1.Value of neutrophil to lymphocytes and platelets ratio for predicting 28-day mortality in sepsis patients
Dadong LIU ; Zongying YU ; Dehou ZHANG ; Jianguo ZHANG ; Yafeng ZHANG ; Xu WANG
Chinese Critical Care Medicine 2021;33(1):33-37
Objective:To evaluate the value of neutrophil to lymphocyte and platelet ratio (N/LPR) for predicting 28-day mortality in sepsis patients.Methods:A retrospective analysis was conducted. The clinical data of 154 sepsis patients admitted to intensive care unit (ICU) of the Affiliated Hospital of Jiangsu University from June 2017 to June 2020 were enrolled. The time of first diagnosis of sepsis in ICU was taken as the research starting point, and the death or 28 days as the end point. The 28-day outcomes of patients were recorded. The counts of peripheral blood neutrophil (NEU), lymphocyte (LYM) and platelet (PLT) were collected from all the enrolled patients within 3 days after diagnosis of sepsis. The ratios of N/LPR and NEU/LYM (NLR) were calculated respectively. The differences of N/LPR and NLR between survival group and death group were compared. Receiver operating characteristic (ROC) curve analysis was used to analyze the value of N/LPR and NLR on predicting the 28-day mortality of sepsis patients. According to the best cut-off value of ROC curve analysis, the 28-day mortality of patients with sepsis was analyzed by subgroup analysis, and the 28-day cumulative survival of patients with sepsis was analyzed by Kaplan-Meier survival curve.Results:Of the 154 sepsis patients, the patients with age < 18 years, pregnancy, blood disease, taking aspirin or other antiplatelet drugs within 1 week, taking leucocyte drugs within 1 week, length of ICU stay < 3 days and incomplete data were excluded. Finally, 50 patients were enrolled. Among them, 30 patients survived on the 28th day and 20 died. Compared with the survival group, the levels of N/LPR and NLR in the death group were significantly increased (N/LPR: 23.85±11.99 vs. 12.41±5.25, NLR: 17.83±8.69 vs. 10.75±3.63), with statistical differences (both P < 0.01). ROC curve analysis indicated that the area under ROC curve (AUC) of N/LPR for predicting 28-day death of sepsis patients was 0.827, it was higher than that of NLR (AUC = 0.762). Base on N/LPR≥15.48 as a predictor of cut-off value of death in 28 days of sepsis patients, the sensitivity was 75.0% and the specificity was 80.0%, respectively. Base on NLR≥10.65 as a predictor of cut-off value of death in 28 days of sepsis patients, the sensitivity was 75.0% and specificity was 56.7%, respectively. Subgroup analysis showed that the 28-day mortality in the patients with N/LPR≥15.48 ( n = 21) was significantly higher than those with N/LPR < 15.48 ( n = 29; 71.4% vs. 17.2%, χ 2 = 14.901, P < 0.01); and the 28-day mortality in the patients with NLR≥10.65 ( n = 28) was also significantly higher than those with NLR < 10.65 ( n = 22; 53.6% vs. 22.7%, χ 2 = 4.884, P < 0.05). The results were consistent with Kaplan-Meier survival curve analysis. Conclusion:Peripheral blood N/LPR has a good predictive value for 28-day mortality of sepsis patients, and which is better than NLR.
2.ECG real time monitoring system based on LabVIEW
Haoyu WANG ; Zhongjun HU ; Xu ZHANG ; Zongying GONG ; Wenting LI ; Chuanyong LI
Chinese Medical Equipment Journal 2003;0(10):-
This paper introduces an ECG real time monitoring system based on LabVIEW.With Wavelet transformation,the original ECG signals are processed to increase the accuracy of R peak detection.The feature of real time in this system is ensured by the application of simplified algorithm.The result panel offers various types of HRV information in time domain,including numerical and graphical displays which make the data more intuitional and more convenient to obtain.The system runs well in lab and the result is acceptable.
3.Data structure representation of 3D reconstruction system of medical images and surface model construction.
Xujia QIN ; Zongying OU ; Yong ZHANG ; Jianhua HOU
Journal of Biomedical Engineering 2002;19(2):239-243
3D reconstruction from medical images is widely used in diagnose, radiotherapy surgery programming and medical research. This paper deals with the framework and key techniques of 3D reconstruction system of medical images. Methods of automatic and manual segmentation of medical images are designed. Data structure of the system is proposed. The system data are encapsulated in object-oriented paradigm and the hierarchical structure of classes is presented for reconstructing 3D geometry models. The 3D surface geometry model is constructed by using MT algorithm from the tissues extracted by automatic or manual segmentation. An edge collapse algorithm of mesh simplification is proposed and implemented, and the surface model constructed by MT algorithm is simplified by using this algorithm, After reduction of 90 percent triangles, the simplified model still maintains the original feature. It can speed up surface rendering of the models.
Algorithms
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Humans
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Image Processing, Computer-Assisted
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Imaging, Three-Dimensional
4.Correlation of serum 25 (OH) D3 and IGF-1 levels with glycolipid metabolism and predictive value of retinopathy in elderly patients with type 2 diabetes mellitus
Yanling ZHANG ; Jingjin ZHANG ; Shilong WANG ; Zongying XU ; Juan TAN ; Aihua TONG ; Fangjiang XU
Chinese Journal of Endocrine Surgery 2024;18(3):346-351
Objective:To investigate the correlation between 25-hydroxyvitamin D3 (25 (OH) D3), insulin-like growth factor 1 (IGF-1) and glycolipid metabolism in patients with diabetes 2 mellitus (T2DM), as well as their predictive value in retinopathy.Methods:A total of 120 T2DM patients admitted to Linyi Central Hospital of Shandong Province from Oct. 2020 to Oct.r 2023 were selected as the study objects (defined as the study group). Another 120 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. Serum 25 (OH) D3, IGF-1, fasting blood glucose (FBG), 2 h plasma glucose (2 hPG) ) and lipid levels (triglycerides) were compared between the two groups. The levels of TG, total cholesterol (TC) and serum 25 (OH) D3 and IGF-1 were analyzed by Pearson correlation analysis. At the same time, the patients in the study group were divided into diabetic group with retinopathy (DR Group, 40 cases) and non-retinopathy group (NDR group, 80 cases) according to the status of retinopathy. Multivariate analysis was used to analyze the risk factors affecting the occurrence of retinopathy in T2DM patients, and receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of serum 25 (OH) D3 and IGF-1 levels in the occurrence of retinopathy in T2DM patients.Results:The level of serum 25 (OH) D3 was (36.15±4.25) nmol/L in the study group, lower than that in the control group (51.24±5.32) nmol/L ( P<0.05), and the level of IGF-1 was (30.26±4.52) mg/L was in the study group, higher than that in the control group ( P<0.05). The levels of FBG, 2 hPG, TG and TC in the study group were (8.67±2.52) mmol/L, (11.36±2.43) mmol/L, (2.05±0.72) mmol/L, (5.05±1.54) mmol/L respectively, higher than those in the control group [ (5.02±0.42) mmol/L, (6.32±0.54) mmol/L, (1.21±0.32) mmol/L, (3.42±0.68) mmol/L] ( P<0.05). Pearson correlation analysis showed that serum 25 (OH) D3 levels were negatively correlated with FBG, 2 hPG, TG and TC levels in T2DM patients ( r=-0.762, -0.782, -0.736, -0.721, P<0.05). Serum IGF-1 levels were positively correlated with the levels of FBG, 2 hPG, TG and TC in T2DM patients ( r=0.741, 0.756, 0.715, 0.698, P<0.05). Family history of diabetes in DR group, FBG, 2 hPG, TG, TC, IGF-1 levels was 35.00%, (9.31±2.49) mmol/L, (12.52±2.34) mmol/L, (2.76±0.61) mmol/L, (5.92±1.42) mmol/L, (37.89±4.41) mg/L respectively, higher than those in NDR group [16.25%, (8.35±2.15) mmol/L, (10.78±1.75) mmol/L, (1.69±0.52) mmol/L, (4.62±1.31) mmol/L, (26.45±4.06) mg/L] ( P<0.05). 25 (OH) D3 in DR group was (30.21±3.51) nmol/L, lower than that in NDR group (39.12±3.85) nmol/L ( P<0.05). Logistic regression analysis showed that family history of diabetes mellitus, duration of diabetes mellitus, 25 (OH) D3, IGF-1, FBG, 2hPG, TG and TC levels were all risk factors for the occurrence of retinopathy in elderly T2DM patients ( P<0.05). ROC curve analysis showed that AUC and sensitivity of 25 (OH) D3 and IGF-1 combined to predict retinopathy in elderly T2DM patients were 0.854 and 92.50%, respectively, higher than that of 25 (OH) D3 and IGF-1 alone ( P<0.05) . Conclusion:Serum 25 (OH) D3 and IGF-1 levels are abnormally expressed in elderly patients with T2DM, and there is a close relationship between glucose and lipid metabolism in elderly patients with T2DM, and the combined detection of these indicators has a higher predictive value for the occurrence of DR In elderly patients with T2DM.
5.Evaluation of the effect of prone ventilation in severe pneumonia in high-altitude areas
Zongying ZHANG ; Jinfang LIU ; Mei GE ; Hui LI ; Shengkui ZHAO ; Youcang WAN ; Chenglan ZHOU ; Weilin ZHAO
Chinese Journal of Nursing 2024;59(22):2742-2746
Objective To evaluate the effect of prone ventilation in children with severe pneumonia at high altitude.Methods By convenience sampling method,80 children with severe pneumonia hospitalized in intensive care department of a tertiary A children's hospital in Xining,Qinghai Province from June 2021 to June 2023 were selected as the study subjects,and the regional randomization group method was used to divide into a test group and a control group with 40 cases in each group.On the basis of routine care,the test group received prone ventilation once a day for 6 to 12 h;the control group received supine ventilation.Respiratory mechanical parameters(oxygenation index,oxygen saturation,arterial oxygen partial pressure,arterial CO2 partial pressure),mechanical ventilation duration and safety parameters(incidence of unplanned extubation,stress injury)at 6 h and 12 h of mechanical ventilation were compared.Results There were no shedding cases.The interaction between oxygenation index,blood oxygen saturation and arterial oxygen partial pressure(P<0.05)in the 2 groups was compared(P>0.05).The results of simple effect analysis showed that at 6 h,the oxygen saturation and oxygenation index in the test group were higher than those in the control group,and the difference was statistically significant(P<0.05).At 12 h of mechanical ventilation,the oxygenation index,blood oxygen saturation and arterial oxygen partial pressure in the test group were higher than those in the control group,and the difference was statistically significant(P<0.05).The time of mechanical ventilation in the test group was102.00(60.00,153.00)h and 126.00(108.00,156.00)h in the control group,and the difference was statistically significant(P=0.013).The incidence of unplanned extubation and pressure injury were compared,and the differences in 2 groups were not significant(P>0.05).Conclusion Prone ventilation in children with severe pneumonia at high altitude is safe and feasible,which is helpful to improve the respiratory function and shorten the time of mechanical ventilation.