全文获取类型
收费全文 | 128009篇 |
免费 | 8242篇 |
国内免费 | 3434篇 |
专业分类
耳鼻咽喉 | 541篇 |
儿科学 | 2385篇 |
妇产科学 | 2008篇 |
基础医学 | 15900篇 |
口腔科学 | 2337篇 |
临床医学 | 8294篇 |
内科学 | 25255篇 |
皮肤病学 | 1699篇 |
神经病学 | 13107篇 |
特种医学 | 1779篇 |
外国民族医学 | 38篇 |
外科学 | 12103篇 |
综合类 | 12113篇 |
现状与发展 | 7篇 |
一般理论 | 3篇 |
预防医学 | 7199篇 |
眼科学 | 1108篇 |
药学 | 19391篇 |
45篇 | |
中国医学 | 4362篇 |
肿瘤学 | 10011篇 |
出版年
2023年 | 1889篇 |
2022年 | 3170篇 |
2021年 | 4592篇 |
2020年 | 3864篇 |
2019年 | 5729篇 |
2018年 | 5093篇 |
2017年 | 4366篇 |
2016年 | 3531篇 |
2015年 | 3714篇 |
2014年 | 6450篇 |
2013年 | 7732篇 |
2012年 | 6045篇 |
2011年 | 6903篇 |
2010年 | 5524篇 |
2009年 | 5447篇 |
2008年 | 5793篇 |
2007年 | 5230篇 |
2006年 | 4434篇 |
2005年 | 3753篇 |
2004年 | 3400篇 |
2003年 | 3123篇 |
2002年 | 2458篇 |
2001年 | 2137篇 |
2000年 | 1892篇 |
1999年 | 1662篇 |
1998年 | 1792篇 |
1997年 | 1634篇 |
1996年 | 1485篇 |
1995年 | 1208篇 |
1994年 | 1136篇 |
1993年 | 973篇 |
1992年 | 769篇 |
1991年 | 684篇 |
1990年 | 520篇 |
1989年 | 451篇 |
1988年 | 370篇 |
1986年 | 361篇 |
1985年 | 1819篇 |
1984年 | 2781篇 |
1983年 | 2482篇 |
1982年 | 1957篇 |
1981年 | 2003篇 |
1980年 | 1641篇 |
1979年 | 1396篇 |
1978年 | 1198篇 |
1977年 | 699篇 |
1976年 | 1139篇 |
1975年 | 1002篇 |
1974年 | 825篇 |
1973年 | 780篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
21.
Susan E. Hickman Alexia M. Torke Greg A. Sachs Rebecca L. Sudore Anne L. Myers Qing Tang Giorgos Bakoyannis Bernard J. Hammes 《Journal of pain and symptom management》2019,57(6):1143-1150.e5
ContextIt is especially important that patients are well informed when making high-stakes, preference-sensitive decisions like those on the Physician Orders for Life-Sustaining Treatment (POLST) form. However, there is currently no way to easily evaluate whether patients understand key concepts when making these important decisions.ObjectivesTo develop a POLST knowledge survey.MethodsExpert (n = 62) ratings of key POLST facts were used to select items for a POLST knowledge survey. The survey was administered to nursing facility residents (n = 97) and surrogate decision-makers (n = 112). A subset (n = 135) were re-administered the survey after a standardized advance care planning discussion to assess the scale's responsiveness to change.ResultsThe 19-item survey demonstrated adequate reliability (α = 0.72.). Residents' scores (x = 11.4, standard deviation 3.3) were significantly lower than surrogate scores (x = 14.7, standard deviation 2.5) (P < 0.001). Scores for both groups increased significantly after administration of a standardized advance care planning discussion (P < 0.001). Although being a surrogate, age, race, education, cognitive functioning, and health literacy were significantly associated with higher POLST Knowledge Survey scores in univariate analyses, only being a surrogate (P < 0.001) and being white (P = 0.028) remained significantly associated with higher scores in multivariate analyses.ConclusionThe 19-item POLST Knowledge Survey demonstrated adequate reliability and responsiveness to change. Findings suggest the survey could be used to identify knowledge deficits and provide targeted education to ensure adequate understanding of key clinical decisions when completing POLST. 相似文献
22.
《Vaccine》2022,40(11):1594-1605
In addition to providing pathogen-specific immunity, vaccines can also confer nonspecific effects (NSEs) on mortality and morbidity unrelated to the targeted disease. Immunisation with live vaccines, such as the BCG vaccine, has generally been associated with significantly reduced all-cause infant mortality. In contrast, some inactivated vaccines, such as the diphtheria, tetanus, whole-cell pertussis (DTPw) vaccine, have been controversially associated with increased all-cause mortality especially in female infants in high-mortality settings. The NSEs associated with BCG have been attributed, in part, to the induction of trained immunity, an epigenetic and metabolic reprograming of innate immune cells, increasing their responsiveness to subsequent microbial encounters. Whether non-live vaccines such as DTPw induce trained immunity is currently poorly understood. Here, we report that immunisation of mice with DTPw induced a unique program of trained immunity in comparison to BCG immunised mice. Altered monocyte and DC cytokine responses were evident in DTPw immunised mice even months after vaccination. Furthermore, splenic cDCs from DTPw immunised mice had altered chromatin accessibility at loci involved in immunity and metabolism, suggesting that these changes were epigenetically mediated. Interestingly, changing the order in which the BCG and DTPw vaccines were co-administered to mice altered subsequent trained immune responses. Given these differences in trained immunity, we also assessed whether administration of these vaccines altered susceptibility to sepsis in two different mouse models. Immunisation with either BCG or a DTPw-containing vaccine prior to the induction of sepsis did not significantly alter survival. Further studies are now needed to more fully investigate the potential consequences of DTPw induced trained immunity in different contexts and to assess whether other non-live vaccines also induce similar changes. 相似文献
23.
24.
Can EGFR mutation status be reliably determined in pre‐operative needle biopsies from adenocarcinomas of the lung?
下载免费PDF全文
![点击此处可从《APMIS : acta pathologica, microbiologica, et immunologica Scandinavica》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Kim Hein Lindahl Flemming Brandt Sørensen Søren Peter Jonstrup Karen Ege Olsen Siegfried Loeschke 《APMIS : acta pathologica, microbiologica, et immunologica Scandinavica》2015,123(4):289-297
The identification of EGFR mutations in non‐small‐cell lung cancer is important for selecting patients, who may benefit from treatment with EGFR tyrosine kinase inhibitors. The analysis is usually performed on cytological aspirates and/or histological needle biopsies, representing a small fraction of the tumour volume. The aim of the present investigation was to evaluate the diagnostic performance of this molecular test. We retrospectively included 201 patients with primary adenocarcinoma of the lung. EGFR mutation status (exon 19 deletions and exon 21 L858R point mutation) was evaluated on both pre‐operative biopsies (131 histological and 70 cytological) and on the surgical specimens, using PCR. Samples with low tumour cell fraction were assigned to laser micro‐dissection (LMD). We found nine (4.5%) patients with EGFR mutation in the lung tumour resections, but failed to identify mutation in one of the corresponding pre‐operative, cytological specimens. Several (18.4%) analyses of the pre‐operative biopsies were inconclusive, especially in case of biopsies undergoing LMD and regarding exon 21 analysis. Discrepancy of mutation status in one patient may reflect intra‐tumoural heterogeneity or technical issues. Moreover, several inconclusive results in the diagnostic biopsies reveal that attention must be paid on the suitability of pre‐operative biopsies for EGFR mutation analysis. 相似文献
25.
Sophocarpine attenuates toll‐like receptor 4 in steatotic hepatocytes to suppress pro‐inflammatory cytokines synthesis
下载免费PDF全文
![点击此处可从《Journal of gastroenterology and hepatology》网站下载免费的PDF全文](/ch/ext_images/free.gif)
26.
27.
目的调查镇江市各医院护士分层培训及分层进阶的方法及现状。方法2018年4—5月间采用自行设计的调查问卷,对全市医院的护理人员进行随机抽样调查。结果调查显示镇江市96.45%的护士受医院分层培训及分层进阶这一模式的管理。其中N1占16.77%,N2占29.5%,N3占41.9%,N4占8.7%,其他占3.11%。有24.53%的护士对医院目前的分层培训方式感到满意并认为无需改进,40.99%的护士表示满意,但需要改进,29.19%的护士表示基本满意,需要改进,5.28%的护士表示不满意需要较大改进。95.82%的医院科室对不用层级的护士有不同的核心能力要求并根据不同核心能力要求进行培训。结论护士分层培训几分层进阶这一管理模式在镇江各医院都有体现,但各医院实行的方式有较大差异,配套的管理方式也有待完善。 相似文献
28.
Claire Letournel François Babinet Bénédicte Allard Vincent Montecot 《Néphrologie & thérapeutique》2019,15(1):51-58
Objective
The “Centre Hospitalier Francois Dunan” is located on an isolated island and ensures patients care in hemodialysis thanks to telemedicine support. Many research studies have demonstrated the importance of hemodialysis fluids composition to reduce morbidity in patients on chronic hemodialysis. The aim of this study was to identify the risks inherent in the production of dialysis fluids in a particular context, in order to set up an improvement action plan to improve risk control on the production of dialysis fluids.Methods
The risk analysis was conducted with the FMECA methodology (Failure Mode, Effects and Criticality Analysis) by a multi professional work group. Three types of risk have been reviewed: technical risks that may impact the production of hemodialysis fluids, health risks linked with chemical composition and health risks due to microbiological contamination of hemodialysis fluids.Results
The work group, in close cooperation with the expert staff of the dialysis center providing telemedicine assistance, has developed an action plan in order to improve the control of the main risks brought to light by the risk analysis.Conclusion
The exhaustive analysis of the risks and their prioritisation have permitted to establish a relevant action plan in this improving quality of dialysis fluids approach. The risk control of dialysis fluids is necessary for the security of dialysis sessions for patients, even more when these sessions are realized by telemedicine in Saint-Pierre-et-Miquelon. 相似文献29.
30.