全文获取类型
收费全文 | 42067篇 |
免费 | 3549篇 |
国内免费 | 116篇 |
专业分类
耳鼻咽喉 | 611篇 |
儿科学 | 1592篇 |
妇产科学 | 1268篇 |
基础医学 | 6048篇 |
口腔科学 | 920篇 |
临床医学 | 3945篇 |
内科学 | 9606篇 |
皮肤病学 | 995篇 |
神经病学 | 4436篇 |
特种医学 | 1263篇 |
外国民族医学 | 3篇 |
外科学 | 5131篇 |
综合类 | 575篇 |
现状与发展 | 1篇 |
一般理论 | 49篇 |
预防医学 | 3132篇 |
眼科学 | 838篇 |
药学 | 2379篇 |
中国医学 | 19篇 |
肿瘤学 | 2921篇 |
出版年
2022年 | 332篇 |
2021年 | 920篇 |
2020年 | 592篇 |
2019年 | 928篇 |
2018年 | 951篇 |
2017年 | 716篇 |
2016年 | 762篇 |
2015年 | 855篇 |
2014年 | 1180篇 |
2013年 | 1570篇 |
2012年 | 2236篇 |
2011年 | 2305篇 |
2010年 | 1307篇 |
2009年 | 1052篇 |
2008年 | 1903篇 |
2007年 | 1985篇 |
2006年 | 1906篇 |
2005年 | 1869篇 |
2004年 | 1748篇 |
2003年 | 1589篇 |
2002年 | 1603篇 |
2001年 | 1148篇 |
2000年 | 1197篇 |
1999年 | 1027篇 |
1998年 | 456篇 |
1997年 | 374篇 |
1996年 | 355篇 |
1995年 | 327篇 |
1994年 | 310篇 |
1993年 | 326篇 |
1992年 | 868篇 |
1991年 | 807篇 |
1990年 | 690篇 |
1989年 | 731篇 |
1988年 | 678篇 |
1987年 | 711篇 |
1986年 | 656篇 |
1985年 | 682篇 |
1984年 | 541篇 |
1983年 | 468篇 |
1982年 | 304篇 |
1980年 | 261篇 |
1979年 | 457篇 |
1978年 | 307篇 |
1976年 | 281篇 |
1975年 | 266篇 |
1974年 | 298篇 |
1973年 | 295篇 |
1972年 | 267篇 |
1971年 | 260篇 |
排序方式: 共有10000条查询结果,搜索用时 406 毫秒
1.
2.
3.
4.
5.
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6.
Julia H. Vermylen Gordon J. Wood Elaine R. Cohen Jeffrey H. Barsuk William C. McGaghie Diane B. Wayne 《Journal of pain and symptom management》2019,57(3):682-687
Introduction
Physician communication impacts patient outcomes. However, communication skills, especially around difficult conversations, remain suboptimal, and there is no clear way to determine the validity of entrustment decisions. The aims of this study were to 1) describe the development of a simulation-based mastery learning (SBML) curriculum for breaking bad news (BBN) conversation skills and 2) set a defensible minimum passing standard (MPS) to ensure uniform skill acquisition among learners.Innovation
An SBML BBN curriculum was developed for fourth-year medical students. An assessment tool was created to evaluate the acquisition of skills involved in a BBN conversation. Pilot testing was completed to confirm improvement in skill acquisition and set the MPS.Outcomes
A BBN assessment tool containing a 15-item checklist and six scaled items was developed. Students' checklist performance improved significantly at post-test compared to baseline (mean 65.33%, SD = 12.09% vs mean 88.67%, SD = 9.45%, P < 0.001). Students were also significantly more likely to have at least a score of 4 (on a five-point scale) for the six scaled questions at post-test. The MPS was set at 80%, requiring a score of 12 items on the checklist and at least 4 of 5 for each scaled item. Using the MPS, 30% of students would require additional training after post-testing.Comments
We developed a SBML curriculum with a comprehensive assessment of BBN skills and a defensible competency standard. Future efforts will expand the mastery model to larger cohorts and assess the impact of rigorous education on patient care outcomes. 相似文献7.
8.
Sex chromosome trisomies (SCT) are among the most common chromosomal duplications in humans. Due to recent technological advances in non-invasive screening, SCT can already be detected during pregnancy. This calls for more knowledge about the development of (young) children with SCT. This review focused on neurocognitive functioning of children with SCT between 0 and 18 years, on domains of global intellectual functioning, language, executive functioning, and social cognition, in order to identify targets that could benefit from early treatment. Online databases were used to identify peer-reviewed scientific articles using specific search terms. In total 18 studies were included. When applicable, effect sizes were calculated to indicate clinical significance. Results of the reviewed studies show that although traditionally, the focus has been on language and intelligence (IQ) in this population, recent studies suggest that executive functioning and social cognition may also be significantly affected already in childhood. These findings suggest that neuropsychological screening of children diagnosed with SCT should be extended, to also include executive functioning and social cognition. Knowledge about these neurocognitive risks is important to improve clinical care and help identify targets for early support and intervention programs to accommodate for the needs of individuals with SCT. 相似文献
9.
We present the case of 7‐year‐old African American girl with loose anagen syndrome. Although this is a common cause of hair loss in Caucasian children, and there have been reports of cases occurring in dark‐skinned children of North African and Middle Eastern descent, to our knowledge there have been no cases reported in black children of sub‐Saharan African ancestry. We present this case to broaden the differential diagnosis of hair loss in African Americans. 相似文献
10.