全文获取类型
收费全文 | 5554篇 |
免费 | 440篇 |
国内免费 | 13篇 |
专业分类
耳鼻咽喉 | 92篇 |
儿科学 | 160篇 |
妇产科学 | 271篇 |
基础医学 | 691篇 |
口腔科学 | 105篇 |
临床医学 | 626篇 |
内科学 | 963篇 |
皮肤病学 | 49篇 |
神经病学 | 503篇 |
特种医学 | 279篇 |
外国民族医学 | 1篇 |
外科学 | 609篇 |
综合类 | 100篇 |
一般理论 | 3篇 |
预防医学 | 763篇 |
眼科学 | 90篇 |
药学 | 433篇 |
1篇 | |
肿瘤学 | 268篇 |
出版年
2022年 | 22篇 |
2021年 | 80篇 |
2020年 | 52篇 |
2019年 | 80篇 |
2018年 | 87篇 |
2017年 | 84篇 |
2016年 | 96篇 |
2015年 | 108篇 |
2014年 | 133篇 |
2013年 | 237篇 |
2012年 | 335篇 |
2011年 | 381篇 |
2010年 | 177篇 |
2009年 | 193篇 |
2008年 | 301篇 |
2007年 | 309篇 |
2006年 | 321篇 |
2005年 | 355篇 |
2004年 | 348篇 |
2003年 | 319篇 |
2002年 | 306篇 |
2001年 | 114篇 |
2000年 | 136篇 |
1999年 | 116篇 |
1998年 | 77篇 |
1997年 | 62篇 |
1996年 | 46篇 |
1995年 | 44篇 |
1994年 | 31篇 |
1993年 | 49篇 |
1992年 | 74篇 |
1991年 | 87篇 |
1990年 | 68篇 |
1989年 | 82篇 |
1988年 | 44篇 |
1987年 | 61篇 |
1986年 | 57篇 |
1985年 | 48篇 |
1984年 | 33篇 |
1983年 | 29篇 |
1982年 | 31篇 |
1981年 | 24篇 |
1980年 | 33篇 |
1979年 | 37篇 |
1978年 | 25篇 |
1976年 | 23篇 |
1975年 | 25篇 |
1974年 | 21篇 |
1973年 | 20篇 |
1971年 | 21篇 |
排序方式: 共有6007条查询结果,搜索用时 15 毫秒
1.
Marta Rozanski Valentin Neuhaus Emily Thornton Stéphanie J. E. Becker James P. Rathmell David Ring 《Journal of hand and microsurgery》2015,7(1):30-35
This study used the National Survey of Ambulatory Surgery (NSAS) database to measure the incidence of and risk factors for symptoms in the ambulatory surgery center and problems within 24 h after isolated carpal tunnel release (CTR). The NSAS contained records on 400,000 adult patients with carpal tunnel syndrome who were treated with CTR in 2006, based on ICD-9 codes. The type of anesthesia used and factors associated with symptoms and problems were sought in bivariate and multivariable statistical analyses. The mean duration of the procedure was 16 ± 8.8 min. Only 5 % were performed under local anesthesia without sedation, 45 % with IV sedation, 28 % regional anesthesia, and 19 % general anesthesia. Symptoms in the ambulatory surgery center or a problem within 24 h after discharge were recorded in 10 % of patients, all of them minor and transient, including difficulties with pain and its treatment. The strongest risk factors were male sex, age of 45 years and older, and participation of an anesthesiologist. Local anesthesia and regional anesthesia were associated with more perioperative symptoms and postoperative problems. Most CTR are performed with some sedation in the United States. CTR is a safe procedure: one in 10 patients will experience a minor issue in the perioperative or immediate postoperative period. 相似文献
2.
Julia Thornton Snider Jesse Sussell Mahlet Gizaw Tebeka Alicia Gonzalez Joshua T. Cohen Peter Neumann 《Value in health》2019,22(3):332-339
Background
Payers frequently rely on budget impact model (BIM) results to help determine drug coverage policy and its effect on their bottom line. It is unclear whether BIMs typically overestimate or underestimate real-world budget impact.Objective
We examined how different modeling assumptions influenced the results of 6 BIMs from the Institute for Clinical and Economic Review (ICER).Study Design
Retrospective analysis of pharmaceutical sales data.Methods
From ICER reports issued before 2016, we collected estimates of 3 BIM outputs: aggregate therapy cost (ie, cost to treat the patient population with a particular therapy), therapy uptake, and price. We compared these against real-world estimates that we generated using drug sales data. We considered 2 classes of BIM estimates: those forecasting future uptake of new agents, which assumed “unmanaged uptake,” and those describing the contemporaneous market state (ie, estimates of current, managed uptake and budget impact for compounds already on the market).Results
Differences between ICER's estimates and our own were largest for forecasted studies. Here, ICER's uptake estimates exceeded real-world estimates by factors ranging from 7.4 (sacubitril/valsartan) to 54 (hepatitis C treatments). The “unmanaged uptake” assumption (removed from ICER's approach in 2017) yields large deviations between BIM estimates and real-world consumption. Nevertheless, in some cases, ICER's BIMs that relied on current market estimates also deviated substantially from real-world sales data.Conclusions
This study highlights challenges with forecasting budget impact. In particular, assumptions about uptake and data source selection can greatly influence the accuracy of results. 相似文献3.
Yinong Young-Xu Julia Thornton Snider Robertus van Aalst Salaheddin M. Mahmud Edward W. Thommes Jason K.H. Lee David P. Greenberg Ayman Chit 《Vaccine》2019,37(11):1484-1490
Background
Observational studies of the relative effectiveness of influenza vaccines are essential for public health decision making. Their estimates, however, are subject to bias due to unmeasured confounders. Instrumental variable (IV) methods can control for observed and unobserved confounders.Methods
We used linked electronic medical record databases in the Veterans Health Administration (VHA) as well as Medicare administrative files to examine the relative vaccine effectiveness (rVE) of high-dose influenza vaccine (HD) versus standard-dose influenza vaccines (SD) in preventing hospitalizations among VHA-enrolled Veterans ≥65?years of age during 5 influenza seasons (2010–2011 through 2014–2015). Using multivariable IV Poisson regression modeling to address unmeasured confounding and bias, we analyzed the data by each season and through longitudinal analysis of all five seasons.Findings
We included 3,638,924 person–influenza seasons of observation where 158,636 (4%) were among HD vaccine recipients and 3,480,288 (96%) were among SD vaccine recipients. Of the 1,728,562 Veterans, 1,702,824 (98.5%) were male and 1,299,412 (75%) were non-Hispanic white. Based on the longitudinal analysis of all five seasons, the IV-adjusted rVE estimate of HD vs. SD was 10% (95% CI, 8–12%) against all-cause hospitalization; 18% (95% CI, 15–21%) against cardiorespiratory-associated hospitalization; and 14% (95% CI, 6–22%) against influenza/pneumonia-associated hospitalization. The findings by season were similar.Interpretation
Our analysis of VHA clinical data collected from approximately 1.7 million Veterans 65?years and older during five seasons demonstrates that high-dose influenza vaccine is more effective than standard-dose influenza vaccines in preventing influenza- or pneumonia-associated hospitalizations, cardiorespiratory hospitalizations, and all-cause hospitalizations. 相似文献4.
Miguel A. Sanz Pau Montesinos Haesook T. Kim Guillermo J. Ruiz-Argüelles María S. Undurraga María R. Uriarte Lem Martínez Rafael H. Jacomo Homero Gutiérrez-Aguirre Raul A. M. Melo Rosane Bittencourt Ricardo Pasquini Katia Pagnano Evandro M. Fagundes Edo Vellenga Alexandra Holowiecka Ana J. González-Huerta Pascual Fernández Javier De la Serna Salut Brunet Elena De Lisa José González-Campos José M. Ribera Isabel Krsnik Arnold Ganser Nancy Berliner Raul C. Ribeiro Francesco Lo-Coco Bob L?wenberg Eduardo M. Rego 《Annals of hematology》2015,94(8):1347-1356
5.
Bob C. Mulder Merel A. A. van Lelyveld Sigrid C. J. M. Vervoort Anne Marike Lokhorst Cees M. J. van Woerkum Jan M. Prins 《Health communication》2016,31(1):35-46
Since the introduction of cART (combination antiretroviral therapy), HIV has evolved into a chronic disease such that it requires lifelong medical treatment to which patients must adhere. Communication with health care providers is pivotal in supporting patients to adapt to having HIV and adhering to treatment, in order to maintain health and quality of life. Previous research indicates that communication is optimal when it matches patient preferences for information exchange, relationship establishment, and involvement in treatment decisions. The aim of the present study is to explore HIV patient communication preferences as well as patient experiences with their providers (not) matching their preferences. A second aim is to explore provider beliefs about patient preferences and provider views on optimal communication. Data were collected through interviews with 28 patients and 11 providers from two academic hospitals. Results indicate that patient preferences reflect their cognitive, emotional, and practical needs such that patients look to increase their sense of control over their HIV. Patients aim to further increase their sense of control (by proxy) through their relationship with their providers and through their decisional involvement preferences. Providers are well aware of patient communication preferences but do not explicate underlying control needs. Implications for clinical practice are discussed. 相似文献
6.
7.
8.
9.
J Thornton D M Ashcroft M Z Mughal R A Elliott T W O'Neill D Symmons 《Archives of disease in childhood》2006,91(9):753-761
AIMS: To evaluate the currently available evidence for the effectiveness of bisphosphonates in children with low bone mineral density (BMD) and fragility fractures associated with juvenile idiopathic arthritis (JIA), and the safety of bisphosphonates in JIA and other conditions. METHODS: Literature databases were searched using a structured search strategy. The effectiveness review included any studies of children with JIA treated with bisphosphonates. The safety review also included studies of osteogenesis imperfecta. Quantitative data analysis was not undertaken because of the heterogeneity of the studies; findings were summarised using tables and narrative synthesis. RESULTS: Ninety four studies were identified. Sixteen studies (78 JIA children) were included in the effectiveness review: one randomised controlled trial, three controlled cohort studies, 11 case series, and one case report. At baseline, children had low BMD below the expected values for age and sex matched children. In all studies, treatment with bisphosphonates increased BMD compared with baseline: the mean percentage increase in spine BMD ranged from 4.5% to 19.1%. Overall, studies were heterogeneous and of variable quality. A total of 59 papers were included in the safety review; treatment durations were up to three years. The most common side effect was a flu-like reaction with intravenous treatment. This occurred during the first infusion and was transient; the symptoms were managed with paracetamol and did not occur during subsequent cycles. CONCLUSIONS: Bisphosphonates are a promising treatment for low BMD and fragility fractures in children with JIA. However, the quality of the current evidence is variable and better studies are needed to more clearly assess their role. 相似文献
10.