Abstract:Systemic juvenile idiopathic arthritis(sJIA)has a unique disease background and clinical profile,with various extra-articular manifestations and disease patterns.Its etiology remains unclear.The interaction between genetic and environmental factors contributes to the onset and progression of the disease.Inflammation control and targeted therapies are key to achieving disease remission.This review outlines the pathogenesis of sJIA,classification criteria,current research advances in diagnosis and treatment,and the main global principles for targeted therapeutic management,highlighting the importance of early diagnosis,precise intervention,and long-term follow-up in improving patient outcomes and quality of life,which helps to deepen clinicians' overall understanding of sJIA.

Abstract:Juvenile Dermatomyositis(JDM)is a chronic autoimmune disease primarily characterized by skin and muscle inflammation,requiring individualized treatment based on disease severity and major organ involved.For non-severe cases,a combination of conventional-dose glucocorticoids with methotrexate serves as the first-line therapy.Methylprednisolone pulse therapy is indicated for severe cases.Recent studies have progressively confirmed the efficacy of intravenous immunoglobulin(IVIG)in JDM.Biological agents and JAK inhibitors may be selectively used for refractory cases,while CAR-T therapy also holds therapeutic promise for these refractory patients.

Abstract:Invasive fungal infection(IFI)is a fungal infection that invades deep tissues and organs as well as the whole body.Premature infants,newborns,and children with severe primary diseases are at high risk of invasive fungal infections.In recent years,with the increasing number of children with IFI,the increasing difficulty of pediatric IFI diagnosis,and the emergence of fungal resistance,the mortality rate has increased significantly.Pediatric IFI patients have low immunity,high complexity of drug use,atypical infection symptoms,and difficulty in early diagnosis,which increase the difficulty of clinical diagnosis and treatment in children with IFI.This article reviews the challenges faced by pediatric IFI in the treatment and the research progress in new drugs and new diagnostic and therapeutic methods,which helps to increase the attention to pediatric IFI patients,thus providing a reference for the prevention of high-risk children,the early diagnosis and treatment of pediatric IFI children,and the research direction of new drugs and new methods.

Abstract:Neurodevelopmental delays or disorders associated with congenital heart disease(CHD)have become a global challenge;however,the concerns about them remain limited in China.The current healthcare system primarily focuses on surgical treatment for CHD,often overlooking the importance of long-term postoperative follow-up and neurodevelopmental management.This interpretation summarizes the latest advancements in the field of CHD,systematically elaborating on neuroprotection strategies and risk stratification methods,and aiming to optimize clinical management and improve neurodevelopmental outcomes of children with CHD in China.

Abstract:Anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV)is an autoimmune disease characterized by small-vessel inflammation,which can involve multiple organs throughout the body.The condition is extremely dangerous.With the in-depth research on pediatric AAV,more evidence has been provided for clinical guidance in the diagnosis and treatment of AAV.This article briefly elaborates on the diagnosis and treatment of pediatric AAV.

Abstract:Remarkable progress has been made in diagnosis and treatment level of rheumatic and autoimmune diseases in children in recent years.On the diagnostic front,the advent of biomarker-driven disease stratification has revolutionized patient management by enabling early identification of high-risk individuals and facilitating personalized treatment plans.The expanding clinical application of genetic sequencing has particularly enhanced our comprehension of monogenic lupus and other prevalent childhood autoimmune disorders.Concurrently,diagnostic classification systems are undergoing continuous refinement to keep pace with the precision medicine paradigm shift.Therapeutic advancements have been equally transformative.Early,standardized intervention has emerged as a critical factor in preventing irreversible organ damage and optimizing long-term prognosis.Modern treatment strategies now feature increasingly targeted immunosuppressive regimens,while the accelerated development of biologic agents has substantially expanded the therapeutic arsenal for pediatric rheumatic diseases.Particularly promising are novel cellular therapies that show great potential in this evolving landscape.These collective developments underscore the growing importance of molecular-guided stratified diagnosis and tailored therapeutic interventions as fundamental components in elevating the standard of care for pediatric rheumatic and autoimmune disorders.

Abstract:Objective To analyze the clinical characteristics of tracheal stenosis in pediatric patients and compare the clinical features between congenital and secondary tracheal stenosis.Methods A retrospective analysis was conducted on clinical data of pediatric inpatients diagnosed with tracheal stenosis through bronchoscopy at the Department of Pediatrics,First Affiliated Hospital of Xiamen University from January 1,2012,to December 31,2021.Statistical analysis was performed using SPSS 28.0 software.Results A total of 53 cases were included(30 males,23 females)with a median age of 8.7 months.Children under 1 year of age accounted for 72.2％of cases.Chronic respiratory symptoms were the predominant manifestation in 60％of patients,including chronic cough,stridor,laryngeal wheezing,and recurrent wheezing.Among the 53 cases,25 were diagnosed with congenital tracheal stenosis(CTS),all of which showed complete tracheal rings affecting various tracheal segments.Twenty-eight cases were secondary tracheal stenosis(STS),with 24 cases caused by cardiovascular compression,primarily from the aortic system,and all were external compression stenosis of the middle and lower trachea.Two cases presented with endotracheal membranous formation,resulting in luminal stenosis.Concomitant airway malformations were more prevalent in CTS compared to STS,with a significantly higher tracheal-bronchial ratio than STS.Fifty-two patients showed improvement after conservative medical management,including anti-infection therapy and airway management,and were discharged.Conclusion Tracheal stenosis predominantly affects infants under one year of age,typically presenting with chronic respiratory symptoms.Chest CT combined with bronchoscopy can accurately evaluate pediatric tracheal stenosis.Clinical manifestations differ between congenital and secondary tracheal stenosis.

Abstract:Pediatric allergic airway diseases and tic disorders,as chronic conditions,are increasingly prevalent,which not only affect the quality of life but also impose substantial economic and social burdens.Clinical studies have revealed a significant correlation between tic disorders and allergic diseases,both of which are associated with immune system imbalances.The symptoms involve various parts or organs,and the pathogenesis is complex,severely impacting the quality of life.Potential factors influencing the development of these diseases include maternal depression and anxiety,maternal allergy history,maternal tobacco exposure history,sleep disorders,and environmental pollution.Furthermore,gut microbiome dysbiosis and T-cell immune imbalance may be potential factors underlying the comorbidity of the two conditions.Exploring and understanding these shared risk factors and comorbidity mechanisms increases the cognition about these two diseases,which is of great significance for the prevention and treatment of allergic airway diseases and tic disorders.

Abstract:Takayasu arteritis is the most common large vessel vasculitis during childhood.In comparison to the diagnosis,the treatment for pediatric TAK is more challenging,and treatment strategy often refers to adult guidelines.In recent years,several academic organizations have updated their recommendations on the diagnosis and treatment of TAK,and the status of targeted drugs has gradually become more prominent,with a tendency from"salvage treatment"to"early intervention".Based on the recommendations of these guidelines/consensuses and recent studies,this article summarizes and sorts out the diagnosis and treatment of pediatric TAK in order to provide references for pediatricians' clinical decision-making;meanwhile,it is expected to conduct more researches on childhood TAK to improve the status of insufficient evidence-based evidence.

Abstract:From January 2022 to December 2023,the Pediatric Intensive Care Unit(PICU)of the Women and Children's Medical Center Affiliated to Guangzhou Medical University admitted 3 children with toxic epidermal necrolysis(TEN),aged 4,8 and 13 respectively.The areas of skin lesion were 50％,70％and 90％respectively,and the involved sites were the eyes,nasal cavity,oral cavity,external genitalia,urethral orifice and perianal mucosa respectively.The SCORTEN score and the in-hospital mortality rate assessment were 2/12％,2/12％,and 3/32％,respectively.After ineffective treatment with glucocorticoids and intravenous immunoglobulin(IVIG),2 to 5 sessions(1.5 to 2.0 times the plasma volume each time)of plasma exchange(PE)treatment were given respectively,with an interval of 48 hours between each two sessions.After treatment,the skin lesions of all three cases improved significantly,and the inflammatory factors decreased significantly,while no ocular complications such as visual field defects occurred.The article holds that PE may be an effective treatment method for children with TEN.

Abstract:Childhood-onset systemic lupus erythematosus(cSLE)is a chronic autoimmune disease characterized by acuter onset,severer clinical manifestations,and poorer prognosis than those of adult-onset SLE.Early diagnosis and standardized treatment are crucial for improving outcomes.Currently,the diagnosis primarily relies on the 2012 SLICC and 2019 EULAR/ACR criteria,which were developed based on adult populations.Although these criteria perform well in the diagnosis of cSLE,they still have limitations in clinical practice.In the treatment a"treat-to-target"goal is emphasized and individualized treatment is conducted.Conventional therapy primarily consists of glucocorticoids combined with immunosuppressants,while the use of biologics can help reduce steroid use,lower disease activity,and decrease disease recurrences.The 2024 ACR guidelines recommend multitarget combination therapy for proliferative lupus nephritis,which shows promising results in adult patients.However,its actual efficacy and long-term safety in pediatric populations still require further validation.

Abstract:To improve the treatment and long-term management of systemic sclerosis(SSc),the European Alliance of Associations for Rheumatology(EULAR)released updated SSc treatment guidelines in September 2024,following the 2017 guidelines.These updated guidelines continue the previous organ-targeted treatment strategies and introduce several key recommendations across eight major domains,including Raynaud's phenomenon,digital ulcers,and pulmonary arterial hypertension.Most of the new recommendations are related to skin fibrosis and interstitial lung disease(ILD).This article provides an interpretation of the main content of the guidelines for clinical reference.

Abstract:Mycoplasma pneumoniae is one of the significant pathogens causing community-acquired pneumonia in children.Since 2000,macrolide-resistant Mycoplasma pneumoniae(MRMP)has begun to spread in the Western Pacific region,including China.MRMP infection often results in prolonged fever and duration of antibiotic use,increased use of glucocorticoids and second-line antibiotics,and an increased risk of complications and sequelae.In 2024,28 pediatric respiratory experts in our country formulated the"Expert consensus on the diagnosis and treatment of MRMP pneumonia in children".In this article,we will interpret the hot issues in the consensus to guide pediatricians to grasp the diagnosis and treatment of MRMP pneumonia more accurately.

Abstract:Respiratory syncytial virus(RSV)is the most com-mon virus causing lower respiratory tract infections in children.Attention should be paid to identifying children at high risk of developing severe infection.There are various detection methods to determine RSV infection,which should be selected rationally.The treatment for RSV infection is mainly symptomatic support,and recent progress in drug research and development is expected to achieve a breakthrough in treatment.

Abstract:The assessment models for severe pediatric pneumonia are centered on clinical features,and integrated with laboratory and imaging indicators to form a multidimensional early warning system.Different predictive models have specific clinical contexts,strengths,and limitations.When applied appropriately,they can significantly enhance early detection,optimize hierarchical diagnosis and treatment pathways,and reduce mortality of children with severe pneumonia.Future efforts should focus on further validation and simplification of these models to promote their widespread application in primary healthcare settings.

Abstract:Hypertrophic cardiomyopathy(HCM)is one of the most important causes of sudden cardiac death in children and adolescents.Since the publication of the first Chinese consensus on pediatric HCM diagnosis in 2019,new and significant advances have been made in the diagnosis and management of HCM.To address these developments,the Cardiovascular Subspecialty Group of the Pediatrics Branch,Chinese Medical Association,in collaboration with the Precision Diagnosis and Treatment Collaborative Group for Childhood Cardiomyopathy,the Heart Failure Collaborative Group,the Genetic and Metabolic Cardiomyopathy Collaborative Group,and the Editorial Board of Chinese Journal of Practical Pediatrics,organized experts to develop this updated consensus.The consensus focuses on the definition,diagnostic approaches,risk stratification,and management of pediatric HCM,with the aim of improving the standardization of diagnosis and treatment of pediatric HCM,thereby enhancing its quality of life and improving prognosis.

Abstract:In the new era of prevention and control of COVID-19,the characteristics of pediatric pneumonia have undergone some changes,such as the diversity and complexity of pathogens,and alteration in clinical characteristics,etc.Besides,much attention should be paid to respiratory virus-associated sepsis,obstructive respiratory failure caused by mucus hypersecretion after infection,and severe pneumonia complicated with pulmonary embolism.It is also necessary to strengthen the illness evaluation and early warning of severe pneumonia in children,and accelerate the application of artificial intelligence in the diagnosis and treatment of severe pneumonia.Clinicians should pay special attention to these issues in order to achieve better diagnosis,treatment,and prevention of severe pneumonia in children.

Abstract:The incidence of pertussis has shown an upward trend in recent years.Pneumonia is the most common complication,which is mostly seen in newborns and infants under 6 months of age.The clinical manifestations of severe cases are complex,and the disease progresses rapidly,which is very likely to cause serious complications and even death.This article reviews the epidemiological characteristics,clinical manifestations,and the latest treatment strategies of pertussis complicated with severe pneumonia in children.By integrating the latest research progress at home and abroad,this article aims to provide clinical physicians with reasonable diagnosis and treatment regimens to reduce the mortality rate.

Abstract:Early diagnosis and timely intervention in severe pneumonia play a vital role in reducing mortality rates of children with pneunomia.Machine learning(ML)holds potential advantages in the early diagnosis and treatment of severe pneumonia.This article analyzes the application progress of ML in three key clinical domains of severe pneumonia in children:early warning,diagnosis,and prognosis prediction,aiming to establish intelligent digital tools for early detection,precise diagnosis and treatment,and stratified management of severe pneumonia in children.

Abstract:Objective To establish reference ranges for left ventricular functional parameters in neonatal echocardiography across different postnatal time intervals,stratified by gestational age(GA),birth weight,and gender,thereby providing reference for left ventricular functional assessment in the application of neonatal critical care bedside cardiac ultrasound.Methods This multicenter,prospective,observational study enrolled 406 term neonates hospitalized or receiving outpatient care at the Children's Hospital of Chongqing Medical University,Yinchuan First People's Hospital of Ningxia Autonomous Region,and Inner Mongolia Maternal and Child Health Hospital between June 2023 and May 2024.Bedside echocardiography was performed by trained neonatologists or sonographers to measure parameters reflecting left ventricular systolic and diastolic function.Reference ranges(95％confidence intervals)were established for postnatal days 1,3,7,14,and 28,with stratification by GA and birth weight.Results Among the 406 term neonates(204 males,202 females),mean GA was(38.9±1.5)weeks,and mean birth weight was(3197.8±449.5)g.Multiple left ventricular functional parameters-including left ventricular outflow tract stroke volume(LVO),weight-indexed LVO(LVO*),mitral annular plane systolic excursion(MAPSE),mitral valve early(MV-E)and late(MV-A)diastolic inflow velocities,and pulmonary vein S/D ratio-showed significant associations with birth weight and GA(all P＜0.05).LVO,LVO*,MV-E,MV-A,MV-E/e'ratio(early diastolic inflow velocity to lateral mitral annular tissue Doppler e'velocity),pulmonary vein S-wave velocity,and pulmonary vein S/D ratio were correlated with postnatal age(all P＜0.05).No parameters exhibited gender-related differences(all P＞0.05).Conclusion Neonatal left ventricular systolic and diastolic functional parameters are associated with postnatal age,GA,and birth weight.This study establishes comprehensive reference ranges for left ventricular functional assessment,stratified by age,GA and birth weight,which play a crucial role in guiding refined hemodynamic evaluation and management of critically ill neonates.