Objective To investigate and compare the clinical values of serum procalcitonin (PCT)and high sensitivity C-reac-tive protein (hs-CRP)levels for predicting the blood culture positivity in the patients with sepsis.Methods 132 adult patients with sepsis were enrolled in this study.Blood cultures were performed before the antibacterial therapy.The white blood cell (WBC) count,absolute neutrophil count(ANC),levels of PCT and hs-CRP were determined.The application value of PCT and hs-CRP for predicting the positive blood culture results were evaluated.Results The median serum PCT levels in the blood culture positive group and the blood culture negative group were 7.92 ng/mL and 0.95 ng/mL respectively,the difference had statistical signifi-cance(P <0.01).The receiver operating characteristic (ROC)curves showed that PCT had a higher predictive accuracy for blood culture positivity compared with hs-CRP,the area under the curve (AUC)was 0.810(P =0.001)and 0.690(P =0.274),respec-tively.The combined detection of PCT and hs-CRP for predicting the blood culture positive results was similar to the performance of PCT alone,AUC as 0.885 (P =0.001 ).The median cut point of PCT was 0.91 ng/mL,the sensitivity of PCT for predicting blood culture positivity was 90%.This sensitivity remained unchanged when PCT cut point was1.14ng/mL.Using the PCT cut points of 0.91 and 1.14 enabled reducing the submitted blood cultures by 51% and 56% respectively.Conclusion Compared with hs-CRP,serum PCT level could better predict the blood culture positivity in the patients with sepsis.

Objective:To develop and validate a predictive model for adverse outcomes in women with hypertensive disorders of pregnancy (HDP).Methods:We retrospectively analyzed the clinical data of patients diagnosed with HDP and delivered at the First Affiliated Hospital of Soochow University or Sichuan Provincial Maternity and Child Health Care Hospital between May 1, 2011, and April 30, 2019. These patients were categorized as the adverse outcome group or the control group with adverse outcomes within 48 h after admission. Univariate analysis, least absolute shrinkage, selection operator (LASSO), and multivariable logistic regression were employed to analyze factors influencing the adverse outcomes and develop a predictive model. The receiver operating characteristic (ROC) curve and calibration plot was used to assess the predictive performance. Bootstrapping was used for the internal validation and the retrospective dataset of patients with HDP from the First Affiliated Hospital of Soochow University from May 1, 2019, to April 30, 2020, for the external validation. A graphic nomogram was created through R software based on the model.Results:(1) Of the 2 978 HDP patients who were included in the development set, 356 were in the adverse outcome group, accounting for 12.0%; of the 233 patients who were included in the external validation set, 40 presented with adverse outcomes within 48 h after admission, accounting for 17.2%. (2) Nine optimal predictors were identified based on the LASSO regression analysis and multivariable logistic regression, consisting of gestational age on admission, routine prenatal care, number of symptoms, mean arterial pressure, platelet count, fibrinogen, albumin, serum urea, and serum creatinine, based on which the logistic predictive model was established. (3) The ROC curve for this predictive model achieved an area under the curve (AUC) of 0.878 (95% CI: 0.858-0.897), and the ideal cut-off value for predicted probability was 0.136, with a sensitivity of 0.778 (95% CI: 0.731-0.820) and specificity of 0.848(95% CI: 0.834-0.862). The model was well-calibrated as the Hosmer-Lemeshow test showed that P>0.05. The calibration plot of the model had a slope of 1 and an intercept of 0. (4) The model showed good consistency in the internal validation and had an AUC of 0.872 (95% CI: 0.807-0.937) in the external validation. The Hosmer-Lemeshow test showed that the P value was >0.05, and the calibration slope was 1.001. (5) A nomogram was constructed for convenient clinical use. Conclusion:A relatively accurate prediction model for adverse outcomes in HDP patients was established, which could be used as a valuable quantitative tool for assessing HDP-related complications.

With in-depth research and development of dermoscopy, the dermoscopic features including perifollicular pigments, perilesional pigments, pigment network structure, satellite phenomenon and "tapioca sago" appearance, micro-Koebner phenomenon and comet tail-like phenomenon have provided a basis for the evaluation of vitiligo activity. This review summarizes progress in the evaluation of vitiligo activity with dermoscopy in recent years, aiming to promote the application of dermoscopy in the assessment of vitiligo activity.