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06 July 2026, Volume 41 Issue 7 Previous Issue   

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Expert consensus on clinical management and vaccination for chronic granulomatous disease Group of Immunology of the Society of Pediatrics of Chinese Medical Association, Inborn Errors of Immunity Alliance of National Children’s Medical and Clinical Research Center 2026, 41(7): 529-537.  DOI: 10.19538/j.ek2026070601 Abstract ( )   Chronic granulomatous disease（CGD）is an inborn error of immunity caused by phagocyte dysfunction. Due to NADPH oxidase deficiency，phagocytes are unable to generate superoxide anions（O2-）normally，leading to recurrent and severe bacterial and fungal infections accompanied by granuloma formation. Currently，there is a lack of standardized consensus or guidelines for the systematic management and vaccination for CGD. Group of Immunology of the Society of Pediatrics of Chinese Medical Association and Inborn Errors of Immunity Alliance of National Children’s Medical and Clinical Research Center（IEI.CHN）have organized experts to develop this consensus based on existing evidence and clinical practice experience. The consensus addresses 10 common clinical issues related to CGD and formulates 18 recommendations，aiming to provide a reference for the diagnosis，treatment，and long-term follow-up management of CGD.

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Expert consensus on precision medication of lacosamide in the treatment of children with epilepsy Division of Therapeutic Drug Monitoring, Chinese Pharmacological Society, Chinese Pediatric Society, Chinese Medical Association, Division of Therapeutic Drug Monitoring, Jiangsu Pharmaceutical Association, et al 2026, 41(7): 538-553.  DOI: 10.19538/j.ek2026070602 Abstract ( )   Epilepsy is one of the most prevalent chronic neurological disorders in the pediatric population.As a third-generation antiseizure medication with a unique pharmacological mechanism and good safety，lacosamide（LCM）has provided a new option for pediatric epilepsy management.However，the pharmacokinetics（PK）profile of LCM in children exhibits substantial inter individual variability because of the fact that children are at the stage of rapid growth and development，highlighting an urgent need for standardized clinical guidance.Initiated by the Division of Therapeutic Drug Monitoring，Chinese Pharmacological Society，and led by the Children’s Hospital of Nanjing Medical University，this consensus has strictly followed the 2022 Edition of the Guideline for the Development and Revision of Clinical Practice Guidelines in China，and registered in the PREPARE registry（PREPARE-2026CN141）.The consensus development group systematically retrieved relevant clinical evidence published from 2005 to 2026 across major Chinese and English academic databases.Based on the evidence grading and recomendation strength criteria made by Oxford Centre for Evidence-Based Medicine（2009），and after Delphi expert consultations and anonymous voting，a total of 21 recommendations were finally formulated，covering the clinical application，PK characteristics，pharmacogenomics，therapeutic drug monitoring（TDM），and model-informed precision dosing（MIPD）of LCM in children with epilepsy.This consensus establishes a preliminary TDM target concentration range of 2-10  μg/mL for LCM in Chinese pediatric patients，and proposes a standardized MIPD workflow.The aim is to provide clinicians and pharmacists with scientific and standardized guidance for individualized medication and improve the safety and efficacy of LCM treatment for pediatric epilepsy.

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Updates to the Rome V criteria for pediatric disorders of gut-brain interaction WU Jie, GONG Si-tang 2026, 41(7): 554-557.  DOI: 10.19538/j.ek2026070603 Abstract ( )   The Rome V Pediatric Criteria have systematically reconstructed the diagnosis and treatment system for Disorders of Gut-Brain Interaction（DGBI）in children.Breaking the age-stratified classification model adopted by Rome Ⅳ，the criteria establish a unified diagnostic framework applicable to all age groups.They categorize conditions into two major groups：upper gastrointestinal tract disorders and lower gastrointestinal and biliary tract disorders based on anatomical locations and symptom patterns，adding 13 new disease diagnoses to fill the gaps in pediatric nomenclature.For the first time，the criteria systematically construct a pathophysiological system centered on the biopsychosocial model，refine the logic for differential diagnosis，and adopt the guidelines from ESPGHAN/NASPGHAN to standardize tiered non-pharmacological，dietary and pharmacological therapies.Pediatric clinical practice in China should draw on these international criteria while integrating domestic consensus on infant functional dyspepsia syndrome as well as Chinese and Western medicine diagnosis and treatment experience，promoting multidisciplinary collaboration，and elevate the standardized diagnosis and treatment of pediatric DGBI.

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Diagnosis and treatment of esophageal diseases of Rome V criteria in children YANG Xia, JIANG Mi-zu 2026, 41(7): 558-563.  DOI: 10.19538/j.ek2026070604 Abstract ( )   The Rome V criteria have made a comprehensive and detailed classification of upper gastrointestinal disorders of gut brain interaction in children，including esophageal disorders，functional feeding disorders in children and gastroduodenal disorders. Among them，esophageal disorders can be divided into 3 types：reflux hypersensitivity，reflux-negative esophageal pain disorder and disorders of esophageal air-transit. Aerophagia syndrome and supragastric belching syndrome are the subtypes of disorders of esophageal air-transit.The advances in pH-impedance monitoring and high-resolution manometry have enabled the association between clinical symptoms and objective testing results in more precision in subtyping and individualized management of esophageal disorders in pediatric DGBI. This article focuses on the Rome V criteria and reviews recent advances in the diagnosis and treatment of esophageal disorders in pediatric DGBI，aiming to improve pediatricians' understanding of these disorders.

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Diagnosis and treatment of pediatric functional feeding disorders based on Rome V diagnostic criteria YU Jing, LI Xiao-qin 2026, 41(7): 564-568.  DOI: 10.19538/j.ek2026070605 Abstract ( )   Functional feeding disorders can significantly affect nutritional status，growth and development，and quality of life in children. The Rome V criteria classify functional pediatric feeding disorders（FPFDs）within pediatric upper gastrointestinal disorders of gut-brain interaction（DGBI）and subdivide them into hypersensitive dysphagia，anticipatory restrictive feeding， hunger dysregulation feeding disorder，and medically triggered functional feeding disorder. This classification emphasizes that feeding disorders are not merely behavioral problems，but rather DGBI manifestations of interactions among gastrointestinal sensorimotor function，nutrition，feeding skills，child behavior，and psychosocial context. Based on PubMed-indexed Rome V pediatric upper gastrointestinal DGBI articles，corresponding Rome Ⅳ documents，and recent English-language guidelines and studies，this review summarizes the diagnostic framework，clinical evaluation，and multidisciplinary management strategies for FPFDs，with the aim of providing evidence-based and operational references for diagnosis and therapy in clinical practice.

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Diagnosis and treatment of pediatric cyclic vomiting syndrome based on the Rome Vcriteria GUAN De-xiu, WU Jie 2026, 41(7): 569-574.  DOI: 10.19538/j.ek2026070606 Abstract ( )   Pediatric cyclic vomiting syndrome（CVS）is a clinically common disorder of gut–brain interaction，whose pathogenesis has not been fully elucidated. Characterized by recurrent episodes，this condition is associated with high rates of emergency visits and hospital admissions for intravenous fluid therapy.It not only seriously impairs children’s growth，development and physical and mental health，but also places a heavy economic burden on affected families and society. Therefore，early identification and standardized diagnosis and treatment of this disorder are crucial.The newly released Rome V Criteria（2026）clearly state that the management of pediatric CVS must adopt a stepwise and individualized comprehensive treatment regimen based on the severity of episodes，the degree of functional impairment and psychosocial impacts. All patients require fundamental interventions，including lifestyle modification，behavioral therapy and alternative therapies. Meanwhile，the disease should be stratified by disease severity，and targeted abortive interventions are administered during acute attacks，alongside long-term prophylactic treatment during interictal periods.

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Interpretation of Rome V criteria and considerations on clinical practice in China:recommendations on diagnosis and treatment of pediatric functional dyspepsia QIN Xiu-min, WU-Jie 2026, 41(7): 575-578.  DOI: 10.19538/j.ek2026070607 Abstract ( )   The Rome V diagnostic criteria for disorder of gut-brain interaction，officially released in 2026，introduce important updates regarding the diagnostic frequency，subtype definitions，and therapeutic strategies for pediatric functional dyspepsia（FD）. Concurrently，significant progress has been made in China in this field: the Diagnostic Consensus for Infant Functional Dyspepsia Syndrome was published in 2022，filling the applicability gap of the Rome criteria in younger populations; between 2025 and 2026，the Guidelines for the Diagnosis and Treatment of Pediatric Functional Dyspepsia with Integrated Traditional Chinese and Western Medicine and the Expert Consensus on the Integrated Traditional Chinese and Western Medicine Treatment for Infant Functional Dyspepsia Syndrome were successively issued，initially establishing a diagnostic and therapeutic system with Chinese characteristics that integrates traditional Chinese and Western medicine. Based on a systematic interpretation of the core updates in the Rome V criteria，this article integrates the latest domestic research evidence and expert consensus and proposes diagnostic and therapeutic recommendations suitable for pediatric clinical practice in China.

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Diagnostic and therapeutic perspectives of pediatric irritable bowel syndrome: from Rome Ⅳ to Rome Ⅴ YAN Wei-hui, WANG Ying 2026, 41(7): 579-583.  DOI: 10.19538/j.ek2026070608 Abstract ( )   Irritable bowel syndrome（IBS）is one of the most common disorders of gut-brain interaction（DGBI）in pediatric practice.Risk factors include environmental and family factors，dietary factors，infectious factors，and genetic factors. Epidemiological data on childhood IBS in China remain limited，and in current clinical practice there may be excessive diagnostic testing，inappropriate dietary restrictions，and inadequate psychobehavioral intervention.This review discusses the clinical approach to diagnose and manage pediatric IBS in the context of the transition from the Rome Ⅳ to the Rome V criteria.Key aspects include updates to the diagnostic criteria，disease subtyping，recognition of alarm features，diagnostic strategies，and stratified treatment，with emphasis on psychobehavioral intervention， dietary management，and multidisciplinary collaboration. The aim is to provide references for clinical practice and future research in pediatrics in China.

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Interpretation and current diagnosis and treatment status of Rome Ⅴ diagnostic criteria for pediatric biliary pain syndrome GENG Lan-lan, GONG Si-tang 2026, 41(7): 584-587.  DOI: 10.19538/j.ek2026070609 Abstract ( )   For the first time，the Rome V criteria published in 2026 incorporates pediatric biliary pain syndrome（BPS）into the spectrum of pediatric disorders of gut-brain interaction，filling the gap of diagnostic criteria for this disease in children. Based on the latest domestic and international evidence-based data，this paper summarizes the epidemiological characteristics of pediatric BPS as well as the Rome V diagnostic criteria and their connotations. It systematically elaborates standardized clinical evaluation procedures and key points of differential diagnosis，analyzes the application controversies between conservative regimens and cholecystectomy，clarifies prudent indications for cholecystectomy in pediatric patients，and prospects future research directions， so as to provide references for standardized clinical diagnosis and management in pediatric practice.

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Diagnosis and treatment of pediatric functional constipation and related defecation disorders based on the Rome Ⅴ criteria ZENG Ling-chao, WANG Bao-xi 2026, 41(7): 588-592.  DOI: 10.19538/j.ek2026070610 Abstract ( )   Functional constipation（FC）is one of the most common pediatric lower gastrointestinal disorders of gut-brain interaction（DGBI）.The RomeⅤcriteria reorganize pediatric lower gastrointestinal and biliary DGBI from an age-based framework toward a classification based on anatomical regions and symptom patterns. Under this framework，FC，functional nonretentive fecal incontinence（FNRFI），and infant dyschezia are addressed as defecation/anorectal disorders，while pediatric developmental context，toilet training，and caregiver-reported symptoms remain essential. Based on the RomeⅤlower and biliary child/adolescent article，the Rome Ⅴdiagnostic questionnaire article，corresponding Rome Ⅳ documents，and recent English-language guidelines and studies，this review summarizes the epidemiology，pathophysiology，diagnostic criteria，clinical evaluation，stepwise treatment， and refractory constipation management of pediatric FC. FNRFI and infant dyschezia are discussed as special-focus differential diagnoses. The goal is to support positive diagnosis，careful identification of alarm features，evidence-based treatment，and multidisciplinary care when needed.

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Stratified assessment and differential diagnosis of infant distress syndrome YANG Nan-lin, WANG Zhao-xia 2026, 41(7): 593-596.  DOI: 10.19538/j.ek2026070611 Abstract ( )   Infant distress syndrome（IDS）is the Rome V update to the concept of infantile colic. It emphasizes that excessive crying and fussiness should not be interpreted simply as intestinal pain，but as a clinical state shaped by interactions among the gastrointestinal tract，central nervous system and psychosocial factors. In infants presenting with excessive crying，clinicians should first identify warning signs，including fever or hypothermia，poor responsiveness，bilious vomiting，bloody stool，neurologic abnormalities，impaired growth，injury or caregiving safety concerns，to avoid missing acute severe disease or non-accidental injury. Common mimics，such as gastroesophageal reflux disease，cow’s milk protein allergy，infant dyschezia，functional constipation，lactose intolerance and urinary tract infection，should then be differentiated. For infants without warning signs，with normal interval status and growth，and with a typical IDS pattern，reassurance，caregiver support and follow-up are appropriate. A stratified approach can reduce missed diagnoses while limiting unnecessary tests and overtreatment.

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A study on the influencing factors of neuropsychiatric comorbidities in children with tic disorders CHENG Huan, YE Fang, LIU Shu-fang, et al 2026, 41(7): 597-602.  DOI: 10.19538/j.ek2026070612 Abstract ( )    Objective　To explore the comorbidities of neuropsychiatric disorders in children with tic disorders（TD）， as well as the influencing factors associated with these comorbidities，in order to provide new insights for the diagnosis， treatment，and family management of this condition. Methods　A cross-sectional study was conducted regarding the clinical data from 201 children newly diagnosed with TD at the Department of Pediatrics of China-Japan Friendship Hospital between January 2023 and December 2023.The Mini International Neuropsychiatric Interview for Children and Adolescents 5.0（MINI-KID 5.0）was utilized to screen for comorbid neuropsychiatric disorders among these children. Logistic regression analysis and other statistical methods were employed to analyze the influencing factors related to comorbid neuropsychiatric disorders in children with TD. Results　Among the participants，a total of 105 cases（52 .24%） exhibited comorbid neuropsychiatric disorders，including 72 cases（35 .82%）of attention-deficit hyperactivity disorder（ADHD），28 cases（13 .93%）of anxiety disorders，and 22 cases（10.95%）of oppositional defiant disorder（ODD）.Identified risk factors for comorbid neuropsychiatric disorders included complex vocal tics，a single-parent family background，and triggering psychological factors. A single-parent family background was also a significant risk factor for comorbid ADHD. Additionally，current/previous manic/hypomanic episodes were found to be risk factors for both ODD and anxiety disorders（all P<0 .05）. Conclusion　The occurrence of comorbidities in children with TD is significantly associated with various factors，including complex vocal tics，psychological triggering factors，tic severity，and a single-parent family background.

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Treatment for anti-NXP2 antibody-positive juvenile dermatomyositis with tocilizumab：a real-world study  ZHAO Rui-ze, WANG Xin-ning, CHI Ying, et al 2026, 41(7): 603-609.  DOI: 10.19538/j.ek2026070613 Abstract ( )   Objective　To study the efficacy and adverse reactions of tocilizumab（TCZ）in the treatment of antinuclear matrix protein 2（NXP2）antibody-positive juvenile dermatomyositis（JDM）and the prognosis，and compare its therapeutic efficacy with that of cyclophosphamide（CTX）. Methods　Five children with anti-NXP2 antibody-positive JDM treated with TCZ were retrospectively enrolled，who were admitted to and followed up at the Department of Rheumatology and Immunology，Capital Center for Children’s Health，Capital Medical University，from November 2021 to September 2025. The following items were analyzed and compared at different time points before and after treatment：skin rash，muscle strength，muscle enzymes，amount of glucocorticoid（GC）use and adverse reactions. Results　This study enrolled five anti-NXP2 antibody-positive JDM patients（3 male and 2 female）treated with TCZ，with onset age ranging from 1 to 12  years old（median 5 years old）.All patients received treatment combining TCZ，GC and immunosuppressants. From baseline to the end of follow-up，all patients showed significant improvement in skin rash，muscle strength，muscle enzymes， and MRI findings of muscles.The GC was rapidly reduced until discontinued，two patients achieved complete drug-free remission，and no serious adverse reactions affecting medication efficacy were reported.Compared with patients treated with CTX，those treated with TCZ demonstrated comparable efficacy in terms of rash，muscle strength，and muscle enzyme levels，exhibited faster tapering of GC，and had fewer cases of infection.Two cases of recurrence in the CTX group responded effectively to TCZ. Conclusion　In patients with anti-NXP2 antibody-positive JDM，TCZ has demonstrated efficacy in improving rash and muscle strength while reducing muscle enzyme levels，with therapeutic effects comparable to those of CTX.TCZ enables rapid tapering of GC until withdrawal， and no adverse reactions that influence medication have been found.Recurrent cases in the CTX group respond well to TCZ，which suggests that TCZ may serve as a potential effective drug for JDM cases.

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Selection strategy of pediatric sleep assessment tools and progress in the clinical application FAN Pan-yu, WANG Xin-hong, WANG Lian, et al 2026, 41(7): 610-616.  DOI: 10.19538/j.ek2026070614 Abstract ( )   Pediatric sleep plays a critical role in neurodevelopment，emotional regulation，and physical growth.Valid and scientific sleep assessment is the cornerstone for early detection and intervention of sleep disorders.Currently，various pediatric sleep assessment tools are available for clinical use，differing in purpose，age applicability，and operational complexity. A key challenge for pediatricians is to rationally select and integrate these tools based on the child’s clinical presentation and environmental conditions to form a systematic diagnostic and therapeutic pathway.This article reviews commonly used subjective and objective pediatric sleep assessment tools by age group，analyzes their strengths，limitations，and applicability，and discusses clinical management workflows for common pediatric sleep disorders（insomnia，sleep-disordered breathing，circadian rhythm disorders）in light of the latest guidelines and cutting-edge AI research.It aims to provide evidence-based and innovative practical guidance for pediatric clinicians.