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Michelle Cleary Catherine Hungerford Violeta Lopez John R. Cutcliffe 《Issues in mental health nursing》2015,36(6):424-429
Micromanagement refers to a management style that involves managers exercising control over team members, teams, and also organizations, particularly in relation to the minutiae or minor details of day-to-day operations. While there is no single reason why some managers may choose to micromanage, many micromanagers exhibit similar behavioral traits, a consequence of perfectionism and/or underlying insecurities. In the culture of high performance that characterizes many contemporary mental health contexts, micromanagement also provides one way by which teams can be driven to achieve targets. However, over time, micromanagement leads to reductions in staff morale, creativity, and productivity; and increases in staff turnover. This paper provides an overview of micromanagement, including points of consideration for managers interested in reflecting on their management styles, and strategies for mental health nurses who find themselves working for a micromanager. 相似文献
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Li? Bárbara Arruda Marilia Ladeira de Araújo Maira Luccia Martinez Claudio Roberto Gonsalez Alberto José da Silva Duarte Eoin Coakley Yolanda Lie Jorge Casseb 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(4):287-290
The clinical application of CCR5 antagonists involves first determining
the coreceptor usage by the infecting viral strain. Bioinformatics programs that
predict coreceptor usage could provide an alternative method to screen candidates for
treatment with CCR5 antagonists, particularly in countries with limited financial
resources. Thus, the present study aims to identify the best approach using
bioinformatics tools for determining HIV-1 coreceptor usage in clinical practice.
Proviral DNA sequences and Trofile results from 99 HIV-1-infected subjects under
clinical monitoring were analyzed in this study. Based on the Trofile results, the
viral variants present were 81.1% R5, 21.4% R5X4 and 1.8% X4. Determination of
tropism using a Geno2pheno[coreceptor] analysis with a false positive rate
of 10% gave the most suitable performance in this sampling: the R5 and X4 strains
were found at frequencies of 78.5% and 28.4%, respectively, and there was 78.6%
concordance between the phenotypic and genotypic results. Further studies are needed
to clarify how genetic diversity amongst virus strains affects bioinformatics-driven
approaches for determining tropism. Although this strategy could be useful for
screening patients in developing countries, some limitations remain that restrict the
wider application of coreceptor usage tests in clinical practice. 相似文献
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Agostino Consoli MD Leszek Czupryniak MD Rui Duarte MD György Jermendy MD Alexandra Kautzky-Willer MD Chantal Mathieu MD Miguel Melo MD Ofri Mosenzon MD Frank Nobels MD Nikolaos Papanas MD Gabriela Roman MD Oliver Schnell MD Alexis Sotiropoulos MD Coen D. A. Stehouwer MD Cees J. Tack MD Vincent Woo MD Gian Paolo Fadini MD Itamar Raz MD 《Diabetes, obesity & metabolism》2020,22(10):1705-1713
The large number of pharmacological agents available to treat type 2 diabetes (T2D) makes choosing the optimal drug for any given patient a complex task. Because newer agents offer several advantages, whether and when sulphonylureas (SUs) should still be used to treat T2D is controversial. Published treatment guidelines and recommendations should govern the general approach to diabetes management. However, expert opinions can aid in better understanding local practices and in formulating individual choices. The current consensus paper aims to provide additional guidance on the use of SUs in T2D. We summarize current local treatment guidelines in European countries, showing that SUs are still widely proposed as second-line treatment after metformin and are often ranked at the same level as newer glucose-lowering medications. Strong evidence now shows that sodium-glucose co-transporter-2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are associated with low hypoglycaemia risk, promote weight loss, and exert a positive impact on vascular, cardiac and renal endpoints. Thus, using SUs in place of SGLT-2is and GLP-1RAs may deprive patients of key advantages and potentially important cardiorenal benefits. In subjects with ascertained cardiovascular disease or at very high cardiovascular risk, SGLT-2is and/or GLP-1RAs should be used as part of diabetes management, in the absence of contraindications. Routine utilization of SUs as second-line agents continues to be acceptable in resource-constrained settings. 相似文献
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Marques DN da Mata AD Silveira JM Marques JR Amaral JP Guilherme NF 《Clinical oral investigations》2012,16(1):155-163
The objective of this study is to compare salivary hydrogen peroxide (HP) release kinetics and potential toxicity of systemic
exposure of four different whitening products. A double-blind, randomized controlled trial was conducted in a Portuguese dental
faculty clinic. Two hundred forty volunteers were randomized to eight intervention groups. Participants were randomly assigned
to receive active or placebo applications of one of four different products: Opalescence 10% PF™ (OPL), Vivastyle? 10%™ (VS10%),
Vivadent Paint On Plus™ (PO+), and Trés White Supreme™ (TWS). Saliva collection was obtained by established methods at different
times. The HP salivary content was determined by a photometric method. Salivary HP variations, total amount of salivary HP,
and counts of subjects above the safe daily HP dose were the main outcome measures. All whitening systems significantly released
HP to the saliva when compared to placebo, and all showed different release kinetics. The adaptable tray system (TWS) presented
a risk increase of 37% [20–54%, 95% confidence interval] when compared to the other systems. The use of an adaptable tray
whitening system with higher concentration of HP increases the toxicity potential. 相似文献
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