Evaluation of the etiology and risk factors for maternal sepsis: A single center study in Guangzhou, China

BACKGROUND Maternal sepsis is a major cause of gestational morbidity and neonatal mortality worldwide and particularly in China.AIM To evaluate the etiology of maternal sepsis and further identify its risk factors.METHODS In this retrospective study,we evaluated 70698 obstetric patients who were admitted to the Third Affiliated Hospital of Guangzhou Medical University between January 1,2009 and June 30,2018.Subjects were divided into sepsis group and non-sepsis group based on the incidence of sepsis.Data about medical history(surgical and obstetric history)and demographic information were collected.The Mann-Whitney U test was used to compare patient age,gestational age and duration of hospitalization between the two groups.Univariate and multivariate logistic regression models were used to analyze the etiology and the risk factors for maternal sepsis.Unadjusted and adjusted odds ratios(OR)are reported.RESULTS A total of 561 of 70698 obstetric patients were diagnosed with infection;of the infected patients,492 had non-sepsis associated infection(87.7%),while 69 had sepsis(12.3%).The morbidity rate of maternal sepsis was 9.76/10000;the fatality rate in the sepsis group was 11.6%(8/69).Emergency admission(OR=2.183)or transfer(OR=2.870),irregular prenatal care(OR=2.953),labor induction(OR=4.665),cervical cerclage(OR=14.214),first trimester(OR=6.806)and second trimester(OR=2.09)were significant risk factors for maternal sepsis.CONCLUSION Mode of admission,poor prenatal care,labor induction,cervical cerclage,first trimester and second trimester pregnancy were risk factors for maternal sepsis.Escherichia coli was the most common causative organism for maternal sepsis,and the uterus was the most common site of infection.

Clinically applicable Gleason grading(GD)system for prostate cancer based on deep learning

To the Editor:Prostate cancer is one of the most common malignant tumors of the male genital system,with approximately 1.1 million new cases in 2012.[1]The accurate diagnosis of prostate cancer leads to a better chance of successful treatment when it is still confined to the prostate gland.The Gleason grading(GD)system was first established by Donald Gleason during 1966 to 1974.[2,3]The Gleason pattern ranges from 1 to 5.A higher score corresponds to poorer differentiation,which indicates a worse prognosis and higher metastasis possibility.The total score is calculated with the first half of the dominant Gleason pattern and the second half based on the non-dominant one.