全文获取类型
收费全文 | 53608篇 |
免费 | 5082篇 |
国内免费 | 96篇 |
学科分类
医药卫生 | 58786篇 |
出版年
2023年 | 465篇 |
2022年 | 764篇 |
2021年 | 1565篇 |
2020年 | 903篇 |
2019年 | 1332篇 |
2018年 | 1418篇 |
2017年 | 1081篇 |
2016年 | 1208篇 |
2015年 | 1253篇 |
2014年 | 1632篇 |
2013年 | 2257篇 |
2012年 | 3255篇 |
2011年 | 3257篇 |
2010年 | 1775篇 |
2009年 | 1567篇 |
2008年 | 2586篇 |
2007年 | 2675篇 |
2006年 | 2514篇 |
2005年 | 2418篇 |
2004年 | 2299篇 |
2003年 | 2115篇 |
2002年 | 1939篇 |
2001年 | 1292篇 |
2000年 | 1283篇 |
1999年 | 1129篇 |
1998年 | 543篇 |
1997年 | 484篇 |
1996年 | 428篇 |
1995年 | 375篇 |
1994年 | 393篇 |
1993年 | 368篇 |
1992年 | 857篇 |
1991年 | 831篇 |
1990年 | 814篇 |
1989年 | 692篇 |
1988年 | 713篇 |
1987年 | 674篇 |
1986年 | 615篇 |
1985年 | 688篇 |
1984年 | 564篇 |
1983年 | 443篇 |
1982年 | 284篇 |
1981年 | 310篇 |
1980年 | 274篇 |
1979年 | 473篇 |
1978年 | 367篇 |
1976年 | 280篇 |
1974年 | 295篇 |
1973年 | 272篇 |
1972年 | 274篇 |
排序方式: 共有10000条查询结果,搜索用时 0 毫秒
1.
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.
Jenny U. Johansson Nathaniel S. Woodling Qian Wang Maharshi Panchal Xibin Liang Angel Trueba-Saiz Holden D. Brown Siddhita D. Mhatre Taylor Loui Katrin I. Andreasson 《The Journal of clinical investigation》2015,125(1):350-364
Microglia, the innate immune cells of the CNS, perform critical inflammatory and noninflammatory functions that maintain normal neural function. For example, microglia clear misfolded proteins, elaborate trophic factors, and regulate and terminate toxic inflammation. In Alzheimer’s disease (AD), however, beneficial microglial functions become impaired, accelerating synaptic and neuronal loss. Better understanding of the molecular mechanisms that contribute to microglial dysfunction is an important objective for identifying potential strategies to delay progression to AD. The inflammatory cyclooxygenase/prostaglandin E2 (COX/PGE2) pathway has been implicated in preclinical AD development, both in human epidemiology studies and in transgenic rodent models of AD. Here, we evaluated murine models that recapitulate microglial responses to Aβ peptides and determined that microglia-specific deletion of the gene encoding the PGE2 receptor EP2 restores microglial chemotaxis and Aβ clearance, suppresses toxic inflammation, increases cytoprotective insulin-like growth factor 1 (IGF1) signaling, and prevents synaptic injury and memory deficits. Our findings indicate that EP2 signaling suppresses beneficial microglia functions that falter during AD development and suggest that inhibition of the COX/PGE2/EP2 immune pathway has potential as a strategy to restore healthy microglial function and prevent progression to AD. 相似文献
6.
7.
José A. Lorente Pablo Cardinal-Fernández Diego Muñoz Fernando Frutos-Vivar Arnaud W. Thille Carlos Jaramillo Aida Ballén-Barragán José M. Rodríguez Oscar Peñuelas Guillermo Ortiz José Blanco Bruno Valle Pinheiro Nicolás Nin María del Carmen Marin Andrés Esteban Taylor B. Thompson 《Intensive care medicine》2015,41(11):1921-1930
8.
Tobias Kisch Julia Maria Klemens Katharina Hofmann Eirini Liodaki Matthias Gierloff Dirk Moellmeier Felix Stang Peter Mailaender Jens Habermann Matthias Brandenburger 《Medicine》2015,94(41)
The regrowth of amputated digit tips represents a unique regenerative healing in mammals with subcutaneous volume regrowth, restoration of dactylogram, and suppression of scar formation. Although factor analysis in amphibians and even in mice is easy to obtain, safety of harvesting biomaterial from human digit tip amputations for analysis has not yet been described.The aim of this study was to evaluate if recovering wound exudate does hamper clinical outcome or influence microbiologic or inflammation status.A predefined cohort of 18 patients with fresh digit tip amputations was randomly assigned to receive standard therapy (debridement, occlusive dressing) with (n = 9) or without (n = 9) collection of the whole wound exudate in every dressing change. Primary endpoint (lengthening) and secondary endpoints (regeneration of dactylogram, nail bed and bone healing, time to complete wound closure, scar formation, 2-point discrimination, microbiologic analysis, inflammatory factors interleukin (IL)-1α, tumor necrosis factor-α, IL-4, and IL-6) were determined by an independent, blinded observer.Patients’ characteristics showed no significant differences between the groups. All patients completed the study to the end of 3 months follow-up. Exudate collection did not influence primary and secondary endpoints. Furthermore, positive microbiologic findings as well as pus- and necrosis-like appearance neither impaired tissue restoration nor influenced inflammatory factor release.Here, the authors developed an easy and safe protocol for harvesting wound exudate from human digit tip amputations. For the first time, it was shown that harvesting does not impair regenerative healing. Using this method, further studies can be conducted to analyze regeneration associated factors in the human digit tip.DRKS.de Identifier: DRKS00006882 (UTN: U1111-1166-5723). 相似文献
9.
10.