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41.
    
Anticardiolipin antibodies were studied in serum and cerebrospinal fluid from 32 consecutive patients with systemic lupus erythematosus, admitted for the assessment of neuropsychiatric disease. Ten of the 16 patients with active neuropsychiatric complaints showed positive anticardiolipin antibodies in cerebrospinal fluid, including eight with the simultaneous presence of antibodies in their sera. By contrast, only 2 of the 16 patients with headaches, lacking further data of neurological disease, revealed anticardiolipin antibodies in their cerebrospinal fluid. The assessment of Q-albumin index showed abnormal values in a subset of patients with active neuropsychiatric changes who showed positive cerebrospinal anticardiolipin antibodies, suggesting that an impairment of the blood brain barrier function may lead to a leakage of intrathecal antiphospholipid antibodies from systemic circulation. Additionally, few patients revealed normal Q-albumin values with high IgG-cerebrospinal fluid index suggesting increased intrathecal synthesis of autoantibodies. The study of anticardiolipin antibodies in cerebrospinal fluid was useful to detect active neuropsychiatric disease in systemic lupus erythematosus.  相似文献   
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This article describes the Medical Expenditure Panel Survey (MEPS), the third in a series of nationally representative surveys of medical care use and expenditures sponsored by the Agency for Health Care Policy and Research. The MEPS is designed to provide extensive data on the types of health care services American use, how frequently they use them, how much is paid for the services, and who pays for them. It also will provide information on the types and costs of private health insurance available to the U.S. population. The survey is unparalleled in its degree of detail, as well as its ability to link medical care use, payments, and health insurance coverage to specific survey respondents and their families. It allows analysts to examine how individual and family characteristics, including the characteristics of their health insurance, affect medical care use and spending. This article discusses each of the MEPS components, focusing on design enhancements that have been made since the survey was last conducted nearly a decade ago.  相似文献   
43.
    
The cytotoxicity of a recombinant interleukin 6 (IL-6)-diphtheria toxin (DT) fusion protein towards human myeloma cell lines was investigated. DAB389-IL-6 inhibited protein synthesis and methylcellulose colony formation by U266 myeloma cells. In the clonogenic assay, the fusion protein approached the level of cytotoxicity achieved by native DT. The specificity of killing by DAB389-IL-6 was demonstrated by inhibition of cytotoxicity by a molar excess of free rhIL-6. The effect of DAB389-IL-6 on colony formation by six OCI-My cell lines was assessed. Similar to U266 cells, colony growth by the OCI-My 5 and -My 2 cell lines was inhibited in a simple dose dependent manner. However, a biphasic effect was observed for the IL-6 dependent OCI-My 4 cells; DAB389-IL-6 stimulated colony formation at low (< or = 10(-11) M) concentrations, yet was inhibitory at higher doses. Three other cell lines whose growth was not altered by IL-6 were relatively unaffected by DAB389-IL-6, despite their sensitivity to native DT. Flow cytometric analysis for IL-6 receptor expression using phycoerythrin-conjugated IL-6 demonstrated specific binding sites on both DAB389-IL-6 sensitive and certain insensitive cell lines, suggesting that other factors in addition to the expression of IL-6 receptors are involved in killing by the fusion toxin. Despite evidence for a role of IL-6 in myeloid cell development, normal bone marrow was insensitive to the IL-6 fusion toxin. In cultures containing both normal bone marrow and U266 cells DAB389-IL-6 effectively inhibited the growth of U266 myeloma colonies but had little effect on normal bone marrow erythroid, granulocyte and mixed erythroid/granulocyte colony growth. From these experiments we conclude that DAB389-IL-6 is specifically cytotoxic towards a subset of IL-6-responsive human myeloma cell lines and may be useful, in some cases, in the selective elimination of tumour cells from mixed populations of normal and malignant cells.  相似文献   
44.
    
In recent years fracture fixation in the horse has changed significantly. New devices, mainly adapted from the human field, have been successfully introduced into large animal surgery. Examples of such implants include the DCS/DHS implant system, the self-tapping screw, the cannulated screw, and the pinless external fixator. However, new devices have also been developed exclusively for equine fracture management, including the interlocking intramedullary nail and the external skeletal fixation device. With these devices the surgeon has more options for repairing fractures in horses. Nevertheless, many problems are still unsolved. Indications exist that during the next few years new, exciting fracture fixation systems will be developed, providing further advancements in the quest for the ideal implant for horses. However, the development stages of these devices are such that mentioning the possibilities here is premature.  相似文献   
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The orbital control of geostationary satellites requires the periodic execution of manoeuvres for gravitational and solar radiation perturbation compensation. To maintain a fine control of the satellite position, it is usually sufficient to perform orbit corrections every two weeks, firing chemical thrusters. The operational load for the manoeuvre's planning and execution is usually quite low. Innovative technologies for station-keeping are available now, based on high efficiency ion thrusters, which allow a significant propellant saving. They are included in Artemis, a telecommunications satellite developed by the European Space Agency. When low acceleration ion thrusters are adopted, a near continuous orbit control is required; the resulting long firing arcs can be in conflict with some operational or technical constraints. The station-keeping planning is a critical process, since it is not based on periodic impulsive manoeuvres, but rather on quasi-continuous firings. Furthermore the orbit control should be planned more on a seasonal or a yearly cycle rather than on short weekly cycles. Since each manoeuvre is defined by its start time and duration, the total number of parameters involved in a station-keeping optimization process amounts to several tens. The presence of many variables and logical constraints makes the use of classical optimization methods quite complex. The model proposed here is based on genetic algorithms, which allows the convergence to an optimum solution through successive iterations, in which a random set of solutions is progressively selected on the basis of a factor of merit tailored to the target. This paper presents some innovative concepts for station-keeping optimization when ion propulsion is adopted for orbital control; furthermore, the general properties of genetic algorithms are discussed, together with the results obtained in the specific station-keeping application.  相似文献   
47.
A multivariate skimmilk extrusion process, designed to produce an acid coprecipitate was studied in terms of minimizing residual lactose, ash and fines. an experimental model system was utilized to simulate the extrusion process and evaluated using response surface methodology to assess the relationship between the responses (fines, residual lactose and minerals) and the process variables (concentration, pH, temperature, agitation, washing time and wash water ratio). Compromise optimum conditions were derived using the Generalized Distance Approach (GDA) and an Extended Response Surface Procedure (ERSP) which made use of the SAS RSREG procedure with and without constraints. the GDA procedure produced good results in terms of providing an optimum for a general acid casein process, while the ERSP allowed more extensive analysis of the data in terms of assessing specific processing conditions. Although more computing intensive, the ERSP conferred additional flexibility in determining optimal conditions for special situations such as extrusion processing. Both approaches are useful for process engineering, with the GDA being a more general tool while the ERSP is advantageous when the GDA procedure becomes limiting.  相似文献   
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BACKGROUND: The degree to which antithrombotic drugs suppress thrombin generation is unknown. Because hirudin, unlike antithrombin III, binds intravascular thrombin rapidly and selectively to yield a circulating inactive complex of 3- to 4-hour half-life, we used intravenous hirudin in humans to investigate the course of thrombin generation during and early after anticoagulation with this potent, direct antithrombin. METHODS AND RESULTS: Intravascular thrombin was measured with an ELISA for the thrombin-hirudin complex formed during and for 18 hours after stopping a 6-hour infusion of hirudin at 0.1, 0.2, and 0.3 mg.kg-1.h-1 in three groups of six patients each. With free hirudin in 20- to 10,000-fold molar excess of thrombin and peak activated partial thromboplastin times of 2.3 to 3.0 times baseline, mean plasma thrombin-hirudin complex increased from 794 +/- 85 pg/mL (mean +/- SEM) 15 minutes after the start of the infusion to 1617 +/- 151 pg/mL at 6 hours of infusion to 2667 +/- 654 pg/mL at 24 hours. During the 24-hour observation period, plasma concentration of fragment 1.2 (the peptide released during conversion of prothrombin to thrombin) never fell below baseline but rather increased transiently during the hirudin infusion. Plasma concentrations of thrombin-antithrombin III complex (in ng/mL) decreased from 4.34 +/- 0.40 at baseline to 1.64 +/- 0.13 at 6 hours (P < .001) and gradually increased after stopping the infusion to 5.7 +/- 0.87 at 24 hours (nonsignificant compared with baseline). CONCLUSIONS: Measurement of thrombin-hirudin complex may be used as a marker of thrombin generation in humans. Persistent accumulation of thrombin-hirudin complex and generation of fragment 1.2 during and after completion of potent anticoagulation with hirudin suggest thrombin generation is not blocked by high-affinity thrombin inhibition. The persistent formation of thrombin during declining plasma levels of hirudin may contribute to the pathogenesis of rethrombosis early after antithrombin therapy or during inadequate anticoagulation.  相似文献   
50.
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