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131.
ANTHONY J. DIXON MBBS FACRRM MARY P. DIXON B Appl Sci DEBORAH A. ASKEW PhD DAVID WILKINSON MBChB FRACGP MRCP DSc PhD 《Dermatologic surgery》2006,32(6):819-827
OBJECTIVE: The study aimed to identify wound sites/procedures where infection incidence was over 5%, such that these circumstances may warrant wound infection antibiotic prophylaxis. METHOD: We undertook a 3-year prospective study of 5,091 lesions (predominantly nonmelanoma skin cancer) treated on 2,424 patients from July 2002 to June 2005. No patient was given prophylactic antibiotics, and no patient ceased warfarin or aspirin. RESULTS: Overall infection incidence was 1.47%. Individual procedures had the following infection incidence: curettage 0.73% (3/412); skin flap repairs 2.94% (47/1601); simple excision and closure 0.54% (16/2974); skin grafts 8.70% (6/69); and wedge excision 8.57% (3/35). Analysis of regions of the body demonstrated that surgery below the knee (n = 448) had an infection incidence of 6.92% (31/448) (p < .0001). Subanalysis demonstrated that all regions below the knee were at high infection risk. Elsewhere, groin excisional surgery had an infection incidence of 10% (1/10) (p = .027). No other body site demonstrated an infection incidence beyond 5% of statistical significance. Procedures on the face demonstrated an infection incidence of 0.81% (18/2,209). Diabetic patients, those on warfarin and/or aspirin, and smokers showed no difference in infection incidence. CONCLUSION: Based on a prediction of infection incidence over 5%, the following cutaneous oncologic procedures warrant consideration of oral antibiotic wound infection prophylaxis: all procedures below the knee, wedge excisions of lip and ear, all skin grafts, and lesions in the groin. Other than under these circumstances, surgery to the nose, ear, fingers, lips, skin flap surgery, and surgery on diabetics, smokers, and those on anticoagulants have previously been considered for wound infection prophylaxis but do not warrant such intervention based on our data. The authors have indicated no significant interest with commercial supporters. 相似文献
132.
133.
DEBORAH HASIN QUN LI STEPHEN MCCLOUD JEAN ENDICOTT 《Addiction (Abingdon, England)》1996,91(10):1517-1527
DSM-III-R, DSM-IV and ICD-10 definitions of alcohol dependence were all developed from the concept of the Alcohol Dependence Syndrome, and thus have a common theoretical link. This link is not shared by DSM-III, and no link exists between definitions of abuse in the different classification systems. The level of agreement on diagnoses produced by the different systems has practical as well as theoretical implications. We tested this agreement in 962 US household residents randomly sampled and screened for heavier than average drinking in the last 12 months. Agreement for most comparisons involving diagnoses of current dependence ranged from good to excellent, with no clear pattern of lower agreement for DSM-III. However, agreement on past dependence was sharply lower for comparisons involving DSM-III than those involving the other classification systems. This appeared to be due to the DSM-III requirement for physiological dependence and the apparently emerging nature of the disorder in this relatively young, non-treatment sample. Comparisons for abuse were generally poor for current as well as past diagnoses. Implications of the findings are discussed. 相似文献
134.
DEBORAH L. HEYL SHARON J. SCHMITTER HASSIBA BOUZIT THOMAS W. JOHNSON ANGELA M. HEPP KATHLEEN R. KURTZ CAROL MOUSIGIAN 《Chemical biology & drug design》1994,44(5):420-426
Deltorphins I and II (Tyr-D-Ala-Phe-Asp-Val-Val-Gly NH2 and Tyr-D-Ala-Phe-Glu-Val-Val-Gly NH2) display a high degree of 6-opioid receptor selectivity. Since they lack the intervening Gly3 residue found between the Tyr and Phe aromatic moieties in pentapeptide enkephalins, deltorphins I and II resemble a previously described series of cyclic tetrapep-tides based on Tyr-c[D-Cys-Phe-D-Pen] (JOM-13). With the goal of development of structure-activity relationships for deltorphins and comparison with that of the cyclic tetrapep-tides, ten analogs of deltorphin I were synthesized in which Phe3 was replaced with specific aromatic and nonaromatic amino acids with varying physicochemical properties. Results indicated that analogs containing the bicyclic aromatic amino acids 3-(l-naphthyl)-L-alanine [1-Nal; Ki(μ) = 767 nM, Ki(§) = 7.70 nM], 3-(2-naphthyl)-L-alanine [2-Nal; Ki(μ)= 1910 nM, Ki(§) = 49.2 nM], tryptophan [Ki(μ)= 1250 nM, Ki(§) = 23.9nM], and 3-(3-benzothienyl)-L-alanine [Bth; Ki(μ)= 112nM, Ki(§) = 3.36 nM] were fairly well tolerated at μ- and §-receptors, though affinity was compromised to varying degrees relative to deltorphin I. Shortening the Phe side chain by incorporation of phenylglycine (Pgl) was detrimental to both μ (Ki= 4710 nM) and § (Ki= 15.6 nM) binding, while extension of the side chain with homophenylalanine (Hfe) enhanced μ binding (Ki= 67.8 nM), leaving § affinity unaffected (Ki= 2.64 nM). Substitution with nonaromatic amino acids valine and isoleucine led expectedly to poor opioid binding [Ki(μ) =≥ 10000 nM for each, Ki(§) = 160 and 94.7 nM, respectively], while peptides containing cyclohexylalanine (Cha) and leucine surprisingly retained affinity at both μ (Ki= 322 and 1240 nM, respectively) and § (Ki= 10.5 and 12.4 nM, respectively) sites. In general, these trends mirror those observed for similar modification in Tyr-c[D-Cys-Phe-D-Pen]. 相似文献
135.
EADIE HEYDERMAN R. M. GRAHAM DEBORAH V. CHAPMAN T. C. RICHARDSON P. H. McKEE 《Histopathology》1984,8(3):423-434
Sixty-five primary malignant skin tumours have been stained for carcinoembryonic antigen (CEA) and epithelial membrane antigen (EMA) using rabbit polyclonal affinity-purified antibodies and an indirect immunoperoxidase technique. The tumours consisted of 15 invasive squamous carcinomas, 23 basal cell carcinomas, 16 malignant eccrine poromas (porocarcinomas), and 11 sebaceous carcinomas. The basal cell carcinomas were negative for CEA and EMA except where there was keratotic or sebaceous differentiation. All the sebaceous and squamous carcinomas and 15/16 porocarcinomas contained EMA. 12/15 squamous carcinomas were positive for CEA. The malignant poromas were negative for CEA except on the ulcerated surface of two. In tumours classified as sebaceous carcinomas there was positive staining for CEA in some cells, cyst contents and/or keratotic foci. These findings have implications for the use of immunoperoxidase localization of epithelial markers in the differential diagnosis of primary and metastatic skin cancer. 相似文献
136.
A.J. CARMICHAEL I.S. FOULDS DEBORAH S. BRANSBURY 《The British journal of dermatology》1991,125(6):573-576
Summary Thirty-seven patients who had shown a relevant positive patch-test response to lanolin within the previous 5 years were retested. Only 41% demonstrated persistence of the positive patch test to lanolin. Analysis according to age, sex, atopic status, interval between patch testings, strength of the original response and the number of concurrent reactions, were not associated with the persistence of the lanolin response. 相似文献
137.
DEBORAH JENSEN RNC SHEILA WALLACE RN CLE IBCLC PATRICIA KELSAY RN BSN 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》1994,23(1):27-32
Nurses most often use a subjective "well/fair/poor" system to assess and document breastfeeding. LATCH is a breastfeeding charting system that provides a systematic method for gathering information about individual breastfeeding sessions. The system assigns a numerical score, 0, 1, or 2, to five key components of breastfeeding. Each letter of the acronym LATCH denotes an area of assessment. "L" is for how well the infant latches onto the breast. "A" is for the amount of audible swallowing noted. "T" is for the mother's nipple type. "C" is for the mother's level of comfort. "H" Is for the amount of help the mother needs to hold her infant to the breast. The system is visually represented in the same form as the Apgar scoring grid, and the numbers are handled in the same way. With the LA TCH system, the nurse can assess maternal and infant variables, define areas of needed intervention, and determine priorities in providing patient care and teaching. 相似文献
138.
Effects of Tactile Stimulation on Premature Infant Weight Gain 总被引:12,自引:0,他引:12
DEBORAH NELSON RN MSN ROBERT HEITMAN EDD CINDY JENNINGS RN MSN 《Journal of obstetric, gynecologic, and neonatal nursing : JOGNN / NAACOG》1986,15(3):262-267
A study was conducted to determine the effect of continuous tactile stimulation on weight gain in premature infants. Thirty infants made up the sample. The experimental group received continuous tactile stimulation by being placed on a pile decubitus pad for a five-day period. Infants in the control group received routine nursery care. Both groups were weighed daily on the same scale. Analysis of covariance was used to analyze the data, which resulted in a failure to reject the hypotheses of no difference. 相似文献
139.
Association of moderate obesity with a poor pregnancy outcome in women with polycystic ovary syndrome treated with low dose gonadotrophin 总被引:3,自引:0,他引:3
140.