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41.
Substance use in pregnancy: do we care? 总被引:3,自引:0,他引:3
Two cohorts of substance-using women were compared retrospectively. From 1969 to 1979 a very high perinatal mortality rate (PMR 9.8%) was found among 92 polydrug-using women (1 twin excluded). Preterm delivery occurred in 25% of all pregnancies and in 30% of the children birth weight was below the 10th percentile. Nineteen women using heroin only had a worse fetal outcome (PMR 32%, preterm delivery in 47%, birth weight < 10th percentile in 42%). These results led to a strict surveillance system. In the period 1980–1989, 240 women (4 twins excluded) delivered after 16 weeks. Total fetal loss decreased to 2.1% and PMR to 0.4%, which was similar to results in controls. However, 22% of the women still delivered before 37 weeks and 27% delivered a child < 10th percentile. Methadone-using women were able to halve their dosage during pregnancy and 16 were detoxified. Multivariate analysis within the substance users of the second cohort showed that the neonatal abstinence syndrome, but not the (registered) amount of opiates used, was related to a lower birth weight. Not coping with prenatal care was related to a shorter pregnancy length. Multivariate analysis, including the controls, showed a significant relation of birth weight (345 g lower) with substance use. Also, head circumference was 0.8 cm smaller. Length of pregnancy however was related to smoking. This study shows that it is difficult to make substance users attend prenatal care, but also that women coping with prenatal care reduce substance intake. Opiate use might be responsible for lower birth weight, although not in a clear dose–response relationship, whereas lifestyle, as represented by not coping with prenatal care and the quantity of cigarette smoking, shortens the length of pregnancy. 相似文献
42.
ANTEROVENTRAL WALL OF THE THIRD VENTRICLE AND DORSAL LAMINA TERMINALIS: HEADQUARTERS FOR CONTROL OF BODY FLUID HOMEOSTASIS? 总被引:3,自引:0,他引:3
MJ McKinley GL Pennington BJ Oldfield 《Clinical and experimental pharmacology & physiology》1996,23(4):271-281
1. The subfornical organ, median preoptic nucleus and the organum vasculosum of the lamina terminalis (OVLT) are a series of structures situated in the anterior wall of the third ventricle and form the lamina terminalis. The OVLT and ventral part of the median preoptic nucleus are part of a region known as the anteroventral third ventricle region.
2. Data from many laboratories, using techniques ranging from lesions, electrophysiology, neuropharmacology, Fos expression, immunohistochemistry and receptor localization, indicate that the tissue in the lamina terminalis plays a major role in many aspects of body fluid and electrolyte balance.
3. The subfornical organ and OVLT lack the blood-brain barrier and detect alterations in plasma tonicity and the concentrations of circulating hormones such as angiotensin II and possibly atrial natriuretic peptide and relaxin.
4. This information is then integrated within the lamina terminalis (probably in the median preoptic nucleus) with neural signals from other brain regions. The neural output from the lamina terminalis is distributed to a number of effector sites including the paraventricular (both parvo- and magno-cellular parts) and supraoptic nuclei and influences vasopressin secretion, water drinking, salt intake, renin secretion, renal sodium excretion and cardiovascular regulation. 相似文献
2. Data from many laboratories, using techniques ranging from lesions, electrophysiology, neuropharmacology, Fos expression, immunohistochemistry and receptor localization, indicate that the tissue in the lamina terminalis plays a major role in many aspects of body fluid and electrolyte balance.
3. The subfornical organ and OVLT lack the blood-brain barrier and detect alterations in plasma tonicity and the concentrations of circulating hormones such as angiotensin II and possibly atrial natriuretic peptide and relaxin.
4. This information is then integrated within the lamina terminalis (probably in the median preoptic nucleus) with neural signals from other brain regions. The neural output from the lamina terminalis is distributed to a number of effector sites including the paraventricular (both parvo- and magno-cellular parts) and supraoptic nuclei and influences vasopressin secretion, water drinking, salt intake, renin secretion, renal sodium excretion and cardiovascular regulation. 相似文献
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Objective. To examine the utilization of screening mammography and the relationship between risk factors and mammography use in women age 40–49 in a managed care environment.
Design. Retrospective observational study based on a mailed survey.
Setting. A large HMO in California.
Patients/participants. The study population included respondents age 40–49 who completed a breast health assessment questionnaire mailed to all women age 34–49 and enrolled in a California HMO in early 1997.
Main results. About 67.6% of the 20,391 women age 40–49 had at least one mammogram during 1995 and 1996. Logistic regression revealed that women age 40–44 were less likely (odds ratio: 0.83–0.90) than women age 45–49 to obtain mammography. Family history of breast cancer (odds ratio: 1.12–1.16), breast biopsy (odds ratio: 1.14–1.18), and a mammogram in the previous three years (odds ratio: 1.15–1.18) were associated with an increased likelihood of taking a mammogram. However, monthly breast self-exams (odds ratio: 0.996–1.04), having a child at or after age 30 (odds ratio: 0.97–1.02), and having menarche at age 12 or younger (odds ratio: 0.96–1.01) had no significant effect on the screening mammography rates.
Conclusion. A relatively higher percentage of younger HMO members receive screening mammography than that of general population. However, some higher-risk groups, especially women whose first pregnancies were late in life, do not show a higher rate of using mammography. 相似文献
48.
LINDA STRAND ANDREW JENKINS NILS GRUDE ANNE‐GRY ALLUM HILDE‐CHRISTINE MYKLAND FOUROUGH L. NOWROUZIAN BJøRN‐ERIK KRISTIANSEN 《APMIS : acta pathologica, microbiologica, et immunologica Scandinavica》2010,118(8):571-577
Strand L, Jenkins A, Grude N, Allum A‐G, Mykland H‐C, Nowrouzian FL, Kristiansen B‐E. Emergence of fluoroquinolone‐resistant clonal group A: clonal analysis of Norwegian and Russian E. coli isolates. APMIS 2010; 118: 571–77. We describe a study of urinary tract and intestinal isolates of Escherichia coli from Norway and Russia using automated ribotyping, single nucleotide polymorphism analysis for clonal group A (CgA) supplemented with phylogrouping, virulence gene profiling and resistance profiling. CgA comprised 19% of the Norwegian UTI isolates from 2001. Two highly multiresistant fluoroquinolone‐resistant CgA isolates were found. Ribotypes clustered into four major and six minor groups (ribogroups). Fluoroquinolone‐resistant isolates and phylogroups A and B1 were associated with ribogroup RA. Ribogroup RB predominated among Russian UTI isolates and was predominantly phylogroup A and depleted in P‐fimbriae. Ribogroup RC predominated among Norwegian UTI isolates and was rich in virulence factors (S‐fimbriae, haemagglutinin and haemolysin) and predominantly phylogroup B2 and D. Ribogroup RG was associated with CgA and predominantly phylogroup D. Ribogroups RD, RE and RF had too few members for statistical analysis. The correlation between ribotype and phylogenetic group was not as strong as reported in other studies. 相似文献
49.
Direct 3-dimensional measurement of scapular kinematics during dynamic movements in vivo. 总被引:2,自引:0,他引:2
P W McClure L A Michener B J Sennett A R Karduna 《Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]》2001,10(3):269-277
The purpose of this study was to describe 3-dimensional scapular motion patterns during dynamic shoulder movements with the use of a direct technique. Direct measurement of active scapular motion was accomplished by insertion of 2 1.6-mm bone pins into the spine of the scapula in 8 healthy volunteers (5 men, 3 women). A small, 3-dimensional motion sensor was rigidly fixed to the scapular pins. Sensors were also attached to the thoracic spine (T3) with tape and to the humerus with a specially designed cuff. During active scapular plane elevation, the scapula upwardly rotated (mean [SD] = 50 degrees [4.8 degrees ]), tilted posteriorly around a medial-lateral axis (30 degrees [13.0 degrees ]), and externally rotated around a vertical axis (24 degrees [12.8 degrees ]). Lowering of the arm resulted in a reversal of these motions in a slightly different pattern. The mean ratio of glenohumeral to scapulothoracic motion was 1.7:1. Normal scapular motion consists of substantial rotations around 3 axes, not simply upward rotation. Understanding normal scapular motion may assist in the identification of abnormal motion associated with various shoulder disorders. 相似文献
50.
Nelson Deborah J.; Sennett Leslie; Lefebvre R.Craig; Loiselle Linda; McClements Lynne; Carleton Richard A. 《Health education research》1987,2(1):27-31
Obesity, because of its association with hypertension, hyperlipidemiaand diabetes, has been identified as an important risk factorfor cardiovascular disease. Approximately 16.7 million workersare more than 20% above their desired weight. This paper focuseson the implementation and cost-effectiveness of a weight lossawareness campaign conducted at worksites. Lighten Upwas a 5-week, self-help weight loss campaign offered free throughthe Pawtucket Heart Health Program. Worksite volunteer coordinators,with the assistance of the PHHP staff, were responsible forimplementing the campaign in their respedive worksites. Fivehundred and twelve employees from 22 companies lost a totalof 1,818 pounds; an average weight loss of 3.55 pounds per person.Program costs, including PHHP personnel time, amounted to $0.81spent per pound lost. The data suggests that the PHHP LightenUp campaign is an effective worksite weight loss strategyfor a large group of people. 相似文献