全文获取类型
收费全文 | 47423篇 |
免费 | 2743篇 |
国内免费 | 954篇 |
专业分类
耳鼻咽喉 | 121篇 |
儿科学 | 433篇 |
妇产科学 | 580篇 |
基础医学 | 2887篇 |
口腔科学 | 637篇 |
临床医学 | 7470篇 |
内科学 | 11620篇 |
皮肤病学 | 298篇 |
神经病学 | 1334篇 |
特种医学 | 717篇 |
外国民族医学 | 4篇 |
外科学 | 3467篇 |
综合类 | 8387篇 |
现状与发展 | 3篇 |
一般理论 | 1篇 |
预防医学 | 4725篇 |
眼科学 | 433篇 |
药学 | 4771篇 |
88篇 | |
中国医学 | 1766篇 |
肿瘤学 | 1378篇 |
出版年
2024年 | 78篇 |
2023年 | 675篇 |
2022年 | 1484篇 |
2021年 | 2000篇 |
2020年 | 1932篇 |
2019年 | 1446篇 |
2018年 | 1564篇 |
2017年 | 1365篇 |
2016年 | 1617篇 |
2015年 | 1677篇 |
2014年 | 3960篇 |
2013年 | 3710篇 |
2012年 | 3510篇 |
2011年 | 3762篇 |
2010年 | 2715篇 |
2009年 | 2615篇 |
2008年 | 2464篇 |
2007年 | 2340篇 |
2006年 | 1917篇 |
2005年 | 1558篇 |
2004年 | 1216篇 |
2003年 | 1020篇 |
2002年 | 760篇 |
2001年 | 652篇 |
2000年 | 551篇 |
1999年 | 455篇 |
1998年 | 325篇 |
1997年 | 314篇 |
1996年 | 319篇 |
1995年 | 331篇 |
1994年 | 299篇 |
1993年 | 242篇 |
1992年 | 231篇 |
1991年 | 169篇 |
1990年 | 181篇 |
1989年 | 190篇 |
1988年 | 170篇 |
1987年 | 145篇 |
1986年 | 135篇 |
1985年 | 197篇 |
1984年 | 139篇 |
1983年 | 69篇 |
1982年 | 117篇 |
1981年 | 73篇 |
1980年 | 67篇 |
1979年 | 44篇 |
1978年 | 57篇 |
1977年 | 46篇 |
1976年 | 34篇 |
1974年 | 33篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
21.
22.
Alexander Real Chierika Ukogu Divya Krishnamoorthy Nicole Zubizarreta Samuel K. Cho Andrew C. Hecht James C. Iatridis 《The spine journal》2019,19(2):225-231
Background Context
Low back pain (LBP) is a common complaint in clinical practice of multifactorial origin. Although obesity has been thought to contribute to LBP primarily by altering the distribution of mechanical loads on the spine, the additional contribution of obesity-related conditions such as diabetes mellitus (DM) to LBP has not been thoroughly examined.Purpose
To determine if there is a relationship between DM and LBP that is independent of body mass index (BMI) in a large cohort of adult survey participants.Study Design
Retrospective analysis of prospectively collected National Health and Nutrition Examination Survey (NHANES) data to characterize associations between LBP, DM, and BMI in adults subdivided into 6 subpopulations: normal weight (BMI 18.5–25), overweight (BMI 25–30), and obese (BMI >30) diabetics and nondiabetics. Diabetes was defined with glycohemoglobin A1c (HbA1c) ≥6.5%.Patient Sample
11,756 participants from NHANES cohort.Outcome Measures
Percentage of LBP reported.Methods
LBP reported in the 1999-2004 miscellaneous pain NHANES questionnaire was the dependent variable examined. Covariates included HbA1c, BMI, age, and family income ratio to poverty as continuous variables as well as race, gender, and smoking as binary variables. Individuals were further subdivided by weight class and diabetes status. Regression and graphical analyses were performed on the study population as a whole and also on subpopulations.Results
Increasing HbA1c did not increase the odds of reporting LBP in the full cohort. However, multivariate logistic regression of the 6 subpopulations revealed that the odds of LBP significantly increased with increasing HbA1c levels in normal weight diabetics. No other subpopulations reported significant relationships between LBP and HbA1c. LBP was also significantly associated with BMI for normal weight diabetics and also for obese subjects regardless of their DM status.Conclusions
LBP is significantly related to DM status, but this relationship is complex and may interact with BMI. These results support the concept that LBP may be improved in normal weight diabetic subjects with improved glycemic control and weight loss, and that all obese LBP subjects may benefit from improved weight loss alone. 相似文献23.
《Patient education and counseling》2022,105(12):3501-3508
ObjectiveCambodian Americans have complex, interrelated and persistent medical and mental health problems stemming from genocide and the social determinants of health. We examined changes in multiple domains of self-reported health outcomes from a diabetes prevention trial. Methods: Cambodian Americans with depression and high risk for diabetes (n = 188) were randomized to one of three community health worker interventions: lifestyle vs lifestyle plus medication therapy management vs social services. Assessments were at baseline, 12- and 15-months. Results: The typical participant was 55 years old, female, earned below $20,000 annually, and had 7 years of education. About one-third were taking antidepressant medication and over half had elevated depressive symptoms. Relative to social services, lifestyle and lifestyle plus medication therapy management were both similarly effective at increasing diabetes knowledge, nutrition habits, sleep quality and decreasing pain; 2) lifestyle alone was superior to social services for self-reported health; and, 3) all three groups showed improved anxiety and insomnia. There were no effects on physical activity or physical functioning. Conclusion: Community health worker interventions have multiple benefits beyond delaying diabetes. Practice Implications: Health promotion programs that are designed and delivered appropriately can impact even hard to reach and hard to treat groups. 相似文献
24.
ObjectiveTo investigate the feasibility of transnasal heated humidified high flow nasal cannula oxygen therapy (HFNC) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with respiratory failure in elderly patients. MethodsA total of 176 elderly patients with AECOPD complicated with respiratory failure who were hospitalized at Peking University Shougang Hospital from December 2016 to January 2022 were enrolled, including 82 patients in an HFNC group and 94 patients in an NPPV group. After treatment, pulse oxygen saturation (SPO2), arterial partial pressure of carbon dioxide (PaCO2), oxygenation index (OI), respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP), comfort score, discharge rate, rate of endotracheal intubation, rate of transfer to intensive care unit (ICU), and mortality were compared between the two groups. The independent sample t-test was used for comparison between the two groups. Statistical data are expressed in percentage or number of cases and the χ2 test was used for their comparisons. ResultsThe SPO2 values at 30 min, 1 h, and 6 h were significantly higher in the HFNC group than in the NPPV group (t=-2.049,-2.618, and -3.314, P=0.043, 0.010, and 0.001, respectively). SPO2 before discharge was significantly lower than that of the NPPV group (t=2.162, P=0.033), but OI at each time point and before discharge had no statistical significance (P>0.05). MAP at 6 h was significantly higher in the HFNC group than in the NPPV group (t=-2.209, P=0.029), but within the normal range. HRs at 2 h and 3 h in the HFNC group were significantly higher than those of the NPPV group (t=-2.199 and -2.336, P=0.030 and 0.021, respectively). There were no significant differences in RR, HR, or MAP between the two groups at other time points and before discharge (P>0.05). There was no significant difference in PaCO2 between the two groups (P>0.05). Comfort score in the HFNC group was significantly higher than that of the NPPV group (t=-46.807, P<0.001). There were no significant differences in discharge rate, ICU transfer rate, endotracheal intubation rate, and mortality between the two groups (P>0.05). ConclusionHFNC is as effective as NPPV in treating elderly patients with AECOPD complicated with type Ⅰ or mild type Ⅱ respiratory failure, and HFNC is more comfortable than NPPV. 相似文献
25.
26.
目的:探讨美托洛尔(β1受体阻滞剂)用于老年COPD合并冠心病史治疗的临床疗效。方法:选取2018年6月—2019年6月在我院接受治疗的60岁以上(包括60岁)COPD合并冠心病史老年患者,分为对照组与观察组。对照组给予接受布地奈德福莫特罗粉吸入剂治疗,观察组在使用布地奈德福莫特罗粉吸入剂治疗的基础上口服琥珀酸美托洛尔缓释片治疗,观察对比两组治疗效果。结果:观察组临床治疗效果优于对照组,观察组住院时长以及并发症的发生率低于对照组(P<0.05),差异具有统计学意义。结论:老年COPD合并冠心病史接受美托洛尔治疗,可有效缩短住院时长、用药效果明显、有效提升用药安全性,值得临床推广。 相似文献
27.
《中国现代医生》2020,58(34):112-115
目的 探讨地佐辛术后镇痛对高龄患者围术期肝功能的影响。方法 选择2018 年1 月~2020 年6 月吉安市中心人民医院麻醉科收治的ASA 分级Ⅱ~Ⅲ级高龄患者80 例,按照随机数字表法,分为A 组、B 组、C 组、D 组,每组各20 例。分别给予0.4 mg/kg、0.5 mg/kg、0.6 mg/kg、0.7 mg/kg 地佐辛进行术后镇痛,评估术后1、2、6、12、24、48 h 患者的疼痛程度[视觉模拟评分法(VAS)]、术后镇静效果(Ramsay 评分法)及肝功能指标(ALT、AST)水平,评价不同剂量的地佐辛术后镇痛对高龄患者围术期肝功能的影响。结果 C 组术后患者不同时间段VAS 疼痛评分低于A 组、B 组、D 组,差异有统计学意义(P<0.05);四组患者术后1、2、6 h Ramsay 镇静评分比较,差异有统计学意义(P<0.05);但术后12、24、48 h Ramay 镇痛评分比较,差异无统计学意义(P>0.05)。C 组肝功能指标ALT、AST优于A 组、B 组、D 组,差异有统计学意义(P<0.05)。结论 高龄患者术后镇痛应用0.6 mg/kg地佐辛对围术期肝功能的影响最小。 相似文献
28.
《中国现代医生》2020,58(20):178-180+184
目的 探讨临床护理路径用于ICU重症颅脑损伤患者护理中的价值。方法 选择2017年11月~2018年10月进行ICU重症颅脑损伤治疗的患者100例作为对象,随机数字表法分为对照组(n=50)和观察组(n=50)。对照组给予常规护理,观察组在其基础上应用临床护理路径,15 d护理后比较患者依从性情况、对患者护理前后心理状态进行评分,对不良并发症产生情况进行比较。结果 观察组康复锻炼依从、按时用药依从及饮食依从高于对照组(P0.05)。护理前两组SDS与SAS评分比较差异无统计学意义(P0.05),护理后,观察组SDS与SAS评分低于对照组(P0.05)。观察组出现压疮、泌尿感染、以及发热的发生率显著低于对照组(P0.05)。结论 将临床护理路径用于ICU重症颅脑损伤患者的护理中,提高了患者的护理依从性,减少了不良情绪以及不良并发症的产生,有助于患者整体治疗,值得推广应用。 相似文献
29.
30.
糖尿病已成为全球威胁人类健康的三大慢性非传染性疾病之一。需要外科手术的患者占所有糖尿病患者的25%,其围手术期病死率、并发症以及住院时间较正常人明显增加,因此对于糖尿病患者围手术期的处理方案显得尤为重要。但目前对于围手术期血糖控制范围仍众说纷纭,综合各研究结论,笔者认为将血糖控制在7.8~10 mmol/L是一个较为理想的范围。在患者术前、术中及术后应联合多学科制定各项相应的治疗方案,围手术期尤为注意避免患者发生低血糖和电解质紊乱的发生。也亟待后续大规模的随机对照试验进一步确定有效的血糖控制目标。 相似文献