全文获取类型
收费全文 | 1409596篇 |
免费 | 115787篇 |
国内免费 | 3332篇 |
专业分类
耳鼻咽喉 | 18364篇 |
儿科学 | 46605篇 |
妇产科学 | 41092篇 |
基础医学 | 200949篇 |
口腔科学 | 37696篇 |
临床医学 | 126079篇 |
内科学 | 284708篇 |
皮肤病学 | 33388篇 |
神经病学 | 116911篇 |
特种医学 | 53868篇 |
外国民族医学 | 464篇 |
外科学 | 210634篇 |
综合类 | 32761篇 |
现状与发展 | 3篇 |
一般理论 | 487篇 |
预防医学 | 110045篇 |
眼科学 | 31519篇 |
药学 | 98578篇 |
1篇 | |
中国医学 | 3348篇 |
肿瘤学 | 81215篇 |
出版年
2021年 | 10881篇 |
2019年 | 11709篇 |
2018年 | 16606篇 |
2017年 | 12695篇 |
2016年 | 14281篇 |
2015年 | 16031篇 |
2014年 | 22584篇 |
2013年 | 33436篇 |
2012年 | 45454篇 |
2011年 | 47982篇 |
2010年 | 28200篇 |
2009年 | 27071篇 |
2008年 | 44359篇 |
2007年 | 46879篇 |
2006年 | 47432篇 |
2005年 | 45899篇 |
2004年 | 43790篇 |
2003年 | 41740篇 |
2002年 | 40231篇 |
2001年 | 73039篇 |
2000年 | 74585篇 |
1999年 | 61598篇 |
1998年 | 17001篇 |
1997年 | 15443篇 |
1996年 | 15600篇 |
1995年 | 14794篇 |
1994年 | 13407篇 |
1993年 | 12591篇 |
1992年 | 45863篇 |
1991年 | 43491篇 |
1990年 | 41510篇 |
1989年 | 39560篇 |
1988年 | 36194篇 |
1987年 | 35364篇 |
1986年 | 32872篇 |
1985年 | 31293篇 |
1984年 | 23833篇 |
1983年 | 20028篇 |
1982年 | 12211篇 |
1981年 | 10780篇 |
1979年 | 20712篇 |
1978年 | 14581篇 |
1977年 | 12089篇 |
1976年 | 11367篇 |
1975年 | 11622篇 |
1974年 | 13995篇 |
1973年 | 13541篇 |
1972年 | 12638篇 |
1971年 | 11475篇 |
1970年 | 10912篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
141.
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142.
143.
Brian C. Werner 《Arthroscopy》2019,35(4):1072-1073
Achieving tendon-bone healing continues to be challenging after arthroscopic rotator cuff repair, particularly for larger tears, despite significant improvements in repair techniques and implants. Considerable effort has been invested in research to identify methods to improve healing, including patches and injectable biologics. Parathyroid hormone improves tendon-to-bone healing. Teriparatide is osteogenic, stimulating bone growth, and chondrogenic, promoting cartilage formation at the enthesis. However, it could be difficult to justify the expense and potential risk of systemic administration of a recombinant hormone to improve structural healing until improvement in clinical outcomes can be shown. 相似文献
144.
145.
Joseph Wheatley Zhengyang Liu Joel Loth Mark P. Plummer Jahan C. Penny-Dimri Reny Segal Julian Smith Luke A. Perry 《Acta anaesthesiologica Scandinavica》2023,67(2):131-141
Background
Patients undergoing cardiac surgery are at significant risk of developing postoperative acute kidney injury (AKI). Neutrophil–lymphocyte ratio (NLR) is a widely available inflammatory biomarker which may be of prognostic value in this setting.Methods
We conducted a systematic review and meta-analysis of studies reporting associations between perioperative NLR with postoperative AKI. We searched Medline, Embase and the Cochrane Library, without language restriction, from inception to May 2022 for relevant studies. We meta-analysed the reported odds ratios (ORs) with 95% confidence intervals (CIs) for both elevated preoperative and postoperative NLR with risk of postoperative AKI and need for renal replacement therapy (RRT). We conducted a meta-regression to explore inter-study statistical heterogeneity.Results
Twelve studies involving 10,724 participants undergoing cardiac surgery were included, with eight studies being deemed at high risk of bias using PROBAST modelling. We found statistically significant associations between elevated preoperative NLR and postoperative AKI (OR 1.45, 95% CI 1.18–1.77), as well as postoperative need for RRT (OR 2.37, 95% CI 1.50–3.72). Postoperative NLR measurements were not of prognostic significance.Conclusions
Elevated preoperative NLR is a reliable inflammatory biomarker for predicting AKI following cardiac surgery. 相似文献146.
Megan L. Robbins Robert C. Wright Ana María López Karen Weihs 《Journal of psychosocial oncology》2019,37(2):160-177
AbstractObjectives: This study examined word use as an indicator of interpersonal positive reframing in daily conversations of couples coping with breast cancer and as a predictor of stress.Design: The Electronically Activated Recorder (EAR) and Linguistic Inquiry and Word Count (LIWC) were used to examine naturally occurring word use conceptually linked to positive reframing (positive emotion, negative emotion, and cognitive processing words).Sample: Fifty-two couples coping with breast cancer.Methods: Couples wore the EAR, a device participants wear, that audio-recorded over one weekend (>16,000 sound files), and completed self-reports of positive reframing (COPE) and stress (Perceived Stress Scale). LIWC, a software program, measured word use.Findings: Both partners’ word use (i.e., positive emotion and cognitive processing words) was associated with their own reported positive reframing, and spouses’ word use was also indicative of patients’ positive reframing. Results also revealed that, in general, words indicating positive reframing predicted lower levels of stress.Conclusions: Findings supported the hypothesis that partners—and particularly spouses of breast cancer patients—may assist each other’s coping by positively reframing the cancer experience and other negative experiences in conversation. 相似文献
147.
van der Heijden Amber A. W. A. de Bruijne Martine C. Nijpels Giel Hugtenburg Jacqueline G. 《International journal of clinical pharmacy》2019,41(4):963-971
International Journal of Clinical Pharmacy - Background Drug-related problems (DRP) following hospital discharge may cause morbidity, mortality and hospital re-admissions. It is unclear whether a... 相似文献
148.
Fabrice Barlesi Edward B. Garon Dong-Wan Kim Enriqueta Felip Ji-Youn Han Joo-Hang Kim Myung-Ju Ahn Mary Jo Fidler Matthew A. Gubens Gilberto de Castro Veerle Surmont Qiao Li Anne C. Deitz Gregory M. Lubiniecki Roy S. Herbst 《Journal of thoracic oncology》2019,14(5):793-801
Introduction
In the phase II/III KEYNOTE-010 study (ClinicalTrials.gov, NCT01905657), pembrolizumab significantly prolonged overall survival over docetaxel in patients with previously treated, programmed death ligand 1–expressing (tumor proportion score ≥ 1%), advanced NSCLC. Health-related quality of life (HRQoL) results are reported here.Methods
Patients were randomized 1:1:1 to pembrolizumab 2 or 10 mg/kg every 3 weeks or docetaxel 75 mg/m2 every 3 weeks. HRQoL was assessed using European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLC) Core 30 (C30), EORTC QLQ–Lung Cancer 13 (LC13), and EuroQoL-5D. Key analyses included mean baseline-to-week-12 change in global health status (GHS)/quality of life (QoL) score, functioning and symptom domains, and time to deterioration in a QLQ-LC13 composite endpoint of cough, dyspnea, and chest pain.Results
Patient reported outcomes compliance was high across all three instruments. Pembrolizumab was associated with better QLQ-C30 GHS/QoL scores from baseline to 12 weeks than docetaxel, regardless of pembrolizumab dose or tumor proportion score status (not significant). Compared with docetaxel, fewer pembrolizumab-treated patients had “deteriorated” status and more had “improved” status in GHS/QoL. Nominally significant improvement was reported in many EORTC symptom domains with pembrolizumab, and nominally significant worsening was reported with docetaxel. Significant prolongation in true time to deterioration for the QLQ-LC13 composite endpoint emerged for pembrolizumab 10 mg/kg compared to docetaxel (nominal two-sided p = 0.03), but not for the 2-mg/kg dose.Conclusions
These findings suggest that HRQoL and symptoms are maintained or improved to a greater degree with pembrolizumab than with docetaxel in this NSCLC patient population. 相似文献149.