Growth hormone deficiency（GHD）is one of the leading endocrine causes of short stature in children and adolescents. Exogenous supplementation with recombinant human growth hormone（rhGH） is currently the main treatment option. While daily rhGH is clinically effective，long-term daily injections pose a substantial treatment burden and compliance challenges on both patients and caregivers.In recent years，long-acting growth hormone（LAGH） products （weekly administration） have become available，substantially reducing dosing frequency and thereby improving compliance. However，LAGH products based on different long-acting technologies vary markedly in molecular structure，drug properties，mechanism of action，pharmacokinetics/pharmacodynamics，clinical application and dosing regimens，as well as in safety monitoring requirements. Clinical experience in these products remains limited，and standardized guidance is lacking. Transient conjugation technology is an innovative technology for prolonging the duration of growth hormone；it has been widely used clinically in the United States and Europe，but its application experience and related research in China remain relatively limited. To optimize treatment strategies for GHD and enhance patients’ treatment experience，we have developed this expert guidance on the clinical application of LAGH based on transient conjugation technology. This expert guidance addresses the developmental background of LAGH，outlines transient conjugation technology，provides an evidence-based interpretation of lonapegsomatropin （a LAGH developed using this technology），and offers specific recommendations on clinical application.

Respiratory diseases remain a major global public health challenge in children.This article provides a comprehensive review of recent diagnosis and treatment advancements in pediatric respiratory infections，bronchial asthma，chronic respiratory diseases and rare respiratory diseases，as well as respiratory interventions and rehabilitation over the past two years.Furthermore，it explores future development directions and challenges，offering valuable insights for pediatric clinicians.

In recent years，neonatal medicine has been undergoing a strategic transformation from focusing on immediate survival to optimizing long-term quality of life.Important advances have been made internationally in areas including the maternal-fetal interface and intergenerational health，precision resuscitation in the delivery room，multimodal brain function monitoring in the neonatal period，early-life microbiome-immune axis regulation，prevention and treatment of infectious and genetic diseases，and long-term rehabilitation for preterm infants. These achievements have deepened the understanding of mechanisms underlying the diseases of developmental origins，and are driving the shift of clinical practice from population-based protocols toward individualized precision medicine. This article systematically reviews significant research findings published in top international journals over the past five years. Based on the authors' clinical and research experience in neonatal neurocritical care，and following the logical thread of maternal-fetal interface-delivery room-neonatal period-post-prematurity，we outline future directions centered on multimodal monitoring and individualized intervention，aiming to provide references for constructing a neonatal precision medicine system tailored to the Chinese population.

By 2025，notable progress has been achieved in both clinical practice and research concerning pediatric digestive diseases in China，covering four domains of pediatric food allergies，gastrointestinal disorders，pediatric nutrition，and liver diseases.This article systematically summarizes and reviews key advancements in updates in epidemiological characteristics，in-depth analysis of disease pathogenesis，standardization of diagnostic and therapeutic techniques，innovations in traditional treatment regimens，and pioneering explorations into cell and gene therapies.Furthermore，it provides an outlook，aiming for substantial breakthroughs in the future to advance disease management from symptomatic intervention toward precise and radical cure.

In recent years，with the innovation in diagnostic technologies，evidence-based optimization of treatment strategies，and improvement in multidisciplinary collaboration models，notable advancements have been achieved in the field of pediatric critical care. This article systematically summarizes the latest research findings in recent years in diagnostic criteria，detection technologies，targeted therapy，and organ support for pediatric sepsis and pediatric acute respiratory distress syndrome（PARDS）. It places a particular focus on the application progress of blood purification technologies（CRRT，adsorption，plasma exchange） in sepsis and the evidence for individualized precision treatment with glucocorticoids. Furthermore，this article provides an in-depth analysis of the challenges encountered in current clinical practice，and prospects the future development directions including personalized medical treatment，intelligent diagnosis and treatment，and deepened multidisciplinary collaboration，aiming to provide references for clinical practice and scientific research exploration.

endocrinology；precision diagnosis；targeted therapy；systematic management

Pediatric rheumatic diseases constitute a heterogeneous group of disorders characterized by immune-mediated inflammation，affecting joints，muscles，bones，and multiple organ systems. In recent years，rapid advancements in immunology，genetics，and biotechnology have led to significant progress in the diagnosis，treatment，and long-term management of pediatric rheumatic diseases. This article reviews recent developments in the pathogenesis，precision diagnosis，targeted therapies，and disease management models of pediatric rheumatic diseases and outlines future research directions，aiming to provide references for clinical practice and research.

In recent years，the rapid development in molecular biology，medical imaging，interventional medicine，and artificial intelligence has continuously driven the evolution of diagnostic and therapeutic techniques for pediatric cardiovascular diseases. The diagnosis and management of congenital heart disease have moved forward to the fetal period，the concept of whole-life-cycle management is being gradually implemented，and genomicsbased precision medicine is becoming increasingly prevalent. This article reviews the latest research evidence and clinical advances in congenital heart disease，arrhythmias，heart failure，cardiomyopathies，pulmonary arterial hypertension，Kawasaki disease，syncope，and rare cardiovascular diseases，aiming to serve as a practical reference for pediatricians.

Child healthcare，which is concerned with the normative patterns of child growth and development and their influencing factors，has attracted increasing attention in recent years. This article provides a systematic review of the latest advances in the early assessment of childhood nutrition and growth status，pediatric nutrition and feeding practices，and other related fields.  Currently，China's demographic structure is characterized by low birth rate，low mortality，high aging，and high life expectancy，and children have been recognized as a strategic resource for sustainable national development. Heightened societal expectations regarding children's growth，health，developmental potential and quality of life have，therefore，created significant opportunities for the advancement of the child healthcare discipline. This article proposes developing an integrated child healthcare system that spans the entire life course and encompasses the full continuum of care，forming a functionally comprehensive child health service chain. It is emphasized that in the new era，child healthcare should take the promotion of child development as its central objective. Achieving this goal requires robust multidisciplinary collaboration in the medical field，strengthened interdisciplinary integration with educational science，psychology，sociology，and related disciplines，and enhanced intersectoral coordination with sectors such as education，civil affairs，and women’s organizations. By fostering an optimal environment for nurturing and care，this integrated approach aims to promote early childhood development and maximize children’s developmental potential，ultimately achieving the strategic goal of enhancing overall population quality and aiding the country’s long-term development.

Over the past 5 years，there has been a rapid development in the field of paediatric clinical nutrition，with remarkable progress made in the clinical practice，application of new technologies as well as new guidelines，recommendations，and consensuses both domestically and internationally. The development of this field has undergone a shift from standardization to precision，from empiricism to evidence-based practice，and from singlediscipline to multidisciplinary collaborations. Against the global background of nutritional development in childhood，China has developed a path of development with Chinese characteristics based on the features of our country and clinical needs. Increased policy support for the development of pediatric clinical nutrition，an improved quality of guidelines and consensuses and elevated standards of clinical research are great underpinnings of the improvement in children's nutritional status in China，as well as the promotion of development in clinical nutrition discipline. Looking ahead，with the in-depth research and the popularization of clinical application，pediatric nutrition also needs to deal with some existing challenges such as the translation of research evidence，the unbalanced development across different regions，and the assessment of long-term clinical outcomes. It is also expected to play an even greater role in improving children's health and increasing the overall quality of the population.

This article reviews the integrated application of immunotherapy and targeted therapy in pediatric leukemia，guided by molecular subtyping and measurable residual disease（MRD），and highlights their clinical value in achieving deeper remissions，optimizing treatment de-intensification，and enabling practical，scalable care pathways.It also proposes that immune reconstitution，infection prevention and control，and long-term functional outcomes should be included in routine follow-up frameworks based on the strategic bridging between CAR-T therapy and hematopoietic stem cell transplantation（HSCT）and the platformbased management. In the field of inherited hematologic disorders，gene therapy/gene editing is advancing“functional cure”from concept toward a viable clinical option；however，this progress requires a closed-loop governance framework encompassing screening and risk stratification，centralized implementation，and lifelong registry-based follow-up. For non-malignant conditions including aplastic anemia，hemophagocytic lymphohistiocytosis（HLH），and immune thrombocytopenia（ITP），the article emphasizes evidence-based risk stratification and standardized supportive treatment. Overall，future gains are most likely to arise from multi-modality synergy and health-system capacity building：positioning MRD and disease biology as the primary decision axis，and underpinning care with standardized monitoring and longitudinal，end-to-end management to achieve populationlevel，reproducible long-term benefit.

Objective　To determine the complete blood count，serum total IgE levels，food-specific IgE（sIgE），and plasma chemokine CCL22 concentrations in children diagnosed with food allergies，and to explore the clinical significance of these indicators in both IgE-mediated and non-IgE-mediated food allergies. Methods　The children aged 0～18 years who were clinically diagnosed with food allergies at Guangdong Provincial People's Hospital between August 2023 and April 2024 were selected for this study.　Measurements included complete blood count，and the expression levels of serum total IgE，sIgE specific to various food allergens，and plasma CCL22. Based on the results of sIgE，participants were categorized into an IgE positive group（sIgE≥0.35 kU/L）and an IgE negative group（sIgE<0.35 kU/L）. Furthermore，subjects were divided into five age groups：infants，toddlers，preschoolers，school-aged children，and adolescents. Differences in complete blood count parameters，total IgE levels，sIgE related to specific foods，and CCL22 expression between the two main groups as well as among different age groups were analyzed. Spearman rank correlation analysis was employed to investigate correlations among age，CCL22 levels，serum total IgE concentrations，sIgEs for specific foods，and complete blood count parameters. Results　A total of 199 children with food allergies were included in the study，including 115 males（57.8%）and 84 females（42.2%）. The age range of participants varied from 4 months to 15 years，with a median age of 3.9（1.3，7.3）years. There were 106 cases（53.3%）exhibiting elevated total serum IgE levels，110 cases（55.3%）with negative serum sIgE for food allergens and 89 cases with positive sIgE. Among the 8 common allergenic foods，40 cases（20.1%） were positive for sIgE in only one kind of food，32 cases（16.1%）were positive for sIgE in two kinds of food，and 17 cases（8.5%）were positive for sIgE in three or more kinds of food. The level of plasma CCL22 was positively correlated with the count of peripheral blood lymphocytes，the percentage of lymphocytes and the sIgE level in milk，but negatively correlated with the count of neutrophils，the percentage of neutrophils，total IgE and the sIgE level in crabs and shrimps. The overall trend of total IgE levels increased with age. Among the eight major types of allergenic foods，the sIgE levels in egg white，milk，wheat and sesame in the infant group were all higher than those in other age groups，and the differences were significant（all P<0.05）. Conclusion　The eosinophils and neutrophils in the blood routine are helpful in distinguishing IgE-mediated from non-IgE-mediated food allergies. The levels of total IgE and food sIgE are age-specific. Plasma CCL22 is associated with specific allergens and immune cell types，which can provide new clues for understanding the immune mechanism of food allergies. In clinical practice，the combined detection of blood routine，total IgE and sIgE can provide a reference for the classification of food allergies.

Objective　To explore the clinical and genetic characteristics of pediatric monogenic diabetes caused by INS gene mutations in order to establish a foundation for precise diagnosis and treatment. Methods　A retrospective analysis was conducted on the clinical data and gene sequencing results of 11 children diagnosed with diabetes caused by INS gene mutations at Children’s Hospital of Nanjing Medical University from January 2013 to December 2024，and the association between genotype and phenotype was analyzed. Results　Of the 11 cases，9 were male and 2 were female，with a median onset age of 0.75 years（ranging from 0.25 to 14 years）. The 6 patients with infantile onset（<1 year）all presented with ketosis/diabetic ketoacidosis at the first onset and required insulin therapy. Among 5 cases of maturity-onset adult diabetes subtype（onset>4 years），4 did not have ketotic onset and 2 were treated with metformin alone. A total of 9 INS gene mutations were identified（7 missense，1 splicing and 1 frameshift mutation），including a novel frameshift mutation（c.111dupA，p.Ala38SerfsTer） and the first childhood-onset case with p.Ala2Thr mutation in China. Seven cases were novel mutations，while 4 cases were familial inherited mutations. Six cases with mutations related to B/A chain disulfide bonds（p.Cys43Tyr/p.Cys95Tyr/p.Cys96Tyr/p.Arg89Cys）and a splicing mutation c.188-31G>A had onset in infancy. The onset age varied significantly in individuals with the same mutation（c.188-31G>A），ranging from 7 months to 14 years old. Conclusion　INS gene mutations can lead to two subtypes of adult diabetes：neonatal diabetes and maturity-onset diabetes of the young，exhibiting significant clinical heterogeneity. A novel INS gene mutation c.111dupA is reported in the study. Relatives carrying the same mutation within a family are often misdiagnosed as type 1 or type 2 diabetes. INS gene mutations can cause progressive β-cell dysfunction，highlighting the importance of long-term follow-up monitoring. Treatment strategies should be individualized based on genotype-phenotype characteristics.

RASopathies are a group of rare developmental disorders caused by germline mutations in genes regulating the RAS/MAPK pathway，including conditions such as Noonan syndrome and Costello syndrome. Hypertrophic cardiomyopathy is one of its primary clinical manifestations，with an extremely high mortality rate among infants and young children. Currently，standardized, safe and effective treatment strategies are still lacking.In recent years，the emergence of MEK inhibitors has brought new hope for the treatment of RASopathies. By inhibiting the RAS/MAPK signaling pathway，MEK inhibitors have demonstrated significant potential in the treatment of hypertrophic cardiomyopathy and arrhythmias，representing a groundbreaking therapeutic strategy in this field. This article reviews the research progress of MEK inhibitors in the treatment of cardiovascular diseases associated with RASopathies.

The clinical characteristics, genetic mutation and the results of gene sequencing of a child with KMT2A mutation-associated Wiedemann-Steiner syndrome（WSS）complicated with rapidly progressive puberty are retrospectively analyzed, who visited Tongji Hospital，Tongji Medical College，Huazhong University of Science and Technology in August 2023, and the related literature materials are reviewed. The patient , an 11-year-old boy，visited the hospital for “excessive weight gain for 3 years”. The 17-hydroxyprogesterone（17-OHP），dehydroepiandrosterone sulfate（DHEA-S），adrenocorticotropic hormone（ACTH），androstenedione（AN），insulin-like growth factor-1（IGF-1），and IGF-binding protein-3（IGFBP-3）were higher than the normal level. Whole-exome sequencing identified a heterozygous frameshift variant c.2078delG in the KMT2A gene on chromosome 11，classified as pathogenic according to ACMG criteria（PVS1+PM2+PM6+PP4），which could cause autosomal dominant Wiedemann-Steiner syndrome. It is a novel KMT2A frameshift variant c.2078delG that has not been described previously in the literature.