This paper summarizes Professor Xiong Lei's clinical experience in the differential diagnosis and treatment of influenza in children based on the theory of "treatment tailored to individual, seasonal, and geographical factors" by using the method of penetrating heat and resolving dampness. Considering the regional climatic characteristics of Yunnan, seasonal features, and the physiological and pathological traits of children, Professor Xiong holds that influenza in children is often characterized by dampness and heat, frequently complicated by phlegm retention, food stagnation, and qi depression. In clinical practice, aromatic herbs for penetrating heat and resolving dampness serve as the main therapeutic approach, with treatment staged and performed according to syndrome differentiation and symptoms. His medication features include: being good at using aromatic Chinese herbs to penetrate heat and resolve dampness and regulate qi movement; skillful application of acrid-warm herbs to release the exterior, relieve stagnation, and preserve healthy qi while eliminating pathogenic factors; placing emphasis on protecting the spleen and stomach, using bitter-cold herbs with care, and combining internal with external treatment. This paper systematically elaborates on his diagnostic and therapeutic thoughts and medication experience, along with a proven case, demonstrating the advantages of TCM treatment tailored to geographical, seasonal, and individual factors.

Objective To systematically evaluate the effectiveness of external therapy in traditional Chinese medicine(TCM) for children with cough variant asthma(CVA), provide relevant references for clinical practice, and promote the advancement of TCM external therapy. Methods Computer searches were conducted for clinical literature published in China National Knowledge Infrastructure(CNKI), Wanfang Data Knowledge Service Platform (Wanfang Data), VIP Chinese Science and Technology Journal Database, PubMed Database, etc. regarding the treatment of cough variant asthma with traditional Chinese medicine external therapy. Literature that met the inclusion criteria was selected and subjected to meta-analysis using Review Manager 5.4 software. Results A total of 59 studies were included，involving 5 266 patients. The results showed statistically significant differences in the primary outcome indicators — total effective rate (RR=1.18, 95%CI: 1.15–1.21, I2=81%, P<0.000 01) and cure rate (RR=1.89, 95%CI: 1.67–2.13, I2=0%, P<0.000 01), as well as in the secondary outcome indicators including cough-related scores, immunoglobulin levels, and vital capacity, compared with the control group (P<0.05). Conclusion TCM external therapy can significantly improve the overall effective rate and cure rate in children with CVA, reduce cough-related symptom scores, shorten the time to cough relief and disappearance, and enhance lung capacity and immune levels.

Refractory Mycoplasma pneumoniae pneumonia(RMPP) represents a special type of pediatric respiratory infection, characterized by prolonged course of disease and frequent complications. Its occurrence is related to not only the persistent existence of drug-resistant Mycoplasma pneumoniae and toxic action but also imbalanced host immune response, inflammatory cytokine storm and formation of airway mucus plug, and some child patients have multiple system organs involved. Current western medicine treatment relies mainly on antibiotics; however, the effect of macrolide is limited because of high drug resistance, while tetracyclines and fluoroquinolones are restricted by age and safety. Corticosteroids and intravenous immunoglobulin(IVIG) can improve short-term outcomes in high-inflammatory phenotypes, yet there is still no unified norms for indications, timing, dosage, and long-term safety of medication. Bronchoscopic alveolar lavage facilitates mucus clearance and ventilation improvement, but there is a lack of randomized controlled multicenter evidence. Based on the pathogenesis of "wind-heat invading the lung, phlegm-heat obstructing the lung and healthy qi deficiency with lingering pathogens", and with its therapeutic principles of "clearing heat and removing toxin, ventilating the lung and resolving phlegm and tonifying qi and strengthening healthy qi", traditional Chinese medicine(TCM) exerts multi-target anti-inflammatory and immunomodulatory effects. Clinical researches and systematic evaluation have shown that related prescriptions and Chinese patent medicines have some advantages in clearing fever, relieving symptoms and imaging absorption. The protocols combining TCM and western medicine have shown synergistic effects in shortening disease course, decreasing inflammatory load and reducing hormone use, which is expected to improve the short-term and long-term prognosis of RMPP children. This review systematically collates the pathogenesis, treatment challenges and evidence-based evidence of RMPP in western medicine, traditional Chinese medicine and integrated Chinese and western medicine, and proposes the comprehensive management ideas based on stages of disease course and phenotypic stratification, aiming to provide a reference for further optimizing therapeutic strategies and designing high-quality clinical trials.

Mycoplasma pneumoniae(MP) is one of the major pathogens causing community-acquired pneumonia in children. While most infections are self-limited, some pediatric patients may develop severe Mycoplasma pneumoniae pneumonia(SMPP) due to an excessive immune response, which significantly increases the difficulty of clinical treatment. This article reviews the immunopathological mechanisms of SMPP, with a focus on the key roles of innate immune dysfunction, adaptive immune imbalance, and cytokine storms in inducing lung tissue damage. Meanwhile, by integrating core theories of traditional Chinese medicine (TCM) such as ＂preservation of healthy qi to prevent invasion by pathogenic factors＂(zheng qi cun nei, xie bu ke gan), ＂exuberant heat-toxin＂, and ＂failure of lung to disperse and descend＂, the article explores how TCM regulates the internal mechanism of immune imbalance through multiple pathways and targets, including clearing heat and detoxifying, dispersing the lung and resolving phlegm, and benefiting qi and nourishing yin. Furthermore, it discusses the potential advantages of integrated traditional Chinese and western medicine interventions in alleviating inflammation and improving prognosis. The aim is to provide new theoretical insights and clinical references for the early identification, immune regulation, and integrated Chinese and western prevention and treatment of SMPP.

Viral pneumonia is a common lower respiratory tract infection in children, and oxidative stress plays a pivotal role in its occurrence and development. Viral infection can induce a storm of reactive oxygen species, disrupting the systemic oxidant-antioxidant balance, and promoting viral replication, excessive inflammatory responses and lung tissue damage by activating key signaling pathways such as Toll-like receptors(TLR), nuclear factor kappa-B(NF-κB), and nuclear factor erythroid-2 related factor 2(Nrf2). Currently, antioxidant therapy for this disease has become a focus of research. Based on elucidating the core mechanism of oxidative stress, this article reviews interventional strategies of traditional Chinese and western medicine. An in-depth exploration of the oxidative stress mechanism is made and antioxidant strategies based on TCM and western medicine are integrated, which will provide novel insights and drug development targets for the clinical prevention and treatment of viral pneumonia in children.

Persistent cough in children is a complex condition often not limited to the lungs alone. Based on the theory of "Shaoyang as the pivot" and the doctrine of "Sanjiao Qi transformation" from the "Inner Canon", combined with the physiological characteristics of children, namely "the liver is often in excess and the spleen is often deficient", this article systematically constructs an explanatory framework for the core pathogenesis of persistent cough in children. The analysis suggests that the malfunction of Shaoyang pivot is the key trigger for the dysfunction of Sanjiao qi transformation, leading to qi stagnation and water metabolism disorders, ultimately forming a core pathogenesis chain of "pivot malfunction-qi transformation dysfunction-phlegm retention-lung qi ascending". The disease location involves multiple systems such as the liver, gallbladder, Sanjiao, spleen, and lungs, and the nature of the disease is often characterized as "deficiency in the root and excess in the branch, mixed cold and heat". Based on this, a "pivot-regulating treatment method" centered on "dredging Shaoyang and smoothing Sanjiao" is proposed. The key lies in restoring the normal distribution pathways of qi and water, while protecting the middle energizer to solidify the axis of rotation. This article provides a new perspective and systematic treatment plan for the diagnosis and treatment of persistent cough in children that goes beyond the lung-centered approach.

Short stature in children represents a common growth and developmental disorder in pediatric practice, with its pathogenesis influenced by multiple factors including genetics, endocrine function, environment, and nutrition. External therapies of traditional Chinese medicine(TCM), characterized by safety, non-invasiveness, and high compliance among pediatric patients, have emerged as critical clinical interventions. Through the retrieval and review of relevant domestic and international literature published in recent years, this article systematically summarizes the clinical application, mechanisms of action, and current research status of TCM external therapies for pediatric short stature, encompassing acupoint application of Chinese herbal patches, moxibustion, acupuncture, acupoint catgut-embedding, pediatric Tuina, auricular pellet pressing, and foot bathing with Chinese herbs. By analyzing the indications, clinical efficacy, and existing limitations of each therapy, the application characteristics and compatibility rules of different therapeutic modalities are concluded. The research findings reveal that various TCM external therapies can promote children's growth and development by regulating meridians and qi and blood, as well as adjusting visceral functions. This article comprehensively summarizes the progress of TCM external therapies in the treatment of pediatric short stature, which provides a literature basis for clinicians to select individualized treatment regimens based on syndrome differentiation, and also offers ideas for the standardized application and further in-depth research of these therapies.

IgA vasculitis is the most common vasculitis in children, often involving the skin, joints, gastrointestinal tract and kidneys. Kidney damage is the most serious complication, and about 8% of children may progress to renal failure. At present, although kidney biopsy is the gold standard for diagnosis, it is difficult to carry out it widely due to its invasiveness and difficulty when performed in children. Therefore, finding non-invasive and reliable biomarkers and constructing predictive models are of great significance for early disease identification, activity assessment, and prognosis judgment. This paper systematically reviews the potential application value of blood, urine and genetic markers related to IgA vasculitis nephritis(IgAVN) in disease diagnosis, activity assessment and prognosis prediction, sorts out the evolution of IgAVN prediction model from traditional statistical methods to machine learning algorithms, analyzes the limitations of existing models, and makes a prospective outlook for future research directions.

Children are a high-risk and susceptible group for infectious diseases, and the prevalence of infectious diseases has adverse effects on their physical and mental health. In traditional Chinese medicine, it is believed that infectious diseases are caused by the accumulation of pathogenic factors such as dampness and heat during the perception of epidemic diseases. The prevention and treatment of infectious diseases in children with traditional Chinese medicine has always revolved around the two major treatment methods of "attacking evil qi" and "reinforcing healthy qi", constantly exploring, contending, and integrating them. This article systematically reviews the medical treatises and clinical cases of medical practitioners from the Song Dynasty to the New China, aiming to clarify the development and evolution of this core treatment concept. Researches have shown that the academic breakthroughs and innovations of medical practitioners throughout history are rooted in a profound understanding of the contradiction between the delicate and underdeveloped physiological characteristics of children's organs and the fierce and rapid pathogenic characteristics of epidemics. Medical professionals seek a dynamic balance between attacking evil qi and reinforcing healthy qi, eliminating toxins and consolidating the foundation, gradually building a system of differential diagnosis and treatment for pediatric diseases. This article summarizes the relevant theories of traditional Chinese medicine in the prevention and treatment of infectious diseases in children, aiming to provide new ideas and theoretical support for modern prevention and treatment practice in pediatric infectious diseases.

Pediatric sleep disorders(PSD) are common neurological and behavioral disorders in pediatrics. In recent years, the incidence has been increasing year by year, and they have become an important public health issue that poses a threat to children's physical and mental health. This disease not only directly interferes with children's normal sleep rhythm, but also significantly affects the secretion of growth hormone, bone development, cognitive function, and emotional regulation, causing multiple adverse effects on the growth and development, mental health, and long-term quality of life of the children. Traditional Chinese medicine(TCM) has a complete system and proven efficacy in the diagnosis and treatment of this disease, and it has unique advantages and clinical value. Based on the core theory of "Shaoyang pivot-mechanism" in traditional Chinese medicine, this article deeply explains the close relationship between the physiological and pathological characteristics of children and the functions of Shaoyang, clarifying that the core pathogenesis of pediatric sleep disorders is the dysfunction of the Shaoyang pivot-mechanism, which further leads to the abnormal ascending and descending of qi, the disorder of qi transformation in the tri-jiao,and the weakness of the Shaoyang gallbladder qi. Eventually, it results in the failure of yang to enter yin, the disturbance of the spirit by phlegm-heat, and the failure of Hun to stay in its abode. Chaihu Longgu Muli decoction is a classic formula in traditional Chinese medicine for harmonizing Shaoyang and calming the mind. It has the effects of regulating liver and resolving depression, calming the spirit and the mind, harmonizing yin and yang, and resolving the pivot-mechanism. In clinical application, it can be flexibly formulated based on the five common syndromes of liver depression to generate fire, imbalance of yin and yang, disturbance of the spirit by phlegm-heat, weakness of the gallbladder qi, and heat in the gallbladder and liver, in order to provide precise treatment. This fully demonstrates the diagnostic and therapeutic concepts of traditional Chinese medicine, which are syndrome differentiation and treatment based on the overall condition and the principle of managing the root cause of the disease. The paper provides new ideas and theoretical basis for the prevention and treatment of pediatric sleep disorders with traditional Chinese medicine.

Objective To investigate the mechanism of Xiaoer Jianpi Jiangzhi formula(XJJF) in the treatment of childhood obesity based on network pharmacology and molecular docking. Methods Chemical ingredients and targets of XJJF were obtained from the TCMSP and BATMAN-TCM databases. Disease-related genes were collected from the GeneCards, CTD, PharmGKB, OMIM, and TTD databases, which were then mapped with the drug targets. The shared targets were imported into the STRING database to construct a protein-protein interaction(PPI) network and into the Metascape database for enrichment analysis. A drug-chemical ingredient-target network diagram was drawn using Cytoscape 3.10.1. The binding affinities between key active ingredients and core targets were validated through molecular docking. Results A total of 134 active ingredients of XJJF were identified, along with 616 targets shared by the drug and the disease. The active ingredients such as Nuciferine,(-)-Epigallocatechin, Nobiletin, Baicalein, 3β-acetoxyatractylone, and Acacetin were identified as the main ingredients of XJJF in the treatment of obesity. These ingredients involved 10 core targets, including ESR1, STAT3, JUN, TP53, and EP300, and may exert therapeutic effects on obese children through multiple biological processes such as lipid metabolism and atherosclerosis, inflammation and immune response, as well as cancer and cell proliferation regulation. Conclusion Xiaoer Jianpi Jiangzhi formula exerts the effects of anti-inflammation, lipid regulation, improvement of insulin resistance, and regulation of adipocyte homeostasis through multiple signaling pathways, thereby exerting therapeutic effects on childhood obesity.

Obsessive-compulsive tic disorder, as a special clinical phenotype of tic disorders, has not received sufficient attention regarding its unique pathogenic characteristics and treatment difficulties. Based on the theory of the Five Spirits in traditional Chinese medicine(TCM), this article primarily explains the TCM pathogenesis of this disease and proposes a treatment strategy centered on regulating the spirit. The Five Spirits in humans are responsible for consciousness control, decision-making, memory and thinking, instinctive sensations and habitual actions, and willpower and determination, jointly maintaining the overall balance of "spirit-body-movement-thought". The pathogenesis of obsessive-compulsive tic disorder begins with the disturbance of heart and mind and obscured heart monarch; subsequently, the liver Hun loses its control, resulting in abnormal movement and wind generation, manifested as involuntary tics; as the condition progresses, the lung Po fails to govern, leading to abnormal regulation of actions and habits, forming stereotyped behaviors; its root cause lies in the failure of the spleen Yi to be stored and the retention of thoughts unable to dissipate, and that the kidney Zhi is not firm and lacks a foundation, causing persistent obsessive thoughts and making the condition difficult to heal. Therefore, the core pathogenesis of this disease lies in the disorder of the Five Spirits. Treatment should be based on regulating the spirit as the cardinal principle, coordinating body and spirit, and taking both the symptoms and the root causes into account. Through methods such as calming the spirit to stabilize Zhi, soothing the liver to extinguish wind, consolidating the lungs to settle Po, strengthening the spleen to store Yi, and filling the essence to solidify Zhi, the normal state can be restored where the Five Spirits perform their respective functions and are coordinated in an orderly manner. This article also presents a case of treatment for obsessive-compulsive tic disorder by Professor Chen Yuyan, in which the diagnosis and treatment process based on the Five Spirits syndrome-differentiation is described in detail, aiming to provide a new theoretical perspective and practical reference for the differentiated treatment of this disease with traditional Chinese medicine in clinical practice.

Pediatric anorexia is a common digestive issue in pediatric department. Clinically, it is usually characterized by a long-term dislike of eating and reduced food intake, which, if persists, can lead to malnutrition and delayed development in children. Professor Duan Xiaozheng, who has years of clinical experience, believes that although the problem lies in the spleen and stomach, the choice of prescriptions and medications is closely related to the child's constitution. He suggests invigorating the spleen and promoting transportation to strengthen the body's foundation, calming the liver and regulating qi to smooth the flow, awaking the spleen and soothing the mind to relieve stagnation, tonifying the kidneys and replenishing essence to tonify the spleen, and nourishing yin and producing fluids to restore moistness. Treatment should be conducted based on syndromes with flexible therapies, first assessing the child's constitution, then identifying what is root cause and what is urgent; based on the child's constitutional characteristics of "three excesses and four deficiencies", the syndrome-differentiated treatment for pediatric anorexia can be performed with constitution as the root and syndrome as manisfestations.

Objective To investigate the influence of gut microbiota composition on neuropsychological development of very preterm infants(gestational age 28–32?? weeks) at a corrected age of 2 years. Methods Totally 31 very preterm infants were chosen, who were admitted for various reasons to NICU of Affiliated Sanming First Hospital of Fujian Medical University from Jan. 1, 2023 to Dec. 31, 2023. Based on the scores of developmental quotient assessment, they were divided into two groups: 20 in the normal neurodevelopment group and 11 in the delayed neurodevelopment group. At the corrected age of 2 years, neuropsychological development was assessed using the Intelligent Child Development Examination System(developmental scale for children aged 0-6 years). A developmental quotient(DQ) score of ≥85 was considered normal, while a score below 85 in one or more domains indicated developmental delay. The structure and diversity of the infant gut microbiota were analyzed using 16S rRNA sequencing, and the relationship between early-life gut microbiota and neuropsychological development scores was analyzed. Results The relative abundance of Actinobacteria within 24 hours after birth was higher in the normal neurodevelopment group than in the delayed group(P<0.001), while the abundance of Bacteroidetes was lower(P<0.001). No significant difference in alpha diversity was observed between the two groups(P>0.05). Spearman's correlation analysis revealed a positive correlation between the relative abundance of Bifidobacterium in the intestines within the first 24 hours after birth and scores in fine motor and language development domains at the corrected age of 2 years. In contrast, the relative abundance of Staphylococcus was negatively correlated with scores in fine motor and social behavior development domains. Conclusion Early-life gut microbiota composition differs in very preterm infants, and the difference is associated with their neurodevelopmental levels.

Objective To explore the clinical efficacy of long-term vitamin D(VitD) supplementation combined with comprehensive behavioral therapy in the treatment of transient tic disorder(TTD) in children. Methods Totally 150 TTD children who were admitted to the Second Affiliated Hospital of Xinjiang Medical University from January 2023 to June 2024 were selected as study subjects, and they were randomly divided into the control group and the observation group with 75 cases in each group. Both groups received comprehensive behavioral therapy, while the observation group received additional vitamin D intervention. After the treatment course of 24 weeks, the total effective rate of treatment, tic disorder severity, lymphocyte subsets, brain-derived neurotrophic factor(BDNF) and neuron-specific enolase(NSE) levels were compared. Results The total effective rate of treatment in the observation group was 92.0%(69/75), which was higher than that in the control group (80.0%, 60/75), being with statistical difference(P<0.05). After 8 weeks, 16 weeks and 24 weeks of treatment, the Yale global tic severity scale(YGTSS) scores in the observation group were all lower than those in the control group, and there were statistical differences(P<0.05). After treatment, the improvement in lymphocyte subsets in the observation group was better than that in the control group, and the differences were statistically significant(P<0.05). After treatment, the BDNF level in the observation group was higher than that in the control group, while the NSE level was lower than that in the control group, both differences being statistically significant(P<0.05). Conclusion Compared to comprehensive behavioral therapy alone, the long-term supplementation of vitamin D combined with comprehensive behavioral therapy for the treatment of TTD has a higher total effective rate of treatment and more significant improvement in tic symptoms, lymphocyte subsets, and levels of BDNF and NSE, which is worthy of clinical application.