收费全文 | 223890篇 |
免费 | 16667篇 |
国内免费 | 784篇 |
耳鼻咽喉 | 2603篇 |
儿科学 | 5889篇 |
妇产科学 | 4590篇 |
基础医学 | 29022篇 |
口腔科学 | 4799篇 |
临床医学 | 21431篇 |
内科学 | 47396篇 |
皮肤病学 | 2862篇 |
神经病学 | 21898篇 |
特种医学 | 7542篇 |
外国民族医学 | 13篇 |
外科学 | 35156篇 |
综合类 | 3610篇 |
现状与发展 | 2篇 |
一般理论 | 297篇 |
预防医学 | 20280篇 |
眼科学 | 4808篇 |
药学 | 15236篇 |
1篇 | |
中国医学 | 383篇 |
肿瘤学 | 13523篇 |
2023年 | 901篇 |
2022年 | 1512篇 |
2021年 | 3757篇 |
2020年 | 2275篇 |
2019年 | 3674篇 |
2018年 | 4321篇 |
2017年 | 3478篇 |
2016年 | 3659篇 |
2015年 | 4343篇 |
2014年 | 6527篇 |
2013年 | 9431篇 |
2012年 | 14036篇 |
2011年 | 15209篇 |
2010年 | 8637篇 |
2009年 | 7729篇 |
2008年 | 14325篇 |
2007年 | 15196篇 |
2006年 | 14725篇 |
2005年 | 15147篇 |
2004年 | 14434篇 |
2003年 | 13586篇 |
2002年 | 13064篇 |
2001年 | 2152篇 |
2000年 | 1711篇 |
1999年 | 2305篇 |
1998年 | 3003篇 |
1997年 | 2555篇 |
1996年 | 2341篇 |
1995年 | 2048篇 |
1994年 | 1848篇 |
1993年 | 1740篇 |
1992年 | 1395篇 |
1991年 | 1342篇 |
1990年 | 1239篇 |
1989年 | 1102篇 |
1988年 | 1152篇 |
1987年 | 1186篇 |
1986年 | 1133篇 |
1985年 | 1224篇 |
1984年 | 1597篇 |
1983年 | 1565篇 |
1982年 | 1891篇 |
1981年 | 1721篇 |
1980年 | 1630篇 |
1979年 | 901篇 |
1978年 | 1046篇 |
1977年 | 1004篇 |
1976年 | 904篇 |
1975年 | 744篇 |
1974年 | 746篇 |
Background
Partial nephrectomy (PN) is generally favored for cT1 tumors over radical nephrectomy (RN) when technically feasible. However, it can be unclear whether the additional risks of PN are worth the magnitude of renal function benefit.Objective
To develop preoperative tools to predict long-term estimated glomerular filtration rate (eGFR) beyond 30 d following PN and RN, separately.Design, setting, and participants
In this retrospective cohort study, patients who underwent RN or PN for a single nonmetastatic renal tumor between 1997 and 2014 at our institution were identified. Exclusion criteria were venous tumor thrombus and preoperative eGFR <15 ml/min/1.73 m2.Intervention
RN and PN.Outcome measurements and statistical analysis
Hierarchical generalized linear mixed-effect models with backward selection of candidate preoperative features were used to predict long-term eGFR following RN and PN, separately. Predictive ability was summarized using marginal , which ranges from 0 to 1, with higher values indicating increased predictive ability.Results and limitations
The analysis included 1152 patients (13 206 eGFR observations) who underwent RN and 1920 patients (18 652 eGFR observations) who underwent PN, with mean preoperative eGFRs of 66 ml/min/1.73 m2 (standard deviation [SD] = 18) and 72 ml/min/1.73 m2 (SD = 20), respectively. The model to predict eGFR after RN included age, diabetes, preoperative eGFR, preoperative proteinuria, tumor size, time from surgery, and an interaction between time from surgery and age (marginal ). The model to predict eGFR after PN included age, presence of a solitary kidney, diabetes, hypertension, preoperative eGFR, preoperative proteinuria, surgical approach, time from surgery, and interaction terms between time from surgery and age, diabetes, preoperative eGFR, and preoperative proteinuria (marginal ). Limitations include the lack of data on renal tumor complexity and the single-center design; generalizability needs to be confirmed in external cohorts.Conclusions
We developed preoperative tools to predict renal function outcomes following RN and PN. Pending validation, these tools should be helpful for patient counseling and clinical decision-making.Patient summary
We developed models to predict kidney function outcomes after partial and radical nephrectomy based on preoperative features. This should help clinicians during patient counseling and decision-making in the management of kidney tumors. 相似文献Background
One approach to boost influenza vaccination coverage has been to expand immunization authority. In 2012, the province of Ontario gave community pharmacists the authority to administer the influenza vaccine.Objective
This study investigates the perspectives of Ontario pharmacy patrons, who had not recently received this vaccine from a pharmacist, regarding this pharmacist service.Methods
A survey was administered in six Ontario community pharmacies to pharmacy patrons who had not received an influenza vaccination from a pharmacist during the previous year. The instrument included questions about influenza vaccination, and knowledge of and attitudes toward vaccines and pharmacist-administered immunization.Results
A total of 541 pharmacy patrons completed the survey (53.9% response rate). About one-third (30.5%) of respondents were not aware that pharmacists could give the influenza vaccine, with younger individuals being less likely to be aware (OR 0.48, 95% CI 0.29–0.77, p?<?0.05) and less likely to receive the vaccine annually (OR 0.28, 95% CI 0.19–0.42, p?<?0.05). Leading reasons respondents gave as to why they did not receive their influenza vaccine from a pharmacist included not wanting or feeling they needed to be immunized (41.6%) and being used to receiving the vaccine from a physician (16.5%). Concerns about the experience and training of pharmacists and lack of privacy in a community pharmacy were uncommon.Conclusion
Reduced awareness of the availability of pharmacist-provided influenza vaccine is still common. Pharmacists have a significant opportunity to address lack of awareness and vaccine hesitancy issues. They can promote this service to increase influenza vaccination rates among pharmacy patrons who do not utilize this professional service. 相似文献Areas covered: We report on medication use research and have conducted a systematic review of observational studies on medication use to provide an updated overview on characteristics, objectives, methods, and patterns in hospitalized neonates. Moreover, a review on aspects of medication use for opioids, anti-epileptics, gastric acid-related disorders and respiratory stimulants with emphasis on trends and impact of interventions is presented, illustrating how research on medication use can contribute to improved neonatal pharmacotherapy and more focused research. Medication use reports describe patterns and provide signals on irrational use, benchmarking, or can guide research priorities. Moreover, this may generate information on how neonatal health topics and their pharmacotherapy are handled over time or across regions.
Expert opinion: Research on medicine utilization is relevant, since it will inform us on aspects like trends, variability, or about the impact and pattern of implementation of guidelines in neonates. Further progress necessitates to merge datasets on medication use with clinical characteristics, and perinatal drug use remains an area in need of additional research. 相似文献
Ressults show that opportunities for improving O&M include; operation of public toilets is a source of livelihood; operators are knowledgeable on occupational risks, and the community is involvedin sanitation activities. Barriers to effective O&M include; high operation costs, failure to break even and a lack of investments in occupational health Therefore, there is need to recognise the significance of public toilets as a viable alternative to open defecation in areas where ownership of private sanitation facilities is difficult. Failure to observe the health and safety of toilet operators may further compromise O&M. 相似文献