Combined hepatocellular and cholangiocarcinoma (HCC-CC) is a unique primary epithelial tumor of the liver classified by the WorldHealth Organization (WHO) as a tumor containing elements of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC).The clinical diagnosis is established by histopathology and a firm pathological diagnosis from definitive evidence of HCC and CC differentiation.HCC-CC's clinical features tend to resemble hepatocellular carcinoma in regards to venous infiltration and like cholangiocarcinoma with respect to lymph node metastasis.To date,the biological behavior of HCC-CC remains ill-defined; however its prognosis seems to be worse than just HCC.Conversely,it is unclear whether the prognosis of HCC-CC is better than that of only ICC.This paper reviews recent studies on the clinicopathological behavior of HCC-CC.

OBJECTIVE： To provide reference for perioperative prophylactic use of antibiotics in urinary surgery department. METHODS： In response to irrational perioperative prophylactic use of antibiotics in urinary surgery department， taking type Ⅱ incision surgery and special diagnosis and treatment and preventive drug use as an example， the management and control mode for perioperative prophylactic use of antibiotics was established and intervened in urinary surgery department so as to intervene in antibiotics use through formulating surgical type risk classification system， forming perioperative medication clinical pathways such as type Ⅱ incision surgery and urinary calculi surgery with different infection risk， establishing tracking and supervision mechanism. The rationality indexes of perioperative prophylactic medication such as the rate of prophylactic antibiotics use were compared among related medical records collected from urinary surgery department within 3 months before and after intervention （186 records before intervention， 179 records after intervention）. Antibiotics use density （AUD） and amount of antibiotics in urinary surgery department were compared within 3 months before and after intervention to evaluate management and control effect. RESULTS： Among surveyed medical records， compared with before intervention， the rate of prophylactic antibiotics use was decreased from 97.3％ （181/186） to 91.6％ （164/179）； the rate of rational drug selection was increased from 17.7％ （32/181） to 71.3％ （117/164）； correct rate of medication timing was increased from 9.9％ （18/181） to 32.3％ （53/164）； the rate of rational post-operative prevention course was increased from 17.1％ （31/181） to 37.2％ （61/164）， with statistical significance （P＜0.05 or P＜0.01）. Average AUD was deceased from 83 DDD to 70 DDD within 3 months after intervention， and the amount of antibiotics was decreased from 689 669.23 yuan to 531 040.11 yuan. CONCLUSIONS： Established management and control mode for perioperative prophylactic use of antibiotics in type Ⅱ incision surgery and special diagnosis and treatment and preventive drug use can effectively reduce the rate of prophylactic antibiotics， AUD and amount of antibiotics in urinary surgery department， and promote rational use of antibiotics during perioperative period.