To better assist primary healthcare providers in recognizing the importance of postnatal bilirubin monitoring, and in developing the ability to promptly identify neonatal jaundice that requires intervention and to provide appropriate evaluation and management, thereby reducing severe neonatal hyperbilirubinemia requiring exchange transfusion and bilirubin encephalopathy while avoiding overtreatment, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association and the Editorial Board of Chinese Journal of Contemporary Pediatrics organized experts who, based on the national expert consensus and guidelines on neonatal hyperbilirubinemia, integrated the latest clinical research evidence on neonatal jaundice and, after thorough discussion, formulated the "Guidelines for the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal jaundice (2025)". The guideline addresses 10 common clinical questions on neonatal jaundice for primary healthcare providers and provides 16 recommendations.

In order to enhance the ability of primary healthcare providers to recognize and manage neonatal infectious pneumonia, and to reduce the incidence and mortality of severe neonatal pneumonia, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association convened a panel of experts to review and synthesize the latest clinical evidence on neonatal infectious pneumonia. After thorough discussion, this guideline was developed to address 10 common clinical issues faced by primary healthcare providers regarding neonatal infectious pneumonia, resulting in 18 recommendations.

The prevalence of depressive disorder among adolescents is rising, causing serious harm to families and society. Examining risk behaviors such as gaming addiction, non-suicidal self-injury, and suicidal behaviors resulting from adolescent depressive disorder in light of psychosocial and pathophysiological perspectives, along with in-depth exploration of diagnostic and therapeutic dilemmas—including insidious onset, high comorbidity, and difficulties in differential diagnosis—helps build a multidimensional intervention system encompassing psychological, pharmacological, and physical therapies. It also provides a theoretical basis for promoting multicenter cohort studies and establishing a comprehensive prevention and control model linking families, schools, and hospitals. This paper systematically outlines the current epidemiological status, comorbidity spectrum, and clinical pathways for early identification and comprehensive intervention in adolescent depressive disorder.

Objective To analyze the Bayesian network of harsh parenting, experiential avoidance, and adolescent short video addiction risk, identify key nodes, and provide precise recommendations for intervention. Methods In March 2025, the Harsh Parenting Scale, Experiential Avoidance Scale, and Short Video Addiction Scale were administered to 1 594 adolescents. Network analysis was performed using JASP 0.95.4, and key nodes were identified via centrality estimation. Results The core nodes of harsh parenting, experiential avoidance, and short video addiction risk were "I am hit with hands or kicked when I do something wrong or make my parents angry" (expected influence = 0.301), "Certain feelings make me feel scared" (expected influence = 0.684), and "Withdrawal" (expected influence = 1.222), respectively. Conclusions Interventions targeting these key nodes serve as an important reference for mitigating the impact of harsh parenting, experiential avoidance, and short video addiction risk on adolescents.

In order to further enhance the capacity of primary healthcare providers to perform neonatal resuscitation, and to reduce the incidence and mortality of asphyxia-related complications, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association, in collaboration with the Editorial Board of the Chinese Journal of Contemporary Pediatrics, organized experts to integrate the latest clinical research advances in neonatal resuscitation. Considering the realities of primary healthcare institutions, this guideline was developed after thorough expert discussion. The guideline addresses nine common issues concerning neonatal resuscitation faced by primary healthcare providers and provides 22 recommendations.

To help primary healthcare providers promptly identify and effectively treat neonatal hypoglycemia, thereby reducing the risk of hypoglycemic encephalopathy, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association led the development of this expert consensus. Through thorough discussion, experts integrated recent clinical advances to formulate the "Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal hypoglycemia (2025)". This consensus addresses 9 common clinical questions and provides 14 recommendations.

Neonatal sepsis is one of the major life-threatening diseases in neonates, with significant regional variations in mortality. The Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association, together with the Editorial Board of the Chinese Journal of Contemporary Pediatrics, organized neonatology experts to integrate the latest advances in clinical research on neonatal sepsis. Taking into account the current situation of primary healthcare institutions in China, they addressed nine common clinical questions regarding the diagnosis, treatment, and referral of neonatal sepsis for primary healthcare providers, and resulting in 19 expert consensus recommendations. This consensus aims to help primary healthcare providers promptly identify neonatal sepsis, ensure timely intervention or referral, and improve clinical outcomes.

Early screening, diagnosis, and intervention for congenital muscular torticollis (CMT) in infants are crucial for improving clinical outcomes. However, in China, limited awareness of CMT among child healthcare institutions and caregivers, as well as inconsistent professional standards among rehabilitation personnel, pose significant challenges to the effective diagnosis and management of CMT. The "Physical therapy management of congenital muscular torticollis: a 2024 evidence-based clinical practice guideline from the American Physical Therapy Association Academy of Pediatric Physical Therapy" includes 17 action statements, primarily addressing the prevention, identification, assessment, and intervention of CMT. This guideline is expected to facilitate early detection of CMT in infants, enhance the treatment capabilities of physical therapists, and improve clinical outcomes. This article provides an interpretation of the guideline in the context of the current status of CMT diagnosis and management in China, aiming to offer a reference for improving the ability of primary child healthcare providers and physical therapists to recognize and manage CMTropriately.

This article interprets the "Expert consensus on the management of neonatal parenteral nutrition (2025)", focusing on precise control of parenteral nutrition fluid volume, key considerations for the stability of compounded nutrient solutions, scientific determination of amino acid dosing, and rational recommendations for intravenous lipid emulsion. The aim is to offer authoritative and clear guidance for frontline clinicians, and facilitate the widespread dissemination and effective implementation of the consensus, thereby strengthening the standardization of neonatal parenteral nutrition management and improving short- and long-term outcomes in neonates.

To effectively assist primary healthcare providers in timely identification, early diagnosis, and early treatment of neonatal urinary tract infections (UTIs), thereby reducing missed diagnoses and improving outcomes, the Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association and the Editorial Board of Chinese Journal of Contemporary Pediatrics organized experts to integrate the latest clinical research progress on neonatal UTIs. Following comprehensive discussions, the "Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: neonatal urinary tract infection (2025)" was developed. This consensus covers 10 common clinical issues faced by primary healthcare providers regarding neonatal UTIs and formulates 17 recommendations.

In order to effectively assist primary healthcare providers in standardizing the screening of congenital heart disease (CHD), enabling early identification of critical CHD in neonates, and ensuring timely referral to reduce the risk of complications and mortality, the Subspecialty Group of Neonatology, Society of Pediatrics,Chinese Medical Association has led a team of experts to integrate the latest clinical research advances on CHD. Following comprehensive discussions, the "Expert consensus on the diagnosis and treatment of common neonatal diseases in primary healthcare institutions: congenital heart disease (2025)" was developed. The consensus covers eight common clinical questions faced by primary healthcare providers regarding CHD and provides 13 recommendations.

Ureaplasma urealyticum (UU) is a common pathogen colonizing or infecting the neonatal respiratory tract. It can be vertically transmitted from mother to infant, irrespective of the duration of premature rupture of membranes and the mode of delivery. UU infection is an important factor contributing to preterm birth and low birth weight and is closely associated with adverse outcomes such as bronchopulmonary dysplasia and neurodevelopmental impairment. Given the immaturity of neonatal immune and organ systems, pharmacologic treatment must balance efficacy and safety. Currently, no unified standard regimen has been established for the treatment of neonatal UU infection. This review summarizes pharmacotherapeutic options for neonatal UU infection to inform clinical practice.

Vasovagal syncope (VVS) is the most common cause of neurally mediated syncope in children. Recurrent syncope severely affects physical and mental health and may lead to unintentional injury. Based on international and domestic guidelines and clinical practice experience, standardized recommendations for the diagnosis and treatment of pediatric VVS are proposed. Management of VVS should be individualized, and non-pharmacological interventions, including lifestyle modifications, are the cornerstone for both classic and malignant VVS. Pharmacological therapy is recommended for children with VVS who have recurrent syncopal episodes, are at risk of trauma, or respond poorly to non-pharmacological interventions. For children in whom the head-up tilt test induces asystole, pacemaker implantation is not recommended as first-line therapy. In malignant VVS with recurrent syncope despite conventional treatment, pacemaker implantation may be considered after specialist evaluation. Data on cardioneuroablation in children are limited, and long-term follow-up is required.

Peripherally inserted central catheter (PICC) placement is an essential routine procedure in neonatal intensive care units and an important life-support technology. In recent years, point-of-care ultrasound-guided catheter insertion and ultrasound localization of catheter tips have been widely applied in neonatal practice and demonstrate clear advantages over traditional methods. This guideline was developed on the basis of currently available evidence and the practical experience of domestic experts, and it is tailored to the Chinese context. It provides clinical practice recommendations for ultrasound-monitored vascular selection, ultrasound-guided PICC cannulation, and ultrasound localization of the PICC tip. In total, 22 recommendations addressing 10 key clinical questions are presented, covering pre-insertion vascular selection, intra-procedural ultrasound-guided localization, post-insertion dynamic monitoring, and troubleshooting of difficult scenarios. The aim is to promote standardized application of this technology in neonatal intensive care units in China, reduce complications, and improve safety.

The "International consensus on early rehabilitation and nutritional management for infants at high risk of neurological impairment" was jointly developed by the Rehabilitation Group of the Pediatrics Branch of the Chinese Medical Association in collaboration with international experts. It aims to provide standardized guidance for early rehabilitation and nutritional management in infants at high risk of neurological impairments. Based on existing evidence and expert opinion, the consensus addresses 10 key clinical questions, including early identification, rehabilitation intervention, and nutritional management, and provides scientific and practical guidance for healthcare professionals in China to improve clinical management and outcomes. This article interprets the consensus to offer relevant guidance for the early rehabilitation and nutritional management of infants at high risk of neurological impairments.

Children with autism spectrum disorder (ASD) frequently have comorbid gastrointestinal problems, with constipation being the most prevalent. The onset and severity of constipation are closely related to the core symptoms of ASD, and improving constipation can alleviate these core symptoms. However, the mechanisms underlying comorbid constipation in ASD remain unclear. Multidisciplinary assessment is the foundation of clinical management for comorbid constipation in ASD. Targeted pharmacological therapy, dietary interventions, gut microbiota modulation, and complementary and alternative medicine interventions can be chosen for personalized treatment. This review summarizes the mechanisms, assessment, and clinical management of comorbid constipation in ASD and aims to provide a reference for comprehensive interventions in ASD.

Neonatal respiratory distress syndrome (RDS) is a critical disease caused by pulmonary surfactant (PS) deficiency, leading to respiratory distress soon after birth. Comprehensive perinatal interventions can significantly improve outcomes. The core goal of RDS management is to maximize infant survival while minimizing lung injury. Based on the latest evidence, European neonatologists and obstetricians jointly developed the "European consensus guidelines on the management of respiratory distress syndrome: 2025". The guidelines provide evidence-based clinical recommendations for the management of RDS in preterm infants, covering the entire pathway from prenatal interventions, delivery room stabilization, surfactant administration, non-invasive and invasive respiratory support, to comprehensive supportive care. The aim is to reduce the incidence of lung injury through targeted interventions, increase survival rates, and improve long-term neurodevelopmental outcomes. This article interprets the 2025 guidelines in comparison with the 2022 version, aiming to improve the clinical competence of Chinese neonatologists in the diagnosis and treatment of RDS.

Based on the current application status and existing challenges of artificial intelligence (AI) in the management of neonatal jaundice in primary medical institutions in China, a multidisciplinary expert panel was convened, including specialists from neonatology, pediatrics, child healthcare, obstetrics, public health, information management, and health administration, to develop the "Expert consensus on artificial intelligence-assisted monitoring and management of neonatal jaundice in primary medical institutions (2026)". This consensus focuses on how AI-assisted monitoring and management can empower early identification, risk assessment, and hierarchical referral of neonatal jaundice in primary medical institutions. It aims to improve the efficiency of early detection and dynamic management, prevent severe hyperbilirubinemia—especially bilirubin encephalopathy—and related adverse outcomes. The consensus addresses six clinical questions and proposes sixteen recommendations, providing standardized scientific guidance for primary healthcare providers in the implementation of AI-assisted monitoring and management of neonatal jaundice. Citation:Chinese Journal of Contemporary Pediatrics, 2026, 28(6): 643-651

The prevalence of adolescent depressive symptoms has been rising, and maternal depression is a key predictor. This review synthesizes evidence on mechanisms of influence and on intervention research. The intergenerational transmission of risk from maternal depression appears more pronounced than that associated with paternal depression. At the biological level, genetic susceptibility and neurodevelopmental alterations underpin intergenerational transmission; at the social level, negative parenting practices and stressful family environments create a vicious cycle; at the psychological level, deficits in emotion regulation and insecure attachment amplify vulnerability to depression. Family-based interventions, including cognitive-behavioral therapy and family systems therapy, can mitigate intergenerational transmission. However, more longitudinal research is needed, and future work may integrate digital technologies to develop structured intervention protocols.

Objective To investigate the correlation between induction therapy response and prognosis in children with high-risk neuroblastoma, and to analyze factors associated with the induction therapy response. Methods Data of 55 children with high-risk neuroblastoma diagnosed and treated at Shanghai Children's Hospital from January 2019 to December 2023 were retrospectively reviewed. Induction response was assessed according to the International Neuroblastoma Response Criteria and patients were categorized into a good-response group (complete response or very good partial response) and a poor-response group (partial response, progressive disease, mixed response, or no response). Clinical and biological characteristics, treatments, and prognostic factors were analyzed. Results Among the 55 children, 29 were male and 26 were female; the median age at onset was 39 months. Follow-up was performed until December 31, 2024. The 3-year overall survival (OS) and event-free survival (EFS) rates were (83.8±5.3)% and (47.0±10.3)%, respectively. Neuron-specific enolase level at initial diagnosis, induction therapy response, radiotherapy, and recurrence were prognostic factors for EFS and OS (P<0.05). The 3-year OS was (83.5±7.4)% in the good-response group and (66.7±13.6)% in the poor-response group (P=0.012), while the 3-year EFS was (62.8±10.4)% and (27.8±14.8)%, respectively (P<0.001). Intracranial metastasis at initial diagnosis was associated with a poor induction response (P=0.033). A platelet count ≥400×10⁹/L was associated with a better induction response (P=0.002). Conclusions Induction therapy response is a significant prognostic factor in high-risk neuroblastoma. Absence of intracranial metastasis and a platelet count ≥400×10⁹/L at initial diagnosis are associated with a favorable induction therapy response.

Duchenne muscular dystrophy (DMD) is an X-linked recessive neuromuscular disorder characterized primarily by progressive degeneration and necrosis of skeletal muscle, resulting from mutations in the Dystrophin gene. Patients with DMD typically present with progressive muscle weakness and atrophy during childhood. Currently, available treatment options for DMD remain limited and their efficacy is suboptimal. This review aims to provide a systematic overview of recent advances in therapeutic strategies for DMD, including an analysis of the mechanisms underlying various treatment approaches, outcomes from clinical trials, and their potential clinical applications, in order to inform and guide clinical decision-making.

A comprehensive retrieval, evaluation, selection, and integration of literature on allogeneic hematopoietic stem cell transplantation (allo-HSCT) for transfusion-dependent thalassemia (TDT) published over the past decade was conducted. For 10 clinical questions related to allo-HSCT in TDT, 26 recommendations were developed. The guideline aims to guide and standardize clinical diagnosis and treatment practices of allo-HSCT for TDT in China.

The number of women with gestational obesity has been increasing year by year and is a serious global challenge. Maternal obesity during pregnancy not only leads to gestational diabetes, hypertension, preterm birth, and miscarriage, but also adversely affects offspring growth and development after birth by increasing the risk of offspring obesity and other metabolic diseases. Changes in the maternal gut microbiota during pregnancy and delivery play important roles, and microbiota-derived metabolites are closely related to the metabolic regulation of obesity. This review summarizes the potential mechanisms by which the maternal gut microbiota in gestational obesity influences offspring, aiming to deepen understanding of how maternal gut microbiota affects offspring and to provide research targets and ideas for clinical intervention.

Osteogenesis imperfecta (OI) is a rare genetic skeletal disorder most commonly caused by variants in COL1A1 and COL1A2, which encode type I collagen. It is characterized by increased bone fragility, recurrent fractures, and skeletal deformities that adversely affect quality of life. With advances in genetic testing and molecular pathophysiology, diagnosis has evolved from traditional imaging-based assessment to comprehensive evaluation guided by genotype-phenotype correlations. Early diagnosis and standardized management are crucial for improving prognosis; however, the rarity of OI and rapid technological progress make it challenging to keep pace with evolving diagnostic and therapeutic strategies. This article discusses the genetic and pathophysiological mechanisms, recent advances in diagnosis and treatment, and key points in the management of OI, aiming to provide up-to-date reference information for OI care and clear, actionable guidance for clinicians.

Mosquito-borne viruses, including dengue virus (DENV), chikungunya virus (CHIKV), and Zika virus (ZIKV), pose major threats to public health in tropical and subtropical regions worldwide. Neonates are particularly vulnerable, and the associated disease burden has drawn increasing attention. Routes of neonatal infection include vertical mother-to-child transmission (transplacental and peripartum) and postnatal mosquito bites. Clinical manifestations are often nonspecific; a proportion of cases may progress to central nervous system infection, hemorrhagic disease, or long-term neurodevelopmental impairment, with serious consequences for survival and quality of life. Although China has issued prevention and control guidelines for adults and pregnant women, systematic clinical guidance tailored to neonates remains lacking. In response, the Perinatal Group of the Pediatric Branch of the Chinese Medical Doctor Association convened a multidisciplinary panel to develop this expert consensus, integrating the latest international evidence with China's practical prevention and control experience. The consensus addresses epidemiology; the effects of maternal infection on fetuses and neonates; clinical manifestations; diagnosis and differential diagnosis; early warning indicators of severe disease; therapeutic strategies and supportive care; and prevention and maternal-infant management. It aims to provide evidence-based, standardized, and practical guidance for frontline clinicians managing neonatal mosquito-borne viral infections.

With continuous advancements in neonatal care in China, the survival rate of extremely preterm infants has markedly increased in recent years. However, the proportion of voluntary withdrawal of treatment for extremely preterm infants remains relatively high. To further improve the overall treatment success rate for extremely preterm infants in Hunan Province, the Hunan Neonatal Medical Quality Control Center, in collaboration with the Perinatal Committee of the Hunan Medical Association, organized experts to develop recommendations on antenatal counseling for extremely preterm infants. These recommendations aim to standardize antenatal counseling procedures, enhance the scientific rigor and consistency of clinical decision-making, and improve survival outcomes.

Objective To evaluate the clinical utility and translational potential of a remote jaundice monitoring system for home-based screening of neonatal hyperbilirubinemia. Methods A prospective self-controlled study was conducted, enrolling 538 newborns with gestational age ≥35 weeks, birth weight ≥2 000 g, and postnatal age ≤14 days at the Women's Hospital of Nanjing Medical University from March to October 2023. Four screening protocols with different predictive indicators were developed based on the Chinese Neonatal Transcutaneous Hourly Bilirubin Nomogram. The effectiveness of the system was evaluated, and the feasibility of using the remote jaundice monitoring system in actual home settings was analyzed. Results A total of 538 paired transcutaneous bilirubin (TcB) and total serum bilirubin (TSB) measurements showed a strong correlation (r=0.85, P<0.001), with 95.0% (511/538) of samples within the 95% limits of agreement. Using TcB ≥ the 95th percentile as the predictive indicator, the system achieved 100% sensitivity, 46.2% specificity, and an area under the receiver operating characteristic curve of 0.731 (95%CI: 0.682-0.780). This approach could reduce unnecessary hospital visits by 41.4% (221/538). Conclusions The system integrates the QBH-801 transcutaneous bilirubinometer, intelligent early warning, and remote guidance services, establishing a closed-loop "hospital-to-home" management model. It demonstrates high safety and feasibility, with significant clinical translational value.

Objective To investigate the clinical features, treatment, and prognosis of pyruvate kinase deficiency (PKD) caused by PKLR gene variants. Methods Clinical data of six patients with PKD who received care at the Affiliated Hospital of Qingdao University from August 2014 to August 2025 were retrospectively analyzed. Results Of the six patients, five were children with onset in infancy, and one was an adult whose disease onset occurred at school age. All presented with jaundice and anemia, and PKD was confirmed by genetic testing. Two patients underwent splenectomy due to frequent transfusion. Three patients were mild, required no regular transfusion, and did not undergo splenectomy. One patient died. Conclusions PKD manifests chronic hemolysis with variable clinical severity. Genetic testing is recommended for diagnosis. Curative therapy remains lacking; management is mainly supportive. Splenectomy may reduce transfusion dependence and improve quality of life.

Abnormalities in growth and development in children with methylmalonic acidemia (MMA) have become a central challenge affecting prognosis. As a relatively common disorder of organic acid metabolism, MMA has a complex etiology and exhibits highly heterogeneous clinical manifestations. Among these, neurodevelopmental delay and impaired somatic growth are particularly prominent and are key determinants of poor long-term outcomes. Accordingly, early identification, refined assessment, and individualized intervention for these growth and developmental problems are focal points of current MMA clinical management. This review focuses on the occurrence status, potential mechanisms, and intervention strategies for growth and developmental abnormalities in MMA, aiming to provide a reference for optimizing patient management and improving long-term outcomes.

This paper systematically explores the integration pathways, challenges, and future directions of artificial intelligence (AI) technology and narrative medicine in pediatric medical education. Due to the unique characteristics of the pediatric population, pediatric diagnosis and treatment place higher demands on physicians' empathy, communication skills, and humanistic qualities. Narrative medicine, as a key paradigm to address deficiencies in medical humanities, provides a theoretical framework and practical methods for cultivating these core humanistic qualities. However, its teaching promotion and practice face challenges such as insufficient scaling, lack of standardization, and limited depth of feedback. Advances in AI technology, particularly in natural language processing and generative AI, offer new opportunities to overcome these challenges. Based on a systematic literature review, relevant theories, research methods, and practical outcomes of the integration between AI and narrative medicine are synthesized, and a three-stage integration model of "independent development - skill empowerment - collaborative deepening" is constructed. The integration process faces significant challenges including technical ethics, educational integration, and value alienation. Finally, a new paradigm for future pediatric medical education centered on "human-machine collaboration" is proposed, aiming to cultivate the next generation of pediatricians who possess excellent technical skills, profound empathy, and resilient professional spirit, thereby opening new perspectives.

Objective To explore the relationship between frontal alpha asymmetry (FAA) assessed by electroencephalogram (EEG) and emotion dysregulation (ED) in children with attention deficit hyperactivity disorder (ADHD). Methods Children with ADHD admitted to Fuyang Women and Children's Hospital from September 2021 to December 2024 were prospectively enrolled (n=104). Based on the Achenbach Child Behavior Checklist (CBCL), participants were classified into an ED group (sum of three subscales <180; n=41) and a non-ED group (sum ≥180; n=63). Clinical data were collected, and the Chinese ADHD SNAP-IV parent version and the Weiss Functional Impairment Rating Scale-Parent Report were used. FAA was measured by EEG. Correlations between FAA in different regions and CBCL score were analyzed, and the predictive value of FAA for ED was evaluated with multivariable logistic regression and receiver operating characteristic curves. Results Compared with the non-ED group, the ED group had a higher proportion of the predominantly inattentive ADHD subtype, higher SNAP-IV total score, higher Weiss Functional Impairment Rating Scale-Parent Report total score, and higher FP1/FP2-FAA and C3/C4-FAA (P<0.05). FP1/FP2-FAA and C3/C4-FAA were negatively correlated with CBCL score (P<0.05). The multivariable logistic regression analysis showed that FP1/FP2-FAA and C3/C4-FAA were closely associated with ED in children with ADHD (P<0.05). The areas under the curve for predicting ED using FP1/FP2-FAA, C3/C4-FAA, and their combination were 0.827, 0.685, and 0.917, respectively (P<0.05), and the combined prediction had a higher area under the curve than either single marker (P<0.05). The FP1/FP2 FAA value in hyperactive-impulsive ADHD was lower than in combined-type ADHD and predominantly inattentive ADHD (P<0.05). Conclusions FP1/FP2-FAA and C3/C4-FAA are reliable neural markers of emotion dysregulation in children with ADHD, and their combination shows superior predictive performance. ADHD subtypes show distinct patterns of FAA-functional impairment associations.

Objective To describe the current status of transition preparation among adolescents with thalassemia major (TM), identify its influencing factors, and provide a basis for transition-period interventions. Methods A convenience sampling approach was used to recruit 138 adolescent inpatients with TM from two tertiary Grade A hospitals in western Guangxi from April to December 2024. Data were collected using a general information questionnaire, a transition preparation questionnaire, the Pediatric Quality of Life Inventory Generic Core Scales, and the Family Caregiving Measurement Scale. Multivariable regression analysis was conducted to determine factors associated with transition preparation. Results Among the 138 adolescents with TM, the mean total transition preparation score was 59±9, the family caregiving score was 189±23, and the quality of life score was 57±14. Age, disease duration, monthly family income, exposure to transition-related information, caregiver education level, family caregiving level, and quality of life level were significantly associated with transition preparation (P<0.05). Conclusions Transition preparation among adolescents with TM is at a moderate level. Nursing staff should tailor family-focused interventions according to patient age and family caregiving capacity to promote transition preparation and improve quality of life.

Objective To evaluate the efficacy and safety of ibuprofen in treating hemodynamically significant patent ductus arteriosus (hsPDA) in preterm infants of different postnatal ages at treatment initiation. Methods Clinical records of infants with gestational age <37 weeks who received ibuprofen for hsPDA in the Department of Neonatology, Fourth Hospital of Shijiazhuang, from January 2020 to December 2023 were retrospectively reviewed. One hundred eligible infants were divided by the postnatal age at the first ibuprofen administration into three groups: group A (≤4 days), group B (5-7 days), and group C (>7 days). Clinical efficacy and safety indicators were compared among groups. Results After treatment, cure rates were 92% in group A, 72% in group B, and 60% in group C, and effective rates were 8%, 25%, and 33%, respectively. Differences in clinical efficacy among the three groups were statistically significant (P<0.05). No significant differences were observed among groups in the incidence of pulmonary hemorrhage, gastrointestinal bleeding, cholestasis, bronchopulmonary dysplasia, necrotizing enterocolitis, intracranial hemorrhage, or acute kidney injury (P>0.05). Conclusions For hsPDA requiring pharmacologic therapy, earlier oral ibuprofen administration yields a higher ductal closure rate and does not increase the incidence of adverse events.

Objective To analyze the serum metabolomic changes of preterm infants with bronchopulmonary dysplasia (BPD) at postmenstrual age (PMA) 36 weeks, screen potential biomarkers and associated metabolic pathways, and assess their relationship with short-term respiratory outcomes. Methods A retrospective case-control study was conducted. Infants with gestational age 28-32 weeks admitted to the Children's Hospital Affiliated to Zhengzhou University from January to December 2024 were included. Twenty infants with BPD and 20 gestational age-, birth weight-, and sex-matched non-BPD preterm infants were included. Serum collected at PMA 36 weeks was subjected to untargeted metabolomics analysis, and associations with short-term respiratory outcomes were analyzed. Results Thirteen potential biomarkers distinguishing BPD were identified (area under the curve >0.75, P<0.05). Eight biomarkers—including terephthalic acid, phosphatidylinositol, fumarate, and lysophosphatidic acid—were significantly upregulated (FC≥1.5), while five biomarkers, such as 7α-hydroxy-3-oxo-4-cholestenoate ester and phosphatidylcholine, were significantly downregulated (FC≤1/1.5). Pathway analysis indicated five pathways associated with BPD, including glycerophospholipid metabolism and phenylalanine metabolism. Dysregulation of glycerophospholipid and bile acid metabolism may affect adverse short-term respiratory outcomes in infants with BPD. Conclusions The 13 significantly different metabolites may serve as biomarkers for the diagnosis of BPD. Glycerophospholipid metabolism is associated with the occurrence of BPD and with adverse short-term respiratory outcomes.

Objective To investigate the incidence of severe cancer therapy-related thrombocytopenia (CTRT) and associated factors in children. Methods A prospective observational study was conducted among 1 047 pediatric inpatients with cancer at Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicinefrom November 2023 to August 2024. Patients were divided into two groups based on the occurrence of severe CTRT. Multivariable logistic regression analysis was used to identify risk factors for severe CTRT. Results Severe CTRT occurred in 343 patients (32.76%). Multivariable logistic regression analysis showed that disease relapse, history of severe CTRT, nutritional risk, use of >3 antineoplastic agents, inclusion of platinum-based agents/cytarabine/anthracyclines in the regimen, and pre-treatment platelet count <100×10⁹/L were significantly associated with severe CTRT (P<0.05). Conclusions The incidence of severe CTRT in children is relatively high, and it is influenced by multiple factors including medical history (relapse, previous severe CTRT), treatment regimen (>3 antineoplastic agents, inclusion of platinum-based agents/cytarabine/anthracyclines), and health status (nutritional risk, pre-treatment platelet count <100×10⁹/L). High-risk children should be identified through comprehensive assessment of medical history, health condition, and treatment regimen to provide timely preventive and supportive care.

Objective To identify infant sleep patterns and explore their influencing factors, providing scientific evidence for the formation and intervention of healthy sleep patterns. Methods A total of 1 483 12-month-old infants from the Shanghai Birth Cohort were included. Sleep status was assessed using the Brief Infant Sleep Questionnaire. Latent class analysis was performed to integrate sleep behavior and sleep problem variables and to identify typical sleep patterns. A binary logistic regression model was employed to examine influencing factors. Results Two sleep patterns were identified: a good sleep pattern characterized by healthier sleep habits and fewer sleep problems, and a poor sleep pattern characterized by poorer sleep habits and more sleep problems. Logistic regression analysis showed that, compared with infants who had stopped breastfeeding, infants still being breastfed at 12 months were more likely to develop poor sleep patterns (OR=1.725, P<0.001). Compared with infants from families with better economic status, those from families with economic hardship were more likely to develop poor sleep patterns (OR=1.638, P=0.003). Outdoor activity for more than one hour per day was associated with better sleep patterns (OR=0.633, P<0.001), while screen exposure increased the risk of poor sleep patterns (OR=1.887, P<0.001). Conclusions Infant sleep patterns are influenced by multiple factors; increasing outdoor activity and limiting screen exposure help infants form good sleep patterns.

Objective To investigate the disease burden of attention-deficit/hyperactivity disorder (ADHD) among children and adolescents in China and to predict future trends, in order to provide evidence for disease control strategies. Methods Based on data from the Global Burden of Disease Study 2021 (GBD 2021), joinpoint regression and prediction models were constructed to analyze and forecast the trends in ADHD burden indicators among Chinese children and adolescents from 1990 to 2021. Results In 2021, the incidence, prevalence, and disability-adjusted life years (DALYs) rates of ADHD among children and adolescents in China increased by 41.46%, 21.44%, and 21.75%, respectively, compared to 1990. From 1990 to 2021, the disease burden of ADHD showed an overall upward trend across sex and age groups, with a heavier burden among males. The highest incidence was observed in children aged 5-9 years, while the highest prevalence and DALY rates were found in those aged 10-14 years. By 2031, the incidence, prevalence, and DALY rates of ADHD among Chinese children and adolescents are projected to reach 324.88 per 100 000, 3 762.36 per 100 000, and 45.85 per 100 000, respectively. Conclusions From 1990 to 2021, the incidence, prevalence, and DALY rates of ADHD among children and adolescents in China have all increased, suggesting that more proactive prevention and intervention measures may be needed to alleviate the disease burden of ADHD in this population.

In 2022, China's National Health Commission issued the health standard "Guideline for pediatric transfusion" (WS/T 795-2022), which provides guidance and recommendations on overall pediatric blood requirements, blood for exchange transfusion, and the use of irradiated red blood cells, washed red blood cells, and fresh red blood cells. This article explains the rationale and evidence base underlying these recommendations to facilitate a clearer understanding of the guideline.

Febrile infection-related epilepsy syndrome (FIRES) mainly affects previously healthy children and adolescents, often leading to severe neurological impairment and long-term sequelae such as drug-resistant epilepsy and cognitive dysfunction. Based on two pediatric FIRES cases, combined with international and domestic guidelines as well as clinical experience, this paper highlights therapeutic strategies and escalation pathways tailored to different inflammatory phases in the acute and chronic stages. Incorporating continuous electroencephalogram monitoring and cerebrospinal fluid inflammatory cytokine profile changes, a phase-specific treatment approach is systematically described, centered on the rapid termination of status epilepticus, targeted cytokine immunotherapy, and multidisciplinary collaborative support, and the active use of tocilizumab, anakinra, and the ketogenic diet is emphasized, to provide practical guidance for clinicians in managing FIRES.

Objective To investigate the potential circular RNA (circRNA)-microRNA (miRNA)-messenger RNA (mRNA) immune regulatory network in childhood allergic asthma by analyzing microarray datasets. Methods GEO database was used to obtain the datasets of circRNA, miRNA, and mRNA from children with allergic asthma and healthy controls. The Limma package was used to identify differentially expressed circRNA (DEcircRNA), miRNA (DEmiRNA), and mRNA (DEmRNA). ENCORI and other tools were used to predict and construct the regulatory network of endogenous RNA. The DAVID database was used to perform GO and KEGG enrichment analyses, and CIBERSORT and Pearson were used to identify genes associated with immune cell infiltration. Results A total of 130 DEcircRNAs, 40 DEmiRNAs, and 802 DEmRNAs were identified between the asthma and control groups, and a regulatory network consisting of 12 circRNAs, 7 miRNAs, and 75 mRNAs was established. The GO analysis showed that the differentially expressed genes were mainly involved in the regulation of growth and development, and the KEGG analysis showed that they were mainly involved in the mTOR signaling pathway. The CIBERSORT analysis showed that compared with the control group, the asthma group had higher percentages of CD8⁺ T cells and resting NK cells and lower percentages of resting CD4⁺ memory T cells and activated mast cells. In addition, the Pearson correlation analysis identified six key mRNAs that were positively correlated with immune cell infiltration. Conclusions The ceRNA immune regulatory network constructed in this study provides a basis for research on the mechanism of childhood allergic asthma and potential therapeutic targets.