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   10288篇
  免费   856篇
  国内免费   212篇
耳鼻咽喉   67篇
儿科学   172篇
妇产科学   118篇
基础医学   563篇
口腔科学   160篇
临床医学   1340篇
内科学   1156篇
皮肤病学   99篇
神经病学   302篇
特种医学   596篇
外国民族医学   2篇
外科学   611篇
综合类   2221篇
一般理论   2篇
预防医学   1745篇
眼科学   118篇
药学   1112篇
  98篇
中国医学   365篇
肿瘤学   509篇
  2024年   47篇
  2023年   242篇
  2022年   491篇
  2021年   711篇
  2020年   736篇
  2019年   425篇
  2018年   410篇
  2017年   472篇
  2016年   552篇
  2015年   449篇
  2014年   973篇
  2013年   893篇
  2012年   690篇
  2011年   631篇
  2010年   441篇
  2009年   375篇
  2008年   355篇
  2007年   381篇
  2006年   285篇
  2005年   267篇
  2004年   192篇
  2003年   160篇
  2002年   134篇
  2001年   119篇
  2000年   99篇
  1999年   79篇
  1998年   90篇
  1997年   59篇
  1996年   72篇
  1995年   62篇
  1994年   65篇
  1993年   61篇
  1992年   41篇
  1991年   37篇
  1990年   38篇
  1989年   31篇
  1988年   26篇
  1987年   22篇
  1986年   27篇
  1985年   28篇
  1984年   16篇
  1983年   9篇
  1982年   20篇
  1981年   10篇
  1980年   6篇
  1979年   6篇
  1978年   8篇
  1976年   3篇
  1974年   2篇
  1973年   4篇
排序方式: 共有10000条查询结果,搜索用时 453 毫秒
1.
2.

Objective

Comparative survival between neoadjuvant chemotherapy and adjuvant chemotherapy for patients with cT2-4N0-1M0 non–small cell lung cancer has not been extensively studied.

Methods

Patients with cT2-4N0-1M0 non–small cell lung cancer who received platinum-based chemotherapy were retrospectively identified. Exclusion criteria included stage IV disease, induction radiotherapy, and targeted therapy. The primary end point was disease-free survival. Secondary end points were overall survival, chemotherapy tolerance, and ability of Response Evaluation Criteria In Solid Tumors response to predict survival. Survival was estimated using the Kaplan–Meier method, compared using the log-rank test and Cox proportional hazards models, and stratified using matched pairs after propensity score matching.

Results

In total, 330 patients met the inclusion criteria (n = 92/group after propensity-score matching; median follow-up, 42 months). Five-year disease-free survival was 49% (95% confidence interval, 39-61) for neoadjuvant chemotherapy versus 48% (95% confidence interval, 38-61) for adjuvant chemotherapy (P = .70). On multivariable analysis, disease-free survival was not associated with neoadjuvant chemotherapy or adjuvant chemotherapy (hazard ratio, 1.1; 95% confidence interval, 0.64-1.90; P = .737), nor was overall survival (hazard ratio, 1.21; 95% confidence interval, 0.63-2.30; P = .572). The neoadjuvant chemotherapy group was more likely to receive full doses and cycles of chemotherapy (P = .014/0.005) and had fewer grade 3 or greater toxicities (P = .001). Response Evaluation Criteria In Solid Tumors response to neoadjuvant chemotherapy was associated with disease-free survival (P = .035); 15% of patients receiving neoadjuvant chemotherapy (14/92) had a major pathologic response.

Conclusions

Timing of chemotherapy, before or after surgery, is not associated with an improvement in overall or disease-free survival among patients with cT2-4N0-1M0 non–small cell lung cancer who undergo complete surgical resection.  相似文献   
3.
The Yakima Valley Farm Workers Clinic (YVFWC) is one of the largest community health centers in the country with clinics throughout south-central Washington and northern Oregon. Its dental program consists of 14 dental clinics providing general and specialty services to the low-income populations it serves. Modeling itself after the YVFWC medical managed care program; the Dental program recently added value-based metrics to its dental practice after Oregon offered a value-based dental reimbursement plan in 2019. This is the first-step YVFWC's dental program that has taken to prepare for value-based reimbursement and transform its dental practice in order to reduce the disease burden in its patient population. The purpose of this article is to describe the processes YVFWC undertook to prepare itself for the new reimbursement model, which included the development of metrics, a metric validation process, a clinical dashboard, and a method for improving metrics. It also outlines its medical/dental integration improvement brought about by embedding hygienists into the medical primary care teams.  相似文献   
4.
目的观察分析在甲状腺手术患者护理中予以围术期优质护理干预的应用价值。方法此研究从本院甲状腺手术患者中选取样本,总例数为80例,研究时间始于2017年4月,止于2019年4月,依据护理方案的异同对患者进行分组,试验组予以围术期优质护理干预,对照组予以常规性护理干预,对比两组护理结果。结果研究可得,试验组护理满意率相对较高,组间数据对比得知与对照组相比统计值合理(P<0.05)。研究可得,试验组并发症发生率相对较低,组建数据对比得知与对照组相比统计值合理(P<0.05);研究可得,试验组预后生活质量相对较高,组建数据对比得知与对照组相比统计值合理(P<0.05)。结论此研究得知,在甲状腺手术患者护理中予以围术期优质护理干预,能提高患者护理效果,降低其并发症发生情况,并进一步改善患者预后效果。  相似文献   
5.
6.
7.
目的探究糖化血红蛋白在糖尿病(DM)诊断中的应用价值。方法选取该院收治的36例糖尿病(DM)患者作为观察组,时间区间为2019年10月—2020年10月,实施糖化血红蛋白展开筛查和诊断,同时选择36名无糖尿病的健康者为对照组,分析并发症发生率、血糖指标、生活质量、心理状态评分等情况。结果观察组的空腹血糖、糖化血红蛋白和餐后2 h血糖的指标均高于对照组,差异有统计学意义(P<0.05);观察组经糖化血红蛋白展开筛查和诊断后,发现其各项生活质量评分均高于筛查诊断前,差异有统计学意义(P<0.05)。结论针对糖尿病(DM)患者,采用糖化血红蛋白展开筛查和诊断,可有效反映患者血糖改变情况,进一步提升临床上患者疾病诊断准确性,改善其不良负性心理情绪,提供可靠的参考资料,同时显著改善患者的生活质量,安全有效,具有临床应用价值。  相似文献   
8.
《Vaccine》2019,37(31):4310-4317
ONRAB® is a human adenovirus rabies glycoprotein recombinant vaccine developed to control rabies in wildlife. To support licensing and widespread use of the vaccine, safety studies are needed to assess its potential residual impact on wildlife populations. We examined the persistence of the ONRAB® vaccine virus in captive rabies vector and non-target mammals. This research complements work on important rabies vector species (raccoon, striped skunk, and red fox) but also adds to previous findings with the addition of some non-target species (Virginia opossum, Norway rats, and cotton rats) and a prolonged period of post vaccination monitoring (41 days). Animals were directly inoculated orally with the vaccine and vaccine shedding was monitored using quantitative real-time PCR applied to oral and rectal swabs. ONRAB® DNA was detected in both oral and rectal swabs from 6 h to 3 days post-inoculation in most animals, followed by a resurgence of shedding between days 17 and 34 in some species. Overall, the duration over which ONRAB® DNA was detectable was shorter for non-target mammals, and by day 41, no animal had detectable DNA in either oral or rectal swabs. All target species, as well as cotton rats and laboratory-bred Norway rats, developed robust humoral immune responses as measured by competitive ELISA, with all individuals being seropositive at day 31. Similarly, opossums showed good response (89% seropositive; 8/9), whereas only one of nine wild caught Norway rats was seropositive at day 31. These results support findings of other safety studies suggesting that ONRAB® does not persist in vector and non-target mammals exposed to the vaccine. As such, we interpret these data to reflect a low risk of adverse effects to wild populations following distribution of ONRAB® to control sylvatic rabies.  相似文献   
9.
BackgroundThe purpose of this study was to assess diagnostic accuracy and neonatal outcomes in fetuses with a suspected proximal gastrointestinal obstruction (GIO).MethodsAfter IRB approval, a retrospective chart review was conducted on prenatally suspected and/or postnatally confirmed cases of proximal GIO at a tertiary care facility (2012–2022). Maternal-fetal records were queried for presence of a double bubble ± polyhydramnios, and neonatal outcomes were assessed to calculate the diagnostic accuracy of fetal sonography.ResultsAmong 56 confirmed cases, the median birthweight and gestational age at birth were 2550 g [interquartile range (IQR) 2028–3012] and 37 weeks (IQR 34–38), respectively. There was one (2%) false-positive and three (6%) false-negatives by ultrasound. Double bubble had a sensitivity, specificity, positive predictive value, and negative predictive value for proximal GIO of 85%, 98%, 98%, and 83%, respectively. Pathologies included 49 (88%) with duodenal obstruction/annular pancreas, three (5%) with malrotation, and three (5%) with jejunal atresia. The median postoperative length of stay was 27 days (IQR 19–42). Cardiac anomalies were associated with significantly higher complications (45% vs 17%, p = 0.030).ConclusionsIn this contemporary series, fetal sonography has high diagnostic accuracy for detecting proximal gastrointestinal obstruction. These data are informative for pediatric surgeons in prenatal counseling and preoperative discussions with families.Level of EvidenceDiagnostic Study, Level III.  相似文献   
10.
A survey of mycology laboratories for antifungal susceptibility testing (AFST) was undertaken in France in 2018, to better understand the difference in practices between the participating centers and to identify the difficulties they may encounter as well as eventual gaps with published standards and guidelines. The survey captured information from 45 mycology laboratories in France on how they perform AFST (number of strains tested, preferred method, technical and quality aspects, interpretation of the MIC values, reading and interpretation difficulties). Results indicated that 86% of respondents used Etest as AFST method, with a combination of one to seven antifungal agents tested. Most of the participating laboratories used similar technical parameters to perform their AFST method and a large majority used, as recommended, internal and external quality assessments. Almost all the participating mycology laboratories (98%) reported difficulties to interpret the MIC values, especially when no clinical breakpoints are available. The survey highlighted that the current AFST practices in France need homogenization, particularly for MIC reading and interpretation.  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