ObjectiveTo understand the epidemiological characteristics of an outbreak of respiratory tract infections caused by Mycoplasma pneumoniae （MP） in a primary school in Huzhou City， Zhejiang Province， and to provide scientific reference for future prevention and control of school outbreaks of upper respiratory tract infections caused by M. pneumoniae. MethodsAccording to the requirements for investigating respiratory infectious disease outbreaks， basic information， clinical history and epidemiological information were collected from the cases. Throat swab samples of cases for COVID-19 nucleic acid testing， influenza A and B virus antigen testing， and serum samples for detecting total antibody of mycoplasma were also collected. ResultsA total of 47 cases related to M. pneumoniae infection were identified. The first case occurred on May 4， 2022， and the cases were concentrated between May 22 and May 31， 2022. The last case occurred on June 21， marking a duration of 48 days for the outbreak. All cases were second-grade students， with an incidence rate of 35.07% （47/134） in the affected classes， with Class 206 at 53.330% （24/45）， Class 207 at 38.64% （17/44）， and Class 211 at 13.33% （6/45）. There was a statistically significant difference in the incidence rates among the classes （χ²=16.57，P<0.05）. The incidence rate was 32.39% （23/71） for boys and 38.10% （24/63） for girls， with no statistically significant difference by gender （χ²=0.48，P>0.05）. The main clinical manifestations included cough， fever， and sore throat， and some cases exhibited signs of pneumonia. Pharyngeal swabs and serum samples were collected from 27 patients. The results were negative for pharynx swab samples， and positive for total mycoplasma antibody in 12 serum samples， with a positive rate of 44.44%. ConclusionSymptoms caused by M. pneumoniae are diverse in clinical manifestations， with atypical signs and a slow progression. Early cases tend to exhibit mild symptoms. The onset of the disease is not detected in time when students are attending classes. The school morning health checks fail to promptly detect it and trigger home isolation control measures， which all contribute to the outbreak of the epidemic. Schools should conduct relevant prevention and control campaigns， improve morning and afternoon health checks， and prevent students from attending classes while sick.

Objective: To understand the epidemiological characteristics of an outbreak of respiratory tract infection caused by human metapneumovirus (hMPV) in a primary school in Huzhou City, and to provide scientific reference for the prevention and control of the outbreak of upper respiratory tract infection caused by hMPV in the future. Methods: The investigation was carried out according to the Guidelines for Handling Influenza Like Case Outbreaks (2018 version). The throat swabs were collected to carry out COVID-19 nucleic acid test. If negative, influenza virus and other common 14 upper respiratory tract virus detection would be conducted. Results: A total of 53 cases of human metapneumovirus infection were found, the first case was found on December 15, 2020; the cases concentrated from December 21 to December 26; the last case was on December 29. It lasted 15 days and the epidemic ended. All the cases were first year students, and the incidence rate of the affected classes was 44.92% (53/118), among which the incidence rate of 101 classes was 23.08% (9/39), 102 classes was 53.85% (21/39), 103 classes was 57.50%( 23/40 ), the difference was statistically significant( χ 2=10.07, P <0.05). The age of the patients ranged from 6 to 7 years. The morbidity rate of boys was 48.00%(24/50) and that of girls was 42.65% (29/68), with no significant difference( χ 2=0.33, P >0.05). The clinical symptoms of all cases were mild, mainly cough, sore throat, runny nose, only a small number of fever. Throat swabs of 20 patients were collected, and 13 cases were positive for human metapneumovirus nucleic acid. Conclusion The symptoms caused by human metapneumovirus are relatively mild, which is not easy to attract the attention of schools and parents. Schools should carry out relevant prevention and control knowledge publicity, do a good job in the morning and afternoon inspection, and put an end to classes with diseases.

Objective:To analyze the effectiveness and safety of reoperation for obstructive azoospermia (OA) with initial microsurgical anastomosis failure.Methods:A retrospective case series was performed for OA patients who underwent reoperation after initial microsurgical anastomosis failure, in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Institute of Urology, Urologic Medical Center from March 2015 to June 2020. Totally, 21 patients were enrolled in the study, and the clinical data, patency and pregnancy outcomes were reviewed.Results:During the initial surgery, 8 cases underwent vasovasostomy and 8 cases underwent vasoepididymostomy, while the other 5 cases underwent crossover anastomosis; 19 cases underwent reoperation because of reproductive needs, and 2 for post-vasectomy chronic testicular pain. During the reoperation, anastomotic stricture was found in 14 cases, and sperm granuloma was found in 6 cases, while spermatogenic dysfunction was confirmed in 1 case. Unilateral or bilateral anastomosis was performed successfully in 19 cases. Testicular sperm extraction was performed for 1 case with non-obstructive azoospermia (NOA) and 1 case with severe adhesion respectively. Totally 19 cases was followed for 3 to 58 months [(30.21±18.43) months], and 2 cases were lost to follow-up. Chronic testicular pain was relieved completely in 1 of the 2 cases suffering from the post-vasectomy testicular pain. Overall, 11 cases achieved patency, and 4 cases concieved naturally. Furthermore, 3 cases underwent in vitro fertilization cycle (1 case with semen sperm, and the other 2 cases with frozen testicular sperm). There were no severe post-operational complications in all cases. Conclusion:Microsurgical reoperation, which allows a favorable patency rate and natural pregnancy rate, is a valid option for the treatment of OA with initial microsurgical anastomosis failure.

Objective:To analyze the feasibility and safety of microsurgical anastomosis for obstructive azoospermia (OA) patients with prior intracytoplasmic sperm injection (ICSI) failure.Methods:From September 2015 to May 2020, the data of 20 OA patients with previous ICSI-assisted pregnancy failure admitted to the Department of Andrology, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The characteristics of seminal tract microsurgical reconstruction were summarized, and the postoperative recurrence rate and clinical pregnancy rate were calculated.Results:Vasal obstruction was found in 8 patients and epididymal obstruction in 12 patients during microscopically reconstructed seminal tract. Among the patients with vasal obstruction, 1 patient developed OA after trauma and underwent laparoscopic-assisted right vasovasostomy (VV). Totally 7 patients developed OA after juvenile bilateral hernia, among whom 6 patients underwent further laparoscopic-assisted VV and 1 patient underwent vasovasostomy and epididymal cross anastomosis. Of the 8 patients who underwent VV, 6 achieved postoperative patency, and 2 couples achieved natural pregnancy. Patients with epididymal obstruction underwent microscopic vasoepididymostomy (VE), and 6 out of 12 patients achieved postoperative pregnancy, while 3 couples achieved natural pregnancy. No significant complications occurred in all patients during and after operation.Conclusion:Microsurgical anastomosis is an effective remedy for patients with OA after ICSI pregnancy failure, which can help patients achieve natural pregnancy.

Objective:To analyze the effectiveness and safety of reoperation for obstructive azoospermia (OA) with initial microsurgical anastomosis failure.Methods:A retrospective case series was performed for OA patients who underwent reoperation after initial microsurgical anastomosis failure, in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Institute of Urology, Urologic Medical Center from March 2015 to June 2020. Totally, 21 patients were enrolled in the study, and the clinical data, patency and pregnancy outcomes were reviewed.Results:During the initial surgery, 8 cases underwent vasovasostomy and 8 cases underwent vasoepididymostomy, while the other 5 cases underwent crossover anastomosis; 19 cases underwent reoperation because of reproductive needs, and 2 for post-vasectomy chronic testicular pain. During the reoperation, anastomotic stricture was found in 14 cases, and sperm granuloma was found in 6 cases, while spermatogenic dysfunction was confirmed in 1 case. Unilateral or bilateral anastomosis was performed successfully in 19 cases. Testicular sperm extraction was performed for 1 case with non-obstructive azoospermia (NOA) and 1 case with severe adhesion respectively. Totally 19 cases was followed for 3 to 58 months [(30.21±18.43) months], and 2 cases were lost to follow-up. Chronic testicular pain was relieved completely in 1 of the 2 cases suffering from the post-vasectomy testicular pain. Overall, 11 cases achieved patency, and 4 cases concieved naturally. Furthermore, 3 cases underwent in vitro fertilization cycle (1 case with semen sperm, and the other 2 cases with frozen testicular sperm). There were no severe post-operational complications in all cases. Conclusion:Microsurgical reoperation, which allows a favorable patency rate and natural pregnancy rate, is a valid option for the treatment of OA with initial microsurgical anastomosis failure.

Objective:To analyze the feasibility and safety of microsurgical anastomosis for obstructive azoospermia (OA) patients with prior intracytoplasmic sperm injection (ICSI) failure.Methods:From September 2015 to May 2020, the data of 20 OA patients with previous ICSI-assisted pregnancy failure admitted to the Department of Andrology, Urologic Medical Center, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The characteristics of seminal tract microsurgical reconstruction were summarized, and the postoperative recurrence rate and clinical pregnancy rate were calculated.Results:Vasal obstruction was found in 8 patients and epididymal obstruction in 12 patients during microscopically reconstructed seminal tract. Among the patients with vasal obstruction, 1 patient developed OA after trauma and underwent laparoscopic-assisted right vasovasostomy (VV). Totally 7 patients developed OA after juvenile bilateral hernia, among whom 6 patients underwent further laparoscopic-assisted VV and 1 patient underwent vasovasostomy and epididymal cross anastomosis. Of the 8 patients who underwent VV, 6 achieved postoperative patency, and 2 couples achieved natural pregnancy. Patients with epididymal obstruction underwent microscopic vasoepididymostomy (VE), and 6 out of 12 patients achieved postoperative pregnancy, while 3 couples achieved natural pregnancy. No significant complications occurred in all patients during and after operation.Conclusion:Microsurgical anastomosis is an effective remedy for patients with OA after ICSI pregnancy failure, which can help patients achieve natural pregnancy.

Objective:To explore the chromosomal genetic factors of maturation arrest non-obstructive azoospermia (NOA).Methods:A case of maturation arrest NOA patients with chromosome reciprocal translocation was retrospective analyzed with literature review.Results:The karyotype of 46,Y,t(X;19)(p22.1;q13.3) was detected in a NOA patient, and the karyotypes of his parents were normal. There were no micro-deletions of Y chromosome. Also, no obvious pathogenic gene mutations were found in whole-exome sequencing (WES). Furthermore, there were no pathogenic copy number variations (CNVs) detected by chromosomal microarray analysis (CMA) in the patient. The histopathological analysis revealed that the spermatogenesis arrested at spermatocyte stage.Conclusion:46,Y,t(X;19) chromosome reciprocal translocation could lead to maturation arrest NOA.

Objective:To explore the chromosomal genetic factors of maturation arrest non-obstructive azoospermia (NOA).Methods:A case of maturation arrest NOA patients with chromosome reciprocal translocation was retrospective analyzed with literature review.Results:The karyotype of 46,Y,t(X;19)(p22.1;q13.3) was detected in a NOA patient, and the karyotypes of his parents were normal. There were no micro-deletions of Y chromosome. Also, no obvious pathogenic gene mutations were found in whole-exome sequencing (WES). Furthermore, there were no pathogenic copy number variations (CNVs) detected by chromosomal microarray analysis (CMA) in the patient. The histopathological analysis revealed that the spermatogenesis arrested at spermatocyte stage.Conclusion:46,Y,t(X;19) chromosome reciprocal translocation could lead to maturation arrest NOA.

Azoospermia accounts for 10%-15% of male infertility, with the prevalence of 1% in male population. Obstructive azoospermia (OA) accounts for 40% of azoospermia and can be caused by a variety of factors, including male reproductive duct inflammation and genetic factors. Given the fact that the spermatogenesis is normal in the testis of OA patients, the OA patients can have their own offspring through testicular biopsy and sperm retrieval followed by assisted reproductive technology (ART). Therefore, the genetic etiology of OA is often overlooked. Subsequently, studies of the following ART strategies and offspring birth defects are also ignored. This article reviewed the genetic disorders of OA patients, and the animal model with OA, providing new ideas for management of OA patients, genetic counseling, and development of male contraceptives.

Azoospermia accounts for 10%-15% of male infertility, with the prevalence of 1% in male population. Obstructive azoospermia (OA) accounts for 40% of azoospermia and can be caused by a variety of factors, including male reproductive duct inflammation and genetic factors. Given the fact that the spermatogenesis is normal in the testis of OA patients, the OA patients can have their own offspring through testicular biopsy and sperm retrieval followed by assisted reproductive technology (ART). Therefore, the genetic etiology of OA is often overlooked. Subsequently, studies of the following ART strategies and offspring birth defects are also ignored. This article reviewed the genetic disorders of OA patients, and the animal model with OA, providing new ideas for management of OA patients, genetic counseling, and development of male contraceptives.