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1.
《Radiography》2022,28(2):454-459
IntroductionMR facilities must implement and maintain adequate screening and safety procedures to ensure safety during MR examinations. The aim of this study was to evaluate a multi-step MR safety screening process used at a 7T facility regarding incidence of different types of safety risks detected during the safety procedure.MethodsSubjects scheduled for an MR examination and having entered the 7T facility during 2016–2019 underwent a pre-defined multi-step MR safety screening process. Screening documentation of 1819 included subjects was reviewed, and risks identified during the different screening steps were compiled. These data were also related to documented decisions made by a 7T MR safety committee and reported MR safety incidents.ResultsPassive or active implants (n = 315) were identified in a screening form and/or an additional documented interview in 305 subjects. Additional information not previously self-reported by the subject, regarding implants necessitating safety decisions performed by the staff was revealed in the documented interview in 102 subjects (106 items). In total, the 7T MR safety committee documented a decision in 36 (2%) of the included subjects. All of these subjects were finally cleared for scanning.ConclusionA multi-step screening process allows a thorough MR screening of subjects, avoiding safety incidents. Different steps in the process allow awareness to rise and items to be detected that were missed in earlier steps.Implications for practiceSafety questions posed at a single timepoint during an MR screening process might not reveal all safety risks. Repetition and rephrasing of screening questions leads to increased detection of safety risks. This could be effectively mitigated by a multi-step screening process. A multi-disciplinary safety committee is efficient at short notice responding to unexpected safety issues.  相似文献   
2.
Introduction: Nutraceuticals, up today, do not have a specific definition distinct from those of other food-derived categories, e.g. food supplements, herbal products, pre and probiotics, functional foods, etc. They have, however, a pharmacological beneficial effect on health. Many studies have been recently addressed to assess their safety, efficacy, and regulation since they are getting growing attention by market and research, with the aim to clear the difference between them and other market available food-derived products that claim beneficial effect on health.

Areas covered: The understanding of the potential mechanisms of action of pharmaceutically active substances contained in nutraceuticals that may improve health and reduce the risk of pathological conditions while enhancing overall well-being is the challenge for nutraceuticals to be considered as a preventive and therapeutic efficient tool in facing some diseases.

Expert commentary: It is of utmost importance to have a proper and unequivocal definition of nutraceuticals and a shared regulation. Nevertheless, there is a lack of clear information and, often, the claimed health benefits may not be properly substantiated by safety and by efficacy in vivo data, which can induce false expectations and miss the target for a product to be effective, as claimed.  相似文献   

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Background

Hospitalization can contribute to insomnia in many patients and is usually treated symptomatically. However, sedative/hypnotic misuse is associated with complications in this population, especially in the elderly. Such complications include dizziness, falls and over-sedation. Due to the implicit dangers, widespread use of these drugs for insomnia, particularly in older patients, has been discouraged by many hospitals. The aim of this study was to review and evaluate prescribing patterns and to optimize the use of the sedative/hypnotic agents through daily pharmacy interventions at a community hospital.

Methods

This was a biphasic before and after study. Data on sedative/hypnotic use was collected retrospectively for a 2-month period and a sample of 100 patients was randomly selected for analysis. A 2-month prospective phase followed, in which daily orders were reviewed by one pharmacy resident and recommendations made to discontinue any unnecessary, newly prescribed sedative/hypnotic orders when appropriate. Finally, results of both phases were compared for any differences in patient demographics, being prescribed more than one sedative/hypnotic, and complications documented.

Results

During the prospective phase, pharmacist interventions led to the discontinuation of 25% of a total of 97 sedative/hypnotic orders in 97 patients. The number of patients receiving more than one sedative/hypnotic agents in the intervention group was significantly lower than the retrospective control group (15 Vs. 34, P?=?0.0026). The incidence of complications was not significantly different between the control and intervention groups for the following: over-sedation, falls and delirium (p?=?0.835, p?=?0.185, p?=?0.697, respectively).

Conclusion

This study suggests that the use of sedative/hypnotics in the inpatient units (excluding the critical care unit), is somewhat prevalent, and many patients may be on more than one sedative/hypnotic, which could potentially cause cumulative harm. During the intervention phase, 25% of the total in-hospital orders for sedative/hypnotics were discontinued following recommendations made by a pharmacist, and significantly lower number of patients receiving duplicate sedative/hypnotics was noted. Further efforts should be implemented to avoid unnecessary sedative/hypnotic initiation in hospitalized patients, and to ensure monitoring by pharmacists is optimized.  相似文献   
5.
目的了解国内外医疗机构患者安全文化测评工具的特征、优劣点及研究趋势,为后续研究及医院管理提供借鉴与参考。方法在Pub Med和CNKI上,对2000—2016年间国内外公开发表的患者安全测评工具进行系统文献综述。结果最终检索并纳入68篇文献,涉及20个患者安全文化测评工具;在调查方法上,除Ma PSAF采用访谈法之外,另外19个测评工具均采用问卷法;在调查对象上,除Parental-reported hospital safety climate是服务对象之外,另外19个测评工具均是医务人员;PSCHO、Ma PSAF、SAQ、HSOPSC和SCOPE 5个测评工具针对不同机构或国家和地区提供了修订版本,其中HSOPSC的修订版本最多达23个。结论国内外医疗机构患者安全文化测评工具研究日趋成熟,针对不同机构或文化背景的测评工具研究已成为研究热点及趋势之一,建议将患者安全文化测评纳入医疗机构的评审指标或规范化管理流程之中,以更好地促进患者安全和医疗服务质量。  相似文献   
6.
目的观察吡拉西坦注射液联合胞磷胆碱注射液治疗缺血性脑卒中的临床疗效与安全性。方法将94例缺血性脑卒中患者随机分为对照组47例和试验组47例。对照组予以吡拉西坦每次20 g,qd,静脉注射;试验组在对照组治疗的基础上,予以胞磷胆碱每次0.5 g,qd,静脉滴注。2组患者均治疗14 d。比较2组患者的临床疗效、血清单核细胞趋化蛋白-1(MCP-1)、同型半胱氨酸(HCY)、高密度脂蛋白胆固醇(HDL-C)水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为87.23%(41例/47例)和63.83%(30例/47例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的血清MCP-1分别为(90.74±10.33)和(120.71±15.42)pg·mL-1,HCY分别为(16.68±2.24)和(21.01±3.03)μmol·L-1,HDL-C分别为(1.31±0.16)和(1.12±0.13)mmol·L-1,差异均有统计学意义(均P<0.05)。试验组发生的药物不良反应以失眠、食欲缺乏和口干为主,对照组发生的药物不良反应以皮疹、腹泻和低血压为主。试验组和对照组的总药物不良反应发生率分别为10.64%和14.89%,差异无统计学意义(P>0.05)。结论吡拉西坦注射液联合胞磷胆碱注射液治疗缺血性脑卒中的临床疗效确切,其能显著降低患者的血清MCP-1及HCY水平,升高HDL-C水平,且不增加药物不良反应的发生率。  相似文献   
7.
Introduction: Budesonide belongs to low-bioavailability steroids class. A novel oral formulation of budesonide, which uses the Multi-Matrix System (MMX) for delivering drugs to the colon, is now available as a possible treatment of ulcerative colitis patients intolerant or not-responding to first-line therapy with 5-ASA.

Areas covered: in this review we present information about the development and the use of budesonide MMX and we provide data about its mechanism of action as well as, pharmacodynamics and pharmacokynetics. Moreover, we present the available literature data about the efficacy and, mainly, the safety of budesonide-MMX.

Expert opinion: budesonide-MMX is a new therapeutic option in mild-to-moderate UC patients. Its good safety profile in clinical trials undoubtedly represents a strength for a possible wide use in clinical practice, mainly if it will be confirmed by post-marketing data. Other indications, such as treatment of colonic Crohn’s disease, could theoretically be considered, if sustained by reliable scientific data.  相似文献   

8.
Introduction: The indications for lisdexamfetamine (LDX), a central nervous system stimulant, were recently expanded to include treatment of moderate to severe binge eating disorder (BED).

Areas covered: This review aims to describe the chemistry and pharmacology of LDX, as well as the clinical trials investigating the efficacy and safety of this medication for the management of BED.

Expert opinion: LDX is the first medication with United States Food and Drug Administration approval for the treatment of BED. It is an inactive prodrug of d-amphetamine that extends the half-life of d-amphetamine to allow for once daily dosing. D-amphetamine acts primarily to increase the concentrations of synaptic dopamine and norepinephrine. Metabolism of LDX to d-amphetamine occurs when peptidases in red blood cells cleave the covalent bond between d-amphetamine and l-lysine. D-amphetamine is then further metabolized by CYP2D6. Excretion is primarily through renal mechanisms. In clinical trials, LDX demonstrated statistical and clinical superiority over placebo in reducing binge eating days per week at doses of 50 and 70 mg daily. Commonly reported side effects of LDX include dry mouth, insomnia, weight loss, and headache, and its use should be avoided in patients with known structural cardiac abnormalities, cardiomyopathy, serious heart arrhythmia or coronary artery disease. As with all CNS stimulants, risk of abuse needs to be assessed prior to prescribing.  相似文献   

9.
目的探讨多壁纳米碳管增强义齿基托树脂(MWCNTs/PMMA)复合材料的生物学性能。方法进行MWCNTs/PMMA复合材料制备,参照ISO7406技术报告相关标准,对MWCNTs/PMMA复合材料生物安全性进行体内及体外试验.包括细胞毒性试验、急性全身毒性试验及口腔黏膜刺激试验.评价复合材料的生物学性能。结果细胞毒性试验评价级别为1级.无明显细胞毒性作用:急性全身毒性试验未见任何急性毒性反应:口腔黏膜刺激试验未见异常组织学反应。结论MWCNTs/PMMA复合材料具有良好的生物安全性.安全无毒。  相似文献   
10.
The authors propose a new checklist model adapted for ambulatory oral surgery procedures based on the ‘surgical checklist’ proposed by the WHO. The proposed document contains 18 items divided into two sets: those that must be verified before beginning surgery and those that must be verified after its completion, but prior to the patient's departure from the site where the surgery is performed. A checklist is an easy-to-use tool that requires little time but provides order, logic and systematization taking into account certain basic concepts to increase the level of patient safety. The authors think that the result is a checklist that is easy to complete and ensures that key patient safety-related matters are dealt with in this field of surgery.  相似文献   
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