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101.
目的通过网络数据库技术及图像后处理技术,借助智能手机应用及医院互联网内、外网界面,初步建立肩关节镜临床登记系统。 方法运用院内数字化建设及互联网大数据技术构建肩关节镜围术期宣教、核心临床信息登记、术后随访、影像信息收集、科研数据统计分析及功能量表等复合评估体系。 结果临床登记系统获得了接受肩关节镜手术患者的人口学信息、围术期临床核心数据、影像学相关信息及各类功能评分量表信息等,建立了科室微网模块服务及网页式联合手机应用界面信息推送服务。 结论肩关节镜临床登记系统初步实现临床管理及科研系统和登记系统间的信息交互,建立了本院特色鲜明的"互联网"肩关节镜临床登记系统及随访公众号,实现临床资料的精细化管理。  相似文献   
102.
Cancer is a major cause of mortality and morbidity throughout the world, including the countries of North-East and South-East Asia. Assessment of burden through cancer registration, determination of risk and protective factors, early detection and screening, clinical practice, interventions for example in vaccination, tobacco cessation efforts and palliative care all should be included in comprehensive cancer control programs. The degree to which this is possible naturally depends on the resources available at local, national and international levels. The present review concerns elements of cancer control programs established in China, Taiwan, Korea, and Japan in North-East Asia, Viet Nam, Thailand, Malaysia, and Indonesia as representative larger countries of South-East Asia for comparison, using the published literature as a guide. While major advances have been made, there are still areas which need more attention, especially in South-East Asia, and international cooperation is essential if standard guidelines are to be generated to allow effective cancer control efforts throughout the Far East.  相似文献   
103.
《医疗器械注册证》是医疗器械招标文件中最重要的资格证明文件之一,是评审技术指标的主要依据之一。招标中,对注册证的审查必须注意是否与招标要求产品一致、是否完整、是否有效等等。这些问题需要在招标评审过程中严格把关。  相似文献   
104.
BACKGROUND: Image-guided intervention using pre-acquired CT/MR 3-dimensional images is an emerging strategy for atrial fibrillation (AF) ablation but may be limited by its use of static images to depict dynamic physiology. The effect of biologic factors such as respiration on the left atrial-pulmonary venous (LA-PV) anatomy is not well understood but is likely to have important implications. Conventional CT/MR imaging is performed during an inspiratory breath-hold, while electroanatomical mapping (EAM) during "quiet" breathing approximates an expiratory breath-hold. This study examined the effects of respiration on LA-PV anatomy and the error introduced by respiration on the integration of EAM with 3D MR imaging. METHODS: Pre-procedural MRI angiography was performed at both end-expiration (EXP) and end-inspiration (INSP) in 20 patients undergoing AF catheter ablation. 3D INSP and EXP surface reconstructions of the LA-PVs were compared. In selected pts, EAM data acquired during the ablation procedure (n=7) were integrated with the 3D MRI datasets. RESULTS: Qualitative assessment of the INSP and EXP 3D images revealed splaying of the PVs and reduction in PV caliber of the right-sided PVs during held inspiration. After aligning these two datasets, the average surface-to-surface distance calculated by region ranged from 1.99mm (right middle PV) to 3.79mm (left superior PV). Registration of the EAM to the MRI models was better for the EXP dataset (2.30+/-0.73mm) than the INSP dataset (3.03+/-0.57mm; p=0.004). CONCLUSION: There are significant changes in LA-PV anatomy with respiration. MR images acquired during standard held inspiration may introduce unnecessary errors in registration during image-guided intervention.  相似文献   
105.

Objective

The purpose of this study was to compare air trapping in healthy volunteers with asthmatics using pulmonary function test and quantitative data, such as specific volume change from paired inspiratory CT and registered expiratory CT.

Materials and Methods

Sixteen healthy volunteers and 9 asthmatics underwent paired inspiratory/expiratory CT. ΔSV, which represents the ratio of air fraction released after exhalation, was measured with paired inspiratory and anatomically registered expiratory CT scans. Air trapping indexes, ΔSV0.4 and ΔSV0.5, were defined as volume fraction of lung below 0.4 and 0.5 ΔSV, respectively. To assess the gravity effect of air-trapping, ΔSV values of anterior and posterior lung at three different levels were measured and ΔSV ratio of anterior lung to posterior lung was calculated. Color-coded ΔSV map of the whole lung was generated and visually assessed. Mean ΔSV, ΔSV0.4, and ΔSV0.5 were compared between healthy volunteers and asthmatics. In asthmatics, correlation between air trapping indexes and clinical parameters were assessed.

Results

Mean ΔSV, ΔSV0.4, and ΔSV0.5 in asthmatics were significantly higher than those in healthy volunteer group (all p < 0.05). ΔSV values in posterior lung in asthmatics were significantly higher than those in healthy volunteer group (p = 0.049). In asthmatics, air trapping indexes, such as ΔSV0.5 and ΔSV0.4, showed negative strong correlation with FEF25-75, FEV1, and FEV1/FVC. ΔSV map of asthmatics showed abnormal geographic pattern in 5 patients (55.6%) and disappearance of anterior-posterior gradient in 3 patients (33.3%).

Conclusion

Quantitative assessment of ΔSV (the ratio of air fraction released after exhalation) shows the difference in extent of air trapping between health volunteers and asthmatics.  相似文献   
106.
目的:分析外科门诊病人挂错号的类别及原因,提出整改措施,减少病人挂号错误的发生率。方法:采用抽样与问卷调查相结合方式,以2010年第2季度门诊外科的病人挂号数量作为统计样本,对病人挂错号的种类及原因进行归纳总结。结果:门诊病人挂错号的原因主要包括病人自身、挂号工作人员以及其他间接因素三方面,并对此提出了相应的整改措施。结论:通过提高对病人普及医学常识的宣传力度、提升挂号工作人员的医学专业水平及优化挂号流程的相关措施,2011年门诊外科挂错号的百分比下降到0.83%,较2010年同期下降了84%。  相似文献   
107.
Abstract Introduction:   Preparation is essential to cope with the challenge of providing optimal care when there is a sudden, unexpected surge of casualties due to a disaster or major incident. By definition, the requirements of such cases exceed the standard care facilities of hospitals in qualitative or quantitative respects and interfere with the care of regular patients. To meet the growing demands to be prepared for disasters, a permanent facility to provide structured, prepared relief in such situations was developed. Methods:   A permanent but reserved Major Incident Hospital (MIH) has been developed through cooperation between a large academic medical institution, a trauma center, a military hospital, and the National Poison Information Centre (NVIC). The infrastructure, organization, support systems, training and systematic working methods of the MIH are designed to create order in a chaotic, unexpected situation and to optimize care and logistics in any possible scenario. Focus points are: patient flow and triage, registration, communication, evaluation and training. Research and the literature are used to identify characteristic pitfalls due to the chaos associated with and the unexpected nature of disasters, and to adapt our organization. Results:   At the MIH, the exceptional has become the core business, and preparation for disaster and large-scale emergency care is a daily occupation. An Emergency Response Protocol enables admittance to the normally dormant hospital of up to 100 (in exceptional cases even 300) patients after a start-up time of only 15 min. The Patient Barcode Registration System (PBR) with EAN codes guarantees quick and adequate registration of patient data in order to facilitate good medical coordination and follow-up during a major incident. Discussion:   The fact that the hospital is strictly reserved for this type of care guarantees availability and minimizes impact on normal care. When it is not being used during a major incident, there is time to address training and research. Collaboration with the NVIC and infrastructural adjustments enable us to not only care for patients with physical trauma, but also to provide centralized care of patients under quarantine conditions for, say, MRSA, SARS, smallpox, chemical or biological hazards. Triage plays an important role in medical disaster management and is therefore key to organization and infrastructure. Caps facilitate role distribution and recognizibility. The PBR resulted in more accurate registration and real-time availability of patient and group information. Infrastructure and a plan is not enough; training, research and evaluation are necessary to continuously work on disaster preparedness. Conclusion:   The MIH in Utrecht (Netherlands) is a globally unique facility that can provide immediate emergency care for multiple casualties under exceptional circumstances. Resulting from the cooperation between a large academic medical institution, a trauma center, a military hospital and the NVIC, the MIH offers not only a good and complete infrastructure but also the expertise required to provide large-scale emergency care during disasters and major incidents.  相似文献   
108.
A number of recent food safety incidents have involved chemical substances, while various activities aim at the early identification of emerging chemical risks. This review considers recent cases of chemical and biochemical risks, as a basis for recommendations for awareness and prevention of similar risks at an early stage. These cases include examples of unapproved genetically modified food crops, intoxications with botanical products containing unintentionally admixed toxic herbs, residues of unapproved antibiotics and contaminants in farmed aquaculture species such as shrimp and salmon; and adverse effects of chemical and biological pesticides of natural origin. Besides case-specific recommendations for mitigation of future incidents of the same nature, general inferences and recommendations are made. It is recommended, for example, to establish databases for contaminants potentially present within products. Pro-active reconnaissance can facilitate the identification of products potentially contaminated with hazardous substances. In international trade, prevention and early identification of hazards are aided by management systems for product quality and safety, rigorous legislation, and inspections of consignments destined for export. Cooperation with the private sector and foreign authorities may be required to achieve these goals. While food and feed safety are viewed from the European perspective, the outcomes also apply to other regions.  相似文献   
109.
目的:描述2003-2007年中国女性乳腺癌的发病和死亡情况.方法:从经审核合格的全国32个肿瘤登记点收集2003-2007年女性乳腺癌发病、死亡和相应的人口数据,对数据进行汇总和描述分析.结果:2003-2007年全国32个肿瘤登记点女性乳腺癌合计发病率为41.64/10万,居女性癌症发病的第1位;合计死亡率为9.63/10万,居女性癌症死因的第6位.女性乳腺癌在全国城市地区的发病率和死亡率均高于农村地区,城市地区发病率是农村地区的3.04倍,城市地区死亡率是农村地区的1.92倍.肿瘤登记点合计女性乳腺癌发病率在GLOBOCAN 2008统计的184个国家中排位第110位,死亡率排位第172位.结论:女性乳腺癌已经成为中国女性最常见的癌症之一,中国城市女性乳腺癌的发病率和死亡率水平显著高于农村,但中国女性乳腺癌的发病率和死亡率在世界范围仍处于中低水平.  相似文献   
110.
BackgroundSex work is partially regulated in Tijuana, but little is known of its health effects. A recent behavioural intervention amongst female sex workers (FSWs) decreased incidence of HIV/STIs by 40%. We evaluated effects of sex worker regulation on condom use amongst FSWs randomized to this intervention.MethodsFSWs aged ≥18 years who reported unprotected sex with ≥1 client in the last 2 months and whether they were registered with Tijuana's Municipal Health Department underwent a brief, theory-based behavioural intervention to increase condom use. At baseline and 6 months, women underwent interviews and testing for HIV, syphilis, Chlamydia trachomatis and Neisseria gonorrhoeae. Negative binomial regression was used to determine the effect of registration on numbers of unprotected sex acts and cumulative HIV/STI incidence.ResultsOf 187 women, 83 (44%) were registered. Lack of registration was associated with higher rates of unprotected sex (rate ratio: 1.7, 95% CI: 1.2–2.3), compared to FSWs who were registered, after controlling for potential confounders.ConclusionsRegistration predicted increased condom use amongst FSWs enrolled in a behavioural intervention. Public health programmes designed to improve condom use amongst FSWs may benefit from understanding the impact of existing regulation systems on HIV risk behaviours.  相似文献   
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