全文获取类型
收费全文 | 138篇 |
免费 | 5篇 |
国内免费 | 4篇 |
专业分类
妇产科学 | 1篇 |
基础医学 | 11篇 |
临床医学 | 11篇 |
内科学 | 20篇 |
皮肤病学 | 1篇 |
神经病学 | 11篇 |
特种医学 | 1篇 |
外科学 | 73篇 |
综合类 | 4篇 |
药学 | 6篇 |
肿瘤学 | 8篇 |
出版年
2021年 | 2篇 |
2018年 | 4篇 |
2017年 | 1篇 |
2016年 | 2篇 |
2015年 | 1篇 |
2013年 | 4篇 |
2012年 | 9篇 |
2011年 | 6篇 |
2010年 | 6篇 |
2009年 | 1篇 |
2008年 | 6篇 |
2007年 | 7篇 |
2006年 | 9篇 |
2005年 | 6篇 |
2004年 | 9篇 |
2003年 | 7篇 |
2002年 | 3篇 |
2001年 | 3篇 |
2000年 | 9篇 |
1999年 | 6篇 |
1998年 | 4篇 |
1997年 | 3篇 |
1996年 | 4篇 |
1995年 | 1篇 |
1993年 | 2篇 |
1992年 | 1篇 |
1991年 | 1篇 |
1989年 | 4篇 |
1988年 | 2篇 |
1987年 | 5篇 |
1986年 | 1篇 |
1985年 | 3篇 |
1984年 | 6篇 |
1983年 | 3篇 |
1981年 | 2篇 |
1979年 | 2篇 |
1978年 | 2篇 |
排序方式: 共有147条查询结果,搜索用时 15 毫秒
1.
D. Finnerty A. Ní Eochagáin M. Ahmed A. Poynton J. S. Butler D. J. Buggy 《Anaesthesia》2021,76(11):1499-1503
Major spinal surgery causes significant postoperative pain. We tested the efficacy and safety of bilateral erector spinae block on quality of recovery and pain after thoracolumbar decompression. We randomly allocated 60 adults to standard care or erector spinae block. Erector spinae block improved the mean (SD) quality of recovery-15 score at 24 postoperative hours, from 119 (20) to 132 (14), an increase (95%CI) of 13 (4–22), p = 0.0044. Median (IQR [range]) comprehensive complication index was 1 (0–3 [0–5]) in the control group vs. 1 (0–1 [0–4]) after block, p = 0.4. Erector spinae block reduced mean (SD) area under the curve pain during the first 24 postoperative hours: at rest, from 78 (49) to 50 (39), p = 0.018; and on sitting, from 125 (51) to 91 (50), p = 0.009. The cumulative mean (SD) oxycodone consumption to 24 h was 27 (18) mg in the control group and 19 (26) mg after block, p = 0.20. In conclusion, erector spinae block improved recovery and reduced pain for 24 h after thoracolumbar decompression surgery. 相似文献
2.
Therapy of relapsing Clostridium difficile-associated diarrhea and colitis with the combination of vancomycin and rifampin 总被引:5,自引:0,他引:5
Seven patients with multiple bacteriologic and symptomatic relapses of Clostridium difficile-associated diarrhea and/or colitis were treated with vancomycin and rifampin in combination. Diarrhea and abdominal pain promptly resolved in all, and neither C. difficile nor its toxin could be recovered from their stools shortly after therapy. However, stools of all patients subsequently became culture-positive for C. difficile and occasionally had demonstrable cytotoxin. Except in one instance following oral antibiotic use, all patients remained free of symptoms. Resistance to either vancomycin or rifampin was not encountered. Biotyping of isolates with clostridial bacteriophages and bacteriocins suggested true relapse with the same organism in all patients studied, rather than reinfection with another strain. Vancomycin and rifampin in combination appear to be useful in the therapy of relapsing antibiotic-associated diarrhea due to C. difficile. 相似文献
3.
Tai YT Chang BY Kong SY Fulciniti M Yang G Calle Y Hu Y Lin J Zhao JJ Cagnetta A Cea M Sellitto MA Zhong MY Wang Q Acharya C Carrasco DR Buggy JJ Elias L Treon SP Matsui W Richardson P Munshi NC Anderson KC 《Blood》2012,120(9):1877-1887
Bruton tyrosine kinase (Btk) has a well-defined role in B-cell development, whereas its expression in osteoclasts (OCs) further suggests a role in osteoclastogenesis. Here we investigated effects of PCI-32765, an oral and selective Btk inhibitor, on osteoclastogenesis as well as on multiple myeloma (MM) growth within the BM microenvironment. PCI-32765 blocked RANKL/M-CSF-induced phosphorylation of Btk and downstream PLC-γ2 in OCs, resulting in diminished TRAP5b (ED(50) = 17nM) and bone resorption activity. PCI-32765 also inhibited secretion of multiple cytokines and chemokines from OC and BM stromal cell cultures from both normal donors (ED(50) = 0.5nM) and MM patients. It decreased SDF-1-induced migration of MM cells, and down-regulated MIP1-α/CCL3 in MM cells. It also blocked MM cell growth and survival triggered by IL-6 or coculture with BM stromal cells or OCs in vitro. Importantly, PCI-32765 treatment significantly inhibits in vivo MM cell growth (P < .03) and MM cell-induced osteolysis of implanted human bone chips in SCID mice. Moreover, PCI-32765 prevents in vitro colony formation by stem-like cells from MM patients. Together, these results delineate functional sequelae of Btk activation mediating osteolysis and growth of MM cells, supporting evaluation of PCI-32765 as a novel therapeutic in MM. 相似文献
4.
Hidetomo Niwa David J. Rowbotham David G. Lambert Donal J. Buggy 《Journal of anesthesia》2013,27(5):731-741
Despite the development of effective chemotherapy and radiotherapy, surgery remains the mainstay treatment of many cancers, requiring anesthesia. Almost all cancer deaths after primary surgery are attributable to recurrence or metastases. Recently it has been hypothesized that the perioperative anesthetic management of cancer patients could potentially affect the risk of recurrence and metastases, which implies a key role for anesthesiologists in choosing anesthetic agents and techniques that optimize the balance between the metastatic potential of the tumor versus its elimination by antimetastatic immune defenses. This review summarizes available experimental information on the potential effects of common anesthetic agents and techniques on cancer metastases and the conflicting retrospective clinical data on regional anesthesia in various types of cancer. A number of prospective, randomized, multicenter, clinical trials are in progress, and their results are eagerly awaited. 相似文献
5.
Objective To establish the incidence of central venous catheter erosion in a patient cohort receiving total parenteral nutrition and
to examine risk factors and complications of vascular erosion.
Design and setting Review of prospectively collected intravenous nutrition service audit records in a tertiary university hospital.
Results Records of 1,499 patients (2,992 catheters) were studied over the 14 year period 1991–2005. Fisher's exact test was used to
determine statistical significance. Five erosions occurred, representing an incidence of 0.17% per catheter or 0.28 per 1,000
catheter days. One of the five patients died from ensuing complications. Mean time to onset of symptoms was 3.6 days following
catheter insertion. Symptoms/signs included dyspnoea (n = 5), chest pain (n = 2) and pleural effusion (n = 5). Diagnosis was delayed by a mean of 1.6 days. Three erosions occurred in left subclavian catheters (n = 583); two in left internal jugular catheters (n = 453). None occurred in right-sided catheters (n = 1956). The relative risk of erosion occurring in left-sided catheters compared to right was 2.9 (95% CI 2.76–3.00; p = 0.009). There was no statistically significantly greater risk of vascular erosion in subclavian than internal jugular catheters
(relative risk 0.9; p = 1.0). Older age was a statistically significant risk factor (p = 0.009); female sex was not (p = 0.18).
Conclusion In patients receiving total parenteral nutrition via central venous catheters, erosion has an incidence per catheter of 0.17%
and is more likely to occur in left-sided catheters and elderly patients. 相似文献
6.
7.
Ropivacaine, a relatively new amide local anaesthetic, reputedly produces less motor block than equivalent doses of bupivacaine, potentially combining high-quality analgesia with the ability to ambulate. We report two cases of prolonged, profound motor block with patient-controlled epidural analgesia using 0.1% ropivacaine, following spinal bupivacaine for Caesarean section. As there was no evidence of inadvertent intrathecal ropivacaine administration or of any neurological injury, we hypothesise that epidural ropivacaine may interact with intrathecal bupivacaine to prolong its effect. 相似文献
8.
P. OScanaill S. Keane V. Wall G. Flood D.J. Buggy 《British journal of anaesthesia》2018,120(4):846-853
Background
Pectoral plane blocks (PECs) are increasingly used in analgesia for patients undergoing breast surgery, and were recently found to be at least equivalent to single-shot paravertebral anaesthesia. However, there are no data comparing PECs with the popular practice of continuous local anaesthetic wound infusion (LA infusion) analgesia for breast surgery. Therefore, we compared the efficacy and safety of PECs blocks with LA infusion, or a combination of both in patients undergoing non-ambulatory breast-cancer surgery.Methods
This single-centre, prospective, randomised, double-blind trial analysed 45 women to receive either PECs blocks [levobupivacaine 0.25%, 10 ml PECs I and levobupivacaine 0.25%, 20 ml PECs II (PECs group); LA infusion catheter (levobupivacaine 0.1% at 10 ml h?1 for 24 h (LA infusion group); or both (PECs and LA infusion)]. The primary outcome measure was area under the curve of the pain verbal rating score whilst moving vs time (AUC) over 24 h. Secondary outcomes included total opioid consumption at 24 h.Results
AUC moving was mean (SD) 71 (34) mm h?1vs 58 (41) vs 23 (20) in PECs, LA infusion, and both, respectively; P=0.002. AUC at rest was also significantly lower in patients receiving both. The total 24 h opioid consumption [median (25–75%)] was 14 mg (9–26) vs 11 (8–24) vs 9 (5–11); P=0.4. No adverse events were observed.Conclusions
The combination of both pre-incisional PECs blocks and postoperative LA infusion provides better analgesia over 24 h than either technique alone after non-ambulatory breast-cancer surgery.9.
10.
Shivering and neuraxial anesthesia 总被引:4,自引:0,他引:4
Shivering, which usually occurs as a thermoregulatory response to cold, may also occur following general or neuraxial anesthesia. Some of the causative factors of this type of shivering may be common to both, but some are particular to neuraxial anesthesia. Although shivering may have beneficial thermoregulatory effects, it places the body under increased physiological stress. In a broad sample of 21 studies, the median incidence of shivering related to neuraxial anesthesia in the control groups was 55%. Both pharmacological and nonpharmacological mechanisms have been found to be effective in reducing this shivering. This review aims to elucidate the mechanisms of the shivering that occurs during neuraxial anesthesia, and to examine strategies for prevention and treatment of this shivering. 相似文献