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941.
目的 研究经导管动脉内化疗栓塞 (TACE)中应用小剂量和常规剂量化疗药物后肝细胞癌 (HCC)细胞坏死及细胞凋亡的情况。方法  3 0例中晚期HCC患者接受超选择性TACE治疗 ,A组 (12例 )给予小剂量化疗药物 :肿瘤瘤径小于 5cm者给予丝裂霉素 (MMC) 2~ 4mg;在 5~ 8cm间者给予MMC 4~ 6mg ,表柔比星 (EPI) 10mg;大于 8cm者给予MMC 6~ 8mg ,EPI 10mg ,卡铂 (CBP)10 0mg ;B组 (18例 )给予常规剂量化疗药物 :MMC 10mg,CBP 3 0 0mg ,EPI 40mg。经导管向供血动脉内注入碘油 化疗药物乳化剂 ,随后用明胶海绵 (GS)或聚乙烯醇 (PVA)微球栓塞该动脉。TACE后切除病灶 ,分别行病理检查和原位细胞凋亡检测评估肿瘤细胞坏死及凋亡程度。另 2 0例切除病灶前未行TACE者 (C组 )为对照组。结果 A、B、C组肿瘤坏死程度分别为 (90 5± 9 0 ) %、(87 9± 9 5 ) %和6 0 % (0 %~ 2 5 0 % )。A、B两组间差异无显著性意义 (χ2 =0 3 45 ,P >0 0 5 )。A、B组分别与C组比较 ,差异均有显著性意义 (χ2 分别为 2 1 897和 2 7 891,P值均 <0 0 0 1)。A、B两组凋亡指数 (% )分别为 9 0 % (3 0 %~ 2 0 0 % )和 10 0 % (5 0 %~ 2 0 0 % ) ,两组间差异无显著性意义 (χ2 =0 3 46,P >0 0 5 ) ,但均明显高于对照组 5 0 % (1 0  相似文献   
942.
In the past few decades, it has become increasingly clear to social scientists and policy makers alike that violence within the family is all too common and carries enormous costs to individuals, families, and society as a whole. Numerous controversies exist in the field, particularly with regard to what factors are significant in the etiology and development of violence between intimate partners. This article focuses on relationship power as a critical construct to consider in domestic violence, as it encompasses aspects of social, dyadic, and individual functioning. The literature on the construct of power and its relationship to domestic violence is reviewed and then placed in cultural context, followed by a discussion of future directions for research on and treatment issues in power and violence.  相似文献   
943.
目的阐释运动系统祖国医学解剖学术语与现代医学解剖学术语的对应关系及其异同.方法查阅资料,制作卡片,比较二者异同.结果祖国医学与现代医学运动系统解剖术语所指结构,在名称上有较大差异,而在形态、功能上差异不大.结论很多运动系统现代医学解剖术语来源于祖国医学解剖术语,二者既有相同之处,又有不同之处.  相似文献   
944.
This study investigates the effects of a brief training programme on the communication skills of doctors in ambulatory care settings in Trinidad and Tobago. Evaluation of doctor performance is based on analysis of audiotapes of doctors with their patients during routine clinic visits and on patient satisfaction ratings. A pre-test/post-test quasi-experimental study design was used to evaluate the effects of exposure to the training programme. Doctors were assigned to groups based on voluntary participation in the programme. Audiotapes of the 15 participating doctors (nine trained and six control) with 75 patients at baseline and 71 patients at the post-training assessment were used in this analysis. The audiotapes were content-coded using the Roter Interaction Analysis System (RIAS). Doctors trained in communication skills used significantly more target skills post-training than their untrained colleagues. Trained doctors used more facilitations in their visits and more open-ended questions than other doctors. There was also a trend towards more emotional talk, and more close-ended questions. Patients of trained doctors talked more overall, gave more information to their doctors and tended to use more positive talk compared to other patients. Trained doctors were judged as sounding more interested and friendly, while patients of trained doctors were judged as sounding more dominant, responsive and friendly than patients of untrained doctors. Consistent with these communication differences, patient satisfaction tended to be higher in visits of trained doctors.  相似文献   
945.
ZNC(C)PR是大鼠脑中具有促进学习记忆作用的神经肽,本文按前文2D-NMR测 定结构和活性比较的结果以及分子动力学的关 类似物加以验证。结果与预则相符,即一定系式计算了45个ZNC(C)PR类似物的能量和紧密度的分子结构是表现活性所必需的。可能的结构趋向,从理论上探讨了各残基对稳定结构的贡献,并据此设计和合成了5个新的  相似文献   
946.
目的 探讨急性超容血液稀释对靶控输注(TCI)异丙酚血药浓度及TCI系统性能的影响。方法 36例ASA Ⅰ~Ⅱ级择期手术患者,随机分为稀释组(n=18)与对照组(n=18)。稀释组按10 m1·kg-1输入乳酸林格氏液补充生理需要量后行TCI,10 min后实施血液稀释(以20 ml·kg-1输入6%羟乙基淀粉)。TCI以恒定靶血浆药物浓度(3μg·ml-1)变速输注60 min,对照组按10 ml·k-1输入乳酸林格氏液并以相同方式行TCI,但不实施血液稀释。间断采集动脉血90 min,用气相色谱.质谱(GC-MS)法测定异丙酚血药浓度并评价TCI系统性能。结果 血液稀释后血红蛋白(Hb)和血球压积(Hct)较基础值分别下降30.8%和31.3%。TCI后稀释组各时点血药浓度均明显低于对照组(P<0.05),最大降幅为38.5%;系统偏离度和精确度分别为-27.18%和27.18%。结论 急性超容血液稀释导致异丙酚TCI血药浓度明显下降,TCI系统先低估后高估了实测血药浓度,原因是血液稀释导致中央室容积增大,室间转运速率加快所致。  相似文献   
947.
The author examines different aspects of patient–doctor relationship in dermatological consultations. At first, a definition of patients satisfaction is given, based on available literature. It has been shown that satisfaction depends on diagnosis, but also on the doctor's ability to provide explanations on the probable cause of the illness, information on how long the symptom will probably last, and if she/he demonstrates empathy. Satisfaction also increases if the illness is serious, but decreases if quality of life linked to the symptom is underestimated by the doctor. After providing a philosophical definition of ethics, which emphasizes the importance of mutual satisfaction of patient and doctor, the concepts of empathy and compassion in patient-doctor relations are defined. Their importance in consultations is underlined, reporting, for example, that doctors with good communication skills experience fewer difficult consultations (8% vs. 23%). Afterwards, the dermatological consultation is analysed in its practical aspects, trying to define a good-quality consultation. First of all, the pitfalls that can affect good time management are analysed, suggesting to structure the consultation using the Soap method. Particular situations are analysed, such as announcing bad news and dealing with borderline patients. Finally, the concept of transference is defined, remembering that doctor–patient relationships can replay some difficult relationship coming from the past, and thus doctors need to be aware of this possibility and learn how to manage it.  相似文献   
948.
论病人知情同意权的回归及在医患关系中的价值   总被引:24,自引:3,他引:21  
知情同意权是病人最基本的权利。目前医患双方对病人权利的主张和尊重均未触及到权利的核心部分,是造成医患矛盾的症结。随着医疗自主时代的来临,病人知情同意权的回归可以预防和减少医疗纠纷,提高医疗服务品质,同时也是相关法律法规充分履行贯彻的表现。  相似文献   
949.
具有复亲和力特性的拮抗剂常对激动剂既表现为竞争性又表现为变活性拮抗的二重作用。定量表示二重拮抗作用强度可用pA_2及pD_2’。竞争性及非竞争性拮抗作用的联合公式可作为二重拮抗作用的数学模型,该模型与Brink作图法求pA_2及pD_2’完全一致。应用电子计算机程序解出模型中的参数K_B及K_B’,从而求出pA_2及pD_2'要比Brink的作图法更正确,方便及可行。  相似文献   
950.
There is increasing emphasis on patients’ rights to dignity. However, studies indicate that patients are vulnerable to a loss of dignity in hospital. There is a dearth of research focusing on the dignity of patients with urological conditions and this study aimed to explain how urological conditions affect patients’ dignity and how patients’ dignity can be promoted when threatened. The research design was a qualitative case study based in a urological ward in the United Kingdom. Four‐hour episodes of participant observation were conducted on 12 separate days, each focused on one patient’s care. Following observation, the 12 patients were interviewed in the ward. Interviews were conducted with a further 12 patients following discharge. Data were analysed using the framework approach. Patients’ urological conditions threatened dignity because of the intimate area of the body affected and accompanying bodily exposure. Urinary catheters and associated procedures were considered threats to dignity. Staff promoted dignity by providing privacy and using therapeutic interactions. Patients promoted their own dignity through rationalization and humour. Where they viewed loss of dignity was inevitable, adopting an attitude of acceptance made patients feel more comfortable. Patients could rationalize their situation better when with other patients with urological conditions who were ‘in the same boat’. In conclusion, patients with urological conditions are particularly vulnerable to a loss of dignity in hospital but staff behaviour and patients’ attitudes can promote dignity in these situations.  相似文献   
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