首页 | 本学科首页   官方微博 | 高级检索  
文章检索
  按 检索   检索词:      
出版年份:   被引次数:   他引次数: 提示:输入*表示无穷大
  收费全文   38119篇
  免费   3557篇
  国内免费   718篇
耳鼻咽喉   334篇
儿科学   880篇
妇产科学   405篇
基础医学   2323篇
口腔科学   1028篇
临床医学   6628篇
内科学   4407篇
皮肤病学   290篇
神经病学   2892篇
特种医学   1511篇
外国民族医学   2篇
外科学   3056篇
综合类   3319篇
现状与发展   1篇
一般理论   6篇
预防医学   7539篇
眼科学   270篇
药学   5071篇
  78篇
中国医学   1175篇
肿瘤学   1179篇
  2024年   116篇
  2023年   838篇
  2022年   1636篇
  2021年   1989篇
  2020年   1946篇
  2019年   1919篇
  2018年   1795篇
  2017年   1709篇
  2016年   1642篇
  2015年   1475篇
  2014年   2720篇
  2013年   3536篇
  2012年   2109篇
  2011年   2353篇
  2010年   1744篇
  2009年   1604篇
  2008年   1698篇
  2007年   1644篇
  2006年   1344篇
  2005年   1178篇
  2004年   953篇
  2003年   844篇
  2002年   679篇
  2001年   626篇
  2000年   560篇
  1999年   466篇
  1998年   389篇
  1997年   338篇
  1996年   302篇
  1995年   285篇
  1994年   257篇
  1993年   191篇
  1992年   202篇
  1991年   160篇
  1990年   135篇
  1989年   110篇
  1988年   116篇
  1987年   108篇
  1986年   91篇
  1985年   118篇
  1984年   104篇
  1983年   64篇
  1982年   73篇
  1981年   46篇
  1980年   34篇
  1979年   48篇
  1978年   24篇
  1977年   16篇
  1976年   18篇
  1975年   14篇
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
991.
The United States Environmental Protection Agency's Integrated Risk Information System (IRIS) includes hazard identification and dose-response assessment values developed by Agency scientists. Uncertainty factors (UFs) are used in the development of IRIS values to address the lack of information in five main areas. The standard UFs account for interspecies uncertainty (UFA) and intraspecies variability (UFH). The UFA addresses uncertainty related to the extrapolation of data from animals to humans, whereas the UFH addresses variability amongst individuals (i.e., intrahuman). Additional UFs have been employed to account for database incompleteness, extrapolations from a lowest-observed-adverse-effect level in the absence of a no-observed-adverse-effect level (UFL), and subchronic-to-chronic extrapolation (UFS). A sixth UF designated as “other uncertainty factors” (UFO) has also been applied in place of the UFL to account for uncertainty with the adversity of points of departure obtained using benchmark dose modeling. This review will discuss how UFL, UFS, and UFO have been applied in IRIS assessments, along with the rationale used to describe the choice of UF values that deviate from the standard default of 10.  相似文献   
992.
993.
Variation in modern crocodilian and extinct thalattosuchian crocodylomorph skull morphology is only weakly correlated with phylogeny, implying that factors other than evolutionary proximity play important roles in determining crocodile skull shape. To further explore factors potentially influencing morphological differentiation within the Thalattosuchia, we examine teleosaurid and metriorhynchid skull shape variation within a mechanical and dietary context using a combination of finite element modelling and multivariate statistics. Patterns of stress distribution through the skull were found to be very similar in teleosaurid and metriorhynchid species, with stress peaking at the posterior constriction of the snout and around the enlarged supratemporal fenestrae. However, the magnitudes of stresses differ, with metriorhynchids having generally stronger skulls. As with modern crocodilians, a strong linear relationship between skull length and skull strength exists, with short‐snouted morphotypes experiencing less stress through the skull than long‐snouted morphotypes under equivalent loads. Selection on snout shape related to dietary preference was found to work in orthogonal directions in the two families: diet is associated with snout length in teleosaurids and with snout width in metriorhynchids, suggesting that teleosaurid skulls were adapted for speed of attack and metriorhynchid skulls for force production. Evidence also indicates that morphological and functional differentiation of the skull occurred as a result of dietary preference, allowing closely related sympatric species to exploit a limited environment. Comparisons of the mechanical performance of the thalattosuchian skull with extant crocodilians show that teleosaurids and long‐snouted metriorhynchids exhibit stress magnitudes similar to or greater than those of long‐snouted modern forms, whereas short‐snouted metriorhynchids display stress magnitudes converging on those found in short‐snouted modern species. As a result, teleosaurids and long‐snouted metriorhynchids were probably restricted to lateral attacks of the head and neck, but short‐snouted metriorhynchids may have been able to employ the grasp and shake and/or ‘death roll’ feeding and foraging behaviours.  相似文献   
994.
Objective: The aims were to give an overview and consider advantages and disadvantages of different approaches used to evaluate dental treatment need and to suggest an alternate Quantitative Summative Dental Treatment Need Index. Methods: The Medline Ovid database was searched for relevant articles published during the last three decades combining the terms "needs assessment,""dental care,""health services needs and demand." Results: There were substantial differences in methods used. Different modifications of the Decayed, Missing, Filled Teeth/Surfaces indices, complex quantitative summative indices, or simplified approaches were used to assess dental treatment need. Differing advantages and disadvantages of these methods can be identified. Previously used approaches have a common limitation for use in oral epidemiology. Conclusions: The suggested alternate Quantitative Summative Dental Treatment Needs Index focuses on an ability to compare both the total burden of treatment need as well as to make a distinction among specific treatment needs across populations. This new approach is an attempt to develop a comprehensive index for use in oral epidemiology with further revisions anticipated.  相似文献   
995.
Patients undergoing elective PCI are traditionally admitted overnight, however day case PCI cuts costs and has been proposed as a safe method for selected patients. We evaluated the success and long term clinical outcomes of day case percutaneous coronary intervention (PCI) for outpatients with stable angina.In total, 484 consecutive patients treated over a five year period with planned day case PCI were studied and followed up for 12 months. Successful PCI with same day discharge was performed in 463 patients (95.7%). There were 21 patients (4.3%) who required hospital admission. Reasons for failed discharge were hematoma formation (n = 7, 1.4%), coronary dissection (n = 4, 0.8%), post-procedural chest pain (n = 3, 0.6%), prolonged procedure (n = 2, 0.4%), and 1 each of acute stent thrombosis, coronary perforation, anaphylaxis, minor drug reaction and a functional study for untreated disease. One year follow up was complete for 439/484 (90.7%). At 12 months there were 6 hospitalizations for angina (1.2%, 95% CI 0.6–3.0%), 20 repeat revascularisations (4.1%, 95% CI 2.7–6.3%), 3 myocardial infarctions (0.6%, 95% CI 0.2–2.1%) and 2 deaths (0.4%, 95% CI 0.1–1.6%). Event free survival at 1 year follow up was 93.6% (95% CI 90.7–95.6%).Selecting patients for day case PCI is safe, and can achieve a high rate of success with excellent long term outcomes.  相似文献   
996.
997.
998.
The aim of this study was to identify differences in the medical management and clinical outcome in a group of elderly patients admitted to a designated geriatric assessment unit (GAU) or to two general medical units (GMUs). A prospective randomised controlled trial was undertaken in 267 patients aged 70 years and over (mean age = 78.3 years). Following discharge from hospital, patients were followed up at three monthly intervals for a total of 12 months. At the time of discharge, no significant differences were found in inpatient management, length of stay, mortality rates, discharge rates to institutional care or utilisation of community services in patients admitted to the GAU and the GMUs. Similarly, no significant differences were found at three, six, nine, and 12 month follow up in case fatality, activities of daily living indices, mental health status, rates of institutional referral and the level of community service support in patients admitted to the GAU and the GMUs studied. These findings do not show any advantage for the unselected 70 + acutely ill elderly patient who is admitted to a designated geriatric assessment unit rather than to a general medical unit. Therefore, an admission policy to GAU, based solely on age 70 + is medically inappropriate and cost-inefficient. Evidence from other sources suggests that an age cohort of acutely admitted patients beyond 80 years may well have returned more optimistic findings for the GAU. In future, GAUs will require a more selective admission policy to maximise the benefits of their rehabilitative and interdisciplinary approach. (Aust NZ J Med 1991; 21: 230–234.)  相似文献   
999.
目的 研究开发适合我国人群疾病特点且方便临床使用的心血管病发病危险度评估方法和评估工具。方法 依据中美心肺血管疾病流行病学合作研究队列随访资料,采用Cox比例风险模型拟合最优预测模型,并校正人群危险因素长期变化趋势的影响,采用独立人群回代检验和计算ROC曲线下面积来检验模型的预测能力。进一步建立简易预测模型,并据此制定适合我国人群的心血管病综合危险度简易评估工具。结果 中美心肺血管疾病流行病学合作研究1983~1984年基线调查年龄35~59岁,剔除基线患有冠心病、脑卒中及主要危险因素资料不全者后男女共计9903人,截止到2000年平均随访15.1年,共发生冠心病事件105例、缺血性脑卒中266例、缺血性心血管病360例。基线年龄、性别、血压、血清总胆固醇、体重指数、吸烟和糖尿病与冠心病、缺血性脑卒中和缺血性心血管病(ischemic cardiovascular diseases,ICVD)事件发病有互相独立的显著关联,且联系的方向和规律一致。据此建立的分性别ICVD事件10年发病危险预测模型,经过校正人群危险因素的长期变化趋势,证明能够很好地用于1992~1994年新建立队列的ICVD发病预测,其ROC曲线下面积(AUC)男性最优模型为0.799,女性最优模型为0.844。简易模型的AUC与最优模型几乎相同。结论 初步开发的ICVD事件10年发病危险预测模型和简易评估工具具有令人满意的预测能力,也能够较好地反映国人发生心血管病的综合危险。  相似文献   
1000.

Background

To estimate patient acceptable symptom state (PASS) and minimal clinically important difference (MCID) for patient-reported outcomes in systemic sclerosis (SSc).

Methods

We conducted a secondary analysis of the SCLEREDUC trial, a 12-month randomized controlled trial comparing the efficacy of physical therapy to usual care in 220 SSc patients followed-up from September 2005 to October 2010. Self-rated state and change in patient health at 12 months were assessed by using 2 external anchors extracted from the Medical Outcomes Study 36-Item Short-Form. Patients who self-rated their health as “excellent”, “very good” or “good” were the PASS group and those who self-rated their health change as “somewhat better” were the MCID group. Main outcomes were the estimates of PASS by using the 75th percentile method and of MCID by using the mean change in scores method for pain and activity limitation.

Results

PASS (95% confidence interval) and mean (SD) MCID estimates at 12 months were 53.75 (34.00 to 68.00) and ?6.74 (32.02) for the joint-pain visual analog scale (range 0–100), 1.41 (1.13 to 1.63) and ?0.21 (0.48) for the Health Assessment Questionnaire (HAQ, range 0–3), 1.27 (1.07 to 1.62) and ?0.13 (0.45) for the scleroderma HAQ (range 0–3), 26.00 (17.00 to 37.00) and -3.38 (9.87) for the Cochin Hand Function Scale (range 0–90), and 19.40 (17.20 to 21.90) and ?5.69 (6.79) for the McMaster-Toronto Arthritis Patient Preference Disability Questionnaire (range 0–30), respectively.

Conclusions

We provide, for the first time, the PASS and MCID estimates for pain and activity limitation in SSc.

Trial registration

ClinicalTrials.gov Identifier: NCT00318188. First Posted: April 26, 2006.  相似文献   
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号