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1.
International Journal of Mental Health and Addiction - Video game use becomes problematic when it disrupts the ability to fulfill social and personal responsibilities. It has also been associated...  相似文献   
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Abstract

Non-invasive ventilation (NIV) is assisted mechanical ventilation delivered via a facemask for people with chronic conditions that affect breathing. NIV is most commonly delivered via an interface (mask) covering the nose (nasal mask) or the nose and mouth (oronasal mask). The number of children in the UK requiring NIV is currently estimated to be around 5000. Mass-produced masks are available for both the adult and paediatric markets but masks that fit well are difficult to find for children who are small or have asymmetrical facial features. A good conforming fit between the mask and the patient’s face to minimise unintentional air leakage is essential to deliver the treatment effectively; most ventilators will trigger an alarm requiring action if such leakage is detected. We present an innovative use of 3D scanning and manufacturing technologies to deliver novel mask-face interfaces to optimise mask fit to the needs of individual patients. Ahead of planned user trials with paediatric patients, the project team trialled the feasibility of the process of creating and printing bespoke masks from 3D scan data and carried out testing of the masks in adult volunteers to select the strongest design concept for the paediatric trial. The evaluation of the process of designing a bespoke mask from scan data, arranging for its manufacture and carrying out user testing has been invaluable in gaining knowledge and discovering the pitfalls and timing bottlenecks in the processes. This allowed the team to iteratively refine the techniques and methods involved, informing user trials later on in the project. It has also provided indicative cost estimates for 3D printed mask prototype components which are useful in project decision making and trial planning. The value of the process extends to considerations for future implementation of the process within a clinical pathway.  相似文献   
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Background

Little is known about zinc intakes and status during complementary feeding. This is particularly true for baby-led approaches, which encourage infants to feed themselves from the start of complementary feeding, although self-feeding may restrict the intake of zinc-rich foods.

Objective

To determine the zinc intakes, sources, and biochemical zinc status of infants following Baby-Led Introduction to SolidS (BLISS), a modified version of Baby-Led Weaning (BLW), compared with traditional spoon-feeding.

Design

Secondary analysis of the BLISS randomized controlled trial.

Participants/setting

Between 2012 and 2014, 206 community-based participants from Dunedin, New Zealand were randomized to a Control or BLISS group.

Intervention

BLISS participants received eight study visits (antenatal to 9 months) providing education and support regarding BLISS (ie, infant self-feeding from 6 months with modifications to address concerns about iron, choking, and growth).

Main outcome measures

Dietary zinc intakes at 7 and 12 months (weighed 3-day diet records) and zinc status at 12 months (plasma zinc concentration).

Statistical analyses performed

Regression analyses were used to investigate differences in dietary intakes and zinc status by group, adjusted for maternal education and parity and infant age and sex.

Results

There were no significant differences in zinc intakes between BLISS and Control infants at 7 (median: 3.5 vs 3.5 mg/day; P=0.42) or 12 (4.4 vs 4.4 mg/day; P=0.86) months. Complementary food groups contributing the most zinc at 7 months were “vegetables” for Control infants, and “breads and cereals” for BLISS infants, then “dairy” for both groups at 12 months. There was no significant difference in mean±standard deviation plasma zinc concentration between the Control (62.8±9.8 μg/dL [9.6±1.5 μmol/L]) and BLISS (62.8±10.5 μg/dL [9.6±1.6 μmol/L]) groups (P=0.75).

Conclusions

BLISS infants achieved similar zinc intake and status to Control infants. However, the BLISS intervention was modified to increase iron intake, which may have improved zinc intake, so these results should not be generalized to infants following unmodified BLW.  相似文献   
5.
Despite being the most common childhood bone tumor, the genomic characterization of osteosarcoma remains incomplete. In particular, very few osteosarcoma metastases have been sequenced to date, critical to better understand mechanisms of progression and evolution in this tumor. We performed an integrated whole genome and exome sequencing analysis of paired primary and metastatic pediatric osteosarcoma specimens to identify recurrent genomic alterations. Sequencing of 13 osteosarcoma patients including 13 primary, 10 metastatic, and 3 locally recurring tumors revealed a highly heterogeneous mutational landscape, including cases of hypermutation and microsatellite instability positivity, but with virtually no recurrent alterations except for mutations involving the tumor suppressor genes RB1 and TP53. At the germline level, we detected alterations in multiple cancer related genes in the majority of the cohort, including those potentially disrupting DNA damage response pathways. Metastases retained only a minimal number of short variants from their corresponding primary tumors, while copy number alterations showed higher conservation. One recurrently amplified gene, KDR, was highly expressed in advanced cases and associated with poor prognosis. © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.  相似文献   
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Background

Trauma exposure has been linked to risky sexual behavior (RSB), but few studies have examined the impact of distinct trauma types on RSB in one model or how the association with trauma and RSB may differ across race.

Purpose

The objective of the current study was to examine the contribution of trauma exposure types to RSB—substance-related RSB and partner-related RSB identified through factor analysis—in young Black and White adult women.

Methods

We investigated the associations of multiple trauma types and RSB factor scores in participants from a general population sample of young adult female twins (n = 2,948). We examined the independent relationship between specific traumas and RSB, adjusting for substance use, psychopathology, and familial covariates. All pertinent constructs were coded positive only if they occurred before sexual debut.

Results

In Black women, sexual abuse was significantly associated with substance-related and partner-related RSB, but retained significance only for partner-related RSB in a fully adjusted model. For White women, sexual abuse and physical abuse were associated with both RSB factors in the base and fully adjusted models. Witnessing injury or death was only associated with RSBs in base models. For both groups, initiating alcohol (for Black women), alcohol, or cannabis (for White women) before sexual debut (i.e., early exposure) was associated with the greatest increased odds of RSB.

Conclusions

Data highlight the contribution of prior sexual abuse to RSBs for both White and Black women, and of prior physical abuse to RSBs for White women. Findings have implications for intervention after physical and sexual abuse exposure to prevent RSB, and thus, potentially reduce sexually transmitted infection/human immunodeficiency virus infection and unintended pregnancy in young women.  相似文献   
8.
Hairy leukoplakia (HL) is a lesion found on the side of the tongue of immunocompromised individuals, including those with human immunodeficiency virus (HIV) infection. The lesion has unique histopathologic features and is characterised by high-level Epstein-Barr virus (EBV) replication, multiple EBV strains, and extensive inter-and intra-strain recombination. Expression of EBV genes spanning the entire viral life cycle from latency-associated genes to late, replicative genes has been detected in the lesion. HL thus provides a unique opportunity to study EBV expression in oral epithelium, and to study expression of novel EBV genes. We therefore constructed a cDNA library from an HL biopsy and detected expression of two genes not previously described in vivo: BMRF-2 and BDLF-3. Sequence analysis of the cDNAs revealed few amino acid changes from the B95-8 sequence. Expression of both genes was localized to the lower prickle cell layer of the tongue epithelium. BMRF-2 protein expression was primarily detected in the cell nuclei of the upper prickle cell layer. BDLF-3 protein expression was observed in the perinuclear space and Golgi compartment. The function of these proteins is currently under investigation.  相似文献   
9.
Aetiological factors for oral manifestations of HIV   总被引:2,自引:0,他引:2  
OBJECTIVES: Describe the oral diseases in HIV-infected individuals in London, UK and identify social and medical factors related to the presence of specific oral diseases.
DESIGN: Cross-sectional analytic study.
SETTING: Dental clinics.
SUBJECTS: Consecutive sample of 456 patients with HIV infection.
METHODS: Social and medical history and clinical examinations. Univariate and logistic regression analysis.
OUTCOMES: Presence of HIV-associated oral disease.
RESULTS: 80% of patients with AIDS and 50% of patients with HIV had a specific oral disease. The most common diseases were hairy leukoplakia (30%), erythematous candidiasis (24%), pseudomembranous candidiasis (14%), angular chielitis (6%), necrotising periodontal disease (8%) and non-recurrent ulceration (6%).
CONCLUSIONS: The presence of erythematous candidiasis was not related to advanced HIV disease. Pseudomembranous candidiasis, hairy leukoplakia and mucosal ulceration were significantly associated with advanced HIV disease. Smoking was also identified as a strong aetiological factor in oral diseases. Longitudinal studies are required to further explore the prognostic significance of oral diseases in HIV infection.  相似文献   
10.
Abstract: Aim: To compare plaque removal efficacy of Oral‐B CrossAction (CA) used for 1 min with an American Dental Association (ADA) manual toothbrush used for 2 or 5 min in an examiner‐blind, three‐treatment, six‐period crossover study. Materials and methods: After refraining from all oral hygiene procedures for 23–25 h, subjects were randomly assigned to one of nine possible six‐period (visit) treatment sequences. Plaque was assessed at baseline (Rustogi Modified Navy Plaque Index). Post‐brushing scores were recorded after brushing with a marketed dentifrice and the assigned toothbrush for the specified duration. The same procedure was followed at each of six subsequent visits. Clinical measurements were carried out by the same examiner. Results: Forty subjects completed the study. All three treatments effectively removed plaque from the whole mouth, along the gingival margin and from approximal surfaces. Whole mouth and gingival margin plaque removal scores with CA for 1 min did not differ significantly from scores with the ADA toothbrush used for 2 min. The ADA brush used for 5 min showed significantly greater whole mouth (P < 0.001) and gingival margin (P < 0.001) plaque reduction than the two other treatments. Approximal plaque removal scores did not differ between the three treatments. Conclusions: Efficient plaque removal can be achieved after 1 min of brushing with CA. The amount of plaque removed did not differ significantly from that achieved with the ADA brush after 2 min of brushing. Greater whole mouth and gingival margin plaque removal scores were seen with the ADA brush after 5 min.  相似文献   
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