Functional dyspepsia syndrome in infants and toddlers is a common gastrointestinal issue, resulting from incomplete physiological development and immature intestinal flora. Apart from feeding guidance and non pharmacological interventions, effective treatment options remain limited. To address this problem, a multidisciplinary expert team was organized to develop an integrated traditional Chinese and Western medicine therapeutic approach for functional dyspepsia syndrome in infants and toddlers.The main clinical manifestations include poor appetite, belching, abdominal distension, increased flatulence，dry retching,vomiting, recurrent crying，abdominal pain, and abnormal bowel movements. In traditional Chinese medicine, it is categorized under “food accumulation (jī zhì)” and “anorexia (yàn shí),” and can be differentiated into three patterns: deficiency syndrome, excess syndrome, and deficiency excess complex syndrome.The consensus emphasizes that treatment should prioritize feeding guidance and non pharmacological interventions, supplemented by medication and external therapies when necessary. Health education should explain the mechanism and prognosis of this syndrome to caregivers to alleviate their anxiety. Nursing guidance highlights creating a comfortable feeding environment, keeping the infant’s abdomen warm, and incorporating techniques such as gentle massage and burping. For different symptoms, corresponding treatment methods, medications, and external therapies should be selected.This consensus is formulated based on both traditional Chinese and Western medical theories as well as evidence based practice, fully integrating the advantages of both systems to provide a comprehensive reference for the standardized management of functional dyspepsia syndrome in infants and toddlers.

Rare diseases are characterized by low prevalence，diverse disease types，and significant challenges in diagnosis, which results in limited development of therapeutic drugs.Although China has implemented multiple policies to promote access to medications for rare diseases，there is still a lack of established consensus or clinical guidelines for medication management in pediatric rare diseases. This consensus clarifies the definition of rare diseases and provides recommendations on the following aspects: therapeutic medication process，management of off-label drug use, monitoring of drug use，hospital-level drug stocking，and the development of pharmaceutical service systems.It emphasizes that clinical pharmacists should participate in formulating drug therapy plans, rigorous assessments and documentation of off-label drug use must be conducted，and a database for monitoring adverse drug reactions associated with rare disease treatments should be established.Furthermore，it is suggested that healthcare institutions establish a designated list of essential drugs for rare diseases，implement temporary procurement mechanisms，strengthen pharmaceutical service frameworks，promote multidisciplinary collaboration，and enhance the overall quality of pharmaceutical care for pediatric patients with rare diseases.The formulation of this consensus is aimed to standardize the clinical medication management in pediatric rare diseases to ensure medication safety and safeguard the rights of pediatric patients, and to provide practical guidance for healthcare professionals in medical institutions.

Allergic diseases in children have become an increasingly severe public health challenge globally.The incidence is continuously rising worldwide，seriously affecting children’s physical and mental health and quality of life，and increasing the social and economic burden.The incidence in China is also increasing year by year， showing a trend of high incidence and low onset age in the central cities， which spreads to the second- and third-level cities and the countryside. This article aims to systematically elaborate on the prevalence status，core driving factors，and challenges faced by the current prevention and control system of allergic diseases in children from a macro perspective，and puts forward integrated and forward - looking coping strategies.The article emphasizes that to enhance the understanding of allergic diseases in children，it is urgently necessary to promote coordinated progress from multiple dimensions，including basic research，clinical practice，public health policies，and public education，and construct an integrated comprehensive prevention and control system of“prevention - diagnosis - treatment - management”， in order to effectively control the disease burden and comprehensively protect children’s health rights and benefits.

Adenoid hypertrophy and allergic diseases are common conditions in the pediatric population，which can cause symptoms such as mouth breathing，nasal congestion，snoring，and nighttime awakenings due to breath-holding.These conditions may lead to chronic sinusitis and recurrent otitis media，and even result in serious sequelae.Adenoid hypertrophy and allergic diseases often cooccur and interact with each other，exacerbating the inflammatory burden in the upper airway.This paper aims to explore the immune mechanisms，as well as diagnosis and management strategies，for adenoid hypertrophy and allergic diseases in children，with the goal of providing new insights for clinicians regarding the standardized diagnosis and treatment of pediatric adenoid hypertrophy accompanied by allergic diseases.

Allergic diseases are inflammatory diseases that cause tissue inflammation or organ dysfunction due to abnormal immune response to allergens，and the global health burden is huge， severely affecting the quality of life of the children.Despite great progress in the understanding of allergic diseases in recent years，especially bronchial asthma， it is found that there are significant differences in clinical characteristics（phenotype），treatment response，or disease progression in many children receiving conventional treatment.With the latest understanding of the pathophysiology of bronchial asthma，biologics provide new therapeutic strategies for severe，and also provide new approach difficult-to-control airway allergic diseases and prevent disease progression.Most of the current studies are conducted in bronchial asthma and show encouraging results.This article summarizes the clinical progress of the application of biologics in children’s bronchial asthma and provides clinicians with relevant application information.

Allergic diseases are among the most common chronic disorders in children，and their global prevalence has been rising markedly.Allergen testing is central to confirming the diagnosis，identifying the pathogenic causes，and formulating the core of precision prevention and control as well as specific immunotherapy plans.Children，however，are not“small adults”；their immune system is undergoing dynamic maturation，their clinical symptoms are often atypical，and the interpretation of test results is therefore intrinsically more complex.This article systematically introduces the common ways of allergen testing in children，including the principles and characteristics of both in-vivo and in-vitro assays.It focuses on how to rationally select an optimal testing strategy in specific clinical scenarios such as atopic dermatitis，food allergy，allergic rhinitis and asthma， and severe anaphylaxis.Further discussion is focused on how to interpret the test results based on patient age，clinical presentation，exposure history，regional features and other confounders to avoid misdiagnosis and over-diagnosis. Finally，the application prospect of emerging technologies is looked forward to， including molecular allergen diagnosis and novel biomarkers，with the aim of providing clinicians with an up-to-date evidence-based reference.

Due to the specialty of age and heterogeneity of clinical features of asthma in preschool children，its diagnosis and treatment pose one of the major challenges in pediatric clinical practice. This article focuses on the epidemiological trends，key points of clinical diagnosis，and current treatment intervention status of asthma in preschool children. By analyzing and elaborating on these aspects in combination with the new guidelines，it aims to provide reference for the clinical practice in asthma management of preschool children.

Atopic dermatitis（AD）is a chronic，recurrent，pruritic，type 2 inflammatory skin disease that commonly affects children.AD is primarily characterized by eczematous skin lesions，intense itching and elevated serum IgE levels， and is often associated with food allergy，asthma and allergic rhinitis.Pediatric cases of mild AD are often controlled by topical corticosteroids and/or calcineurin inhibitors.However，pediatric patients with moderate-to-severe AD usually require systemic therapies.Currently，first-line systemic treatments for moderate-to-severe AD include biologics，cyclosporine and corticosteroids， while second-line treatment mainly consists of JAK inhibitors and other traditional immunosuppressants.This article focuses on the latest advances in the systemic pharmacological therapies.

Allergic rhinitis（AR）is a common inflammatory disease of the upper respiratory tract in children，which adversely affects local nasal function and exacerbates asthma，inducing otitis media and sinusitis and leading to olfactory dysfunction in children.The condition can also impair children’s sleep quality and their growth and development.Furthermore，long-term mouth breathing may lead to craniofacial dysplasia.Concurrently，AR has been associated with a decline in cognitive and learning abilities and a broad deterioration in quality of life in children，causing emotional and behavioral problems. Therefore，we need to not only raise public awareness about AR in children but also pay attention to its effects on their physical and mental health.It is important to establish a comprehensive assessment system that addresses both local and overall complications and to conduct early diagnosis and treatment in order to stop disease progression.

Chronic cough in children（lasting >4 weeks with no significant abnormalities on chest X-ray）is a common yet challenging management issue in pediatric outpatient practice.This article focuses on this condition and proposes a clinical diagnostic and therapeutic framework based on initial classification of dry and productive cough.This framework helps clinicians quickly narrow down the focus to the most common etiologies，such as cough variant asthma，upper airway cough syndrome，and protracted bacterial bronchitis.It guides targeted evaluation and treatment，emphasizes time-limited diagnostic treatment trials in special outpatient settings，and standardizes the referral pathway.The goal is to reduce the misuse of antibiotics and antitussives，achieve precise management，and improve patient outcomes.

With the improvement in economic level and changes in lifestyle，the prevalence of food allergy among children in China has increased，especially in relatively economically developed regions where the increase is more significant.Children with food allergies face multiple challenges ranging from diagnosis and treatment to nutritional management.It is necessary to extensively carry out education and training on food allergies and enhance the understanding about food allergies among pediatric clinicians and child health care physicians at all levels，in order to provide scientific and comprehensive management for children with food allergies.

Although the overall incidence of drug allergy in children is lower than that in adults，its impact on prescribing decisions，antimicrobial strategies and healthcare costs is substantial.Standardized diagnosis is key to improving medication safety and avoiding unnecessary drug avoidance.This commentary reviews mechanisms of drug hypersensitivity and speciality of pediatric hypersensitivity，proposes a practicable，stratified diagnostic pathway，and outlines diagnostic pathway points for common “allergic” drugs in children，including β-lactam antibiotics，NSAIDs，and vaccines.In light of China’s current context，we highlight system bottlenecks and propose targeted solutions to strengthen diagnostic capacity in drug allergy and improve medication safety in children.

Wheat-dependent，exercise-induced anaphylaxis（WDEIA）is an immunoglobulin E（IgE）-mediated disease which is characterized by systemic allergic reactions triggered by synergistic factors such as exercise after wheat ingestion.It is characterized by sudden onset，high risk，and easy misdiagnosis.The clinical manifestations mainly involve the skin and respiratory and cardiovascular systems.In older children，severe cases are more common，but due to non-specific symptoms，it is often misdiagnosed.Accurate diagnosis depends on a detailed medical history，skin prick tests（especially fresh food prick tests），specific IgE（sIgE）detection，and confirmation by exercise-food combined challenge tests when necessary.The management of WDEIA in acute stage focuses on the timely use of adrenaline，while long-term strategies include avoiding high-risk factors，individualized dietary adjustments，and exploring immunotherapy，such as omalizumab and sublingual immunotherapy.Given the particularities of children’s behavior and lifestyle，the collaborative management involving families，schools，and medical teams is crucial for preventing attacks and improving the quality of life.In the future，further promotion of standardized diagnostic procedures and long-term intervention studies is needed to achieve precise prevention and control of WDEIA in children.

Allergic diseases in children are characterized by high prevalence and a tendency for recurrent episodes，imposing a substantial burden on affected children and their families.Pharmacological treatments only alleviate symptoms but don’t interrupt the allergic process.Allergen-Specific Immunotherapy（AIT）is currently the only therapeutic approach which is likely to modify the natural course of allergic diseases.Given that the pediatric immune system is in a developmental and plastic stage，early initiation of AIT during childhood can better improve quality of life，prevent new sensitivities，and offer cost-effectiveness while promoting physical and mental health.This article systematically reviews the definition，therapeutic mechanisms，indications，contraindications，medication selection，adverse reactions，and management of special clinical issues related to AIT，aiming to provide a reference for the standardized application of AIT in children.

Objective　To investigate the clinical characteristics，treatment，prognosis，and influencing factors of pediatric renal malignant tumors. Methods　A retrospective analysis was conducted on the clinical data of children with newly diagnosed renal malignant tumors treated in Department of Hematology and Oncology，Children’s Hospital Affiliated to Zhengzhou University from January 2020 to December 2023.All patients received the CCCG-WT-2019 regimen （Wilms tumor protocol established by the Chinese Children’s Cancer Group）， and clinical data including age， sex, symptoms， physical signs， histopathology， and treatment outcomes were analyzed.Survival analysis was performed using the Kaplan-Meier curve-based cumulative survival estimation method.The Kaplan-Meier curve combined with the Log-rank test was used to depict and compare the prognostic differences among different groups. Results　A total of 42 patients were included，comprising 22 males and 20 females，with ages ranging from 4 months and 8 days to 7 years and 3 months，and a median age of 24 months.The tumors were located in the left kidney in 23 cases，the right kidney in 17 cases，and both kidneys in 2 cases.Pathological types included favorable-histology Wilms’ tumor（FHWT）in 37 cases，clear cell sarcoma of the kidney（CCSK）in 3 cases，and malignant rhabdoid tumor of the kidney（MRTK）in 2 cases.The disease stages were as follows：Stage Ⅰ in 9 cases，Stage Ⅱ in 17 cases，Stage Ⅲ in 8 cases，Stage Ⅳ in 6 cases，and Stage V in 2 cases.A total of 13 patients required radiotherapy，with 12 completing the treatment.The median follow-up time was 2.27-54.03 months（median 38 months），and the 3-year event-free survival（EFS）rate and overall survival（OS）rate were 95.238% and 97.561%，respectively.Univariate analysis of prognostic factors，including gender，age，primary tumor location，pathological type，disease stage，and radiotherapy，revealed a significant correlation between pathological type and prognosis（P<0.001）. Conclusion　The CCCG-WT-2019 has shown significant efficacy in the treatment of pediatric renal malignant tumors.Pathological type is significantly correlated with disease prognosis.

Objective　The objective is to study the efficacy of ivabradine in the treatment of heart failure with preserved ejection fraction（HFpEF）. Methods　We searched China National Knowledge Infrastructure（CNKI），Wanfang database，VIP database，and China Biomedical database（CBM）as well as PubMed，Embase，Cochrane and Web of Science for all available randomized controlled trials（RCTs）on ivabradine in the treatment of heart failure with preserved ejection fraction.Search terms included “ivabradine”，“preserved ejection fraction”，“heart failure” in both Chinese and English.These articles were further screened based on inclusion and exclusion criteria.We extracted the outcome indicators such as heart rate （HR），N-terminal pro-brain natriuretic peptide （NT-proBNP）， left ventricular ejection fraction （LVEF）， 6-minute walking test （6MWT）， left atrial volume index（LAVI），mitral antegrade flow E wave/mitral annular tissue Doppler e wave ratio（E/e’），peak early diastolic mitral flow velocity/late diastolic mitral flow velocity（E/A），left ventricular end-diastolic volume index（LVEDVI）and adverse reactions.The risk bias assessment was conducted on the literatures included， the data extracted were statistically analyzed by the RevMan 5.3 system， and the final results were discussed. Results　Six articles with a total of 607 trial subjects were finally included in the study.The final study results showed that ivabradine was more effective than conventional drug treatment in reducing heart rate（MD=-9.91，95% CI： -12.46 — -7.36，P<0.001）and NT-proBNP（MD=-110.24，95% CI：-124.47 — -96.02，P<0.001），and in improving 6MWT（MD=55.46，95%CI： 44.35 — 66.58，P<0.001），while there were no statistically significant differences in LAVI，LVEDVI，LVEF，E/A ratio，E/e’ or incidence of adverse reactions. Conclusion　Conventional drugs combined with ivabradine were more effective than conventional drugs alone in lowering heart rate and NT-proBNP，and improving 6MWT in the treatment of HFpEF.

A case of infant botulism presenting with ‘poor mental response’ was reported， who was admitted for treatment at the Department of Pediatrics，Peking Union Medical College Hospital，Chinese Academy of Medical Sciences on February 24，2025. A 7-month-old girl presented with progressive symmetric muscle weakness，ptosis and constipation，with no abnormalities on routine examination.Repeated history taking during multidisciplinary discussion revealed exposure to a honey-containing enema.Stool testing confirmed type B Clostridium botulinum.The patient improved rapidly after antitoxin therapy.This case highlights the critical role of high-quality history taking in diagnosing flaccid paralysis in infants.