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Objective To investigate the effects of limited resuscitation on hepatic ischernia-reperfusion in-jury in rots with hemorrhagic shock. Method Uncontrolled hemorrhagic shock was induced in 54 rats by transect-ing the middle branch of the splenic artery to produce standardized massive splenic injury. Resuscitation started when the mean arterial pressure (MAP) reached 40 mmHg. The rats were randomly divided (n = 9per group) in-to sham-operated group (SS), or one of five treatment groups in which infusion of Ringer' s solution was continually administrated to maintain MAP at 40 (RS40), 50 (RS50), 60 (RS60), 80 (RS80) or 100 mmHg (RS100) for 45 minutes (T45 point). After the bleeding was controlled, resuscitation was continued with Ringer's solution and whole blood (2:1) to increase the MAP to 100 mmHg for 120 minutes (T165 point), which was followed by obser-vation for 240 minutes (T405 point). All animals were observed for 240 minutes or until death. Blood specimens were collected at TO, T45, T165 and T405 for determination of blood lactate levels. At the end of the experiment,a small amount of hepatic tissue was collected to measure tissue blood perfusion, total antioxidative capacity (TAOC), Na+K+ ATPase activity and malondialdehyde (MDA) levels. Results At T405, the blood lactate lev-els in the RS80 and RS100 groups [(3.60±0.68) and (3.84 ± 1.09) mmol/L, respectively] were significantly higher than those in the SS, RS40, RS50 and RS60 groups [(2.00±0.66),(2.74±1.45),(2.43 +0.94) and (2.07±0.95) mmol/L, respectively;all:P < 0.05]. The MDA levels were significantly higher in the RS80 and RS100[(7.32±0.31) and (7.71±0.23) nmol/mg,respectively] than those in the SS, RS40, RS50 and RS60 groups[(4.95±0.80),(6.14±0.94),(6.42±0.48) and (6.84±0.36) nmol/mg, respeetively;all: P <0.05]. The Na+ K+ ATPase and TAOC levels were significantly lower in all of the RS groups than those in the SS group (all: P < 0.05), and those in the RS80 and RS100 groups was significantly lower than those in the RS40,RS50 and RS60 groups (all: P <0.05). Blood perfusion in the RS80 and RS100 groups was significantly lower than that in the other groups (all: P < 0.05). Conclusions If hemorrhage is uncontrolled, limited resuscitation appears to balance the needs for organ perfusion, improve the microcircttlation and decrease lactate levels. Fur-thermore, limited resuscitation could decrease ischemia-reperfusion injury in liver tissue. 相似文献
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Objective To investigate the effects of limited resuscitation on hepatic ischernia-reperfusion in-jury in rots with hemorrhagic shock. Method Uncontrolled hemorrhagic shock was induced in 54 rats by transect-ing the middle branch of the splenic artery to produce standardized massive splenic injury. Resuscitation started when the mean arterial pressure (MAP) reached 40 mmHg. The rats were randomly divided (n = 9per group) in-to sham-operated group (SS), or one of five treatment groups in which infusion of Ringer' s solution was continually administrated to maintain MAP at 40 (RS40), 50 (RS50), 60 (RS60), 80 (RS80) or 100 mmHg (RS100) for 45 minutes (T45 point). After the bleeding was controlled, resuscitation was continued with Ringer's solution and whole blood (2:1) to increase the MAP to 100 mmHg for 120 minutes (T165 point), which was followed by obser-vation for 240 minutes (T405 point). All animals were observed for 240 minutes or until death. Blood specimens were collected at TO, T45, T165 and T405 for determination of blood lactate levels. At the end of the experiment,a small amount of hepatic tissue was collected to measure tissue blood perfusion, total antioxidative capacity (TAOC), Na+K+ ATPase activity and malondialdehyde (MDA) levels. Results At T405, the blood lactate lev-els in the RS80 and RS100 groups [(3.60±0.68) and (3.84 ± 1.09) mmol/L, respectively] were significantly higher than those in the SS, RS40, RS50 and RS60 groups [(2.00±0.66),(2.74±1.45),(2.43 +0.94) and (2.07±0.95) mmol/L, respectively;all:P < 0.05]. The MDA levels were significantly higher in the RS80 and RS100[(7.32±0.31) and (7.71±0.23) nmol/mg,respectively] than those in the SS, RS40, RS50 and RS60 groups[(4.95±0.80),(6.14±0.94),(6.42±0.48) and (6.84±0.36) nmol/mg, respeetively;all: P <0.05]. The Na+ K+ ATPase and TAOC levels were significantly lower in all of the RS groups than those in the SS group (all: P < 0.05), and those in the RS80 and RS100 groups was significantly lower than those in the RS40,RS50 and RS60 groups (all: P <0.05). Blood perfusion in the RS80 and RS100 groups was significantly lower than that in the other groups (all: P < 0.05). Conclusions If hemorrhage is uncontrolled, limited resuscitation appears to balance the needs for organ perfusion, improve the microcircttlation and decrease lactate levels. Fur-thermore, limited resuscitation could decrease ischemia-reperfusion injury in liver tissue. 相似文献
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胸部撞击伤时游离Ca2+浓度与中性粒细胞凋亡及肺损伤的关系 总被引:1,自引:0,他引:1
目的 :动态观察兔胸部撞击伤时中性粒细胞 (PMN)凋亡的发生以及与肺损伤之间的关系。方法 :制备兔胸部撞击伤模型 ,分离纯化肺灌洗液中的 PMN,应用流式细胞术测定 PMN凋亡、坏死、存活细胞比例及呼吸爆发功能的变化 ,并且观察与乳酸脱氢酶 (L DH)和胞浆游离 Ca2 变化之间的关系。结果 :肺灌洗液中PMN的凋亡延迟持续至 12小时 ,在伤后各时间点活细胞增多 ;而肺灌洗液 PMN呼吸爆发从伤后 2小时即显著增强 ,8小时达到峰值 ;同时肺灌洗液 L DH的升高在伤后 4~ 2 4小时显著高于正常对照组 ;伤后 PMN胞浆游离 Ca2 有短暂升高。结论 :胸部撞击伤时 ,PMN在肺组织中大量扣押 ,且正常的凋亡途径发生障碍 ,造成PMN持续处于激活状态及毒性内容物的持续释放 ,与肺组织损伤有密切关系 ,并且 PMN凋亡延迟可能与胞浆游离 Ca2 的短暂升高有关 相似文献
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3种不同分子量的羟乙基淀粉对大鼠非控制出血性休克的复苏效果比较 总被引:1,自引:0,他引:1
目的 比较3种不同分子量的6%羟乙基淀粉(HES)/0.9%氯化钠(NaCl)溶液对大鼠非控制出血性休克的早期低压复苏效果.方法 采用脾脏损伤 切断脾动脉的一分支造成大鼠非控制出血性休克模型,32只Sprague-Dawley(SD)大鼠按照止血前输注液体的不同分为4组:Ⅰ组,不复苏(no resuscitation,NR)组;Ⅱ组,HES40组;Ⅲ组,HES130组;Ⅳ组,HES200组.伤后平均动脉压(MAP)降至40mmHg时各组分别用3种不同的6%HES/0.9%Nacl溶液开始进行低压复苏,使MAP维持在50mmHg,持续1小时(低压期),Ⅰ组此期不输注任何液体.然后结扎脾动脉止血,各组均以林格氏液加肝素化的供体大鼠全血进行充分液体复苏2小时.观察血流动力学、出血量、血细胞比容(Hct)、止血前期和止血后期的输液量、存活时间.结果 与Ⅰ组比较,早期低压复苏虽然增加了出血量,却显著延长了存活时间,其中Ⅲ、Ⅳ组存活时间比Ⅱ组显著延长,且止血前和止血后输液量显著少于Ⅱ组,而Hct显著高于Ⅱ组,其改善血流动力学的作用显著强于Ⅱ组.结论 用HES进行低压复苏,较之不复苏延长了非控制出血性休克大鼠的存活时间.不同分子量的HES复苏效果不同,HES130和HES200的复苏效果优于HES40. 相似文献
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失血性休克及复苏后大鼠肠上皮UCP2变化及其线粒体功能损伤的研究 总被引:2,自引:0,他引:2
目的研究失血性休克及复苏后解偶联蛋白2(UCP2)在肠上皮线粒体功能损伤中的作用.方法复制大鼠失血性休克复苏模型, 分别于休克前、休克90分钟及复苏2小时、6小时、12小时、24小时取小肠上皮,用Western-blot法测线粒体UCP2的含量,用荧光分光光度法测UCP2对线粒体膜电位(MP)、线粒体内活性氧(ROS)产生的影响作用,用高效液相色谱法(HPLC)测组织中三磷酸腺苷(ATP)的含量.结果 (1)失血性休克及复苏后肠上皮线粒体中UCP2含量增高 (P<0.05);(2)UCP2可降低MP并抑制线粒体内ROS产生,但UCP2对线粒体内ROS产生的调节作用受MP影响;(3)失血性休克后,肠上皮组织中ATP含量明显下降,是对照组的20.81%,复苏后24小时,其水平仍低于正常.结论 UCP2可能参与失血性休克及复苏后肠上皮线粒体功能的损伤. 相似文献