收费全文 | 31192篇 |
免费 | 2556篇 |
国内免费 | 686篇 |
医药卫生 | 34434篇 |
2024年 | 171篇 |
2023年 | 653篇 |
2022年 | 1296篇 |
2021年 | 1752篇 |
2020年 | 1719篇 |
2019年 | 1602篇 |
2018年 | 1428篇 |
2017年 | 1275篇 |
2016年 | 1040篇 |
2015年 | 1003篇 |
2014年 | 2547篇 |
2013年 | 2873篇 |
2012年 | 1787篇 |
2011年 | 2094篇 |
2010年 | 1747篇 |
2009年 | 1574篇 |
2008年 | 1580篇 |
2007年 | 1438篇 |
2006年 | 1226篇 |
2005年 | 1165篇 |
2004年 | 849篇 |
2003年 | 787篇 |
2002年 | 383篇 |
2001年 | 311篇 |
2000年 | 268篇 |
1999年 | 237篇 |
1998年 | 187篇 |
1997年 | 155篇 |
1996年 | 143篇 |
1995年 | 115篇 |
1994年 | 91篇 |
1993年 | 87篇 |
1992年 | 121篇 |
1991年 | 65篇 |
1990年 | 68篇 |
1989年 | 43篇 |
1988年 | 45篇 |
1987年 | 44篇 |
1986年 | 39篇 |
1985年 | 51篇 |
1984年 | 65篇 |
1983年 | 42篇 |
1982年 | 34篇 |
1981年 | 44篇 |
1980年 | 39篇 |
1979年 | 30篇 |
1978年 | 26篇 |
1977年 | 24篇 |
1976年 | 14篇 |
1975年 | 18篇 |
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Objectives
The current study investigated the effects of two exercise interventions on cognitive function amongst breast cancer survivors.Design
Pilot randomised-controlled trial.Methods
Seventeen female cancer survivors (mean: 62.9 ± 7.8 years) were randomised into three groups: high-intensity interval training (HIIT, n = 6); moderate-intensity continuous training (MOD, n = 5); or wait-list control (CON, n = 6). The HIIT and MOD groups exercised on a cycle ergometer 3 days/week for 12-weeks. Primary outcomes were cognitive function assessments utilising CogState. Secondary outcomes were resting middle cerebral artery blood flow velocity, cerebrovascular reactivity and aerobic fitness (VO2peak). Data were analysed with General Linear Mixed Models and Cohen’s d effect sizes were calculated.Results
All 17 participants who were randomised were available for follow-up analysis and adherence was similar for HIIT and MOD (78.7 ± 13.2% vs 79.4 ± 12.0%; p = 0.93). Although there were no significant differences in the cognitive and cerebrovascular outcomes, HIIT produced moderate to large positive effects in comparison to MOD and CON for outcomes including episodic memory, working memory, executive function, cerebral blood flow and cerebrovascular reactivity. HIIT significantly increased VO2peak by 19.3% (d = 1.28) and MOD had a non-significant 5.6% (d = 0.72) increase, compared to CON which had a 2.6% decrease.Conclusions
This study provides preliminary evidence that HIIT may be an effective exercise intervention to improve cognitive performance, cerebrovascular function and aerobic fitness in breast cancer survivors. Considering the sample size is small, these results should be confirmed through larger clinical trials. 相似文献Findings: A 30-year-old man with complete paraplegia used the HAL® for 1 month (10 sessions) using his remaining muscle activity, including hip flexor and upper limb activity. Electromyography was used to evaluate muscle activity of the gluteus maximus, tensor fascia lata, quadriceps femoris, and hamstring muscles in synchronization with the Vicon motion capture system. A HAL® session included a knee extension session with the hip flexor and voluntary gait with upper limb activity. After using the HAL® for one month, the patient’s manual muscle hip flexor scores improved from 1/5 to 2/5 for the right and from 2/5 to 3/5 for the left knee, and from 0/5 to 1/5 for the extension of both knees.
Conclusion/clinical relevance: Knee extension sessions with HAL®, and hip flexor and upper-limb-triggered HAL® ambulation seem a safe and feasible option in a patient with complete paraplegia due to spinal cord injury. 相似文献