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BACKGROUND: Paediatric audiology services and screening programmes are currently under review. AIMS AND METHODS: To investigate current practice and performance of the school hearing screening programme (SHSP) by means of a questionnaire. RESULTS: SHSP was found to detect previously unrecognised hearing loss at low cost. Wide variation in practice was shown, and the majority of services had no computerised system for data collection. CONCLUSION: There is a need for nationally agreed protocols and quality assurance procedures. 相似文献
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The long-term consequences for infants with problems of feeding and crying behavior remain unknown. The purpose of this research was to determine whether such children are later perceived by their parents as vulnerable and more often have behavior problems and have different personalities than children without problems in infancy. The implications of managing such problems by changing milk formulas is explored. Mothers of 379 infants were enrolled in the postpartum period. Information about problems of feeding and crying behavior was obtained at 4 months. Thirty-six percent of the infants had problems and the formula had been changed for 17%. At 3 1/2 years, 320 (84%) mothers completed a questionnaire. Children who had had problems were more often perceived as vulnerable (relative risk [RR] 1.86; 95% confidence interval [CI] 1.09, 3.19) and more often had behavior problems (RR 1.78; 95% CI 1.03, 3.07). There were no differences in personality. Children whose problems had been managed by changing milk formulas were more often perceived as vulnerable (RR 2.18; 95% CI 1.05, 4.53). Although allergies were reported significantly more often for those children who had had problems, there were no differences in the prevalence of asthma or eczema. Problems of feeding and crying behavior in early infancy and the way they are managed may have long-term implications for the child. 相似文献
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New epidemiologic evidence confirming that bias does not explain the aspirin/Reye's syndrome association 总被引:1,自引:0,他引:1
B W Forsyth R I Horwitz D Acampora E D Shapiro C M Viscoli A R Feinstein R Henner N B Holabird B A Jones A D Karabelas 《JAMA》1989,261(17):2517-2524
To determine the validity of the aspirin/Reye's syndrome association, we developed an epidemiologic investigation to assess the effects of five potential sources of bias. A case-control study incorporated procedures to avoid temporal precedence and susceptibility bias. These included classifying cases as having monophasic or biphasic patterns of illness and matching for severity of symptoms at zero-time. To evaluate the effect of a potential recall bias, an "alternate-condition" control group was enrolled. A medical record review study was conducted to assess the potential for diagnostic bias, and a blanket surveillance of all hospitals in a region was conducted to evaluate reporting bias. Twenty-four case subjects and 48 matched controls were enrolled. Eight-eight percent of case subjects and only 17% of controls had received aspirin prior to the onset of Reye's syndrome (matched odds ratio, 35; 95% confidence interval, 4.2 to 288). Further analyses demonstrated that the association could not be attributed to the five potential sources of bias. 相似文献
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Impaired Microvascular Function in Normal Children: Effects of Adiposity and Poor Glucose Handling 总被引:1,自引:0,他引:1
Faisel Khan Fiona C. Green J. Stewart Forsyth Stephen A. Greene rew D. Morris Jill J. F. Belch 《The Journal of physiology》2003,551(2):705-711
Clustering of cardiovascular risk factors is thought to occur early in life. The endothelium is an important regulator of microvascular function. We investigated the relationship between microvascular function and cardiovascular risk factors in 145 normal, healthy children aged 11-14 years. Skin microvascular responses, measured using laser Doppler imaging, to iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP), were negatively correlated with percentage body fat ( r =−0.20, P < 0.05 and r =−0.18, P < 0.05, respectively). Subjects were stratified into quintiles based on 2-h, post-feeding glucose levels. Subjects in the upper glucose quintile (range 7.4-11.4 mmol l−1 ) showed significantly lower vasodilatation to both ACh ( P < 0.005 ) and SNP ( P < 0.02 ) than those in the lower quintile (range 3.9-4.9 mmol l−1 ). Waist-to-hip ratio and the fasting insulin resistance index were significantly greater in subjects in the upper quintile than those in the lower quintile ( P < 0.001 and P < 0.05, respectively). Additionally, in subjects in the upper glucose quintile, fasting triglyceride correlated with fasting insulin ( r = 0.59, P < 0.001) and with the fasting insulin resistance index ( r = 0.49, P < 0.009), and plasma levels of cholesterol and 2-h glucose were also correlated ( r = 0.40, P < 0.05). In a cross-section of normal children, microvascular function was negatively associated with adiposity. Additionally, in a subgroup of subjects, there was a clustering of high post-feeding glucose, impaired microvascular function, increased insulin resistance and higher central fat distribution. These findings suggest that risk factors for adult cardiovascular disease begin to cluster in normal children, which might have important consequences for development of atherosclerosis later in life. 相似文献
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Comparison of ultrasonographic findings in spontaneous abortions with normal and abnormal karyotypes 总被引:2,自引:2,他引:2
To determine whether ultrasonographic findings can predict the karyotype of
spontaneous abortions, 137 pregnancies (54 spontaneous, 83 assisted
ovulatory cycles) that subsequently aborted and had chromosome analysis
performed on the products of conception were studied ultrasonographically.
Transvaginal ultrasound was performed using an Acuson 128XP/10 with 7.5 MHz
probe. The numbers of empty gestational sacs, small and normal for
gestational size, embryonic poles and embryos with documented cardiac
activity were calculated. The frequency of each of these findings in
pregnancies with normal and abnormal karyotypes was compared. Of the 137
spontaneous abortions, 51 had normal chromosome analyses and 86 had
abnormal karyotypes (68 aneuploidies and 18 polyploidies). Ultrasonographic
findings in the 51 karyotypically normal pregnancies included 16 (31%) with
empty gestational sacs, and 35 (69%) with embryonic poles, of which 24
(69%) were at least 1 week smaller than expected for gestational age and 11
(31%) were the expected size. Embryonic cardiac activity was documented in
22 (63%) of the 35 embryonic poles. Amongst 86 pregnancies with abnormal
karyotypes, similar frequencies of ultrasound findings were found: 23 (27%)
with empty gestational sacs, 42 (67%) with embryonic poles smaller than
expected for gestational age, and 50 (79%) embryos lost after documentation
of embryonic cardiac activity. No differences in the frequency of
ultrasonographic findings of empty gestational sacs, small embryonic pole
and embryonic cardiac activity were observed between karyotypically normal
and abnormal spontaneous abortions. Ultrasonographic findings cannot
predict the karyotype of spontaneous abortions.
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