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Randomized trial of breast self-examination in Shanghai: methodology and preliminary results 总被引:3,自引:0,他引:3
DB Thomas DL Gao SG Self CJ Allison Y Tao J Mahloch R Ray Q Qin R Presley P Porter 《Canadian Metallurgical Quarterly》1997,89(5):355-365
BACKGROUND: The efficacy of breast self-examination in helping to reduce mortality from breast cancer has not been rigorously demonstrated. PURPOSE: To assess efficacy, a large, randomized trial was initiated in Shanghai, China. METHODS: From October 1989 to October 1991, 267040 current and retired female employees associated with 520 factories in the Shanghai Textile Industry Bureau were randomly assigned on the basis of factory to either a self-examination instruction group (133375 women) or a control group (133665 women). The women were born within the period from 1925 through 1958. Women in the instruction group were given intensive training in breast self-examination, including the use of silicone breast models and personalized instruction, plus two subsequent reinforcement sessions and multiple reminders to practice the technique. Women in the control group were asked to attend training sessions on the prevention of low back pain. All women have been followed for the development of breast diseases and for death from breast cancer. RESULTS: A high level of participation during the first 4-5 years of the trial was documented among women in the instruction group. Randomly sampled women in this group demonstrated greater proficiency in detecting lumps in breast models than did randomly sampled women in the control group. Approximately equal numbers of breast cancers were detected in the two groups (331 in the instruction group and 322 in the control group) through 1994, which is the last year for which case-finding efforts have been completed. The breast cancers detected in the instruction group were not diagnosed at an appreciably earlier stage or smaller size than those in the control group. More benign breast lesions were detected in the instruction group than in the control group (1457 versus 623, respectively), suggesting a higher index of suspicion for women who received training. Cumulative breast cancer mortality rates through 5 years from entry into the study were nearly equivalent for the two groups. CONCLUSIONS: Breast self-examination has not led to a reduction in mortality from breast cancer in this study cohort in the first several years since the trial began. A shift toward the diagnosis of disease at a less advanced stage in women given instruction has also not been demonstrated. Longer follow-up of participants in this trial is required before final assessment can be made of the efficacy of breast self-examination. IMPLICATIONS: At this time, there is insufficient evidence to recommend for or against the teaching of breast self-examination. 相似文献
85.
Final-offer salary arbitration in major league baseball offers a unique institutional arrangement that creates a naturally occurring, non-equivalent-groups, repeated measures research design. The structural arrangements allow for examination of anticipatory expectancy effects and assessment of behavioral responses consistent with equity theory predictions. In addition, equity theory can be tested without the methodological problems inherent in defining the referent other. Performance and mobility were examined for major league baseball position players who won and lost their arbitration hearings. Prearbitration performance significantly predicted arbitration outcome. A significant relationship was noted between losing arbitration and postarbitration performance decline. Losers were significantly more likely to change teams and leave major league baseball. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
86.
Youngjohn James R.; Larrabee Glenn J.; Crook Thomas H. 《Canadian Metallurgical Quarterly》1992,4(1):54
The authors attempt to provide a better understanding of the differences between the normal memory decline characteristic of age-associated memory impairment (AAMI) and the pathological decline typical of mild Alzheimer's disease (AD). Batteries of traditional memory tests and computer-simulated everyday-memory tests discriminated between the 2 groups, which were matched on age, gender, and education, with reasonable degrees of accuracy (87.5% and 88.4%, respectively). False positives were the most frequent classification errors when using either battery. These results indicate that it is possible to use ecologically valid memory assessment paradigms without sacrificing discriminant validity. The clinical significance of discriminating mild AD from AAMI is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
87.
Bouchard Thomas J.; Arvey Richard D.; Keller Lauren M.; Segal Nancy L. 《Canadian Metallurgical Quarterly》1992,77(1):89
Responds to the points made by R. Cropanzano and K. James (see record 1991-00462-001) concerning the article by R. D. Arvey et al (1989). The authors acknowledge that the Arvey et al study is based on a single design, makes use of a small and special sample, and, as such, is vulnerable to threats of internal and external validity. Nevertheless, after providing a more comprehensive conceptual and empirical context for the study, and after reviewing a number of the issues raised by Cropanzano and James, the authors conclude that it is not premature to accept the idea that work attitudes are partially genetically influenced. Indeed, the authors use behavioral genetic theory, together with data gathered in the Arvey et al study, to make specific point predictions regarding the outcomes of an array of studies that easily can be undertaken. Finally, the authors acknowledge that the comments and issues raised by Cropanzano and James, along with the interchange, can offer directions for future research in this important area. (PsycINFO Database Record (c) 2010 APA, all rights reserved) 相似文献
88.
Marcos Craizer Thomas Lewiner Jean-Marie Morvan 《Journal of Mathematical Imaging and Vision》2007,29(2-3):131-140
Image and geometry processing applications estimate the local geometry of objects using information localized at points. They usually consider information about the tangents as a side product of the points coordinates. This work proposes parabolic polygons as a model for discrete curves, which intrinsically combines points and tangents. This model is naturally affine invariant, which makes it particularly adapted to computer vision applications. As a direct application of this affine invariance, this paper introduces an affine curvature estimator that has a great potential to improve computer vision tasks such as matching and registering. As a proof-of-concept, this work also proposes an affine invariant curve reconstruction from point and tangent data. 相似文献
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Thomas J. R. Hughes Arif Masud Isaac Harari 《International journal for numerical methods in engineering》1995,38(19):3193-3210
Finite element methods for dynamic analysis employing elements with drilling degrees of freedom are presented. The formulation is based on a variational principle in which displacements and rotations are interpolated independently. The issue of zero masses corresponding to rotational degrees of freedom is addressed and techniques for defining consistent and lumped rotational mass matrices are presented. 相似文献