简介：BackgroundSepticshockcausedbybacteremiaisalife-threateninginfectionwhoseprognosisishighlydependentonearlyrecognitionandappropriatetreatment.Procalcitonin(PCT)hasbeenshowntoaccuratelyandquicklydistinguishbacteremiafromnoninfectiousinflammatorystatesincriticallyseverepatients.However,theextentofPCTmagnitudeelevationaccordingtotheGramstainresultinelderlypatientswithcoronaryheartdisease(CHD)attheonsetofsepticshockcausedbybacteremiavaries,andhasnotbeenclearlyelucidated.MethodsThemedicalrecordsofadvancedage(non-neutropenic)patientwithCHDandsepticshockbetweenMar2013andJun2015whohadbacteremiacausedbyeitherGram-positive(GP)bacteriaorGram-negative(GN)bacteriawerereviewed,andthelevelsofPCT,C-reactive(CRP)proteinandwhitebloodcellscount(WBC)inbothgroupswereanalyzed.Results75episodesofeitherGNbacteremia(n=40)orGPbacteremia(n=35)wereenrolled.PCTlevelswerefoundtobemarkedlyhigherinpatientswithGNbacteremiathaninthosewithGPbacteremia[(8.93±17.58)vs.(64.42±58.56)ng/L(P<0.001)],whereastherewasnosignificantdifferenceinCRPandWBC(P>0.05).Moreover,ahighPCTlevelwasfoundtobeindependentlyassociatedwithGNbacteremiainthisstudypopulation.APCTlevelof19.69ng/mLyieldeda72.5%sensitivity,a91.4%specificity,an8.43positivelikelihoodratioanda0.30negativelikelihoodratioforGN-relatedbacteremiainthestudycohort[AUROCC=0.870(0.041),95%CI(0.790-0.949)].ConclusionInanelderlypatient(non-neutropenic)withCHDandsepticshock,GNbacteremiacouldbeassociatedwithhigherPCTvaluesthanthosefoundinGPbacteremia(PCT>19.69ng/mL).

简介：我们与高风险的前列腺癌症在271个病人报导全面的率，地点和积极外科的边缘(PSM)的预兆的因素。在2008年4月和2011年10月之间，我们有希望地从作为D'Amico分类的病人收集了数据高风险经历了帮助机器人的laparoscopic激进分子前列腺切除术。PSM的全面的率和地点被报导。逐步的逻辑回归模型被适合估计PSM的预兆的因素。PSM的全面的率是25.1%(271个病人中的68个)。这些PSM，(68中的26个)38.2%是posterolateral(PL)，26.5%(68中的18个)multifocal，16.2%(68中的11个)在顶，14.7%(68中的10个)在膀胱颈，并且4.4%(3/68)在另外的地点。有病理学的阶段pT2的病人的PSM率是8.6%(140中的12个)，26.6%(64中的17个)pT3a，53.3%(32/60)pT4的pT3b，和100%(7中的7个)。在包括pre-，intra-，和手术后的参数的一个逻辑回归模型，身体团索引(机会比率[或]：1.09；95%信心间隔[CI]：1.01-1.19，P=0.029)，病理学的舞台(pT3b或更高对pT2；或：5.14；95%CI：1.92-13.78；P=0.001)并且肿瘤的百分比(或：46.71；95%CI：6.37-342.57；P<0.001)是为PSM的独立预兆的因素。在病人在的PSM的最普通的地点高风险是PL方面，它反映报导肿瘤攻击性。PSM的唯一的重要预兆的因素是病理学的结果，例如在标本和病理学的舞台的肿瘤的百分比。

简介：Objective:Apreviousstudydemonstratedthatnon-anthracycline-containingdocetaxelpluscyclophosphamide(TC)regimenwasinferiortodocetaxel,anthracyclineandcyclophosphamide(TAC)inneoadjuvanttreatmentoftriple-negativebreastcancer(TNBC)andhumanepidermalgrowthfactorreceptor-2-(HER2)-positivebreastcancerinashort-termfollow-up.Herein,long-termfollow-upsurvivaloutcomeshavebeeninvestigated.Methods:TNBCorHER2-positivepatientswererandomizedtoreceive6cyclesofTCorTACneoadjuvanttreatment.Theprimaryendpointwaspathologicalcompleteremission(pCR).Secondaryendpointsincludedclinicalresponserate,event-freesurvival(EFS),andoverallsurvival(OS).Results:Acohortof96patientsconsistedof45inTCand51inTACarm.Withamedianfollow-upperiodof53(range,8–76)months,thepatientsachievingpCRpostneoadjuvantchemotherapyexhibitedsuperiorEFSandOSthanpatientswithoutpCR(P<0.05).TACtreatmentresultedinconsistentlybetterEFSthanTCtreatment:theestimated5-yearEFSwas66.1%vs.29.8%(P=0.002).Moreover,theestimated5-yearOSwasalsoinfavorofTAC:88.4%vs.51.6%(P<0.001).Multivariableanalysisdemonstratedthatthetreatmentregimenwasanindependentprognosticfactor,andpatientstreatedwithTAChadasuperiorEFS[hazardratio(HR),0.48;95%confidenceinterval(95%CI),0.26–0.90;P=0.021]andOS(HR,0.20;95%CI,0.08–0.60;P=0.003).Conclusions:Theupdatedlong-termfollow-updatademonstratedasustainedbenefitinEFSandOSfromanthracycline-containingTACtreatment,indicatingthatanthracyclineisanessentialandeffectivedruginthisclinicaltrial.