全文获取类型
收费全文 | 980篇 |
免费 | 21篇 |
国内免费 | 4篇 |
专业分类
耳鼻咽喉 | 5篇 |
儿科学 | 12篇 |
妇产科学 | 37篇 |
基础医学 | 89篇 |
口腔科学 | 7篇 |
临床医学 | 42篇 |
内科学 | 152篇 |
皮肤病学 | 12篇 |
神经病学 | 73篇 |
特种医学 | 10篇 |
外科学 | 130篇 |
综合类 | 11篇 |
预防医学 | 285篇 |
眼科学 | 9篇 |
药学 | 41篇 |
中国医学 | 2篇 |
肿瘤学 | 88篇 |
出版年
2023年 | 34篇 |
2022年 | 40篇 |
2021年 | 41篇 |
2020年 | 51篇 |
2019年 | 48篇 |
2018年 | 44篇 |
2017年 | 40篇 |
2016年 | 21篇 |
2015年 | 18篇 |
2014年 | 66篇 |
2013年 | 59篇 |
2012年 | 39篇 |
2011年 | 63篇 |
2010年 | 50篇 |
2009年 | 71篇 |
2008年 | 75篇 |
2007年 | 48篇 |
2006年 | 44篇 |
2005年 | 26篇 |
2004年 | 16篇 |
2003年 | 15篇 |
2002年 | 17篇 |
2001年 | 9篇 |
2000年 | 4篇 |
1999年 | 12篇 |
1998年 | 6篇 |
1997年 | 7篇 |
1996年 | 6篇 |
1995年 | 3篇 |
1994年 | 1篇 |
1993年 | 5篇 |
1992年 | 2篇 |
1991年 | 1篇 |
1990年 | 3篇 |
1989年 | 1篇 |
1988年 | 2篇 |
1986年 | 1篇 |
1984年 | 1篇 |
1983年 | 6篇 |
1978年 | 1篇 |
1977年 | 1篇 |
1976年 | 1篇 |
1975年 | 2篇 |
1974年 | 1篇 |
1973年 | 2篇 |
1971年 | 1篇 |
排序方式: 共有1005条查询结果,搜索用时 78 毫秒
31.
Erin C. Peckham-Gregory Kenneth L. McClain Carl E. Allen Michael E. Scheurer Philip J. Lupo 《Annals of epidemiology》2018,28(8):521-528
Purpose
Potential roles of inherited and environmental risk factors in pathogenesis of Langerhans cell histiocytosis (LCH), a myeloid neoplastic disorder, are undefined. We therefore evaluated the role of parental and perinatal factors on the risk of this childhood cancer.Methods
Information on LCH cases (n = 162) for the period 1995–2011 was obtained from the Texas Cancer Registry. Birth certificate controls were frequency-matched on year of birth at a ratio of 10:1 for the same period. Variables evaluated included parental age, race/ethnicity, size for gestational age, and birth order. Logistic regression was used to generate an adjusted odds ratio (aOR) and 95% confidence interval (CI) testing the association between each factor and LCH.Results
Few perinatal or parental factors were associated with LCH risk, with the exception of race/ethnicity. Mothers of Hispanic ethnicity were more likely to have children who developed LCH compared to non-Hispanic whites (aOR: 1.51; 95% CI: 1.02–2.25). This risk increased when both parents were Hispanic (aOR: 1.80; 95% CI: 1.13–2.87). Non-Hispanic black mothers were suggested as less likely to give birth to offspring who developed LCH compared to non-Hispanic whites (aOR: 0.50; 95% CI: 0.24–1.02).Conclusions
LCH is characterized by somatic mutations in MAPK pathway genes in myeloid precursors. Increased risk for LCH in children of Hispanic parents suggests potential impact of inherited factors on LCH pathogenesis. 相似文献32.
33.
Matthew J. Orringer Madeleine A. Salesky Matt Callahan Brian T. Feeley 《Seminars in Arthroplasty》2022,32(3):437-443
BackgroundPrevious research has highlighted disparities in access to and outcomes following shoulder arthroplasty. The purpose of this study is to compare travel distance for primary vs. revision surgery and to determine the relationships between travel distance to undergo revision shoulder arthroplasty and patient demographics and postoperative adverse outcomes. We hypothesized that older patients, those with increased medical comorbidities, and those with greater financial resources would travel farther for surgery.MethodsThe Healthcare Cost and Utilization Project, American Hospital Association, and UnitedStatesZipCodes.org Enterprise data sets were compiled to collect data on patient demographics, operation performed, and postoperative adverse outcomes. Population-weighted zip code centroid points of patients’ residences as well as hospital coordinates were used to approximate the distance traveled to undergo shoulder arthroplasty. Kruskal-Wallis tests and logistic regression analyses were used to analyze the relationship between travel distance and patients’ demographics and postoperative outcomes.ResultsPatients traveled farther to undergo revision shoulder arthroplasty than to undergo primary shoulder arthroplasty (P = .0001). Among patients who underwent revision operations, older age (P = .0001) and increased medical comorbidities (P = .003) were associated with decreased travel distance. White patients and those with commercial insurance traveled farther to receive care (P = .0001). There were no clinically significant associations between postoperative outcomes following revision surgery and travel distance.ConclusionPatients may travel farther to undergo revision surgery owing to patient preferences or because these complex operations are performed at fewer centers. Younger and healthier patients, white patients, and those with commercial insurance plans traveled farther to receive care. Future work is needed to determine the underlying causes of these disparities and whether it is patient preferences or systemic factors such as hospital density or access to high-quality health insurance that are influencing access to this specialized surgical care. 相似文献
34.
35.
《Surgery for obesity and related diseases》2020,16(10):1392-1400
BackgroundThe obesity rate for the Hispanic population is significantly higher than that of white, non-Hispanic people in the United States, yet Hispanic people undergo disproportionately fewer metabolic and bariatric surgery procedures. This study used the Metabolic Bariatric Surgery Accreditation and Quality Improvement Program data registry to examine potential differences in preoperative co-morbidities and postoperative outcomes in Hispanic adults undergoing sleeve gastrectomy or Roux-en-Y gastric bypass procedures in the United States.ObjectivesTo study the presence of the Hispanic paradox in metabolic and bariatric surgery utilizing the MBSAQIP registry.SettingAcademic Teaching Institution.MethodsParticipant User Files from the Metabolic Bariatric Surgery Accreditation and Quality Improvement Program were reviewed for patients undergoing sleeve gastrectomy or Roux-en-Y gastric bypass (2015–2017). Patients were grouped by race (Hispanic versus all other races) and primary procedure performed. Variables for major and minor postoperative complications were combined. A univariate analysis was performed on unmatched and propensity-matched cohorts.ResultsAfter applying exclusions, 53,353 (13.7%) Hispanic patients and 335,299 non-Hispanic patients remained. A univariate analysis demonstrated Hispanic patients had the lowest preoperative co-morbidity profile compared with all other races and decreased rates of major and minor postoperative complications. Using matched-cohort data, when complications were assessed and grouped as major/minor complications, rates of major and minor complications in Hispanic patients were lower in the Roux-en-Y gastric bypass group, despite Hispanic patients having higher leak rates. Similarly, there were no differences between Hispanic/non-Hispanic sleeve gastrectomy patients in overall major/minor complication rates despite Hispanic patients exhibiting higher venous thromboembolism and lower bleeding compared with non-Hispanic patients.ConclusionHispanic patients undergo disproportionately low rates of metabolic and bariatric surgery procedures and present with lower incidence of preoperative co-morbidities. Additionally, Hispanic patients have the same or decreased incidence of postoperative complications compared with non-Hispanic patients, thereby corroborating the Hispanic paradox. 相似文献
36.
Shemille A. Collingwood Russell B. McBride Michael Leapman Adele R. Hobbs Young Suk Kwon Kristian D. Stensland Rebecca M. Schwartz Matthew E. Pollard David B. Samadi 《Urologic oncology》2014,32(4):419-425
ObjectivesLongitudinal studies report racial disparities in prostate cancer (PCa) including greater incidence, more aggressive tumor biology, and increased cancer-specific mortality in African American (AA) men. Regret concerning primary treatment selection is underevaluated in patients with PCa. We investigated the relationships between clinicopathologic variables across racial and socioeconomic lines following robotic-assisted laparoscopic prostatectomy.Materials and methodsWe assessed treatment decisional regret using a validated questionnaire in a total of 484 white and 72 AA patients with PCa who were followed up for a median of 16.6 months post–robotic-assisted laparoscopic prostatectomy. Socioeconomic status (SES) information was aggregated from 2010 US census zip code data. Perioperative clinicopathologic characteristics and functional outcomes were compared between groups. Univariate and multivariate regression analyses were used to evaluate the influence of race, aggregate SES, and other clinical and demographic characteristics on decisional regret.ResultsThe majority (87.7%) of the population was not regretful of their decision to undergo treatment. However, a greater proportion of AA vs. white patients were regretful (20.6% vs. 11.2%, respectively; P = 0.03). AA and white men were similar on all functional, clinical, and pathologic features with the exception of younger age among AA men (56 vs. 60 y, respectively; P<0.001). Although there were significant differences in SES by race (P<0.001), regret did not differ by SES (β =?1.53; P = 0.15). Race, postoperative sexual dysfunction, pad usage, and length of hospital stay, however, were significantly associated with decisional regret.ConclusionsAA men were more regretful than white men, after adjusting for clinicopathologic characteristics and postoperative functional outcomes. 相似文献
37.
38.
Rebecca S. Gold Jonathan T. Unkart Robyn L. McClelland Alain G. Bertoni Matthew A. Allison 《Primary Care Diabetes》2021,15(2):378-384
AimsTo investigate associations of health insurance with measures of glucose metabolism, and whether associations vary by diabetes status or insurance type.MethodsCross-sectional analysis of baseline data from the Multi-Ethnic Study of Atherosclerosis. Cohort a priori stratified by age <65 (N = 3,665) and ≥65 years (N = 2,924). Multivariable linear and logistic regression assessed associations between insurance and fasting glucose, HOMA-IR, and prevalent diabetes, controlling for relevant confounders, including age, sex, race/ethnicity, income, and education.ResultsIn participants <65, compared to uninsured, having any insurance was associated with lower fasting glucose in participants with diabetes (Mean Difference = ?20.4 mg/dL, P = 0.01), but not in participants without diabetes. Compared to Private insurance, uninsured participants had higher fasting glucose (Mean Difference = 3.8 mg/dL, P = 0.03), while participants with Medicaid had higher HOMA-IR (Mean Difference = 3.5 mg/dL, P < 0.01). In participants ≥65, compared to Private insurance, uninsured participants (Mean Difference = 7.5 mg/dL, P = 0.02), and participants with Medicaid only (Mean Difference = 19.9 mg/dL, P < 0.01) or Medicare + Medicaid (Mean Difference = 5.2 mg/dL, P = 0.03) had higher fasting glucose.ConclusionsIn this large multiethnic cohort, having any insurance was associated with significantly lower fasting glucose for individuals with diabetes. Levels of fasting glucose and insulin resistance varied across different insurance types. 相似文献
39.
Aparna Vadlamani Justin A. Perry Maureen McCunn Deborah M. Stein Jennifer S. Albrecht 《Archives of physical medicine and rehabilitation》2019,100(9):1622-1628
ObjectiveTo determine if there were racial differences in discharge location among older adults treated for traumatic brain injury (TBI) at a level 1 trauma center.DesignRetrospective cohort study.SettingR Adams Cowley Shock Trauma Center.ParticipantsBlack and white adults aged ≥65 years treated for TBI between 1998 and 2012 and discharged to home without services or inpatient rehabilitation (N=2902).Main Outcome MeasuresWe assessed the association between race and discharge location via logistic regression. Covariates included age, sex, Abbreviated Injury Scale-Head score, insurance type, Glasgow Coma Scale score, and comorbidities.ResultsThere were 2487 (86%) whites and 415 blacks (14%) in the sample. A total of 1513 (52%) were discharged to inpatient rehabilitation and 1389 (48%) were discharged home without services. In adjusted logistic regression, blacks were more likely to be discharged to inpatient rehabilitation than to home without services compared to whites (odds ratio 1.34, 95% confidence interval, 1.06-1.70).ConclusionsIn this group of Medicare-eligible older adults, blacks were more likely to be discharged to inpatient rehabilitation compared to whites. 相似文献
40.
《The Journal of adolescent health》2014,54(6):724-729
PurposeTo explore relationships between harassment (i.e., race-, weight-, socioeconomic-status (SES)-based, and sexual) and health-related outcomes, including self-esteem, depressive symptoms, body satisfaction, substance use, and self-harm behavior, among diverse adolescents.MethodCross-sectional analysis using data from a population-based study of adolescents participating in Eating and Activity in Teens 2010 (EAT 2010) (n = 2,793; mean age = 14.4 years). Sample was socioeconomically and racially/ethnically diverse (81% racial/ethnic minority; 54% low or low-middle income).ResultsHaving experienced any type of harassment was significantly associated with poor self-esteem, depressive symptoms, low body satisfaction, substance use, and self-harm behaviors. After mutually adjusting for other types of harassment, weight-based harassment was consistently associated with lower self-esteem and lower body satisfaction in both genders (standardized βs ranged in magnitude from .39 to .48); sexual harassment was significantly associated with self-harm and substance use in both genders (ORs: 1.64 to 2.92); and both weight-based and sexual harassment were significantly associated with depressive symptoms among girls (standardized βs = .34 and .37). Increases in the number of different harassment types reported by adolescents were associated with elevated risk for alcohol, cigarette, and marijuana use, and self-harm (ORs: 1.22 to 1.42) as well as emotional well-being (standardized βs: .13 to .26).ConclusionsHaving had any harassment experience was significantly associated with a variety of negative health and well-being outcomes among adolescents, and risk for these outcomes increases with the number of harassment types an adolescent experiences. Early detection and intervention to decrease harassment experiences may be particularly important in mitigating psychological and behavioral harm among adolescents. 相似文献