Objective To evaluate the significance and reasonability of select in various types of circumcision in children of different ages.
Methods A retrospective analysis was performed for 1 440 children of different ages(3-15 years) between Jan 2019 and Sep 2019 in urological ward and ambulatory surgery area of our hospital.280 were preschool children,620 were school-age children,240 were adolescent children.In different ages,divide them into 4 groups by different types of circumcision：traditional circumcision group,circumcision group with ligation device,circumcision group with anastomoses device,circumcision group with stitching instrument.The indications such as blood loss、operating time、  pain duration、 shedding time、 short-term complication and long-term complication were compared.
Result Among the 4 surgical procedures,preschoolers had the shortest pain duration,shedding time and fewer short-term complication.School-age children had the lowest operative time and blood loss by circumcision with ligation device.Adolescent children had lower operative time,blood loss and the fewer long-term complication by circumcision with stitching instrument.
Conclusion With the development of circumcision apparatus,different surgical methods should be adopted for children's  circumcision in combination with different age.Traditional circumcision should be recommended for preschoolers,circumcision with ligation device for school-age children,circumcision with stitching instrument for adolescent children.

Objective To compare the therapeutic effect of silver ion antibacterial dressing and povidone iodine gauze on the incision and drainage of the abscess.
Methods From March 2019 to November 2019,62 patients were included in this study,and divided randomly into the observation group and the control group with 31 cases in each group.The patients in the observation group were treated with silver ion antibacterial dressing,while the patients in the control group were treated with povidone iodine gauze.The patients in the two groups were recorded in detail.The infection control time of abscess incision was compared before treatment,the third day and the second week after the first treatment,the number of dressing changes and wound healing time of the two groups,and the clinical effect of the patients was evaluated.
Results .The time of wound control in the observation group was (13.9±1.81)d,shorter than that in the control group (23.4±2.32)d(P<0.05);the BWATBWAT(Bates-Jensen Wound  assessment tool，BWAT) score of the observation group in the second week after the first treatment was (14.98±1.51),lower than that in the control group (19.78±2.46)(P<0.05);the times of drug change and wound healing in the Observation group were significantly shorter than that in the control group(P<0.05).
Conclusion Compared with the traditional povidone iodine gauze,the silver ion antibacterial dressing can control the wound infection and improve the wound healing more quickly,and the dressing change times are less,the wound healing time is obviously shortened.

Objective:To investigate the effect of Solifenacin on detrusor function and prognosis in patients with overactive bladder.Methods:128 cases of patients with overactive bladder admitted to our hospital from March 2016 to December 2018 were selected，and 64 cases were divided into control group and research group according to different treatment methods.The control group was treated with trotrodine and the research group with Solifenacin.The clinical efficacy of the two groups was compared and analyzed.Results:The bladder compliance of the study group，the number of bladder compression inhibition，the initial bladder urination，the maximum bladder volume，and the maximum urine flow rate[（53.1±26.4）ml/cm H2O，（1.5±1.2）times，（177.0±88.0）ml，（298.0±88.0）ml，（53.4±17.1）ml/s]was significantly better than the control group[（58.2±29.5）ml/cm H2O，（1.9±1.5）times，（155.0±90.0）ml，（275.0±98.0）ml，（54.0±20.1）ml/s，and the difference was statistically significant（P<0.05）.The OABSS score（5.9±2.4）scores of the study group before and after medication were better than the control group（6.7±3.4），and the difference was statistically significant（P<0.05）.The incidence of adverse events in the study group was 4.6% significantly lower than that in the control group（14.0%），and the difference was statistically significant（P<0.05）.Conclusion:The use of solifenacin for the treatment of OAB patients，the clinical results are satisfactory，the adverse reactions are mild，it is worthy of clinical use.

Congenital chylous ascites is a rare disease in infants and young children,which is characterized with milky white ascites,but as a result of the relevant reports and study is less,and the lack of standardized diagnosis and treatment standards,clinical practitioners don't understand it deeply,and children can't get timely and effective treatment,which not only cause the prolonged course of the disease,but also bring great worries and troubles to parents and children.In severe cases,the children can die.In this paper,combined with the existing literature,the pathogenesis,clinical manifestations,diagnostic examination and treatment of congenital chylous ascites are systematically summarized,so as to provide clinicians with a perfect basis for the treatment of congenital chylous ascites,and provide suggestions for refractory chylous ascites,amd promote the early recovery of children.

Articular cartilage is a major tissue distributed at the joint surface;it plays a role in loadbearing and lubricating.The articular cartilage of the joints in the extremities mainly consists of hyaline cartilage composed of collagen II.Fibrocartilage formation is easily observed when the cartilage is injured or degenerated,which has abundant type I collagen.In this study,a new viewpoint and concept,focusing on the modification of fibrocartilage in situ approach and regeneration of hyaline cartilage,namely “fibrocartilage hyalinization”,was proposed as a practical clinical strategy.We conducted preliminary discussions and prospects on the feasibility and potential mechanisms of fibrocartilage hyalinization.It is hoped that the strategy will be helpful to the development and clinical transformation of cartilage regeneration research.

Holmium laser is the most commonly used laser for minimally invasive treatment of urinary calculi.To understand the principle of the action of holmium laser and to reasonably set and optimize holmium laser parameters（pulse energy，frequency，pulse width）can improve the efficiency and effect of lithotripsy.We review the present status of laser lithotripsy technology and the recent advances in laser technology，such as Moses technology holmium laser，Laser Lithotripsy System with Automatic RealTime Urinary Stone Recognition and thulium fiber laser.

The idea of surgical treatment for anal fistula has gone through the process from damaged resection to repair to reconstruction and regeneration.The principle of surgical treatment for anal fistula is to pursue the protection of anal function on the basis of guaranteeing curative effect at present.Therefore，the prospects of minimally invasive treatment for anal fistula，which can maximize the protection of sphincter function，are very broad.This article reviews the articles on minimally invasive treatment for anal fistula in PubMed，Cochrane Library CENTRAL，Embase，CKNI，Wanfang and Weipu databases，and introduces the current research progress.

Hemifacial spasm is a kind of common cranial nerve disease，characterized by intermittent involuntary convulsions of facial muscles.The effect of drug therapy is limited，microvascular decompression is the only radical treatment.In this paper，the pathogenesis of HFS，the application of preoperative radiological evaluation and intraoperative electrophysiological monitoring are reviewed.

The complex anatomy of the distal radioulnar joint is the basis for its forearm rotation function and power transmission.It is important to research the anatomical structure and biomechanical mechanism of the distal radioulnar joint to understand the mechanism of the instability of the distal radioulnar joint.The instability of the distal radioulnar joint can be divided into primary instability，post-traumatic or postoperative instability.The combination of medical history，physical examination and imaging findings on the classification of instability of the distal radioulnar joint is helpful for the diagnosis and treatment of the disease.The treatments for the instability of the distal radioulnar joint are conservative treatment and surgical treatment.

Objective To investigate the risk factors study and measures of postoperative intestinal adhesion in patients with laparoscopic cholecystectomy.Methods A total of 224 patients who treatment by LC in our hospital between April 2015 and April 2018 were selected as the study subjects，and occurrence of intestinal adhesions in all subjects after LC postoperation were recorded.According to the occurrence of intestinal adhesions that the patients with after postoperation were divided as intestinal adhesions group（n=45）and without intestinal adhesions group（n=179），and useing analyzed by relevant statistical analysis software the time of anal exhaust，sex，residual infection of abdominal cavity，BMI，patients's experience in LC operation，age，indwelling drainage tube，etc were conducted by monofactor analysis，and logistic regression analysis was conducted on the meaningful indexes of univariate analysis.The 45 cases of intestinal adhesions after LC postoperation were divided into conservative treatment group（n=25）and laparoscopic enterolysis treatment group（n=20）according to the different treatment methods，and the therapeutic effect of intestinal adhesion after LC was compared between the two groups，and effective prevention and treatment measures were summarized.Results After LC，intestinal adhesion occurred in 45 cases，but not in 179 cases.Patients with intestinal adhesion were randomly divided into conservative treatment group（25 cases）and laparoscopic intestinal adhesion release（20 cases）.Group of intestinal adhesion after LC postoperation that after postoperation Indwelling drain tube，abdominal residual infection，diabetes mellitus，anal exhaust time >24h，and the proportion of LC operation ≤50 cases was significantly higher than that of no postoperative intestinal adhesion group，and there was statistical difference（P<0.05）；diabetes mellitus，abdominal residual infection after postoperation，postoperative indwelling drainage tube，LC operation of patients ≤50 cases were independent risk factors of intestinal adhesion after LC（P<0.05）；the total effective rate of laparoscopic enterolysis group was significantly higher than that of conservative treatment group，and there was statistical difference（P<0.05）.Conclusion Complicated with diabetes，postoperative abdominal residual infection，postoperative indwelling drainage tube and performer LC operation≤50 cases，which are risk factors for postoperative intestinal adhesion in patients with laparoscopic cholecystectomy.

Objective：To observe the effect of systemic functional exercise combined with Jianghuang Huoxue Zhitong plaster on the functional recovery in the postoperative patients undergoing lumbar fusion.Methods：100 patients undergoing lumbar fusion were randomly divided into treatment group(50 cases) and control group(50 cases).The treatment group was treated with systematic function exercise combined with Jianghuang Huoxue Zhitong plaster, while the control group was treated with systematic function exercise.Before and 1,7,14 and 30 days after operation,visual analog score(VAS) and JOA were used to evaluate the clinical effect.Result：The patients in both groups were followed up successfully.On the first day after treatment,there was no significant difference in VAS and JOA scores between the treatment group and the control group(P>0.05).After 7 days,14 days and 30 days,the JOA score of the treatment group was significantly higher than that of the control group,and the neurological recovery of the patients was significantly improved,the difference was statistically significant(P<0.05).VAS score was significantly lower than that of the control group,and the pain degree of the patients was significantly reduced.The difference was statistically significant(P<0.05).Conclusion：The combination of systemic functional exercise and Jianghuang Huoxue Zhitong plaster can significantly promote the recovery of nerve function and the improvement of pain in the postoperative patients undergoing lumbar fusion,and can improve the quality of life of the patients.

   Children and adolescents are increasingly suffering from articular cartilage and osteochondral deficiencies Traumatic incidents often result in damage to the joint surfaces,Surgery is indicated in young patients when conservative measures fail.The operative techniques for articular cartilage injuries traditionally performed in adults may be performed in children,while an individualized approach must be tailored according to patient and defect characteristics.Autologous chondrocyte transplantation has good biological potential,especially for large cartilage defects on the joint surface.In recent years,emerging PRP and tissue engineering technologies have not been reported in children and adolescents.Clear guidelines for defect dimensionassociated techniques have not been reported.Knee joint dimensions must be considered and correlated with respect to the cartilage defect size.In addition,the damage of the subchondral bone can not be ignored.Articular cartilage repair techniques appear to be safe in this cohort of patients,and no differences in complication rates have been reported when compared with adult patients.

In clinical research on articular cartilage injury repair,traditional treatment modalities can improve patients’ symptoms to a certain extent,but these approaches have limitations in long-term functional maintenance.In recent years,cartilage organoids (CORG) have drawn extensive attention due to their demonstrated potential advantages in the field of cartilage regeneration.This article aims to introduce the construction technology of CORG,providing a more promising application paradigm for cartilage repair.