A multiple closed-loops robotic calibration for accurate surgical puncture.

BACKGROUND: Robotic puncture system increasingly demands stringent standard in target location accuracy. The positional and orientational transformation relationships among all components of the system are supposed to be calibrated and identified preoperatively. AIMS: The target location performance is directly determined by the calibration result. Therefore, a multiple closed-loops calibration approach is proposed to achieve high-level calibration accuracy in robotic puncture system. MATERIALS & METHODS: This method takes as input the three-dimensional position information of the retro-reflective markers mounted on the surgical tool, which is detected by the optical tracking system in real time during robotic movement. There is less complicated mathematical derivation and calculation in the presented algorithm by applying the closed-loop principle. RESULTS: Experimental results validate that it can achieve accurate robotic target location with less input data and computation-cost, satisfying the clinical puncture requirements. DISCUSSION: The spatial calibration between robotic arm and optical tracking system efficiently realised by the presented approach present an alternative which can be safely applied to the robotic puncture system for accurate insertion. CONCLUSION: Overall, a multiple closed-loops calibration approach is proposed in this work, which may increase surgical efficiency.

Therapeutic targets for the anemia of predialysis chronic kidney disease: a meta-analysis of randomized, controlled trials.

Anemia is one of the major complications in predialysis patients with chronic kidney disease (CKD). A clearer cognition of the prognostic impact of hemoglobin (Hb) or hematocrit (Hct) target on the outcomes of predialysis patients with CKD is significant. This article aims to establish the suitable hemoglobin target to provide clinical guidance. MEDLINE, EmBase, the Cochrane Library and other databases were searched with both MeSH terms and keywords to gather researches that assessed all-cause mortality, stroke, treatment of renal replacement, and transfusion. The meta-analysis was accomplished via Revman 5.3 version. Totally, 13 eligible studies involving 7606 patients were included. There was a significantly lower risk of transfusion (risk ratio (RR) 0.59, 95% CI 0.52 to 0.67; p<0.00001) in the higher hemoglobin group than in the lower one. However, no significant difference was found in all-cause mortality (RR 1.10, 95% CI 0.98 to 1.23; p=0.11), stroke (RR 1.32, 95% CI 0.82 to 2.10; p=0.25) and treatment of renal replacement including hemodialysis, peritoneal dialysis and renal transplant (RR 1.08, 95% CI 0.95 to 1.22; p= 0.23) between the higher hemoglobin group and the lower one. The results favor the higher hemoglobin target. To target the higher hemoglobin when treating predialysis patients with CKD may decrease the risk of transfusion without increasing the risk of death, stoke, and treatment of renal replacement.

[Automatic Robotic Puncture System for Accurate Liver Cancer Ablation Based on Optical Surgical Navigation].

This paper designed an automatic robotic puncture system for accurate liver cancer ablation based on optical surgical navigation. The near-infrared optical surgical navigation system we constructed for liver ablation was applied to carry out surgical planning and simulation, the near-infrared cameras dynamically tracked the current position of puncture needle relative to the location of the patient's anatomy, then guided the surgery robot to position precisely in three-dimensional space and performed the surgery.

Hemoglobin targets for the anemia in patients with dialysis-dependent chronic kidney disease: a meta-analysis of randomized, controlled trials.

BACKGROUND: Anemia is extremely common among dialysis patients and underlies some of the symptoms associated with reduced kidney function, including fatigue, depression, reduced exercise tolerance, and dyspnea. OBJECTIVES: A clearer cognition of the prognosistic impact of hemoglobin (Hb) or hematocrit (Hct) target for the outcomes of dialysis patients is urgent. This article aims to establish the suitable hemoglobin in order to provide clinical guidance. METHODS: MEDLINE, EmBase, the Cochrane Library and other databases were searched with both MeSH terms and keywords to gather randomized controlled trials that assessed all-cause mortality, cardiovascular events, fistula thrombosis, infectious diseases and transfusion among dialysis-dependent patients using erythropoiesis-stimulating agents. The meta-analysis was accomplished via Revman 5.3 version. FINDINGS: Totally, nine eligible studies were included, with study subjects involving 3228 patients. There was a significantly higher risk of fistula thrombosis without heterogeneity (RR 1.34, 95% CI 1.15-1.55; p < 0.05) in the higher Hb target group than in the lower Hb target group in the fixed effects model. However, no significant difference was found in all-cause mortality in the fixed effects model (RR 1.09, 95% CI 0.93-1.27; p = 0.30), cardiovascular events (RR 0.77, 95% CI 0.31-1.92; p = 0.58), infectious diseases (RR 0.69, 95% CI 0.24-1.96; p = 0.49) and transfusion (RR 0.92, 95% CI 0.42-1.99; p = 0.82) in the random effects model between the higher Hb target group and the lower Hb target group. DISCUSSION: The results favor lower Hb target. To target lower Hb target when treating dialysis patients with anemia may decrease the risk of fistula thrombosis without increasing the risk of death, cardiovascular events, infectious diseases and transfusion.