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1.
2.
A cost evaluation of implementing a quality-oriented, regional perinatal data system. 总被引:2,自引:0,他引:2
We evaluated the cost impact of implementing a perinatal data system (PDS) on birth certificate (BC) processing and perinatal quality improvement (QI) reporting. Relevant staff in all birthing hospitals in the 15-county Central New York region (N = 23) were interviewed at baseline prior to implementation of the PDS and one year after implementation of the PDS to ascertain the time and costs of BC processing and of QI report generation. The average time and cost to collect and complete BCs did not change significantly from baseline to year 1. The time and costs to complete QI reports decreased significantly by 70 percent during this same period. Hospitals fully using the PDS for QI reporting purposes took, on average, six percent of the time it took other hospitals to generate comparable QI reports. The PDS significantly reduced the time and cost of generating perinatal reports from a consolidated database over what hospitals had done previously. Given the richness of the reports and the efficiency with which they are produced, hospitals are encouraged to adopt electronic means of BC processing and accessing these data for QI reporting purposes. 相似文献
3.
S. Foulds C. H. Wakefield M. Giles J. Gillespie J. F. Dye P. J. Guillou 《British journal of cancer》1993,68(3):610-616
mRNA for the suppressive epitope of p15E was found to be present in 24 of 30 samples of human colorectal cancer and in all four specimens of gastric cancer. mRNA for p15E was seldom seen in nonmalignant colonic or gastric mucosa but, when present, was associated with inflammatory or pre-malignant conditions of the digestive tract. Synthetic peptides derived from the conserved p15E sequence were found to suppress some aspects of the immune response implicated in anti-tumour activity. These data suggest that a p15E-related material with immunomodulatory properties is elaborated within human tumours, either by the tumour itself or as a normal component of the endogenous anti-tumour reaction. 相似文献
4.
Alister Oliver Mark Wright Andrew Matson Graham Woodrow Neil King Louise Dye 《Nephrology, dialysis, transplantation》2004,19(11):2883-2885
BACKGROUND: Interdialytic weight gain (IDWG) can be reduced by lowering the dialysate sodium concentration ([Na]) in haemodialysis patients. It has been assumed that this is because thirst is reduced, although this has been difficult to prove. We compared thirst patterns in stable haemodialysis patients with high and low IDWG using a novel technique and compared the effect of low sodium dialysis (LSD) with normal sodium dialysis (NSD). METHODS: Eight patients with initial high IDWG and seven with low IDWG completed hourly visual analogue ratings of thirst using a modified palmtop computer during the dialysis day and the interdialytic day. The dialysate [Na] was progressively reduced by up to 5 mmol/l over five treatments. Dialysis continued at the lowest attained [Na] for 2 weeks and the measurements were repeated. The dialysate [Na] then returned to baseline and the process was repeated. RESULTS: Baseline interdialytic day mean thirst was higher than the dialysis day mean for the high IDWG group (49.9+/-14.0 vs 36.2+/-16.6) and higher than the low weight gain group (49.9+/-14.0 vs 34.1+/-14.6). This trend persisted on LSD, but there was a pronounced increase in post-dialysis thirst scores for both groups (high IDWG: 46+/-13 vs 30+/-21; low IDWG: 48+/-24 vs 33+/-18). The high IDWG group demonstrated lower IDWG during LSD than NSD (2.23+/-0.98 vs 2.86+/-0.38 kg; P<0.05). CONCLUSIONS: Our results indicate that patients with high IDWG experience more intense feelings of thirst on the interdialytic day. LSD reduces their IDWG, but paradoxically increases thirst in the immediate post-dialysis period. 相似文献
5.
Kevin R. Dye Barry J. Marshall Henry F. Frierson Jr Richard L. Guerrant Richard W. McCallum 《Digestive diseases and sciences》1989,34(11):1787-1791
Summary
Campylobacter pylori may not be the only organism that causes active chronic gastritis in man. We report two cases of gastric infection with a spiral organism distinct fromC. pylori. The first patient is a 36-year-old female who presented with epigastric pain and abdominal colic present since childhood and who had 14 cats. Endoscopy was normal. The second patient kept two dogs. Histology of gastric mucosal biopsy specimens in both patients revealed active chronic gastritis, most severe in body mucosa. Giemsa stain revealed bacteria with four to eight spirals, 0.5 m in diameter and 3–7 m in length. The organisms had multiple sheathed flagella at the pole and smooth cell walls without axial filaments. The organisms resembled the gastric spirillum that has been seen in cats, dogs, and nonhuman primates. After antibacterial therapy with bismuth subsalicylate, amoxicillin, and metronidazole, the organisms disappeared in both patients and the gastritis healed.UnlikeC. pylori, this new spirillum prefers to colonize gastric mucosa containing parietal cells. Whereas this type of organism is a common commensal in other mammals, it appears to be associated with and a possible cause of gastritis in humans. 相似文献
6.
Hormonal fluctuations associated with the menstrual cycle influence
appetite control and eating behaviour. Energy intake varies during the
reproductive cycle in humans and animals, with a periovulatory nadir and a
luteal phase peak. Patterns of macronutrient selection show less
consistency but a number of studies report carbohydrate cravings in the
premenstrual phase, particularly in women with premenstrual syndrome. The
cyclical nature of food cravings are frequently, but not invariably,
associated with depression. Fluctuations in appetite, cravings and energy
intake during the menstrual cycle may occur in parallel with cyclical
rhythms in serotonin, which can be accompanied by affective symptoms. The
premenstrual phase can be considered as a time when women are especially
vulnerable to overconsumption, food craving and depression; this is often
associated with low serotonin activity.
相似文献
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Abscesses were generated in the peritoneal cavity of mice by the inoculation of 10(9) staphylococci. Abscess weight increased rapidly, reaching about 200 mg by the fourth day; for the next 60 days, abscess weight increased only slightly. The amount of total lipid increased during abscess development, attaining a peak level of about 19 mg per abscess at 7 days before decreasing. Almost all of this lipid resulted from the accumulation of neutral lipids. The small increases seen in the phospholipid and glycolipid fractions could be accounted for through the accumulation of host cellular elements in the abscess. Leucocytes containing cytoplasmic lipid droplets were first seen 4-12 h after infection and these cells were widely scattered around the periphery. During the next 2 days, the number of cells with lipid droplets increased markedly and lipid droplets were also found in the deeper portions of the abscesses. Although lipid droplets were found subsequently throughout the abscess, the greatest amounts always occurred in the leucocyte zone immediately proximal to the connective tissue capsule. During abscess development, the bactericidal activity also increased rapidly, reaching a maximum by the seventh day and declining thereafter. 相似文献
10.
This study measured the amount of time women spent obtaining prenatal care, and related that time spent to satisfaction with care. Women with Medicaid coverage (n = 364) were interviewed about several parameters related to their most recent prenatal visit: (1) how long it took them to get to the visit; (2) how long they waited upon arrival; and (3) how much time they spent with practitioners during the visit. Women were asked questions regarding satisfaction with the most recent visit, and with their care in general. They received care from four sources: private practitioners, community health centres (CHCs), hospital clinics and health department clinics. Women's satisfaction with care decreased as time spent with practitioners decreased, relative to time spent travelling and waiting. Those obtaining care from CHCs were more likely to have shorter waiting times and longer visit times than women obtaining care from other sources. Women spent approximately 3 h during pregnancy in face-to-face contact with practitioners. Satisfaction with care is closely associated with women's relative time investment in obtaining care. Both satisfaction and time investment parameters vary widely by source of prenatal care. 相似文献