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991.

Objectives

To systematically locate, critically appraise, and synthesize the available evidence regarding the effectiveness of cognitive behavioral therapies (CBTs) and psychoeducation that can be implemented by rehabilitation specialists to treat fear-avoidance beliefs in patients with acute, subacute, and chronic low back pain (LBP).

Data Sources

Electronic databases (CINAHL, PubMed, Psychology and Behavior Sciences Collection, SPORTDiscus, PsycINFO) were searched from inception to September 2017.

Study Selection

Assessment of methodological quality was completed using the Physiotherapy Evidence Database (PEDro) scale. The Strength of Recommendation Taxonomy was used to evaluate the quality of evidence.

Data Extraction

Study sample, subject demographics, CBT and/or psychoeducation intervention details, data collection time points, outcome assessments, statistical analysis, results, and conclusions were extracted from each study. In addition, effect sizes were calculated.

Data Synthesis

Five high-quality studies (PEDro ≥6) were included. All included studies evaluated fear-avoidance beliefs. CBTs and psychoeducation strategies designed to target patient-specific fears demonstrated clinically meaningful results, while psychoeducation methodologies were not as effective.

Conclusions

There is inconsistent, patient-oriented evidence (grade B) to support the use of CBTs and/or psychoeducation strategies by rehabilitation specialists to treat fear-avoidance beliefs. Patient-centered and personalized CBTs were most effective to treat these psychosocial factors in patients with LBP when compared with a control treatment.  相似文献   
992.
993.
目的:探讨小干扰RNA(siRNA)沉默人结肠癌SW480细胞β-catenin基因表达对SW480细胞增殖和凋亡的影响。方法:采用脂质体转染法合成靶向β-catenin的双链siRNA(β-catenin-siRNA),转染SW480细胞,RTPCR及Western blotting检测SW480细胞中β-catenin mRNA及蛋白的表达,MTT实验和流式细胞术分别检测SW480细胞的增殖和凋亡。结果:RT-PCR及Western blotting检测结果显示β-catenin-siRNA转染后,与空白组、阴性对照组及实验组相比,β-catenin-siRNA转染组SW480细胞中β-catenin mRNA水平明显下降,其蛋白表达也明显下调。β-catenin-siRNA转染后,SW480细胞的凋亡率明显高于阴性对照组及实验组,细胞增殖能力明显下降。结论:siRNA沉默β-catenin的表达可诱导SW480细胞凋亡,抑制细胞的增殖,为结肠癌的临床治疗提出新的思路,可以作为结肠癌治疗的一个新靶点。  相似文献   
994.
目的:研究CCL25是否影响鼻咽癌CNE-2细胞的迁移。方法:采用Transwell实验,上室中加入CNE-2细胞,下室中加入不同浓度的CCL25,观察其对CNE-2向下室迁移的影响。另外同时在下室中加入anti-CCR9,再观察CNE-2向下室的迁移情况。结果:CCL25具有趋化CNE-2细胞的作用,同空白对照组相比,50ng/ml的CCL25能明显增强CNE-2细胞的迁移率(P<0.01)。而1μg/ml的anti-CCR9能逆转CCL25对CNE-2细胞的促迁移作用(P<0.05)。结论:CCL25具有趋化CNE-2细胞,促进CNE-2细胞迁移的作用。Anti-CCR9能阻断CCL25对CNE-2细胞的促迁移作用。  相似文献   
995.

Context

Targeted therapies with epidermal growth factor receptor tyrosine kinase inhibitors have been widely used in the treatment of advanced non–small-cell lung cancer (NSCLC). However, little research has focused on the use of targeted therapies at the end of life (EOL).

Objectives

This study investigated the determinants of receiving targeted therapy during the last month of life and how targeted therapies affect the quality of EOL care.

Methods

We conducted a retrospective population-based study using a cancer registry and National Health Insurance claims data among 42,678 Taiwanese NSCLC decedents in 2005–2012. Propensity score matching and generalized linear mixed models were used to estimate associations.

Results

We identified 3439 (21.3%) NSCLC patients who received targeted therapy within 30 days of death. Younger age, adenocarcinoma histology, postdiagnosis survival exceeding six months, and later year of death were associated with receiving targeted agents at EOL. The odds increased when patients were treated by pulmonologists or oncologists or in district hospitals or facilities with a higher case volume. Patients who were prescribed targeted therapy near death were significantly more likely to undergo aggressive EOL care (odds ratio = 2.35, 95% CI = 1.83–3.02) including multiple emergency department visits, hospitalization exceeding 14 days, admission to intensive care units, use of intubation and mechanical ventilation, cardiopulmonary resuscitation, and late hospice referrals.

Conclusions

Targeted therapy at EOL should be considered a quality-of-care indicator. Guidance in the cessation of targeted therapy and the ongoing monitoring of practice initiatives are warranted. The decision-making processes associated with EOL care also require further investigation.  相似文献   
996.
Vision is the sense that we use to navigate the world around us. Thus it is not surprising that blindness is one of people's most feared maladies. Heritable diseases of the retina, such as age-related macular degeneration and retinitis pigmentosa, are the leading cause of blindness in the developed world, collectively affecting as many as one-third of all people over the age of 75, to some degree. For decades, scientists have dreamed of preventing vision loss or of restoring the vision of patients affected with retinal degeneration through drug therapy, gene augmentation or a cell-based transplantation approach. In this review we will discuss the use of the induced pluripotent stem cell technology to model and develop various treatment modalities for the treatment of inherited retinal degenerative disease. We will focus on the use of iPSCs for interrogation of disease pathophysiology, analysis of drug and gene therapeutics and as a source of autologous cells for cell transplantation and replacement.  相似文献   
997.
998.
《Biochemical pharmacology》2015,97(4):306-314
Metastasis is the major cause of death in cancer patients. Elevated expression of cyclooxygenase-2 (COX-2) is observed in many human cancers and over-production of downstream prostaglandins (PGs) has been shown to stimulate metastasis. A role for increased PGE2 production has been proposed, but whether other PGs contribute is currently unclear. In this study the pro-migratory actions of individual PGs were evaluated in MDA-MB-468 breast cancer cells that stably over-expressed COX-2 (MDA-COX-2 cells); cell migration was quantified using 3D-matrigel droplet assays. Inhibition of the prostacyclin and PGE synthases, but not alternate prostanoid synthases, prevented the increase in MDA-COX-2 cell migration produced by arachidonic acid (AA); direct treatment of cells with the stable prostacyclin analogue cicaprost also promoted migration. Pharmacological antagonism and knockdown of the IP receptor decreased cell migration, while antagonists of the alternate DP, EP2, FP, and TP prostanoid receptors were inactive. In support of these findings, activation of the IP receptor also enhanced migration in the MDA-MB-468, MDA-MB-231 and A549 cell lines, and IP receptor knock-down in MDA-COX-2 cells decreased the expression of a number of pro-migratory genes. In further studies, the prostacyclin/IP receptor and PGE2/EP4 receptor pathways were found to be functionally independent and the inhibition of phosphatidylinositol 3-kinase (PI3K) and p38 mitogen-activated protein kinase (MAPK) selectively impaired the IP-receptor-dependent migration in MDA-COX-2 cells. Taken together, the prostacyclin/IP/PI3K-p38 MAPK axis has emerged as a novel pro-migratory pathway in breast cancer cells that over-express COX-2. This information could be utilized in novel treatment strategies to minimize tumor metastasis.  相似文献   
999.
1000.
Phthalates are a class of chemicals widely used as plasticisers in a multitude of common consumer products. Through contact with such products, people are regularly exposed to phthalates, which are suspected to contribute to adverse health effects, particularly in the reproductive system.In the present study, 14 urinary phthalate metabolites of 10 parent phthalates were analysed by HPLC–MS/MS among the Austrian population aged 6–15 and 18–81 years in order to assess phthalate exposure. In the total study population, ranges of urinary phthalate metabolite concentrations were n.d.–2,105 μg/l (median 25 μg/l) for monoethyl phthalate (MEP), n.d.–88 μg/l (10 μg/l) for mono-n-butyl phthalate (MnBP), n.d.–248 μg/l (28 μg/l) for mono-isobutyl phthalate (MiBP), n.d.–57 μg/l (1.8 μg/l) for mono-benzyl phthalate (MBzP), n.d.–20 μg/l (n.d.) for mono-(2-ethylhexyl) phthalate (MEHP), n.d.–80 μg/l (2.6 μg/l) for mono-(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), n.d.–57 μg/l (1.9 μg/l) for mono-(2-ethyl-5-oxohexyl) phthalate (5oxo-MEHP), n.d.–219 μg/l (11 μg/l) for mono-(5-carboxy-2-ethylpentyl) phthalate (5cx-MEPP), n.d.–188 μg/l (1.6 μg/l) for 3-carboxy-mono-proply phthalate (3cx-MPP), n.d.–5.5 μg/l (n.d.) for mono-cyclohexyl phthalate (MCHP), n.d.–4.5 μg/l (n.d.) for mono-n-pentyl phthalate (MnPeP), n.d.–3.4 μg/l (n.d.) for mono-n-octyl phthalate (MnOP), n.d.–13 μg/l (n.d.) for mono-isononyl phthalate (MiNP), and n.d.–1.1 μg/l (n.d.) for mono-isodecyl phthalate (MiDP). Generally, children exhibited higher levels of exposure to the majority of investigated phthalates, except to MEP, which was found in higher concentrations in adults and senior citizens at a maximum concentration of 2,105 μg/l. Individual daily intakes were estimated based on urinary creatinine and urinary volume excretion and were then compared to acceptable exposure levels, leading to the identification of exceedances of mainly the Tolerable Daily Intakes (TDI), especially among children. The execution of a cumulative risk assessment based on Hazard Indices showed cause for concern mainly for children, as well as in rare cases for adults.Although phthalate exposure seems to have decreased in previous years, the wide distribution and existing exceedances of acceptable levels indicate that phthalate exposure should be further monitored in order to identify exposure sources and enable appropriate minimisation measures.  相似文献   
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