全文获取类型
收费全文 | 2070404篇 |
免费 | 143163篇 |
国内免费 | 4800篇 |
专业分类
耳鼻咽喉 | 29999篇 |
儿科学 | 64073篇 |
妇产科学 | 60342篇 |
基础医学 | 290069篇 |
口腔科学 | 60258篇 |
临床医学 | 174309篇 |
内科学 | 408723篇 |
皮肤病学 | 45843篇 |
神经病学 | 165045篇 |
特种医学 | 82743篇 |
外国民族医学 | 749篇 |
外科学 | 323806篇 |
综合类 | 46579篇 |
现状与发展 | 6篇 |
一般理论 | 663篇 |
预防医学 | 146000篇 |
眼科学 | 48503篇 |
药学 | 152517篇 |
4篇 | |
中国医学 | 4411篇 |
肿瘤学 | 113725篇 |
出版年
2018年 | 19117篇 |
2016年 | 16713篇 |
2015年 | 18956篇 |
2014年 | 26817篇 |
2013年 | 41216篇 |
2012年 | 54357篇 |
2011年 | 57606篇 |
2010年 | 34636篇 |
2009年 | 33468篇 |
2008年 | 55372篇 |
2007年 | 59870篇 |
2006年 | 60530篇 |
2005年 | 59087篇 |
2004年 | 57086篇 |
2003年 | 55416篇 |
2002年 | 54480篇 |
2001年 | 95525篇 |
2000年 | 98391篇 |
1999年 | 83549篇 |
1998年 | 22871篇 |
1997年 | 20793篇 |
1996年 | 20292篇 |
1995年 | 19032篇 |
1994年 | 18003篇 |
1993年 | 16773篇 |
1992年 | 65077篇 |
1991年 | 62809篇 |
1990年 | 61557篇 |
1989年 | 59893篇 |
1988年 | 55811篇 |
1987年 | 54774篇 |
1986年 | 52602篇 |
1985年 | 50052篇 |
1984年 | 37502篇 |
1983年 | 31912篇 |
1982年 | 19221篇 |
1981年 | 17288篇 |
1979年 | 35752篇 |
1978年 | 25312篇 |
1977年 | 21907篇 |
1976年 | 20060篇 |
1975年 | 22545篇 |
1974年 | 26804篇 |
1973年 | 25843篇 |
1972年 | 24771篇 |
1971年 | 23077篇 |
1970年 | 21988篇 |
1969年 | 20935篇 |
1968年 | 19766篇 |
1967年 | 17996篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
71.
72.
M.A. Mashrah T.A. Aldhohrah A. Abdelrehem Moustafa H.M. Al-Sharani A. Alrmali L. Wang 《International journal of oral and maxillofacial surgery》2021,50(1):21-31
Donor site morbidity following radial forearm flap (RFF) harvest remains a controversial issue. The aim of this meta-analysis was to answer the question “Are the range of wrist movements (range of motion, ROM) and hand strength affected after RFF harvesting?” The PubMed, Embase, Scopus, and Cochrane Library electronic databases were systematically searched (to December 2019). Self-controlled studies evaluating hand biomechanics after RFF harvest were included. Weighted mean differences with 95% confidence intervals were calculated using the random-effects model. The outcome variables were ROM, forearm movements, grip, and pinch strengths. Thirteen studies involving a total of 335 patients were included. With the exception of grip strength and supination, which showed statistically significant reductions of about 2.40 kg and 2.86° (P < 0.05), all other ROM, forearm movements, and pinch strengths showed an insignificant difference when the operated hand was compared to the non-operated hand (P > 0.05). Regression analysis showed that the method of donor site closure and size of the donor site defect had an insignificant impact on hand biomechanics. This study confirms the lack of discernible biomechanical morbidity after RFF transfer. The minimal reduction in hand biomechanics after RFF is considered to be clinically negligible. 相似文献
73.
T.F.A. Lees L. Bogdashich D. Godden 《The British journal of oral & maxillofacial surgery》2021,59(1):e9-e12
Fibroepithelial polyps (FEPs) are common, benign intraoral lesions that tend to develop slowly at predictable sites, often in response to local irritation or trauma. Historical precedent often results in referral to oral and maxillofacial surgery (OMFS) departments for biopsy, often irrespective of symptoms, and histological assessment. OMFS and pathology services are struggling to cope with an increasing workload that will potentially lead to widespread delays to diagnosis and treatment. Over the past 20 years, clinical pathways and guidance have been developed to ensure that healthcare interventions, such as the removal of third molars, tonsils, skin tags, and benign moles, are evidence-based, have a net patient benefit, and ensure the best use of finite NHS resources. However, no such guidance exists for intraoral lesions and we regard this as an oversight. We analysed the removal of 682 FEPs over a seven-year period and report sensitivities of 92.4% for a “confirmed clinical suspicion of an FEP” and 99.7% for a “confirmed clinical suspicion of a benign diagnosis”. The incidence of non-benign disease was 0.3%. Primary care dentists should be able to diagnose and monitor FEPs and refer only if symptoms are serious or in high-risk patients or sites. Adopting this practice across the UK could free up to 1825 four-hour OMFS clinics, 405 hours of consultant histopathologists’ time, and recurring savings to the NHS estimated to be in the region of £620 000/annum. We believe that the removal of FEPs should be reclassified as an “intervention not normally funded”, and the time and resources put to better use treating patients with lesions of questionable pathology. 相似文献
74.
75.
Julia H. Vermylen Gordon J. Wood Elaine R. Cohen Jeffrey H. Barsuk William C. McGaghie Diane B. Wayne 《Journal of pain and symptom management》2019,57(3):682-687
Introduction
Physician communication impacts patient outcomes. However, communication skills, especially around difficult conversations, remain suboptimal, and there is no clear way to determine the validity of entrustment decisions. The aims of this study were to 1) describe the development of a simulation-based mastery learning (SBML) curriculum for breaking bad news (BBN) conversation skills and 2) set a defensible minimum passing standard (MPS) to ensure uniform skill acquisition among learners.Innovation
An SBML BBN curriculum was developed for fourth-year medical students. An assessment tool was created to evaluate the acquisition of skills involved in a BBN conversation. Pilot testing was completed to confirm improvement in skill acquisition and set the MPS.Outcomes
A BBN assessment tool containing a 15-item checklist and six scaled items was developed. Students' checklist performance improved significantly at post-test compared to baseline (mean 65.33%, SD = 12.09% vs mean 88.67%, SD = 9.45%, P < 0.001). Students were also significantly more likely to have at least a score of 4 (on a five-point scale) for the six scaled questions at post-test. The MPS was set at 80%, requiring a score of 12 items on the checklist and at least 4 of 5 for each scaled item. Using the MPS, 30% of students would require additional training after post-testing.Comments
We developed a SBML curriculum with a comprehensive assessment of BBN skills and a defensible competency standard. Future efforts will expand the mastery model to larger cohorts and assess the impact of rigorous education on patient care outcomes. 相似文献76.
Gregory S. Orgel Robert A. Weston Christopher Ziebell Lawrence H. Brown 《The American journal of emergency medicine》2019,37(9):1729-1733
ObjectiveTo evaluate changes in insurance status among emergency department (ED) patients presenting in the two years immediately before and after full implementation of the Affordable Care Act (ACA).MethodsWe evaluated National Hospital Ambulatory Medical Care Survey (NHAMCS) Emergency Department public use data for 2012–2015, categorizing patients as having any insurance (private; Medicare; Medicaid; workers' compensation) or no insurance. We compared the pre- and post-ACA frequency of insurance coverage—overall and within the older (≥65), working-age (18–64) and pediatric (<18) subpopulations—using unadjusted odds ratios with 95% confidence intervals. We also conducted a difference-in-differences analysis comparing the change in insurance coverage among working-age patients with that observed for older Medicare-eligible patients, while controlling for sex, race and underlying temporal trends.ResultsOverall, the proportion of ED patients with any insurance did not significantly change from 2012 to 2013 to 2014–2015 (74.2% vs 77.7%) but the proportion of working-age adult patients with at least one form of insurance increased significantly, from 66.0% to 71.8% (OR 1.31, CI: 1.13–1.52). The difference-in-differences analysis confirmed the change in insurance coverage among working-age adults was greater than that seen in the reference population of Medicare-eligible adults (AOR 1.70, CI: 1.29–2.23). The increase was almost entirely attributable to increased Medicaid coverage.ConclusionIn the first two years following full implementation of the ACA, there was a significant increase in the proportion of working-age adult ED patients who had at least one form of health insurance. The increase appeared primarily associated with expansion of Medicaid. 相似文献
77.
78.
79.
80.