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Harmful alcohol use encompasses a spectrum of habits, including heavy episodic drinking (HED) which increases the risk of acute alcohol-related harms. The prevalence of HED in Saint Vincent and the Grenadines (SVG) is 5.7% among the overall population aged 15 years and older and 10.2% among drinkers. Responsible Beverage Service interventions train alcohol servers to limit levels of intoxication attained by customers and decrease acute alcohol-related harms. The objectives of this study were to determine bar tenders’ and rum shopkeepers’ knowledge of and attitudes toward problem drinking and willingness to participate in server training. Researchers used convenience and purposive sampling to recruit 30 participants from Barraouile, Kingstown, and Calliaqua to participate in semi-structured interviews designed to explore study objectives. Results and conclusions were derived from grounded theory analysis. Heavy episodic drinking is common but not stigmatized. Heavy drinking is considered a “problem” if the customer attains a level of disinhibition causing drunken and disruptive or injurious behavior. Bartenders and rum shopkeepers reported intervening with visibly intoxicated patrons and encouraging cessation of continued alcohol consumption. Participants cited economic incentives, prevention of alcohol-related harms, and personal morals as motivators to prevent drunkenness. Respondents acknowledged that encouraging responsible drinking was a legitimate part of their role and were favorable to server training. However, there were mixed opinions about the intervention’s perceived efficacy given absent community-wide standards on preventing intoxication and limitations of existing alcohol policy. Given respondents’ motivation and lack of standardized alcohol server training in SVG, mandated server training can be an effective strategy when promoted as one piece of a multi-component alcohol policy.  相似文献   
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Various types of physical and physiological stress in animals have been shown to affect their humoral and cell-mediated immune responses. The present study was designed to investigate the possible influence of acute pain on the immune system. BALB/c mice were exposed to an increasing number of heat shocks using a Tail Flick apparatus; an equal number of control mice received no shock treatments. After each of the regimens was completed, the spleen of each mouse was recovered and various cell populations isolated to assess: the proliferative response to phytohemagglutinin by lymphocytes; cytotoxic activities of natural killer (NK) cells; and, the production of select important cytokines by splenic lymphocytes. The results indicated that NK cell activity and proliferation of lymphocytes were significantly (p < 0.001) increased due to the shock regimens after only a single day's rounds of stimulation (i.e., 3 rounds of ≈12 equally time-spaced shocks/hr with 30–45 min gap between rounds). After 2 and 3 days' rounds of stimulations, no significant changes were detected in the proliferative response of isolated lymphocytes; conversely, the activity of NK cells remained significantly elevated compared to the controls hosts' cells, even on the second day of stimulation but not on the third. Regarding effects on cytokines, no significant changes were detected in the amount of Interferon-γ (IFNγ) and Interlukin-10 (IL-10) produced by lymphocytes obtained from the spleens of any of the shocked mice. These results could suggest that certain acute stressors might actually strengthen a host's immunological reactivity and, possibly, result in an enhanced capacity to resist pathogens that might infect the body.  相似文献   
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We determined the prevalence of rifampin-monoresistant tuberculosis (RMR-TB) in Iran. Because development of RMR-TB is not common, we also identified the major risk factors associated with RMR-TB reported from different provinces of Iran. Data for 3,020 TB patients who remained or became smear positive after two, four, six, and nine months of standard first-line chemotherapy were retrospectively analyzed. Of 3,020 patients, 1,242 patients (41.1%) were culture and DNA positive for Mycobacterium tuberculosis. Of these patients, 73 (7.4%) patients had monoresistant isolates to rifampin, which was significantly higher than that for multidrug-resistant TB (5.8%). The average rate of RMR-TB in the studied population ranged from 5% to 10%. Classical investigation showed that 33.6% of patients had either a previous or family history of TB. Molecular epidemiology methods (i.e., spoligotyping and Mycobacterium intespersed repetitive unit–variable number tandem repeat), defined transmission link in three clusters (13%). These results outline the urgent need for a comprehensive plan for detection and treatment of RMR-TB cases.  相似文献   
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Rheumatoid arthritis (RA), the most prevalent autoimmune arthritis worldwide, usually presents with a circannual manner and, meanwhile, follows a circadian rhythm for symptoms like morning stiffness. Therefore, association between RA and some hormones such as melatonin (MLT) and vitamin D, whose serum values are related to body circadian rhythms or seasonal variations, has become more noticeable recently. Since some studies proposed that RA patients show altered MLT circadian rhythms, especially in concordance with symptoms, in this research, we present the correlation between MLT serum values and RA disease activity score (DAS28ESR). The current cross-sectional study was carried out on 80 volunteers (60 patients and 20 healthy controls). Fifty percent of the participants in each group were sampled in cold, and the same percentage were sampled in warm seasons at 8 a.m. Disease activity was estimated utilizing DAS28ESR. Patients with possible known confounders of MLT secretion were excluded. A commercial MLT ELISA kit was employed to measure MLT. Statistical analysis was conducted by SPSS-11 software. This study outlined higher serum values of MLT in RA patients compared with controls (P = 0.006, z = ?2.73). However, MLT did not correlate with DAS in patients (P = 0.45, r = ?0.09). GLM analysis demonstrated that DAS28ESR, age, disease duration, medications, gender, and season of sampling had no influence on serum MLT. However, newly diagnosed RA patients presented higher MLT values than established ones (P = 0.03, t = ?2.2). A cutoff point value of 23 pg/mL (63.3 % sensitivity and 90 % specificity) for MLT was computed between patients and controls. This study denoted that morning MLT serum values are higher in RA patients than in healthy volunteers. However, MLT and RA disease activity or other disease characteristics do not correlate. MLT serum values were higher in newly diagnosed RA patients than established ones.  相似文献   
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