全文获取类型
收费全文 | 2185篇 |
免费 | 155篇 |
国内免费 | 5篇 |
专业分类
耳鼻咽喉 | 32篇 |
儿科学 | 98篇 |
妇产科学 | 54篇 |
基础医学 | 338篇 |
口腔科学 | 18篇 |
临床医学 | 255篇 |
内科学 | 351篇 |
皮肤病学 | 29篇 |
神经病学 | 383篇 |
特种医学 | 55篇 |
外科学 | 224篇 |
综合类 | 7篇 |
一般理论 | 2篇 |
预防医学 | 222篇 |
眼科学 | 24篇 |
药学 | 124篇 |
中国医学 | 1篇 |
肿瘤学 | 128篇 |
出版年
2024年 | 6篇 |
2023年 | 41篇 |
2022年 | 80篇 |
2021年 | 134篇 |
2020年 | 67篇 |
2019年 | 99篇 |
2018年 | 90篇 |
2017年 | 77篇 |
2016年 | 72篇 |
2015年 | 50篇 |
2014年 | 93篇 |
2013年 | 101篇 |
2012年 | 161篇 |
2011年 | 149篇 |
2010年 | 77篇 |
2009年 | 94篇 |
2008年 | 147篇 |
2007年 | 127篇 |
2006年 | 148篇 |
2005年 | 122篇 |
2004年 | 98篇 |
2003年 | 80篇 |
2002年 | 71篇 |
2001年 | 9篇 |
2000年 | 6篇 |
1999年 | 14篇 |
1998年 | 17篇 |
1997年 | 14篇 |
1996年 | 8篇 |
1995年 | 12篇 |
1994年 | 12篇 |
1993年 | 11篇 |
1992年 | 11篇 |
1991年 | 2篇 |
1990年 | 5篇 |
1989年 | 5篇 |
1988年 | 3篇 |
1987年 | 2篇 |
1986年 | 4篇 |
1982年 | 3篇 |
1981年 | 7篇 |
1975年 | 2篇 |
1974年 | 3篇 |
1972年 | 1篇 |
1971年 | 1篇 |
1969年 | 1篇 |
1968年 | 2篇 |
1967年 | 1篇 |
1964年 | 1篇 |
1962年 | 1篇 |
排序方式: 共有2345条查询结果,搜索用时 0 毫秒
61.
Vijay Narayan Grace John-Stewart George Gage Gabrielle O’Malley 《Human resources for health》2018,16(1):50
Background
Sierra Leone’s health outcomes rank among the worst in the world. A major challenge is the shortage of primary healthcare workers (HCWs) in rural areas due to especially high rates of attrition. This study was undertaken to determine the drivers of job dissatisfaction and poor retention among Sierra Leone’s rural HCWs.Methods
Interviews were conducted with 58 rural and 32 urban primary HCWs in Sierra Leone’s public health sector, complemented by key informant discussions and review of national policy documents. HCW interviews included (1) semi-structured discussion, (2) questionnaire, (3) card sort about HCW priorities, and (4) free-listing of most pressing challenges and needs. Sampling for HCW interviews was stratified purposive, emphasizing rural HCWs.Results
Among 90 HCWs interviewed, 67% were dissatisfied with their jobs (71% rural vs 52% urban) and 61% intended to leave their post (75% rural vs 38% urban). While working and living conditions and remuneration were significant factors, a major reason for rural HCW disenchantment was their inability to access worker rights, benefits, and advancement opportunities. This was caused by HCWs’ lack of knowledge about human resource (HR) policies and procedures, as well as ambiguity in many policies and inequitable implementation. HCWs reported feeling neglected and marginalized and perceived a lack of transparency. These issues can be attributed to the absence of systems for regular two-way communication between the Ministry of Health and HCWs; lack of official national documents with up-to-date, clear HR policies and procedures for HCWs; pay statements that do not provide a breakdown of financial allowances and withholdings; and lack of HCW induction.Conclusions
HCWs in Sierra Leone lacked accurate information about entitlements, policies, and procedures, and this was a driver of rural HCW job dissatisfaction and attrition. System-oriented, low-cost initiatives can address these underlying structural causes in Sierra Leone. These issues likely apply to other countries facing HCW retention challenges and should be considered in development of global HCW retention strategies.62.
63.
64.
65.
Temidayo Abe Harry Onoriode Eyituoyo Gabrielle De Allie Titilope Olanipekun Valery Sammah Effoe Kikelomo Olaosebikan Paul Mather 《World journal of cardiology》2021,13(1):11
BACKGROUNDThere is a lack of data on the clinical outcomes in patients with native valve infective endocarditis (NVIE) and diabetes mellitus (DM).AIMTo investigate (1) trends in the prevalence of DM among patients with NVIE; and (2) the impact of DM on NVIE outcomes. METHODSWe identified 76385 with NVIE from the 2004 to 2014 National Inpatient Sample, of which 22284 (28%) had DM. We assessed trends in DM from 2004 to 2014 using the Cochrane Armitage test. We compared baseline comorbidities, microorganisms, and in-patients procedures between those with vs without DM. Propensity match analysis and multivariate logistic regression were used to investigate study outcomes in in-hospital mortality, stroke, acute heart failure, cardiogenic shock, septic shock, and atrioventricular block.RESULTSCrude rates of DM increased from in 22% in 2004 to 30% in 2014. There were significant differences in demographics, comorbidities and NVIE risk factors between the two groups. Staphylococcus aureus was the most common organism identified with higher rates in patients with DM (33.1% vs 35.6%; P < 0.0001). After propensity matching, in-hospital mortality (11.1% vs 11.9%; P < 0.0001), stroke (2.3% vs 3.0%; P < 0.0001), acute heart failure (4.6% vs 6.5%; P = 0.001), cardiogenic shock (1.5% vs 1.9%; P < 0.0001), septic shock (7.2% vs 9.6%; P < 0.0001), and atrioventricular block (1.5% vs 2.4%; P < 0.0001), were significantly higher in patients with DM. Independent predictors of mortality in NVIE patients with DM include hemodialysis, congestive heart failure, atrial fibrillation, staphylococcus aureus, and older age.CONCLUSIONThere is an increasing prevalence of DM in NVIE and it is associated with poorer outcomes. Further studies are crucial to identify the clinical, and sociodemographic contributors to this trend and develop strategies to mitigate its attendant risk. 相似文献
66.
67.
Crowther-Swanepoel D Wild R Sellick G Dyer MJ Mauro FR Cuthbert RJ Jonsson V Matutes E Dearden C Wiley J Fuller S Catovsky D Houlston RS 《Blood》2008,111(12):5691-5693
To address the proposition that familial B-cell chronic lymphocytic leukemia (CLL) may exhibit a more restricted phenotype than sporadic CLL with respect to immunoglobulin gene usage or ontogenic development, we compared immunoglobulin (Ig) heavy chain variable region (VH) gene usage and IgVH mutation status in 327 patients with CLL from 214 families with 724 patients with sporadic cases. The frequency of mutated CLL was higher in familial CLL (P < .001), and there was evidence of intrafamilial concordance in mutation status (P < .001). The repertoire and frequency of IgVH usage was, however, not significantly different between familial and sporadic CLL. Furthermore, IgVH usage was not correlated between affected members of the same family. These observations provide evidence that familial CLL is essentially indistinguishable from sporadic CLL, favoring a genetic basis to disease development in general rather than a simple environmental etiology. 相似文献
68.
OBJECTIVES: A landmark Canadian randomized controlled clinical trial compared treatment of acute proximal vein thrombosis via low-molecular-weight heparin (LMWH) [enoxaparin] administered primarily at home with IV unfractionated heparin (UH) in the hospital. Results demonstrated equivalent safety and efficacy for home care with enoxaparin with a reduction in cost. Our objective was to validate these findings in the routine practice setting of a US health maintenance organization. DESIGN: Retrospective analysis of medical and administrative records of health-plan members meeting inclusion-exclusion criteria of the Canadian trial during the period from 1995 to 1998. SETTING: Staff-model health maintenance organization serving New Mexico. PATIENTS:Persons presenting as outpatients from 1995 to 1996 or from 1997 to 1998 with acute, proximal deep vein thrombosis (DVT) diagnosed by duplex ultrasonography. INTERVENTIONS: Initial anticoagulant therapy of IV UH administered in the hospital (from 1995 to 1996 group, n = 64) or subcutaneous LMWH (enoxaparin) administered primarily at home (from 1997 to 1998 group, n = 65), followed by warfarin therapy. RESULTS: No statistically significant differences were observed in the number of recurrent venous thromboembolic events (p = 0.36) or bleeding events (p = 1.0). Mean +/- SD cost per patient was 9,347 dollars +/- 8,469 in the enoxaparin group compared with 11,930 dollars +/- 10,892 in the UH group, a difference of - 2,583 dollars (95% bootstrap-adjusted asymmetrical confidence interval, - 6,147 dollars, + 650 dollars). CONCLUSIONS: Retrospective replication of the Canadian study in a US routine (managed) care setting found similar clinical and economic outcomes. Treatment of acute proximal DVT with enoxaparin in a primarily outpatient setting can be accomplished safely and yields savings through avoidance or minimization of inpatient stays. 相似文献
69.
Clive M. Brown Aaron E. Aranas Gabrielle A. Benenson Gary Brunette Marty Cetron Tai-Ho Chen Nicole J. Cohen Pam Diaz Yonat Haber Christa R. Hale Kelly Holton Katrin Kohl Amanda W. Lee Gabriel J. Palumbo Kate Pearson Christina R. Phares Francisco Alvarado-Ramy Shah Roohi Lisa D. Rotz Jordan Tappero Faith M. Washburn James Watkins Nicki Pesik 《MMWR. Morbidity and mortality weekly report》2014,63(49):1163-1167
70.