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.

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.

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.

Objective To investigate the long-term neurodevelopmental outcomes of neonates with different types of stroke. Methods Data from 41 neonates diagnosed with stroke at the Third Affiliated Hospital of Zhengzhou University between January 2017 and May 2024 were retrospectively reviewed. Stroke types included arterial ischemic stroke (AIS), hemorrhagic stroke (HS), and cerebral sinovenous thrombosis (CSVT). All infants were followed to 2 years of age. Neurodevelopmental outcomes were assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), focusing on motor and cognitive development. Outcomes were compared according to vascular involvement. Results Of the 41 neonates, 35(85%) had AIS, 5(12%) had HS, and 1(2%) had CSVT. Among the 35 AIS cases, 16(46%) involved the main trunk of the middle cerebral artery (MCA). The incidences of cerebral palsy (CP) and cognitive developmental delay were significantly higher in the MCA main trunk group than in the non-main-trunk group (P<0.05). Among the 5 HS cases, 1 involving the frontal cortical branch of the MCA died at 12 days of life. Two cases involving the temporal cortical branches had BSID-III cognitive development indices of 102 and 106, and motor development indices of 90 and 95 at 2 years. The remaining 2 cases involving the MCA main trunk developed CP. The single CSVT case involved the great cerebral vein and presented with CP and language developmental impairment. Conclusions AIS is the most common type of neonatal stroke and shows poorer outcomes by 2 years of age. Early identification and early intervention are essential in clinical practice.

Objective To systematically evaluate neurodevelopmental differences between children with congenital heart disease (CHD) and healthy controls. Methods A comprehensive search was conducted in Web of Science, PubMed, Embase, Wanfang Data, China National Knowledge Infrastructure, Chinese Biomedical Literature Service System, and VIP Database to identify studies published from database inception to February 2025 that assessed the neurodevelopment of children with CHD (CHD group) and healthy controls (control group) using the Bayley Scales of Infant Development (BSID) and the Wechsler Intelligence Scale. In total, 33 studies involving 3 316 children were included. Hedges' g was used as the effect size. Meta analysis, subgroup analysis, sensitivity analysis, and publication bias analysis were performed using STATA/SE 17.0. Results Based on BSID-II, compared with the control group, the CHD group had significantly lower mental development index (Hedges' g=-1.09) and psychomotor development index (Hedges' g=-1.22) scores (both P<0.001). Based on BSID-III, compared with the control group, the CHD group had markedly lower scores in cognition (Hedges' g=-0.78), language (Hedges' g=-0.65), and motor (Hedges' g=-0.98) (all P<0.001). The Wechsler Intelligence Scale indicated that, compared with the control group, the CHD group had significantly lower full-scale intelligence quotient (Hedges' g=-0.74), verbal intelligence quotient (Hedges' g=-0.86), and performance intelligence quotient (Hedges' g=-0.67) (all P<0.001). Conclusions Children with CHD exhibit developmental delays in cognition, language, motor function, and intelligence.

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.

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 effect of antenatal corticosteroids (ACS) on the risk of transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS) within 24 hours after birth in late preterm infants born to mothers with gestational diabetes mellitus (GDM). Methods Clinical data of mothers with GDM and their late preterm infants admitted to the Department of Obstetrics, Xiamen Maternal and Child Health Hospital, from January 2017 to December 2023 were retrospectively reviewed. Based on whether mechanical ventilation was required within 24 hours after birth, infants were classified into a mechanical ventilation group (n=322) and a control group (n=1 098), and perinatal and maternal characteristics were compared. According to the interval from the first ACS dose to delivery, infants were categorized into <2 days (n=399), 2-7 days (n=305), and >7 days (n=60) groups; according to ACS dosage, they were categorized into no ACS (n=656), incomplete course (<2 doses; n=399), and complete course (≥2 doses; n=365) groups. Associations between ACS timing/dose and TTN and RDS were analyzed. Results A total of 1 420 infants were included. Multivariable logistic regression showed that ACS administration was a protective factor against the need for mechanical ventilation within 24 hours after birth (OR=0.125, 95%CI: 0.085-0.183). A complete ACS course was associated with a more pronounced reduction in the mechanical ventilation rate (OR=0.080, 95%CI: 0.049-0.130) and a lower incidence of TTN (P<0.001), while the incidence of RDS did not differ significantly (P>0.05). An interval of >7 days from the first ACS dose to delivery had the most marked association with reduced postnatal mechanical ventilation (OR=0.127, 95%CI: 0.047-0.348). Conclusions ACS does not reduce the incidence of RDS in late preterm infants of mothers with GDM, but it effectively reduces TTN and the need for mechanical ventilation within 24 hours after birth. A complete ACS course and an interval of >7 days from the first dose to delivery provide the greatest benefit in reducing TTN and early postnatal mechanical ventilation.

Objective To establish a predictive model for severe Mycoplasma pneumoniae pneumonia (SMPP) in children younger than 5 years. Methods Clinical data of 504 children younger than 5 years with Mycoplasma pneumoniae pneumonia admitted to Xiaogan Hospital of Wuhan University of Science and Technology from January to December 2023 were retrospectively analyzed. Based on discharge diagnosis, patients were classified into a non-SMPP group (n=345) and an SMPP group (n=159). Univariate analysis and LASSO regression were used to screen predictors of SMPP. The selected variables were then entered into a multivariable logistic regression to construct the prediction model, and its performance was evaluated. Results Multivariable logistic regression identified lung imaging findings (proportion with consolidation), duration of fever, high-sensitivity C-reactive protein, lactate dehydrogenase, creatine kinase, and lymphocyte-to-neutrophil ratio as predictors of SMPP (P<0.05). The model based on these six indicators achieved an area under the receiver operating characteristic curve of 0.862 (95%CI: 0.824-0.900), with a sensitivity of 85.8% and a specificity of 77.4%. The calibration curve was close to the ideal curve, and Spiegelhalter's Z test indicated good calibration (P=0.313). Decision curve analysis showed a net benefit across a threshold probability range of 0.75%-100%, indicating high clinical applicability. Conclusions The predictive model based on lung imaging findings (proportion with consolidation), duration of fever, high-sensitivity C-reactive protein, lactate dehydrogenase, creatine kinase, and lymphocyte-to-neutrophil ratio shows good performance for predicting SMPP in children younger than 5 years.

Objective To investigate risk factors for pediatric intensive care unit (PICU) admission among children with acute lymphoblastic leukemia (ALL) and risk factors for receipt of life-sustaining therapy (LST) in the PICU. Methods Clinical data of ALL patients treated at the Children's Medical Center of the Second Xiangya Hospital from June 2016 to June 2021 were retrospectively reviewed. Patients were categorized into PICU and non-PICU groups according to PICU admission. Multivariable logistic regression was applied to identify risk factors for PICU admission. The cumulative probability of PICU admission was estimated using Kaplan-Meier curves. PICU patients were further stratified into LST and non-LST groups according to whether LST was received, and multivariable logistic regression was used to identify risk factors for receiving LST. Results A total of 200 children with ALL were included; 42 (21.0%) were admitted to the PICU at least once, with 48 total admissions. Multivariable logistic regression analysis showed that hyperleukocytosis at diagnosis and lactate dehydrogenase (LDH) >500 U/L were independent risk factors for PICU admission (both P<0.05). Kaplan-Meier curves demonstrated that T-cell ALL and hyperleukocytosis were associated with higher cumulative PICU admission rates. Univariate analysis showed that C-reactive protein, albumin, and respiratory failure were significantly associated with the receipt of LST (all P<0.05). Further multivariable logistic regression analysis revealed that respiratory failure was significantly associated with an increased risk of receiving LST (OR=13.254, P=0.027). Conclusions Children with ALL who have hyperleukocytosis at diagnosis and LDH >500 U/L have a higher risk of PICU admission; respiratory failure is an independent risk factor for receipt of LST among PICU-admitted ALL patients.

Objective To study the clinical characteristics of DUX4-IGH fusion B-cell acute lymphoblastic leukemia (B-ALL) in children in order to inform the diagnosis and treatment of this subtype. Methods Clinical data of children with DUX4-IGH fusion B-ALL treated at Women and Children's Medical Center, Guangzhou Medical University from September 2020 to April 2024 were collected. DUX4-IGH fusion was identified by transcriptome sequencing, and clinical features, laboratory findings, and treatment outcomes were retrospectively analyzed. Results Among 315 children with B-ALL, 17 DUX4-IGH fusion cases were detected by transcriptome sequencing, accounting for 5.4%. The median age was 5.5 years (range: 2 years and 10 months to 12 years). Chromosome karyotypes were mostly normal. Based on age, white blood cell count, and central nervous system involvement, 15 patients (88.2%) were classified as low risk at initial diagnosis. After evaluation of treatment response, 7 patients were low risk and 10 were intermediate risk. The median follow-up was 38 months (range: 34 to 43 months), and the longest follow-up was 55 months. Minimal residual disease remained persistently negative in all 17 patients, and all patients remained event-free during follow-up. Conclusions DUX4-IGH fusion is relatively common in pediatric B-ALL. Transcriptome sequencing enables sensitive detection of this fusion, aiding precise subtyping and prognostic assessment. Early induction response is suboptimal, but the overall prognosis is favorable.

Objective To explore the clinical characteristics and prognostic factors of pediatric acute myeloid leukemia (AML) with monosomy 7 (-7) and deletion of the long arm of chromosome 7 (7q-). Methods A retrospective study was conducted on the clinical data, treatment, and prognosis of children with -7/7q- AML who were admitted to the Department of Pediatrics at Peking University People's Hospital from January 2010 to December 2024. Results A total of 869 children with AML who had complete karyotype data were included, of whom 32 (3.7%) had -7/7q- chromosomal abnormalities. There were 20 males and 12 females, and the median age at diagnosis was 6 years. Six children (19%) had isolated -7; 2 (6%) had isolated 7q-; and 24 (75%) had additional chromosomal abnormalities. After induction chemotherapy, complete remission (CR) was achieved in 16 children (50%). At the last follow-up, 15 children (47%) had died and 17 (53%) were alive. The 3-year disease-free survival (DFS) rate was (54.1±0.1)%, and the 3-year overall survival (OS) rate was (52.6±0.1)%. The multivariable analysis showed that hematopoietic stem cell transplantation (HSCT) was an independent prognostic factor for DFS (HR=0.17, 95%CI: 0.04-0.62, P=0.008) and OS (HR=0.16, 95%CI: 0.04-0.59, P=0.006), with better outcomes in children who underwent HSCT. Conclusions The incidence of -7/7q- chromosomal abnormalities in children with AML is 3.7%. Additional chromosomal aberrations are common, and the CR rate after induction chemotherapy is low. HSCT is associated with improved prognosis and survival.

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.

Objective To investigate whether miR-100-5p regulates the proliferation and apoptosis of acute myeloid leukemia (AML) cells by targeting Tribbles pseudokinase 1 (TRIB1). Methods Peripheral blood was collected from 16 healthy children (control group) and 16 children with AML (AML group). HL-60 cells were divided into seven groups: blank, mimic negative control (mimic NC), miR-100-5p mimic, small interfering RNA negative control (si-NC), si-TRIB1, miR-100-5p mimic + TRIB1 overexpression plasmid negative control (OE-NC), and miR-100-5p mimic + TRIB1 overexpression plasmid (OE-TRIB1). The expression of miR-100-5p and TRIB1 mRNA in peripheral blood and HL-60 cells was detected by quantitative real-time PCR. Cell proliferation was assessed by 5-ethynyl-2'-deoxyuridine (EdU) staining and the cell counting kit-8 (CCK-8) assay (OD₄₅₀). Apoptosis was analyzed by flow cytometry. Protein levels of TRIB1, proliferating cell nuclear antigen (PCNA), p53, programmed cell death protein 1 (PD-1), and programmed death-ligand 1 (PD-L1) were determined by Western blot. The targeting relationship between miR-100-5p and TRIB1 was validated by a dual-luciferase reporter assay. Results Compared with the control group, miR-100-5p expression was decreased and TRIB1 mRNA expression was increased in the peripheral blood of the AML group (P<0.05). Compared with the blank and mimic NC groups, the miR-100-5p mimic group showed higher miR-100-5p expression, apoptosis rate, and p53 protein, and lower TRIB1 mRNA expression, EdU-positive rate, OD₄₅₀ value, and TRIB1, PCNA, PD-1, and PD-L1 proteins (P<0.05). Compared with the blank and si-NC groups, the si-TRIB1 group exhibited reduced TRIB1 mRNA expression, EdU-positive rate, OD₄₅₀ value, and TRIB1, PCNA, PD-1, and PD-L1 proteins, together with increased apoptosis rate and p53 protein (P<0.05). Compared with the miR-100-5p mimic and miR-100-5p mimic + OE-NC groups, the miR-100-5p mimic + OE-TRIB1 group had elevated TRIB1 mRNA expression, EdU-positive rate, OD₄₅₀ value, and TRIB1, PCNA, PD-1, and PD-L1 proteins, and reduced apoptosis rate and p53 protein (P<0.05). Compared with the TRIB1-WT + mimic NC group, luciferase activity was decreased in the TRIB1-WT + miR-100-5p mimic group (P<0.05). Conclusions Overexpression of miR-100-5p inhibits proliferation and induces apoptosis of HL-60 cells by downregulating TRIB1.

A 26-day-old male infant presented with recurrent convulsions from 18 days of life. Laboratory investigations revealed severe hypomagnesemia (0.07 mmol/L) and hypocalcemia (1.65 mmol/L). Whole-exome sequencing was performed and identified compound heterozygous pathogenic variants in the TRPM6 gene, comprising c.5616G>A (p.Trp1872Ter) and a deletion of exons 20-23. The c.5616G>A variant was inherited from the father, and the exon 20-23 deletion was inherited from the mother; neither variant has been previously reported. Based on these findings, the diagnosis of primary hypomagnesemia with secondary hypocalcemia was confirmed. Oral magnesium sulfate supplementation was initiated, and no further convulsions occurred. At the 8-year follow-up, the patient exhibited persistent hypomagnesemia without other abnormalities. This case highlights that genetic testing helps confirm the diagnosis, and early magnesium supplementation effectively controls symptoms and prevents irreversible neurological impairment.

A 16-day-old male infant was hospitalized because of recurrent fever with rash for 14 days, unresponsive to anti-infective therapy. Clinical features included persistently elevated inflammatory markers, multisystem involvement (skin, nervous system, and heart), and facial dysmorphism (frontal bossing and saddle nose). Genetic testing revealed a de novo heterozygous, likely pathogenic NLRP3 variant (c.2269G>A, p.Gly757Arg). In combination with clinical findings, neonatal-onset multisystem inflammatory disease (NOMID) was diagnosed. Prenatal ultrasonography showed absence of the ductus venosus and bilateral ventriculomegaly, expanding the prenatal sonographic phenotype of NOMID. This case suggests that in neonates with unexplained fever, rash, poor response to anti-infective treatment, and facial dysmorphism, the presence of prenatal ultrasound abnormalities such as absent ductus venosus or ventriculomegaly should raise clinical suspicion for NOMID, and early genetic testing is recommended to confirm the diagnosis and guide intervention. Citation:Chinese Journal of Contemporary Pediatrics, 2026, 28(1): 111-114

Patient 1, a 4-year-old boy, presented with delayed language development. Persistently elevated free triiodothyronine (FT3) and free thyroxine (FT4) were found, with normal or elevated thyroid-stimulating hormone (TSH). A de novo heterozygous mutation in the THRB gene (c.1373T>C, p.Val458Ala) was identified, and resistance to thyroid hormone syndrome (RTH) was diagnosed. No specific medication was administered, and regular follow-up was arranged. Patient 2, a 2-year-old boy, had elevated TSH detected on neonatal screening. Thyroid dysfunction persisted for 1 year and 10 months and was accompanied by growth delay and tachycardia. Genetic testing revealed a de novo heterozygous mutation in the THRB gene (c.959G>A, p.Arg320His), and pituitary-type RTH was diagnosed. Propranolol was administered for heart rate control. RTH shows marked clinical heterogeneity and is prone to misdiagnosis or missed diagnosis. For children with unexplained thyroid dysfunction and developmental disorders, early THRB gene testing helps achieve precise diagnosis and guide treatment decisions.

Streptococcal toxic shock syndrome in children is a severe complication of group A Streptococcus infection, characterized by acute shock and multiple organ dysfunction. It is a critical illness with high mortality, and early diagnosis and treatment are key to improving prognosis. Children with this syndrome have a higher risk of death, and the pathogenesis is complex. This review summarizes the pathogenesis and recent advances in the diagnosis and treatment of streptococcal toxic shock syndrome caused by group A Streptococcus infection in children, aiming to improve clinical outcomes and reduce mortality.

Exercise-induced hyperinsulinism, also known as monocarboxylate transporter 1 hyperinsulinemia, is a rare subtype of congenital hyperinsulinism caused by gain-of-function variants in the SLC16A1 gene, which encodes monocarboxylate transporter 1. Fewer than 20 cases have been reported in the literature. In this review, the genetic pathogenesis, current diagnosis, and treatment of exercise-induced hyperinsulinism are systematically reviewed to improve clinicians' understanding of the disease.