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11.
Summary A retrospective study of 61 patients with glomus jugulare tumours treated at the National Hospital for Neurology and Neurosurgery, and at the Royal National Throat, Nose and Ear Hospital, London. The average age at presentation was 41.7 years. The patients were mainly treated by a posterolateral combined otoneurosurgical approach. 42/61 of the patients had total or subtotal excision of their tumours, 7/61 had partial removal and the remaining 11/61 had no operation. Only one case required a 2-staged procedure. There were two deaths in the postoperative period, one from intracerebral haemorrhage and the other from the left hemisphere infarction.Postoperative radiotherapy was given to 5/7 of the patients who had partial removal. 3/40 of the patients with total removal had postoperative radiotherapy, and a further 3/40 had received radiotherapy pre-operatively.Of the 11 patients who did not undergo surgery, 7/11 were treated with radiotherapy and 4/11 had embolisation only. 相似文献
12.
13.
Motor-vehicle crash fatalities among American Indians and non-Indians in Arizona, 1979 through 1988. 总被引:4,自引:2,他引:2 下载免费PDF全文
D Campos-Outcalt D Prybylski A J Watkins G Rothfus A Dellapenna 《American journal of public health》1997,87(2):282-285
OBJECTIVES: This study evaluated the contributions of rural residence, alcohol use, and pedestrian fatalities to the high American Indian motor-vehicle crash mortality rate in Arizona. METHODS: Records from the Fatal Accident Reporting System were used to examine mortality rates between 1979 and 1988. RESULTS: American Indians had increased relative risks in all motor-vehicle crash categories in all residence-gender groups. The percentage of excess mortality associated with alcohol varied from 36.8% to 66.7%, and the percentage associated with pedestrian deaths ranged from 27.2% to 55.4%. CONCLUSIONS: Efforts to reduce excess motor-vehicle crash mortality among American Indians should concentrate on preventing pedestrian and alcohol-related fatalities. 相似文献
14.
Eleanor LeBourdais 《Canadian Medical Association journal》1989,140(11):1374-1376
15.
Lawrence Watkins Richard Hayward Unday Andar William Harkness 《Child's nervous system》1994,10(2):87-90
A prospective study was undertaken of all children referred to the Hospital for Sick Children with a provisional diagnosis of shunt blockage over a 5-month period. Fifty-two admissions were recorded, relating to 45 children, 5 of whom had multiple admissions. Only 19 of the 52 admissions led to a final diagnosis of shunt malfunction. No source of referral, whether by the child's general practitioner or from another hospital, was found to be more accurate than direct referral by the parents to the neurosurgical ward. Headache, vomiting and irritability were not significant indicators as to whether the child's shunt was actually blocked, and nor was the duration of the symptoms. Drowsiness was a significant, but not definite, indicator of shunt blockage, while pyrexia made it more likely that the patient had an alternative diagnosis. In 35 of the admissions a computed tomographic scan was performed: a normal scan, unchanged from previous scans, did not reliably exclude the diagnosis of shunt blockage. Percutaneous manometry via the reservoir of the shunt system was performed during 26 admissions: this investigation produced no false positives nor false negatives, but was equivocal in 5 cases, all of which were found at surgery to have a definite shunt blockage. The accuracy of the diagnosis of shunt blockage made prior to referral to a neurosurgical unit is discussed, together with the implications for resource use. 相似文献
16.
Many mental health clinics rely heavily on group treatment in the outpatient care of individuals with schizophrenia. Groups are used because they economize clinician time and provide social interaction for isolated patients. Empirical evidence suggests that groups, combined with medication, are at least as effective as other common treatments. Many group formats and techniques have been used. Choices are often based on pragmatism or inclination, rather than theory or experiment. The authors review recent findings from research on the neurobiology of schizophrenia, its natural history, and the impact of psychosocial factors in its course and treatment. From these findings, they elaborate research based principles for outpatient group therapy in schizophrenia. They describe three distinct formats for group treatment, and delineate the scope of use for each. Finally, they propose guidelines for assignment of patients to appropriate group treatments.Portions of this material were presented at the 1988 Hospital Community Psychiatry Institute, and at the 1989 meeting of the American Psychiatric Association. 相似文献
17.
N R Newberry T S Sprosen C J Watkins R A Leslie D G Grahame-Smith 《European journal of pharmacology》1992,219(1):135-140
The action of a novel 5-HT3 receptor antagonist, AS-5370, has been studied on two electrophysiological models for 5-HT3 receptors: whole-cell patch-clamp recordings from mouse neuroblastoma-rat glioma (NG108-15) cells and grease-gap recordings from rat isolated vagus nerve. The 5-hydroxytryptamine (5-HT)-induced fast inward current of voltage-clamped NG108-15 cells was antagonized by 1 nM AS-5370 in an insurmountable manner. On the rat vagus, AS-5370 reduced the maximum depolarizing response to 5-HT in a concentration-dependent manner. The IC50 for AS-5370 on the rat vagus was 0.3-1.0 nM. The EC50 for 5-HT on the rat vagus was not appreciably affected by AS-5370. On the rat vagus, the (R) enantiomer of AS-5370 was about 30 times more potent than the (S) enantiomer. The antagonist action of AS-5370 on these two cell types was compared with that of (+)-tubocurarine. Unlike tubocurarine, the effect of AS-5370 on NG108-15 cells was not readily reversed during wash. On the rat vagus, tubocurarine antagonized in a competitive manner with an IC50 of 0.3-1.0 microM (pKb = 7.2). It is concluded that AS-5370 is a potent 5-HT3 receptor antagonist on both NG108-15 cells and the rat vagus, but it does not act in a competitive manner. 相似文献
18.
H Israelson J M Plemons P Watkins C Sory 《The International journal of periodontics & restorative dentistry》1992,12(1):52-61
At surgery, the results of preoperative radiographic evaluation are used in conjunction with surgical stents to determine the ideal site and angulation of implants. However, it would be desirable to be able to plan the optimal implant location before the actual surgical appointment. This paper presents a technique in which barium-coated stents or dentures are used in conjunction with computer-assisted tomography to locate important anatomic landmarks, such as the inferior alveolar nerve, and anomalies of the underlying bone, such as deficiencies in ridge height, preoperatively. This allows more accurate determination of optimal implant placement. 相似文献
19.
The mistreatment of elderly is subject to various social constructions. On two geographically distinct Plains Indian Reservations which we call Lone Mountain and Abundant Lands, the abuse or neglect of elderly is construed as a health problem which is a dysfunction of the community as a whole. Both physical abuse and neglect are more common on the Lone Mountain Reservation, occurring in association with other indicators of community disorganization such as unemployment and substance abuse. On the Abundant Lands Reservation physical abuse was categorically denied and what neglect existed appeared to be a function of role strain, geographic dispersal, climate and terrain. We attribute differences in the prevalence of mistreatment of elders to variations in economic opportunities for younger residents. Examining the historical and present contexts of intergenerational relationships on the reservations, we discuss the implications of this study for social exchange theory and policy applications.This research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America AppliedThis research was supported by the Gerontological Society of America Applied 相似文献
20.
Parminder Suchdev Kym Ahrens Eleanor Click Lori Macklin Doris Evangelista Elinor Graham 《Ambulatory Pediatrics》2007,7(4):317-320
The health status of many people in developing countries is often dismal compared with the norms in industrialized countries. Increasingly, medical practitioners in the United States and other industrialized countries have become interested in global health issues, an interest that often takes the form of short-term international medical trips. We discuss several ethical issues associated with participation in such trips and use our experiences in developing the Children's Health International Medical Project of Seattle (CHIMPS) to outline and illustrate a set of 7 guiding principles for making these trips. CHIMPS is a resident-run, faculty-supported international medical program founded in 2002 by pediatric residents at the University of Washington in Seattle. Members of CHIMPS work with a rural community in El Salvador to support ongoing public health interventions there and provide sustainable medical care in collaboration with the community and a local nongovernmental organization. The 7 principles developed as a result of this work-mission, collaboration, education, service, teamwork, sustainability, and evaluation-can be used as a model for health practitioners as they develop or select international medical trips. The importance of partnering with the community and working within the existing medical and public health infrastructure is emphasized. Many of the challenges of doing international medical work can be overcome when efforts are guided by a few specific principles, such as those we have outlined. 相似文献