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06 January 2026, Volume 41 Issue 1 Previous Issue   

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Forge ahead to break boundaries and ride the waves to scale new heights WANG Tian-you 2026, 41(1): 1-1.  DOI: 10.19538/j.ek2026010601 Abstract ( )

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Guidelines of integrated traditional Chinese and Western medicine for the diagnosis and treatment of short stature in children Pediatric Branch of China Association of Chinese Medicine, Endocrine and Genetic Metabolism Academic Group of Pediatric Branch of Chinese Medical Association, Endocrinology Working Group of Pediatric Committee of Chinese Association of Integrative Medicine 2026, 41(1): 2-8.  DOI: 10.19538/j.ek2026010602 Abstract ( )   Short stature is a common reason for pediatric consultations. With complex etiology and diverse clinical manifestations，it significantly impacts children’s quality of life and even their physical and mental development. This guideline recommends the integration of traditional Chinese medicine（TCM）syndrome differentiation and treatment with Western medical therapy. It has been finalized through repeated revisions with reference to the latest domestic and international guidelines，consensus documents，and research advances in both TCM and Western medicine. The aim is to provide rational recommendations and references for the integrated diagnosis and treatment of short stature in children and to advance the development of researches on short stature in children in integrated Chinese and Western medicine.

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Management strategies for Helicobacter pylori infection in children and adolescents： interpretation of international guidelines and guideline analysis LAI Jun-hong, ZHAO Shi-guo, ZHANG Huan, et al 2026, 41(1): 9-15.  DOI: 10.19538/j.ek2026010603 Abstract ( )   With the increasing prevalence of antibiotic resistance and changes in the epidemiology of Helicobacter pylori（Hp）infection，the 2024 ESPGHAN/NASPGHAN guidelines have been jointly updated and published regarding the management of Hp infection in children and adolescents. This article aims to systematically interpret the key updates in the new international guidelines，compare them with the previous edition and Chinese expert consensus，and propose practical recommendations tailored to the Chinese clinical context. The new guidelines explicitly refute the association between Hp infection and functional abdominal pain in children，while acknowledging its potential role in iron-deficiency anemia，chronic immune thrombocytopenia，and certain inflammatory diseases. For diagnosis，noninvasive testing is recommended for high-risk children，with endoscopy and molecular resistance testing as adjuncts when necessary. In terms of treatment，individualized quadruple therapy guided by antimicrobial susceptibility testing is emphasized，especially in regions with high resistance rates. In contrast，the Chinese consensus focuses more on the role of Hp eradication in the primary prevention of gastric cancer and supports empirical bismuth-containing regimens when diagnostic resources are limited.

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Diagnosis and treatment of hypoxic-ischemic encephalopathy in neonates： opportunities and challenges JI Xiao-shan, ZHOU Wen-hao 2026, 41(1): 16-19.  DOI: 10.19538/j.ek2026010604 Abstract ( )   Hypoxic-Ischemic Encephalopathy（HIE） in newborns is a multi-stage，multi-factor pathophysiological cascade reaction caused by perinatal hypoxia-ischemia，which can lead to acute or even permanent damage to the nervous system. The standardized diagnosis and treatment strategies for HIE in China still face difficulties and challenges. How to further promote individualized neuroprotective strategies based on multimodal assessment，while emphasizing the core principles of “early recognition，accurate prediction，multiple combinations，and close follow-up，” is a key direction for future development in clinical practice.

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Application of novel molecular biomarkers in the diagnosis and prognostic assessment of hypoxic-ischemic encephalopathy in the newborn LIU Hong-qi, YANG Lin 2026, 41(1): 20-24.  DOI: 10.19538/j.ek2026010605 Abstract ( )   Neonatal hypoxic-ischemic encephalopathy（HIE） represents a critical condition contributing to neonatal mortality and disability，and its early and precise intervention heavily relies on time-sensitive biomarker identification. Current clinical assessment systems are notably limited by their latency and subjectivity，failing to meet the decision-making demands of precision diagnostics such as the“golden window”for therapeutic hypothermia. With breakthroughs in advanced technologies including phenomics，proteomics，genomics，and artificial intelligence-driven multimodal data integration，research on HIE biomarkers is evolving towards a dynamic network integrating phenome-proteome-metabolome-transcriptome data. This shift is enabling a transition from static evaluation to real-time dynamic precision monitoring，and from diagnostic classification to treatment response and prediction. This review focuses on the most promising novel biomarkers，systematically explores recent advances in reconstructing early warning，precise stratification，and individualized neuroprotective strategies for HIE，and analyzes the challenges and opportunities of multi-omics integration and AI modeling in transforming the diagnostic and therapeutic paradigm for HIE.

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Problems and challenges facing neonates with mild hypoxic-ischemic encephalopathy SUN Zhuang, FU Jian-hua 2026, 41(1): 24-30.  DOI: 10.19538/j.ek2026010606 Abstract ( )   Hypoxic-ischemic encephalopathy（HIE）is a common neurological disorder in the perinatal period. In the past，more attention is paid to moderate and severe HIE，and many studies have reported on the incidence，diagnosis and treatment，as well as prognosis. Among them，therapeutic hypothermia（TH） has become a routine treatment for moderate and severe HIE. Recent studies have found that mild HIE also has a high incidence and a risk of adverse prognosis，and has gradually attracted clinical attention. However，there are still many problems and controversies in the diagnosis，classification and treatment of mild HIE，which require further research and exploration.

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Neuroprotection strategies and long-term evaluation of therapeutic hypothermia for neonates with moderate to severe hypoxic-ischemic encephalopathy#br# QIU Xia, TANG Jun 2026, 41(1): 30-36.  DOI: 10.19538/j.ek2026010607 Abstract ( )   Therapeutic hypothermia is the standard treatment strategy for moderate to severe hypoxic-ischemic encephalopathy（HIE）. It exerts significant neuroprotective effects through multiple mechanisms，including decreasing brain tissue metabolic levels，suppressing neuroinflammation，reducing brain tissue cell apoptosis，improving blood-brain barrier permeability，and reducing the production of free radicals，etc. Currently，therapeutic hypothermia alone is insufficient in neuroprotection strategies for infants with moderate to severe HIE. It is crucial to explore combined neuroprotection strategies of hypothermia along with erythropoietin，antiepileptic drugs，melatonin，and stem cell transplantation for the treatment of moderate to severe HIE. Furthermore，hypothermia therapy can significantly reduce longterm mortality and incidence of neurological adverse events in individuals with moderate to severe HIE. However，the long-term evaluation of hypothermia for neonates beyond 6 hours after birth or preterm infants under 35 weeks of gestation warrants further investigation， which may provide scientific reference for the clinical treatment of moderate to severe HIE.

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A novel AI-powered framework for enhancing rehabilitation in neonates with hypoxic-ischemic encephalopathy LI Ting-song, XIANG Ling-ling, HUA Zi-yu 2026, 41(1): 36-39.  DOI: 10.19538/j.ek2026010608 Abstract ( )   It remains a critical point in clinical research to improve severe adverse neurodevelopmental outcomes caused by hypoxic-ischemic encephalopathy（HIE）. Artificial Intelligence（AI）is increasingly demonstrating advantages in neonatal HIE management，including early therapeutic decision-making，prediction of long-term prognosis，development of precision rehabilitation protocol，and the application of telemedicine. AIpowered approaches are expected to redefine traditional diagnostic and therapeutic paradigms and significantly improve adverse neurodevelopmental outcomes of HIE. However，AI-based diagnostic and therapeutic paradigms of HIE will bring benefits to HIE children， but further clinical data is needed in terms of the concomitant safety risks and broad applicability in various situations.

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Multicenter collaborative networks for neonatal hypoxic-ischemic encephalopathy：advances in research and quality improvement JIANG Si-yuan, FU Jian-hua, ZHOU Wen-hao 2026, 41(1): 39-44.  DOI: 10.19538/j.ek2026010609 Abstract ( )   Neonatal hypoxic-ischemic encephalopathy is a leading cause of neonatal mortality and long-term neurodevelopmental impairment worldwide. Over the past two decades，therapeutic hypothermia and other interventions have significantly improved the clinical diagnosis and treatment levels，yet substantial regional variations in practice remain，and several critical clinical questions remain unresolved. Multicenter collaborative networks have become essential drives of progress in this field，encompassing population-based registries，randomized controlled trial consortia，and quality improvement initiatives. This review summarizes the characteristics and development of major international collaborative networks of neonatal hypoxic-ischemic encephalopathy，highlighting their contributions to registries，clinical trials，and quality improvement. Drawing on international experience，this review also discusses directions for the future development of multicenter collaborative networks for neonatal hypoxic-ischemic encephalopathy in China.

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Analysis of the incidence of hypoglycemia and related factors associated with 6-mercaptopurine short-course treatment for children with acute lymphoblastic leukemia HUANG Jing-yi, ZHANG Xiao-li, WANG Li-na, et al 2026, 41(1): 45-49.  DOI: 10.19538/j.ek2026010610 Abstract ( )   Objective　To analyze the incidence of 6-mercaptopurine（6MP）-related hypoglycemia in childhood acute lymphoblastic leukemia（ALL）during a short course of therapy. Methods　Forty-eight children with ALL during treatment with the CAM regimen（containing cyclophosphamide，cytarabine and 6MP）were consecutively enrolled from Jan. 2020 to May 2021（6MP group），and 21 children during treatment with the AML consolidation regimen 1，which did not contain 6MP，were also enrolled as controls（no-6MP group）. Incidence of hypoglycemia and the related clinical data during the treatment were collected and the risk factors for developing hypoglycemia were analyzed. Results　No hypoglycemia was observed in the no-6MP group，and the incidence of hypoglycemia was 39.6% in the 6MP group，of which only 10.5% had hypoglycemic symptoms；the median age of the hypoglycemia subgroup was significantly lower than that of the no-hypoglycemia subgroup（3.6 and 6.0 years old，P<0.001），and the median values of glutamic oxalate aminotransferase were also higher in the hypoglycemia subgroup（123.3 U/L and 87.4 U/L，P=0.040），but there was no statistical difference in the median values of total bilirubin（16.8 μmol/L and 15.0 μmol/L，P=0.052）. Logistic regression analysis showed that younger age and liver damage were the risk factors for developing hypoglycemia. Conclusion　Hypoglycemia is also common in children receiving short-term exposure to 6-MP. Younger age with liver function impairment is the risk factor for developing hypoglycemia.Most hypoglycemic symptoms are insidious and clinically overlooked. Therefore，sufficient attention should be paid to them to avoid hypoglycemia in ALL children during 6MP treatment， and thus avoid negative impact on children’s brain development.

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Analysis of free amino acids content in breast milk of mothers with allergic infants under exclusive breastfeeding and its significance LI Zhan-hua, DUAN Jiang, WANG Qiong, et al 2026, 41(1): 50-55.  DOI: 10.19538/j.ek2026010611 Abstract ( )   Objective　To determine the content of free amino acids（FAAs）in breast milk from mothers of infants with allergies who are exclusively breastfed，analyze the differences in FAA distribution characteristics between these mothers and those of non-allergic infants exclusively breastfed，and explore the mechanism of food allergy in the allergic infants and its significance in the optimization of breastfeeding strategies. Methods　Exclusively breastfed infants aged 0.5-6.0 months were selected， who visited the Outpatient Department of Pediatrics and the Department of Preventive Health Care of the First Affiliated Hospital of Kunming Medical University from September 2022 to May 2023. The infants were paired and divided into a non-allergic group（n=30）and an allergic group（n=30）based on the presence or absence of allergic manifestations. Breast milk samples were collected from the mothers of these infants.Tandem mass spectrometry（LC-MS/MS）was used for quantitative detection of FAAs in the breast milk samples. The differences in the contents of FAA between the two groups were analyzed and compared， and their statistical significance was explored. Results　The total amino acid content in the non-allergic group was higher than that in the allergic group. The contents of leucine（t=2.336，P=0.023）and ornithine（t=-2.93，P=0.005）showed statistically significant differences between the two groups（P<0.05），while no statistically significant differences were observed in the contents of other amino acids between the two groups（P>0.05）. Specifically，the leucine content in the non-allergic group was higher than that in the allergic group，and the ornithine content was lower in the non-allergic group than in the allergic group. Conclusion　In this study，the total amino acid content in the allergic group is lower than that in the non-allergic group，suggesting that the degree of protein degradation in breast milk of the allergic group may be lower，which may be associated with the mechanism of allergy development in exclusively breastfed infants. The higher leucine level in the non-allergic group may affect the infant’s immune regulation and intestinal barrier function，thereby reducing the risk of allergies.

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Analysis of clinical characteristics and follow-up of hereditary pancreatitis in children ZHANG Jian-xia, ZHENG Yu-can, CHENG Wei-xia, et al 2026, 41(1): 56-60.  DOI: 10.19538/j.ek2026010612 Abstract ( )   Objective　To analyze the clinical characteristics and follow-up data of hereditary pancreatitis（HP），providing reference for individualized and multidisciplinary comprehensive treatment in clinical practice. Methods　A retrospective analysis was conducted on the clinical data，treatment methods，and follow-up outcomes of 5 hereditary pancreatitis（HP） cases diagnosed at the Department of Gastroenterology，Nanjing Children’s Hospital from December 2018 to January 2024，who presented with recurrent abdominal pain. The study aimed to investigate the clinical characteristics and genetic mutation features of HP. Results　All 5 cases presented with recurrent abdominal pain accompanied by elevated amylase levels，and imaging changes consistent with pancreatitis were confirmed by abdominal ultrasound or magnetic resonance imaging. One case showed pancreatic stones with pseudocysts，while another case demonstrated pancreatic anatomical abnormalities with stone formation. The age of onset ranged from 4 to 11 years. Genetic testing revealed SPINK1 gene mutation in 3 cases and PRSS1 gene mutation in 2 cases. During acute episodes，symptoms were relieved after symptomatic and supportive treatment including acid suppression，inhibition of pancreatic secretion and fluid replacement. Long-term follow-up revealed that the frequency of pancreatitis attacks decreased after dietary and lifestyle adjustments. The HP patient with pancreatic anatomical abnormalities showed no recurrence of pancreatitis after stent placement. Conclusion　In clinical practice，children with recurrent pancreatitis and chronic pancreatitis who have no obvious cause and a positive family history should be highly suspected of HP，and genetic testing is recommended for further diagnosis. For children with risk factors，early intervention and treatment can be achieved by detecting hotspot mutations in the SPINIK1 and PRSS1 genes.Individualized，multidisciplinary comprehensive treatment and regular monitoring of endocrine function should be carried out for HP and its complications.

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Effect of fecal microbiota transplantation on children with autism spectrum disorder：a systematic review XIN Qing-gang, XU Gang, WANG Wei, et al 2026, 41(1): 61-70.  DOI: 10.19538/j.ek2026010613 Abstract ( )   Objective　To systematically review the clinical studies of fecal microbiota transplantation（FMT）intervention in children with autism spectrum disorder（ASD），and evaluate the therapeutic effect of FMT on children with ASD. Methods　Clinical researches on the treatment of fecal microbiota transplantation for ASD children were searched on PubMed，Cochrane Library，EMBASE，China National Knowledge Infrastructure（CNKI），Wanfang Medical Database and VIP database. Papers published from the establishment date of the databases to Jun 1，2025 were extracted. Two persons independently screened the retrieved literature and extracted data. Meta-analysis was performed with RevMan 5.3 software. Results　A total of 12 articles were included，including 3 randomized controlled trials（RCTs），1 case-control study，3 retrospective observational studies，2 prospective open-label studies，and 3 case reports. All 12 studies have shown that symptoms of ASD were improved after FMT treatment.Meta-analysis of 5 studies showed that the Autism Behavior Checklist（SMD=-0.53，95%CI 0.67-0.38），Aberrant Behavior Scale（SMD=-0.79，95%CI -1.33- -0.26），Childhood Autism Rating Scale（CARS）（SMD=-0.54，95%CI -0.68- -0.41），Social Responsiveness Scale（SRS）（SMD=-1.47，95%CI -2.66- -0.28），and Gastrointestinal Symptom Rating Scale（GSRS）（SMD=-1.39，95%CI -2.03- -0.74）showed a significant decrease after FMT compared to the baseline.Meta-analysis of 3 RCTs and 1 case-control study showed that Autism Behavior Checklist（SMD=-0.67，95%CI -1.3- -0.03）and CARS（SMD=-1.08，95%CI -1.67- -0.48）showed a significant decrease after FMT compared to control group or placebo group，but heterogeneity existed among studies in the analysis of the two scales. Conclusion　In observational studies and RCTs，FMT treatment has therapeutic effects on children with ASD without serious adverse reactions. However，there is heterogeneity among RCTs， and some conclusions are inconsistent. More randomized double-blind placebo-controlled clinical studies are still needed to further support the effectiveness of FMT in the treatment of children with ASD.

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Progress in diagnosis and treatment of pediatric status dystonicus ZHOU An-na, DAI Li-fang, DING Chang-hong, et al 2026, 41(1): 71-77.  DOI: 10.19538/j.ek2026010614 Abstract ( )   Status dystonicus（SD）in children is the most severe stage of dystonia with life-threatening complications if not treated promptly. We outline the clinical characteristics，severity assessment，diagnosis，and treatment of pediatric status dystonicus，aiming to provide clinicians with a visulized process of the early identification，grading assessment，timely standard treatment，and multidisciplinary management of this critical condition.

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Starting from respiratory distress：diagnostic practice and multidisciplinary management insights in brain-lung-thyroid syndrome CHENG Yun-gai, WANG Ying-shuo 2026, 41(1): 78-83.  DOI: 10.19538/j.ek2026010615 Abstract ( )   Brain-Lung-Thyroid syndrome（BLTS） is an infrequent autosomal dominant disorder that manifests as neurological impairment，interstitial lung disease，and thyroid dysfunction. This article presents a comprehensive report on the diagnosis and treatment practice，along with multidisciplinary management insights，of BLTS cases primarily manifested as respiratory distress. Through a detailed account of the entire diagnosis and treatment process of a pediatric case，the clinical characteristics and challenges associated with this disease are summarized. In the case of term infants presenting with respiratory distress or children diagnosed with childhood interstitial lung disease（chILD） who exhibit an inadequate response to conventional treatment，particularly when concurrent with thyroid dysfunction and/or neurological manifestations，BLTS should be strongly suspected. The article centers on the pathogenesis based on NKX2-1 gene mutations，the heterogeneity of clinical presentations encompassing multiple systems（including the lungs，thyroid gland，and brain），and the indispensable role of multidisciplinary teamwork（MDT） in early detection，precise diagnosis，and individualized long-term management. This article offers essential references for clinicians in the early identification and management of this rare disorder.

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A case of MIRAGE syndrome with immunodeficiency caused by a SAMD9 gene mutation ZHANG Yi-shi, YU Lang, TAO Jing, et al 2026, 41(1): 84-88.  DOI: 10.19538/j.ek2026010616 Abstract ( )   The clinical data and laboratory findings of a 4-month-old female infant with MIRAGE syndrome caused by a SAMD9 Arg1293Trp mutation were collected，who was admitted to Department of Rheumatology，Children’s Hospital of Chongqing Medical University on De.23，2024，and her clinical and laboratory results were analyzed. The patient visited the hospital for recurrent pulmonary infection，and the clinical manifestations included laryngomalacia，adrenal insufficiency，gastroesophageal reflux，and intestinal dilation.A diagnosis of MIRAGE syndrome was confirmed based on these clinical features and the results of gene sequencing. Based on the immunological profiles of the other five previously reported cases with the same Arg1293Trp mutation，the causes of death were analyzed. Hematopoietic stem cell transplantation may be the only treatment option for this patient in the later stages of the disease.