Vacuum impregnation of chitosan‐based edible coating in minimally processed pumpkin

The goal of this research was to evaluate the use of vacuum impregnation (VI) and soaking techniques (ST) in the application of edible coatings of chitosan and chitosan + lauric acid to minimally processed pumpkins (MPP). The vacuum impregnation method led to greater component incorporation (5.9% and 1.75%, respectively) in the pumpkins when compared to soaking and consequently the formation of more uniform, thicker coatings (25.6 and 22.3 μm, respectively). However, VI caused greater changes in pH, acidity, colour and firmness. Relating to water content and carotenoid content, noncoated pumpkins presented greater losses during the storage period, regardless of impregnation method. The pumpkins with edible coatings, regardless of method, presented lower numbers of psychrotrophic micro‐organisms and coliforms during the storage period. Therefore, soaking was considered the best method for the application of chitosan‐based edible coatings to minimally processed pumpkins, as it led to smaller changes in the properties of the product.     

User authentication in a tactile internet based remote surgery environment: Security issues,challenges, and future research directions

Recently, the Tactile Internet (TI) becomes a new era of the Internet. The TI provides ultra-reliable, ultra-responsive and intelligent network connectivity for delivering real-time control and physical haptic experiences from a remote location. The TI provides a different feeling to human–machine interaction by implementing the real-time interactive systems. In this review article, we discuss a generalized authentication model which can be used to perform authentication procedure among different communicating parties in order to secure remote surgery in the TI environment. By using the proposed authentication model, an authentication protocol can be designed so that an authenticated surgeon can use the robot/robotic arms to perform the surgery securely as well as remotely. Since the application is very critical, the important instructions provided by the surgeon to the robot/robotic arms must not be leaked in between the communication during the surgical procedure. To deal with this emerging research area, a secure mutual user authentication mechanism should be provided between a remote surgeon and the robot/robotic arms so that they can communicate securely using the established session key among them. Further, several security issues and challenges for such kind of communication are also discussed in this article. Finally, we discuss few points that need to be considered as future research works that are related to authentication for securing remote surgery in the TI environment.     

一种激光眼组织切割系统设计及实验

针对医生手工进行白内障手术,病人术后视力恢复效果取决于医生手术熟练度的问题,提出了一种激光眼组织切割光路运动系统。系统采用直线电机带动平面镜运动的形式改变光路,利用聚焦透镜实现激光对样品单点切割。建立了白内障手术中碎核、撕囊扫描轨迹的数学模型,通过MATLAB仿真验证扫描轨迹数学模型的正确性。最后以透明塑料为样品模拟眼球实验,结果表明此系统可以实现给定轨迹切割,为激光眼组织切割设备研发提供了一种新方案。     

左西孟旦在心脏外科术后重症患者的应用研究

目的：研究左西孟旦对重症心脏外科术后患者心功能、肺高压、肾功能等方面的影响。方法：选取2014年1月－2019年6月在宁波市医疗中心李惠利医院胸外科接受心脏手术治疗的重症患者320例，采用随机数字表法将患者分为实验组和对照组，各160例。根据患者具体病情选择心脏换瓣手术或非体外循环搭桥手术，实验组围术期同时给予左西孟旦治疗。比较2组患者手术前后不同时间心、肾功能指标水平及肺动脉收缩压（PASP）变化。结果：术后24 h 2组患者心率（HR）、平均动脉压（MAP）、中心静脉压（CVP）比较无明显差异，实验组血乳酸（LAC）在术后12 h及术后24 h明显低于对照组（P<0.05或P<0.01）；术后1～14 d 2组左室舒张末期容积（LVEDV）、收缩末期容积（LVESV）均呈减小趋势，且同一时间点实验组明显小于对照组（P<0.05或P<0.01）；2组心脏指数（CI）及左室射血指数（LVEF）均呈升高趋势，且同一时间点实验组明显高于对照组（P<0.01）。术后3～14 d 2组血浆N末端前脑利钠肽（NT-proBNP）水平及PASP均呈降低趋势，且同一时间点实验组明显低于对照组（P<0.05或P<0.01）；实验组血清尿素氮（BUN）、24 h尿蛋白定量（24Upro）及血肌酐（Scr）水平均无明显变化（P>0.05），对照组血清BUN、24Upro及Scr水平先升高后降低，且同一时间点实验组明显低于对照组（P<0.05或P<0.01）。与对照组比较，实验组术后死亡率、ICU住院时间、呼吸机及主动脉球囊反搏（IABP）支持时间均明显低于对照组（P<0.05）。结论：心脏手术后给予左西孟旦可有效改善重症患者术后心功能，保护由于低灌注引起的肾损伤，且可降低术后早期肺动脉高压的发生，值得临床借鉴。     

复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的半数有效血浆靶浓度

目的：确定复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的半数有效血浆靶浓度（Cp50）。方法：选择21例拟行宫腔镜手术患者，年龄20～55岁，ASA Ⅰ或Ⅱ级。麻醉采用非插管静脉麻醉，麻醉诱导采用靶控输注丙泊酚，当血浆靶浓度和效应室靶浓度达平衡时方可宫腔镜手术操作，手术操作前5 min静脉缓慢注射酒石酸布托啡诺20 μg/kg。监测麻醉不同时点的麻醉深度及不良反应。采用序贯法确定丙泊酚血浆靶浓度（Cp），第1例患者丙泊酚血浆Cp设为2.5 μg/mL，手术中发生体动时为阳性，下一例采用高一级浓度，否则采用低一级浓度，浓度的比值为1∶1，根据结果将患者分为阳性和阴性组。用序贯法公式计算复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的Cp50及其95%CI。结果：复合布托啡诺时丙泊酚抑制宫腔镜手术患者体动的Cp50及其95%CI为2.23（2.12～2.34）μg/mL。所有患者均未发生严重不良反应。结论：复合20 μg/kg布托啡诺时丙泊酚抑制宫腔镜手术患者体动的Cp50为2.23 μg/mL，为宫腔镜手术麻醉安全用药提供参考。     

减少手术创伤始终是妇科肿瘤手术快速康复的决定性因素

减少手术创伤始终是快速康复的决定性因素,这一点在目前的加速康复外科研究尤其是复杂手术,如妇科肿瘤手术中尚未得到充分重视。尊重学习曲线、全面规划手术方案、总结失利经验、开展前瞻性研究是解决此问题的主要方案。本文着重讨论妇科肿瘤手术创伤对术后加速康复的影响及可能的改进措施。     

Sex ratio and reproduction of invasive red devil, (Amphilophus labiatus: Cichlidae) in Lake Sentani,Indonesia

The Red Devil Cichlid Amphilophus labiatus (Günther 1864), native to Lake Nicaragua and Lake Managua in Central America, is widely cultivated as an attractive, yet aggressive, aquarium fish that has been introduced to several freshwater locations around the world. It was recently introduced into Lake Sentani in Indonesian New Guinea, a naturally rich aquatic habitat home exhibiting a diverse fauna with high endemism. To better understand the invasive potential and impacts of A. labiatus, the present study was undertaken to describe the sex ratio and reproductive potential of A. labiatus in Lake Sentani through determination of its gonad maturation stages, gonado‐somatic index and fecundity. The fish were collected using floating gill nets at six locations around the lake between June and August 2019. Sex identification, gonads type, gonad stage and weight, fecundity were observed in the laboratory. Of the total 542 of A. labiatus collected during the survey, 345 individuals were sampled for sex ratio and reproduction. The overall male:female ratio was skewed towards males in a ratio of 3.28:1. The males were generally found to be in the gonad maturation stage I, while the females were commonly found in gonad maturation stages III and IV for all sampling locations during the study period. The highest male mean GSI value was found for the Yakonde site (0.24 ± 0.21) and at the Ayapo site (1.11 ± 1.01) for the females, with a fecundity of 191–2,720 eggs. The fish have spread to most parts of the lake, being conditioned to potentially spawn at any location, thereby providing an explanation for the observed rapid increase of the A. labiatus population over the last ten years. The results of the present study suggest a high invasive potential for this species in this and other similar lake habitats, warning that their careful management should be undertaken to restrict their further spread in Indonesia and elsewhere.     

Systematic Review: Adipose-Derived Mesenchymal Stem Cells,Platelet-Rich Plasma and Biomaterials as New Regenerative Strategies in Chronic Skin Wounds and Soft Tissue Defects

The number of clinical trials evaluating adipose-derived mesenchymal stem cells (AD-MSCs), platelet-rich plasma (PRP), and biomaterials efficacy in regenerative plastic surgery has exponentially increased during the last ten years. AD-MSCs are easily accessible from various fat depots and show intrinsic plasticity in giving rise to cell types involved in wound healing and angiogenesis. AD-MSCs have been used in the treatment of soft tissue defects and chronic wounds, employed in conjunction with a fat grafting technique or with dermal substitute scaffolds and platelet-rich plasma. In this systematic review, an overview of the current knowledge on this topic has been provided, based on existing studies and the authors’ experience. A multistep search of the PubMed, MEDLINE, Embase, PreMEDLINE, Ebase, CINAHL, PsycINFO, Clinicaltrials.gov, Scopus database, and Cochrane databases has been performed to identify papers on AD-MSCs, PRP, and biomaterials used in soft tissue defects and chronic wounds. Of the 2136 articles initially identified, 422 articles focusing on regenerative strategies in wound healing were selected and, consequently, only 278 articles apparently related to AD-MSC, PRP, and biomaterials were initially assessed for eligibility. Of these, 85 articles were excluded as pre-clinical, experimental, and in vitro studies. For the above-mentioned reasons, 193 articles were selected; of this amount, 121 letters, expert opinions, commentary, and editorials were removed. The remaining 72 articles, strictly regarding the use of AD-MSCs, PRP, and biomaterials in chronic skin wounds and soft tissue defects, were analyzed. The studies included had to match predetermined criteria according to the patients, intervention, comparator, outcomes, and study design (PICOS) approach. The information analyzed highlights the safety and efficacy of AD-MSCs, PRP, and biomaterials on soft tissue defects and chronic wounds, without major side effects.