Objective To analyze the kinds and diug resistance of bacterial.Methods 1 200 cases were detected who used the antimicrobial drugs.The drug use and drug resistance were investigated.Results 612 bacterias were isolated from the 1 200 patients,the rate was 51.0％.The top five pathogens were Pseudomonas aeruginosa,fungi,Escherichia coli,Klebsiella pneumoniae,Pseudomonas alcaligenes etc..The Cefoperazone/sulbactam and imipenem against Pseudomonas aeruginosa,Escherichia coli and Klebsiella pneumoniae had better antibacterial activity,and the cefazolin,cotrimoxazole and chloramphenicol antibacterial activity were relatively low.Conclusion The clinical use and drug resistance in different regions are unique,it should pay attention to the pathogenic examination and drug susceptibility testing,early and timely antimicrobial therapy.

Objective To probe into the nursing experience of reasonable cooperation between op-eration room nurses and anesthesiologists. Methods Strengthening preoperative propaganda and psy-chological education,paying attention to the temperature and humidity in operation room,assisting the anesthesiologists to arrange patients'body position,giving cooperation of infusion and transfusion,actively involving in rescue work.Results Surgery patients got good care,anesthesia and surgery went along smoothly. Conclusions Smooth coordination between operation room nurses and anesthesiologists has great significance on the smooth going and satisfactory results of operation.

The occurrence of 20 to 25 percent of ovarian cancer is associated with genetic factors.Hereditary ovarian cancer includes genetic ovarian cancer and familial ovarian cancer.The genetic characteristics of tumors and the development of gene testing technology make it possible to detect tumor-related mutational genes by testing the gene of the proband and thus identify the other family members at risk and intervene early so as to realize early prevention and detection of the cancer.The paper reviews the genetic basis and pathogenesis of hereditary ovarian cancer as well as methods of detecting mutational genes, management of the proband, problems at present, and disease prevention for high-risk individuals.It stresses that we should pay attention to hereditary ovarian cancer in clinical work, identify the proband, and make comprehensive evaluation of risks of the patients` relatives so as to provide individualized guidance and carry out the concept of precision medicine.

Objective To study the indication, efficacy, safety, anesthesia method, and complication of extracorpereal shockwave lithotripsy (ESWL) in combination with endoscopic retrograde eholangiopanereatography (ERCP) for pancreatic duct stones. Methods From November 2011 to February 2016, we observed the success rate and safety of ESWL in combination with ERCP in treatment of 33 patients with chronic pancreatitis and large pancreatic duct stones and evaluate the efficacy in 6 month and 4 years follow-up. Results All the 33 patients underwent 52 ESWL, the successful fragmentation rate was 100.00%; complete clearance was achieved in 27 patients (81.82%) under the treatment of ESWL in combination with ERCP. Their pain and steatorrhea relieved, the weight increased. Conclusions ESWL combined with ERCP is effective, safe for chronic pancreatitis with pancreatic duct stones.

A series of reforms on the teaching of analytical chemistry experiment has been carried out in accordance with the characteristics of medicine examination and the actuality,which includes the content of course,the teaching method,and the inspection method.Good results have been achieved in the aspect of development of students' comprehensive quality and practical ability.

The effective running of the teaching quality supervision system in institutions of higher learning is closely connected with the efficiency of the teaching quality supervision,thus affecting whether the teaching quality can be guaranteed and promoted or not.The paper,based on the formation of the teaching quality supervision system in institutions of higher learning,probes into the problem of how to effectively run the supervision for the purpose of promotion of teaching quality in colleges and universities.

Objective To investigate the feasibility and safety of laparoscopic myomectomy in patients with large-diameter hyste-romyoma .Methods A retrospective analysis of data from 37 patients in which the uterus were larger than 14-week gestational size and the diameter of myoma was ≥7 cm treated by laparoscopic myomectomy from January 2007 to December 2011 in our hospital was conducted .The outcome of the operation were compared with that in 53 large-diameter hysteromyoma cases by abdominal sur-gery .Results 37 patients were carried out laparoscopic surgery in which 28 cases were treated successfully by total laparoscopy , and small abdominal incision was made in 6 cases .3 of the cases converted to open surgery .The ureteral abdominal fistula was ob-served in 1 case ,which was cured by a reoperation of abdominal ureteral anastomosis .All patients were successfully cured and re-tained the uterus .The cases converted to open had no significant correlation with the patient′s age ,the fibroids size ,fibroids num-ber ,operative time and blood loss volume(P>0 .05) .Compared with the laparotomy group ,the operative time ,blood loss and post-operative morbidity were similar between groups (P>0 .05) .Postoperative recovery times after laparoscopic group were less than the control group(P<0 .05) .In the follow-up of 51 months(18 to 78) ,the laparoscopic myomectomy is equally effective with the laparotomy group in the number of cases of the postoperative normal menstruation and the postoperative spontaneous pregnancy . There were no statistically significant differences between the two groups (P>0 .05) .Conclusion Laparoscopic myomectomy in pa-tients with large-diameter hysteromyoma is safe and feasible while excellent surgical skills were required for a successful surgery .

Forty-eight male Wistar rats,weighing 280 to 320 g,were selected and prepared by fasting but free drinking for 12 hours before the experiment.They were randomly divided into four groups by random number table (12 rats in each group):control group,ischemic group,reperfusion group and propofol group.Control group:normal saline infusion[10 ml /(kg?h)]for 1 h in caudal vein without any other treatment.Ischemic group:on the basis of control group,supply with 20 mmHg(1 mmHg =0.133 kPa)pneumoperitoneum pressure for 1 h. Reperfusion group:on the basis of ischemic group,keep pneumoperitoneum pressure open for 30 min.Propo-fol group:infusion propofol in caudal vein [10 ml /(kg?h),saline 10-fold dilution],given 20 mmHg pneu-moperitoneum pressure for 1 h,then kept this pressure open for 30 min.The expression changes of blood urea nitrogen(BUN),creatinine(Cr),superoxide dismutase(SOD),malondialdehyde(MDA)and nuclear factor E2-related factor 2(Nrf2)were detected individually.Results The levels of BUN,Cr and MDA gradually increased,while the level of SOD decreased in control group,ischemic group and reperfusion group (P ﹤0.05,respectively).Compared with ischemic group and reperfusion group,the levels of BUN,Cr and MDA decreased significantly,and the level of SOD increased markedly in propofol group(P ﹤0.05,respectively). The expression of Nrf2 protein and mRNA gradually increased in the control group,ischemia group,reperfu-sion group and propofol group (P ﹤0.05).Conclusion Carbon dioxide pneumoperitoneum can cause renal IRI in rats.Propofol has a protective effect of IRI by regulating the expression of Nrf2 protein.

Studies demonstrate that peptides have great potential in cancer therapy and inhibitation of tumor progression.Peptides can be used as hormones,vaccines,carriers of redionuclides and cytotoxic drugs as well as anti-tumor drugs playing important roles in oncotherapy.Targeting chemotherapy and targeting drug transportation technique can enable the drugs to concentrate expected location selectively and effectively,emerging as an alternative to the conventional chemotherapy.

Objective To investigate the prevalence of H.Pylori infection and antibiotic resistance in patients with peptic ulcer.Methods A retrospective analysis of 429 endoscopy and H.Pylori culture results in the First People's Hospital of Hangzhou from 2012 to 2013 was conducted.The rate of H.Pylori infection in patients with peptic ulcer, and the resistance rates of H.Pylori to metronidazole, levofloxacin, clarithromycin,amoxicillin, gentamicin, furazolidone were analysed.Results The positive rate of H.Pylori in people with peptic ulcer was 53.1％ (228/429).The resistance rates to metronidazole, levofloxacin, clarithromycin,amoxicillin, gentamicin and furazolidone were 94.7％ (216/228), 18.9％ (43/228), 18.9％ (43/228), 0, 0 and 0.Double antibacterial resistant rates of metronidazole and clarithromycin, metronidazole and levofloxacin were 18.0％ (41/228) and 17.1％ (39/228).Triple antibacterial resistant percentage of levofloxacin + metronidazole + clarithromycin was 8.3％ (19/228).The resistance rate of clarithromycin in 43 patients who were also resistant to levofloxacin was 46.5％ (20/43), while the resistance rate of clarithromycin in 185 patients who were also sensitive to levofloxacin was 12.4％ (23/185)with significant difference(x2 =26.480,P =0.000).A positive association between the resistance to levofloxacin and to clarithromycin was found.Conclusion The H.Pylori infection is closely related to the occurrence of peptic ulcer.Without the basis of culture results in patients with H.Pylori positive, amoxicillin, gentamicin and furazolidone could be the first choices in clinical,because of their low resistance rates.Clarithromycin can be used as an alternative.