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81.
B. P. Kavanagh MB BSc Dr A. N. Sandler MB MSc K. E. Turner MD V. Wick BScN S. Lawson 《Journal of clinical monitoring and computing》1992,8(3):226-230
This study was designed to assess the accuracy of end-tidalPco 2 and transcutaneousPco 2 as measurements of arterialPco 2 in extubated, spontaneously breathing patients recovering from general anesthesia. In 30 patients, measurement of arterial transcutaneous, and end-tidalPco 2 were taken simultaneously with body temperature approximately every 15 minutes over a 2-hour period. ArterialPco 2 values were corrected for body temperature. Values for Paco 2 were compared with those forPetCO2 and Psco 2 by linear regression analysis and by calculation of bias ± precision. Thirty-six percent of the capnogram tracings obtained did not develop a plateau phase. We found poor correlation between end-tidal and arterialPco 2 regardless of the shape of the capnogram tracing, as well as poor correlation between transcutaneous and arterialPco 2. Although the measurements of bias and precision of noninvasivePco 2 monitors in this population are comparable to studies in other populations, we advise caution in relying on the routine use ofPetCO2 or Psco 2 for the noninvasive assessment of respiratory depression in extubated, spontaneously breathing patients recovering from general anesthesia. 相似文献
82.
A programme of clinical studies was carried out to determine the basic efficacy and safety of 2% nedocromil sodium eye drops (Tilavist) in treating allergic conjunctivitis, in 2,905 patients from 3–76 years of age. Results of all the double-masked placebo comparative studies completed to date - five in vernal keratoconjunctivitis (VKC), five in perennial (PAC) and 16 in seasonal allergic conjunctivitis (SAC) - have been assessed in a statistical overview analysis. Nedocromil sodium, administered four times daily to 153 patients with VKC, was significantly more effective than placebo (155 patients) and in the clinicians' opinion gave good control in 76% of cases, compared with 46% for placebo (p < 0.001). Patients with chronic symptoms of PAC also responded better to nedocromil sodium given four times daily (n = 146) rather than twice daily (n = 86), and significantly more patients (p < 0.001) were effectively controlled by four times daily treatment with nedocromil sodium (72%) than with placebo (47%; n= 156). Twice-daily dosage with nedocromil sodium (n = 677) was adequate for SAC, however, and the treatment was statistically better than placebo (p < 0.01-p < 0.001) whether dosed twice or four times daily. Speed of action was assessed in seven SAC studies in which 79% of all patients (n = 295) using nedocromil sodium had experienced relief of symptoms when questioned, half of them within 15 minutes and 74% during the first hour after dosing. Test treatments were well-accepted by both adults and children, and there were no major adverse events. Minor irritations reported more frequently with nedocromil sodium than placebo were stinging or burning of the eyes on application of the drops and a distinctive taste, noted by 5% of the active treatment group (n = 1,552). 相似文献
83.
This work describes our experience in reviewing the performance criteria for display systems and how we have implemented a
practical approach to the assessment of the workstation environment in a large tertiary care hospital. The acceptance criteria
contained in the draft report of Topic Group 18 of the American Association of Physicists in Medicine (AAPM) were used as
a basis for assessment of primary and secondary displays. A telescopic photometer was used to measure the maximum luminance
and the contrast ratio of the image for the displays used in our radiology department and in the operating and emergency rooms
using the standard Society of Motion Picture and Television Engineers (SMPTE) pattern, in ambient light and with light decreased
as much as possible. About half of the displays met the AAPM criteria for minimum luminance and contrast ratio in low light.
None of the systems met the contrast ratio criteria in ambient light. The challenges in improving the performance and calibrating
displays are discussed. 相似文献
84.
Atypical carcinoid tumour of the thymus: a study of eight cases 总被引:1,自引:0,他引:1
M. VALLI G.A. FABRIS A. DEWAR S. CHIKTE C. FISHER B. CORRIN M.N. SHEPPARD 《Histopathology》1994,24(4):371-375
Atypical carcinoids of the thymus are rare neoplasms of uncertain prognosis. We have studied eight cases (six male, two female; age range 48–60 years, mean 55 years), none with evidence of a paraneoplastic neuroendocrine syndrome. Tumour size was large and ranged from 7.5 to 10 cm. Microscopically, all had a nesting/insular or trabecular pattern, eosinophilic cytoplasm, round nuclei with fine chromatin and small nucleoli. No small cell features were evident. Mitotic activity ranged from 2 to 21 per 1.52 mm2 . Focal necrosis was seen in all cases. All were positive for cytokeratin (AE1/AE3, CAM 5.2) and the neuroendocrine markers NSE, synaptophysin and chromogranin; five cases were positive for calcitonin. On electronmicroscopy all contained dense core granules, often numerous. Three cases were stage I and five stage III (infiltrating lung or chest wall). Follow-up information was available in four cases (one stage I and three stage III): the stage I tumour had local recurrence and metastasis to the lung within a year whilst the three patients with stage III tumours died of liver, bone and brain metastases within 3 years. 相似文献
85.
Kris Deering DipHe RMN BSc MH Inpatient Care MSc P.G. Ed PhD student. Jo Williams BSc RMN MSc PhD. Kay Stayner BSc RMN. Chris Pawson BSc PGCHE PhD. 《Nursing philosophy》2021,22(1):e12329
As a philosophical position, pragmatism can be critiqued to distinguish truth only with methods that bring about desired results, predominantly with scientific enquiry. The article hopes to dismiss this oversimplification and propose that within mental health nursing, enquiry enlightened by pragmatism can be anchored to methods helping to tackle genuine human problems. Whilst pragmatists suggest one reality exists, fluctuating experiences and shifting beliefs about the world can inhabit within; hence, pragmatists propose reality has the potential to change. Moreover, pragmatism includes being cognisant of what works to whom reality concerns, making reality context-driven, with a view to understand how actions shape experiences so what is generated has usefulness. Hence, it somewhat follows pragmatism can inform mental health nursing, after all, nursing is a discipline of action, and awareness is needed in how actions produce experiences that patients find helpful. Given the principles of recovery are preferably adopted in mental health care, the paper will explore how pragmatism can help nurses move towards that goal; specifically, with patients voicing their experiences. This is because like pragmatism, recovery subscribes to hope that reality can progress, and through meaningful experiences and beliefs, patients have expertise about personal difficulties alongside how life may flourish, despite mental illness. 相似文献
86.
The importance of developing cultural competence among healthcare professionals is well recognized. However, the widespread reports of insensitivity and deficiencies in care for culturally diverse patients illuminate the need to review how cultural competence development is taught, learnt and applied in practice. Unless we can alter the ‘hearts and minds’ of practising nurses to provide the care that they know they should, culturally insensitive care will continue operating in subtle ways. This paper explores the ideas behind nurses’ actions and omissions when caring for culturally diverse patients and proposes the need to examine cultural competence development through a moral reasoning lens. Examining cultural competence development through a moral reasoning lens can help empower nurses, whilst nurturing commitment and courage to providing quality care that meets the needs of culturally diverse patients. The model of morality provides a framework that explores how moral motivation and behaviour occur and can provide a vehicle for critically examining the knowledge, skills and attitudes required to provide culturally responsive care. 相似文献
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