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991.
Tessa M. L. Kaufman Tina Kretschmer Gijs Huitsing René Veenstra 《Prevention science》2018,19(6):822-832
Although anti-bullying interventions are often effective, some children continue to be victimized. To increase knowledge of potential factors that might impede children’s benefiting from an anti-bullying intervention, we examined potential reasons for individual differences in victimization trajectories during a group-based anti-bullying intervention. Data stem from a five-wave survey among 9122 children (7–12 years old; grades 2–5) who participated in the KiVa anti-bullying intervention (n?= 6142) or were in control schools (n?= 2980 children). Three trajectories were found in the intervention sample, representing children who experienced stable high, decreasing, or stable low/no victimization. A two-trajectory model of high and low trajectories represented the control sample best. Multinomial regressions on the intervention sample showed that children who experienced particularly high levels of peer rejection, internalizing problems, and lower quality parent-child relationships decreased less in victimization; thus these characteristics appeared to contribute to persistent victimization. The results call for tailored strategies in interventions aiming to reduce victimization for more children. 相似文献
992.
Frank Eijkenaar René C. J. A. van Vliet 《The European journal of health economics》2018,19(2):203-211
Background
Worldwide, risk-equalization (RE) models in competitive health insurance markets have evolved from simple demographic models to sophisticated models containing diagnosis and pharmacy-based indicators of health. However, these models still have important imperfections; adding information on (diagnoses of) physiotherapy treatment may further improve RE-models. Therefore, a new risk-adjuster based on physiotherapy costs in the prior year was introduced in the Dutch RE-model of 2016.Methods
Physiotherapy claims-data (2012) and administrative data on costs and risk-characteristics (2013) for 94% of the Dutch population (N = 15.8 million) are used to evaluate the current risk-adjuster based on physiotherapy costs and to assess the effects of replacing it by different modalities of a risk-adjuster based on physiotherapy diagnoses. Of the 89 diagnoses in the claims-data, 62 are dropped because they relate to temporary health problems. The 27 retained diagnoses are added to the Dutch model in 4 modalities: 27 separate risk-classes, 9 diagnosis-clusters based on main pathology category, 4 diagnosis-clusters based on residual costs, and the 4 clusters of modality 3 interacted with age.Results
Although the cost-based risk-adjuster improves the model’s predictive power and removes the average undercompensation (€919) for enrollees with physiotherapy costs in the prior year, it is outperformed by all 4 diagnosis-based modalities. Of these modalities, modality 3 is preferred based on its simplicity and comparable predictive power.Conclusions
Adding information on physiotherapy can further improve the performance of sophisticated RE-models. Regarding the Dutch model, a risk-adjuster containing 4 risk-classes for clustered diagnoses based on residual costs is the preferred modality.993.
Qualitative analyses of lived experience for residents in the Elderly Care Departments at the community health service centres in Southwestern China
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With its huge ageing population, China faces an enormous challenge for its elderly support and care. One of the proposed solutions was to diversify the elderly support systems. Towards this goal, setting up the Elderly Care Departments in the community health service centres is one of such new Chinese endeavour. This qualitative study was conducted among the residents enrolled in existing Elderly Care Departments established at the community health service centres in Chongqing, a Southwestern Chinese city, to evaluate the lived experience of the residents and to find strategies for improvement. Eighteen participants were recruited from the residents of the Elderly Care Departments of three community health service centres in the city. Data were collected through semi‐structured in‐depth individual interviews and were analysed utilising the Colaizzi's phenomenological method. Five main themes were identified: Safety and trust; Satisfaction and relief; Gratitude and mutual understanding; Complaints and helplessness; and Worries and apprehension. We found that set‐up of the Elderly Care Departments at the community health service centres appeared to be consistent with the idea of integrated care and in general, the current running mode was able to provide the elderly with effective medical, nursing and other cares. The psychological and cultural services at these departments, however, need to be further enhanced. 相似文献
994.
目的 观察培哚普利在经皮冠状动脉介入治疗(PCI)前后对患者肾功能的影响.方法 将入选的147例行冠状动脉支架植入术的患者按随机数字表法分为培哚普利组(77例)和对照组(70例).培哚普利组术前服用培哚普利(4 mg· d-1)至少3d,术后继续服用培哚普利.对照组治疗期间不使用任何血管紧张素转换酶抑制剂(ACEI)类药物.两组患者术中均使用对比剂碘克沙醇造影.记录患者术前1d,术后1d、3d的肌酐、尿酸、血尿素氮(BUN)和肾小球滤过率,分析比较两组患者手术前后肾功能的变化和对比剂肾病(CIN)发生率的差异.结果 两组术前1d肌酐、肾小球滤过率、尿酸和BUN均差异无统计学意义(P>0.05),但培哚普利组BUN术后3d较术前1d上升(P<0.05).对照组肌酐术后3d较术前1d升高(P<0.05),对照组尿酸术后3d较术前1d升高(P<0.05),对照组肾小球滤过率术后3d较术前1d下降(P<0.05).对照组各项肾功能主要指标术后1d较术前1d均差异无统计学意义(P>0.05).两组患者CIN的发生率差异无统计学意义(P>0.05).结论 培哚普利可预防患者冠脉PCI术后应用对比剂引起的肾功能损伤. 相似文献
995.
A new p-coumaroylated santalane-type sesquiterpenoid, 8-p-coumaroyl-α-santalene (1), a new p-coumaroylated oplopanane-type sesquiterpenoid, 8-β-p-coumaroyl-oplopanone (2), and three known p-coumaroylated humulene-type sesquiterpenoids (3–5) were isolated from the ethanol extract of the whole herbs of Pilea cavaleriei. Their structures were elucidated based on the combination of 1D and 2D NMR and HRMS methods. Compound 2 was found to show anti-tuberculosis activity with MIC of 16 μg/ml. 相似文献
996.
Dongmei Lu Diana Vivian Ping Ren Yongsheng Yang Hongling Zhang Xiaojian Jiang Ethan Stier 《The AAPS journal》2018,20(2):26
There are several drug products that bind phosphate or bile acid in the gastrointestinal (GI) tract to exert their therapeutic efficacy. In vitro binding studies are used to assess bioequivalence (BE) of these products. The objective of this study is to identify the common deficiencies in Abbreviated New Drug Applications (ANDAs) for these products. Deficiencies were compiled from ANDAs containing in vitro binding BE studies. The deficiencies were classified into eight categories: Pre-Study Method Validation, During-Study Sample Analysis, Study Design, Study Procedure, Dissolution/Disintegration, Analytical Site Inspection, Data Submission, and Formulations. Within each category, additional subcategories were defined to characterize the deficiencies. A total of 712 deficiencies from 95 ANDAs for 11 drug products were identified and included in the analysis. The four categories with the most deficiencies were During-Study Sample Analysis (27.8%), Pre-Study Method Validation (17.3%), Data Submission (16.7%), and Study Design (15.7%). For the During-Study Sample Analysis category, failure to submit complete raw data or analytical runs ranked as the top deficiency (32.8%). For the Study Design category, using an unacceptable alternate study design (26.8%) was the most common deficiency. Within this category, other commonly occurring deficiencies included incorrect/insufficient number of absorbent concentrations, failure to pre-treat drug product with acid, insufficient number of replicates in study, incorrect calculation of k1 and k2 values, incorrect dosage form or pooled samples used in the study, and incorrect pH of study medium. The review and approval of these products may be accelerated if these common deficiencies are addressed in the original ANDA submissions. 相似文献
997.
Unravelling residents’ and supervisors’ workplace interactions: an intersubjectivity study
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Francisco M Olmos‐Vega Diana HJM Dolmans Carlos Guzmán‐Quintero Renée E Stalmeijer Pim W Teunissen 《Medical education》2018,52(7):725-735
Context
Successful engagement between residents and supervisors lies at the core of workplace learning, a process that is not exempt from challenge. Clinical encounters have unique learning potential as they offer opportunities to achieve a shared understanding between the resident and supervisor of how to accomplish a common goal. How residents and supervisors develop such a mutual understanding is an issue that has received limited attention in the literature. We used the ‘intersubjectivity’ concept as a novel conceptual framework to analyse this issue.Methods
We conducted a constructivist grounded theory study in an anaesthesiology department in Bogota, Colombia, using focus groups and field observations. Eleven residents of different training levels and 18 supervisors with varying years of teaching experience participated in the study. Through iterative data analysis, collection and constant comparison, we constructed the final results.Results
We found that residents and supervisors achieved a shared understanding by adapting to one another in the process of providing patient care. Continuous changes in the composition of resident–supervisor dyads exposed them to many procedural variations, to which they responded by engaging in various adaptation patterns that included compliance by residents with supervisors’ directions, negotiation by residents of supervisors’ preferences, and the sharing of decision making. In the process, the resident played an increasingly key role as a member of the supervisory dyad. Additionally, experiencing these adaptation patterns repeatedly resulted in the creation of a working repertoire: an attuned working code used by the members of each supervisory dyad to work together as a team.Conclusions
The development of shared understanding between residents and supervisors entailed experiencing diverse adaptation patterns which resulted in the creation of working repertoires. Seeing supervisory interactions as adaptation processes has essential theoretical and practical implications regarding workplace learning in postgraduate settings. Our findings call for further exploration to understand learning in postgraduate education as a social process.998.
999.
Hard palate mucoperiosteal graft for posterior lamellar reconstruction of the upper eyelid: histologic rationale 总被引:2,自引:0,他引:2
Reconstruction of full-thickness upper eyelid defects often requires repair of both the anterior lamella (skin and orbicularis oculis muscle) and the posterior lamella (tarsus and conjunctiva). Various autogenous grafts have been used for posterior lamellar reconstruction, but it is still unclear which material is most suitable for repairing the posterior lamella. We report a patient in whom a subtotal defect of upper eyelid was reconstructed with a bipedicled myocutaneous flap lined by hard palate mucoperiosteum. We also examined tarsoconjunctiva, labial mucosa, hard palate mucoperiosteum, and auricular cartilage histologically and assessed the histologic features of these tissues as substitutes for the posterior lamella. An even and stable upper eyelid was formed by our method of reconstruction. A mucoperiosteal graft from the hard palate bears a close resemblance to the tarsoconjunctiva histologically because it contains both fibrous connective tissue and a mucous membrane. The graft took completely and there was no donor site morbidity or postoperative complications. A hard palate mucoperiosteal graft may be an optimal substitute for the posterior lamella of the upper eyelid. 相似文献
1000.
Objective: To study the potential therapeutic effect of Yigan Powder on Alzheimer's disease (AD) comorbid Depressive Disorder with Network Pharmacology. Methods: The active ingredients of Yigan Powder were screened from Traditional Chinese Medicine Systems Pharmacology database and analysis platform (TCMSP) by ADME parameters, targets are predicted by Swiss Target Prediction database, disease targets are downloaded from GeneCards, OMIM and PharGKB database. Using R to run GO terms enrichment and KEGG pathway enrichment analysis. Protein interaction data is downloaded from the String database. Cytoscape software is used to build network. AutoDock Vina and PyMOL software are used for molecular docking. Results: There are 125 active ingredients in Yigan Powder with 953 predicted targets, 85 of predicted targets are related to Alzheimer's Disease comorbid Depressive Disorder, shows highly enriched signaling pathways and biological processes. PPI network shows APP, MAPK1 and STAT3 may be important potential treatment of Alzheimer's Disease comorbid Depressive Disorder. The results of AutoDock Vina docking showed that the active ingredients of Yigan Powder had good binding activity with important receptors. Conclusion: Yigan Powder shows effect on neurotransmitter metabolism, synaptic transmission, neuroinflammation and other aspects in the treatment of Alzheimer's Disease comorbid Depressive Disorder. 相似文献