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06 June 2026, Volume 41 Issue 6 Previous Issue   

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Forty decades of steadfast original aspiration， pragmatic commitment to safeguard children’s health WANG Tian-you 2026, 41(6): 441-441.  DOI: 10.19538/j.ek2026060601 Abstract ( )

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Expert consensus on diagnosis，management and prevention of acute respiratory tract infections in pediatric outpatient and #br# emergency departments#br# National Institute of Hospital Administration, Editorial Board of Chinese Journal of Practical Pediatrics 2026, 41(6): 442-459.  DOI: 10.19538/j.ek2026060602 Abstract ( )   Acute respiratory tract infection（ARTI） is one of the most common reasons for pediatric outpatient and emergency visits in China and represents a significant public health issue due to its association with increased complications and healthcare utilization. In order to implement the relevant requirements of the National Health Commission for improving medical quality，a multidisciplinary panel of experts was convened by the National Institute of Hospital Administration，in collaboration with the Editorial Board of Chinese Journal of Practical Pediatrics and China Medical and Health Culture Association. Based on clinical experience and a systematic review of domestic and international evidence，the Expert Consensus on Diagnosis，Management and Prevention of Acute Respiratory Tract Infections in Pediatric Outpatient and Emergency Departments is developed. The consensus provides guiding recommendations on common pathogens，disease assessment，auxiliary examinations，rational drug use，and comprehensive prevention strategies. It aims to standardize clinical management，optimize decision-making，and promote appropriate antibiotic use，hence reducing the incidence of severe disease and risk of death and increasing the comprehensive prevention and treatment level of ARTI in children in China.

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Expert consensus on the rational application of β2 receptor agonists in children’s respiratory diseases （2026） Respiratory Group of the Pediatric Branch of the Chinese Medical Association , Respiratory Group of the Pediatric Branch of the Chinese Medical Doctor Association, Pediatric Drug Specialty Committee of the Chinese Pharmaceutical Association, et al 2026, 41(6): 460-473.  DOI: 10.19538/j.ek2026060603 Abstract ( )   β2 receptor agonists are one of the commonly used drugs for treating respiratory diseases in children，playing a significant role in the treatment of asthma and other wheezing disorders. To promote their standardized use，the Respiratory Group of the Pediatric Branch of the Chinese Medical Association，together with multidisciplinary experts，developed the"Expert Consensus on the Rational Application of β2 Receptor Agonists in Children’s Respiratory Diseases （2026）"in accordance with the "Guidelines for Formulating and Revising Clinical Diagnosis and Treatment Guidelines in China （2022 edition）". This consensus reviews the pharmacological knowledge and proposes 8 clinical questions and 18 recommendations based on the "5R" framework of rational drug use， aiming to guide pediatricians， general practitioners， and clinical pharmacists at all levels in medical institutions to use β2 receptor agonists rationally in children’s respiratory diseases.

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Current status and considerations of the assessment of pediatric critical conditions in outpatient and emergency departments YAN Jing-li, XU Wei 2026, 41(6): 474-479.  DOI: 10.19538/j.ek2026060604 Abstract ( )   As the initial site of care for pediatric emergencies and critical illness，the outpatient and emergency department plays a decisive role in patient outcomes，with assessment performance directly influencing prognosis. In high-demand clinical settings，the combination of insidious disease onset and limited physiological reserve in children complicates early risk recognition. Emergency assessment should therefore be conceptualized as a continuous process spanning prehospital management，transport，and inhospital evaluation rather than an isolated in-hospital task. Despite substantial progress in pediatric emergency system development，further integration between prehospital and inhospital assessment—particularly in unified risk frameworks and continuity of dynamic monitoring—is warranted. This paper reviews current practices and emphasizes physiology-centered clinical reasoning and dynamic reassessment as key strategies for detecting occult critical illness，with the goal of strengthening anticipatory risk appraisal and enhancing the resilience of the pediatric emergency care continuum.

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Re-understanding of inborn errors of immunity：from a“rare pediatric disease”to a lifespan disorder SUN Jin-qiao 2026, 41(6): 480-483.  DOI: 10.19538/j.ek2026060605 Abstract ( )   Inborn Errors of Immunity（IEI），also known as primary immunodeficiency diseases（PID），were long regarded as a group of rare congenital disorders primarily affecting infants and young children. However， over the past two decades，increased diagnostic awareness and technological advancements have profoundly transformed their epidemiological landscape. The prevalence has significantly increased，and the range of onset age has greatly expanded，extending from the neonatal period to adulthood and even old age. This review systematically elaborates on this evolutionary process of IEI， with a particular focus on groundbreaking advances in diagnostic technologies such as high-throughput sequencing，as well as the leap in therapeutic strategies from replacement therapies to gene editing. It is proposed that these advancements have not only reshaped our understanding of IEI but have also greatly improved patient outcome，marking the entrance of the field of IEI into a new era of precision medicine.

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Diagnostic thinking in children’s cough TIAN Dai-yin 2026, 41(6): 484-488.  DOI: 10.19538/j.ek2026060606 Abstract ( )   Cough is a protective physiological reflex of the body and the most common reason for children to attend pediatric outpatient and emergency departments， serving as a common symptom of various diseases rather than an independent one. The etiologies and management methods of cough vary significantly with different courses， natures and ages of children， bringing many challenges to clinical diagnosis and treatment. This paper classifies pediatric cough by course， nature and etiology， and clarifies the clinical characteristics of acute and chronic cough as well as dry and wet cough， focusing on the common etiologies for chronic dry and wet cough and the key diagnostic points in children； meanwhile， the diagnosis and treatment process from initial assessment to transfer to specialty department is sorted out， which provides references for constructing a systematic line of thinking about diagnosis and differential diagnosis of pediatric cough and achieving precise diagnosis and treatment.

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Diagnostic thinking in hematuria HE Yong-hua, QIU Li-ru 2026, 41(6): 489-492.  DOI: 10.19538/j.ek2026060607 Abstract ( )   Hematuria is one of the most common chief complaints in pediatric emergency and outpatient settings，as well as pediatric nephrology clinics. It can either be a transient and benign finding or an early sign of glomerular disease or hereditary nephropathy. Clinical evaluation requires establishing a reasonable diagnostic pathway：first，confirm“true hematuria”and its persistence，and then determine the“glomerular/non-glomerular”localization based on urine sediment morphology，urinary protein，blood pressure，and renal function，followed by stratification using warning signs to decide on examinations and follow-up. For most low-risk children，standardized follow-up is a form of treatment：through dynamic monitoring of changes in urinary red blood cells，microalbumin，and renal function，it not only avoids excessive examinations and iatrogenic anxiety but also enables timely escalation of evaluation and intervention when proteinuria，elevated blood pressure，or decreased renal function occurs. Based on clinical practice，this article summarizes the core principles，key steps，and common pitfalls. in the diagnosis and managment of hematuria，proposes reasonable initial screening items and stratified follow-up strategies，and provides a practical pathway for junior clinicians to refer to.

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Diagnostic thinking about childhood arthralgia LUO Xuan, DENG Jiang-hong 2026, 41(6): 493-497.  DOI: 10.19538/j.ek2026060608 Abstract ( )   Arthralgia is one of the common chief complaints in pediatric department. Due to its complex etiology and non-specific clinical manifestations，it is challenging to identify severe diseases at an early stage. Centered on the concept of risk priority，this paper emphasizes the importance of structured clinical thinking. A preliminary judgment pathway is established through detailed history-taking and physical examination，and a goal-oriented auxiliary examination strategy is implemented on the basis of risk stratification，so as to increase the early recognition rate of severe diseases and reduce excessive medical treatment. This paper analyzes the common cognitive biases and misunderstandings of young physicians in the diagnosis and treatment of pediatric arthralgia，and proposes the application value of the structured clinical thinking model in clinical practice.

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Multimodal artificial intelligence in the diagnosis of abnormal blood cells：clinical application strategies and challenges WU Ke-fei, ZHANG Hui 2026, 41(6): 498-502.  DOI: 10.19538/j.ek2026060609 Abstract ( )   Blood cell morphology assessment is a fundamental component of hematologic diagnosis but relies heavily on expert experience and is subject to inter-observer variability. With advances in deep learning，artificial intelligence has achieved substantial progress in digital hematopathology，ranging from automated single-cell recognition to whole-slide–level abnormality screening，which provides a new tool for improving diagnostic efficiency and consistency. However，clinical decision-making depends on the integrated interpretation of morphology，clinical context，and molecular data. This review summarizes the major research paradigms of AI-based blood cell analysis based on the current researches and clinical workflows，with a particular focus on the potential value of multimodal AI in abnormal cell detection，risk assessment，and prognostic clues. Current challenges regarding data scale，multicenter generalizability，interpretability，and clinical translation are also analyzed. With continued standardization efforts and multicenter collaboration，AI is expected to facilitate more precise and standardized diagnosis of blood cell abnormalities.

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Clinical analysis of the application of nirsevimab in premature infants at high risk of severe respiratory syncytial virus infection WANG Min, CHENG Kun, ZHAO Fang-ping, et al 2026, 41(6): 503-510.  DOI: 10.19538/j.ek2026060610 Abstract ( )   Objective　To analyze the effectiveness and safety of nirsevimab injection in preterm infants at high risk of severe respiratory syncytial virus（RSV） infection. Methods　This was a retrospective study. The clinical data of 75 preterm infants at high risk of severe RSV infection were collected，who received nirsevimab when discharged from Gansu Provincial Maternal and Child Healthcare Hospital（Gansu Provincial Central Hospital） from September 2024 to March 2025，with follow-up for acute respiratory infections（ARIs） and adverse reactions within 5 months after discharge. Results　In the 75 child patients，41 were male and 34 were female. The median age at injection was 56（34，74） d， adjusted chronological age was 37（35+4，38） w， and median weight was 2180（1930，2440） g. Among these infants，74（98.7%） were low birth weight infants，67（89.3%） were preterm infants with a gestational age of ≤32 weeks， and 37（49.3%） had extrauterine growth restriction（EUGR）. Most parents had some knowledge of RSV disease and the efficacy and safety of nirsevimab. During the follow-up，only 1 case（1.3%） developed RSV infection；this infant had a history of severe bronchopulmonary dysplasia（BPD） and was complicated with temporary hypogammaglobulinemia，and was cured and discharged after 9 days of mechanical ventilation. Adverse reactions occurred in 2 cases（fever in 1 case，local pain in 1 case），both of which resolved spontaneously within 48 hours.　Conclusion　Nirsevimab injection in preterm infants at high risk of severe RSV infection can effectively reduce the incidence of RSV infection with good safety profile.

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Clinical analysis and diagnostic-therapeutic insights of 4 cases of non-tuberculous mycobacterial pulmonary disease in children with immunodeficiency WU Xiao-hui, YANG Hai-ming, SHEN Yue-lin, et al 2026, 41(6): 511-515.  DOI: 10.19538/j.ek2026060611 Abstract ( )   Objective　To explore the clinical characteristics，causes of diagnostic delay and treatment response of nontuberculous mycobacterial（NTM） pulmonary disease in children with immunodeficiency，and provide reference for early clinical identification，diagnosis and treatment. Methods　Clinical data of 4 children with immunodeficiency complicated with NTM pulmonary disease admitted to the Department of Respiratory Medicine of Beijing Children’s Hospital from January 2019 to  December 2025 were collected and retrospectively analyzed. Results　Among the 4 children，3 were male and 1 female，with onset age of 4-14 years. Underlying diseases included GATA2 deficiency，hyper-IgM syndrome after hematopoietic stem cell  transplantation（HSCT），chronic granulomatous disease（CGD） and autoimmune lymphoproliferative syndrome（ALPS）. NTM strains were Mycobacterium kansasii，Mycobacterium abscessus and Mycobacterium avium-intracellulare complex. All children were misdiagnosed for 1-9 months before confirmation. All improved after anti-NTM treatment；during 2-60 months of followup，1 case had no recurrence after 24 months of standard treatment and drug withdrawal，1 case was lost to follow-up after 12 months of treatment，and the rest two cases remained stable under follow-up. Conclusion　The children with immunodeficiency are at high risk of NTM lung disease，which can be an important diagnostic clue for potential immunodeficiency. Metagenomic next-generation sequencing（mNGS） can increase the early diagnostic rate，and individualized anti-infective therapy combined with reasonable immunomodulatory therapy can improve prognosis.

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Diagnostic and therapeutic reflections on misdiagnosed pediatric ANCA-associated vasculitis as lung abscess and practice of multidisciplinary collaboration ZHANG Teng-teng, ZHANG Ying-qian, XING Yu, et al 2026, 41(6): 516-523.  DOI: 10.19538/j.ek2026060612 Abstract ( )   This case involved a 10-year-old female patient who presented with a 46-day history of intermittent fever and cough. Chest computed tomography（CT） revealed multiple thick-walled cavitary lesions and nodular opacities in both lungs. Polymicrobial bacterial infection was identified by etiological testing，and the provisional diagnosis was pneumonia with lung abscess. The patient's condition initially improved after anti-infective therapy but relapsed rapidly，with the subsequent gradual development of multisystem involvement manifestations including anemia，oral ulcers，skin rashes and purpura. After 58 days of complicated diagnosis and treatment，the patient was definitively diagnosed with granulomatosis with polyangiitis（GPA） via vasculitis-related antibody testing，skin tissue biopsy，and multidisciplinary team（MDT）consultation. The core value of this case lies in revealing the atypical onset characteristics of rare pediatric autoimmune diseases，highlighting the diagnostic challenges when infection is intertwined with autoimmune lesions，and emphasizing the importance of multidisciplinary collaboration，dynamic monitoring of inflammatory markers and timely completion of specific examinations in avoiding misdiagnosis.

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Current status of research on early identification parameters for pulmonary hypertension complicating bronchopulmonary #br# dysplasia #br# HUA Si-rui, LUO Zheng-xiu 2026, 41(6): 524-528.  DOI: 10.19538/j.ek2026060613 Abstract ( )   Bronchopulmonary dysplasia is a chronic lung disease that poses significant threats to both survival quality and long-term health of preterm infants. In some infants，impaired pulmonary vascular development leads to irreversible vascular injury and remodeling，progressing to pulmonary hypertension（PH）. BPD-associated PH（BPD-PH） not only substantially increases mortality risk during infancy and early childhood but also causes long-term cardiopulmonary dysfunction，growth retardation，and neurodevelopmental impairments . This review aims to systematically elucidate the latest definition and classification of BPD-PH， sort out the pathophysiological mechanism that involves inflammation，hypoxia and vascular dysplasia，and summarize the risk factors and prediction model associated with BPD-PH，with a particular focus on summarizing the research progress in biochemical biomarkers and imaging techniques，which is expected to provide references for early clinical identification and intervention.