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We retrospectively analysed the long-term treatment results (median 8 years) of 31 patients with macroprolactinoma. 17 patients were treated by pituitary surgery (group 1) followed by long-term dopamine agonist therapy whereas 14 patients received long-term dopamine agonist therapy alone (group 2). 2 patients of group 1 and 1 patient of group 2 had external pituitary irradiation because of progressive disease. The two groups were comparable with respect to age, gender and initial prolactin (PRL) levels. At the end of the observation period dopamine agonist dosage could be reduced by 50% in group 1 and by 39.3% in group 2. Pituitary function did not change substantially during therapy. Complete remissions (no visible tumour in CT or MRI, normal PRL levels under current dopamine agonist medication) were achieved in 23.5% of group 1 vs. 21.4% of group 2, partial remissions (reduction of PRL and tumour size) in 35.3% vs. 64.3%, stable disease in 23.5% vs. 7.1% and progressive disease in 17.7% vs. 7.1% (differences not significant). Visual field defects showed 28.4% remissions (complete and partial) in group 1 versus 50% in group 2. Dopamine agonist therapy could be stopped definitively in only 1 patient of group 2 with an invasive macroprolactinoma. Initial surgical reduction of tumour load followed by medical therapy does not seem to guarantee a better long-term outcome than dopamine agonist therapy alone if the patient responds to and tolerates dopamine agonist therapy. Surgery should be reserved for non-responders, drug-intolerant or non-compliant patients, and for those with acute severe neurological compromise.  相似文献   
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Zusammenfassung Die Arbeit befaßt sich mit der Ermittlung von Vierpolen vorgeschriebener Frequenzabhängigkeit bei Berücksichtigung der Verluste. Gegeben sind als Maß für die Betriebsdämpfung das Quadrat des Verhältnisses zwischen Urspannung der Quelle und Sekundärspannung als ganze rationale Funktion der Frequenz, ferner Innenwiderstand der Quelle und der von ihm im allgemeinen verschiedene Sekundärwiderstand sowie die beiden Verlustziffern für Spulen und für Kondensatoren. Die Arbeit liefert alle Schaltungen der vorgeschriebenen Eigenschaften und die Bedingungen, denen die gegebene Funktion gehorchen muß, damit sie durch ausführbare, also positive Schaltungsteile sich verwirklichen läßt. Eine Zusammenstellung des Verfahrens dient der praktischen Anwendung.  相似文献   
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Even Parity? Old Parity? Polynomial Checksum? Vertical Byte Parity? BCH Check Code? Cyclical Redundancy Check Code? These are just some of the communication formats currently being used to send information between computers within a network. Whenever a supplier provides a system, a “proprietary” or peculiar protocol is established to operate between the elements of the network. When it is desired to interconnect digital equipment of two or more suppliers, a “custom” interface is required. As long as the two suppliers do not revise their native codes, the custom interface can be reproduced for another application.

MAP is a standardized communication format intended to eliminate the wide variety of proprietary formats and the need for custom interfaces between different suppliers of digital equipment and systems. Thus, the term “open” systems interconnect (OSI) and interoperability have been popularized to represent this emerging technology.  相似文献   

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The value of intravenous crystalloid administration in preventing spinal-induced hypotension in the parturient has recently been questioned. Also, the association between increasing crystalloid volume and decreasing postpartum colloid osmotic pressure (COP) raises concern regarding the risk of maternal and fetal pulmonary edema. To study the dose-response effect of varying amounts of crystalloid volume prior to spinal anesthesia, we measured maternal hemodynamic variables and maternal and fetal COP in three groups of healthy parturients receiving spinal anesthesia for elective cesarean delivery. Fifty-five parturients were randomized in a double-blind fashion to receive one of 10, 20, or 30 mL/kg of crystalloid volumes prior to induction of spinal anesthesia. Measurements included mean arterial blood pressure (MAP), cardiac index (CI), and systemic vascular resistance index (SVRI) recorded using noninvasive thoracic impedance monitoring until delivery. Maternal and neonatal COP were measured. All groups showed declines in MAP and SVRI from baseline at 5 min after spinal anesthesia, but the amount of decline did not differ among groups. Total ephedrine and additional intravenous (i.v.) fluid administered did not differ among groups. The 20- and 30- mL/kg groups showed a larger decline in maternal COP than the 10-mL/kg group; no differences in neonatal COP were seen with varying preload. We conclude that increasing the amount of i.v. crystalloid administered to 30 mL/kg in the healthy parturient does not significantly alter maternal hemodynamics or ephedrine requirements after spinal anesthesia and has no apparent benefit.  相似文献   
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The National Eye Institute (NEI) computer planimetry system has been shown to have good reproducibility in assessing the size of cortical cataracts from retroilluminatin photographs. In this study, we determined the usefulness of this system in monitoring cortical cataract changes over time. Using the Neitz Kawara retroillumination camera, retroillumination photographs of cortical cataracts in 81 eyes were obtained every six months for an average of 31 months. As previously described, the cortical cataract outlines were traced in a masked fashion onto transparent plastic overlays, and the tracings then digitized into a Macintosh Quadra computer using a computer scanner. Cortical cataract area was then determined using a specially developed software program. For each eye, the rate of cortical area change was determined by the slope of the regression line fitted to the follow-up measurements. Cataract progression was classified to be significant if the slope exceeded a critical value. Of the 81 eyes, 24 (30%) had significant cataract progression, while 57 (70%) did not progress. This study presents data on progression of the area of cortical cataracts and suggests the usefulness of the NEI computer planimetry system for monitoring such changes from retroillumination photographs. The slope-based test can also play a useful part in longitudinal studies with irregular time intervals and variable number of visits.  相似文献   
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The influence of the loading orientation with respect to the grain direction of wood and the influence of the lateral dowel displacement boundary condition on the embedment behaviour of steel dowels in laminated veneer lumber (with parallel‐laminated veneers) are investigated in this study. For limit states of the lateral boundary condition, the load‐displacement behaviour was experimentally studied by means of full‐hole embedment tests on screw‐reinforced laminated veneer lumber, for two dowel diameters and up to large dowel displacements. A novel biaxial test set‐up is proposed for embedment tests with constrained lateral dowel displacement boundary condition, in order to quantify laterally evoked reaction forces. Corresponding forces were found to change orientation with increasing dowel displacement and amounted to about 20% and 40% of the vertical reaction force for dowel displacements of 5 mm and twice the dowel diameter, respectively. The influence of the lateral displacement boundary condition was highlighted by comparison of the test data with a previously established data set for unconstrained embedment testing. Constrained loading showed a stiffer response and higher nominal embedment stresses, as well as a more pronounced displacement hardening, compared to unconstrained loading.  相似文献   
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