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101.
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K Dakin T Sanders S Harrison JD Dickman VK Anand 《Canadian Metallurgical Quarterly》1998,119(6):603-608
BACKGROUND: The use of plasma-exchange therapy has increased the longevity of patients with homozygous familial hypercholesterolemia (HFH), and pregnancy in affected women is expected to become more common. We describe the clinical course, feasibility and risks of repeated pregnancies in patients with HFH treated by long-term plasma exchange. METHODS: We followed the clinical course of five pregnancies in two HFH patients, with attention to the effect of repeated plasma exchange on maternal and fetal status; specifically, lipid profile, hemodynamics, and uteroplacental circulation on Doppler flow study. RESULTS: Increasing the frequency of plasma-exchange therapy prevented the extreme serum cholesterol elevation that occurs in pregnant HFH patients and was associated with a significant improvement in uteroplacental circulation. In four pregnancies the clinical course was uneventful, ending in normal deliveries of full-term infants with heterozygous familial hypercholesterolemia. The third pregnancy of one of the patients had to be terminated owing to the development of hypotension and syncope during plasma exchange because of severe aortic stenosis. CONCLUSIONS: Repeated pregnancies in HFH patients treated by long-term plasma exchange are feasible but may be associated with untoward effects, especially hemodynamic compromise. The frequency of plasma exchange therapy should be increased to prevent marked hypercholesterolemia and its possible deleterious effect on maternal and fetal status. Cardiac evaluation with close hemodynamic monitoring are needed during pregnancy to detect complications of the cardiac valvular lesion and the coronary atherosclerosis that are associated with HFH. 相似文献
103.
OBJECTIVE: To study the trends of paralytic poliomyelitis in pre Pulse Polio Immunization period. SETTING: Hospital based sentinel surveillance. METHODS: Analysis of 6704 line-listed poliomyelitis cases from January 1989 to December 1994 attending the Department of Physical Medicine and Rehabilitation. RESULTS: 85% of all cases reported in Delhi were from this center. A decline in alternate year peaks was observed from 1621 cases in 1990 to 1062 cases in 1994. There was an increase in proportion of cases with poliomyelitis in fully vaccinated children from 14% to 22.9%. Polio type I virus was the commonest isolated virus in all the years except 1993, when type II was isolated in 38.7% of cases. CONCLUSION: Despite improvement in immunization coverage, the study reveals that a large number of children (67.2%) who suffer from poliomyelitis are unvaccinated. This stresses need to intensify and sustain high level of immunization coverage with effective vaccine. 相似文献
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A technique for simultaneous roentgen stereophotogrammetry (RS) was developed, and its accuracy was assessed. In vitro models fabricated from dried cadaveric C4 and C5 vertebrae were used to simulate the motion behavior of the cervical spine. Metallic markers made of Vitallium beads (diameter < 0.3 mm) were implanted into the posterior and anterior surfaces of each vertebra at surgically accessible locations to simulate the bead placement for both posterior and anterior surgical approaches to the cervical spine. A series of roentgen stereo pairs were obtained to systematically assess the accuracy (validity) of displacement measurements in anteroposterior (AP) translation, axial rotation, and flexion/extension. In addition, the effects of soft tissue density on the accuracy of the system were investigated by obtaining a series of roentgen stereo pairs with the experimental model immersed in a water bath. The coordinates of the metallic markers on the radiographs were then digitized by two raters who were not informed of the actual motion (i.e., blind study). The results indicated a high accuracy throughout the study. Overall root mean square errors were 0.07 mm for AP translation, 0.08 degrees for axial rotation, and 0.14 degrees for flexion/extension. The corresponding accuracy estimates (R2 values by linear regression analysis) were very high (0.992, 0.998, and 0.995) when the measurement results were compared with the actual displacements. The water bath did not affect measurement accuracy, indicating that soft tissue density should have little effect on the accuracy of the technique for in vivo applications. This system appears to be an accurate and reliable method for assessment of simulated in vivo cervical spine motion, regardless of the rater. The technique has been further used in in vivo assessment of cervical spine kinematics in one patient to confirm the efficacy of the developed technique. 相似文献
107.
An approach to tackle protein-calorie malnutrition through domiciliary management is described. Children suffering from moderate and severe protein-calorie malnutrition were managed using a food supplement containing low cost locally available foodstuffs and nutrition education. An evaluation showed that the anthropometric improvement was closely associated with better concepts in nutrition and improved dietary practices following nutrition education. Parents of children suffering from kwashiorkor had better knowledge and practice compared with those of marasmus. 相似文献
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VK Naik AN Thakur AR Sheth UM Joshi SS Rao DS Pardanani JK Kulsreshtha RK Handa 《Canadian Metallurgical Quarterly》1976,48(2):441-442
The testosterone concentration in allantoic fluid between 90 and 150 days of gestation in cattle can be used to determine the fetal sex; values were 442 +/- 20-3 (S.E.M.) pg testosterone/ml for males fetuses and 215 +/- 8-2 pg/ml for female fetuses. 相似文献
110.