A total of 167 coronary heart disease (CHD) patients were divided into metabolic syndrome (MS) group (68 cases) and non-MS group (99 cases). There were significant differences in the disease-related metabolic indicators and coronary angiography (multivessel lesions, diffuse stenosis, occlusive lesions, Ginsini score) between MS group and non-MS group ( all P<0.05 ). When the patients with MS were divided into 3 groups according to the number of componernts of MS, three lesions, diffuse stenosis, and occlusive lesions were more frequent in five components group compared with three components group. Ginsini points rised with the increased risk factors. There existed differences in Ginsini score between three components group and four, five components group (P<0. 05 or P<0.01 ). Multivariable logistic regression analysis showed that obesity, hypertension,diabetes, high low-density lipoprotein-cholesterol, and low high-density lipoprotein-cholesterol were the predictors of CHD in patients with MS (P<0.05 or P<0.01 ).

'Social beings' model of standardized training program for residents in Shanghai is one of the important measures in the health care reform. According to the requirements of the standardized training of residents in thoracic surgery, the article preliminarily explored the standardized training model for residents from four aspects such as individualized treatment of different professional backgrounds, focus-ing on the training needs of residents with different starting point of social beings, developing training programs for different training time and combining the master's degree graduate education. And based on the characteristics of thoracic surgery, it also summed up the past experience and explored the clinical practice teaching.

Objective:To explore the clinical effects of penile ventral Z-shaped cross flap and penile dorsal pedicled transfer flap in penoplasty for concealed penis.Methods:From January 2017 to June 2019, the data of 151 patients with concealed penis admitted to our hospital was retrospectively reviewed. The patients were divided into 2 groups according to the surgical method. 69 cases were treated with penis ventral Z-shaped cross flap to form penis and 82 cases were treated with dorsal penis pedicled flaps to form the penis. In Z-shaped flap group, the penis length of 33 patients with tight scrotum was (3.06±0.25)cm before surgery and the penis length of 36 patients with relaxed scrotum was (2.99±0.28) cm before surgery. In flap with transfer group, the penis length of 39 patients with tight scrotum was (3.04±0.30)cm before surgery and the penis of 43 patients with relaxed scrotum was (3.04±0.24)cm before surgery. The length of the penis after surgery and incidence of postoperative complications were compared between Z-shaped flap group and flap with transfer group. Common complications included penile body retraction, foreskin edema, foreskin stenosis and penile wound splitting.Results:151 patients were followed up for 6-12 months, and all patients were satisfied with penis appearance. There was no penile necrosis or urinary fistula. In Z-shaped flap cross group, the penis length of 33 patients with tight scrotum extended (2.47±0.22)cm after surgery.The penis length of 36 patients with scrotum relaxation extended (2.61±0.27)cm after surgery, 39 patients was adopted the penile dorsal pedicled transfer flap with scrotum tight had extended penis (2.90± 0.16)cm, which significantly different from the Z-shaped flap group( P<0.05). In flap with transfer group, 43 patients with relaxed scrotum extended (2.79±0.18)cm after surgery, which was significantly different from the Z-shaped flap group ( P<0.05). In Z-shaped flap group, 33 patients with scrotum tight, there were 2 cases of penile retraction, 1 case of stenosis of the foreskin, 2 cases of foreskin edema, 2 cases of penile wound rupture. In transfer flap group, of 39 patients with scrotum tight, there was 1 case of foreskin edema. The incidence of complications that adopted the penile dorsal pedicled transfer flap with scrotum tight was lower than those adopted penile ventral Z-shaped cross flap [2.56%(1/39) vs. 21.21%(7/33), P=0.033]. In transfer flap group, of the 43 patients with scrotum relaxation, there were 3 cases of penile retraction, 3 cases of foreskin stenosis, 2 cases of penile ventral foreskin edema, and 1 case of penile wound rupture. Z-shaped flap group: 36 patients was scrotum relaxation was 1 case of foreskin edema. The incidence of complications that adopted the penile dorsal pedicled transfer flap was higer than those adopted penile ventral Z-shaped flap [20.93%(9/43) vs. 2.78%(1/36), P =0.038]. Conclusions:In terms of children with tight scrotum or loose scrotum, the effect of the transfer flap method to extend the penis is better than that of the Z-shaped flap method. However, the transfer flap method has a low complication rate for children with tight scrotum, while the Z-shaped flap method has a low complication rate for children with loose scrotum.

The temporomandibular joint (TMJ) is surrounded by a joint capsule, the smooth inner layer of which is called the synovial membrane. Synovium is involved in various intraarticular diseases, and it is a key area of joint disease. Synovial type-A cells are located in the lining layer of the synovial membrane, mostly on the side of the membrane close to the joint cavity. They have a strong phagocytic effect, and their main role is to remove the degradation products of the intra-articular and extracellular matrix. Various intra-articular diseases will affect the synovium, which is the key area of joint disease. The method of cell culture in vitro can effectively simulate the growth environment of cells in vivo and can accurately understand the effects of single and multiple factors on synovial cells, which has become a basic research method. In this review paper, the latest research progress in human temporomandibular joint type-A synoviocytes is reviewed from the aspects of cell origin, in vitro culture, cell purification, and cell biological function.

Objective:To compare the advantages and disadvantages of laparoscopic robot-assisted transmesenteric approach and retrocolic approach disconnected pyeloplasty in the treatment of children with hydronephrosis.Methods:From October 2020 to March 2021, 19 children with hydronephrosis were divided into two groups: intra-renal type and extra-renal type. Among them, 15 were males and 4 were females. The average age of the patients was 3.5 years old (0.2 years old to 16.8 years old), and the average weight was 18.4 kg (5.5 kg to 67.0 kg). The average ERPF of affected kidney before surgery was 35.4%(23.0%-49.8%). All of them were treated with laparoscopic robot-assisted transmesenteric approach and retrocolic approach disconnected pyeloplasty. The operation was performed in accordance with the standard surgical procedures of the guidelines. After the insertion of the trocar, the children in the transmesenteric group were exposed to the renal pelvis by incising the colonic mesangium into the retroperitoneal space, while in the retrocolic group, the peritoneum was cut into the retroperitoneal space to expose the renal pelvis. After that, the steps of incision, cutting, tube placement, and suture of the renal pelvis and ureter were the same in the two groups. Among the 10 cases of the extrarenal type, 6 cases were in the transmesenteric group and 4 cases were in the retrocolic group; among the 9 cases of the intrarenal type, 5 cases were in the transmesenteric group and 4 were in the retrocolic group. There was no statistically significant difference in age, weight, and renal function of the affected side before operation in different surgical approach groups ( P>0.05). The operation time, intraoperative anastomosis time, intraoperative blood loss and postoperative hospital stay were recorded and compared. There was no statistical difference in the age, weight, and renal function of the affected side before the operation. Results:19 cases were followed up for 6 months, no complications such as fever or wound infection occurred. The operation was successfully completed in all patients, no patients were transferred to open surgery, and the hydronephrosis was significantly reduced. Symptoms disappeared in both groups. Of the 19 children. In children with extrarenal type, the operation time of the transmesenteric group and the retrocolic group were (108.8±15.5) min and (132.8±7.6) min, and the intraoperative anastomosis time was (40.7±6.1) min and (51.5±5.5)min, the estimated intraoperative blood loss was (9.5±2.1) ml and (9.3±0.8) ml, respectively, and the postoperative hospital stay was (9.0±1.6) d and (9.3±2.9) d. The operation time and the difference of intraoperative anastomosis time was statistically significant ( P<0.05). In children with intrarenal type, the operation time of the transmesenteric group and the retrocolic group were (136.6±7.9) min and (116.5±13.5) min, and the intraoperative anastomosis time was (52.8±6.9) min and (40.8±6.2), min, the estimated blood loss during the operation was (11.4±2.3) ml and (10.5±0.9) ml, and the postoperative hospital stay was (8.8±1.7) d and (8.0±1.6) d. The operation time and The difference of intraoperative anastomosis time was statistically significant ( P<0.05). The 19 cases were followed up for 6 months, and there was no complications such as fever or wound infection. The volume of hydronephrosis was significantly reduced compared with that before operation, and the renal blood perfusion increased compared with that before operation. The difference was statistically significant ( P<0.05). Conclusion:In terms of shortening the operation time and suture time, for laparoscopic robot-assisted transmesenteric approach and retrocolic approach disconnected pyeloplasty in the treatment of children with hydronephrosis, the transtransmesenteric approach is more advantageous in the treatment of extrarenal hydronephrosis, while the retrocolic approach is more advantageous in the treatment of intrarenal hydronephrosis.