Background Rat renal transplantation is an essential experimental model and requires greater microsurgical skills.Thus,training novices to perform quick and reliable microvascular anastomosis is of vital importance fo...Background Rat renal transplantation is an essential experimental model and requires greater microsurgical skills.Thus,training novices to perform quick and reliable microvascular anastomosis is of vital importance for rat renal transplantation.In this study,we developed and evaluated a staged microvascular anastomosis training program for novices,harvesting and transplanting both kidneys from one rat donor.Methods Five trainees without any prior microsurgical experience underwent a training program in which the goals were staged according to difficulty.Each trainee had to achieve satisfactory results as evaluated by a mentor before entering the next stage.Rat renal transplantation was accomplished by end-to-end technique with a bladder patch.In the intensive rat renal transplantation stage,the trainees required an average of 20 independent attempts at isotransplantation as final training assessment.Results After 2 months of intensive practice,all trainees had achieved stable and reproducible rat renal transplantation,with a satisfactory survival rate of 85.9% at postoperative Day 7.The total mean operative time was 78.0 minutes and the mean hot ischemia time was 26.2 minutes.With experience increasing,the operative time for each trainee showed a decreasing trend,from 90-100 minutes to 60-70 minutes.After 20 cases,the mean operative time of the trainees was not statistically significantly different from that of the mentor.Conclusion Harvesting and transplanting both kidneys from one rat donor after a staged microvascular anastomosis training program is feasible for novices without any prior microsurgical skills.展开更多
For the segmentation of X-ray angiograms （XRA）, the essential feature and the prior knowledge of angiographic image were analyzed, and a multi-feature based fuzzy recognition （MFFR） algorithm was proposed to infer...For the segmentation of X-ray angiograms （XRA）, the essential feature and the prior knowledge of angiographic image were analyzed, and a multi-feature based fuzzy recognition （MFFR） algorithm was proposed to infer the local vessel structure in this paper. Guided by the prior knowledge of artery vessel, a probability tracking operator （PTO） can rapidly track along the artery tree, and walk across the weak region or gaps because of disturbance or preprocessing to angiographic image. Another, the accurate measurement of the vascular axis-lines and diameters can be synchronously implemented in the tracking process. To correctly evaluate the proposed method, a simulated image of CAT and some clinical XRA images were used in the experimentations. The algorithms performed better than the conventional one： given one start-point, on average 92.7% of the visible segments or branches was automatically delineated; the correctness ratio of vessel structure inference reached to 90.0% on the average.展开更多
基金the grants from the National Science Foundation of China，the Outstanding Medical Academic Leader Program of Jiangsu Province，the Key Discipline of Medicine of Jiangsu Province，the Key Laboratory Foundation of Suzhou
文摘Background Rat renal transplantation is an essential experimental model and requires greater microsurgical skills.Thus,training novices to perform quick and reliable microvascular anastomosis is of vital importance for rat renal transplantation.In this study,we developed and evaluated a staged microvascular anastomosis training program for novices,harvesting and transplanting both kidneys from one rat donor.Methods Five trainees without any prior microsurgical experience underwent a training program in which the goals were staged according to difficulty.Each trainee had to achieve satisfactory results as evaluated by a mentor before entering the next stage.Rat renal transplantation was accomplished by end-to-end technique with a bladder patch.In the intensive rat renal transplantation stage,the trainees required an average of 20 independent attempts at isotransplantation as final training assessment.Results After 2 months of intensive practice,all trainees had achieved stable and reproducible rat renal transplantation,with a satisfactory survival rate of 85.9% at postoperative Day 7.The total mean operative time was 78.0 minutes and the mean hot ischemia time was 26.2 minutes.With experience increasing,the operative time for each trainee showed a decreasing trend,from 90-100 minutes to 60-70 minutes.After 20 cases,the mean operative time of the trainees was not statistically significantly different from that of the mentor.Conclusion Harvesting and transplanting both kidneys from one rat donor after a staged microvascular anastomosis training program is feasible for novices without any prior microsurgical skills.
基金Supported by the National Basic Research Program of China (Grant No. 2003CB716101)the National Natural Science Foundation of China (Grant No. 60772120)the Key National Science Foundation of China (Grant No. 30730026)
文摘For the segmentation of X-ray angiograms （XRA）, the essential feature and the prior knowledge of angiographic image were analyzed, and a multi-feature based fuzzy recognition （MFFR） algorithm was proposed to infer the local vessel structure in this paper. Guided by the prior knowledge of artery vessel, a probability tracking operator （PTO） can rapidly track along the artery tree, and walk across the weak region or gaps because of disturbance or preprocessing to angiographic image. Another, the accurate measurement of the vascular axis-lines and diameters can be synchronously implemented in the tracking process. To correctly evaluate the proposed method, a simulated image of CAT and some clinical XRA images were used in the experimentations. The algorithms performed better than the conventional one： given one start-point, on average 92.7% of the visible segments or branches was automatically delineated; the correctness ratio of vessel structure inference reached to 90.0% on the average.
