全文获取类型
收费全文 | 10309篇 |
免费 | 811篇 |
国内免费 | 52篇 |
专业分类
耳鼻咽喉 | 145篇 |
儿科学 | 197篇 |
妇产科学 | 153篇 |
基础医学 | 1197篇 |
口腔科学 | 169篇 |
临床医学 | 1071篇 |
内科学 | 2163篇 |
皮肤病学 | 128篇 |
神经病学 | 855篇 |
特种医学 | 391篇 |
外科学 | 2108篇 |
综合类 | 125篇 |
一般理论 | 11篇 |
预防医学 | 818篇 |
眼科学 | 230篇 |
药学 | 631篇 |
中国医学 | 12篇 |
肿瘤学 | 768篇 |
出版年
2024年 | 15篇 |
2023年 | 152篇 |
2022年 | 227篇 |
2021年 | 587篇 |
2020年 | 300篇 |
2019年 | 491篇 |
2018年 | 548篇 |
2017年 | 364篇 |
2016年 | 367篇 |
2015年 | 398篇 |
2014年 | 555篇 |
2013年 | 659篇 |
2012年 | 990篇 |
2011年 | 909篇 |
2010年 | 512篇 |
2009年 | 408篇 |
2008年 | 603篇 |
2007年 | 588篇 |
2006年 | 526篇 |
2005年 | 477篇 |
2004年 | 420篇 |
2003年 | 353篇 |
2002年 | 252篇 |
2001年 | 39篇 |
2000年 | 23篇 |
1999年 | 32篇 |
1998年 | 38篇 |
1997年 | 30篇 |
1996年 | 29篇 |
1995年 | 22篇 |
1994年 | 18篇 |
1993年 | 20篇 |
1992年 | 13篇 |
1991年 | 14篇 |
1990年 | 15篇 |
1989年 | 9篇 |
1988年 | 11篇 |
1987年 | 7篇 |
1986年 | 8篇 |
1985年 | 13篇 |
1984年 | 11篇 |
1983年 | 12篇 |
1982年 | 7篇 |
1980年 | 4篇 |
1979年 | 5篇 |
1978年 | 4篇 |
1976年 | 9篇 |
1954年 | 5篇 |
1943年 | 4篇 |
1927年 | 5篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
101.
Jeph Herrin Ph.D. Justin St. Andre M.A. Kevin Kenward Ph.D. Maulik S. Joshi Dr.P.H. Anne‐Marie J. Audet M.D. M.Sc. Stephen C. Hines Ph.D. 《Health services research》2015,50(1):20-39
Objective
To examine the relationship between community factors and hospital readmission rates.Data Sources/Study Setting
We examined all hospitals with publicly reported 30-day readmission rates for patients discharged during July 1, 2007, to June 30, 2010, with acute myocardial infarction (AMI), heart failure (HF), or pneumonia (PN). We linked these to publicly available county data from the Area Resource File, the Census, Nursing Home Compare, and the Neilsen PopFacts datasets.Study Design
We used hierarchical linear models to assess the effect of county demographic, access to care, and nursing home quality characteristics on the pooled 30-day risk-standardized readmission rate.Data Collection/Extraction Methods
Not applicable.Principal Findings
The study sample included 4,073 hospitals. Fifty-eight percent of national variation in hospital readmission rates was explained by the county in which the hospital was located. In multivariable analysis, a number of county characteristics were found to be independently associated with higher readmission rates, the strongest associations being for measures of access to care. These county characteristics explained almost half of the total variation across counties.Conclusions
Community factors, as measured by county characteristics, explain a substantial amount of variation in hospital readmission rates. 相似文献102.
Andrew M. Ryan Ph.D. James F. Burgess Ph.D. Jr. Michael F. Pesko Ph.D. William B. Borden M.D. M.P.H. Justin B. Dimick M.D. M.P.H. 《Health services research》2015,50(1):81-97
Objective
To evaluate the impact of hospital value-based purchasing (HVBP) on clinical quality and patient experience during its initial implementation period (July 2011–March 2012).Data Sources
Hospital-level clinical quality and patient experience data from Hospital Compare from up to 5 years before and three quarters after HVBP was initiated.Study Design
Acute care hospitals were exposed to HVBP by mandate while critical access hospitals and hospitals located in Maryland were not exposed. We performed a difference-in-differences analysis, comparing performance on 12 incentivized clinical process and 8 incentivized patient experience measures between hospitals exposed to the program and a matched comparison group of nonexposed hospitals. We also evaluated whether hospitals that were ultimately exposed to HVBP may have anticipated the program by improving quality in advance of its introduction.Principal Findings
Difference-in-differences estimates indicated that hospitals that were exposed to HVBP did not show greater improvement for either the clinical process or patient experience measures during the program''s first implementation period. Estimates from our preferred specification showed that HVBP was associated with a 0.51 percentage point reduction in composite quality for the clinical process measures (p > .10, 95 percent CI: −1.37, 0.34) and a 0.30 percentage point reduction in composite quality for the patient experience measures (p > .10, 95 percent CI: −0.79, 0.19). We found some evidence that hospitals improved performance on clinical process measures prior to the start of HVBP, but no evidence of this phenomenon for the patient experience measures.Conclusions
The timing of the financial incentives in HVBP was not associated with improved quality of care. It is unclear whether improvement for the clinical process measures prior to the start of HVBP was driven by the expectation of the program or was the result of other factors. 相似文献103.
Dayton D. McMillan Junko Maeda Justin J. Bell Matthew D. Genet Garrett Phoonswadi Kelly A. Mann Susan L. Kraft Hisashi Kitamura Akira Fujimori Yukie Yoshii Takako Furukawa Yasuhisa Fujibayashi Takamitsu A. Kato 《Journal of radiation research》2015,56(5):784-791
Radioactive copper (II) (diacetyl-bis N4-methylthiosemicarbazone) (Cu-ATSM) isotopes were originally developed for the imaging of hypoxia in tumors. Because the decay of a 64Cu atom is emitting not only positrons but also Auger electrons, this radionuclide has great potential as a theranostic agent. However, the success of 64Cu-ATSM internal radiation therapy would depend on the contribution of Auger electrons to tumor cell killing. Therefore, we designed a cell culture system to define the contributions to cell death from Auger electrons to support or refute our hypothesis that the majority of cell death from 64Cu-ATSM is a result of high-LET Auger electrons and not positrons or other low-LET radiation. Chinese hamster ovary (CHO) wild type and DNA repair–deficient xrs5 cells were exposed to 64Cu-ATSM during hypoxic conditions. Surviving fractions were compared with those surviving gamma-radiation, low-LET hadron radiation, and high-LET heavy ion exposure. The ratio of the D10 values (doses required to achieve 10% cell survival) between CHO wild type and xrs5 cells suggested that 64Cu-ATSM toxicity is similar to that of high-LET Carbon ion radiation (70 keV/μm). γH2AX foci assays confirmed DNA double-strand breaks and cluster damage by high-LET Auger electrons from 64Cu decay, and complex types of chromosomal aberrations typical of high-LET radiation were observed after 64Cu-ATSM exposure. The majority of cell death was caused by high-LET radiation. This work provides strong evidence that 64Cu-ATSM damages DNA via high-LET Auger electrons, supporting further study and consideration of 64Cu-ATSM as a cancer treatment modality for hypoxic tumors. 相似文献
104.
External electrical cardioversion in patients with cardiac implantable electronic devices: Is it safe and is immediate device interrogation necessary? 下载免费PDF全文
Nikki AHA Pluymaekers MD Elton AMP Dudink MD MSc Lucas Boersma MD PhD Ömer Erküner MD Marloes Gelissen MSc Vincent van Dijk MD Maurits Wijffels MD PhD Trang Dinh MD Kevin Vernooy MD PhD Harry JGM Crijns MD PhD Jippe Balt MD PhD Justin GLM Luermans MD PhD 《Pacing and clinical electrophysiology : PACE》2018,41(10):1336-1340
105.
Carla Dillon Justin Peddle Laurie Twells Kendra Lester William Midodzi Kimberley Manning Raleen Murphy David Pace Chris Smith Darrell Boone Deborah Gregory 《The Canadian journal of hospital pharmacy》2015,68(2):113-120
Background:
Patients who have undergone bariatric surgery generally need fewer medications as they experience improvement in, or even resolution of, various medical conditions, including type 2 diabetes mellitus, hypertension, and dyslipidemia. Published data on changes in medication use after laparoscopic sleeve gastrectomy, a type of bariatric surgery that is growing in popularity, are limited.Objective:
To determine whether patients took fewer medications for management of type 2 diabetes, hypertension, and dyslipidemia after laparoscopic sleeve gastrectomy, relative to preprocedure medications.Methods:
In this prospective, single-centre cohort study, a nurse practitioner used standard medication reconciliation and study data-extraction forms to interview adult patients who had undergone laparoscopic sleeve gastrectomy and determine their medication use and pertinent demographic data. The data were analyzed using generalized estimating equations and standard statistical software. Outcome measures included changes in the use of antidiabetic, antihypertensive, and antilipemic medications at 1, 3, and 6 months after the surgery.Results:
A total of 65 patients who underwent laparoscopic sleeve gastrectomy between May 2011 and January 2014 met the study inclusion criteria. Before surgery, the 30 patients with type 2 diabetes were taking an average of 1.9 antidiabetic medications. One month after the procedure, 15 (50%) had discontinued all antidiabetic medications, with a further decline at 3 and 6 months (p < 0.001 at each time point). Among the patients who were taking antihypertensives (n = 48) and antilipemics (n = 33) before surgery, the decline in use occurred at a more modest rate, with 6 (12%) and 2 (6%), respectively, discontinuing these medication classes within 1 month, and 12 (25%) (p = 0.001) and 8 (24%) (p = 0.015) having discontinued by 6 months.Conclusions:
These findings suggest that patients with a history of type 2 diabetes mellitus, hypertension, and/or dyslipidemia who undergo laparoscopic sleeve gastrectomy are less likely to require disease-specific medications shortly after surgery. 相似文献106.
107.
108.
AIM: Because very little is known about the parenting of drug-abusing men, this study was designed to document ways that drug abuse contributes to compromise of responsible fathering. DESIGN, SETTING, PARTICIPANTS: Generalized linear models and data representing different dimensions of responsible fathering were used to clarify ways that the fathering of 106 men receiving methadone maintenance treatment differed from that of 118 men living in the same community with no history of alcohol or drug abuse. MEASUREMENT: Men who enrolled in the study completed two structured interviews and a battery of five self-report measures selected to document current and historical dimensions of responsible fathering. FINDINGS: When the opioid-dependent fathers were compared to the other fathers, there were significant differences in: (i) economic resources to support family formation; (ii) patterns of pair-bonding; (iii) patterns of procreation; and (iv) parenting behavior. When fathering of the youngest biological child was examined, the opioid-dependent fathers confirmed few differences in historical dimensions of fathering, but they reported significant differences in current dimensions reflecting: (i) constricted personal definitions of the fathering role; (ii) poorer relationships with biological mothers; (iii) less frequent residence with the child; (iv) less frequent provision of financial support; (v) less involvement in positive parenting; (vi) poorer appraisal of self as a father; and (vii) less satisfaction as a father. CONCLUSIONS: The findings highlight ways that drug abuse contributes to compromise of responsible fathering, and they raise questions about ways that the drug abuse treatment system might better address parenting as a treatment issue for men. 相似文献
109.
Kendall S. Hunter PhD Justin K. Gross BSc Craig J. Lanning BSc K. Scott Kirby RDCS Karrie L. Dyer MD D. Dunbar Ivy MD Robin Shandas PhD 《Congenital heart disease》2008,3(2):106-116
Objective. Noninvasive diagnostics for pulmonary arterial hypertension (PAH) have traditionally sought to predict main pulmonary artery pressure from qualitative or direct quantitative measures of the flow velocity pattern obtained from spectral Doppler ultrasound examination of the main pulmonary artery. A more detailed quantification of flow velocity patterns in the systemic circuit has been obtained by parameterizing the flow trace with a simple dynamic system model. Here, we investigate such a model's utility as a noninvasive predictor of total right heart afterload and right heart function. Design. Flow velocity and pressure was measured within the main pulmonary artery during right heart catheterization of patients with normal hemodynamics (19 subjects, 20 conditions) and those with PAH undergoing reactivity evaluation (34 patients, 69 conditions). Our model parameters were obtained by least‐squares fitting the model velocity to the measured flow velocity. Results. Five parameter means displayed significant (P < .05) differences between normotensive and hypertensive groups. The model stiffness parameter correlated to actual pulmonary vascular resistance (r = 0.4924), pulmonary vascular stiffness (r = 0.6811), pulmonary flow (r = 0.6963), and stroke work (r = 0.7017), while the model initial displacement parameter had good correlation to stiffness (r = 0.6943) and flow (r = 0.6958). Conclusions. As predictors of total right heart afterload (resistance and stiffness) and right ventricle work, the model parameters of stiffness and initial displacement offer more comprehensive measures of the disease state than previous noninvasive methods and may be useful in routine diagnostic monitoring of patients with PAH. 相似文献
110.