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31.
Clinical efficacy of amiodarone as an antiarrhythmic agent   总被引:28,自引:0,他引:28  
Amiodarone, administered orally in doses of 200 to 600 mg/day, was remarkably effective in the treatment and prevention of a wide variety of atrial and ventricular arrhythmias. Total suppression and control was provided in 98 (92.4 percent) of 106 patients with supraventricular arrhythmias and in 119 (82 percent) of 145 patients with ventricular arrhythmias. The rates of total control of the arrhythmia were: 96.6 percent in 30 patients with recurrent atrial flutter or fibrillation, 96.6 percent in 59 patients with repetitive supraventricular tachycardia, 100 percent in 27 patients with Wolff-Parkinson-White syndrome and 77.2 percent in 44 patients with recurrent ventricular tachycardia unsuccessfully treated with other drugs. Excellent results were obtained in 6 of 8 patients with repetitive ventricular tachycardia and ventricular fibrillation related to postinfarction ventricular aneurysm and in 12 of 14 patients with ventricular extrasystoles and ventricular tachycardia related to Chagasic myocarditis. Amiodarone proved safe in patients with severe congestive heart failure and severe myocardial damage. Its clinical efficacy was related to its electrophysiologic properties and to two unique properties: its wide safety margin and its cumulative effect. The latter liberates patients from a rigid hourly schedule and provides for continuous antiarrhythmic control, days and even weeks after treatment is discontinued.  相似文献   
32.

Background

Work engagement is a positive, fulfilling affective and motivational state of work-related wellbeing and a protective factor for workers' mental health. The aim of the present study was to examine the association between psychological distress (conceptualised as the target variable), job satisfaction, and work engagement in contexts of low-intensity warfare and political violence. According to the salutogenic perspective, the relationship between job satisfaction and psychological distress is influenced by the level of work engagement.

Methods

We selected a convenience sample of 380 Palestinian teachers from Gaza (40%, 152 out of 380) and the West Bank (60%, 228 out of 380). The participants were recruited on-site during morning breaks from the classroom teaching activity. The selection criteria were being in a teaching position, and working in a primary or lower secondary school. The participants completed the Arabic versions of the Teacher Job satisfaction Scale (TJSS-9), the General Health Questionnaire (GHQ-12) and the Utrecht Work Engagement Scale (UWE-SF). The statistical strategy was based on structural equation modelling. The study was approved by the Ethical Board of the University of Milano Bicocca. Informed written consent was obtained from all participants.

Findings

The General Health Questionnaire cumulative score revealed a medium to high level of psychological distress (mean 18·68 [SD 4·03]) among teachers, but high job satisfaction (mean 27·18 [SD 5·65]). The structural model showed an excellent fit (χ2 (23)=69·6, p<0·0001, NC=3·021, NFI=0·939, NNFI=0·959, CFI=0·958, RMSEA=0·073). Job satisfaction and psychological distress had a moderate and inverse relationship that was, statistically speaking, fully mediated by the level of work engagement (F=17·05, p<0·001, R2=0·16). The direct effect of job satisfaction on work engagement was positive and medium (according to Cohen, 1988) in strength.

Interpretation

The main finding of the study is that work engagement may mediate the impact of job satisfaction on teachers' psychological distress by lessening the effect of difficult working conditions. It further suggests that in order to mediate the effect of low job satisfaction on psychological distress of teachers, organisational policies and practices should focus on improving employees' work engagement. This means that, in developing job programmes for teachers in contexts characterised by difficult working conditions, the main focus must be to increase the level of subjective resources (eg, inner states, emotional activation, personal motivational processes) and workers' engagement rather than focusing primarily on job satisfaction.

Funding

None.  相似文献   
33.
目的 探索互联网+”健康教育模式在乳腺外科的构建及应用效果。方法 选择2019年3月至2020年3月在河北大学附属医院乳腺外科手术治疗的160例乳腺癌(breast cancer,BC)患者作为研究对象,按照入院先后顺序分为对照组和观察组,每组80例。对照组采取传统健康宣教模式,观察组在对照组的传统健康教育模式基础上,重点运用317护”微信平台开展健康宣教。比较干预后两组患者健康教育内容掌握情况、依从性以及患者满意度指标。结果 干预后,观察组乳腺癌患者健康教育内容掌握情况、依从性、满意度评分均明显高于对照组,差异均有统计学意义(P<0.05)。结论 互联网+”健康教育模式在乳腺外科的应用效果较传统健康教育方式有显著优势, 值得临床推广应用。  相似文献   
34.
My effort here is to try to clarify some of the historical and also political bases for the ways relational” and interpersonal” intersect and overlap and how they diverge, and some of the issues involved. I describe also how I locate my own conception of working at the intimate edge” in historical context in this framework, and why I believe that a recognition of the intersubjective nature of the analytic field requires a radical reconceptualization of how we think about the analytic process, the data of analysis, the analyst's role in the process, and the nature of therapeutic action.  相似文献   
35.
Background: Deficits in the production of complex structures have been widely documented in non-fluent forms of aphasia. Nevertheless, the data available on fluent deficits are scarcer. In both cases, reduced complexity is attributed to syntactic factors. In the related field of syntactic theory, there exist a number of studies on the production of non-brain damaged (NBD) subjects which try to account for the existence of two alternative constructions in embedded complement clauses in English (as in I think that the situation will improve/I think the situation will improve). The absence of that in the embedded clauses of verbs like say, know or think in colloquial English is very frequent and this suggests that verbs of this type may select a clause lacking a complementiser phrase (CP) layer, namely tense phrase (TP). The presence of that is taken to be the result of insertion, which is triggered by cues associated to contextual factors like register.

Aims: To compare the presence and absence of the complementiser that in the speech of English subjects diagnosed with aphasia with the same phenomenon in NBD subjects with the objective of clarifying the nature of the phenomenon of that-omission.

Methods &; Procedures: We carried out an analysis of spontaneous speech that included the performance of 200 individuals brought together by the AphasiaBank project. Two groups were included in the study, an experimental group comprising 100 individuals diagnosed as aphasic according to the standards of the Western Aphasia Battery (WAB), and a control group including 100 non-brain damaged control subjects ( NBDs).

Outcomes &; Results: This study shows that the asymmetries across populations (NBDs vs. subjects with aphasia) are restricted to the number of occurrences of subordinate clauses. NBD subjects produce more embeddings than subjects diagnosed with fluent aphasia (although they do produce embedded clauses and crucially prefer the omission” option) and subjects with non-fluent aphasia.

Conclusions: Our results confirm the findings on fluent aphasias as for the presence of deficits with complex constructions. These results may be regarded as evidence for the claim that TP is the default selection for the verbs analysed.  相似文献   
36.
PurposeTo identify clinical and imaging variables associated with symptomatic recurrence of osteoid osteomas (OOs) treated with computerized tomography (CT)–guided radiofrequency (RF) ablation.Materials and MethodsSeventy-one patients treated with the use of CT-guided RF ablation for OO at a single institution from July 2005 to May 2018 were included in this retrospective cohort analysis. Clinical data, including patient age, sex, race, and clinical outcomes, were collected from institutional electronic health records and telephone follow-up. Imaging variables regarding tumor characteristics were gathered from imaging reports and a blinded review of preprocedural images by an experienced musculoskeletal radiologist. Logistic regression, Cox proportional hazards, and Kaplan-Meier analyses were used to identify variables that are significantly associated with symptomatic recurrence, which was defined as pain occurring > 2 weeks after RF ablation.ResultsTen patients (14.1%) experienced symptomatic recurrence at a median of 21.5 months after RF ablation. Univariable logistic regression classified young age (≤ 13 years), female sex, maximum tumor length, and eccentricity index” (EI) ≥ 3 as predictive variables significantly associated with symptomatic recurrence. Multivariable logistic regression identified female sex and EI ≥ 3 to be significant predictors for symptomatic recurrence. A multivariable proportional hazards Cox regression of time to recurrence revealed EI ≥ 3 to be the only significant predictor of symptomatic recurrence.ConclusionsFemale patients with OOs with an EI ≥ 3 have a greater risk of symptomatic recurrence following RF ablation. The EI is a useful tool to identify OOs with elongated 3-dimensional morphology, which may warrant more extensive ablation.  相似文献   
37.
The aim of the study is to demonstrate the successful use of Hour 1” transfer of sperm microinjected oocytes in natural cycles of poor responder women. Seventy women were selected from 92 consecutive poor responders undergoing intracytoplasmatic sperm injection (ICSI) in a natural cycle at our Sterility and Assisted Reproduction Unit from September 2009 to July 2013, and randomly distributed in two homogeneous groups: Group A or B. Women in Group A (35) underwent transfer within 1 h after ICSI; Group B (35, control group) underwent transfer 3 days after ICSI. In Group A, seven clinical pregnancy and one miscarriage occurred; in Group B, eight clinical pregnancies and two miscarriages were observed. Pregnancy, miscarriage, term pregnancy and overall live birth rates’ difference between the two groups was not statistically significant (p?>?0.05). Difference between the two groups in terms of timing, type of delivery and newborn birthweight was not observed. Neither ectopic pregnancy nor multiple pregnancies occurred. Hour 1” uterine transfer of ICSI oocytes, still to be considered with caution because of the relatively low number of observations of the pilot study, deserves further attention on a larger scale, and might be evaluated for clinical and financial effectiveness in other clinical settings.  相似文献   
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