全文获取类型
收费全文 | 19640篇 |
免费 | 1431篇 |
国内免费 | 45篇 |
专业分类
耳鼻咽喉 | 220篇 |
儿科学 | 570篇 |
妇产科学 | 577篇 |
基础医学 | 2548篇 |
口腔科学 | 226篇 |
临床医学 | 3308篇 |
内科学 | 3642篇 |
皮肤病学 | 381篇 |
神经病学 | 1571篇 |
特种医学 | 440篇 |
外科学 | 1997篇 |
综合类 | 148篇 |
一般理论 | 18篇 |
预防医学 | 2216篇 |
眼科学 | 294篇 |
药学 | 1456篇 |
中国医学 | 64篇 |
肿瘤学 | 1440篇 |
出版年
2023年 | 118篇 |
2022年 | 299篇 |
2021年 | 551篇 |
2020年 | 327篇 |
2019年 | 482篇 |
2018年 | 559篇 |
2017年 | 359篇 |
2016年 | 416篇 |
2015年 | 463篇 |
2014年 | 651篇 |
2013年 | 975篇 |
2012年 | 1408篇 |
2011年 | 1457篇 |
2010年 | 757篇 |
2009年 | 696篇 |
2008年 | 1339篇 |
2007年 | 1376篇 |
2006年 | 1335篇 |
2005年 | 1291篇 |
2004年 | 1176篇 |
2003年 | 1117篇 |
2002年 | 1111篇 |
2001年 | 252篇 |
2000年 | 208篇 |
1999年 | 258篇 |
1998年 | 262篇 |
1997年 | 186篇 |
1996年 | 164篇 |
1995年 | 125篇 |
1994年 | 114篇 |
1993年 | 105篇 |
1992年 | 107篇 |
1991年 | 92篇 |
1990年 | 113篇 |
1989年 | 81篇 |
1988年 | 69篇 |
1987年 | 71篇 |
1986年 | 59篇 |
1985年 | 57篇 |
1984年 | 63篇 |
1983年 | 58篇 |
1982年 | 66篇 |
1981年 | 56篇 |
1980年 | 52篇 |
1979年 | 26篇 |
1978年 | 38篇 |
1977年 | 24篇 |
1976年 | 23篇 |
1974年 | 21篇 |
1973年 | 17篇 |
排序方式: 共有10000条查询结果,搜索用时 15 毫秒
1.
Kara S. Tanaka MD Veronica R. Andaya BA Steven W. Thorpe MD Kenneth R. Gundle MD James B. Hayden MD Yee-Cheen Duong MD Raffi S. Avedian MD David G. Mohler MD Lee J. Morse MD Melissa N. Zimel MD Richard J. O'Donnell MD Andrew Fang MD Robert Lor Randall MD Tina H. Tran BS Christin New BA Rosanna L. Wustrack MD other members of Study Group FORCE 《Journal of surgical oncology》2023,127(1):148-158
2.
3.
4.
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5.
6.
Diane C. Ling Bryanna L. Moppins Colin E. Champ Vikram C. Gorantla Sushil Beriwal 《Practical radiation oncology》2021,11(1):e30-e35
PurposeRegional nodal irradiation (RNI) improved disease-free survival by 3% to 5% in 2 large randomized trials, but this small absolute advantage relies on accurate contouring and dose delivery. We audited our network to determine compliance on regional nodal coverage, contouring, and dosimetric parameters with respect to accepted guidelines.Methods and MaterialsIn our network, we have established a clinical pathway for patients with node-positive breast cancer that guides indications for RNI and dosimetric goals. We reviewed records of 183 patients with nodal macrometastases after upfront surgery or involved nodes of any size after neoadjuvant chemotherapy. Radiation treatment plans were examined to determine lymph node volumes treated, whether nodes were contoured, quality of nodal contours, and whether target coverage and normal organ dosimetric constraints were met when RNI was delivered.ResultsDespite the presence of macrometastases on sentinel lymph node biopsy, no lymph nodes were treated in 2.2% (4 of 183). Of 179 patients who received nodal irradiation, 18 received radiation to axillary levels 1 and 2 only, and 161 patients received RNI. Overall, regional nodes were not treated despite strong indications in 7.6% (14 of 183). Treated nodes were not contoured for 2.2% (4 of 179), and lymph node contours were unacceptable in 15.4% (27 of 175). Of patients receiving RNI, 14.9% (24 of 161) did not have adequate nodal target volume coverage, mean heart dose was >4 Gy for 3.1% (5 of 161), and lung V20 Gy was >35% for 8.7% (14 of 161).ConclusionsAdherence to indications for regional nodal treatment was high, but nodes were either not contoured or had unacceptable contour quality in 18% of plans, and coverage was inadequate in 15%. Because the small disease-free survival advantage seen in trials may be decreased with these deviations, routine clinical practice requires detailed peer review to fully translate results of clinical trials. 相似文献
7.
M. Masson Regnault J. Castañeda-Sanabria M.H.T. Diep Tran M. Beylot-Barry H. Bachelez N. Beneton O. Chosidow A. Dupuy P. Joly D. Jullien E. Mahé M.-A. Richard M. Viguier F. Tubach E. Sbidian C. Paul The PsoBioTeq Study Group 《Journal of the European Academy of Dermatology and Venereology》2020,34(2):293-300
8.
9.
V. Schmitz U. P. Neumann G. Puhl Z. V. Tran P. Neuhaus J. M. Langrehr 《American journal of transplantation》2006,6(2):379-385
Choledochojejunostomy (CJS) is commonly used for biliary reconstruction in liver transplantation for primary sclerosing cholangitis (PSC). We alternatively performed choledochoduodenostomy (CDS) and side-to-side choledochodocholedochstomy in a large cohort of patients. Fifty-one patients with PSC, transplanted between 1988 and 2000, were analyzed retrospectively. Biliary reconstruction was CDS in 25 (49%), CJS in 20 (39%) and CC in 6 transplantations (12%). Biliary leaks occurred in the early follow-up (< or =41 days) only in CDS patients (20%). However, in the late follow-up (>4 months), stricturing of anastomosis was found once in CDS (4%) and CJS (5%). Later (>9 months), intrahepatic bile duct strictures were diagnosed in four CDS (16%), one CJS (5%) and one CC (17%) patient(s). In 48% of CDS (12/25), 60% of CJS (12/20) and 17% of CC (1/6) at least one incidence of cholangitis was observed. Overall, biliary complication rates were significantly higher in CDS (40%) than CJS (10%) and CC (17%); of those none in CC and 12% in CDS were anastomosis-related. Graft/patient survival showed no significant differences among groups. Based on our results we consider CJS the standard method for biliary reconstruction in PSC; however, in selected cases where CJS is difficult to accomplish because of previous surgery or for retransplantation, CDS may present an alternative technique. 相似文献
10.
Saifudin Rashiq Diane Edlund Bruce D Dick 《BMC medical informatics and decision making》2006,6(1):8-6