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Ten years after its introduction the Special Admissions to Psychiatric Hospitals Act (Bopz) still awaits full implementation in the field of psychogeriatric nursing home care. Ethnographic research into moral problems related to care giving in dementia patients in Dutch nursing homes yielded several reasons for this discrepancy between law and care practice. Firstly, practical effectuation of this law rests predominantly on the shoulders of nurses and nurse assistants who are mainly inspired by moral motives such as carefulness and providing safety and who are ill informed about the law and its prerequisites. Secondly, there is the problem of the loss of a common shared world of meaning, which in relational terms is typical for the process of dementia. As a result of this, crucial concepts of the Bopz loose their applicability as the disease progresses. Finally, there is an immanent tension between the anthropology of care and care giving and the anthropological presuppositions of the law, health law included, which on a fundamental level contributes to the resistance of the care practice to the legal procedures of the Bopz. These factors must be accounted for in new legislation or revision of the current law. In the mean time we urge the necessity to develop a moral code concerning how to deal with resistive behaviour and opposition to care of demented nursing home patients. 相似文献
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Tomlinson IP Carvajal-Carmona LG Dobbins SE Tenesa A Jones AM Howarth K Palles C Broderick P Jaeger EE Farrington S Lewis A Prendergast JG Pittman AM Theodoratou E Olver B Walker M Penegar S Barclay E Whiffin N Martin L Ballereau S Lloyd A Gorman M Lubbe S;COGENT Consortium;CORGI Collaborators;EPICOLON Consortium Howie B Marchini J Ruiz-Ponte C Fernandez-Rozadilla C Castells A Carracedo A Castellvi-Bel S Duggan D Conti D Cazier JB Campbell H Sieber O Lipton L Gibbs P Martin NG Montgomery GW 《PLoS genetics》2011,7(6):e1002105
Genome-wide association studies (GWAS) have identified 14 tagging single nucleotide polymorphisms (tagSNPs) that are associated with the risk of colorectal cancer (CRC), and several of these tagSNPs are near bone morphogenetic protein (BMP) pathway loci. The penalty of multiple testing implicit in GWAS increases the attraction of complementary approaches for disease gene discovery, including candidate gene- or pathway-based analyses. The strongest candidate loci for additional predisposition SNPs are arguably those already known both to have functional relevance and to be involved in disease risk. To investigate this proposition, we searched for novel CRC susceptibility variants close to the BMP pathway genes GREM1 (15q13.3), BMP4 (14q22.2), and BMP2 (20p12.3) using sample sets totalling 24,910 CRC cases and 26,275 controls. We identified new, independent CRC predisposition SNPs close to BMP4 (rs1957636, P = 3.93×10(-10)) and BMP2 (rs4813802, P = 4.65×10(-11)). Near GREM1, we found using fine-mapping that the previously-identified association between tagSNP rs4779584 and CRC actually resulted from two independent signals represented by rs16969681 (P = 5.33×10(-8)) and rs11632715 (P = 2.30×10(-10)). As low-penetrance predisposition variants become harder to identify-owing to small effect sizes and/or low risk allele frequencies-approaches based on informed candidate gene selection may become increasingly attractive. Our data emphasise that genetic fine-mapping studies can deconvolute associations that have arisen owing to independent correlation of a tagSNP with more than one functional SNP, thus explaining some of the apparently missing heritability of common diseases. 相似文献
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WU YU ZHANG YING WAN DAO GUO LI YAN TANG WEI ZHOU Institute of Immunology PLA The Third Medical University Chongqing China Medical Center General Hospital of Weifang Weifang China 《Cell research》2001,(3)
INTRODUCTIONHepatitis B virus (HBV) infection is the mostcommon viral infection in humans especially inChina and East Asia. At present, the most effi-cient method to control the disease is vaccinationof new-borns. Both blood derived vaccine and re-combinant vaccine are hepatitis B surface alltigen(HBsAg)-based and useful in the prevention of thedisease[1-3]. HBsAg could evoke protective humoralimmune response in vivo, but the immune memoryonly last for 5 years or so[3, 4]. How to des… 相似文献
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Deborah M. Money Emily C. Wagner Evelyn J. Maan Tessa Chaworth-Musters Izabelle Gadawski Julie E. van Schalkwyk John C. Forbes David R. Burdge Arianne Y. K. Albert Zoe Lohn Hélène C. F. C?té The Oak Tree Clinic Research Group 《PloS one》2015,10(8)
Introduction
Combination antiretroviral therapy (cART) can effectively prevent vertical transmission of HIV but there is potential risk of adverse maternal, foetal or infant effects. Specifically, the effect of cART use during pregnancy on mitochondrial DNA (mtDNA) content in HIV-positive (HIV+) women is unclear. We sought to characterize subclinical alterations in peripheral blood mtDNA levels in cART-treated HIV+ women during pregnancy and the postpartum period.Methods
This prospective longitudinal observational cohort study enrolled both HIV+ and HIV-negative (HIV-) pregnant women. Clinical data and blood samples were collected at three time points in pregnancy (13-<23 weeks, 23-<30 weeks, 30–40 weeks), and at delivery and six weeks post-partum in HIV+ women. Peripheral blood mtDNA to nuclear DNA (nDNA) ratio was measured by qPCR.Results
Over a four year period, 63 HIV+ and 42 HIV- women were enrolled. HIV+ women showed significantly lower mtDNA/nDNA ratios compared to HIV- women during pregnancy (p = 0.003), after controlling for platelet count and repeated measurements using a multivariable mixed-effects model. Ethnicity, gestational age (GA) and substance use were also significantly associated with mtDNA/nDNA ratio (p≤0.02). Among HIV+ women, higher CD4 nadir was associated with higher mtDNA/nDNA ratios (p<0.0001), and these ratio were significantly lower during pregnancy compared to the postpartum period (p<0.0001).Conclusions
In the context of this study, it was not possible to distinguish between mtDNA effects related to HIV infection versus cART therapy. Nevertheless, while mtDNA levels were relatively stable over time in both groups during pregnancy, they were significantly lower in HIV+ women compared to HIV- women. Although no immediate clinical impact was observed on maternal or infant health, lower maternal mtDNA levels may exert long-term effects on women and children and remain a concern. Improved knowledge of such subclinical alterations is another step toward optimizing the safety and efficacy of cART regimens during pregnancy. 相似文献110.
Lijian Pei Yidong Zhou Gang Tan Feng Mao Dongsheng Yang Jinghong Guan Yan Lin Xuejing Wang Yanna Zhang Xiaohui Zhang Songjie Shen Zhonghuang Xu Qiang Sun Yuguang Huang The Outcomes Research Consortium 《PloS one》2015,10(11)