全文获取类型
收费全文 | 127882篇 |
免费 | 11378篇 |
国内免费 | 2090篇 |
专业分类
耳鼻咽喉 | 786篇 |
儿科学 | 1272篇 |
妇产科学 | 1295篇 |
基础医学 | 4058篇 |
口腔科学 | 1729篇 |
临床医学 | 46604篇 |
内科学 | 8555篇 |
皮肤病学 | 888篇 |
神经病学 | 4096篇 |
特种医学 | 2839篇 |
外国民族医学 | 6篇 |
外科学 | 8053篇 |
综合类 | 18445篇 |
现状与发展 | 2篇 |
一般理论 | 7篇 |
预防医学 | 21025篇 |
眼科学 | 1197篇 |
药学 | 9610篇 |
547篇 | |
中国医学 | 6655篇 |
肿瘤学 | 3681篇 |
出版年
2024年 | 620篇 |
2023年 | 2828篇 |
2022年 | 4048篇 |
2021年 | 5610篇 |
2020年 | 6739篇 |
2019年 | 4935篇 |
2018年 | 4334篇 |
2017年 | 5412篇 |
2016年 | 5714篇 |
2015年 | 5353篇 |
2014年 | 10596篇 |
2013年 | 9905篇 |
2012年 | 9459篇 |
2011年 | 9540篇 |
2010年 | 7602篇 |
2009年 | 6940篇 |
2008年 | 6537篇 |
2007年 | 6456篇 |
2006年 | 5638篇 |
2005年 | 4662篇 |
2004年 | 3636篇 |
2003年 | 2812篇 |
2002年 | 2207篇 |
2001年 | 1884篇 |
2000年 | 1543篇 |
1999年 | 1217篇 |
1998年 | 959篇 |
1997年 | 825篇 |
1996年 | 637篇 |
1995年 | 493篇 |
1994年 | 386篇 |
1993年 | 313篇 |
1992年 | 283篇 |
1991年 | 174篇 |
1990年 | 146篇 |
1989年 | 123篇 |
1988年 | 103篇 |
1987年 | 99篇 |
1986年 | 54篇 |
1985年 | 84篇 |
1984年 | 84篇 |
1983年 | 48篇 |
1982年 | 53篇 |
1981年 | 58篇 |
1980年 | 40篇 |
1979年 | 36篇 |
1978年 | 26篇 |
1977年 | 20篇 |
1976年 | 27篇 |
1975年 | 14篇 |
排序方式: 共有10000条查询结果,搜索用时 0 毫秒
1.
2.
Fur-Hsing Wen Jen-Shi Chen Wen-Chi Chou Wen-Cheng Chang Wen Chi Shen Chia-Hsun Hsieh Siew Tzuh Tang 《Journal of pain and symptom management》2019,57(1):64-72
Context
Family caregivers constitute a critical component of the end-of-life care system with considerable cost to themselves. However, the joint association of terminally ill cancer patients' symptom distress and functional impairment with caregivers' subjective caregiving burden, quality of life (QOL), and depressive symptoms remains unknown.Objectives/Methods
We used multivariate hierarchical linear modeling to simultaneously evaluate associations between five distinct patterns of conjoint symptom distress and functional impairment (symptom-functional states) and subjective caregiving burden, QOL, and depressive symptoms in a convenience sample of 215 family caregiver–patient dyads. Data were collected every 2 to 4 weeks over patients' last 6 months.Results
Caregivers of patients in the worst symptom-functional states (States 3–5) reported worse subjective caregiving burden and depressive symptoms than those in the best two states, but the three outcomes did not differ between caregivers of patients in State 3 and States 4–5. Caregivers of patients in State 5 endured worse subjective caregiving burden and QOL than those in State 4. Caregivers of patients in State 4 suffered worse subjective caregiving burden and depressive symptoms but comparable QOL to those in State 2.Conclusion
Patients' five distinct, conjoint symptom-functional states were significantly and differentially associated with their caregivers' worse subjective caregiving burden, QOL, and depressive symptoms while caring for patients over their last 6 months. 相似文献3.
Daniel J. Snyder Thomas R. Kroshus Aakash Keswani Evan B. Garden Karl M. Koenig Kevin J. Bozic David S. Jevsevar Jashvant Poeran Calin S. Moucha 《The Journal of arthroplasty》2019,34(4):613-618
Background
Nursing Home Compare (NHC) ratings, created and maintained by Medicare, are used by both hospitals and consumers to aid in the skilled nursing facility (SNF) selection process. To date, no studies have linked NHC ratings to actual episode-based outcomes. The purpose of this study was to evaluate whether NHC ratings are valid predictors of 90-day complications, readmission, and bundle costs for patients discharged to an SNF after primary total joint arthroplasty (TJA).Methods
All SNF-discharged primary TJA cases in 2017 at a multihospital academic health system were queried. Demographic, psychosocial, and clinical variables were manually extracted from the health record. Medicare NHC ratings were then collected for each SNF. For patients in the Medicare bundle, postacute and total bundle cost was extracted from claims.Results
Four hundred eighty-eight patients were discharged to a total of 105 unique SNFs. In multivariate analysis, overall NHC rating was not predictive of 90-day readmission/major complications, >75th percentile postacute cost, or 90-day bundle cost exceeding the target price. SNF health inspection and quality measure ratings were also not predictive of 90-day readmission/major complications or bundle performance. A higher SNF staffing rating was independently associated with a decreased odds for >75th percentile 90-day postacute spend (odds ratio, 0.58; P = .01) and a 90-day bundle cost exceeding the target price (odds ratio = 0.69; P = .02) but was similarly not predictive of 90-day readmission/complications.Conclusion
Results of our study suggest that Medicare's NHC tool is not a useful predictor of 90-day costs, complications, or readmissions for SNFs within our health system. 相似文献4.
Orapan Poachanukoon Nualanong Visitsunthorn Watcharee Leurmarnkul Pakit Vichyanond 《Pediatric allergy and immunology》2006,17(3):207-212
Quality of life (QoL) is an important consideration among asthma sufferers. The Pediatric Asthma Quality of Life Questionnaire (PAQLQ) is one of the most widely used instruments for measuring health-related QoL in children with asthma. The standardized version of PAQLQ contains 23 questions in three domains, i.e., activity limitation, symptoms and emotional function. The objective of this study was to validate the Thai-translated version of the PAQLQ. The study design consisted of a five-week single cohort study. Patients recorded symptoms, and peak expiratory flow rate (PEFR) each morning and evening during the first and fifth week of the study in asthma diary. At each clinic visit, a trained-interviewer administered the PAQLQ and performed spirometric measurements. Fifty-one children, ages between 7 and 17 yr participated in the study. Scores from the asthma diary were used to classify patients into stable vs. unstable groups. The construct validity of the questionnaire was confirmed in both cross-sectional and longitudinal studies by demonstrating correlations between various PAQLQ domains with clinical asthma parameters (asthma diary, beta-agonist use and PEFR). There was high internal consistency for scores of the three domains (Cronbach's alpha-coefficient = 0.83-0.95). For those with stable asthma, the reliability of PAQLQ was good for the rating scale (intra-class correlation coefficient--ICC = 0.84) and for total score (alpha = 0.97) indicating high reproducibility of the PAQLQ. The significant difference of changes QoL scores between stable and unstable groups was observed in all domains. We conclude that the Thai version of PAQLQ is valid and reliable for implementing in Thai children with asthma. 相似文献
5.
Michiel R. de Boer Jos Twisk Annette C. Moll Hennie J. M. Völker-Dieben Henrica C. W. de Vet Ger H. M. B. van Rens 《Ophthalmic & physiological optics》2006,26(6):535-544
Consecutive patients (n = 215) who were referred to optometric (55%) or multidisciplinary (45%) low-vision services and above 50 years of age were recruited from four hospitals in the Netherlands. They completed two vision-related quality of life questionnaires, the Vision Quality of Life Core Measure (VCM1) and the Low Vision Quality of Life Questionnaire (LVQOL), before their first visit with low-vision services and 1 year later. At follow-up, patients referred to multidisciplinary low-vision services had lower scores on the mobility subscale of the LVQOL than patients referred to optometric low-vision services [5.3 points; 95% confidence interval (CI): 0.2-10.5]. Paired sample t-tests for the two groups of patients taken together show improvement for the VCM1 (3.1 points; 95% CI: 0.6-5.6) and deterioration for the basic aspects of vision (3.5 points; 95% CI: 1.1-5.9) and the mobility (6.6 points; 95% CI: 3.7-9.5) subscales of the LVQOL. In conclusion, people referred to optometric services showed less deterioration in mobility than those referred to multidisciplinary services. No differences were observed for any of the other subscales of the LVQOL and the VCM1. Future research in this field should include randomized controlled designs comparing low-vision services with no treatment or placebo. 相似文献
6.
改变督导方式促进临床教学质量 总被引:1,自引:0,他引:1
刘晋才 《解放军医院管理杂志》2006,13(9):755-756
目的:发挥教学督导的作用,提高医学院校临床教学的质量.方法:对教学督导工作进行了大胆的改革:①督导前移,加强了教学的环节质量;②疏通反馈通道,保证教学督导效果;③言传身教,加强对青年教师的培养和指导;④扩大督导范围,促进各层次教学质量;⑤全程随机评价,客观评价教学效果.结果:保证了教学效果,使教学质量有了明显的提高.结论:加速我军现代化建设,培养高素质医学人才,教学督导的作用显的尤其重要. 相似文献
7.
Eija Heikkinen MNSc RN Merja Nikkonen PhD RN & Helena Aavarinne PhD RN 《Journal of advanced nursing》1998,27(5):1069-1075
The definition of envy is commonly based on psychoanalytical views of organizational culture. The purpose of this paper is to describe envy in a nursing community. The population study consisted of random sample of 120 subjects drawn from among the employees of one central hospital in Finland. The study material consisted of data collected by questionnaires (response rate 65%). The data were processed by various statistical methods. Open-ended questions were analysed by inductive content analysis. The results of this study indicated that the employee's view of his/her official position in the nursing community, his/her relationships with his/her fellow workers and the management as well as relationships with other nursing communities are all related to envy. The employee's view of his/her official position intensified his/her feelings of envy, if he/she had other negative feelings, anxiety, dissatisfaction with him/herself, and negative feelings towards fellow workers. The major object of envy was fellow workers' salaries. Envy towards other nursing communities was generated by alleged differences in the amount of labour, or by the charge nurse's greater interest in other sections. Employees coped with envy by hiding these feelings and being modest. Women coped with envy by being silent, while men denied the value of the object of envy. 相似文献
8.
Nursing in the health care system of the postmodern world: crossroads, paradoxes and complexity 总被引:1,自引:0,他引:1
Ada Spitzer RN PhD 《Journal of advanced nursing》1998,28(1):164-171
Entering the postmodern world in which society is confronting crossroads, paradoxes, and complexity, the health care system is encountering a transformation more comprehensive and revolutionary than has ever been seen before. Analysis of the state of nursing vis a vis these transformations indicates that the current paradigm does not ensure the existence of the profession in the postmodern health care system. That is because of increased difficulties in consolidating the economic and quality issues into the core of nursing, and in understanding the complexity inherent in health related situations. 相似文献
9.
David C. Cone MD Susan M. Nedza MD MBA James J. Augustine MD Steven J. Davidson MD MBA 《Academic emergency medicine》2002,9(11):1085-1090
This paper reports the proceedings of the discussion panel assigned to look at clinical aspects of quality in emergency medicine. One of the seven stated objectives of the Academic Emergency Medicine consensus conference on quality in emergency medicine was to educate emergency physicians regarding quality measures and quality improvement as essential aspects of the practice of emergency medicine. Another topic of interest was a discussion of the value of information technology in facilitating quality care in the clinical practice of emergency medicine. It is important to note that this is not intended to be a comprehensive review of this extensive topic, but instead is designed to report the discussion that occurred at this session of the consensus conference. 相似文献
10.
Nuttan K. Tanna 《Pharmacy World & Science》2005,27(1):4-6
The evaluation of healthcare practice and service delivery is fraught with difficulties. Service development and / or delivery occurs within socially dynamic settings which are in a continual state of change. Service development also often involves large elements of improvisation. The action research approach is useful for health service research, as it supports collaboration between researchers and practitioners, and not only allows but makes explicit that the action researcher has both roles within the setting being studied. This paper discusses action research methodology and offers insight into principles that favor its use for service delivery development. This includes consideration of the interactive variables within studies of health care systems and the importance of
evaluating relationships between stakeholders to understand how these factors or variables, which cannot be controlled for, are responsible for successful development of the service. Action research facilitates change and helps bridge the heory--practice gap. With the current dynamic changes within both the pharmacy profession and national health services, researchers may find the action research technique of value
when considering new roles and innovative ways of engaging in collaborative, multi-disciplinary working to improve delivery of patient care.Accepted july 2004 相似文献