii) Is median rhomboid glossitis (MRG) a manifestation of candidal infection? (iii) Can candidal infection cause palate papillary hyperplasia (PPH)? (iv) What is the best therapeutic treatment for denture‐associated erythematous stomatitis (DAES)? Results from extensive literature searches, including a systematic review, suggested the following: (i) the diagnosis of OC merely on the basis of the presence of yeasts is an oversimplification of a complex process. No convincing evidence of a single test or method better able to discriminate the transition from candidal saprophytism to pathogenicity has been reported in the literature; (ii–iii) conclusive evidence of a direct aetiopathogenic relationship between MRG and PPH and candidal infection has not been found; and (iv) only limited evidence is available for any DAES treatment, thus making it impossible to make strong therapeutic recommendations. 相似文献
998.
N Choudhury I Amer M Daniels MJ Wareing 《Annals of the Royal College of Surgeons of England》2013,95(1):34-36
Introduction
Aural microsuction is a common ear, nose and throat procedure used in the outpatient setting. Some patients, however, find it difficult to tolerate owing to discomfort, pain or noise. This study evaluated the effect of audiovisual distraction on patients’ pain perception and overall satisfaction.Methods
A prospective study was conducted for patients attending our aural care clinic requiring aural toileting of bilateral mastoid cavities over a three-month period. All microsuction was performed by a single clinical nurse specialist. Any patients with active infection were excluded. For each patient, during microsuction of one ear, they watched the procedure on a television screen while for the other ear they did not view the procedure. All patients received the same real time explanations during microsuction of both ears. After the procedure, each patient completed a visual analogue scale (VAS) to rate the pain they experienced for each ear, with and without access to the television screen. They also documented their preference and reasons why.Results
A total of 37 patients were included in the study. The mean pain score for patients viewing the procedure was 2.43 compared with a mean of 3.48 for patients with no television view. This difference in patients’ pain perception was statistically lower in the group who observed the procedure on the television (p=0.003), consistent with the majority of patients reporting a preference to viewing their procedure (65%).Conclusions
Audiovisual distraction significantly lowered patients’ VAS pain scores during aural microsuction. This simple intervention can therefore reduce patients’ perceived pain and help improve acceptance of this procedure. 相似文献999.
S Mukhtar BE Ayres R Issa MJ Swinn MJA Perry 《Annals of the Royal College of Surgeons of England》2013,95(3):200-206
Introduction
The implementation of enhanced recovery programmes (ERPs) in colorectal surgery has seen improvements in the length of inpatient stay with no increase in complications. We investigated the role of ERP in radical cystectomy at our institution.Methods
Prospective data were collected from 26 consecutive patients prior to the introduction of the ERP and 51 patients who underwent open radical cystectomy within an ERP. Individuals in the ERP cohort did not receive bowel preparation or nasogastric drainage but received preoperative carbohydrate drinks, perioperative epidural analgesia and immediate mobilisation on day 1. Primary outcome measures included duration of intensive care unit (ICU) stay and length of hospital stay. Secondary outcome measures included the time to the passage of flatus and faeces, and time to mobilisation. Other measures that were analysed included operation time and complications.Results
Baseline characteristics for both groups were similar. The median length of hospital stay fell from 11.5 days to 10.4 days and the mean ICU stay dropped from 2.4 days to 1.0 days (p=0.01). Time to removal of nasogastric tube, and time to passage of flatus and faeces were significantly shorter in the ERP group, as was the time to full oral diet. Clavien complication rates and 30-day mortality rates were similar in both groups. There were no readmissions.Conclusions
ERP in radical cystectomy is safe and not associated with any increase in complications or readmissions. It is associated with reductions in ICU stay, and could also reduce length of hospital stay and duration of postoperative ileus. 相似文献1000.
DH Kim H Wit M Thurston M Long GF Maskell MJ Strugnell D Shetty IM Smith NP Hollings 《The British journal of radiology》2021,94(1122)
Objectives:Small bowel obstruction is a common surgical emergency which can lead to bowel necrosis, perforation and death. Plain abdominal X-rays are frequently used as a first-line test but the availability of immediate expert radiological review is variable. The aim was to investigate the feasibility of using a deep learning model for automated identification of small bowel obstruction.Methods:A total of 990 plain abdominal radiographs were collected, 445 with normal findings and 445 demonstrating small bowel obstruction. The images were labelled using the radiology reports, subsequent CT scans, surgical operation notes and enhanced radiological review. The data were used to develop a predictive model comprising an ensemble of five convolutional neural networks trained using transfer learning.Results:The performance of the model was excellent with an area under the receiver operator curve (AUC) of 0.961, corresponding to sensitivity and specificity of 91 and 93% respectively.Conclusion:Deep learning can be used to identify small bowel obstruction on plain radiographs with a high degree of accuracy. A system such as this could be used to alert clinicians to the presence of urgent findings with the potential for expedited clinical review and improved patient outcomes.Advances in knowledge:This paper describes a novel labelling method using composite clinical follow-up and demonstrates that ensemble models can be used effectively in medical imaging tasks. It also provides evidence that deep learning methods can be used to identify small bowel obstruction with high accuracy. 相似文献