Appendicular Mucocele: About a Case Observed in Bamako

It is a globally rare condition that can present in a variety of clinical syndromes or can occur as an incidental surgical finding. It poses the double problem of its possible malignancy and the risk of gelatinous disease of the peritoneum in the event of perforation. We report a case treated in the “A” Surgery Department of the Point-G University Hospital Center (CHU) in Mali in 2022. It was a 62-year-old woman, a housewife who presented to the department. “A” surgery at the Point G University Hospital Center for pain in the iliac fossa. As a medical history, she was hypertensive on atenolol and a known diabetic on diet and metformin-based treatment, as well as symptomatic sickle cell disease (AS) and an undocumented history of peptic ulcer disease. The biological assessments revealed hyperleukocyte with granulocyte predominance. C-reactive protein was positive at 32 mg/l. Ultrasound revealed a 27 mm cystic dilation of the appendicitis in favor of appendicular mucocele. We proceeded with the appendix. The surgical specimen containing gelatinous fluid was removed and histological examination was in favor of a mucinous adenocarcinoma of the appendix.

Appendicular Mucosal Tube Implant with Dartos Wrap Operation for Hypospadias

Aims and Objective: To develop a better operation for hypospadias patients with poor and bad quality urethral plate and damaged urethral plate as in hypospadias cripples. Materials and Methods: I operated 21 cases of hypospadias with Appendicular mucosal tube implant with Dartos wrap operation from 17/04/2017 to 03/03/2019, in Jawale Institute of pediatric Surgery, and that group was labeled as group A. 27 cases of hypospadias were operated in same time span with conventional techniques such as extended Snodgrass operation and Byar’s two-stage operation (group B), kept as control. 7 patients (33.33%) were cases of hypospadias cripples with multiple surgeries done in the past. 4 patients (9.52%) patients had congenital short urethra. Remaining 10 patients (50%) were fresh cases with no operation done in past but with bad and fibrotic urethral plate. The longest follow up was 3 years and the shortest of 1 year. Technique of Operation: Appendicectomy performed by open technique and the serosa of Appendix cut longitudinally and stripped off the mucosal tube. The proximal hypospadias opening sutured with the appendicular mucosal tube with 6 sutures of 5-0 Vicryl. Dartos fascia is raised from the scrotum wrapped over the tube and 8 - 10 interrupted stitches taken with 5-0 Vicryl. Glanuloplasty performed over it. Suprapubic diversion did and kept for 3 weeks postoperatively. Results: In group A, 3 patients developed fistula and only 1 (4.76%) required repair at the end of 6 weeks. 2 (9.52%) patients developed grade 3 infection and settled with conservative treatment. UFR was normal at the end of 12 weeks (12.85 Ml/sec. In group B, 11 patients developed fistula and 9 (33.33%) required repaired. 9 (33.33%) patients developed strictures and all of them required multiple urethral dilatation under GA. 7 (25.92%) patients developed meatal stenosis.UFR was badly reduced with average of 5.78 ML/Sec. Conclusion: The operation proves to be a much better option compared to the conventional for group A patients. We need a series with longer follow up and larger number of patients.

Appendicular Abscess in the Service of General Surgery at the Teaching Hospital Gabriel Toure, Bamako, Mali

Objectives: To determine hospital frequency and to write the diagnostic and therapeutic aspects of appendicular abscess in adults in the General Surgery Department of teaching Hospital Gabriel Touré from 2005 to 2017. Material and Methods: This was a retrospective study conducted from January 1, 2005 to December 31, 2017 in the General Surgery De-partment of Gabriel Touré University Hospital in all patients with appen-dicular abscess. Results: In 13 years, 1420 cases of acute appendicitis have been reported, including 105 cases of appendicular abscess (7.4%). Mean age of the patients was 32 years with extremes of 16 years and 70 years. Abdominal pain and fever were present in all patients. Pain sat in the right iliac fossa in 73.3% and was epigastric in 11.4%. In almost all cases abdominal defense was present (97.1%). There was generalized abdominal contracture in 2.8% of cases. Average duration of evolution was 27 days with extremes of 1 day and 60 days. Ultrasonography was performed in 42.6% of cases and found peri-appendicular effusion in 29 cases (27.6%). 90 incisions were made by incision of Mac Burney, 8 by median umbilical, 7 by midline above and below umbilical. The amount of fluid aspirated was greater than 100 cc in 47 patients. We performed an appendectomy with appendicular stump burying followed by washing plus drainage of the abdominal cavity in 65 patients. Morbidity rate was 14.3%. No deaths were recorded. Average duration of hospitalization was 6.5 days with extremes of 2 days and 26 days.

Appendicular Abscess in General Surgery at the Bocar Sidi Sall University Hospital in Kati

Introduction: Appendicular abscess is a progressive complication of acute appendicitis in which the spread of infection is contained by the greater omentum and the slender loops resulting in the formation of a true septate abscess of the large peritoneal cavity. Materials and Methods: This was a retrospective study from January 2010 to December 2019 carried out at the Bocar Sidi Sall University Hospital in Kati (CHU BSS in Kati) in general surgery. It concerned all patients operated on for appendicular abscess in the department. Results: 75 cases of appendicular abscess were collected, which represented 5.76% of surgical emergencies and 25% of acute appendicitis. The average age of the patients was 29 years. The male sex represented 67% of our patients with a sex ratio of 2. The average consultation time was 5 days. Abdominal pain was noted in all patients. It was localized in the right iliac fossa in 80% (n = 60) and diffuse in 2.7% of cases (n = 2). It was accompanied by nausea and vomiting in 93% of cases (n = 70), urinary disorders in 20% (n = 15), fever in 94% (n = 71), cessation of materials and gas in 1.33% (n = 1). Abdominal ultrasound was performed in 86% (n = 65). It made it possible to suggest a peri-appendicular effusion. Biological examination revealed a neutrophilic hyperleukocytosis greater than 20,000/mm3 in 47 patients, or 63%. All the patients were operated on by laparotomy (Marc Burney or midline subumbilical) under general anesthesia. The length of hospitalization was 6 days. We have not recorded any deaths. Morbidity was 8% (n = 6) represented by parietal suppuration. The postoperative course was straightforward in 92% of cases (n = 69). Conclusion: Appendicular abscess is a frequent medico-surgical emergency, the prognosis of which depends greatly on early diagnosis and adequate and immediate management.

Peritonitis Management through Appendicular Perforation in the Department of Surgery Bougouni Hospital (Mali)

Introduction: Appendicular peritonitis is a complication of acute appendicitis characterized by the spread of the infectious process in the peritoneal cavity thus achieving wide spread or localized purulent peritonitis;it’s a medico-surgical emergency. Our objectives are to determine the frequency, describe the clinical, therapeutic and prognostic aspects of peritonitis by appendicular perforations. Patients-Method: This was a 24-month retro, prospective, descriptive study from January 1, 2018 to December 31, 2019;conducted in the Bougouni Reference Health Center Surgery Unit. All patients of appendicular peritonitis at the Bougouni Reference Health Centre were included. Results: During the study period, 68 cases of generalized acute peritonitis including 30 appendicular peritonitis cases were collected. Appendicular peritonitis accounted for 44.1% of surgical procedures. Males accounted for 71.0% with a sex ratio of 1.2 at risk of men, the average age was 26.07 years. Abdominal pain and vomiting were the reasons for consultation in 86.7% and 76.7% of cases. Physical examination was used in most cases to make the diagnosis. X-ray of the abdomen without preparation, and abdominal ultrasound were performed systematically. Surgical treatment consisted of an appendectomy with peritoneal toilet followed by drainage. The average length of hospitalization was 8.8 days with extremes of 1 - 44 days. Hospital mortality was 3.3%;morbidity and high mortality were related to delayed consultation. Conclusion: Appendicular generalized acute peritonitis is a medical-surgical emergency with a high mortality rate associated with delayed management.

Appendicular Abscess: Unusual Clinico-Radiological Appearance

Introduction: Appendicitis is the most common surgical emergency in childhood. It’s a common surgical disease that can be presented with a wide variety of atypical clinical features. Clinical Case: We report a case of a 7-year-old female patient admitted for abdominal pain dating back 20 days, radiological exploration suggested a right ovarian teratoma, while laparoscopic exploration has objective an appendicular abscess. Conclusion: This case has allowed us to clarify an atypical case of complicated appendicitis, and also to show the contribution of laparoscopy.

Appendicular Mucocele with Robotic Partial Typhlectomy and Correction of Rectus Abdominal Muscles’ Diastasis: A Case Report

Low-grade appendiceal mucinous neoplasm (LAMN) is rare, and patients are often asymptomatic or have nonspecific symptoms. Appendicectomy should be performed with care and limited handling of the appendix, with extraction of the specimen through an extraction bag to prevent perforation and spillage of mucin, which can result in the development of pseudomyxoma peritonei (PMP). This case report aims to shed light on the approach to appendicular mucocele in contemporary medicine. The reported case shows a presentation of mucocele in a young female patient with symptoms compatible with appendicitis. This case report serves as an example of how to diagnose, manage, and follow-up on appendicular mucocele treatment for colleagues who may encounter similar conditions.

Appendicular Peritonitis in the General Surgery Department of Gabriel TOURE CHU

The appendicular peritonitis is complications of acute appendicitis which are characterized by the diffusion of the infectious process to the peritoneal cavity thus carrying out a generalized or located purulent peritonitis. It can appear from the start or follow the stage of appendicular abscess. Our objectives were to determine the frequency, to describe the clinic and para clinic aspects, to identify the principal germs and their sensitivities to antibiotics and to describe the operative continuations. Our prospective and descriptive study focused on patients treated for appendicular peritonitis, from January 1st to December 31st 2016, in the General Surgery Department of the Hospital of Sikasso. During the period of our study, 31 cases of appendicular peritonitis were collected, which represented 4.36% of surgical interventions, 19.25% of urgent surgeries. The male sex accounted for 71.0% with a sex-ratio of 2.44 at the risk of males, the average age was of 20 years ± 12.99, the abdominal pain + vomiting was the reason for consultation in 54.8% of cases. The physical examination allowed in most cases to make the diagnosis. In doubtful cases some additional examinations have been requested (abdomen without preparation, abdominal ultrasound). The surgical treatment consisted of an appendectomy with peritoneal lavage followed by drainage. The average length of hospital stay was 8.8 days with extremes of 1 - 44 days. Hospital mortality was 9.7%. Delay in consultation and age were factors of morbidity and high mortality.

Long-term disease-free survival in a dog with appendicular osteosarcoma

Postoperative prognosis is generally poor even with adjuvant chemotherapy in dogs with an appendicular osteosarcoma. The purpose of this report was to present the long-term disease-free survival time in a dog with appendicular osteosarcoma receiving amputation,adjuvant chemotherapy and adoptive immunotherapy. A 12-year-old spayed Golden retriever was referred to our hospital with a suspicion of osteosarcoma in right distal radius. The patient underwent the computed tomography (CT) and incisional biopsy on the next day after the first presentation. The CT revealed the osteolysis in the right distal radius and no metastases in the lungs and lymph nodes. The histopathologic diagnosis was made as an osteosarcoma. On the 13th day after,the patient underwent right forelimb amputation. Six doses of carboplatin (250 mg / m2) were postoperatively administered every 3 weeks. The intravenous infusion of lymphokine-activated killer (LAK) cells suspension was performed every 3 ~ 4 weeks after the adjuvant chemotherapy. At the time of our writing this abstract (on the 880thday after the first presentation),no recurrences and metastases were observed after the 32 transfers of LAK cells. In canine appendicular osteosarcoma,some reports have described that postoperative median survival times were 235 ~ 540 d with adjuvant chemotherapy. In our report,the disease free interval and survival time were prolonged compared with the previous reports. We strongly believed that early diagnosis and surgical intervention and adoptive immunotherapy had a great impact on the improvement of survival time in canine appendicular osteosarcoma.

中国肿瘤住院患者肌肉减少症调查报告

目的报告中国恶性肿瘤患者肌肉减少症的流行病学调查结果。方法纳入中国肿瘤营养队列研究常见恶性肿瘤营养状态与临床结局相关性研究(INSCOC)数据库2013年7月至2023年12月86家三级甲等医院19种恶性肿瘤患者61627例。采用亚洲肌肉减少症工作组(AWGS)2019年肌肉减少症诊断标准诊断肿瘤患者肌肉减少症。χ2检验或Fisher确切概率法分析比较不同特征肿瘤患者肌肉减少症患病情况。结果肿瘤患者中肌肉减少症的患病率为18.1%(11175/61627)。肌肉减少症患病率因肿瘤类型、TNM分期、年龄、性别、地理区域及治疗情况不同而存在差异:消化系统肿瘤患者肌肉减少症患病率较高,其中胰腺癌患者患病率最高[32.4%(311/961)];肌肉减少症患病率随TNM分期增高而增大(P<0.05);70岁以上患者肌肉减少症患病率最高[34.7%(3510/10129)];女性肿瘤患者肌肉减少症患病率高于男性患者[16.1%(5544/34381)比20.7%(5631/27246),P<0.05];东北地区的患者患病率最低[14.7%(2398/16300)],接受手术治疗的患者患病率最高[22.1%(1635/7412)]。此外,在某些肿瘤类型中,不同医疗保险类型、职业、教育水平、民族、居住地的患者肌肉减少症患病率存在显著性差异,文化水平低、农民患者发生肌肉减少症的风险更高。结论本研究首次以大规模数据报告了肿瘤患者肌肉减少症的患病率,消化道系统、老年、农民、低教育水平及进展期肿瘤患者等是发生肌肉减少症的高风险人群。

骨骼肌质量和肌肉力量对缺血性脑卒中患者神经功能的预测效能评价

目的 探讨并评价缺血性脑卒中患者骨骼肌质量和肌肉力量对脑卒中后3个月神经功能预后的预测效能。方法 纳入117例缺血性脑卒中患者,根据脑卒中后3个月的改良Rankin量表(mRS)评分分为预后不良组(54例)和预后良好组(63例),比较两组骨骼肌质量、肌肉力量等相关指标的差异。采用Pearson相关分析骨骼肌质量、肌肉力量与mRS评分之间的相关性,采用logistic回归分析ASM/Ht2、握力与神经功能预后之间的关系,同时应用受试者工作特征(ROC)曲线评估其对神经功能预后的预测效能。结果 与预后良好组相比,预后不良组年龄均数较大、国立卫生研究院脑卒中量表(NIHSS)评分均数较高,合并低肌肉质量的患者比例、合并低肌肉力量的患者比例以及同时合并低肌肉质量与低肌肉力量的患者比例均较高;而ASM/Ht2和握力均数则较低,差异均有统计学意义(t分别=3.55、4.94,χ^(2)分别=7.27、20.35、11.51,t分别=-4.40、-9.56,P均<0.05)。ASM/Ht2、握力与mRS评分呈负相关(r分别=-0.56、-0.74,P均<0.05)。多因素logistic回归分析发现,ASM/Ht2和握力大是神经功能预后不良发生的保护因素(OR分别=0.64、0.54,P均<0.05)。ROC分析显示,握力的曲线下面积(AUC)为0.89,明显大于ASM/Ht2的AUC(0.71),差异有统计学意义(Z=3.05,P<0.05)。结论 脑卒中患者发病早期的骨骼肌质量和肌肉力量均与其康复期神经功能不良预后密切相关。骨骼肌质量和肌肉力量对脑卒中患者神经功能预后均具有较好的预测价值,尤其是握力,其预测效能更优。

生物电阻抗法测量18~42岁成人四肢骨骼肌质量的准确性评价

目的评价生物电阻抗法(bioelectrical impedance analysis,BIA)测量成人四肢骨骼肌质量(appendicular skeletal muscle mass,ASM)的准确性。方法采用方便抽样法,于2021年4月至2022年9月在广州全市招募836名18~42岁成人,采用BIA与双能X线吸收法(dual-energy X-ray absorptiometry,DXA)同步检测ASM。以DXA为标准方法,通过组内相关系数以及在对数变换数据中进行Bland-Altman分析判断BIA与DXA所测值的一致性,以此评价BIA测量ASM的准确性。绘制受试者工作特征曲线,评价BIA识别低肌肉质量的诊断价值。结果最终纳入774名研究对象。男、女性中两法所测ASM组内相关系数分别为0.774和0.667。男、女性中BIA与DXA所测ASM比值均值(一致性限)分别为0.94(0.80~1.10)和0.91(0.78~1.05)。BIA识别男、女性低肌肉质量的曲线下面积分别0.91和0.94。BIA判断男、女性低肌肉质量的Z值最佳界值分别为-0.57和-0.66,男性中BIA识别低肌肉质量的灵敏度、特异度分别为82.5%、86.0%,女性中分别为86.8%、93.8%。结论BIA与DXA所测成人四肢骨骼肌质量的一致性尚可,且BIA识别18~42岁成人低肌肉质量的诊断价值较好。

绿鳍马面鲀附肢骨骼的早期发育研究

运用软骨-硬骨双染色技术观察绿鳍马面(Thamnaconus septentrionalis)初孵仔鱼与1~60 d仔、稚和早期幼鱼附肢骨骼的发育,以确定其发育时序和骨化特征。结果表明,附肢骨骼的出现时序依次为胸鳍(1 d)、第一背鳍(8 d)、腹鳍(11 d)、第二背鳍(14 d)、臀鳍(14 d)、尾鳍(18 d);硬骨化时序依次为第一背鳍(23 d)、腹鳍(23 d)、第二背鳍(25 d)、臀鳍(25 d)、尾鳍(25 d)、胸鳍(27 d)。由骨膜化硬骨的包括匙骨、后匙骨和尾杆骨,肩喙骨于13 d分化为肩胛骨和乌喙骨。第一背鳍26 d硬骨化完成;胸鳍和腹鳍60 d硬骨化完成;第二背鳍与臀鳍的支鳍骨和鳍条发育基本同步,60 d二鳍中部延伸的骨片彼此近相连;21 d尾部尾下骨、侧尾下骨、尾上骨和尾鳍鳍条清晰可见,共12根鳍条,其中尾下骨附着8根,尾上骨和尾杆骨各附着1根,侧尾下骨附着2根。研究结果填补了绿鳍马面仔、稚和早期幼鱼骨骼研究的空白,可为其苗种繁育提供理论参考,丰富了鱼类骨骼形态学和发育生物学的资料,有助于鱼类系统分化和系统分类的研究。

Mohs显微描记手术治疗小汗腺汗孔癌一例

患者,男,56岁。左颞部肿物4年余,切除后复发半年。组织病理示:真皮内肿瘤团块,部分伴中央片状坏死。免疫组化示:肿瘤细胞CK5/6阳性,瘤团坏死周边瘤细胞EMA阳性。诊断为小汗腺汗孔癌。Mohs显微手术切除及全厚皮片移植术后恢复良好,随访18个月无复发。

老年人肌少症患病情况调查及其与老年衰弱综合征的相关性分析

目的调查成都市成华区某社区老年人肌少症患病情况并分析其与老年衰弱综合征的关系。方法选取成都市成华区某社区586例老年人为研究对象,对其进行老年综合评估,包括一般资料调查、人体测量(身高、体质量、握力、步速、骨骼肌等)和衰弱筛查量表调查。评估肌少症及老年衰弱综合征发生情况,分析肌少症与老年衰弱综合征的关系。结果83例被诊断为肌少症,肌少症患病率为14.98%。肌少症组与正常组的性别、受教育程度、吸烟、饮酒及基础疾病情况比较,差异均无统计学意义(P>0.05)。与正常组相比,肌少症组年龄60~74岁者比率更低,75~84岁及≥85岁者比率更高,老年衰弱综合征发生率更高,差异有统计学意义(P<0.05)。与正常组比较,肌少症组的握力、步速、四肢骨骼肌量及四肢骨骼肌指数(ASMI)更低,差异有统计学意义(P<0.05)。多因素分析显示,年龄、体质量指数(BMI)、老年衰弱综合征均是肌少症的影响因素(P<0.05)。结论成都市成华区某社区老年人肌少症的患病率较高,肌少症与老年衰弱综合征的发生密切相关。

中老年男性肌肉减少症与骨质疏松性骨折的相关性分析

目的 探讨中老年男性肌肉减少症(SP)与骨质疏松症性骨折(OF)的相关性。方法 选取2020年2月至2023年2月中老年(50~70岁)男性骨质疏松症(OP)患者85例,其中OF 64例,非骨质疏松性骨折(NOF)21例。选取同期、同年龄段体检中心体检的非骨质疏松症患者(NOP)110例作为对照组。采用双能X线吸收骨密度仪(DXA)测量四肢骨骼肌肌肉量(ASM),计算出四肢骨骼肌指数(ASMI),观察6 m步行速度。分析中老年男性SP与OF的相关性。结果 OF组患者中SP患病率(71.88%)高于NOF组(61.90%),且高于NOP组(15.45%)。SP组患者中,OP患病率(77.63%)高于NOP组(22.37%),其中OF患病率(77.97%)亦高于NOF组(22.03%)。OP组患者ASM、ASMI、步行速度低于NOP组,其中OF组患者ASM、ASMI、步行速度低于NOF组,差异均有统计学意义(P<0.05)。多因素分析显示,ASMI是OF的独立危险因素。结论 中老年男性SP患者易发生OP,且更易发生OF,预防OF对提高患者的生活质量,降低家庭和社会的经济负担有重要意义。

绝经后女性肌少症与颈动脉斑块发生风险的关系

目的:探讨绝经后女性肌少症与颈动脉斑块发生风险的相关性。方法:采用整群抽样法,选取2022年3月—10月在华东疗养院体检中心进行健康体检的绝经后女性527例为研究对象。采用人体成分分析仪(InBody720)检测人体四肢骨骼肌质量,计算四肢骨骼肌指数(ASMI)并测量握力与步速。收集一般资料及实验室指标,采用多因素Logistic回归分析探讨绝经后女性肌少症与颈动脉斑块发生风险的关系,并采用受试者工作特征(ROC)曲线探讨ASMI对颈动脉斑块发生的预测价值。结果:527例绝经后女性中,172例发生颈动脉斑块,发生率为32.6%。绝经后女性颈动脉斑块组ASMI低于非颈动脉斑块组[5.42(4.88,6.09)kg/m^(2)与6.63(5.73,7.78)kg/m^(2),P<0.001],同时颈动脉斑块组肌少症发生率显著高于非颈动脉斑块组(45.30%与18.00%,P<0.001)。绝经后女性ASMI越小,颈动脉斑块发生风险越高(Pfor trend<0.001)。多因素Logistic回归分析显示,肌少症增加绝经后女性颈动脉斑块发生风险[OR=3.486,95%CI(2.237,5.432)]。ROC分析显示,相比于腰围及体质指数,ASMI对颈动脉斑块有更高的预测价值(ROC曲线下面积=0.756)。结论:绝经后女性肌少症增加其颈动脉斑块发生风险,ASMI可作为预测其颈动脉斑块发生的简易指标。

美洲鲥仔稚鱼脊柱及附肢骨骼系统的早期发育

使用软骨-硬骨双染色技术,描述了美洲鲥(Alosa sapidissima)仔稚鱼(1~51日龄)脊柱、胸鳍、尾鳍、背鳍等附肢骨骼的形态发育特征。结果显示,脊柱的发育开始于10日龄仔鱼尾部的髓弓、脉弓和尾下骨的出现,16日龄髓弓和脉弓延伸形成髓棘和脉棘,19日龄脊柱出现分节的硬骨环,23日龄所有椎体形成。各附鳍支鳍骨发育顺序先后依次为胸鳍、尾鳍、背鳍、臀鳍和腹鳍。胸鳍在2日龄时出现乌喙骨,13日龄形成软骨质的胸鳍支鳍骨,19日龄仔鱼肩带和上匙骨开始骨化;尾鳍的尾下骨最早出现在5日龄,12日龄尾鳍形成2枚尾上骨、1枚尾杆骨和6枚尾下骨,19日龄仔鱼尾椎和尾鳍率先开始骨化,直至23日龄尾鳍骨骼系统钙化完全。最终背鳍和臀鳍分别形成18和22根鳍条。美洲鲥骨骼发育研究对其早期发育功能趋向、环境优化及分类鉴定有重要作用。

Hem-o-lok结扎锁在腹腔镜阑尾切除术中的应用

目的总结腹腔镜阑尾切除应用Hem-o-lok结扎锁处理阑尾根部的经验。方法 2009年5月～2011年6月对284例急性阑尾炎和40例慢性阑尾炎急性发作行腹腔镜阑尾切除术,超声刀切断系膜至阑尾根部,16 mm Hem-o-lok结扎锁(Weck Closure Systems)处理阑尾根部。根部近心端1～2枚Hem-o-lok结扎锁夹闭,远心端以超声刀切断。结果 324例均顺利完成手术,未发生严重并发症。阑尾根部处理顺利,所有病例均用结扎锁完成,无结扎锁滑脱现象。手术时间20～70 min,平均35 min。术中出血2～20 ml,平均10 ml。术后住院3～5 d,平均4 d。300例随访5～14个月,平均7个月,无切口感染、再发右下腹痛等发生。结论腹腔镜阑尾切除术中应用Hem-o-lok结扎锁处理阑尾根部,安全可靠,经济实用,操作方便,值得临床推广应用。

褐菖鲉仔稚鱼脊柱及附肢骨骼系统的早期发育

使用软骨-硬骨双染色技术对褐菖鲉(Sebastiscus marmoratus)仔稚鱼(1～50日龄)脊柱,腹鳍、臀鳍等附肢骨骼进行观察。结果显示:1～7日龄仔鱼脊索为无分节的圆锥体,13日龄仔鱼脉弓和髓弓的出现标志着脊柱发育开始,18日龄髓弓和脉弓延伸形成髓棘和脉棘,29日龄仔鱼出现分节的硬骨环,并从前往后硬骨化,36日龄仔鱼脊柱形成23～24节椎骨(躯椎9～10节,尾椎14～15节)。所有附肢支鳍骨发育的顺序为胸鳍、尾鳍、背鳍、臀鳍和腹鳍。尾鳍的尾下骨最早出现在8日龄仔鱼中,13日龄仔鱼尾鳍形成1枚尾杆骨、2枚尾上骨和5枚尾下骨,15日龄仔鱼的第2枚与第3枚、第4枚和第5枚尾下骨分别逐渐结合,40日龄仔鱼尾鳍骨化完成;胸鳍在1日龄时出现乌喙骨,16日龄时形成胸鳍支鳍骨,39日龄仔鱼上匙骨和肩带骨化;背鳍在13日龄时形成8枚软骨质的支鳍骨,16日龄时出现担鳍软骨,31日龄仔鱼背鳍前11～12根鳍条锐化成背棘;臀鳍在15日龄仔鱼的排泄孔与尾下骨之间出现5根软骨质的支鳍骨,19日龄时出现担鳍软骨,20日龄时臀鳍前3根锐化臀刺,31日龄时臀鳍开始骨化。褐菖鲉仔稚鱼骨骼发育研究结果对其分类鉴定和早期发育环境适应有重要作用。