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1.
OBJECTIVE: To evaluate what nursing home medical directors actually do, what they and other nursing home personnel believe would be desirable to do, and what problems and deficiencies are perceived. DESIGN: Mail survey with follow-up telephone interview when necessary. SETTING: Forty-five nursing facilities in upstate New York. PARTICIPANTS: The medical directors, administrators, and directors of nursing of the 45 facilities. MEASUREMENTS: Inventory of what medical directors reported as to their actual activities and time spent, and of what they, the administrators, and the directors of nursing felt should be their responsibilities and activities under ideal circumstances. RESULTS: For part-time medical directors, self-reported time spent on medical directorship activities averaged 12 hours per month; of all directors, 45% spent 8 hours or less per month. Proportion of time spent on various specific activities varied widely. There was general agreement that substantially more time should be spent, in particular, on evaluating and addressing problems of adequacy and quality of care, communicating with attending physicians about problems, and assisting with inservice training programs. CONCLUSIONS: To fill the role adequately, more time should be spent by many part-time medical directors, which will require greater financial commitment by facilities and reimbursement systems. Efforts need to made to better coordinate the expectations of medical directors and facility staff.  相似文献   
2.
Summary: Polyacrylonitrile (PAN) particles with micro‐size ranges (0.15–2 μm) were prepared by emulsion and dispersion polymerizationa and in supercritical carbon dioxide media. The PAN particles were blended with Nylon 6 (PA6) at 220 °C by using a miniature mixer; it was found that melt‐mixing was possible for PAN‐rich compositions as high as 70 wt.‐%. Blends were characterized by scanning electron microscopy, IR, viscosity measurements, differential scanning calorimetry, and dynamic mechanical thermal analysis (DMTA). The size and shape of original PAN particles were retained in PAN/PA6 blends. The useful range to blend PAN particles size was less than 1 μm in terms of shape retention of the PAN particles in blends. Blends with 40 wt.‐% PAN content were found to be melt‐processable. The elastic modulus was higher for PAN/PA6 blends than pure PA6.

SEM photograph of PAN‐SC/PA6 blend with a 40/60 weight ratio.  相似文献   

3.
H. Mitomo  K. Nakazato  I. Kuriyama 《Polymer》1978,19(12):1427-1432
Nylon-6,6 — a typical polyamide — was annealed in the swollen state in glycerol to promote the partial melting of the polymer crystal. The recrystallization or lamellar thickening of nylon-6,6 crystal following partial melting was easily induced by this annealing, and the lamellar thickness of the crystal increased stepwise by 12 monomer unit length with increasing annealing temperature or annealing time. In addition, another distinct layer-thickening mechanism was observed which led to approximately doubling (and frequently quadrupling) the straight stem length of the lamellar crystal for all samples annealed under adequate conditions. New melting endotherms corresponding to these layer thicknesses (range of long spacings 140–180Å) were obtained by differential scanning calorimetry (d.s.c.) at temperatures ranging from 270° to 282°C. The mechanism of lamellar thickening is discussed with reference to the experimental results.  相似文献   
4.
OBJECTIVE: For resuscitation of hemorrhagic hypovolemia, we compared the effectiveness of (1) isotonic lactated Ringer's solution (LRS), (2) 2400 mOsm of 7.5% NaCl:6% dextran 70 (HSD), and (3) 2400 mOsm of 7.9% sodium acetate:1.9% NaCl:6% dextran 70 (HAD). DESIGN: In six randomized, blinded experiments for each solution, conscious instrumented adult sheep were hemorrhaged by removing approximately 1.8 L (42 +/- 3 mL/kg) of blood, while maintaining the mean arterial pressure (MAP) at 50 mm Hg for 2 hours. METHODS: Test solutions were infused as needed to restore the cardiac index to baseline. RESULTS: Volume requirements with HAD (236 +/- 29 mL) and HSD (244 +/- 39 mL) were significantly less (p < 0.05) than LRS (3463 +/- 234 mL). Mean arterial pressure was normalized with HSD and LRS, but not with HAD, which resulted in MAPs of 20 to 25 mm Hg less than baseline resulting from a reduced peripheral resistance. Oxygen delivery, however, was significantly higher with HAD during the resuscitation period. Acid-base balance (pH) and oxygen consumption were normalized within 5 minutes of infusion only with HAD. CONCLUSIONS: Small-volume infusion with HAD resulting in "high-flow-low-pressure" resuscitation may offer unique hemodynamic and metabolic advantages for the initial treatment of hemorrhage from trauma.  相似文献   
5.
Crystallite size distributions and lattice distortions have been analysed for highly-irradiated linear polyethylene in the direction normal to 1 1 0 and 0 0 1 lattice planes through X-ray line profile analysis. It has been found that the lateral crystallite size is little affected irradiation greater than 1000 Mrad, whereas that in the chain direction decreases almost linearly with the dose of irradiation. A minor difference in the crystallite size between irradiation atmospheres, i.e. irradiation in air or in vacuum, has been disclosed at a very high dose of irradiation. The above degradation behaviour of crystallites and the change in lattice distortions have proved that radiation cross-links are mainly formed in the amorphous region near the lamellar surface of polyethylene.  相似文献   
6.
Osteoarthritis of the knee (OAK) is a chronic degenerative disease and progresses with an imbalance of cytokines and macrophages in the joint. Studies regarding the use of platelet-rich plasma (PRP) as a point-of-care treatment for OAK have reported on its effect on tissue repair and suppression of inflammation but few have reported on its effect on macrophages and macrophage polarization. Based on our clinical experience with two types of PRP kits Cellaid Serum Collection Set P type kit (leukocyte-poor-PRP) and an Autologous Protein Solution kit (APS leukocyte-rich-PRP), we investigated the concentrations of humoral factors in PRPs prepared from the two kits and the effect of humoral factors on macrophage phenotypes. We found that the concentrations of cell components and humoral factors differed between PRPs purified using the two kits; APS had a higher concentration of M1 and M2 macrophage related factors. The addition of PRP supernatants to the culture media of monocyte-derived macrophages and M1 polarized macrophages revealed that PRPs suppressed M1 macrophage polarization and promoted M2 macrophage polarization. This research is the first to report the effect of PRPs purified using commercial kits on macrophage polarization.  相似文献   
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8.
There has been an increasing prevalence of neurodegenerative diseases with the rapid increase in aging societies worldwide. Biomarkers that can be used to detect pathological changes before the development of severe neuronal loss and consequently facilitate early intervention with disease-modifying therapeutic modalities are therefore urgently needed. Diffusion magnetic resonance imaging (MRI) is a promising tool that can be used to infer microstructural characteristics of the brain, such as microstructural integrity and complexity, as well as axonal density, order, and myelination, through the utilization of water molecules that are diffused within the tissue, with displacement at the micron scale. Diffusion tensor imaging is the most commonly used diffusion MRI technique to assess the pathophysiology of neurodegenerative diseases. However, diffusion tensor imaging has several limitations, and new technologies, including neurite orientation dispersion and density imaging, diffusion kurtosis imaging, and free-water imaging, have been recently developed as approaches to overcome these constraints. This review provides an overview of these technologies and their potential as biomarkers for the early diagnosis and disease progression of major neurodegenerative diseases.  相似文献   
9.
Analysis of photoproducts derived from 1‐(methoxynaphthalen‐1‐ylmethyloxy)pyrene initiators and polymer end groups demonstrated that methoxynaphthalen‐1‐ylmethyl carbocation is involved in the initiation steps for both styrene (St) and cyclohexene oxide (CHO) polymerization. Charge transfer from the pyrenyloxy oxygen atom to the methoxynaphthalen‐1‐ylmethyl chromophore in the singlet excited state is assumed to be responsible for the efficient generation of the carbocation species, which also initiates the copolymerization of St and CHO. © 2014 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2014 , 131, 40510.  相似文献   
10.
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