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06 April 2025, Volume 40 Issue 4 Previous Issue   

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Expert consensus on clonidine transdermal patches in the treatment of children with tic disorders Pediatric Professional Committee of Chinese Association of Integrated Traditional and Western Medicine, Tic Disorder Collaboration Group of Child Neurology Society of Chinese Medical Association, Pediatric Professional Committee of Shanghai Association of Chinese Integrative Medicine, et al 2025, 40(4): 265-270.  DOI: 10.19538/j.ek2025040601 Abstract ( )   Tic disorder is a neurodevelopmental disorder whose onsetis often in childhood. It is clinically characterized by a variety of sudden，rapid，repetitive，involuntary motor and/or vocal tics. At present，clonidine has been used as a common drug in the treatment of tic disorder in domestic and foreign guidelines，yet its specific use scenario in clinical practice remains unclear. Therefore，the Pediatric Professional Committee of the Chinese Association of Integrated Traditional and Western Medicine，the Tic Disorder Collaboration Group of Child Neurology Society of Chinese Medical Association，Pediatric Professional Committee of Shanghai Association of Chinese Integrative Medicine，and the Shanxi Tic Online Public Welfare Foundation have collectively initiated the development of this consensus. This consensus has been formulated using the modified Delphi method，in which a total of 13 recommendations are put forward on the use of clonidine transdermal patches in the treatment of children with tic disorders，providing clinical reference.

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Chinese expert consensus on the clinical application of arsenic trioxide in pediatric solid tumors Pediatric Oncology Committee of Chinese Anti-Cancer Association, Pediatric Oncology Committee of Guangdong Anti-Cancer Association, Editorial Board of Chinese Journal of Practical Pediatrics 2025, 40(4): 271-283.  DOI: 10.19538/j.ek2025040602 Abstract ( )   Arsenic trioxide（ATO），a traditional Chinese medicine with a longstanding history，is renowned for its efficacy in the treatment of acute promyelocytic leukemia（APL）. Recently，more and more studies have demonstrated that ATO exhibits anti-tumor effects across a variety of malignancies，and it also showed some effects in the clinical treatment of pediatric tumors，which deserves further study. The lack of established guidelines and consensus regarding its clinical application in pediatric solid tumors has prompted the Specialty Committee of Pediatric Oncology of the Chinese Anti-Cancer Association and the Specialty Committee of Pediatric Oncology of Guangdong Anti-Cancer Association to organize domestic experts to make literature review and analysis and summary regarding the history of ATO，its anti-tumor mechanisms，its clinical application，and its pharmacokinetics. A full discussion was carried out concerning the indications，administration methods and the management of adverse reactions associated with ATO use in pediatric solid tumors，and reasonable suggestions were put forward based on evidence-based medical evidence and clinical experience，aiming to provide clinicians with evidence for the rational use of ATO in order to better improve the prognosis of pediatric patients with tumors and offer valuable references for pharmaceutical management departments.

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Expert consensus on the diagnosis and treatment of childhood vitiligo Professional Committee of Child Allergology, China Maternal and Child Health Association 2025, 40(4): 284-292.  DOI: 10.19538/j.ek2025040603 Abstract ( )   Childhood vitiligo is a common depigmenting skin disorder associated with various factors， including immune andgenetic factorsand oxidative stress.There is currently no consensus on the diagnosis and treatment of childhood vitiligo either domestically orinternationally. The Group of Dermatologyof the Professional Committee of Child Allergology of China Maternal and Child Health Association has developed this consensus based on evidence-based medical evidence and expert opinions，takingthe latest research progressinto accountand considering the unique characteristics of pediatric patients.This consensus offers guidance for the diagnosis，differential diagnosis，and standardized treatment of childhood vitiligo，providing a reference for dermatologists and general practitioners.

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Attention to standardized diagnosis and treatment of tic disorders in children LIU Zhi-sheng 2025, 40(4): 293-297.  DOI: 10.19538/j.ek2025040604 Abstract ( )   The diagnosis and treatment of tic disorders，including Tourette syndrome，have been developing for nearly 200 years.This paper discusses the standardized diagnosis and treatment of children with tic disorders and introduces the research outlook， in order to guide the theory and practice in the standardized clinical diagnosis and treatment of tic disorders in our country.

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Diagnosis and evaluation of tic disorder in children CHEN Wen-xiong, LIU Huan 2025, 40(4): 298-302.  DOI: 10.19538/j.ek2025040605 Abstract ( )   Tic disorder（TD）is a common neurodevelopmental disorder in children，which is classified into provisional tic disorder（PTD），chronic motor or vocal tic disorder（CTD），and Tourette's syndrome（TS），and often coexists with other disorders such as attention-deficit hyperactivity disorder and obsessive compulsive disorder. It is easy to cause damage to patients' social function and quality of life，especially in the children with TS.Evaluation should take multiple sources of information into consideration，combining direct observation and past information and including general information，symptom interviews，and severity assessment. The Yale Global Tic Severity Scale（YGTSS）is commonly used in clinical practice.Diagnosis is based on clinical manifestations，with attention toexcluding pseudo-refractory tic disorders. Comprehensive and thorough evaluation，early diagnosis，and comprehensive treatment are essential ways to improve patients' quality of life.

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Diagnosis and treatment of tic disorder accompanied by obsessive-compulsive disorder in children ZHANG Wen-yan, CUI Yong-hua 2025, 40(4): 302-307.  DOI: 10.19538/j.ek2025040606 Abstract ( )   Tic disorder（TD）is a neurodevelopmental disorder primarily characterized by motor and/or vocal tics. Obsessive-compulsive disorder（OCD）is a common comorbidity of TD. Early identification of obsessive thoughts and behaviors in children with TD，and early intervention for co-occurring conditions，can improve the prognosis of these children.In recent years，research on TD comorbid with OCD has increased both domestically and internationally. This review summarizes the epidemiology，etiological mechanisms，clinical manifestations，and treatment interventions for TD comorbid with OCD，aiming to enhance clinicians’understanding of this field and promote early identification and intervention for children with TD comorbid with OCD.

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Diagnosis and treatment of anxiety and depression disorder in children with tic disorder SHI Ruo-lin , HE Fan 2025, 40(4): 308-311.  DOI: 10.19538/j.ek2025040607 Abstract ( )   Tic disorder （TD） is a neurodevelopmental disorder that begins in childhood, characterized by repetitive and stereotyped movements or vocalizations. Anxiety disorders （AD） are primarily marked by feelings of anxiety and fear, while depressive disorder （DD） is characterized by persistent low mood and loss of interest. Early screening and comorbidity identification of anxiety and depressive symptoms in children with TD facilitate the implementation of precision interventions to improve clinical outcomes. This review systematically examines the epidemiology, etiology, clinical characteristics, and therapeutic interventions for TD comorbid with AD and DD, aiming to explore more effective management strategies to improve the quality of life and social functioning of children with TD.

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Psychological interventions for tic disorders in children KE Xiao-yan, ZHONG Le-le 2025, 40(4): 311-314.  DOI: 10.19538/j.ek2025040608 Abstract ( )   Psychological intervention is an essential compo-nent in the comprehensive management of tic disorders in children.The effectiveness of psychological intervention may be influenced by factors such as the choice of treatment protocols，patient age，comorbid conditions，and the professional skills of therapists.This article will introduce the current status and development trends of various psychological interventions for tic disorders，with the aim of providing guidance for clinical treatment.

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Neuromodulation therapy for children with tic disorders LIANG Shu-li, LI Shen-shen, LIU Ting-hong 2025, 40(4): 314-319.  DOI: 10.19538/j.ek2025040609 Abstract ( )   Tic disorders （TD） are neurodevelopmental disor-ders characterized primarily by tics. The etiology and pathogenesis of TD are unknown and may be related to genetic， neuropsychological and environmental factors. TD is associated with the disorder of complex brain networks， particularly the dysregulation of the cortical- basal ganglia-thalamic-cortical circuit. At present， the treatment for TD mainly includes three aspects： behavioral therapy， drug therapy， and neuromodulation therapy. Neuromodulation therapy includes deep brain stimulation （DBS）， repetitive transcranial magnetic stimulation， and vagus nerve stimulation. In recent years， many clinical studies have found that neuromodulation also has promising therapeutic outcomes in the treatment of tic symptoms， especially DBS. This article focuses on summarizing the history， mechanism of action， surgical approach， goals of treatment， age at surgery and efficacy of DBS in childrenwith TD，which providesreference for clinical practice.

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Chinese medicine treatment for children with tic disorder RONG Ping, MA Rong, MA Rong, et al 2025, 40(4): 319-324.  DOI: 10.19538/j.ek2025040610 Abstract ( )   Tic disorder is a chronic neurodevelopmental diso-rder that starts in childhood or adolescence，and its incidence has been increasing year by year in recent years.Based on the holistic concept and syndrome differentiation，TCM has the advantages of precise curative effect，fewer adverse reactions and improvement of comorbidities in the treatment of tic disorders.This paper introduces the TCM treatment for children with tic disorder from three aspects：the idea of TCM treatment，clinical research， and the study on TCM treatment evaluation methods. The treatment plan includes TCM compound，Chinese patent medicine and TCM external treatment，etc. aiming to provide diagnosis and treatment ideas and guidance for clinicians.

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Clinical characteristics of 131 cases of infectious mononucleosis in pediatric patients and analysis of the risk factors for liver injury HU Yu-ting, ZHENG Wei, JIANG Mi-zu 2025, 40(4): 325-330.  DOI: 10.19538/j.ek2025040611 Abstract ( )   Objective　To explore the general clinical characteristics and risk factors for liver injury in children with infectiousmononucleosis（IM），and summarize the clinical experience in diagnosis and treatment. Methods　Retros-pective analysis of 131 cases of children with IM was performed， who were hospitalized in Children's Hospital Affiliated to Zhejiang University School of Medicine from July 2020 to August 2021.Clinical data， including gender，age，course of disease，clinical manifestations，laboratory examination，imaging examination and disease outcome， were collected.Results　Among 131 children with IM，76.3%（100/131）were considered to have liver injury（ALT>40 U/L）.Compared with normal liver injury group，the percentage of hepatomegaly（38.7% vs.64%，P=0.013）and splenomegaly（41.9% vs.75%，P=0.001）was significantly increased in the liver injury group，and so were age［（4.0±2.1）vs.（5.4±3.2）］ （P=0.012），median disease duration（12 d vs.19 d，P=0.001），hemoglobin［（119.94±13.99）g/L vs.（124.55±10.34） g/L］ （P=0.008），abnormal lymphocyte ratio（2%vs.6%，P=0.001），and EBV DNA copy number（0 vs. 2.7×106copies/L，P=0.015）. Logistic regression analysis results showed that age（OR 1.323；95%CI  1.046-1.675，P=0.02），female（OR 3.225，95% CI 1.178-8.833，P=0.023）and abnormal lymphocyte ratio（OR 1.216，95% CI 1.054-1.402，P=0.007）were high-risk factors for IM complicated with liver injury. Conclusion　The clinical characteristics of children with IM are complex and changeable.Liver injury of IM is related to gender，age and increase in abnormal lymphocyte rate.The understanding of clinical features of IM in children and the risk factors for liver injury is improved.

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Study on the  correlation between fecal calprotectin levels and serum slgG levels in children with functional abdominal pain disorders WANG Guo-zhen, HUI Qin, WANG Lin, et al 2025, 40(4): 331-334.  DOI: 10.19538/j.ek2025040612 Abstract ( )   Objective　To explore the correlation between fecal calprotectin levels and serum levels of specific IgG antibodies for food intolerance（FI）in children with functional abdominal pain disorders. Methods　Totally 240 children from China-Japan Friendship Hospital between Mar. 2023 to Oct. 2023 were included in the study，including 120 with functional abdominal pain disorders and 120 healthy children.Analyses were conducted on fecal samples and peripheral venous blood samples from both groups by measuring levels of fecal calprotectin，serum specific IgG antibodies for food intolerance，and inflammatory markers［including C-reactive protein （CRP） and IL-6］. Statistical analysis was performed using SPSS software. Results　The positive rate of specific IgG antibodiesfor food intolerance in the group of children with functional abdominal pain disorders was significantly higher than that in the control group（80.83% vs.26.67%，χ²=109.48，P<0.05）. Additionally，levels of fecal calprotectin in children with functional abdominal pain disorders were significantly higher than those in the healthy control group（P<0.01）. No significant differences were observed in serum CRP or IL-6 levels between the two groups（P>0.05）. Notably，a positive correlation was found between serum levels of specific IgG antibodies for food intolerance and fecal calprotectin levels（r=0.683，P<0.01）. Conclusion　There is a close relationship between food intolerance and functional abdominal pain in children，and there is a positive correlation between food-specific IgG levels and fecal calprotectin levels.This provides important clues for unveiling the underlying mechanisms of functional abdominal pain disorders in children.

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Research progress in brain network ofchildren with tic disorders XIANG Yu-xin, SUN Dan, LIU Zhi-sheng 2025, 40(4): 335-340.  DOI: 10.19538/j.ek2025040613 Abstract ( )   Tic disorders（TD）are common neurodevelopmental disorders characterized by repetitive motor and/or vocal tics in children. Brain networks，including structural brain networks and functional brain networks，are plastic.Damage to brain networks can be seen in many neurodevelopmental diseases.At present，a large number of studies have pointed out that brain networks of TD have changes in network properties and disruption of functional and structural connections.In this article，we will conduct a comprehensive review of the research progress in the functional and structural brain networks of TD，so as to deeply explore the pathogenesis of TD and put forward new prospects.

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Research advancements in assessment tools with inflammatory bowel disease transiting from adolescence to adulthood NIE Xiao-lu, HU Fang, LI Qian, et al 2025, 40(4): 341-347.  DOI: 10.19538/j.ek2025040614 Abstract ( )   Assessment tools based on patient-reported outcomes play a crucial role in systematically monitoring and evaluating the readiness and self-efficacy of adolescents with chronic diseases transiting to adulthood. In China， the management practices and models for pediatric patients with inflammatory bowel disease （IBD） transiting from adolescence to adulthood are still in the exploratory and initial stages. It is necessary to comprehensively review mature transition-related assessment tools from both domestic and international sources to provide a reference for developing practice guidelines for pediatric patients with inflammatory bowel disease transiting to adulthood which are suitable to China's national conditions and cultural background.

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MOG antibody-associated disease with prolonged fever as the main presentation：report on six cases DING Xiu-fang, JIN Rui-feng, LI Juan, et al 2025, 40(4): 348-352.  DOI: 10.19538/j.ek2025040615 Abstract ( )   A retrospective analysis was performed on the medical data of 6 children with positive anti-myelin oligodendrocyte glycoprotein （MOG） antibody and prolonged fever， who attended the Children's Hospital Affiliated to Shandong University from January 2021 to September 2021， in order to explore the clinical characteristics of MOG antibody-related diseases with prolonged fever as the main manifestation. The medical data included clinical manifestations， physical examinations， and auxiliary examinations.The results showed that all 6 cases had prolonged fever as the main clinical manifestation; only 1 case had a positive Babinski sign upon physical examination.In all 6 cases，the white blood cell（WBC）counts in blood routine were elevated，ranging from 19.8 to 34.0×109/L，with a neutrophil percentage of 77.4% to 89.9%; the erythrocyte sedimentation rate was between 61 and 105 mm/h， and the C-reactive protein was between 21.6 and 57.3 mg/L. WBC counts in the cerebrospinal fluid ranged from（15~180）×106/L.Inflammatory changes were observed in 3 cases in the brain magnetic resonance imaging （MRI） ， with 1 case showing inflammatory signal changes in the thalamus and cerebellum on day 35 of the disease course. Two cases had an MOG antibody titer of 1∶100，3 had an MOG antibody titer of 1∶32，and 1 had an MOG antibody titer of 1∶320.From this， it can be concluded that MOG antibody-related diseases can cause prolonged fever.