Children's Hospital of Chongqing Medical University

Male reproductive dysfunction has been reported during the acute phase of COVID-19. However, the long-term patterns in semen quality and hormonal parameters across the extended pandemic and post-pandemic periods, and whether these patterns differ by age, remain poorly characterized. This large-scale, retrospective study was conducted to delineate these trajectories in infertile men. Among 90,125 records, normal sperm morphology showed a sustained deficit: the proportion of men with morphology ≥ 4% declined from 88.9% pre-pandemic to 55.1% in Post-Phase 2 (p < 0.001), with nearly half falling below the WHO clinical threshold (4%). Serum testosterone decreased modestly from 4.46 to 4.19 ng/mL (6.1% reduction; (p = 0.006) but remained above the hypogonadism threshold for most men. These alterations persisted two years into the post-pandemic period without returning to pre-pandemic baselines. The COVID-19 pandemic was associated with persistent, clinically meaningful deficits in normal sperm morphology and a moderate, non-hypogonadal testosterone suppression, with distinct age-dependent patterns. These findings underscore the need for age-stratified reproductive health surveillance following major population-level stressors.

To compare the long-term efficacy and safety of Cohen versus modified Glenn-Anderson pneumovesicoscopic ureteral reimplantation and to define the learning curves for both procedures. A single-center retrospective cohort study (2007-2021) included 75 children with primary obstructive megaureter (POM) (Cohen: n = 27; modified Glenn-Anderson: n = 48). Primary outcomes were reoperation rates and ureteral recovery (diameter <7mm) during long-term follow-up. Cumulative sum (CUSUM) analysis was used to model learning curves based on operative time. A meta-analysis of 10 studies (529 patients) established a benchmark success rate. After a mean follow-up of 99.0 (Cohen) and 75.7 (modified Glenn-Anderson) months, reoperation-free rates were 92.6% and 95.8%, respectively (P > 0.05), with no significant differences in complication rates or functional improvement. CUSUM analysis indicated a learning phase of 22 cases for Cohen and 19 cases for modified Glenn-Anderson, with operative time decreasing by over 30% upon mastery. The meta-analysis yielded a pooled reoperation-free rate of 99.4%. Both techniques demonstrate comparable long-term safety and efficacy for POM. The modified Glenn-Anderson technique offers a valid alternative that preserves the ureter's anatomical course. Achieving procedural proficiency requires approximately 20 cases. While global success rates are high, long-term follow-up is crucial for detecting late complications.

Plasma microbial cell-free DNA sequencing (mcfDNA-seq) has emerged as a promising diagnostic and prognostic tool for infectious diseases, with early enthusiasm driven by its potential to outperform conventional microbiological assays in detection sensitivity. However, its anticipated clinical superiority has not consistently translated into transformative improvements in infection management, particularly in high-risk populations. Since its inception in 2015, key controversies have persisted regarding the optimal timing of mcfDNA-seq testing, clinical utility of longitudinal quantification, preferred testing modality (plasma mcfDNA-seq vs blood cell DNA sequencing), and integrative analysis of mcfDNA-seq data incorporating host immune biomarkers and antimicrobial resistance (AMR) gene profiling to enhance diagnostic precision. To address these unresolved questions, this review synthesizes the current evidence on the clinical applications of plasma mcfDNA-seq, critically evaluates its performance across diverse infectious disease contexts, and concludes by delineating future challenges and opportunities to optimize its translational utility for clinical practice.

International Practice Guidelines Registry Platform (PREPARE-2024CN606).