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11.
《Global public health》2013,8(12):1803-1814
ABSTRACT

Environmental change is projected to decrease the availability of key natural resources. Decreasing availability of resources that support food security and livelihoods for vulnerable populations is hypothesised to increase engagement in transactional sex. Therefore, we systematically examined the peer-reviewed literature to characterise what is known about transactional sex for natural resources, document the natural resources that are exchanged for sex, and identify qualitative trends. Of the 1063 articles, 33 were retained for full abstraction. A majority of articles were published after 2005 (93%) and focused on Africa (90%). Two-thirds of articles focused on sex-for-fish exchanges. Reports of transactional sex were also found for other resources, including agricultural land (12%) as well as food, water, and fuel in emergency contexts (12%). Migration and altered resource availability were described as underlying causes of transactional sex. Some studies described an increased risk of sexually transmitted infection, including HIV, as a health consequence of transactional sex. We offer three possible explanations for why the preponderance of previous studies have focused on sex-for-fish rather than other natural resources, and suggest directions for future research.  相似文献   
12.
Malaria infections repeatedly have been reported to induce nephrotic syndrome and acute renal failure. Questions have been raised whether the association of a nephrotic syndrome with quartan malaria was only coincidental, and whether the acute renal failure was a specific or unspecific consequence of Plasmodium falciparum infection. This review attempts to answer questions about “chronic quartan malaria nephropathy” and “acute falciparum malaria nephropathy”. The literature review was performed on all publications on kidney involvement in human and experimental malarial infections accessible in PubMed or available at the library of the London School of Hygiene and Tropical Medicine. The association of a nephrotic syndrome with quartan malaria was mostly described before 1975 in children and rarely in adult patients living in areas endemic for Plasmodium malariae. The pooled data on malaria-induced acute renal failure included children and adults acquiring falciparum malaria in endemic areas either as natives or as travellers from non-tropical countries. Non-immunes (not living in endemic areas) had a higher risk of developing acute renal failure than semi-immunes (living in endemic areas). Children with cerebral malaria had a higher rate and more severe course of acute renal failure than children with mild malaria. Today, there is no evidence of a dominant role of steroid-resistant and chronic “malarial glomerulopathies” in children with a nephrotic syndrome in Africa. Acute renal failure was a frequent and serious complication of falciparum malaria in non-immune adults. However, recently it has been reported more often in semi-immune African children with associated morbidity and mortality.  相似文献   
13.
Most Ghanaian research in the area of victimization among children has focused on the school setting. Little research has been done in an attempt to understand inmate-on-inmate victimization within the juvenile correctional facilities in Ghana. This study, therefore, investigated the extent to which peer victimization influences psychological distress among juvenile offenders in the Senior Correctional Center of Ghana. A cross-sectional design was used to purposively sample 115 juvenile offenders for the study. Following mediation analysis performed in PROCESS, the results revealed that prison climate and resilience serially mediated the relationship between peer victimization and psychological distress. Independently, both prison climate and resilience mediated the relationship between peer victimization and psychological distress. It was recommended that anti-bullying programs ought to be institutionalized to create mental health awareness within the correctional facilities. Also, support systems such as the Listener Scheme need to be deployed within the correctional facilities.  相似文献   
14.
护士对医院伦理气氛认知现状调查分析   总被引:1,自引:0,他引:1  
目的了解护士对医院伦理气氛的认知现状并对其影响因素进行分析,为医院管理部门提高护士伦理气氛认知水平提供参考。方法采用伦理气氛认知量表(ECQ)对衡阳市某三甲医院348名注册护士进行调查。结果护士伦理气氛认知总均分为81.64±8.20,不同人事关系、第一学历、护龄及月收入的护士伦理气氛认知得分比较,差异有统计学意义(均P<0.05);护士对医院伦理气氛的认知受其月收入、第一学历的影响。结论医院管理者可通过增加护士人员编制,提高薪金待遇,加强在职人员伦理培训,从而提高护士对医院伦理气氛的认知水平。  相似文献   
15.
徐奇  姚志珍 《中国全科医学》2018,21(22):2690-2695
目的 探讨社区卫生服务中心全科医生组织创新气氛状况,分析变革型领导、心理授权对全科医生组织创新气氛的影响。方法 于2016年9—10月,采用多阶段抽样方法,首先根据城区、郊区、城乡结合区域分层,按照约1∶1∶1的比例,从上海市浦东新区45所社区卫生服务中心中随机抽取10所;然后整群纳入各社区卫生服务中心中全部在岗注册的全科医生,共计380例为调查对象。采用自行设计的全科医生基本情况调查表、组织创新气氛量表、变革型领导量表、心理授权量表调查社区卫生服务中心全科医生的基本情况、组织创新气氛、变革型领导、心理授权水平。共发放问卷380份,回收有效问卷355份,问卷的有效回收率为93.4%。结果 355例全科医生组织创新气氛量表得分为(3.82±0.57)分,其中团队协力、上级支持维度得分较高,分别为(4.13±0.66)、(4.00±0.74)分,资源保障、激励机制的维度得分较低,分别为(3.14±0.88)、(2.89±0.60)分。变革型领导量表得分为(5.61±0.89)分;心理授权量表得分为(3.92±0.69)分。变革型领导量表得分、心理授权量表得分与组织创新气氛量表得分呈线性正相关(P<0.01);除资源保障维度得分外,变革型领导量表得分、心理授权量表得分与组织创新气氛量表各维度(团队协力、上级支持、领导躬行、组织促进、自主工作、激励机制)得分呈线性正相关(P<0.01)。多元逐步回归分析结果显示,变革型领导、心理授权量表得分是组织创新气氛量表得分的影响因素(P<0.01)。结论 社区卫生服务中心全科医生组织创新气氛处于中等水平,变革型领导、心理授权与组织创新气氛呈线性正相关。管理者应以加强变革型领导和心理授权为切入点,充分发挥变革型领导行为作用,提升全科医生心理授权水平,营造组织创新气氛,从而高效高质地推进社区卫生工作。  相似文献   
16.
目的 探讨2012~2013年浙江省沿海地区热带气旋对医院门诊呼吸系统疾病日就诊量的影响。 方法 使用时间分层的病例交叉研究,控制气象因素的混杂作用,以Poisson回归模型分析浙江省苍南县2012~2013年夏季(7~10月)热带气旋与医院门诊呼吸系统疾病日就诊量的关系,并按性别、年龄进行分层分析。 结果 在热带气旋影响期,全人群、男性和女性的呼吸系统疾病发病风险均上升,分别在滞后第3、4、6天达到最大值。<15岁人群呼吸系统疾病发病风险上升,在滞后第6天达到最大值(RR=1.298, 95%CI:1.016~1.658)。热带气旋对15~65岁人群及>65岁人群的呼吸系统疾病发病影响无统计学意义(P>0.05)。 结论 热带气旋可增加呼吸系统疾病的发病风险且存在滞后效应,<15岁人群为易感人群。  相似文献   
17.
介绍并采用一种基于信息熵的不确定条件下的多属性评价方法,探讨中医证候与季节关联的复杂性问题,为中医干预慢性病毒性乙型肝炎(乙肝)及其临床诊断提供参考。方法:将871例乙肝患者的中医临床资料按发病季节进行分类,然后统计各个季节不同证候的发生次数,建立评价表,利用信息熵评价方法进行计算和分析。结果:经过实例计算,对中医乙肝肝肾阴虚证在不同季节气候发生的可能性进行排序,发现乙肝肝肾阴虚证在夏季发生的可能性最大,在春季3、4月发生的可能性最小。结论:不同季节对中医证候的演化具有一定影响,能为中医临床诊断和评价提供一定的借鉴。  相似文献   
18.
The East Siberian Arctic Shelf holds large amounts of inundated carbon and methane (CH4). Holocene warming by overlying seawater, recently fortified by anthropogenic warming, has caused thawing of the underlying subsea permafrost. Despite extensive observations of elevated seawater CH4 in the past decades, relative contributions from different subsea compartments such as early diagenesis, subsea permafrost, methane hydrates, and underlying thermogenic/ free gas to these methane releases remain elusive. Dissolved methane concentrations observed in the Laptev Sea ranged from 3 to 1,500 nM (median 151 nM; oversaturation by ∼3,800%). Methane stable isotopic composition showed strong vertical and horizontal gradients with source signatures for two seepage areas of δ13C-CH4 = (−42.6 ± 0.5)/(−55.0 ± 0.5) ‰ and δD-CH4 = (−136.8 ± 8.0)/(−158.1 ± 5.5) ‰, suggesting a thermogenic/natural gas source. Increasingly enriched δ13C-CH4 and δD-CH4 at distance from the seeps indicated methane oxidation. The Δ14C-CH4 signal was strongly depleted (i.e., old) near the seeps (−993 ± 19/−1050 ± 89‰). Hence, all three isotope systems are consistent with methane release from an old, deep, and likely thermogenic pool to the outer Laptev Sea. This knowledge of what subsea sources are contributing to the observed methane release is a prerequisite to predictions on how these emissions will increase over coming decades and centuries.

The East Siberian Arctic Shelf (ESAS) is the world’s largest and shallowest shelf sea system, formed through inundation of northeast Siberia during sea level transgression in the early Holocene. The ESAS holds substantial but poorly constrained amounts of organic carbon and methane (CH4). These carbon/methane stores are contained in unknown partitions as gas hydrates, unfrozen sediment, subsea permafrost, gas pockets within and below the subsea permafrost, and as underlying thermogenic gas (13). Methane release to the atmosphere from these compartments could potentially have significant effects on the global climate (4, 5), yet there are large uncertainties regarding the size and the vulnerability toward remobilization of these inaccessible and elusive subsea carbon/methane pools. Conceptual development and modeling have predicted that warming of the ESAS system by a combination of geothermal heat and climate-driven Holocene heat flux from overlying seawater, recently further enhanced by Anthropocene warming, may lead to thawing of subsea permafrost (6, 7). Subsea permafrost drilling in the Laptev Sea, in part at the same sites as 30 y ago, has recently confirmed that the subsea permafrost has indeed come near the point of thawing (8). In addition to mobilization of the carbon/methane stored within the subsea permafrost, its degradation can also lead to the formation of pathways for gaseous methane from underlying reservoirs, allowing further methane release to the overlying water column (3, 9).Near-annual ship-based expeditions to the ESAS over the past two decades have documented widespread seep locations with extensive methane releases to the water column (3, 10). Methane levels are often found to be 10 to 100 times higher than the atmospheric equilibrium and are particularly elevated in areas of strong ebullition from subsea gas seeps (“methane hotspots”). Similarly, elevated dissolved methane concentrations in bottom waters appear to be spatially related to the thermal state of subsea permafrost as deduced from modeling results and/or geophysical surveys (7, 9). Currently, we lack critical knowledge on the quantitative or even relative contributions of the different subsea pools to the observed methane release, a prerequisite for robust predictions on how these releases will develop. An important distinction needs to be made between pools that release methane gradually, such as methane produced microbially in shallow sediments during early diagenesis or in thawing subsea permafrost, versus pools with preformed methane that may release more abruptly once pathways are available, such as from disintegrating methane hydrates and pools of thermogenic (natural) gas below the subsea permafrost. Multidimensional isotope analysis offers a useful means to disentangle the relative importance of these different subsea sources of methane to the ESAS: Stable isotope data (δ13C-CH4 and δD-CH4) provide useful information on methane formation and removal pathways, and the radiocarbon content of methane (Δ14C-CH4) helps to determine the age and methane source reservoir (see SI Appendix, text S1 for details on these isotope systematics and typical isotopic signatures for the ESAS subsea system).Here, we present triple-isotope–based source apportionment of methane conducted as part of the Swedish–Russian–US investigation of carbon–climate–cryosphere interactions in the East Siberian Arctic Ocean (SWERUS-C3) program. To this end, the distribution of dissolved methane, its stable carbon and hydrogen isotope composition, as well as natural radiocarbon abundance signature, were investigated with a focus on the isotopic fingerprint of methane escaping the seabed to pinpoint the subsea sources of elevated methane in the outer Laptev Sea.  相似文献   
19.
Intervening on risk factors for noncommunicable diseases (including cancer) in industrialized countries could achieve a reduction of between 30% and 40% of premature deaths. In the meantime, the need to intervene against the threat of climate change has become obvious. CO2 emissions must be reduced by 45% by the year 2030 and to zero by 2050 according to recent agreements. We propose an approach in which interventions are designed to prevent diseases and jointly mitigate climate change, the so‐called cobenefits. The present article describes some examples of how climate change mitigation and cancer prevention could go hand in hand: tobacco control, food production, and transportation (air pollution). Many others can be identified. The advantage of the proposed approach is that both long‐term (climate) and short‐term (health) benefits can be accrued with appropriate intersectoral policies.

Abbreviations

GHG
greenhouse gases
IARC
International Agency for Research on Cancer
LMICs
low‐ and middle‐income countries
NCD
noncommunicable disease
PMI
Philip Morris International
SDGs
Sustainable Development Goals
UPF
ultraprocessed food
  相似文献   
20.

Background

A public health research system is the bedrock of health systems to improve population health, system responsiveness, and equity. An international concern, referred to as the 10/90 gap, is that less than 10% of global funds are devoted to diseases or conditions that account for 90% of the global disease burden, particularly in developing countries. Palestinian health research is progressing, but it is not sufficiently investigated, with a remarkable knowledge gap on its conceptualisation, stewardship, stakeholders, and capacity and resources. The aim of this study was to understand the Palestinian public health research system by investigating challenges related to the system components that need to be strengthened.

Methods

The study was done in the Gaza Strip and West Bank in the occupied Palestinian territory between January and July, 2016. We targeted relevant government institutions, academic schools, and large local and international health agencies. Data were collected through 52 in-depth interviews and six focus group discussions with policy makers, academics, and experts. Participants and institutions were selected purposively on the basis of stated criteria and peer review. Data were translated, transcribed, checked, and imported into MAXQDA 12 for thematic and content analysis. Approvals were obtained from The Research Commission of Swiss TPH, “Ethikkommission Nordwest- und Zentralschweiz” (EKNZ) in Switzerland, the Palestinian Ministry of Health, Helsinki Committee, and An-Najah National University in Palestine.

Findings

The health research system is not well structured, whereas public health research is promising but probably without regulated national policies. Most experts emphasised that governance is not clearly framed in managing research functions, whereas public health research activities are most likely scattered and individually driven. There is a consensus that the concept of the health research system is misunderstood and that the system is underperforming because of various problems such as resource insufficiency. Research is also not fundamentally at the heart of the political agenda or itemised in central budgets. Besides workforce scarcity with poor incentives and infrastructure, priorities in public health research are inconsistent and efforts are uncoordinated with poor multidisciplinary research. Dissemination and application of the public health research agenda among stakeholders are lacking. The research culture seems to be insufficiently cultivated. The international support to the public health research system is inconspicuous although some initiatives have been successful. The overall environment in the occupied Palestinian territory formed one of obstacles of the public health research system. Precious opportunities are proposed to strengthen public health research system synergistically through best strategies.

Interpretation

The occupied Palestinian territory is a fertile place for growth of public health research system activity. Development actions should therefore be taken to get the system materialised by reactivating a unified governance body that cooperatively manages the national policies, capacities, priorities, research utilisation, and application of the public health research system.

Funding

The Swiss Federation and Swiss Tropical and Public Health Institute.  相似文献   
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