收费全文 | 33173篇 |
免费 | 3625篇 |
国内免费 | 984篇 |
耳鼻咽喉 | 284篇 |
儿科学 | 545篇 |
妇产科学 | 385篇 |
基础医学 | 3272篇 |
口腔科学 | 355篇 |
临床医学 | 8222篇 |
内科学 | 4844篇 |
皮肤病学 | 126篇 |
神经病学 | 2223篇 |
特种医学 | 2678篇 |
外科学 | 2728篇 |
综合类 | 4537篇 |
现状与发展 | 2篇 |
一般理论 | 3篇 |
预防医学 | 3690篇 |
眼科学 | 277篇 |
药学 | 1560篇 |
270篇 | |
中国医学 | 1242篇 |
肿瘤学 | 539篇 |
2024年 | 184篇 |
2023年 | 820篇 |
2022年 | 1512篇 |
2021年 | 1968篇 |
2020年 | 2036篇 |
2019年 | 1533篇 |
2018年 | 1436篇 |
2017年 | 1559篇 |
2016年 | 1373篇 |
2015年 | 1325篇 |
2014年 | 2492篇 |
2013年 | 3008篇 |
2012年 | 1991篇 |
2011年 | 1893篇 |
2010年 | 1619篇 |
2009年 | 1411篇 |
2008年 | 1395篇 |
2007年 | 1263篇 |
2006年 | 1070篇 |
2005年 | 881篇 |
2004年 | 751篇 |
2003年 | 701篇 |
2002年 | 552篇 |
2001年 | 539篇 |
2000年 | 456篇 |
1999年 | 362篇 |
1998年 | 329篇 |
1997年 | 300篇 |
1996年 | 320篇 |
1995年 | 276篇 |
1994年 | 210篇 |
1993年 | 240篇 |
1992年 | 262篇 |
1991年 | 182篇 |
1990年 | 164篇 |
1989年 | 137篇 |
1988年 | 169篇 |
1987年 | 163篇 |
1986年 | 121篇 |
1985年 | 121篇 |
1984年 | 107篇 |
1983年 | 74篇 |
1982年 | 87篇 |
1981年 | 72篇 |
1980年 | 85篇 |
1979年 | 48篇 |
1978年 | 37篇 |
1977年 | 32篇 |
1976年 | 31篇 |
1975年 | 29篇 |
Introduction
Physician communication impacts patient outcomes. However, communication skills, especially around difficult conversations, remain suboptimal, and there is no clear way to determine the validity of entrustment decisions. The aims of this study were to 1) describe the development of a simulation-based mastery learning (SBML) curriculum for breaking bad news (BBN) conversation skills and 2) set a defensible minimum passing standard (MPS) to ensure uniform skill acquisition among learners.Innovation
An SBML BBN curriculum was developed for fourth-year medical students. An assessment tool was created to evaluate the acquisition of skills involved in a BBN conversation. Pilot testing was completed to confirm improvement in skill acquisition and set the MPS.Outcomes
A BBN assessment tool containing a 15-item checklist and six scaled items was developed. Students' checklist performance improved significantly at post-test compared to baseline (mean 65.33%, SD = 12.09% vs mean 88.67%, SD = 9.45%, P < 0.001). Students were also significantly more likely to have at least a score of 4 (on a five-point scale) for the six scaled questions at post-test. The MPS was set at 80%, requiring a score of 12 items on the checklist and at least 4 of 5 for each scaled item. Using the MPS, 30% of students would require additional training after post-testing.Comments
We developed a SBML curriculum with a comprehensive assessment of BBN skills and a defensible competency standard. Future efforts will expand the mastery model to larger cohorts and assess the impact of rigorous education on patient care outcomes. 相似文献Objectives
The current study investigated the effects of two exercise interventions on cognitive function amongst breast cancer survivors.Design
Pilot randomised-controlled trial.Methods
Seventeen female cancer survivors (mean: 62.9 ± 7.8 years) were randomised into three groups: high-intensity interval training (HIIT, n = 6); moderate-intensity continuous training (MOD, n = 5); or wait-list control (CON, n = 6). The HIIT and MOD groups exercised on a cycle ergometer 3 days/week for 12-weeks. Primary outcomes were cognitive function assessments utilising CogState. Secondary outcomes were resting middle cerebral artery blood flow velocity, cerebrovascular reactivity and aerobic fitness (VO2peak). Data were analysed with General Linear Mixed Models and Cohen’s d effect sizes were calculated.Results
All 17 participants who were randomised were available for follow-up analysis and adherence was similar for HIIT and MOD (78.7 ± 13.2% vs 79.4 ± 12.0%; p = 0.93). Although there were no significant differences in the cognitive and cerebrovascular outcomes, HIIT produced moderate to large positive effects in comparison to MOD and CON for outcomes including episodic memory, working memory, executive function, cerebral blood flow and cerebrovascular reactivity. HIIT significantly increased VO2peak by 19.3% (d = 1.28) and MOD had a non-significant 5.6% (d = 0.72) increase, compared to CON which had a 2.6% decrease.Conclusions
This study provides preliminary evidence that HIIT may be an effective exercise intervention to improve cognitive performance, cerebrovascular function and aerobic fitness in breast cancer survivors. Considering the sample size is small, these results should be confirmed through larger clinical trials. 相似文献Methods: Forty male Sprague–Dawley 10-week-old rats, weighing 300 ± 50 g, were subjected to photothrombotic cerebral infarction. The remaining 36 rats were randomly divided into four groups (n = 9 per group: non-exercise (group A); swimming exercise of short duration-intensity (5 min/day, group B); swimming exercise of moderate duration-intensity (10 min/day, group C); and swimming exercise of long duration-intensity (20 min/day, group D). Exercise was performed five times a week for 4 weeks, beginning the day after cerebral infarction. Neurocognitive function was evaluated with the Morris water maze test. Immunohistochemistry and western blot analysis examined brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) at 4 weeks postinfarction.
Results: At 4 weeks postinfarction, escape latency was found to be shorter in group C than in any of groups A, B, or D. Immunohistochemistry revealed the most significant immunoreactivity for BDNF and VEGF in group C. Western blot analysis demonstrated that BDNF and VEGF proteins were markedly expressed in group C.
Conclusions: Regular swimming exercise of moderate duration-intensity may be the most effective exercise protocol for the recovery of neurocognitive function in cerebral infarction rat model. 相似文献