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Background and objectives
We aimed to evaluate the effect of bupivacaine and dexmedetomidine added to bupivacaine used in tranversus abdominis plane (TAP) block on postoperative pain and patient satisfaction in patients undergoing lower abdominal surgery.Methods
Patients submitted to lower abdominal surgery were enrolled in the study. After anesthesia induction, ultrasound guided TAP block was performed. TAP block was obtained with 21 mL 0.9% saline in Group C (n = 31), 20 mL 0.5% bupivacaine + 1 mL saline in Group B (n = 31), and 20 mL 0.5% bupivacaine + 1 mL dexmedetomidine (100 μg) in Group BD (n = 31).Results
Visual analog scale scores were lower in Group BD compared to Group C, at all time points (p < 0.05); it was lower in group BD than in group B at 10–24 h. In Group B, it was lower than Group C at 2–8 h (p < 0.05). Total morphine consumption was lower in Group BD compared to other groups and lower in group B than in the controls (p < 0.001). Patient satisfaction was higher in Group BD than in other groups and was higher in both study groups than in the controls (p < 0.001). Nausea‐vomiting scores, antiemetic requirement, or additional analgesic administration were not significant among groups (p > 0.05).Conclusions
The addition of dexmedetomidine to bupivacaine on TAP block decreased postoperative pain scores and morphine consumption; it also increased patient satisfaction in patients undergoing lower abdominal surgery. Dexmedetomidine did not have any effect on nausea and vomiting score and antiemetic requirement. 相似文献Objectives
This experimental study investigated the possible protective effect of beta glucans on amikacin ototoxicity.Methods
Thirty-eight rats with normal distortion product otoacoustic emissions (DPOAEs) were divided into four groups. Group K was the control group. Group A was injected intramuscularly (i.m.) with amikacin 600 mg/kg/day between days 1-15. Group AB was given beta glucan gavage 1 mg/kg/day on days 0-15 and given amikacin 600 mg/kg/day i.m. on days 1-15. Group B was administered only beta glucan gavage, 1 mg/kg/day, on days 0-15. The DPOAEs were elicited in different frequency regions between 2,003 and 9,515 Hz, as distortion product diagrams (DPgrams), before and after the medication was administered, in all groups, on days 1, 5, 10, and 15.Results
No significant changes in the DPgrams were observed in group K. In group A, significant deterioration was observed at the 8,003 and 9,515 Hz frequencies on day 10, and at the 3,991, 4,557, 5,660, 6,726, 8,003, and 9,515 Hz frequencies on day 15. For group AB, statistically significant deterioration was observed at the 2,824, 8,003, and 9,515 Hz frequencies on day 15. The results for group B showed a significant improvement of hearing at the 2,378, 2,824, 3,363, and 3,991 Hz frequencies on day 1, at the 3,363, 3,991, and 8,003 Hz frequencies on day 10, and at the 8,003 Hz frequency on day 15.Conclusion
This study suggests that amikacin-induced hearing loss in rats may be limited to some extent by concomitant use of beta glucan. 相似文献Purpose
This study compares the effectiveness of midazolam and dexmedetomidine for the sedation of eclampsia patients admitted to our intensive care unit (ICU).Patients and Methods
Forty women with eclampsia requiring termination of pregnancy by caesarean delivery were randomized in to 2 groups of 20 to receive either midazolam or dexmedetomidine. The midazolam group received a loading dose of 0.05 mg/kg followed by an infusion of 0.1 mg kg−1 h−1. The dexmedetomidine group loading dose was 1 μg/kg per 20 minutes, followed by continuous infusion at 0.7 μg kg−1 h−1. Heart rate, blood pressure, Ramsey sedation score, antihypertensive need, convulsion fits, and duration in ICU were monitored and recorded all through the ICU stay.Results
Dexmedetomidine markedly reduced heart rates for the first 24 hours (P < .05) compared with midazolam, but there were no differences at 48 and 72 hours. Mean arterial blood pressures were similar in the 2 groups (P > .05), although in the dexmedetomidine group, it was lower at 5, 6, 12, and 24 hours compared with the first 4 hours (P < .05). Moreover, fewer patients given dexmedetomidine required nitroglycerine and nitroprusside (P < .05). The duration of ICU stay was less in the dexmedetomidine group, 45.5 hours (range, 15-118 hours), than in the midazolam group, 83 hours (minimum-maximum, 15-312 hours).Conclusion
Dexmedetomidine sedation in eclampsia patients is effective in reducing the demand for antihypertensive medicine and duration of ICU stay. 相似文献Objective: To assess the stiffness of biceps brachialis muscles in stroke patients by strain EUS and to investigate the sonoelastographic changes and its correlations with clinical evaluation parameters after botulinum toxin-A (BTA) injections.
Methods: This is a prospective study. A total of 48 chronic stroke patients requiring BTA injections to biceps brachialis muscles were included in the study. All patients received injections with BTA to biceps brachialis muscles under ultrasound guidance. MAS, goniometric measurements, and strain EUS assessments were performed at preintervention and at 4-week postintervention.
Results: Strain index values of biceps muscle on the affected side were significantly increased compared with those on the unaffected side (p < 0.01). At 4 weeks after BTA injection, significant improvements were observed in MAS grades and goniometric measurements (p < 0.05). Statistically significant differences were also found between the MAS grades and strain index values in both pre-/postintervention period (p < 0.01). No significant correlations were observed between clinical parameters and strain EUS findings.
Conclusions: Strain EUS is a promising diagnostic tool for assessing stiffness in spastic muscles, in establishing the treatment plan and monitoring the effectiveness of the therapeutic modality. 相似文献