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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.
Endogenous tocochromanols in extracted lipids from rice brans of the five cultivars were determined by high-performance liquid chromatography, and were investigated in relation to the fatty acid (FA) distribution of triacylglycerols (TAG) and phospholipids (PL). The dominant tocols were α-tocopherol and γ-tocotrienol, followed by α-tocotrienol and with much smaller amounts of γ-tocopherol and δ-tocotrienol. The lipids of these rice brans comprised mainly TAG (80.6–86.0 wt.%), free FA (4.2–9.0 wt.%), and phospholipids (5.5–6.7 wt.%), whilst other components were also detected in minor proportions (0.2–2.1 wt.%). The PL components included phosphatidyl choline (31.8–46.8 wt.%), phosphatidyl ethanolamine (25.0–38.9 wt.%) and phosphatidyl inositol (20.2–23.2 wt.%). Comparison of these different cultivars showed, with a few exceptions, no significant differences (P > 0.05) in FA distribution. FA distribution of TAG among the five cultivars was evident in the rice brans: unsaturated FA were predominantly concentrated at the sn-2 position and saturated FA primarily occupying the sn-1 or sn-3 position. These results suggest that the tocopherol content, lipid component, and FA distribution in rice brans are not dependent on the cultivation areas during the growing season.  相似文献   
7.
A 57-year-old man was admitted to our hospital because of restenosis of the left main coronary trunk (LMT) after patch angioplasty for the LMT lesion. PTCA was repeated four times during three years after patch angioplasty, but recent coronary angiogram still demonstrated 75% restenosis of the LMT lesion. Double-CABG was performed to LAD and LCX using the left internal thoracic artery and saphenous vein graft. Postoperative coronary angiogram revealed an excellent result. A careful consideration must be given to the indication of the patch angioplasty of the LMT lesion.  相似文献   
8.
Continuous cultures of Saccharomyces cerevisiae show a robust autonomous temperature compensated oscillation in many metabolic functions. Respiratory activity, a convenient output to measure, oscillates with a period of 40 min. Deletion of GTS1, whose protein product has homology to the circadian per protein, has been implicated in temporal events within yeast, causes a reduction in periodicity to 18 min (wild-type period 40-60 min). The dilution rate was steadily increased from 0.04/h to 0.085/h and the oscillation stabilized after four to six dilutions. However, Gts1p's involvement in the maintenance and generation of metabolic synchrony, and in the central oscillating loop, appear to be minimal, as the mutant oscillation was robust and autonomous. Deletion of GTS1 did cause decreased temperature compensation of the period of the oscillation from Q(10) = 1.07 for the wild-type to Q(10) = 1.6 for the mutant. Also the degree of nutrient compensation observed for the wild-type was not observed in the GTS1-null mutant strain. It is postulated that Gts1p is involved in the mechanism that communicates external conditions, such as temperature, to the central oscillating loop.  相似文献   
9.
The stoichiometric mixture of 2MgH2 + Co was ball milled under a hydrogen atmosphere to synthesize nanocrystalline metal hydride Mg2CoH5. Upon milling, the mixture was analyzed by X-ray powder diffraction (XRD) and thermal methods employing the techniques of differential scanning calorimetry (DSC), thermogravimetry (TG) and differential thermal analysis (DTA). Hydrogen absorption and desorption measured by pressure-composition-temperature (P-C-T) curves indicated that the capacity loss was small after 20 consecutive cycling tests. The enthalpies associated with hydride formation and decomposition were measured to be –69.5 and –83.2 kJ mol–1 H2, respectively. At the temperatures of this study (553 to 653 K), hysteresis decreases with increasing temperature.  相似文献   
10.
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