全文获取类型
收费全文 | 4547篇 |
免费 | 194篇 |
国内免费 | 22篇 |
专业分类
耳鼻咽喉 | 31篇 |
儿科学 | 207篇 |
妇产科学 | 93篇 |
基础医学 | 335篇 |
口腔科学 | 55篇 |
临床医学 | 169篇 |
内科学 | 1589篇 |
皮肤病学 | 78篇 |
神经病学 | 163篇 |
特种医学 | 58篇 |
外科学 | 630篇 |
综合类 | 315篇 |
一般理论 | 2篇 |
预防医学 | 651篇 |
眼科学 | 90篇 |
药学 | 206篇 |
1篇 | |
中国医学 | 34篇 |
肿瘤学 | 56篇 |
出版年
2023年 | 32篇 |
2022年 | 84篇 |
2021年 | 135篇 |
2020年 | 101篇 |
2019年 | 447篇 |
2018年 | 374篇 |
2017年 | 230篇 |
2016年 | 107篇 |
2015年 | 98篇 |
2014年 | 134篇 |
2013年 | 161篇 |
2012年 | 131篇 |
2011年 | 195篇 |
2010年 | 116篇 |
2009年 | 130篇 |
2008年 | 92篇 |
2007年 | 103篇 |
2006年 | 109篇 |
2005年 | 58篇 |
2004年 | 46篇 |
2003年 | 50篇 |
2002年 | 34篇 |
2001年 | 30篇 |
2000年 | 30篇 |
1999年 | 23篇 |
1998年 | 24篇 |
1997年 | 16篇 |
1996年 | 10篇 |
1995年 | 10篇 |
1994年 | 13篇 |
1993年 | 17篇 |
1992年 | 7篇 |
1991年 | 13篇 |
1990年 | 8篇 |
1988年 | 6篇 |
1987年 | 5篇 |
1986年 | 5篇 |
1985年 | 105篇 |
1984年 | 186篇 |
1983年 | 129篇 |
1982年 | 138篇 |
1981年 | 135篇 |
1980年 | 144篇 |
1979年 | 145篇 |
1978年 | 114篇 |
1977年 | 105篇 |
1976年 | 98篇 |
1975年 | 93篇 |
1974年 | 83篇 |
1973年 | 93篇 |
排序方式: 共有4763条查询结果,搜索用时 15 毫秒
1.
目的调查镇江市各医院护士分层培训及分层进阶的方法及现状。方法2018年4—5月间采用自行设计的调查问卷,对全市医院的护理人员进行随机抽样调查。结果调查显示镇江市96.45%的护士受医院分层培训及分层进阶这一模式的管理。其中N1占16.77%,N2占29.5%,N3占41.9%,N4占8.7%,其他占3.11%。有24.53%的护士对医院目前的分层培训方式感到满意并认为无需改进,40.99%的护士表示满意,但需要改进,29.19%的护士表示基本满意,需要改进,5.28%的护士表示不满意需要较大改进。95.82%的医院科室对不用层级的护士有不同的核心能力要求并根据不同核心能力要求进行培训。结论护士分层培训几分层进阶这一管理模式在镇江各医院都有体现,但各医院实行的方式有较大差异,配套的管理方式也有待完善。 相似文献
2.
Shingo Hashimoto Masaki Katsurada Rie Muramatsu Kumiko Asai Kenichiro Tanaka Kensuke Hayashi Yoshiaki Kibe Koichiro Nakajima Yukiko Hattori Hiromitsu Iwata Jun-etsu Mizoe Hiroyuki Ogino Yuta Shibamoto 《Practical radiation oncology》2019,9(2):e149-e155
Purpose
Suppression of respiratory movement of the liver would be desirable for high-precision radiation therapy for liver tumors. We aimed to investigate the effect of our original device-free compressed shell fixation method and breathing instruction on suppression of respiratory movement. The characteristics of liver motion based on the movement of a fiducial marker were also analyzed.Methods and Materials
First, respiratory amplitudes of the liver with the device-free compressed shell were analyzed from the data of 146 patients. The effect of this shell fixing method on liver movement was evaluated. Second, as another cohort study with 166 patients, interfractional internal motion of the liver for patients fixed in the shell was calculated using the fiducial marker coordinate data of images for position setting before daily irradiation. Third, in another 12 patients, intrafractional internal motion was calculated from the fiducial marker coordinate data using x-ray images before and after irradiation.Results
The median respiratory movement without the shell, after fixing with the shell, and after instructing on the breathing method with the shell was 14.2 (interquartile range, 10.7-19.8), 11.5 (8.6-17.5), and 10.4 mm (7.3-15.8), respectively. Systematic and random errors of interfractional internal motion were all ≤2 mm in the left-right and anteroposterior directions and 3.7 and 3.0 mm, respectively, in the craniocaudal direction. Systematic and random errors of intrafractional internal motion were all ≤1.3 mm in the left-right and anteroposterior directions and 0.8 and 2.4 mm, respectively, in the craniocaudal direction.Conclusions
The device-free compressed shell fixation method was effective in suppressing the respiratory movement of the liver. Irradiation position matching using the fiducial marker can correct the interfractional internal motion on each day, which would contribute to the reduction of the margin to be given around the target. 相似文献3.
Mei-Yi Wu Yu-Wei Chen Lie-Yee Hung Chii-Hong Lee Hsin-An Chen Yung-Ho Hsu Mai-Szu Wu 《Transplantation proceedings》2019,51(5):1472-1474
IntroductionThe immunosuppressant agents in kidney transplantation (KT) may lead to various complications such as opportunistic infections and malignancies. BK virus associated nephropathy is a significant complication following KT, and it can result in graft failure. BK virus causes tubulointerstitial nephritis, ureter stenosis, and even graft failure in KT recipients with impaired immune system. We described a 63-year-old woman, who was a hepatitis C carrier and on dialysis for 22 years before KT, who received cadaveric-donor KT 2 years previously. She reported decreasing urine output and general weakness. The serum creatinine level was slightly increased from 2.94 to 4.38 mg/dL.MethodsImmunosuppressant medications including prednisolone, everolimus, cyclosporin, and mycophenolate sodium were continued as maintenance therapy post KT. Kidney biopsy was performed due to deterioration of graft function.ResultsThe kidney biopsy showed consistent results with early-stage polyomavirus nephropathy, characterized by focal viral cytopathic changes with positive immunohistochemical signals and mesangial proliferative glomerulonephritis, immune-complex-mediated (Fig 1 and Fig 2). Negative C4d staining at peritubular capillary was reported. The dosage of mycophenolate sodium was tapered from 720 to 360 mg daily and that of everolimus increased from 0.5 to 1.0 mg daily due to BK viral infection with BK nephropathy. The serum creatinine level was 2.75 mg/dL after treatment.ConclusionEarly detection of BK nephropathy and decreasing immunosuppressant agents are the mainstay of treatment. Substituting leflunomide for mycophenolate sodium and increasing dosage of everolimus has been proposed to solve BK nephropathy. We presented that the use of leflunomide in such situation is in a timely manner. 相似文献
4.
Understanding why persons with human immunodeficiency virus (HIV) have accelerated atherosclerosis and its sequelae, including coronary artery disease (CAD) and myocardial infarction, is necessary to provide appropriate care to a large and aging population with HIV. In this review, we delineate the diverse pathophysiologies underlying HIV-associated CAD and discuss how these are implicated in the clinical manifestations of CAD among persons with HIV. Several factors contribute to HIV-associated CAD, with chronic inflammation and immune activation likely representing the primary drivers. Increased monocyte activation, inflammation, and hyperlipidemia present in chronic HIV infection also mirror the pathophysiology of plaque rupture. Furthermore, mechanisms central to plaque erosion, such as activation of toll-like receptor 2 and formation of neutrophil extracellular traps, are also abundant in HIV. In addition to inflammation and immune activation in general, persons with HIV have a higher prevalence than uninfected persons of traditional cardiovascular risk factors, including dyslipidemia, hypertension, insulin resistance, and tobacco use. Antiretroviral therapies, although clearly necessary for HIV treatment and survival, have had varied effects on CAD, but newer generation regimens have reduced cardiovascular toxicities. From a clinical standpoint, this mix of risk factors is implicated in earlier CAD among persons with HIV than uninfected persons; whether the distribution and underlying plaque content of CAD for persons with HIV differs considerably from uninfected persons has not been definitively studied. Furthermore, the role of cardiovascular risk estimators in HIV remains unclear, as does the role of traditional and emerging therapies; no trials of CAD therapies powered to detect clinical events have been completed among persons with HIV. 相似文献
5.
A study was undertaken of all drowning deaths that occurred over a 30-year period from 1988 to 2017 in the urban section of the River Torrens, Adelaide, South Australia, an augmented waterway that runs through the central business district. Autopsy records from Forensic Science South Australia (FSSA) were reviewed. There were 34 drownings (0–5 cases/yr) with 28 males and 6 females (M;F = 4.6:1), with an age range for males of 18-76yrs (mean 42.0; SD 18.0) and for females of 20-84yrs (mean 69.3; SD 24.5). There were 15 (44%) accidents, 11 (32%) suicides, 1 (3%) homicide and 7 (21%) undetermined. Of the 22 cases during or after 1994 with complete toxicology reports, 10 (45%) had a blood alcohol concentration (BAC) of greater than 0.05% (g/100 mL) with an illicit substance detected in 4 (18%) cases: (MDMA (3,4-methylenedioxymethamphetamine), methylamphetamine and THC (delta-9-tetrahydrocannabinol) acid). The presence of various therapeutic drugs was also detected in 10 cases (45%) including temazepam, fluoxetine, diazepam, olanzapine, amitriptyline, carbamazepine, codeine, citalopram and valproate. Although the numbers of cases were not high, the urban portion of the River Torrens had a much higher number of drowning events per kilometre compared to other inland waterways in South Australia such as the Murray River. This is most likely due to the vulnerability that exists for intoxicated individuals in the city from falls into the water and to the availability of the river as a means of suicide to members of the adjacent urban population. 相似文献
6.
Eitaro Ito Akihiro Takai Yoshinori Imai Hiromi Otani Yoshihiro Onishi Yosuke Yamamoto Kohei Ogawa Taiji Tohyama Shunichi Fukuhara Yasutsugu Takada 《Surgery》2019,165(2):353-359
Background
Controversy continues as to whether single-incision laparoscopic cholecystectomy, with the somewhat larger incision at the umbilicus, may lead to a worse postoperative quality of life and more pain compared with the more classic 4-port laparoscopic cholecystectomy. The aim of this study was to compare single-incision and 4-port laparoscopic cholecystectomy from the perspective of quality of life.Methods
This study was a multicenter, parallel-group, open-label, randomized clinical trial. A total of 120 patients who were scheduled to undergo elective cholecystectomy were randomly assigned 1:1 into the single-incision laparoscopic cholecystectomy or the 4-port laparoscopic cholecystectomy group and then assessed continuously for 2 weeks during the postoperative period. The primary outcome was quality of life, defined as the time to resume normal daily activities. Postoperative pain was also assessed. To explore the heterogeneity of treatment effects, we assessed the interactions of sex, age, and working status on recovery time.Results
A total of 58 patients in the single-incision group and 53 in the 4-port group (n?=?111, 47 male, mean age 57 years) were analyzed. The mean time to resume daily activities was 10.2 days and 8.8 days, respectively, for single-incision and 4-port laparoscopic cholecystectomy (95% confidence interval –0.4 to 3.2, P?=?.12). Similarly, the time to relief from postoperative pain did not differ significantly between the groups. Statistically insignificant but qualitative interactions were noted; in the subgroups of women, full-time workers, and patients younger than 60 years, recovery tended to be slower after single-incision laparoscopic cholecystectomy.Conclusion
Postoperative quality of life did not differ substantially between single-incision laparoscopic cholecystectomy and 4-port laparoscopic cholecystectomy. Patients younger than 60 years, women, and full-time workers tended to have a somewhat slower recovery after single-incision laparoscopic cholecystectomy. 相似文献7.
目的了解丽水市呼吸道病原体感染情况及流行病学特征,为呼吸道传染病诊疗与防控提供科学依据。方法回顾性分析2020年3月至2021年12月丽水市人民医院收治的4035例呼吸道感染患者13项呼吸道病原体PCR毛细电泳核酸检测结果,并分析病原体感染分布特征。结果呼吸道病原体感染患者阳性检出率为32.24%(1301/4035),检出率前5位分别是HRV(16.60%)、HRSV(7.09%)、HPIV(2.87%)、HMPV(2.21%)、HADV(1.96%)。混合感染阳性占比为7.61%(99/1301),Boca病毒(76.0%)与Ch(46.15%)易与其它病原体形成混合感染。不同性别呼吸道病原体感染率差异无统计学意义(P>0.05)。虽然不同季节呼吸道病原体整体感染率差异无统计学意义(P>0.05),但HRV好发于春秋两季,而HPIV在春秋两季感染率较低,春季HRSV感染率较低,HADV在夏秋两季感染率较低,HMPV在冬季较为流行。未成年人呼吸道病原体感染率较高,HRSV、HRV、HPIV、HADV和Boca主要发生于未成年人组,InfB和HMPV在未成年和青年人群感染率都较高。结论未成年人群是呼吸道病原体易感人群,应加强未成年人呼吸道传染病防控。 相似文献
8.
氟哌啶醇季铵盐衍生物的合成及其对冠状动脉的作用 总被引:3,自引:1,他引:2
目的 :合成氟哌啶醇季铵盐衍生物并研究其对动物冠状动脉的作用。方法 :以氟哌啶醇为原料 ,将其与卤代烃在回流的情况下进行反应而得到其季铵盐衍生物。采用猪冠状动脉条生物测定法和Langendorff灌流法研究这些衍生物对冠状动脉的作用。结果 :合成了 7个新化合物 ( 1~ 7) ,其中化合物 7量效依赖地压低KCl所致的猪冠状动脉条收缩曲线 ,阻断较大剂量所致的冠状动脉条痉挛 ,并量效依赖地拮抗脑垂体后叶素所致的离体豚鼠心脏冠脉流量减少。结论 :化合物 7显示了良好的扩张冠状动脉的作用 ,值得进一步研究 相似文献
9.
Susan Goldstein Garth Japhet S. Usdin E. Scheepers 《Health promotion journal of Australia》2004,15(2):114-120
This paper outlines the programming model employed by the Soul City Institute for Health and Development Communication, a South African NGO, in using ‘edutainment’ to facilitate social change. The paper refers to the intersection of this model and current thought on health promotion and various social change theories. It also discusses key challenges and factors contributing to sustainability over 12 years. 相似文献
10.