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1.
CL Mesh BL Cmolik DW Van Heekeren JH Lee D Whittlesey LM Graham AS Geha SJ Bowlin 《Canadian Metallurgical Quarterly》1997,11(6):612-619
A premise of cardiac risk stratification is that the added risk of coronary artery bypass grafting (CABG) is offset by the improved safety of subsequent vascular reconstruction (VR). We questioned if elective CABG is patients with severe peripheral vascular disease (PVD) is a relatively high-risk procedure. A cohort study of 680 elective CABG patients from January 1993 to December 1994 was performed using three mutually exclusive outcomes of complication-free survival, morbidity, and mortality. Patient characteristic, operative, and outcome data were prospectively collected. Retrospective review determined that 58 patients had either a standard indication for or a history of VR. Overall CABG mortality was 2.5%, with statistically similar but relatively higher rates for PVD as compared to non-PVD patients. In contrast, major morbidity occurred at rates 3.6-fold higher in PVD patients (39.7%) than in disease-free patients (16.7%) after adjustment for the effects of patient and operative variables (odds ratio [OR] 3.67, 95% confidence interval [CI] 1.93-6.99). CABG morbidity in the PVD patient was most likely in those patients with aortoiliac (OR 9.51, CI 3.20-28.27) and aortic aneurysmal (OR 5.24, CI 1.28-21.41) disease types. CABG in PVD patients is associated with significant major morbidity. Such morbidity may preclude or alter the timing of subsequent VR. 相似文献
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OBJECTIVE: To evaluate the effect of preoperative localization studies on the surgical management of patients with primary hyperparathyroid disease (PHPT). SUMMARY BACKGROUND DATA: Reported cure rates of initial surgical exploration for PHPT are close to 95%. Preoperative localization studies are frequently obtained to improve surgical success and decrease operative time. METHODS: Initial cervical exploration was performed in 113 patients with PHPT from 1981 to 1993. Twenty-four patients (21%) had surgery without preoperative localization studies. The remaining 89 patients (79%) had 132 noninvasive preoperative localization studies. Success of the localization studies in tumor localization, pathologic findings, postoperative serum calcium levels, and operative times were compared. Patient costs of the studies were calculated. RESULTS: Disease was identified during operation in 23 of 24 patients (96%) having cervical exploration without preoperative localization studies, and they had normal calcium levels after surgery. Eighty-seven of 89 patients (98%) having preoperative localization studies were surgically cured. The highest sensitivity rate (60%) and highest positive predictive value (79%) of the localization studies were found with thallium-technetium scintiscanning. Average cost of the localization studies was $901 per patient. Combination studies were obtained in 32 patients at an average cost of $1,314 per patient without improving sensitivity. Mean operating time did not differ for localized and nonlocalized patients. CONCLUSIONS: Preoperative localization studies did not improve parathyroid localization or cure rate and did not substantially shorten operating time in initial cervical exploration for PHPT. The economic burden of routine preoperative localization studies in these patients is not justified. 相似文献
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A remarkably good correlation between the rate of proton transfer from excited protonated 1-aminopyrene and the gas phase basicities of the organic component in water: organic solvent binary mixtures has been found. We suggest that use of anilinium acids minimizes the effect of anion solvation and Coulomb interactions and enables the influence of the organic cosolvent on the proton transfer to be clearly observed. The model proposed is one in which the proton is always transferred to a water molecule and a concerted proton transfer to a water molecule solvated by the organic cosolvent also occurs. The cosolvent influence is then on this latter species via hydrogen bond interactions. The correlation holds in pure water but not in pure organic solvents where, clearly, the proton must be transferred to the organic molecule. 相似文献
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Oral health care providers have taken various positions toward the concept of correct behavior toward and management of patients who are seropositive for human immunodeficiency virus. Several tribunal judgments and articles have discussed and analyzed this subject. This article presents a new detailed report and analysis and decision issued by a dental profession panel (tribunal) in Ontario, Canada. The concepts of universal precautions and antidiscriminatory acts are discussed. 相似文献
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Graham A. Jullien Wenzhe Luo Neil M. Wigley 《The Journal of VLSI Signal Processing》1996,14(2):207-220
This paper discusses strategies for implementing DSP systems using residue replication. The theory, recently introduced by two of the authors, uses formal polynomial ring mappings, from binary representations, to direct product ring implementation of integer processing arrays. The mapping produces completely independent computational arrays each computing over the same ring. This paper describes an architecture and processing array to implement, and take advantage of, the special computational ring structures that result from the mapping. A brief review of the theory and mapping techniques, is followed by the discussion of the architecture and VLSI design of an efficient inner product processing array using Fermat Primes. 相似文献
7.
Peter Eaton Andrea Ragusa Caroline Clavel Cristina T Rojas Paul Graham Raúl V Durán Soledad Penadés 《IEEE transactions on nanobioscience》2007,6(4):309-318
Glyconanoparticles which present carbohydrate and amino groups motifs at their surface were produced. These particles were highly stable and soluble in aqueous solutions. The presence of the carbohydrate groups also allowed the inclusion of more strongly binding groups, without affecting solubility. The binding of a model DNA, plasmid by these nanoparticles was studied by atomic force microscopy, transmission electron microscopy, and gel electrophoresis. Significant differences between the nanoparticles based on their affinities for the DNA were found, with implications for their potential use as nonviral gene delivery agents. 相似文献
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This paper reports a method to produce networks of crystalline gallium oxide comprised of one‐dimensional (1D) nanostructures. Because of the unique arrangement of wires, these crystalline networks are termed as ‘nanowebs’. Nanowebs are of great technological interest since they contain wire densities of the order of 109 cm–2. A possible mechanism for the fast self‐assembly of crystalline metal oxide nanowires involves multiple nucleation and coalescence via oxidation–reduction reactions at the molecular level. The preferential growth of nanowires parallel to the substrate enabled them to coalesce into regular polygonal networks. The individual segments of the polygonal network consist of both nanowires and nanotubules of β‐gallium oxide. Individual wire properties contribute to a nanoweb’s overall capacity and the implications for devices based on nanowebs are expected to be enormous. 相似文献