Conservative therapy is the primary choice for mild-to-moderate adolescent idiopathic scoliosis (AIS), and its multidimensional attributes are critical clinical characteristics. Effectively assessing these dimensions, tailoring treatment strategies, and evaluating their effectiveness are essential aspects of clinical practice in conservative therapy. However, discrepancies often exist between imaging-based outcomes and patient-reported concerns, and the frequent use of imaging is limited by radiation exposure. Consequently, some evaluation tools, particularly those based on patient-reported outcomes, have gradually become important clinical references. This study aims to explore the multidimensional evaluation indicators and tools associated with conservative therapy for AIS, to guide the selection of appropriate evaluation methods in clinical practice. Relevant literature was systematically retrieved and reviewed to categorize and summarize the multidimensional evaluation tools used in conservative therapy, clarifying their applicability and limitations. Five main dimensions and their corresponding evaluation tools were identified, including physical appearance assessment, quality of life assessment, negative emotions assessment, pulmonary function and exercise tolerance assessment, and joint laxity assessment. Multidimensional evaluation methods have increasingly become critical references in conservative treatment for AIS, particularly tools based on patient-reported outcomes, which provide guidance for individualized interventions. Future efforts should focus on optimizing or developing evaluation tools tailored to the characteristics of Chinese adolescents to improve the effectiveness of conservative therapy.

Research shows that China's primary and secondary school students scoliosis rate of 4.40%, the high incidence of age 13-15 years old, 79.5% of students with mild scoliosis, the number of incidence and the degree of scoliosis with the time of the annual trend, prevention and control of the situation is grim.

To investigate the efficacy of 3-times-weekly proprioceptive neuromuscular facilitation (PNF) technique combined with spiral stabilizing muscle chain training (SPS) on adolescent idiopathic scoliosis (AIS), which can promote the high quality of adolescent spinal health management work and provide a reference to achieve multifaceted screening and monitoring and precise scoliosis prevention and control.

The experiment was designed to screen 1 060 primary and middle school students in Nanjing from January to March 2024. A total of 32 AIS students aged 10 to 18 years with an angle of trunk rotation (ATR) of 5°to <10° were finally included as study subjects, and the students were randomly and equally grouped into the SPS, PNF, combined, and control groups of 8 students each based on electronic spinal measurements selected from previous subjects and surface electromyography measurements in Sorensen test. The 4 groups of students underwent a period of 12-week exercise intervention with 3 training sessions per week: the SPS group used only SPS, the PNF group used only PNF, the combined group used SPS combined with PNF, and the control group used traditional core stabilization training. The primary outcome measures will include the degree of scoliosis and the angle of trunk inclination angle (ATI), and the secondary outcome measures will include the body balance parameters of head deflection, shoulder height, hip height, and the surface electromyographic indices of root mean square (RMS), integrated electromyography (IEMG), median frequency (MF), and mean power frequency (MPF). Spine morphology and surface EMG indexes before and after the intervention were compared among the four groups, and correlation analysis was used to explore the correlation between electronic spine measurements and surface EMG values before and after the exercise intervention.

The results showed that Comparison of baseline age, BMI, type of column scoliosis, direction of scoliosis, site of scoliosis, degree of scoliosis, ATI, head deflection, shoulder height, hip height among the students in the 4 groups showed no statistically significant differences (P>0.05). The degree of scoliosis, ATI, head deflection, shoulder height of students in the combined group were lower than those in the control group after the intervention (P<0.05) ; compared with the pre-intervention period, the degree of scoliosis, ATI, head deflection, shoulder height, and hip height of the students in the SPS group, the PNF group, and the combined group were all lower after the intervention (P<0.05). The results of correlation analysis showed that ATI and RMS ratio (RMSR) before and after the intervention were positively correlated with the degree of scoliosis before and after the intervention (P<0.05) ; ATI after the intervention was positively correlated with head deflection, shoulder height after the intervention (P<0.05) ; and RMSR after the intervention was positively correlated with head deflection and hip height after the intervention (P<0.05). The RMS and IEMG of the trapezius muscle on both sides were higher than those of the PNF group and those of the multifidus muscle on both sides were higher than those of the control group in the combined group after the intervention (P<0.05) ; compared with the pre-intervention period, the RMS and IEMG of the trapezius, erector spinae, and multifidus muscles on both sides were higher after the intervention in the students of the SPS group, the PNF group, and the combined group, and the overall RMSR was lower after the intervention (P<0.05). Compared with pre-intervention, SlopeMF was elevated in both trapezius, erector spinae, and multifidus muscles in the SPS group and combined group of students after intervention; and in both trapezius, erector spinae, and left multifidus muscles in the PNF group of students after intervention (P<0.05). Compared with the pre-intervention period, SlopeMPF of the trapezius, erector spinae, and left multifidus muscles on both sides were elevated after intervention for students in the SPS, PNF, and combined groups; SlopeMPF of the right multifidus muscle was elevated after intervention for students in the SPS and combined groups (P<0.05). Shoulder height after intervention was negatively correlated with the RMS of both trapezius and right multifidus muscles, the SlopeMPF of left erector spinae muscle, and the SlopeMF of right multifidus muscle (P<0.05) ; hip height was negatively correlated with the RMS of both trapezius and both multifidus muscles (P<0.05) .

Our findings suggest that ATI, body balance, and surface EMG values improved significantly in all test groups (SPS, PNF, and combined groups) after treatment, with the combined group showing a particularly strong treatment effect in shoulder and hip balance, and fatigue resistance of the paravertebral muscles on both sides of the joint group after treatment. The PNF combined with the SPS intervention can benefit AIS students through the activation of more muscle fibers for exercise and improved muscle fatigue.

Chronic cough is a common disease of pediatric consultations, and the etiology of chronic cough in children varies in different regions. Lanzhou is located in the inland northwest of China, with a dry climate, more dusty weather, and higher pollen concentrations in the fall, but there is a lack of research on the etiology of chronic cough in children.

To investigate the etiological composition of chronic cough and the major etiological changes in children in Lanzhou from 2014 to 2023.

We retrospectively analyzed the clinical data of 944 children with chronic cough treated in outpatient and inpatient clinics of Gansu Provincial Maternal and Child-care Hospital (Gansu Provincial Central Hospital) from 2014 to 2023. And explored the etiology of chronic cough in children and its relationship with gender, age, season, and year.

The etiological distribution of chronic cough in children from 2014 to 2023 was listed as follows. There were 314 cases (33.26%) of cough variant asthma (CVA), 259 cases (27.44%) of upper airway cough syndrome (UACS), 221 cases (23.41%) of post-infectious cough (PIC), 34 cases (3.60%) of protracted bacterial bronchitis (PBB), 9 cases (0.95%) of gastroesophageal reflux cough (GERC), and other etiologies of cough in 107 cases (11.34%). Among 107 children with cough of other etiologies, 80 children with multiple etiologies (8.47% of total cases) and 30.00% (24/80) of children with multiple etiologies had UACS combined with PIC. There was no statistical significance in the etiological distribution of chronic cough in children of different genders (χ²=0.894, P=0.971). The etiological distribution of chronic cough in children of different ages and seasons was statistically significant (χ²=361.544, P<0.001; χ²=31.793, P=0.007). Trend χ² test showed that CVA gradually decreased with the increase of years (χ²=43.252, P<0.001), UACS gradually increased (χ²=30.431, P<0.001) .

CVA, UACS, and PIC were the leading causes of chronic cough in children in Lanzhou from 2014 to 2023. Among the multiple etiologies, UACS combined with PIC is the first cause. Age and season affected the composition of chronic cough in children in this region. As the years changed, CVA gradually decreased and UACS showed a significant increasing trend.

Myopia is a refractive error, and in recent years, the prevalence of myopia among children and adolescents has remained high and has shown a tendency to be at a younger age, posing a great threat to the physical and mental health of children and adolescents. Currently, there are few systematic studies on myopia and risk factors in children and adolescents.

To explore the prevalence and influencing factors of myopia among children and adolescents in China using Meta-analysis.

A combination of Mesh subject terms and free terms was used to search for information on the prevalence of myopia in the databases of Web of Science, PubMed, Cochrane Library, China Knowledge Network (CNKI), Wanfang Data, VIP, and China Biomedical Literature Service System (SinoMed). Databases were searched for studies on the prevalence and influencing factors of myopia up to November 2024. The inclusion of studies was determined by consultation after independent screening by 2 investigators, and the studies were assessed for literature quality using the Agency for Healthcare Research and Quality (AHRQ) evaluation criteria, and Meta-analysis was performed using Stata 18.0 software.

A total of 33 papers were included, with 768 813 cases of myopia. Meta-analysis showed that the prevalence of myopia among children and adolescents in China was 58% (95%CI=54%-62%), with the prevalence of myopia among females (OR=1.41, 95%CI=1.21-1.64), high school (OR=3.59, 95%CI=1.17-10.97), and senior grades (OR=1.53, 95%CI=1.33-1.77), urban (OR=2.12, 95%CI=1.29-3.48), one or both parents myopic (OR=1.88, 95%CI=1.78-1.99; OR=2.45, 95%CI=1.97-3.06), overweight or obese (OR=1.74, 95%CI=1.63-1.85), and incorrect reading and writing posture (OR=1.35, 95%CI=1.14-1.60), reading books or electronic screens while lying down or lying on their stomachs (OR=1.17, 95%CI=1.03-1.33), terminal video screen use >2 h per day (OR=1.29, 95%CI=1.15-1.44), and of outdoor activity <2 h per day (OR=1.41, 95%CI=1.10-1.80), average daily sleep time ≤8 h (OR=1.71, 95%CI=1.28-2.30), and attending cultural tutorial classes for ≥2 h in the past week (OR=1.27, 95%CI=1.12-1.42) were the risk factors for myopia in children and adolescents (P<0.05) ; doing eye exercises (OR=0.79, 95%CI=0.64-0.98), preferring vegetables and fruits (OR=0.84, 95%CI=0.76-0.92), and having outdoor activities during recess (OR=0.75, 95%CI=0.74-0.77) were protective factors for myopia in children and adolescents (P<0.05) .

The prevalence of myopia among children and adolescents in China is high, and females, high school, urban, family history of myopia, obesity, eye habits and conditions, sleep time, and insufficient outdoor activities are the main risk factors for myopia among children and adolescents, which should be improved to increase the attention to myopia among children and adolescents, and to provide early identification of myopia and intervention for children and adolescents, so as to reduce the prevalence of myopia and improve the quality of life of children with myopia.

Children, as a special group, have received public attention. Although a series of policies have been released in recent years to ensure the safety of children's medication, there are still problems such as fewer suitable varieties of drugs and irrational use of medication, which require scientific and reasonable policies on children's medication to promote their development.

To quantitatively evaluate China's pediatric drug policy texts and provide reference for the formulation and improvement of future pediatric drug policies.

Based on the text mining method, 23 pediatric drug policy documents issued at the national level from 2014 to 2023 were processed, the policy modeling consistency (PMC) index model of pediatric drug policy was constructed, and the quantitative evaluation and analysis of China's 23 pediatric drug policies were carried out through 10 primary variables and 41 secondary variables.

The mean value of PMC index of the 23 policies on pediatric drug was 5.65, and the mean value of PMC depression index was 4.35, including 1 excellent-grade policy, 17 good-grade policies and 5 qualified-grade policies, and there were no perfect-grade policies and bad policies. 23 medication policies for children scored high on policy tools and policy receptors and low on publishing organizations and policy timeliness.

China's pediatric drug policy is generally at a good level, and can be further improved in terms of policy timeliness, issuing organization and policy content.

The incidence of precocious puberty (PP) in Chinese children is increasing year by year, precocious children are more likely to have physical and mental health problems than normal children, and their growth can be affected. In view of the current clinical lack of understanding and prevention measures for PP, it's of great significance to clarify the relevant influencing factors and provide references for the prevention and treatment of PP.

To systematically evaluate the factors associated with PP in Chinese children.

We searched PubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI, VIP and Wanfang databases, the search period was from the establishment of the database to April 30, 2024. Two researchers independently screened the literature, extracted data and assessed the quality of the included literature, and we performed Meta-analysis using Stata 15.0 software.

A total of 41 studies covering 44 221 cases were selected, and 31 influencing factors were extracted. Methodological quality evaluation of the literature shows that 20 medium-quality and 21 high-quality studies were included. Meta-analysis demonstrated that: female (OR=1.64) , urban settlement (OR=4.13) , residential near chemical industry park (OR=2.52) , maternal age at menarche≤12 years old (OR=2.37) , >12-14 years old (OR=3.04) , low parental education (OR=2.41) , poor parental relationship (OR=4.37) , parental companionship <0.5 years (OR=2.05) , screen time (OR=3.07) , love romantic films and novels (OR=5.94) , outdoor activity<1 h/d (OR=3.86) , sleep with the light on (OR=2.48) , use of adult chemical products (OR=5.36) , plastic products are often used at home (OR=2.45) , heavy school workload (OR=2.63) , family history of PP (OR=3.23) , high BMI (OR=1.57) , sleep duration (OR=2.57) , frequent consumption of nutritional supplements (OR=3.01) , high-calorie and high-fat diets (OR=3.05) , high protein diets (OR=2.47) , animal food (OR=3.35) , sweets (OR=5.85) , food containing pigments or preservatives (OR=1.80) , leptin (OR=5.34) , estradiol (OR=3.32) , luteinizing hormone (OR=3.71) , insulin-like growth factor 1 (OR=2.70) and follicle stimulating hormone (OR=2.40) levels were the main risk factors for PP in Chinese children (P<0.05) , whereas maternal age at menarche >14 years (OR=0.64) , outdoor activity ≥2 h/d (OR=0.73) and consumption of vegetables and fruits ≥200 g/d (OR=0.60) were protective factors (P<0.05) .

Our findings show that the occurrence of PP in Chinese children is influenced by a multitude of sociodemographic, psychosocial, genetic, physiological, dietary, and environmental factors, among which the later age of mother´s menarche, the longer outdoor activities and the consumption of vegetables and fruits ≥200 g/d are protective factors. In the future, it is necessary to investigate and intervene on controllable factors. Families, schools and hospitals can work together to avoid or reduce the occurrence of PP in children.

With adva nces in medical technology, more than 90 percent of children with chronic diseases need to be transitioned from pediatric to adult care, and the greater number of chronic diseases a child has, the higher risk of morbidity and mortality. However, until now, research in China focused mainly on multiple chronic diseases in adults, and there are no systematic and comprehensive interventions for the transition of children with multiple chronic diseases.

To form healthcare transition intervention models for multiple chronic diseases in children based on the E-Coach management model.

In April 2024, a systematic search was conducted for domestic and international literature on the medical transition of children with multiple chronic diseases. Two researchers independently screened the literature, evaluated the methodological quality of the included literature, extracted and summarized the evidence, and initially formed an intervention model for the medical transition of children with multiple chronic diseases based on the E-Coach management model after discussion in the research group. From May to June 2024, two rounds of correspondence were conducted with experts using the expert correspondence method, and the medical transition intervention model was finalized by calculating the coefficient of expert positivity, the coefficient of expert authority, the coefficient of expert coordination, and the coefficient of variation for each level of entries.

A total of 1 734 documents were searched, and 11 documents were finally included, summarizing 36 pieces of evidence involving four aspects: intervention goals, intervention forms, intervention targets, and intervention measures. The E-Coach management model-based multiple chronic disease medical transition intervention model for children, which was initially constructed after discussion by the research group, contains 4 primary indicators, 13 secondary indicators, and 21 tertiary indicators. The recovery rates of the two rounds of expert questionnaires were 100.0%, the expert authority coefficients were 0.813 and 0.830, the Kendall's W coefficients of the importance of the indicators were 0.270 (χ²=149.866, P<0.001) and 0.321 (χ²=154.058, P<0.001), and the Kendall's W coefficients of the feasibility of the indicators were 0.266 (χ²=147.396, P<0.001), 0.362 (χ²=173.605, P<0.001), respectively. The finalized medical transition intervention model for children with multiple chronic diseases based on the E-Coach management model included four primary indicators (intervention target, intervention team, intervention form, and intervention measures), 10 secondary indicators, and 19 tertiary indicators.

The medical transition intervention model for children with multiple chronic diseases based on the E-Coach management model has strong reliability and operability, and can provide guidance for clinical healthcare professionals to carry out medical transition interventions for children with multiple chronic diseases.

Currently, the number of obese adolescents in China is increasing dramatically, and adolescent obesity is not only closely related to metabolic diseases, but also a risk factor for coronary heart disease mortality in adulthood. Lipid metabolic flexibility is regarded as an important indicator of the metabolic health of an organism. Studies confirm that cardiorespiratory fitness is associated with lipid metabolic flexibility, but are lacking in obese adolescents with different metabolic phenotypes.

To investigate the association of cardiorespiratory fitness with lipid metabolic flexibility in metabolically unhealthy obesity (MUO) adolescents and metabolically healthy obesity (MHO) adolescents.

Ninety-one obese adolescents were selected to participate in the Shenzhen Weight Loss Camp (2022-2023), and were divided into 35 in the MUO group and 56 in the MHO group in accordance with the "Expert Consensus on the Definition and Screening of Metabolically Healthy Obesity in Chinese Children". The gas metabolism data from the resting metabolic test, incremental load treadmill test and heart rate data were collected using a gas metabolism analyzer and a heart rate meter; the maximum oxygen uptake (VO_2max) was estimated based on the heart rate-oxygen uptake relationship; and the third-order polynomial fitting curve was used to obtain the maximal fat oxidation rate (MFO) or the corresponding maximal fat oxidation intensity (FAT_max) to reflect the flexibility of lipid metabolism. The linear regression analysis was used to explore the correlation between VO_2max and MFO and FAT_max.

The overall MFO and FAT_max of the two groups were (5.54±1.37) mg·min^-1·kg^-1 and (4.19±0.87) MET. The BMI, systolic blood pressure, diastolic blood pressure, and triacylglycerol levels in the MUO group were higher than those in the MHO group, and the level of high-density lipoprotein cholesterol was lower than that in the MHO group (P<0.05). Before adjustment, the MFO in the MUO group was lower than that in the MHO group (P<0.05) ; after adjustment for VO_2max, the difference in MFO between the two groups of obese adolescents was not statistically significant (P>0.05) ; before adjustment and after adjusting VO_2max, there was no statistically significant difference between the two groups of obese adolescents when comparing FAT_max (P>0.05). VO_2max was positively correlated with MFO in obese adolescents in the overall (B=0.077, 95%CI=0.011-0.144, P=0.023) and MHO groups (B=0.105, 95%CI=0.027-0.182, P=0.009) ; VO_2max was positively correlated with FAT_max in obese adolescents in the MHO group (B=0.057, 95%CI=0.003-0.111, P=0.041) ; VO_2max was not linearly related to MFO and FAT_max in obese adolescents in the MUO group (P>0.05) .

MUO adolescents have lower MFO than MHO adolescents; during running exercise, obese adolescents with different metabolic phenotypes could reach MFO at (4.19±0.87) MET intensity. Cardiorespiratory fitness is a key factor influencing lipid metabolic flexibility in MHO adolescents, and MUO adolescents may need to be transformed into MHO adolescents to promote lipid metabolic flexibility.

Pneumonia in children poses a serious disease burden globally, and pneumococcal conjugate vaccination is the most direct and effective preventive measure against pneumococcal disease, while there is a lack of information on the coverage of 13-valent pneumococcal conjugate vaccine (PCV13) in children.

To analyze the vaccination rate of PCV13 in children born from 2017 to 2022 in Jiangsu Province, find the difference and reasons under different circumstances, and provide reference on improvement of PCV13 vaccination rate for future.

Through the Jiangsu provincial vaccination management information system, the basic information and vaccination information of PCV13 (as of 2023-12-31) were collected, including the date of birth, gender, household registration attributes, date of vaccination, and the number of doses of vaccination and other basic information, and the data were descriptive analyzed.

There were 4 537 123 children registered in the Jiangsu provincial vaccination management information system from 2017 to 2022, of which 784 220 children were vaccinated with 2 406 974 doses of PCV13, with a vaccination rate of 17.28%. In Jiangsu Province, there were 697 698 children given the first dose of vaccination, of which 82 503 (11.83%) were given the first dose at <2 months of age, 511 273 (73.28%) at 2-6 months of age, 26 106 (3.74%) at 7-11 months of age, 38 530 (5.52%) at 12-24 months of age, and 39 286 (5.63%) at 2-5 years of age. The rate of 1, 2, 3, and 4 doses of vaccination was higher among resident children (16.11%, 14.71%, 13.43%, and 11.50%) than among migrant children (13.87%, 12.70%, 11.42%, and 9.52%) (P<0.05). In terms of regional distribution, the vaccination rate of each dose was in the order of South Jiangsu, Central Jiangsu and North Jiangsu from high to low, and the difference was statistically significant (P<0.05). In terms of gender, there was no statistically significant difference in the rates of the first dose and the second doses of vaccination between boys and girls (P>0.05) ; but the rates of the 3rd and 4th doses of vaccination were lower in boys than in girls (P<0.05). Among children born in 2017-2022, the rate of 1, 2, 3, and 4 doses of vaccination increased with the year of birth (P<0.05). The proportion of children aged 2-6 months who received the first dose of PCV13 was the highest among children of different household registration, gender, year of birth and region, and significant differences were also observed in the ages at the first vaccination of the children from various household registration, of both genders, with various regions, and in various years of birth (P<0.05) .

The vaccination rate of PCV13 among children in Jiangsu Province is 17.28%, which is at a relatively low level. The age of the first dose of vaccination is the highest in the age of 2-6 months, and the vaccination rate of each dose increases with the year of birth, so in order to improve the coverage level of PCV13 in the target population, it is recommended that PCV13 be included in the National Immunization Program.

In 2022, the United States Preventive Services Task Force (USPSTF) published a recommendation statement on Screening for Depression and Suicide Risk in Children and Adolescents: US Preventive Services Task Force Recommendation Statement in JAMA with an updated evidence report and results of a systematic evaluation (USPSTF statement). The statement suggested screening for major depressive disorder in adolescents aged 12 to 18 years. However, the evidence regarding the risks and benefits of suicide screening for children and adolescents is insufficient, making it challenging to determine its overall impact. This article interprets the content of the USPSTF statement in the context of the national and international literature, including the concepts of major depressive disorder and suicidal behaviours, risk factors, early screening tools, pros and cons of early screening, treatment and interventions, and the value of the USPSTF statement in guiding primary care providers. Intending to serve as a reference for clinical healthcare professionals involved in the screening of children and adolescents for depression and suicide risk.

Childhood trauma is a risk factor for suicidal ideation in patients with depressive disorder, and plasma vitamin D level is also related to suicidal ideation. However, there is still insufficient research on the relationship between them in adolescent patients with depressive disorder.

To explore the relationship between suicidal ideation and childhood trauma and to analyze the mediating role of depressive symptom severity and low vitamin D levels.

Adolescent patients with depressive disorder who attended Chaohu Hospital of Anhui Medical University and the Fourth People's Hospital of Hefei City in 2021 were used as the depressive disorder group (n=168), and adolescents with no history of mental illness recruited during the same period were used as the control group (n=89). Childhood trauma, depressive symptoms, and suicidal ideation were assessed using the Childhood Abuse Questionnaire (CTQ), the Current Evaluation of Depression Scale (CES-D), and the Suicidal Ideation Scale (PANSI), and plasma 25-hydroxyvitamin D[25 (OH) D] levels were also tested. Differences between adolescents with depressive disorders and control adolescents in suicidal ideation, depressive symptoms, childhood trauma, and vitamin D levels were compared; Pearson correlation analyses were used to test the correlation of scores on each scale, and the mediating roles of depression and vitamin D levels between childhood trauma and suicidal ideation were analyzed by the PROCESS macro program.

Adolescents in the depressive disorder group had higher PANSI scores, CTQ subscale scores, and total scores than those in the control group (P<0.05), and lower 25 (OH) D levels than those in the control group (P<0.5). Pearson correlation analyses showed that there were correlations between the PANSI scores and the CTQ total scores, the CES-D scores, and the 25 (OH) D levels of adolescents in the depressive disorder group (P< 0.05), and the PANSI scores of adolescents in the control group were correlated with total CTQ scores, CES-D scores (P<0.05), and no correlation with 25 (OH) D levels (P>0.05). The mediation benefit analysis showed that the CES-D score and 25 (OH) D level in the adolescent group with depressive disorder played a partial mediating role between the CTQ total score and PANSI score, with mediation effects accounting for 61.8% and 5.3%, respectively; and a partial mediating role between the CTQ affective abuse subscale score and PANSI score, with mediation effects accounting for 58.9% and 6.5%; a partial mediating role between CTQ emotional neglect subscale scores and PANSI scores, with mediating effect percentages of 67.2% and 5.6%, respectively; and a full mediating role between CTQ somatic neglect subscale scores and PANSI scores, with mediating effect percentages of 92.2% and 7.8%. None of the mediating effects of 25 (OH) D levels were significant for control adolescents; CES-D scores played a fully mediating role between CTQ total scores and PANSI scores, and between CTQ emotional maltreatment subscale scores and PANSI scores; and a partially mediating role between CTQ emotional maltreatment subscale scores and PANSI scores, with a direct effect percentage of 41.5% and a mediating effect accounted for 58.5%; the mediating effect between CTQ somatic neglect subscale scores and PANSI scores was not significant.

The severity of depressive symptoms and low vitamin D levels in patients with adolescent depressive disorder are potential mechanisms of childhood trauma leading to suicidal ideation. In view of the disorder of childhood trauma of adolescent depression in clinical should be timely and effective control and improvement of patient, improve their vitamin D levels and actively carry out mental health education, in order to reduce the occurrence of suicidal ideation, improve clinical outcomes.

The majority of caregivers of left-behind children in rural China are their mothers and grandmothers. The mental health of children's caregivers is one of the significant factors affecting the early development of children. Currently, there is a lack of research and comparison on the factors influencing depression among mothers and grandmothers of left-behind children in rural China.

To investigate the determinants of depression among female caregivers of left-behind children in rural China.

Data were collected from the baseline survey of the Home Visit Intervention Evaluation Segment of the Health and Development Promotion Program for Left-behind Children, conducted by UNICEF from April to July in 2018. The villages were selected through multi-stage stratified sampling. 1 or 2 towns were chosen as program towns in each of the 5 impoverished counties in 5 provinces. Villages in program towns were stratified by number of under-3-year-old children except Pingshan, where all villages from the program town were included. Three villages were randomly selected in each stratum as intervention villages, matched with control villages of similar number of under-3-year-old children, socioeconomic status and the distance from county. Ultimately 113 villages in 27 towns were included in the survey. This study focused on the mothers and grandmothers of left-behind children under 3. Questionnaire was used to collect the data of left-behind children under 3 years old and their main caregivers participating in the survey, and Zung Self-rating Depression Scale (ZSDS) was used to assess the depression status of caregivers. Multivariate Logistic regression was used to analyze the determinants of depression in the main caregivers of left-behind children.

A total of 728 subjects were included in this study, including 282 mothers and 446 grandmothers. The overall incidence of depressive symptoms was 32.8% (239/728) . The prevalence of depression among mothers and grandmothers of left-behind children was 29.8% (84/282) and 34.8% (115/446) respectively, with no statistical significance between two groups (P>0.05) . Multivariate Logistic analysis revealed that for mothers, caring for 1-year-old children (OR=2.041, 95%CI=1.065-3.913) , 2-3-year-old children (OR=2.128, 95%CI=1.023-4.425) , and experiencing caregiving stress (OR=4.043, 95%CI=2.152-7.594) were risk factors for depression (P<0.05) . A mean communication time ≥10 minutes per time with absent fathers (OR=0.396, 95%CI=0.175-0.898) was a protective factor against maternal depression (P<0.05) . For grandmothers, looking after girls rather than boys (OR=0.506, 95%CI=0.331-0.772) was a protective factor for depression (P<0.05) . Conversely, being 60 years or older (OR=1.879, 95%CI=1.082-3.261) , self-rated health status affecting caregiving (OR=2.402, 95%CI=1.364-4.231) and children's mothers cumulative longer absence from home (OR=2.468, 95%CI=1.059-5.751) were the risk factors for depression (P<0.05) .

The incidence of depression among female caregivers of left-behind children in rural China is high. Mothers and grandmothers, as the primary caregivers of most left-behind children, experience different factors affecting depression. Older children, high caregiving stress are risk factors for maternal depression, whereas greater communication with the children's fathers is protective factor for maternal depression. Grandmothers face a higher risk of depression when advanced age, self-report health status affacts caregiving, and children's mothers are absent from home for extended period, while caring for a granddaughter is a protective factor against grandmother's depression.

The transition stage from acute kidney injury (AKI) to chronic kidney disease (CKD) is referred to as acute kidney disease (AKD). Currently, there are relatively few studies on the intervention of traditional Chinese medicine in the progression of AKI to AKD in children.

To explore the intervention effect and impact on prognosis of Modified Shengjiang Powder on AKI and AKD in children.

A total of 136 children with AKI admitted to the Department of Pediatrics of Jinling Hospital Affiliated to Medical College of Nanjing University from June 2017 to June 2022 were selected and divided into the treatment group (65 cases) and the control group (71 cases) by random number method. The control group was treated with conventional Western medicine, while the children in the treatment group were treated with oral Modified Shengjiang Powder decoction in addition to Western medicine. Laboratory examination indicators were collected from the children at 7 days and 14 days after treatment, and the TCM syndrome score was evaluated at 14 days after treatment. The AKI children were re-evaluated after 7 days of treatment. The children were followed up for 3 to 60 months after treatment. Univariate and multivariate Cox regression analyses were used to explore the risk factors for AKI children progressing to AKD and the risk factors for AKD children progressing to CKD stage 3. The Kaplan-Meier method was used to draw the survival curve of the cumulative survival rate of the children, and the Log-rank test was used for survival curve comparison.

A total of 136 AKI children were included, including 81 boys and 55 girls, with an average age of (12.6±4.5) years. After 7 days of treatment, a total of 67 children progressed to AKD, among which 26 children in the treatment group and 41 children in the control group progressed to AKD. According to the previous AKI grouping and treatment results, the AKD children were divided into the AKD treatment sub-group (26 cases) and the AKD control sub-group (41 cases) again. After treatment, the levels of serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA), urinary N-acetyl-β-D-glucosaminidase (NAG) enzyme, urinary retinol-binding protein (RBP), urinary neutrophil gelatinase-associated lipocalin (NGAL), TCM syndrome score, and the proportion of CKD stage 3 in the treatment group were lower than those in the control group, while the estimated glomerular filtration rate (eGFR) and the proportion of complete recovery of AKI were higher than those in the control group (P<0.05). After 14 days of treatment for AKD children, the levels of Scr, urinary NAG enzyme, urinary NGAL, the proportion of CKD stage 3, and end-stage renal disease (ESRD) in the AKD treatment sub-group were lower than those in the AKD control sub-group (P<0.05). The results of multivariate Cox regression analysis showed that urinary NAG enzyme≥9.7 U·g^-1·Cr^-1 was a risk factor for AKI children progressing to AKD (HR=2.724, 95%CI=1.886-4.519, P=0.007), and traditional Chinese medicine treatment was a protective factor for AKI children progressing to AKD (HR=0.482, 95%CI=0.319-0.843, P=0.008) ; stage 3 of AKD was a risk factor for AKD children progressing to CKD stage 3 (HR=2.865, 95%CI=2.213-3.619, P=0.011), and traditional Chinese medicine treatment was a protective factor for AKD children progressing to CKD stage 3 (HR=0.665, 95%CI=0.422-0.953, P=0.040). At the end of the treatment course, the risk of progression to AKD in the AKI treatment group was lower than that in the AKI control group (χ²=5.343, P=0.021) ; at 90 days of follow-up, the risk of progression to CKD stage 3 in the AKI treatment group was lower than that in the AKI control group (χ²=4.623, P=0.032), and the risk of progression to CKD stage 3 in the AKD treatment group was lower than that in the AKD control group (χ²=7.409, P=0.006) ; at the end of the follow-up, the renal survival rate in the AKD treatment group was higher than that in the AKD control group (χ²=8.133, P=0.004) .

MLD can delay the progression of AKI and AKD, protect renal function and improve prognosis.

Mitigating child health poverty is an integral part of consolidating the achievements of poverty eradication. This paper conducts an in-depth analysis of the "Guguding" medical science popularization and training program from a public health perspective, leveraging SWOT theory and the McKinsey 7S Model. The analysis reveals that the program's value lies in overcoming challenges faced by current non-profit organizations, such as insufficient credibility, weak cultural atmosphere, limited funding sources, and lack of an effective closed-loop mechanism. By adhering to the "prevention-first" approach in health and wellness work, the program establishes a supporting system for medical hardware and software in underdeveloped regions, thereby achieving primary and secondary prevention of childhood diseases. It enhances one-on-one medical supplementation and fosters a government-oriented mechanism for medical talent retention, ultimately elevating the health standards of low-income school-age children. This endeavor further embodies the pursuit of equity and sustainable health development, serving as a proactive contribution to children, the future, and the global health cause.

Previous research has indicated that adolescence is associated with physiological changes in sleep patterns. And there are significant variations in sleep duration among adolescents from different regions. Chinese adolescents face short sleep durations and intense academic pressures, which can lead to insomnia and affect their physical and mental health development.

To systematically review the assessment tools and influencing factors of insomnia in Chinese adolescents, and provide guidance for future research in this field.

Initiated in October 2022, this study conducted a systematic search in 5 databases: Web of Science Core Collection, PubMed, China National Knowledge Infrastructure, Wanfang Data, and VIP Database. Two researchers screened articles related to insomnia in Chinese adolescents aged 12 to 18. And then they extracted the following information independently: authors, publication year, region, type of research design, size of study sample, assessment tools, prevalence, and influencing factors.

A total of 1 440 articles were retrieved from the databases, with 39 articles ultimately included in the study-34 in English and 5 in Chinese-covering 23 studies. The sample sizes ranged from 62 to 33 692. Cross-sectional studies were the most common method (15 studies) among the included research. Analysis revealed that the 23 studies utilized 8 kinds of insomnia assessment tools. Only 1 study provided objectively measured sleep features. Three studies involved localized assessment or development of 5 self-report tools, and provided reliability and validity data. The internal consistency of the 5 tools ranged from 0.50 to 0.83, test-retest reliability after two weeks ranged from 0.40 to 0.82, and area under the curve ranged from 0.79 to 0.85. The influencing factors of insomnia in Chinese adolescents were diverse and complicated, which included demographic factors (age, gender, etc.), physiological factors (genetics, health status, etc.), psychological factors (anxiety, depression, etc.), and behavioral factors (exercise, smoking, etc.) .

The assessment tools and influencing factors of insomnia in Chinese adolescents are diverse. However, there is insufficient validation of the reliability and validity of the assessment tools. Few studies have provided objectively measured sleep features of insomnia in Chinese adolescents. And the causal relationship between insomnia and its influencing factors remains unclear. Further research is still required in the future.

Cancer is the second leading cause of death among children. The level of health literacy of caregivers of pediatric oncology patients not only affects their ability to search for health information on the Internet, but also has an impact on the health outcomes of patients. There is a lack of study exploring the relationship between health literacy and online health information search among caregivers of pediatric oncology patients.

To explore the relationship between health literacy and online health information search among caregivers of pediatric oncology patients and to analyze the factors that influence caregivers' online health information search.

A total of 424 caregivers of pediatric oncology patients were included in the study using purposive sampling in three hospitals in Shandong Province from May to August 2021, as well as whole cluster sampling and snowball sampling in Guangdong Province through Shenzhen HengHui Public Welfare Foundation from June to August 2022 as subjects. The survey was conducted using the basic characteristics questionnaire and the health literacy questionnaire, and subjective answers from caregivers were used to confirm whether online health information searches were done. Point two-column correlation analysis was used to test the correlation between health literacy and online health information search among caregivers of pediatric oncology patients; binary Logistic regression (forward stepwise regression based on maximum likelihood estimation) was used to analyze the influencing factors of online health information search among caregivers of pediatric oncology patients.

The health literacy scores of caregivers of pediatric oncology patients were (2.60±0.30) (2.76±0.30) (2.76±0.30), and (2.76±0.30) for the four dimensions of "Perceived understanding and support from healthcare professionals""Evaluation of health information""Ability to interact with healthcare professionals", and "Know enough about health information to know what to do", respectively; the proportion of high health literacy was 56.13%, 63.21%, and 63.21%, 35.61%, respectively; negative correlation (r=-0.161), positive correlation (r=0.006), positive correlation (r=0.073), positive correlation (r=0.102), with online health information search, respectively. The education level of junior high school, high school/vocational school, or college/junior college and above, one-child family, "evaluation of health information" and "ability to interact with healthcare professionals" were facilitating factors for caregivers to conduct online health information search; and "perceived understanding and support from healthcare professionals" was a hindering factor for caregivers to conduct online health information search.

Most caregivers of pediatric oncology patients search for health information on the Internet, and a higher level of education, being a one-child family, having a better ability to assess health information, maintaining positive interactions with healthcare professionals, and rarely feeling the understanding and support of healthcare professionals can promote the occurrence of online health information searching behaviors among caregivers of pediatric oncology patients. The government and related departments should actively carry out health education initiatives for caregivers of pediatric oncology patients to improve their health literacy and ability to use the Internet to search for health information.

Mycoplasma pneumoniae pneumonia (MPP) is a common respiratory disease in children, which can easily develop into refractory Mycoplasma pneumoniae pneumonia (RMPP). Children with RMPP have complex conditions, are difficult to treat, and are associated with multiple serious complications. A risk prediction model for RMPP in children can help healthcare professionals to identify children at high risk of RMPP and provide timely therapeutic countermeasures.

To systematically review the risk prediction models for RMPP in children.

CNKI, Wanfang Data, VIP, CBM, PubMed, Embase, Web of Science and Cochrane Library were searched to collect the related studies on risk prediction models for RMPP in Children to February 20th, 2024. Two reviewers independently screened the literature, extracted data and evaluated the quality of the included studies. Meta-analysis of the incidence and predictors of RMPP in children was performed using Stata 18.0 software.

A total of 14 papers were included, containing 17 risk prediction models. Ten studies were internal validated, and only four studies were external validated, all of which had AUC>0.7. PROBAST results showed that 14 included papers were all at high risk of bias. The results of Meta-analysis showed that the incidence of RMPP in children was 28.2% (95%CI=21.2%-35.1%), hyperthermia, lactate dehydrogenase, C-reactive protein, age, neutrophil ratio, procalcitonin and D-dimer were independent influences on the occurrence of RMPP in children (P<0.05) .

Risk prediction models for RMPP in children have good predictive performance, but the overall risk of bias was high and external validation was lacking. The future risk prediction model should focus on hyperthermia, lactate dehydrogenase, C-reactive protein, age, neutrophil ratio, procalcitonin and D-dimer.

The imaging of COVID-19 (COVID-19) in children is different from that of adults, mainly manifested as subpleural ground glass shadows, patchy high-density shadow, and solid shadow, and rarely complicated with pneumomediastinum. The formation of a large number of emphysema can seriously affect the respiratory and circulatory function, resulting in obvious wheezing and hypoxemia, which need to be actively treated.

To analyze and summarize the imaging and clinical characteristics of COVID-19 with pneumomediastinum in children.

A retrospective analysis was conducted on 8 pediatric patients with COVID-19 complicated with pneumomediastinum admitted to the Department of Pediatrics at Jingzhou Hospital Affiliated with Yangtze University from December 1, 2022 to January 30, 2023, including age, gender, imaging, clinical characteristics, and treatment.

8 children were 3.5 years to 12 years, with a female ratio of 3∶5. High Resolution CT Scan in all children showed double lung infection combined with pneumomediastinum, and multiple emphysema involved the neck and chest wall. The pulmonary manifestations were various: subpleural ground glass shadow, consolidation, tree bud sign, vascular bronchial bundle thickening and bronchial wall thickening, grid sign, etc., no large consolidation and "white lung" found. One case was observed to have a small amount of pleural effusion. In addition to fever and cough, the clinical manifestations were obvious shortness of breath, pulmonary auscultation, but dry or moist rales were not significant. Four children with mycoplasma infection were treated with azithromycin, and one with B. catarrhalis. was treated with azithromycin. All given oxygen therapy. A patient was treated with an invasive ventilator because traditional treatment was unable to alleviate her dyspnea and hypoxemia. The patient's leucocytes and hypersensitive CRP were significantly increased. After 3 days, the symptoms improved and the machine was successfully withdrawn. 5 cases were treated with intravenous immunoglobulin (IVIG), and 3 cases were treated with glucocorticoids. a week after the review of chest CT, pneumomethinum were completely absorbed, and lung lesions significantly improved.

Children with pneumomediastinum complicated by COVID-19 were mostly pre-school or school-age children, rare in infants. Pneumomediastinum can coexist with gas accumulation in the neck and chest wall. In addition, pulmonary lesions could involve the stroma or parenchyma, and both lungs were affected, with various manifestations. At the onset of the disease, there were obvious shortness of breath, active oxygen therapy was recommended. When the white blood cell count and hypersensitivity CRP significantly increase, close attention should be paid to respiratory conditions. IVIG and glucocorticoids may have positive effects, and if necessary, a mechanical ventilation should also be used.

At present, the proportion of DRUG-RESISTANT epilepsy (DRE) in children is still maintained at about 30%, and it is often combined with mental retardation, affecting the quality of life, so the diagnosis and treatment of DRE is still a major challenge in neurology.

Analyze the genetic and clinical characteristics of DRE in children to provide a theoretical basis for clinical genetic testing.

A retrospective analysis of 95 children with DRE who were hospitalized in Hebei Children's Hospital from 2020 to 2022. According to the genetic test results, they were divided into gene mutation positive group (44 cases) and gene mutation negative group (51 cases). Collected general information (including gender, age of onset, medication use, history of febrile convulsions, family history of epilepsy, etc.), clinical features (seizure types, epilepsy syndromes, developmental conditions), and ancillary examinations [genetic testing, video electroencephalography (VEEG) examination, neuroimaging] from the children, and analyse the genetic aetiology and clinical features of DRE.

Of the 95 children with DRE, 55 (57.9%) were male and 40 (42.1%) were female, with a median age of onset of 1.00 (0.50, 4.00) years and number of medications used of 3 (2, 4) ; the age of onset of the children in the mutation-positive group was younger than that in the mutation-negative group (Z=-5.322, P=0.001) ; comparing the gender of the children, history of febrile seizures, family history of epilepsy, and number of medications used in the two groups, the differences were not statistically significant (P>0.05). Epileptic syndromes were diagnosed in 38 (40.0%) of the children, of which 76.3% (29/38) had onset in the neonatal or infantile period; the percentage of epileptic syndromes was higher in the mutation-positive group than in the mutation-negative group (χ²=12.065, P=0.001). Clinical seizure types were diverse, with 2 or more seizure types being the most common, accounting for 52.6% (50/95), followed by a single focal seizure, accounting for 33.7% (32/95) ; there was no statistically significant difference in the comparison of seizure types between the two groups of children with DRE (χ²=2.920, P=0.404). Developmental screening was improved in 57 children, of whom 43 (75.4%) showed varying degrees of developmental delay after the onset of the disease, and 33 (76.7%) showed generalised developmental delay; the percentage of children with developmental delay in the mutation-positive group was higher than that in the mutation-negative group (χ²=5.728, P=0.017). Genetic variations were detected in 44 cases, resulting in a positive detection rate of 46.3%, predominantly involving ion channel-related mutations, with SCN1A being the most prevalent single-gene mutation. Ninety (94.7%) children had abnormal VEEG examinations, with focal epileptic discharges predominating; the percentage of peak dysrhythmias was higher in the mutation-positive group than in the mutation-negative group (χ²=7.425, P=0.006). Structural etiology was present in 25 (26.3%) children, including 12 in the mutation-positive group and 13 in the mutation-negative group; the difference in the structural etiology of the children with DRE was not statistically significant when comparing the two groups (χ²=0.039, P=0.844) .

Genetic factors are an important etiological factor for DRE in children. The young age of onset and developmental delay suggests that it is related to a genetic etiology, and genetic testing should be actively improved at an early stage, which can help in the early diagnosis of DRE and precise treatment.

The incidence of major depressive disorder (MDD) in adolescents is annually elevated. Non-suicidal self-injury (NSSI) is a common clinical manifestation of MDD. Evidence suggested that vitamin D and lipid levels are associated with MDD, but whether they are related to NSSI is unclear.

To compare the levels of 25 (OH) D₃ and blood lipids in MDD adolescents with or without NSSI behavior, and to explore their diagnostic value for NSSI.

A total of 129 MDD adolescents who received treatment in the Department of Psychiatry, Chaohu Hospital of Anhui Medical University and the Fourth People's Hospital of Hefei from October 2020 to March 2022 were recruited. They were assigned into NSSI group (n=77) and non-NSSI group (n=52) based on the diagnostic criteria of NSSI in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) . The Positive and Negative Suicide Ideation (PANSI) , Insomnia Severity Index (ISI) , and Center for Epidemiological Survey, Depression Scale (CES-D) were used to evaluate the clinical symptoms. Fasting venous blood samples were collected to measure the levels of 25 (OH) D₃ and blood lipids, and compared between groups. In addition, multivariate Logistic regression analysis was performed to identify influencing factors for NSSI behavior in MDD adolescents. The diagnostic value of 25 (OH) D₃ and lipid levels in NSSI behaviors was assessed by plotting the receiver operating characteristic (ROC) curves.

The age of the NSSI group was significantly lower than that of the non-NSSI group, whereas the total scores of PANSI, ISI, and CES-D were significantly higher than those of the non-NSSI group (P<0.05) . The level of 25 (OH) D₃ in the NSSI group was significantly lower than that in the non-NSSI group, whereas the levels of total cholesterol (TC) , high-density lipoprotein cholesterol (HDL-C) , and low-density lipoprotein cholesterol (LDL-C) were significantly higher than those in the non-NSSI group (P<0.05) . Multivariate Logistic regression analysis showed that both LDL-C (OR=5.695, 95%CI=2.422-13.388, P<0.001) and 25 (OH) D₃ (OR=0.871, 95%CI=0.768-0.987, P<0.05) were the influencing factors of MDD adolescents with NSSI. The area under curve (AUC) of LDL-C and 25 (OH) D₃ levels in assessing the risk of developing NSSI behavior in MDD adolescents was 0.73 (95%CI=0.65-0.82, P<0.001) and 0.62 (95%CI=0.52-0.72, P=0.023) , respectively. Their optimal cut-off value was 1.89 mmol/L and 19.15 μg/L, respectively. The AUC of 25 (OH) D₃ combined with LDL-C levels [ln (p/1-p) =1.364X1-0.143X2-0.161, where X1 and X2 was LDL-C and 25 (OH) D₃, respectively] in diagnosing NSSI behavior in MDD adolescents was 0.77 (95%CI=0.69-0.85, P<0.001) , with 77.92% of sensitivity and 67.31% of specificity.

25 (OH) D₃ and lipid levels are out of normal ranges in MDD adolescents with NSSI. Measurement of LDL-C combined with 25 (OH) D₃ levels may provide information to predict the occurrence of NSSI behaviors in MDD adolescents. A regular measurement of LDL-C and 25 (OH) D₃ and a dynamic monitor is valuable to provide symptomatic supports.

Enuresis is one of the common diseases in children and adolescents, and in recent years, enuresis has posed a great threat to the physical and mental health of children and adolescents, seriously affecting the quality of life of the affected children, and bringing a serious burden to the society and families. At present, there are still controversies about the influencing factors of enuresis in children and adolescents, and there are few relevant systematic evaluations at home and abroad.

To explore the prevalence and influencing factors of enuresis in children and adolescents in China using Meta-analysis.

Computer searches were conducted for relevant studies in the databases of CNKI, Wanfang Data, VIP, SinoMed, PubMed, Embase, Web of Science, and Cochrane Library from the construction of the database to May 2024. Independent screening and cross-checking by 2 investigators, cross-sectional studies were assessed using the Agency for Healthcare Research and Quality, and Meta-analysis was performed using Stata 17.0 software.

A total of 27 papers were included, including 243 530 children patients. The results showed that the prevalence of enuresis in Chinese children and adolescents was 6.1% (95%CI=5.1%-7.2%), of which, male (OR=1.52, 95%CI=1.41-1.64), family history of enuresis (OR=3.46, 95%CI=2.01-5.93), constipation (OR=2.32, 95%CI=1.59-3.40), history of urinary tract infections (OR=2.33, 95%CI=1.81-3.01), and sleep disorder (OR=2.01, 95%CI=1.10-3.67), urinary frequency (OR=1.90, 95%CI=1.43-2.52), urinary urgency (OR=1.67, 95%CI=1.31-2.12), and urinary incontinence (OR=4.85, 95%CI=2.78-8.45) were risk factors for enuresis in children and adolescents (P<0.05) ; urinary training (OR=0.11, 95%CI=0.02-0.46) was a protective factor for enuresis in children and adolescents (P<0.05) .

The prevalence of enuresis is high in Chinese children and adolescents, and that gender, family history of enuresis, constipation, history of urinary tract infection, voiding training, sleep disorders, urinary frequency, urinary urgency, and urinary incontinence are the main influencing factors of enuresis in children and adolescents. Therefore, in the future, early identification and intervention of enuresis in children and adolescents should be carried out, parents' attention to enuresis should be raised, and the popularisation of disease education should be done to reduce the prevalence of enuresis and improve the quality of life of the affected children and their families.

With the rapid development of the society, the detection rate of dyslipidemia in children has gradually increased. At present, there are few data on the application of traditional Chinese medicine (TCM) constitution identification in sub-health of children, and there is a lack of clinical correlation data analysis.

To observe the trend of changes in TCM constitution and blood lipid metabolism in children, and to analyze the correlation between them, thus providing relevant basis for subsequent continuous monitoring research.

Sourced from the Shanghai Child and Adolescent Health Cohort (SCAHC), a total of 2 080 healthy primary school students in the second and third grade from Pudong New Area, Shanghai were selected as the research subjects. Using the＂Zhaoming System＂that was independently developed by Shanghai University of Traditional Chinese Medicine, physical information of included subjects in 2021 (first year) and 2022 (second year) was collected. Based on the TCM constitution classification of facial complexion and tongue appearance, clinical symptoms and signs and questionnaire information, children were divided into five types of constitution, including the spleen-deficiency constitution, balanced constitution, Qi-stagnation constitution, deficiency-heat constitution, and excess heat constitution (unbalanced constitution referred to all constitutions except for the balanced constitution). Blood samples were collected to detect on triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC). To analyze and compare the incidence of blood lipid abnormalities in children of different genders, as well as the distribution characteristics and changes of TCM constitution in different ages and genders. Multivariate Logistic regression analysis was performed to explore the correlation between TCM constitution and dyslipidemia in children.

Among the 2 080 children, 1 122 (53.9%) were males and 958 (46.1%) were females, with an average age of (8.2±0.4) years. There were 522 children with dyslipidemia (25.09%), including 272 males (52.1%) and 250 females (47.9%). In 2021, there were 815 (39.2%) cases of the balanced constitution and 1 265 (60.8%) cases of the unbalanced constitution. In 2022, 764 (36.7%) children had a balanced constitution and 1 316 (63.3%) had a unbalanced constitution. There was a statistically significant difference in the distribution of TCM constitution in children between 2021 and 2022 (χ²=106.28, P<0.001). The detection rate of unbalanced constitution in boys was significantly higher than that in girls (χ²₂₀₂₁=14.073, P<0.001; χ²₂₀₂₂=20.090, P<0.001). Multivariate Logistic regression analysis, after excluding demographic factors such as gender and age, showed that elevated HDL-C in children was a contributing factor to the occurrence of balanced constitution (OR=1.624, 95%CI=1.258-2.097, P<0.001), and deficiency-heat constitution (OR=0.654, 95%CI=0.499-0.858, P=0.002) .

Through analyzing the changing trend in TCM constitution and blood lipid metabolism in children from the SCAHC cohort, an increased HDL-C promotes the occurrence of balanced constitution but inhibits the occurrence of deficiency-heat constitution.

The incidence of delay language development in early childhood is high, and the early recognition rate is low, which has a significant negative impact on the early childhood development of other dimensions. The family cognitive environment is a key factor affecting early childhood language development.

This study aimed to explore the influence of family cognitive environment on early childhood language development, and provide theoretical basis for promoting early childhood language development from the perspective of community intervention on family cognitive environment.

A retrospective case-control study was conducted on 4 307 children who were admitted to a community child healthcare department in Shanghai from 2018 to 2020. The Shanghai Pediatric Development Screening Scale Ⅱ (DenverⅡ) was used for developmental screening, which was conducted at the child's age of 1, 2, and 3 years old. A total of 172 children with delay language development were selected as the case group, and 516 children with normal language development were included in the control group, which was determined by the matching factor of age, with a ratio of the number of children in the case and control groups being 1∶3. The following information of children in both groups were collected, including children's basic birth characteristics, parental demographic characteristics, maternal pregnancy and childbirth characteristics, and family cognitive environment characteristics. The Logistic regression analysis was used to explore the influencing factors of delay early childhood language development.

A total of 172 children with delayed early language development had an incidence rate of 3.99%, among them ,1-year-old, 2-year-old, and 3-year old children accounted for 33.14% (57 cases), 53.49% (92 cases), and 13.37% (23 cases), respectively. The proportions of male children, children with premature birth, and children with maternal education of high school and below were higher in the case group than those in the control group (P<0.05). The overall family cognitive environment, emotional warmth, social adaptation, linguistic environment, and neglectful environment of the children in the case group were less favorable compared to those in the control group (P<0.05). premature birth, low maternal education, and poor family cognitive environment were risk factors of delay early childhood language development (P<0.05) .

Interventions for language development before the age of 2 were key to effectively reducing the rate of delay childhood language development. Guiding and optimizing the family caregiving environment, assisting in establishing good parent-child communication and interaction by community child healthcare doctors could be effective strategies for promoting early childhood language development. Community child healthcare doctors should pay special attention to children with young gestational age and low maternal education, and provide more targeted interventions and guidance on parent-child activities and communication.

Currently, the treatment of refractory epilepsy (RE) in children is still a difficult point in epilepsy treatment. In China, pirenzapine (PER) is still a new drug for treating RE in children, and there is currently a lack of recommendations for adding PER to the treatment of RE in children. And in Chinese reports, the sample size of RE patients treated with PER is relatively small. Therefore, the efficacy of PER for pediatric RE, especially for young children with RE, still needs to be further studied with a large sample size.

To explore the efficacy, possible indications, adverse reactions, and tolerability of PER addition therapy for RE in children.

A self-control and retrospective analysis was conducted on children with RE aged 0-18 who were treated at the Women and Children's Hospital, Qingdao University from January 2022 to January 2023. The frequency of seizures at different observation points before and after the addition of PER treatment was compared, and the effective rate of PER was evaluated. Adverse drug reactions and drug retention rates were recorded, and the clinical characteristics of the effective and ineffective groups of PER were analyzed.

A total of 192 study subjects were included. After adding PER treatment, the effective rates at 12, 24, and 36 weeks were 56.3% (108/192), 62.1% (113/182), and 69.7% (122/175), respectively, and the seizure free rates were 19.3% (37/192), 21.4% (39/182), and 24.6% (43/175). The incidence of adverse reactions was 16.1% (31/192), mainly including dizziness, irritability, weakness, and drowsiness. The last follow-up drug retention rate was 91.1% (175/192). There was a statistically significant difference in the onset age, duration of anti-epileptic treatment, type of origin, seizure form, frequency of seizures before the addition of PER, number of combined anti-epileptic drugs (ASMs), and ketogenic diet/surgical treatment between patients with RE who received continuous medication for 12 weeks (P<0.05). In addition, 178 children underwent EEG examination, and 167 children underwent cranial magnetic resonance imaging examination. There was a statistically significant difference in the electroencephalogram (EEG) and head magnetic resonance imaging (MRI) results between patients who received effective and ineffective treatment. In the results of electroencephalogram examination, the effective rate of discharge in the anterior (anterior, middle, temporal anterior, and middle) part of the brain was higher (P<0.05) ; In the results of cranial imaging examination, the normal group had a higher effective rate, followed by children with mainly white matter damage.

The overall effective rate and retention rate of PER addition therapy for RE in children are high, with mild adverse reactions and good drug tolerance. It is more effective for children with RE who have a late onset age, seizures in the form of motor seizures, focal origin, short course of anti-epileptic treatment, fewer combination medications, and less frequency of seizures. In electroencephalography, patients with normal discharge in the anterior (anterior, middle, anterior temporal, and middle temporal) of the brain and normal results in cranial magnetic resonance imaging have a higher effective rate.

The prevalence of overweight and obesity among children and adolescents is continuously rising. As countries have developed several school-based nutrition policies to control overweight and obesity, it is important to examine the effectiveness of nutrition policies.

To evaluate the effect of the centralized distribution of food material system on overweight and obesity rates among children and adolescents aged 6-15 years.

In April 2023, a total of 104 749 BMI data from sixteen schools aged 6 to 15 years (8 schools were included in the unified food distribution system and recorded as the unified distribution group, and 8 schools were not included in the unified food distribution and supply system and recorded as the non-unified distribution group) in Wuxi were retrospectively collected between 2017 and 2021. The data of physical examination was collected from Student Health Monitoring System in Jiangsu Province. The overweight and obesity epidemiologic trends among children and adolescents were analyzed from 2017 to 2021 in Wuxi, and the changes in BMI-Z scores and trends in overweight and obesity rates among children and adolescents were compared before and after the implementation of the centralized distribution of food material system by the Joinpoint regression and grey GM (1, 1) model.

The prevalence of overweight and obesity among in children and adolescents aged 6-15 years was increasing from 2017 to 2021. The results of the Joinpoint regression analysis indicated that the prevalence of overweight (APC 1.8% vs 4.6%) and obesity (APC 6.9% vs 13.3%) among students included in the system exhibited a slower rate of increase than among those not included. The disparity in the increase of BMI-Z scores among students included in the system and those not included changed from -0.055 (95%CI=-0.108--0.002) to -0.195 (95%CI=-0.246--0.145) before and after the implementation of the system. The results of grey GM (1, 1) model showed that the incidence rate of overweight among children and adolescents in Wuxi in 2022, 2023 and 2024 was 22.02%, 22.39% and 22.77% respectively, with the incidence rate of overweight being 17.02%, 18.50% and 20.12% respectively.

The increasing trend in the prevalence of overweight and obesity, as well as the increase in BMI-Z scores among children and adolescents, has slowed down after the implementation of the centralized distribution of food material system. The system may be an effective method of improving the nutritional status of children and adolescents. Therefore, it is recommended that the centralized distribution of food material system still needs to be implemented and the monitoring area needs to be expanded.

The increasing incidence of childhood obesity has emerged as a novel challenge in the realm of global public health. Studies have demonstrated that alterations in the composition of intestinal flora during the early stages of life contribute to the development of obesity by influencing nutrient absorption and metabolism, triggering inflammatory responses, and regulating the communication between the gut and brain. Currently, Bifidobacterium and Akkermansia muciniphila have been found to reduce body fat content, exhibit anti-inflammatory properties, and enhance intestinal barrier function, whereas Prevotella is strongly associated with improvements in individual glucose metabolism induced by dietary fiber. Translational application of specific intestinal flora benefits to body glycolipid metabolism is helpful for the early prevention and therapy of pediatric obesity. This review elucidates the impact of early-life changes in intestinal flora composition on childhood obesity explores the mechanisms by which intestinal flora contributes to obesity pathogenesis, and specifically focuses on recent advances in utilizing short-chain fatty acids for the regulation of intestinal flora and the amelioration of obesity, aiming to provide a theoretical foundation for the intervention of childhood obesity from the perspective of intestinal flora.

With the improvement of economic level and changes in lifestyle of residents, the obesity among children and adolescents has become increasingly severe, threatening the healthy growth of children and adolescents. BMI was used as an evaluation index of obesity in most previous studies, which may underestimate the prevalence of central obesity. Therefore, it is urgent to evaluate the waist circumference (WC) and trend of the prevalence of central obesity among children and adolescents in Putuo District, in order to provide scientific basis for targeted proposed intervention.

To analyze WC and the trend in the prevalence of central obesity among children and adolescents aged 7-18 years in Putuo District, Shanghai, from 2018 to 2023.

Data on medical examinations of primary and secondary school students in Putuo District in 2018 and 2020 to 2023 were used to analyze the WC, the prevalence of central obesity and the trends. The 90th percentile (P₉₀) age-specific children and adolescents of different genders was used as the cut-off point of high WC, and WC exceeding the P₉₀ value was defined as central obesity. SPSS 22.0 and SAS 13.1 were used for statistical analysis and Excel 2021 was used for graphic plotting.

A total of 280 648 primary and secondary school students participated in the medical examination in Putuo District, Shanghai, from 2018 to 2023, of which 146 334 (52.1%) were male students and 134 314 (47.9%) were female students, with an median age of 10.5 (8.7, 12.6) years. WC of male and female students from 2018 to 2023 showed fluctuating downward trends with a statistically significant difference (H_male=209.785, H_female=373.076; P<0.001). WC of male students decreased from 65.2 (58.0, 74.0) cm in 2018 to 64.8 (56.9, 74.0) cm in 2023 and female students decreased from 60.5 (55.0, 67.0) cm to 59.8 (53.8, 66.2) cm. Comparison of the prevalence of central obesity among male and female students in each year showed statistically significant differences (χ²_male=264.123, χ²_female=448.289; P<0.001). The results of Cochran-Armitage trend test showed decreasing trends in prevalences of central obesity among male and female groups from 2018 to 2023 (Z_{trend male}=-10.974, Z_{trend female}=-15.218; P_trend<0.001). The prevalence of central obesity among male students decreased from 28.8% (6 714/23 286) to 24.6% (7 935/32 227), while that among female students decreased from 21.9% (4 604/21 062) to 15.5% (4 604/29 695). The WC and prevalence of central obesity among male students were higher than that among female students (U=7 128 257 114.500、χ²=2 928.075, P<0.001). Prevalence of central obesity showed increasing trends with age for both sexes (Z_{trend male}=35.167, Z_{trend female}=6.533; P_trend<0.001) .

This study suggests that WC and the prevalence of central obesity among children and adolescents aged 7-18 in Putuo District are fluctuating and decreasing. WC and the prevalence of central obesity of male students are high than those of female students of the same age. The prevalence of central obesity is increasing with age. Results of this study provide theoretical support for the targeted intervention of central obesity in children and adolescents.

Primary medical institutions, with the characteristics of comprehensive, continuous, coordinated, convenient and economical, play an important role in the diagnosis and treatment of common and frequently-occurring children's diseases, planned immunization and child health management, and lay a solid foundation for children's health services. It is essential to improve the quality of child health services for children under the management of family doctor contract. There are regional differences in the ability of children's health services at primary institutions in China. Therefore, accurate evaluation of the quality of children's health services at primary institutions is helpful to find problems in time and promote the development of children's health services at a higher level.

To assess the quality of community children's health services for contracted children, analyze the quality problems and optimization strategies, and provide international vision and decision-making reference for further improving the quality.

Taking a district of Chengdu as a typical case, three community health service centers with stronger child health service ability in the district were selected as the sample institutions, and the parents of children contracted by the sample institutions were surveyed with the online questionnaire on the quality of community child health service by using the Chinese version of primary care assessment tool (PCAT) .

Totally, 3 631 parents of contracted children were investigated. The total PCAT score of community child health service quality in the sample centers was (58.72 ± 13.43). The dimensions with relatively high PCAT scores of community child health service quality includes "continuity" "community first consultation (service availability and service use) " and "comprehensive service (service provision) ", while the dimensions "children and family-Centered" "comprehensive (available services) " and "coordination (referral) " had low scores.

It is suggested to strengthen the supply of diagnosis and treatment services for common pediatric diseases in the community, unblock the referral mechanism of Pediatrics, strengthen the awareness of parents of contracted children to be included in the contracted service team to participate in diagnosis and treatment decisions, and pay attention to the health services for children with non local registered residence.

The imbalance between the supply and demand of pediatric medical resources and health management services in our country has been a long-standing issue, primary healthcare institutions are particularly prominent in this context. How to achieve integration and optimization of pediatric medical resources at the grassroots medical and health institutions is an urgent problem that needs to be addressed. This article primarily summarizes and analyzes the concept and framework of integrated health management services for children, including children's health assessment, early intervention, long-term follow-up, and case studies and practical experiences. Through a review of domestic and international literature, it concludes feasible models of integrated health services for children. This review suggests that integrated health management services have broad potential and promising applications, providing personalized and efficient health management and intervention for children.

The sleep characteristics of school-age children have a crucial impact on the development of emotional and behavioral problems. Sleep characteristics also play a role in the development of executive function in school-age children. There is a close relationship between the emergence of emotional and behavioral problems and the development of executive function in these children. Currently, there are few studies on the mediating effect of the relationship between sleep characteristics, executive function, and emotional and behavioral problems in school-age children.

To explore the relationship between sleep characteristics, executive function, and emotional and behavioral problems in school-age children, and to examine the mediating role of executive function in the relationship between sleep characteristics and emotional and behavioral problems.

From August 21 to October 8, 2021, a convenience sampling method was used to select 516 school-age children from grades 1 to 6 in Xiwu Primary School and the Fourth Experimental Primary School in Shexian County, Handan City, Hebei Province. The Children's Sleep Habits Questionnaire (CSHQ), the Strengths and Difficulties Questionnaire (SDQ), and the Behavior Rating Inventory of Executive Function (BRIEF) were used to assess the sleep characteristics, emotional and behavioral problems, and executive function of the school-age children, respectively. Correlation analysis, regression analysis, and mediation analysis were conducted using SPSS 27.0 and the PROCESS 4.1 plugin.

A total of 516 questionnaires were distributed, and 496 valid questionnaires were recovered, with an effective recovery rate of 96.1%. Correlation analysis showed that the total score of the CSHQ was negatively correlated with the Behavioral Regulation Index (BRI), Metacognition Index (MI), inhibition, shifting, emotional control, task initiation, working memory, planning, organization, and monitoring factors of the BRIEF (P<0.001). The total score of the SDQ was positively correlated with the BRI, MI, inhibition, shifting, emotional control, task initiation, working memory, planning, organization, and monitoring factors of the BRIEF (P<0.001). Forced entry method results showed that sleep characteristics negatively predicted emotional and behavioral problems (B=-0.15, t=-5.33, P<0.01), while executive function positively predicted emotional and behavioral problems (B=0.13, t=20.88, P<0.01). Mediation analysis showed that when executive function, BRI, and MI were used as mediating variables, there was a complete mediating effect between sleep characteristics and emotional and behavioral problems in children. The 95%CI for both the main effect and the indirect effect did not include 0 (P<0.001), and the 95%CI for the direct effect included 0 (P>0.05) .

There is a close relationship between sleep characteristics, executive function, and emotional and behavioral problems in school-age children. Executive function has a complete mediating effect on the relationship between sleep characteristics and emotional and behavioral problems. This finding emphasizes the importance of good sleep for the behavioral and emotional well-being of school-age children and provides new perspectives and intervention approaches for enhancing executive function and overall development in school-age children.

Henoch-Schonlein purpura is a vascular inflammatory illness that develops in childhood and in some children involves the kidneys, clinically known as Henoch-Schonlein purpura nephritis. Different studies have suggested different interventions, and there is a wide variation in the outcome indicators used for the intervention approaches.

To investigate and analyze the current status of clinical research outcome indicators for Henoch-Schonlein purpura nephritis in China, so as to provide a reference basis for the establishment of a core set of outcome indicators in this field.

CNKI, CBM, VIP, Wanfang Data, PubMed, Cochrane Library, Embase and Web of Science were systematically searched to collect publicly available Henoch-Schonlein purpura nephritis studies from January 2010 to June 2021. The Chinese databases were searched using the search strategy of title or keywords combined with subject terms, and the English databases were searched using subject terms combined with free words. Two investigators independently screened the literature and extracted information according to the inclusion and exclusion criteria, processed and analyzed the data on outcome indicators.

A total of 148 randomized controlled trials of Henoch-Schonlein purpura nephritis were included, and the outcome indicators of Henoch-Schonlein purpura nephritis studies were mainly physical and chemical indicators, with fewer symptomatic indicators. The highest frequency of outcome indicators were clinical efficacy (121 times, 81.76%), adverse reactions (74 times, 50.00%), 24-hour urine protein (68 times, 45.95%), urinary red blood cells (43 times, 29.05%), and recurrence rate (20 times, 13.51%). The division between primary and secondary outcome indicators was clearly distinguished in only two articles.

There are several indicators for the research outcomes of Henoch-Schonlein purpura nephritis in China, primarily physical and chemical variables, with significant variation. The research focuses on efficacy measures but ignores adverse reactions. As a result, it is necessary to establish a set of outcome indicators for clinical intervention studies on Henoch-Schonlein purpura nephritis in order to provide a reference basis for selecting outcome indicators and guiding clinical decision-making in future similar studies.

Studies have confirmed that executive function in overweight and obese children is closely related to obesity and may have a bidirectional association. Aerobic exercise, as an effective intervention, can effectively promote their brain development and cognitive function, especially executive function, but the quantitative relationship of the improvement effect still needs to be further explored.

To systematically evaluate the intervention effect of aerobic exercise on executive function-related indexes in overweight and obese children.

Randomized controlled trials of aerobic exercise interventions for executive function in overweight and obese children were searched in CNKI, Wanfang Data, CBM, Cochrane Library, PubMed, Embase, and Web of Science databases, and the timeframe for searching was from the establishment of each database to July 2023. The quality of the included literature was assessed according to the Cochrane Risk of Bias Assessment Tool, and Meta-analysis of outcome indicators was performed using RevMan 5.3 and Stata 15.0 software.

Nine randomized controlled trials, including 940 overweight and obese children, were finally included. The results of Meta-analysis showed that a single session of aerobic exercise intervention was effective in improving the executive function of overweight and obese children (WMD=-6.98, 95%CI=-11.89 to -2.07, P=0.005). Subgroup analyses showed no significant differences in the improvement of any of the executive function subcomponents in overweight and obese children with a single intervention duration of less than 30 minutes of aerobic exercise (WMD=-0.84, 95%CI=-9.37 to 7.68, P=0.85) ; aerobic exercise with a single intervention duration longer than 30 minutes improved inhibitory function in overweight and obese children (WMD=-10.50, 95%CI=-19.15 to -1.85, P=0.02). When a long-term exercise intervention was carried out (the intervention period was 8 weeks), in contrast to the control group, the aerobic exercise improved interference control in overweight and obese children (WMD=-0.16, 95%CI=-0.18 to -0.14, P<0.000 01), on planning (WMD=4.20, 95%CI=-8.34 to 16.73, P=0.51), attention (WMD=0.41, 95%CI=-12.08 to 12.91, P=0.95), synchronization (WMD=3.93, 95%CI=-8.22 to 16.08, P=0.53), and continuity (WMD=2.48, 95%CI=-9.18 to 14.14, P=0.68) were not significantly improved.

Aerobic exercise for a single long period of time had a selective positive effect on executive function subcomponents in overweight and obese children, and aerobic exercise for a long period of time with a fixed frequency and duration improved interference control in overweight and obese children, but did not produce an improvement in planning, attention, synchronization, or continuity.

The prevalence of allergic diseases is rapidly increasing among the global population, affecting 10%-40% of people worldwide. Allergic diseases often begin in childhood. So far, data for analyzing the trends in the incidence of pediatric allergic diseases in China over the past decade are scant. This study aims to provide an epidemiological support for the prevention and management of pediatric allergic diseases in China by mining electronic medical record data from a single-center institution.

To analyze the annual proportion and trend of outpatient visits for allergic diseases among children aged 0-18 years in the Beijing Children's Hospital, Capital Medical University from 2014 to 2021.

A retrospective analysis of outpatient electronic medical records from the hospital information system of Beijing Children's Hospital, Capital Medical University from 2014 to 2021 was conducted to examine the annual proportional composition and changes in the trend changes of allergic diseases. The gender- and age-based proportions of different allergic diseases including eczema, urticaria, allergic rhinitis, bronchial asthma, allergic cough, allergic conjunctivitis, food allergies, drug allergies, pollen allergy, and anaphylaxis were calculated. The trend of changes in the proportion of allergic diseases with stable annual composition ranking in the top 10 was further analyzed.

From 2014 to 2021, there were a total of 1 231 890 outpatient visits for pediatric allergic diseases in our center. After excluding missing data, a total of 1 231 863 eligible cases were included, involving 727 082 (59.0%) boys and 504 781 (41.0%) girls. The majority of children visited for allergic diseases were under the age of 3 years (46.9%). Non-IgE mediated allergic diseases, such as henoch-schoenlein purpura, bronchitis, and respiratory tract infections were excluded, and the remaining 1 208 265 cases included in the disease spectrum analysis. From 2016 to 2021, the proportion of outpatient visits for pediatric allergic diseases in Beijing Children's Hospital, Capital Medical University showed an upward trend. From 2014 to 2017, the top 5 allergic diseases visited in the outpatient department were eczema, urticaria, allergic rhinitis, bronchial asthma, and allergic cough. From 2018 to 2021, allergic rhinitis, eczema, urticaria, allergic conjunctivitis, and bronchial asthma ranked the top 5. The trend analysis for an annual proportion of pediatric allergic diseases showed that the ratios of allergic rhinitis, allergic conjunctivitis, and food allergies among all allergic diseases from 2014 to 2021 showed an increasing trend, with peak ratios of 45.4%, 11.1% and 2.8%, respectively. The ratios of urticaria, eczema, and bronchial asthma showed a decreasing trend, with peak ratios of 46.5%, 24.9% and 11.3%, respectively.

From 2016 to 2021, the proportion of outpatient visits for pediatric allergic diseases in Beijing Children's Hospital, Capital Medical University showed an upward trend. Between 2014 and 2021, the annual proportions of allergic rhinitis, allergic conjunctivitis, and food allergies exhibited an increasing trend, while the annual proportions of eczema, urticaria, and bronchial asthma demonstrated a decreasing trend.

Previous studies have confirmed that screen exposure is widespread in preschool children and is related to children's emotional and behavioral problems. Most of the existing studies focus on normal preschool children, but the research on screen exposure and emotional and behavioral problems of preschool autistic children is relatively rare.

To investigate the screen exposure and the abnormal detection of emotional and behavioral problems in preschool children with autism, and to explore the association between screen exposure and emotional and behavioral problems in preschool children with autism.

Preschool children with autism who met the diagnostic and Statistical Manual of Mental Disorders (DSM-V) autism diagnostic criteria and visited the Department of Child Development and Behavior of the Third Affiliated Hospital of Zhengzhou University from February to August 2022 were selected as the autism group. At the same time, children with normal development in kindergartners in Zhengzhou were selected as the normal control group. The screen exposure questionnaire and the Strengths and Difficulties Questionnaire (parent version) were completed by the main caregivers of the children in the two groups.

There were significant differences between the two groups in terms of screen time, parents' response to screen management, and screen deprivation (P<0.001). Compared with the normal control group, the children in the autism group had significantly higher detection rates of prosocial behavior, total difficulties, and sub-dimensions (emotional symptoms, conduct problems, hyperactivity/inattention problems, and peer problems) (P<0.001). Logistic regression showed that the influencing factors of emotional and behavioral problems in preschool children included placing electronic devices in the sleeping or playing space, whether caregivers interacted with each other during watching, caregivers' attitudes toward children's electronic screen watching, whether they were active or passive participants in touching electronic screens, and children's reactions to forced turning off electronic screens (P<0.05) .

Screen exposure can affect the emotional and behavioral problems of preschool children with autism. Parents should rationally plan screen use for preschool children with autism.

Bronchial asthma (asthma) is the most common chronic respiratory disease in childhood, with long disease course and repeated attacks, which affecting the development and life quality of children. As the main providers of primary healthcare, general practitioners play important role in the early diagnosis and grading management of childhood asthma. Understanding their level of prevention and treatment services for this disease can provide suggestions for improving the quality of primary care childhood asthma prevention and treatment services.

To investigate the service level of primary general practitioners in the prevention and treatment of childhood asthma, and the influencing factors on the service level.

From April to July 2022, 22 districts (counties) were randomly selected from the 38 districts (counties) in Chongqing Municipality, and conducted a questionnaire survey on primary general practitioners in the sampling. The questionnaire was designed by the research team based on relevant guidelines and literatures, and formed through two rounds of expert consultation and pre-investigation, including four dimensions of knowledge, attitude, behavior and self-evaluation. We investigated the knowledge, attitude, behavior and self-evaluation of primary general practitioners regarding the prevention and treatment of childhood asthma and analyzed the influencing factors.

A total of 234 general practitioners participated in the questionnaire survey. The knowledge score of general practitioners on the prevention and treatment of childhood asthma was (6.03±2.04) , with a pass rate of 44.9%; the attitude score was (49.42±4.94) , with a pass rate of 100.0%; the behavior score was (30.55±6.66) , with a pass rate of 87.2%; and the self-evaluation score was (21.57±5.30) , with a pass rate of 85.0%. Regarding the selection of referral indications, 98.7% (231/234) of the general practitioners believed that children with moderate or severe acute asthma attack that was not significantly relieved after emergency treatment needed to be referred, and 94.0% (220/234) of the general practitioners believed that children with asthma that could not be controlled effectively after standardized treatment needed to be referred. For children with poorly controlled symptoms, 33.8% (79/234) of the general practitioners would carefully analyze the cause of poor control, and 17.5% (41/234) of the general practitioners would advise patients to follow the doctor's advice, temporarily observe the condition and make an appointment for next reexamination. 33.8% (79/234) of the general practitioners held an uncertain or opposed attitude towards the diagnosis and treatment of childhood asthma in primary medical institutions. The main influencing factors of this attitude was the lack of disease-related knowledge and learning opportunities for general practitioners, reluctance of parents to visit primary medical institutions, strained pediatric doctor-patient relationship, the small number of children suffering from asthma, and the lack of related facilities and equipment. Multiple linear regression analysis showed that professional title and training experience on childhood asthma were the influencing factors of knowledge score (P<0.05) ; academic qualification and years of service in primary medical institutions were the influencing factors of attitude score (P<0.05) ; and pediatric work experience and training experience on childhood asthma were the influencing factors of behavior and self-evaluation scores (P<0.05) .

The general practitioners in Chongqing have some confidence in the management of children with asthma, but their knowledge of asthma prevention and treatment is poor. Their attitude and behavior were both positive, but there is a gap between the two. It is suggested that while optimizing the allocation of pediatric facilities and equipment in primary medical institutions and improving the trust of patients, knowledge and practical training is important to improve the knowledge, confidence and abilities of general practitioners. Academic education and continuing education training of general practitioners should be strengthened to effectively improve their learning and self-improvement ability.

Stigma in adolescents with type 1 diabetes mellitus (T1DM) is closely associated with their health outcomes. Currently, there is a lack of stigma assessment tools for this population.

To translate the Type 1 Diabetes Stigma Assessment Scale (DSAS-1) and test its reliability and validity in Chinese adolescents with T1DM.

A total of 194 patients with T1DM admitted to the First Affiliated Hospital with Nanjing Medical University and Children's Hospital of Nanjing Medical University were selected as the study subjects by using the convenient sampling method from March 2022 to March 2023. The English version of DSAS-1 was directly translated, back-translated and culturally adapted by using Brislin's classical back translation model to form a Chinese version. The Self-designed General Information Questionnaire, the Chinese version of the DSAS-1, the Diabetes Strengths and Resilience Measure for Adolescents, the Parent-child Relationship Scale, and the Quality of Life Scale was used to conduct investigation. Exploratory factor analysis and confirmatory factor analysis were used to test the structural validity of the scale, and the internal consistency of the version was evaluated by calculating the Cronbach's α coefficients. Correlation analyses with the Diabetes Strengths and Resilience Measure for Adolescents, the Parent-child Relationship Scale, and the Quality of Life Scale were conducted to confirm the effect of the Chinese version of DSAS-1 in detecting stigma among adolescents.

A total of 194 valid questionnaires were recovered. The exploratory factor analysis and confirmatory factor analysis results showed that the Chinese version of DSAS-1 for adolescents was categorized into three dimensions of differential treatment, complaints and comments and identity concerns, with good structural validity (all factor load>0.55, cumulative variance=67.98%), convergent validity (AVE>0.5), and discriminant validity (correlation coefficients of each dimension less than the square root of AVE). The reliability test results showed good internal consistency of the scale (Cronbach's α coefficient of 0.930). The total score of the Chinese version of DSAS-1 for adolescents was negatively correlated with the total scores of the Diabetes Strengths and Resilience Measure for Adolescents (r=-0.425, P<0.001), the Parent-child Relationship Scale (r=-0.302, P<0.001), and the Quality of Life Scale (r=-0.408, P<0.001) .

The Chinese version of DSAS-1 for adolescents has good reliability and validity and is simple and easy to conduct, which can provide a reliable quantitative assessment tool for the stigma of adolescents with T1DM in China.

Traditionally, open reduction with Kirschner wire fixation (ORKF) is used to treat paediatric patients with significantly displaced lateral humeral condyle fractures. However, in recent years, the use of closed reduction percutaneous pinning (CRPP) to treat lateral humeral condyle fractures in children has been increasingly reported. However, there is some controversy as to which surgical technique is more effective and safe.

To evaluate the efficacy and safety of CRPP and ORKF in paediatric patients with lateral humeral condyle fractures.

Chinese databases including CNKI, Wanfang Data, VIP and CBM and English databases including PubMed, Embase, Cochrane Library and Web of Science were searched from inception to 2023-01-01 for the case-control studies of CRPP and ORKF to treat the lateral humeral condyle fractures, the quality of the literature was evaluated and data were extracted. RevMan 5.3 software was performed to conduct a meta-analysis comparing the relevant efficacy and safety indexes of the two surgical techniques.

A total of 16 studies involving 1 165 cases were included for this meta-analysis. The results of meta-analysis indicated that CRPP was superior in status of surgical time (MD=-11.81, 95%CI=-15.04 to -8.58, P<0.000 01), intraoperative bleeding (MD=-3.36, 95%CI=-4.37 to -2.36, P<0.000 01), postoperative fracture healing time (MD=-3.92, 95%CI=-6.80 to -1.03, P=0.008), Kirschner wire rtention time (MD=-3.35, 95%CI=-6.33 to -0.38, P=0.03), and postoperative functional recovery of elbow joint (OR=0.44, 95%CI=0.25 to 0.76, P=0.006). The incidence of overall postoperative complications (OR=0.33, 95%CI=0.19 to 0.56, P<0.000 1) and superficial infections (OR=0.39, 95%CI=0.21 to 0.73, P=0.003) was lower than that in the ORKF group. However, there is no statistically significant difference in the deep infections, poor fracture healing, and ischemic necrosis of the lateral condyle between the two groups (P>0.05) .

CRPP was superior to ORKF in the treatment of pediatric lateral humeral condyle fractures, both in terms of efficacy and overall complications, but more high-quality studies are needed to further validate CRPP in terms of specific complications.

In recent years, the incidence of Mycoplasma pneumoniae pneumonia in children has continued to rise, with a corresponding increase in the number of severe Mycoplasma pneumoniae pneumonia, attracting widespread attention from clinical physicians. Understanding the risk factors associated with severe Mycoplasma pneumoniae pneumonia with the aim to determine the severity of the condition in affected children, prevent the occurrence of severe cases, and reduce sequelae has been a focal point in research. Although numerous studies have been conducted on the risk factors of severe Mycoplasma pneumoniae pneumonia, variations in time and geographical regions of the studies necessitate a systematic review and analysis for a comprehensive understanding.

To systematically review the risk factors for severe Mycoplasma pneumoniae pneumonia.

CNKI, Wanfang Data, VIP, CBM, Duxiu, Yiigle, Cochrane Library, PubMed, Embase, Web of Science, Science Direct, and BioMed Central were searched for studies related to risk factors of severe Mycoplasma pneumoniae pneumonia in children from inception to August 2023. Two investigators independently screened literature, extracted data, and assessed the bias risk of included studies. Meta-analysis was performed using Stata 14.0 and RevMan 5.4 software.

A total of 22 retrospective case-control studies involving 4 531 childre were included. Meta-analysis showed that C-reactive protein (CRP) (OR=1.92, 95%CI=1.72-2.15, P<0.000 01), erythrocyte sedimentation rate (ESR) (OR=2.61, 95%CI=2.12-3.22), P<0.000 01), procalcitonin (PCT) (OR=2.60, 95%CI =1.43-4.75, P=0.002), D-dimer (OR=4.36, 95%CI=2.93-6.50, P<0.000 01), white blood cell count (WBC) (OR=1.98, 95%CI=1.66-2.36, P<0.000 01), lower lobe lesions (OR=5.70, 95%CI=3.48-9.35, P<0.000 01), large patchy lesions (OR=6.37, 95%CI=4.09-9.92, P<0.000 01), high Mycoplasma pneumoniae antibody titers (OR=2.83, 95%CI=1.78-4.49, P<0.000 1), lactate dehydrogenase (LDH) (OR=1.03, 95%CI=1.00-1.05, P=0.05), and duration of fever (OR=8.33, 95%CI=3.38-20.56, P<0.000 01) were positively correlated with severe Mycoplasma pneumoniae pneumonia in children.

Elevated inflammatory markers (CRP, ESR, PCT, LDH, WBC), the presence of characteristic imaging changes (large patchy consolidation, lower lobe lesions), high Mycoplasma pneumoniae antibody titer, elevated D-dimer, and prolonged fever duration may be risk factors for severe Mycoplasma pneumoniae pneumonia in children. Future high-quality studies are needed to further explore the relationship of other clinical, radiographic, and laboratory findings with severe Mycoplasma pneumoniae pneumonia in children, and develop prognostic models based on identified risk factors.

Cardiovascular disease (CVD) is the leading cause of death in China and the world as a whole, and lipid metabolism disorder is the key factor for this disease. A comprehensive understanding of the prevalence of dyslipidemia in children and adolescents can contribute to the early prevention of dyslipidemia in adulthood.

To systematically evaluate the status quo of the prevalence of dyslipidemia in Chinese children and adolescents.

Cross-sectional studies on the morbidity rate of dyslipidemia among Chinese children and adolescents and published from January 2015 to July 2023 were retrieved from databases of CBM, CNKI, Wanfang, VIP, Embase, Web of Science and Cochrane Library. Processes of literature screening, data extraction and risk bias analysis were performed by two researchers. A meta-analysis was performed by taking advantage of Stata 17.0.

34 cross-sectional studies were collected and a total of 134 438 children and adolescents were involved. Results of the meta-analysis indicated that the overall morbidity rate of dyslipidemia in Chinese children and adolescents was 19% (95%CI=16%-21%), and the morbidity rates of high cholesterol (TC), high triacylglycerol (TG), high low-density lipoprotein cholesterol (LDL-C), low high-density lipoprotein cholesterol (HDL-C) were 6% (95%CI=5%-7%), 9% (95%CI=6%-12%), 4% (95%CI=3%-5%) and 10% (95%CI=7%-13%) respectively. Regarding time distribution, the detection rate of dyslipidemia was fluctuant and showed a decreasing trend; the detection rate of high TC and high LDL-C showed an increasing trend in general, but it fell slightly in 2023; the detection rate of high TG and low HDL-C fluctuated greatly: the detection rate of high TG gradually decreased from 2018 to 2022 and rebounded slightly in 2023. The results of subgroup analysis showed that, concerning age, the overall morbidity rate of dyslipidemia in children and adolescents and that of high TC showed an ascending tendency with the increasing of age (10% and 2% for those aged from 3 to 6, 17% and 10% for those aged from 7 to 11, and 27% and 14% for those aged from 12 to18), the morbidity rate of lowered HDL-C was higher among 12-to-18-year olds (20%) than among 7-to-11-year olds (9%), and the morbidity rate of high TC among 3-to-6-year olds (9%) was higher than that among 7-to-11-year olds and 12-to-18-year-olds (4% and 3%) (P<0.05). Concerning region, the morbidity rates of low HDL-C were higher in the West (15%) than in the East (7%), and the morbidity rates of high TC and high LDL-C were higher in the East (7% and 6%) than in the West (3% and 2%) (P<0.05). Concerning BMI, the morbidity rates of dyslipidemia, high TG and high LDL-C were higher in obese children and adolescents (48%, 18%, 25%, and 7%) than in overweight (27%, 6%, 9%, and 4%) and normal children and adolescents (15%, 4%, 3%, and 3%) (P<0.05) .

The morbidity rate of dyslipidemia in Chinese children and adolescents is relatively high and varied across the age, region and BMI of children and adolescents. Due to the limitation of the number and quality of included studies, more high-quality studies are needed to be conducted to further validate these findings.

In order to solve the children's medical dilemmas of poor accessibility and high cost, a hierarchical medical system has been carried out in our country. No systematic research on policy analysis of children's hierarchical medical system has been reported in China at present.

Beijing and Shenzhen are the first pilot cities of the hierarchical medical system, but there are obvious differences in the status of community health services for children. This study aims to explore the impact of policies on community health services for children by analyzing the policies in these two cities.

According to the research framework of policies on community health services developed by an expert group (community first contact care, dual referral, medical alliance, salary compensation mechanism, pediatric professional training, publicity, rural medical accessibility), policy documents about hierarchical medical services for children were searched from the official website of Beijing Municipal Government, Beijing Municipal Health Commission, Shenzhen Municipal Government, and Shenzhen Municipal Health Commission. Compare the number and content of policies that meet the inclusion and exclusion criteria in the two cities and analyze similarities and differences.

Thirty-five policy documents that fit the research framework were selected from 6 953, of which 27 were from Beijing and 8 from Shenzhen. Both cities have policies on medical alliances, wage incentives and pediatric training. Compared with Shenzhen, Beijing has policies on publicity, and rural medical accessibility, but not on community first contact care and dual referral.

It may be of great significance to improve the situation of community health services for children by implementing the community first contact care or increasing the gap in medical insurance payment ratio, completing the indications for dual referral, promoting the medical alliance, salary compensation mechanism and training of pediatric skills policies.