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1.
Paul Roderick Ruth Davies Chris Jones Terry Feest Steve Smith Ken Farrington 《Nephrology, dialysis, transplantation》2004,19(3):692-701
BACKGROUND: The demand for renal replacement therapy (RRT) in England has risen steadily, although from a lower base than many other developed countries. Predicting the future demand for RRT and the impact of factors such as the acceptance rate, transplant supply and patient survival, is required in order to inform the planning of such services. METHODS: A discrete event simulation model estimates the future demand for RRT in England in 2010 for a range of scenarios. The model uses current prevalence and current and projected future acceptance rates, survival rates and the transitions between modalities to predict future patient numbers. National population and mortality data, published literature and data from the UK Renal Registry and UK Transplant, are used to estimate unmet need for RRT, the impact of changing demography and incidence of Type 2 diabetes, patient haemodialysis (HD) survival and transplant supply. RESULTS: By 2010 the predicted prevalence will have increased from about 30,000 in 2000 to between 42 and 51,000 (900-1000 p.m.p.), an average annual growth of 4.5-6%. Changing transplant supply has a small effect on overall numbers but changes the proportion of patients with functioning graft by up to 8%. Even with an optimistic increase in transplant supply (11% p.a. for 5 years), numbers on HD will continue to rise substantially, especially in the elderly. The factors most influencing future patient numbers are the acceptance rate and dialysis survival. CONCLUSION: This model predicts a substantial growth in the RRT population to 2010 to a rate approaching 1000 p.m.p., particularly in the elderly and those on HD, with a steady state not being reached for at least 25 years. 相似文献
2.
Christopher J. Holmgren Esmonde F. Corbet L. P. Lim 《Community dentistry and oral epidemiology》1994,22(5):396-402
Abstract The aim of this study was to describe the periodontal conditions in 372 35–44-yr-old and 537 noninstitutionalized 65–74-yr-old Hong Kong Chinese who were examined clinically for loss of attachment, recession, probing depth, calculus, and bleeding after probing. Community Periodontal Index (CPI) data and treatment need indications were compiled from index teeth or their substitutes. The prevalence of loss of attachment varied considerably in both cohorts according to the definition of the threshold (≥6, ≥9, and ≥12 mm, respectively). The mean numbers of teeth with loss of attachment at the ≥6-mm threshold and at higher thresholds were small. In both age cohorts, about one-fifth of subjects had probing depths ≥6-mm, while al the ≥9-mm threshold only 2–3% were so affected. Although recession was an important component of loss of attachment in the younger cohort, in the older cohort the prevalence and extent of recession were greater than for probing depths at thresholds ≥4 mm. All subjects had one or more teeth with calculus, bleeding, or both, most teeth being so affected. Eighty-four of the 537 65–74-yr-old subjects were excluded either because of edentulousness or because extractions indicated for the remaining teeth would have rendered the subjects edentulous. The distribution of subjects according to their highest CPI score was remarkably similar for the two cohorts. No subjects in either age group were assessed as “healthy” (CPI code 0) or had “bleeding only” (code 1) as their highest score. While most subjects scored CPI code 2 or 3 us their highest score, only 17% of the younger and 15% of the older cohort scored Community Periodontal Index of Treatment Needs (CPITN) code 4. Differences in the mean number of sextants affected by CPI codes between the two cohorts were mainly due to a greater number of excluded sextants in the older cohort. CPI findings for 35–44-yr-olds differed little from those reported in 1984. 相似文献
3.
汪国翠 《安徽卫生职业技术学院学报》2003,2(5):83-84
根据笔者在传染科病房工作中的体会,从六个方面针对传染科工作的特殊性和存在的共性分别阐述了传染科护士在工作中如何高标准、严要求自己,如何对病人做到到位的护理,旨在提高传染科病房的整体护理质量,从而把更多的实惠让利于患者。 相似文献
4.
R. J. Rona A. V. Swan R. Beech D. M. Wilson F. B. Kavanagh C. Brown C. Axtell S. Mandalia 《Clinical genetics》1992,42(4):186-195
For certain genetic conditions DNA testing identifies carriers and determines the risk status of foetuses, thus helping parents to make more informed prenatal decisions. Data, collected from three genetic centres in England and Wales from August 1986 to July 1990, are used to describe trends in demand for DNA testing, the impact of DNA tests on carrier risk assessment, and the use of DNA tests in relation to pregnancy outcome. Altogether the data include 23,388 subjects and 681 pregnancies in 8738 families divided into five cohorts by year of entry and referral. The most frequent gene disorders referred to the genetic centres are currently being tested or will soon be tested. For these disorders the initial high level of activity has declined and may have reached steady state. Demand for DNA services is high for cystic fibrosis and Duchenne muscular dystrophy, intermediate for Huntington's disease, and low for adult polycystic kidney disease, phenylketonuria and tuberous sclerosis. Based on these findings we suggest that demand for DNA tests will be high in serious, untreatable and slow progressing conditions with early onset; intermediate for conditions affecting intellect and neurological integrity with later onset; and low for treatable, late-onset conditions, or those for which there is evidence of heterogeneity, and variable penetrance. It would be helpful to assess the extent to which this view of demand is confirmed when the new disorders being DNA tested are considered and for the pattern of activity of DNA testing for some types of cancer. Since no DNA centre could offer a fully comprehensive testing service, it is recommended that a structure is created to audit overall activity, assist in policy formulation, and influence supraregional service organisation, in order that the spread of DNA services be planned as effectively as possible. This structure would facilitate monitoring of the evolution of contract specifications agreed by commissioners and providers on a regional basis. 相似文献
5.
Background Respite care may act as a means to reduce stress and fatigue in people caring for a dependent who has a disability. Despite this, a variety of barriers may exist to obtaining such services. This study explored caregivers' experiences seeking respite care for their children with special needs within a province in Canada.
Methods Caregivers were recruited from two agencies providing respite care for children with fetal alcohol spectrum disorders and other mental health and developmental difficulties. In total, 10 caregivers participated in in-depth individual interviews. A constructivist grounded theory approach was employed in the design and analysis of the data.
Results Caregivers discussed their frustrations with the process of finding and obtaining respite care, a course of action described as 'jumping through hoops'. This construct was composed of subcategories emphasizing the complexity of 'navigating the system', the bidirectional process of 'meeting the requirements' and the challenges of 'getting help'.
Conclusions The collective experiences of these caregivers point to the need for more flexibility and co-ordination of respite care services for children with special needs. 相似文献
Methods Caregivers were recruited from two agencies providing respite care for children with fetal alcohol spectrum disorders and other mental health and developmental difficulties. In total, 10 caregivers participated in in-depth individual interviews. A constructivist grounded theory approach was employed in the design and analysis of the data.
Results Caregivers discussed their frustrations with the process of finding and obtaining respite care, a course of action described as 'jumping through hoops'. This construct was composed of subcategories emphasizing the complexity of 'navigating the system', the bidirectional process of 'meeting the requirements' and the challenges of 'getting help'.
Conclusions The collective experiences of these caregivers point to the need for more flexibility and co-ordination of respite care services for children with special needs. 相似文献
6.
解放军医学图书馆电子阅览室的技术特点 总被引:2,自引:2,他引:0
从阅览室网络拓扑结构、硬盘保护、网络控制、网址限制及视频点播等几个方面对电子阅览室采用技术的特点逐一做了简要介绍,并以此阐明通过综合管理,使阅览室各计算机能够正常、安全的运行,从而达到既可为读者提供优质服务又可保证系统安全的目的. 相似文献
7.
8.
Summary Five normal men performed seven sets of seven squats at a load equal to 80% of their seven repetition maximum. Plasma growth
hormone (GH) and lactate levels increased during and after the completion of the exercise. A significant (r=0.93, P<0.001) linear correlation was found between GH changes and the corresponding oxygen Demand/Availability (D/A) ratio expressed
by
(where f=[lactate at time x]/[lactate at time 0]). A retrospective examination of previously published data from our laboratory and others also demonstrated
the existence of a significant correlation between changes in plasma GH levels and the D/A ratios over a wide variety of exercise;
aerobic and anaerobic, continuous and intermittent, weight lifting and cycling, in both fit and unfit subjects under normoxic
and hypoxic conditions. It is suggested that the balance between oxygen demand and availability may be an important regulator
of GH secretion during exercise.
DCIEM No. 87-P-27 相似文献
9.
The frequency of response and trials to habituation of the electrodermal onset and terminal orienting response were manipulated as a function of discrimination tasks involving either stimulus content (pitch) or duration. There were no significant differences between the groups on either measure for onset ORs; however, the duration task group demonstrated more TORs and required a greater number of trials to habituate than the content task group. The results, interpreted in terms of the development of cortical models, supported Stern's suggestion that OR and TOR habituation are related to the content and duration of the stimulus respectively. 相似文献
10.
目的 调查5省基层卫生技术人员医防融合相关培训状况以及相关知识能力的需求状况,为完善我国基层医防融合建设,提高基层卫生服务机构防病治病能力提供参考建议。方法 对五个省15个区县的乡镇卫生院和社区卫生服务中心(站)的卫生技术人员进行分层抽样问卷调查,对调查数据进行描述并对各种医防融合相关知识能力需求进行单因素χ2检验和多因素logistic分析。结果 76.0%的基层卫生技术人员近一年参加过培训,乡镇卫生院卫生技术人员培训参与率(73.2%)低于社区卫生服务中心(站)(84.3%)(χ2= 83.812,P<0.001),不同特征基层卫生技术人员培训参与率不同(P<0.01)。各类培训参与率均低于相关知识技能的需求率,公共卫生相关知识技能的需求率最高。χ2检验和多因素logistic分析显示不同特征基层卫生技术人员对各类知识技能的需求率不同:相对于社区卫生服务中心(站),乡镇卫生院人员对传染病防控技能(OR = 0.756,95%CI:0.666~0.858)和一般病与常见病诊疗技能(OR = 0.860,95%CI:0.762~0.971)的需求程度更高;临床医疗岗位人员对传染病防控技能及一般病与常见病诊疗技能、的需求程度更高(P<0.001);年轻人员对慢病管理与病因监测技能的需求更高(OR = 0.937,95%CI:0.885~0.992);公共卫生岗位人员(OR = 1.346,95%CI:1.114~1.626)和专职管理岗位人员(OR = 2.334,95%CI:1.707~3.191)对信息化技能的需求程度更高。结论 应以需求为导向,加强基层卫生技术人员的培训强度,提升培训内容和知识技能需求的匹配程度,建立完善医防交叉培训机制和医防能力兼备的复合型人才培养供给体系。 相似文献