Objective To investigate the risk factors of postoperative infectious complications (PIC) after liver resection for hepatocellular carcinoma (HCC) using evidence based medicine to provide a basis for prediction and prevention of PIC.Methods The fixed-effects or random-effects model was performed on studies on risk factors of PIC in HCC patients published from January 1990 to May 2015 by searching the PubMed,Embase,CNKI,VIP and Wanfang Data.Results Fourteen studies involving HCC 5 841 patients were included in this meta-analysis.The level of serum albumin was significantly lower in the PIC group than the NPIC group (WMD =-1.80,95％ CI:-2..79 ～-0.80 ; P ＜ 0.05) ; Patients with diabetes mellitus had a higher incidence of PIC than those without diabetes mellitus (OR =1.94,95％ CI:1.27 ～ 2.95 ; P ＜ 0.05) ; Patients with operation time less than 5 h had an decreased incidence of PIC than the other group (OR =0.31,95 ％ CI:0.22 ～ 0.45 ; P ＜ 0.05).Patients with blood loss less than 2 000 ml had a lower incidence of PIC than the other group (OR =0.30,95％ CI:0.19 ～ 0.48 ; P ＜ 0.05).Patients with blood transfusion had a higher incidence of PIC than those without transfusion (OR =2.83,95％ CI:2.04 ～ 3.93 ; P ＜ 0.05).Patients with postoperative bile leakage had a higher incidence of PIC than those without bile leakage (OR =3.79,95％ CI:2.06 ～ 6.96; P ＜ 0.05).Patients after primary hepatectomy had a higher incidence of PIC than those after repeat hepatectomy,but there was no significant difference between the two groups (OR =1.52,95％ CI:0.99 ～ 2.33 ; P =0.05).Patients with tumor diameter less than 5 cm had a higher incidence of PIC than the other group,but there was no significant difference between the two groups (OR=1.09,95％CI:0.76 ～1.56; P＞0.05).Conclusion A low level of serum albumin,diabetes mellitus,operation time more than 5 h,blood loss more than 2 000 ml,blood transfusion,bile leakage were risk factors for the development of PIC.

Objective To investigate the effect of Dicer knockdown on the proliferation,migration and invasion of cholangiocarcinoma cell line TFK-1.Methods The study used liposome-mediated method to transfect Dicer-siRNA into TFK-1 cells.The mRNA and protein expressions of Dicer after transfection were detected by real-time PCR and western blot.CCK8 assay,scratch test and transwell assays were performed to analyze the influence on the proliferation,migration and invasion of cells,respectively.Results Compared with the control,Dicer mRNA level at 48 h and Dicer protein level at 96 h were both significantly reduced after transfection with Dicer-siRNA (P ＜ 0.01).CCK8 assay revealed that the absorbance value significantly increased at 72 h,96 h and 120 h after transfection (P ＜0.01).Scratch test and transwell assay showed that the migration ability and the number of invasive cells significantly increased (P ＜ 0.05).Conclusion Dicer knockdown enhanced the proliferation,migration and invasion of cholangiocarcinoma cell line TFK-1.

Objective To observe the effect of leflunomide and cyclophosphamide combined with prednisone in the treatment of idiopathic membranous nephropathy .Methods 30 patients with idiopathic membranous nephropa-thy were randomly divided into two groups ,15 cases in each group .A group was treated by leflunomide combined with prednisone , B group was treated by cyclophosphamide combined with prednisone , 6 months a course .The clinical effect,24h urine protein quantity,serum albumin levels,blood fat,renal functions and adverse reactions were com-pared.Results 3,6 months after treatment ,the remission rates in A group were 60.00%,73.33%,those in B group were 53.33%,66.67%(χ2 =0.965,0.896,all P>0.05).After treatment,24h urine protein quantity,serum albu-min levels in the two groups [A group:(1.33 ±1.25)g/24h,(38.24 ±4.84)g/L;B group:(1.42 ±1.37)g/24h, (37.12 ±5.43)g/L] were significantly lower than those before treatment [A group:(7.34 ±2.75)g/24h,(20.31 ± 7.33)g/L;B group:(7.22 ±2.84)g/24h,(20.46 ±7.73)g/L] (A group:t=6.232,5.734,all P<0.05;B group:t=5.934,5.267,all P<0.05).After treatment,total cholesterol,triglyceride in the two groups [A group:(6.74 ± 1.45)mmol/L,(2.43 ±0.75)mmol/L;B group:(6.63 ±1.45)mmol/L,(2.14 ±0.63)mmol/L] were significantly lower than those before treatment [A group:(11.94 ±2.98) mmol/L,(3.56 ±1.35) mmol/L;B group:(11.53 ± 2.84)mmol/L,(3.24 ±1.46)mmol/L] (A group:t=6.246,5.234,all P<0.05;B group:t=5.256,5.672,all P<0.05).There were no significant differences in urea nitrogen ,serum creatinine between before and after treatment in the two groups(all P>0.05).There were no significant differences in above indicators between A group and B group after treatment (all P>0.05).The incidence rate of adverse reactions in A group (13.33%) was significantly lower than that in B group(40.00%)(χ2 =4.246,P<0.05).Conclusion The clinical efficacy of leflunomide is similar to cyclophosphamide in treating idiopathic membranous nephropathy with fewer adverse reactions .

ve method of limb salvage.

Objective To detect Ureaplasma urealyticum (Uu) and Mycoplasma hominis (Mh) in urogenital tract of healthy elementary and high school students,and to determine the biovars and serotypes of Uu isolates.Methods Urine specimens were collected from 957 healthy school children,including 404 elementary school students,260 junior high school students and 293 senior high school students,and submitted for Uu and Mh culture in selective liquid medium.Thc specimens positive for Uu and (or) Mh culture were subsequently subjected to PCR.The biovars and serotypes of Uu were determined.Results Uu was detected in 4.81％ (46/957) of the school children.Among the 46 Uu positive specimens,32 (69.57％) harbored Ureaplasma Parvum (biovar 1 ),14 (30.43％) Ureaplasma urealytieum (biovar 2); 12 (2.97％) were from elementary school students,including 9(75.00％) cases of Ureaplasma Parvum and 3(25.00％) Ureaplasma urealytieum,8(3.08％) were from junior high school students,including 5 cases of Ureaplasma Parvum and 3 Ureaplasma urealytieum,26 (8.87％) were from senior high school students,including 18 (69.23％) cases of Ureaplasma Parvum and 8 (30.77％)Ureaplasma urealytieum.Mh was positive in 9 (0.94％) school students,including 1 elementary school student,1 junior school student and 7 senior high school students.The detection rate of Uu was significantly higher in females than in males in all the 3 groups (elementary school,junior and senior high school) of students.Conclusions Mh and Uu are commensals in urogenital tract of elementary and high school students without symptoms.Ureaplasma Parvum is the predominant biovar in this population,though Ureaplasma urealytieum accounts for a significant proportion,which implies that Uu is commensal in healthy elementary and high school students,and females are more liable to be colonized than males.

Objective To compare the therapeutic effects of closed reduction and transverse fixation with Kirschner wires and open reduction and fixation with mini-plates or Kirschner wires for the fifth metacarpal base fracture.Methods Data of 50 patients,who had been treated in our hospital for the fifth metacarpal base fracture from August 2005 to May 2012,were enrolled in this study.Twenty-six patients underwent closed closed reduction and transverse fixation with Kirschner wires,including 22 males and 4 females,aged from 17 to 41 years; according to the OTA classification,there were 8 of type A1,11 of type B1,and 7 of type C1.Twenty-four patients underwent open reduction and fixation with mini-plates or Kirschner wires,including 21 males and 3 females,aged from 19 to 46 years (average,26 years); according to the OTA classification,there were 11 of type A1,8 of type B1 and 5 of type C1.The total active motion (TAM) score of Chinese Medical Associaition was used to evaluate the range of motion of the joint.Results In closed reduction group,the operation time ranged from 14 to 33 min; the treatment costs ranged from 2018 to 2995 yuan; 23 patients were followed up for 6 to 26 months; X-rays showed the anatomic reduction was achieved in all patients,and the fracture healing time ranged from 4 to 7 weeks; according to the TAM score,the result was excellent in 15,good in 6 and fair in 2,and the excellent and good rate was 91.3％.In open reduction group,the operation time ranged from 45 to 105 min; the treatment costs ranged from 3874 to 4793 yuan; 22 patients were followed up for 6 to 21 months; X-rays showed the anatomic reduction was achieved in all patients,and the fracture healing time ranged from 4 to 8 weeks; according to the TAM score,the result was excellent in 13,good in 7 and fair in 2,and the excellent and good rate was 90.9％.Conclusion Closed reduction and transverse fixation with Kirschner wires is an effective method for the fifth metacarpal base fracture,which has several advantages,such as simple operation,stable fixation,satisfactory results,short operation time and low treatment costs.

A competency dictionary of advanced health informatization application persons was compiled by inter-viewing 20 health information persons with behavior events interview , their competency characteristics were coded By Nvivo, the coding frequency and characteristics score in good performance group and ordinary group were ana-lyzed by variance analysis, which showed 8 characteristics of key competency and 12 characteristics of basic compe-tency in advanced health information application persons.

With the deepening and subdivision development of health informatization industry, the advanced applied talents training mode reform of medical informatics put forward a new requestto college medical information,information management and information system (medical) and relevant majors. Based on advanced applied talents' competency iceberg model,the personnel training mode of medical informatics subject was reconstructed from several dimensions such as the training objectives, capacity-building programs,faculty and training system.Andan empirical research on competency based talent training mode reform was conducted in a school's information management and informa-tion system(medical and health) field of Chongqing.

Objective To investigate the diagnosis and therapy of the sclerosing hemangioma of the lung.Mothods The case history of 15 patients were analyzed retrospectively and summarized the diagnosis and therapy of the Sclerosing hemangioma of the lung.Results There were 2 males and 13 females(1:6.5).No patients were diagnosed this disease before operation for there were no specific imageology features.The tumor cell indicated pantomorphia and there were 3 cases were misdiagnosed during the operation frozen section pathology.The optimization therapy methods was to resect the tumor with the VATS.The prognosis of this disease was well and there were no cases recurrence in these 15 patients.Conclusion The sclerosing hemangioma of the lung was the benign tumor and there were no specific imageology features.The misdiagnosis was frequently before operation.To resect the tumor with the VATS was the optimal therapy method.

Objective To discuss the clinical outcome of the modified super large dorsal metacarpal artery flap in reconstruction of circumferential fingertip avulsion. Methods Twenty-four patients with circumferential fingertip avulsion were treated by the modified super large dorsal metacarpal artery flap from January 2004 to August 2008. There were six index fingers, 11 middle fingers, five ring fingers and two little fingers with surface defects beyond the distal interphalangeal joint and the distal degloving length ranged from 0.8 cm to 3.1 cm. Emergency operation was performed on 22 fingers and stage Ⅱ surgery was done for distal skin necrosis of two fingers. Results Twenty-one patients with 21 fingers were followed up for 6-28 months, which showed that all flaps survived, with satisfactory appearance and function, and that the point discrimination of flap was for 6-9 mm ( average 7.6 mm). Conclusion Modified super large dorsal metacarpal artery flap is an ideal method for reconstruction of the circumferential fingertip avulsion with advantages of easiness, convenience and short treatment period.