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1.
穴位体表电刺激对术后PCEA的强化效应 总被引:1,自引:1,他引:0
目的 观察穴位体表电刺激对术后患者硬膜外自控镇痛(PCEA)效果、镇痛药用量、血清皮质醇浓度和不良反应的影响。方法 选择经腹全宫切除术患者40例(ASAⅠ~Ⅱ级),随机分成二组,每组20例。A组:于术后第4,8小时 Han's各刺激30 min,术后行PCEA。B组:单纯行术后PCEA(对照组)。术后随访镇痛效果、镇静评分、布氏舒适评分(BCS),分段记录24 h镇痛药用量及总按压次数/实进次数(D1/D2)比值,血清皮质醇含量,肛门恢复排气时间和不良反应情况。结果 两组镇痛效果满意,A组BCS评分高于B组(P<0.05)。A组镇痛药用量为(31.7±1.9)ml,与对照组(34.2±2.1)ml相比差异有显著性(P<0.01)。血清皮质醇浓度两组均较术前下降,但A组术后8 h的下降幅度大于对照组。A组恢复肛门排气时间快于B组,而且恶心、呕吐与对照组相比有所减少。结论 术后患者硬膜外腔自控镇痛(PCEA)复合应用穴位体表电刺激,可增强镇痛效果,减少用药量,降低不良反应,是安全有效的复合镇痛方法。 相似文献
2.
目的 构建携带色氨酸羟化酶(TPH)-2基因的小分子干扰RNA表达载体.方法 设计并合成shRNA TPH-2对应的两条互补的寡核苷酸链,pU6-CMV-GFP质粒经Age Ⅰ和EcoRⅠ双酶切与退火后的寡核苷酸连接,目的 质粒转化感受态细胞,对长出的克隆应用菌落聚合酶链反应(PCR)鉴定,再对PCR鉴定阳性的克隆进行测序和比对分析.结果 经PCR、酶切及测序证实,pU6-CMV-GFP-TPH-2 shRNA表达载体片段大小为332 bp,其中插入的片段序列和位点与预期完全一致.结论 实验成功构建pU6-CMV-GFP-TPH2 shRNA表达载体. 相似文献
3.
Objective To investigate the efficacy and safety of patient-controlled analgesia (PCA) with target controlled infusion (TCI) of sufentanil after abdominal total hysterectomy. Methods Sixty ASA I or II patients aged 20-59 yr weighing 45-75 kg undergoing elective abdominal total hysterectomy were randomly allocated into 3 groups of 20 patients each. The initial target plasma concentration (CP ) of sufentanil was set at 0.08 μg/L in group I and II and at 0.1 μg/L in group Ⅲ . The operation was performed under combined spinal-epidural anesthesia with 0.75% bupivacaine (for spinal) and 2% lidocaine (for epidural). The epidural catheter was removed after operation. TCI of sufentanil was started after operation when the patients felt no pain (VAS = 0) in group I and when VAS ≥ 2 in group Ⅱ and Ⅲ . The lockout interval was set at 6 min. If the patients pressed the button once, the target CP increased by 0.005 μg/L. If the button was pressed 3 times successively within 20 s, the target CP increased by 0.008 μg/L. If the button was not pressed for 80 min, the target CP decreased by 0 .005 μg/L automatically. VAS scores, BIS values, MAP, HR, SpO2 and RR were recorded immediately before (T0) and at 1, 2, 4, 8, 16, 24 h (T1-6) after TCI was started. The number of attempts (D1) and successfully delivered doses (D2) was recorded. The total amount of sufentanil administered and side effects were recorded during the 24 h after operation. Results The analgesia was satisfactory in all 3 groups. The VAS scores were < 3 and significantly higher in group Ⅱ and Ⅲ than in group I . The total amount of sufentanil administered during the 24 h after operation was significantly larger in group II and HI than in group I . The D1 and D2 were significantly larger during the 0-2 h after operation in group Ⅱ and Ⅲ than in group I .Tachycardia, bradycardia, respiratory depression, hypotension and over-sedation were not observed. Conclusion PCA with TCI of sufentanil is effective and safe for postoperative analgesia. It is better to start PCA-TCI before the patient feels pain after operation with the initial target CP set at 0.08 μg/L. 相似文献
4.
目的总结影响关节镜下前交叉韧带重建疗效的相关因素。方法回顾性分析135例前交叉韧带翻修病例的相关临床资料,进行膝关节Lysholm评分综合分析。结果膝关节继发性疾患、骨隧道位置、移植物的张力、髁间窝撞击、所移植肌腱的固定和术后康复训练6大因素是影响关节镜下膝关节前交叉韧带重建疗效的关键因素。结论高度重视以上6方面因素并正确处理,能有效提高关节镜下膝关节前交叉韧带重建的成功率和治疗效果。 相似文献
5.
Objective To investigate the efficacy and safety of patient-controlled analgesia (PCA) with target controlled infusion (TCI) of sufentanil after abdominal total hysterectomy. Methods Sixty ASA I or II patients aged 20-59 yr weighing 45-75 kg undergoing elective abdominal total hysterectomy were randomly allocated into 3 groups of 20 patients each. The initial target plasma concentration (CP ) of sufentanil was set at 0.08 μg/L in group I and II and at 0.1 μg/L in group Ⅲ . The operation was performed under combined spinal-epidural anesthesia with 0.75% bupivacaine (for spinal) and 2% lidocaine (for epidural). The epidural catheter was removed after operation. TCI of sufentanil was started after operation when the patients felt no pain (VAS = 0) in group I and when VAS ≥ 2 in group Ⅱ and Ⅲ . The lockout interval was set at 6 min. If the patients pressed the button once, the target CP increased by 0.005 μg/L. If the button was pressed 3 times successively within 20 s, the target CP increased by 0.008 μg/L. If the button was not pressed for 80 min, the target CP decreased by 0 .005 μg/L automatically. VAS scores, BIS values, MAP, HR, SpO2 and RR were recorded immediately before (T0) and at 1, 2, 4, 8, 16, 24 h (T1-6) after TCI was started. The number of attempts (D1) and successfully delivered doses (D2) was recorded. The total amount of sufentanil administered and side effects were recorded during the 24 h after operation. Results The analgesia was satisfactory in all 3 groups. The VAS scores were < 3 and significantly higher in group Ⅱ and Ⅲ than in group I . The total amount of sufentanil administered during the 24 h after operation was significantly larger in group II and HI than in group I . The D1 and D2 were significantly larger during the 0-2 h after operation in group Ⅱ and Ⅲ than in group I .Tachycardia, bradycardia, respiratory depression, hypotension and over-sedation were not observed. Conclusion PCA with TCI of sufentanil is effective and safe for postoperative analgesia. It is better to start PCA-TCI before the patient feels pain after operation with the initial target CP set at 0.08 μg/L. 相似文献
6.
目的 探讨异丙酚对内毒素诱导人脐静脉内皮细胞过氧亚硝基阴离子(ONOO-)生成的影响.方法 培养至活细胞计数大于95%的人脐静脉内皮细胞,随机分为7组(n=5),对照组(C组)不给予任何处理;LOS0.1组、LPS1组和LPS10组分别加入内毒素(LPS)至终浓度为0.1、1和10 μg/ml,于37℃5%CO2培养箱中孵育6 h;P4+LPS10组和P40+LPS10组预先加入异丙酚至终浓度为4、40μg/ml,I40+LPS10组预先加入脂质溶剂Introlipid至终浓度为40 μg/ml,于37℃ 5%CO2培养箱中孵育30 min,再分别加入LPS至终浓度为10μg/ml,于培养箱中继续孵育6 h.孵育6 h时,测定细胞活力和乳酸脱氢酶(LDH)释放率;采用免疫组化法和Western blot法测定硝基酪氨酸蛋白(NT)表达.结果 与C组比较,其余各组细胞活力降低,内皮细胞NT表达上调,LPS1组、LPS10组、I40+LPS10组、P4+LPS10组和P40+LPS10组LDH释放率升高(P<0.01);与LPS0.1组比较,LPS1组细胞活力、LDH释放率和内皮细胞NT表达差异无统计学意义(P>0.05),LPS10组细胞活力降低,LDH释放率升高,内皮细胞NT表达上调(P<0.01);与LPS10组比较,I40+LPS10组细胞活力、LDH释放率和内皮细胞NT表达差异无统计学意义(P>0.05),P4+LPS10组和P40+LPS10组细胞活力升高,LDH释放率降低,内皮细胞NT表达下调(P<0.01).结论 异丙酚可通过抑制ONOO'-的生成,减轻内毒素诱导人脐静脉内皮细胞损伤. 相似文献
7.
目的 比较不同液体复苏对失血性休克-内毒素二次打击大鼠急性肺损伤的影响.方法 60只雄性SD大鼠,体重250~280 g,随机分为5组(n=12):假手术组(S组)、失血性休克-内毒素组(SL组)、乳酸钠林格氏液组(LR组)、7.5%氯化钠组(HS组)和羟乙基淀粉(HES)130/0.4组(HES组).分为院前期(90 min)、院内复苏期(1 h)和复苏后观察期(3.5 h).院前期:SL组、LR组、HS组和HES组颈总动脉放血建立失血性休克模型(维持MAP 35~45 mm Hg 60 min)后,气管内注射内毒素2mg/kg,同时断尾,注射内毒素后即刻分别经30 min静脉输注3倍放血量的乳酸钠林格氏液、7.5%氯化钠4ml/kg和等放血量的6%HES 130/0.4;院内复苏期:结扎尾部断端止血,在1 h内回输全部放出的血液及等放血量的0.9%氯化钠;复苏后观察期3.5 h时采集动脉血样,进行血气分析,计算肺组织湿/干重量比(W/D)和肺通透指数(PPI),测定肺泡灌洗液(BALF)蛋白浓度和肺组织AQP-1 mRNA和AQP-5mRNA表达水平,光镜下观察肺组织病理学结果,记录大鼠存活情况.结果 与SL组和LR组比较,HS组和HES组MAP、pH值、PaO2和SaO2升高,血乳酸浓度、BE、W/D、PPI和BALF蛋白浓度降低,HS组肺组织AQP-1 mRNA表达上调,HES组肺组织AQP-1 mRNA和AQP-5 mRNA表达上调,大鼠存活率升高(P<0.05或0.01);与HS组比较,HES组W/D降低,AQP-5 mRNA表达上调,大鼠存活率升高(P<0.05),肺组织损伤程度减轻.结论 6%HES 130/0.4和7.5%氯化钠可减轻失血性休克-内毒素二次打击大鼠急性肺损伤,6%HES 130/0.4的效果更好,其机制与抑制AQP-1和(或)AQP-5表达下调有关;而乳酸钠林格氏液对其无效. 相似文献
8.
强啡肽(dynorphin)是作用于κ-阿片受体的神经肽,广泛分布于外周和中枢神经系统,涉及到许多生理和病理变化如吗啡耐受和依赖等[1].我们利用前强啡肽基因(prodynorphin gene)构建pUC57-prodynorphin重组质粒为下一步探讨其在吗啡耐受和依赖中的作用奠定了基础. 相似文献
9.
1993年~ 2 0 0 0年上半年 ,我们对心内科住院的急性心肌梗死 (AMI)、陈旧性MI及诊断为冠心病的患者常规作 18导联心电图 ,即除常规 12导联外 ,加作V3R~V5R 和V7~V9导联心电图。现就 80例急性前间壁MI患者的右胸导联 (V3R~V5R)心电图作初步分析。 80例AMI患者均符合下列条件 :①病史、心电图和心肌酶学检查确诊为AMI。②发病后 6~14h入院并有完整 18导联心电图资料和心肌酶学检查。③心电图定位为急性前间壁MI。④除外急性下壁、后壁、正后壁、高侧壁和侧壁等MI,并除外右心室肥大、肺心病、心包炎、心肌病… 相似文献
10.