Short stature has a significant impact on the physical and mental health of children, and it is a common disease in the endocrine department of pediatrics. Due to the rapid changes in children's growth and development and the complex etiology of short stature, there have always been such issues as missed diagnoses, misdiagnoses and insufficient intervention or overtreatment. This necessitates the strengthening of standardized diagnosis and treatment. This article discusses the challenges faced in the clinical diagnosis and treatment of children with short stature, especially emphasizing two aspects: one is to find out the etiology and make precise diagnosis, and the other is to perform individualized treatment strictly based on the indications. Meanwhile, the future direction of diagnosis and treatment of short stature is prospected, and suggestions are put forward for further standardization of diagnosis and treatment behavior of short stature, in order to provide useful reference for clinicians and policy makers.

Short stature is affected by many congenital and acquired environmental factors, which involves every stage from pregnancy to adolescence. From the perspective of integrated Chinese and western medicine, this article systematically summarizes the definition and epidemiological features of short stature in clinical practice, as well as its diagnosis and treatment strategies in Chinese and western medicine. It is emphasized that a comprehensive intervention should be performed in order to scientifically cope with the issues on children's growth and development, especially short stature, which includes life style adjustment, nutritional regulation, exercise and sleep management. Researches have shown that the integrated Chinese and western medicine therapy can not only increase the growth rate of children's height effectively, but also adjust the constitution of children in a comprehensive way, which improves the general health level of children. This article aims to provide theoretical support and practical reference for future clinical management of short stature and not-up-tostandard stature.

The clinical manifestation of precocious puberty is the premature development of secondary sexual characteristics, which can cause increased growth rate, rapid skeletal maturation, premature epiphyseal closure, etc. If not treated in time, it may cause children to be short in adulthood and increase the risk of endocrine diseases. Gonadotrophin releasing hormone analogue is the first choice in the treatment of this disease in western medicine, which can significantly inhibit the sexual development process by regulating the hypothalamicpituitarygonadal axis, but there is still controversy in terms of benefits to children's height. Traditional Chinese medicine therapy has been proven to be safe and effective in improving children's symptoms, regulating sex hormone levels, delaying gonadal development, improving height impairment, and increasing adult height. Professor Xiong Lei believes that the core pathological mechanism of this disease is kidneyyin deficiency and hyperactivity of liveryang fire. The treatment should be nourishing yin to strengthen the root, and lowering fire to clear sources. At the same time, for the patients with stagnated heat of liver channel, the method of dispersing stagnatedliver qi and clearing fire is used; for those with internal retention of phlegmdampness, the method of invigorating spleen to dissipate phlegm is used; for those with disharmony in the middle jiao, the method of invigorating spleen and harmonizing stomach is used. For children with rapid progression, gonadotrophin releasing hormone analogue can be used at the same time; for children with growth retardation and height impairment, recombinant human growth hormone should be considered to maximize their benefits to the height.

Because children with short stature are shorter than children of the same age,they may suffer from low self-esteem,which seriously affects their mental health and has different degrees of impact on their future learning and lives.Traditional Chinese medicine has some advantages in the treatment of this disease because its syndrome differentiation and treatment can improve the growth and development of children.This paper first sorts out the historical development of short stature,which,as an independent name of the disease,was firstly seen in the textbook of Integrated Traditional Chinese and Western Medicine Pediatrics edited by Prof.Wang Xuefeng.Then,the etiology and mechanism of short stature are summarized.Its etiology is the deficiency of innate endowment and the lack of nutrition in later life.The disease is located in the spleen and kidneys,and it is closely related to the heart,liver and lungs. The nature of the disease is mostly deficiency.The primary mechanism of the disease is the deficiency of the five organs and the deficiency of essence and qi.The basic treatment principle is determined again,which is to support the spleen and nourish kidneys and also to take into account other organs.Among the treatment methods,the method of tonifying the kidneys and nourishing the liver is suitable to those with deficiency of yin in the liver and kidneys and loss of nourishment of the muscles and bones;the method of supporting the spleen and strengthening the stomach is suitable to those with weakness of the spleen and stomach and deficiency of qi and blood;the method of nourishing the kidneys and clearing the heart is suitable to those with deficiency of the heart and kidneys and imbalance of water and fire;the method of strengthening the spleen and nourishing the lungs is suitable to those with deficiency in the lungs and spleen and loss of qi of the mother;the method of warming and tonifying the kidney-yang is suitable to those with insufficiency of the kidney-yang and dysfunction of warming.Finally,the strategy of multi-dimensional care and prevention before the onset of disease is put forward.For children with short stature,attention should be paid to balanced nutrition,moderate increase in exercise,reasonable arrangement of sleep,and adjustment of the body in line with the four seasons.

Short stature and not-up-to-standard stature belong to the category of "Wu Chi" and "Wu Ruan" in Chinese medicine, and Chinese medicine believes that the pathogenesis of them is deficiency in the spleen and kidney, which gets the heart and liver involved. External treatment of Chinese medicine is a unique natural and green therapy under the guidance of Chinese medicine theory, which has certain advantages in the treatment of short stature and not-up-to-standard stature. This article summarizes the treatment methods such as massage, acupuncture, moxibustion and acupoint application, as well as the mechanism of external treatment of Chinese medicine for children with short stature and not-up-to-standard stature, with a view to guide the early and timely clinical intervention, improve the function of children's internal organs and promote their growth and development.

The causes of short stature in children can be summarized as insufficient innate endowment or improper postnatal nourishment. The spleen is the source of life after birth, and when the spleen is healthy, the nutrients it generates can be distributed throughout the body, providing sufficient material basis for the internal organs and abundant qi and blood, allowing normal growth and development of children. On the other hand, if the spleen and stomach functions are impaired, the source of qi and blood generation is lacking, which affects other organs and causes dysfunction of other internal organs, leading to delayed growth and development in children. Additionally, children have the physiological state and constitutional feature of "spleen often being insufficient". Therefore, treating childhood short stature based on the spleen is of great significance. Taking "nourishing and strengthening the spleen" as the basic treatment principle and based on the theory of "the spleen governing the four internal organs", the author lists eight common Chinese medical syndrome types: spleen deficiency, spleen deficiency with food stasis, spleen deficiency with dampness, spleen deficiency with liver hyperactivity, spleen- and stomach-yin deficiency, lung- and spleen-qi deficiency, spleen and kidney deficiency, and heart and spleen deficiency. This paper summarizes the experience in the differentiated treatment of short stature in children based on the basic formula of Sijunzi soup, aiming to provide clinical references for the treatment of short stature in children with traditional Chinese medicine.

Childhood short stature is mostly caused by insufficient cong enital endowment and improper nutrition later on, and the key pathogenesis is the spleen and kidney insufficiency. At present, recombinant human growth hormones are used most often for the treatment of short stature in western medicine, and the treatment plan is relatively simple. Traditional Chinese medicine(TCM) has obvious effects in the treatment of short stature based on syndrome differentiation, which can effectively improve children's growth rate and regulate physical fitness. Based on the clinical experience of Professor Zhang Guiju and the theory of "Yang transforming qi and yin shaping stature" it is believed that childhood short stature is closely related to the insufficiency of "Yin shaping stature". Yin essence plays an important role in the growth and development of the human body. Children can gradually grow taller and stronger if the function of "Yin shaping stature" is normal. On the contrary, insufficiency in "Yin shaping stature" will lead to delayed growth and short stature in children. Therefore, in the treatment of childhood short stature, it is necessary to add yin-nourishing Chinese medicines based on syndrome differentiation, such as Radix rehmanniae praeparata, Cornus officina, yam, Fructus lycii, Polygonatum kingianum, Polygonatum odoratum, lily, etc. Such medicines contain a variety of effective ingredients, which can not only supplement the nutrients needed by the human body, but also have a variety of effects such as regulating immunity and protecting the internal organs. In addition, spleen-strengthening and digestion-assisting drugs should be added to the prescription to protect the spleen and stomach and prevent getting too greasy.

Wan Quan has proposed the "Four methods of infant rearing":pre-raising to cultivate origin,fetal raising to ensure health,peripartum raising to prevent changes,and postpartum raising to be alert to diseases-The method of pre-raising to cultivate origin involves preparing for pregnancy,avoiding harm,and ensuring a healthy birth-The method of fetal raising to ensure health means that parents should focus on mental adjustment,moral cultivation,diet and daily habits,exercise,and fetal education to ensure the healthy development of the fetus-The method of peripartum raising to prevent changes includes care for the child,disease prevention and control,and care for the mother′s body from the neonatal period to the infant period-The method of postpartum raising to be alert to diseases includes daily care,diet and nutrition,disease prevention,and early education from early childhood to the early school age-Fully exploring the implications of Wan Quan′s "Four methods of infant rearing" theory and connecting it with the growth and development of children has certain referential significance for the upbringing of children today

Pharyngitis and tonsillitis are common respiratory infectious diseases in childhood,and are highly prevalent in spring and fall.They can be categorized into acute and chronic stages.The acute stage is characterized by rapid onset and progression of the disease,and in severe cases,hoarseness and even respiratory difficulties may occur.In the chronic stage,the disease is prolonged due to the lack of proper treatment.Repeated pharyngitis and tonsillitis can lead to voice changes in children.At present,there are not many western medicines that can effectively treat childhood pharyngitis and tonsillitis,which are mainly antibiotic drugs,and although there are many types of traditional Chinese medicines used to clear the throat,western pediatricians are not standardized in the selection,syndrome differentiation and application of traditional Chinese medicines.Therefore,it is particularly important to explore the treatment for pharyngitis and tonsillitis in children with integrated Chinese and western medicine.This consensus firstly systematizes the Chinese and western medical understanding of pharyngitis and tonsillitis in children;secondly,it discusses its staging,etiology and main risk factors;thirdly,it clarifies its diagnostic criteria;finally,it gives a detailed elaboration on the principle of integrated Chinese and western medicine treatment for pharyngitis and tonsillitis in children and the Chinese and western medicine treatment methods.This consensus provides Chinese and western pediatricians,especially western physicians,with ideas on integrated Chinese and western medicine treatment,and further standardizes the rational selection and application of Chinese and western medicines.

Simple obesity refers to the fact that the body′s intake of energy is greater than the consumption of energy,which is accumulated in the body in the form of fat,resulting in the main clinical manifestation of obesity,and it can be accompanied by abnormal metabolism of glucose and lipid and endocrine disorders.Its incidence is increasing year by year,and it has become a serious social public health problem.Simple obesity is a chronic low-grade inflammatory state,and its mechanism is closely related to endoplasmic reticulum stress,mitochondrial dysfunction,oxidative stress,and macrophage polarisation in the body.For this disease,both Chinese medicine and western medicine have their intervention and treatment means,but modern medicine believes that the treatment for obesity is a combination of dietary and nutritional structural adjustment,exercise,psycho-psychological and medication,which requires a high level of execution and compliance of the patient,and the medication also has obvious side effects.Chinese medicine has a unique theoretical understanding of obesity,and Chinese medicine treatment also has its unique advantages.In this paper,we will make a review of the mechanism of adipose tissue inflammation in simple obesity and the current status of Chinese and western medicine treatment.

Sleep disorders have gradually become one of the common diseases in children,and sleep quality is very important for children′s growth and development.Traditional Chinese medicine has achieved remarkable results in the treatment of sleep disorders in children.Because of its safety,reliability,having no adverse reactions and simple operation,TCM external treatment is easy to be accepted by parents.This paper systematically sorts out the commonly used external treatment methods of Chinese medicine for children with sleep disorders,including acupuncture,acupoint application,massage and transcranial magnetic therapy,etc.,and summarizes and studies the relevant literature of these methods.

Hypomyotonia accompanied by growth retardation is an early symptom and sensitive sign of global developmental delay(GDD) in infants and young children,and is one of the early clinical manifestations of neurodevelopmental disorders and genetic metabolic diseases,which has a high incidence rate.According to the location of neuromuscular damage and involvement,hypotonia can be divided into three types:central hypotonia(CH),peripheral hypotonia(PH),or mixed hypotonia(MH).On the basis of etiological diagnosis of hypotonia,clinical evaluation and rehabilitation evaluation are conducted.Rehabilitation evaluation includes assessment of motor development level,developmental evaluation,evaluation of communication ability,and evaluation of daily life activity ability.Under the theoretical framework of the international classification of functioning,disability,and health(children and youth edition)(ICF-CY),the methods such as exercise therapy,traditional Chinese medicine rehabilitation,neuromuscular electrical stimulation,intramuscular patches,and assistant braces are adopted to promote the development of anti-gravity postures.Based on function-orientation and with the goal being to continuously improve activity and participation abilities,environmental factors such as rehabilitation aids are used to modify and improve the ability of daily life activities.

ObjectiveTo analyze the diversity,structure and functional characteristics of the intestinal flora of girls with central precocious puberty (CPP),and to explore the differential flora and potential functions of them with those of healthy girls of the same age.MethodsWe selected 20 girls who attended the pediatric outpatient clinic of Hubei Provincial Hospital of Traditional Chinese Medicine from November to December 2023 and were diagnosed with CPP as the CPP group,and 20 healthy girls volunteers of the same age during the same period were included as the control group.Stool samples were collected for 16S rRNA sequencing to analyze the differences in the composition,structure and function of the intestinal flora between the two groups.ResultsThe difference in α-diversity of intestinal flora between the two groups was not statistically significant (P>0.05).The β-diversity of intestinal flora in the CPP group showed a clear tendency to segregate,and the difference between the two groups was statistically significant (P<0.05).Genes in the CPP group were enriched for endocrine and metabolic disorders,nucleotide metabolism,amino acid metabolism,cellular processing,and signal transduction.ConclusionDifferences between girls with CPP and healthy girls are not significant in terms of the number,species diversity,and distributional homogeneity of intestinal flora,but there are significant structural differences;the functions in predicting endocrine and metabolic diseases,nucleotide metabolism,amino acid metabolism,cellular processing,and signaling are potentially correlated with CPP.

ObjectiveTo systematically assess the clinical efficacy of traditional Chinese medicine in conjunction with recombinant human growth hormone, as well as that of recombinant human growth hormone alone, in the treatment of children with idiopathic short stature, thereby providing an evidence-based reference for clinical treatment. MethodsCNKI, VIP, Wanfang, CBM, and Pubmed were searched for literature that met the inclusion and exclusion criteria from the establishment of the database to September 30, 2024. RevMan 5.4 software was used for statistical analysis.ResultsA total of 19 randomized controlled clinical trials with 1 756 patients were included, including 873 cases in the observation group and 883 cases in the control group. The results of Meta-analysis showed that the application of traditional Chinese medicine combined with recombinant human growth hormone in the treatment of idiopathic short stature was significantly better than the simple application of recombinant human growth hormone in improving the total effective rate, height, weight, growth rate, insulin-like growth factor 1 and insulin-like growth factor binding protein 3 levels, and the incidence of adverse reactions was lower than the simple application of recombinant human growth hormone.ConclusionThe integration of traditional Chinese medicine with recombinant human growth hormone demonstrates significant efficacy in the treatment of children with idiopathic short stature.

ObjectiveTo explore the clinical efficacy of Xiaoer Kechuanling oral solution (concentrated) in the treatment of children with Mycoplasma pneumoniae pneumonia and the changes in inflammatory factor levels.MethodsTotally 110 children with Mycoplasma pneumoniae pneumonia who received treatment in the Pediatric Department of Liaoning University of Traditional Chinese Medicine Affiliated Hospital were selected as the research subjects. Using a random number table method, they were divided into an observation group and a control group, with 55 cases in each group. All patients received basic western medicine treatment, and the observation group received combined treatment with Xiaoer Kechuanling oral solution (concentrated) additionally. Compare the clinical efficacy, symptom improvement time, time of pulmonary rales disappearing, levels of inflammatory factors, and incidence of adverse reactions during treatment between the two groups of children.ResultsThe total effective rate of the observation group(94.55%, 52/55) was higher than that of the control group(81.82%, 45/55)(P<0.05). The duration of fever, cough, expectoration, and pulmonary rales in the observation group was significantly shorter than that in the control group (P<0.05). There was no statistical difference in the improvement of the levels of tumor necrosis factor alpha(TNF-α) in these children between the two treatment regimens(P>0.05), while there was statistical difference in the improvement of IL-6 levels between the two treatment regimens (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups during the treatment period (P>0.05).ConclusionOn the basis of western medicine treatment, the application of Xiaoer Kechuanling oral solution (concentrated) can effectively improve the clinical efficacy in the treatment of Mycoplasma pneumoniae pneumonia in children, shorten the duration of fever, cough, expectoration and lung rales and inhibit inflammatory reactions, and it is quite safe.

ObjectiveTo investigate the risk factors for coronary artery injury in children with Kawasaki disease and to establish a risk prediction model for verification.MethodsA total of 296 children with Kawasaki disease who were treated in Hunan Children′s Hospital from July 2022 to October 2023 were selected and divided into a group with concurrent coronary artery injury (47 cases) and a group without concurrent coronary artery injury (249 cases) according to their own conditions.Multivariate Logistic regression was used to analyze the risk factors affecting concurrent coronary artery injury in children with Kawasaki disease.The prediction model was constructed and its predictive value was analyzed by ROC curve.ResultsThe incidence of coronary artery injury in Kawasaki disease children was 15.88%(47/296).Age≤2 years old,duration of fever ≥10h,and delay of IVIG treatment were independent risk factors for coronary artery injury in children with Kawasaki disease.Multivariate Logistic regression analysis was used to build a prediction model,and the ROC curve showed that the AUC of the prediction model in predicting coronary artery loss in Kawasaki disease children was 0.989,the sensitivity of the prediction was 92.3%,and the specificity was 98.4%.ConclusionThe risk factors for coronary artery loss in children with Kawasaki disease are related to age≤2 years old,duration of fever≥10h,and delay of IVIG treatment.The prediction model constructed has good clinical value,and clinical medical staff can take targeted preventive measures according to the risk factors for coronary artery loss in children with Kawasaki disease.

ObjectiveTo investigate the effect of low-dose esketamine on relieving pain of propofol medium-chain triglyceride/long-chain triglyceride (MCT/LCT) emulsion injection in children.MethodsA total of 165 children undergoing general anesthesia treated in Hunan Children′s Hospital from July to December 2023 were selected as the study subjects,and they were randomly divided into 3 groups:control group,esketamine group and lidocaine group,55 cases in each group.The esketamine group was injected with 0.2 mg/kg esketamine before propofol MCT/LCT injection,the lidocaine group was injected with 0.5 mg/kg lidocaine,and the control group was injected with the same volume of normal saline.The incidence of injection pain,pain score and adverse reactions were recorded.ResultsThe incidence of injection pain in esketamine group and lidocaine group was 20.0% (11/55) and 21.8% (12/55),which was significantly lower than that in control group (45.5%,25/55),and the difference was statistically significant(P<0.05).The pain score of esketamine group and lidocaine group was (0.22±0.46) and (0.27±0.56) respectively,which was significantly lower than that of control group(0.87±1.10),and the difference was statistically significant (P<0.05).There was no significant difference in the incidence of injection pain or pain score between esketamine group and lidocaine group(P>0.05).There was no significant difference in the incidence of adverse reactions among the three groups（P>0.05）.ConclusionLow-dose esketamine pre-treatment can reduce the incidence and intensity of pain from propofol MCT/LCT injection in children,which is equivalent to lidocaine,and there are no serious complications.

ObjectiveTo explore the effect of Chiqiao Qingre granules combined with cefuroxime in the treatment of acute respiratory tract infection(ARTI) in children and its influence on inflammatory factors.MethodsA total of 103 children with ARTI admitted to our hospital from March 2021 to March 2023 were selected and divided into observation group(treated with Chiqiao Qingre granules combined with cefuroxime,n=52) and control group(treated with cefuroxime,n=51) according to different treatment methods.The clinical curative effect and symptom disappearance time of the two groups were observed,and the inflammatory factors,immune function and the incidence of adverse reactions of the two groups were compared.ResultsAfter treatment,the total effective rate of the observation group was 90.4%(47/52),significantly higher than that of the control group(70.6%,36/51)(P<0.05).Compared with the control group,the disappearance time of fever and other symptoms,such as cough,dry throat,running nose and chest pain,in the observation group was significantly shorter(P<0.05).The levels of serum interleukin-6(IL-6),serum amyloid A(SAA),C-reactive protein(CRP) and procalcitonin(PCT) in the two groups were reduced,and the level in the observation group was lower than that in the control group(P<0.05).The Th1 and Th1/Th2 in the two groups were increased,and the Th1/Th2 in the observation group was higher than that in the control group(P<0.05).The Th2 in both groups was decreased,and the Th2 in the observation group was lower than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).ConclusionChiqiao Qingre granules combined with cefuroxime is more effective in treating ARTI in children,which can speed up the disappearance of symptoms,relieve the body′s inflammatory response,and maintain immune balance,and it is safe and reliable.

ObjectiveTo explore Professor Wang Xiaoming′s medication experience and prescription rules for treating childhood recurrent abdominal pain with the help of data mining methods and summarize the academic experience in order to guide clinical practice.MethodsCollect the data of 98 cases of childhood recurrent abdominal pain diagnosed and treated by Professor Wang Xiaoming at Famous Chinese Medicine Clinic from January 2022 to December 2022,and enter prescription information by using Microsoft Excel software.R language was used for data mining,and the use frequency of Chinese medicine,association rules and clustering were analyzed.ResultsA total of 98 Chinese medicine prescriptions were included,involving 71 Chinese medicines with a total frequency of use of 1 112 times.Among them,there were 8 Chinese medicines with the frequence of more than 70%.A total of 282 association rules were obtained,and clustering analysis resulted in 1 cluster prescription.ConclusionProfessor Wang Xiaoming treats childhood recurrent abdominal pain based on the principles of promoting digestion,strengthening the spleen,soothing the liver and promoting qi flow,and takes into account the methods of relieving the exterior,calming the liver,promoting qi flow,and expelling dampness,which provides ideas for the clinical diagnosis and treatment of childhood recurrent abdominal pain.

Cough-variant asthma(CVA) is a common and frequently occurring respiratory disease in children.In recent years,with the aggravation of air pollution,the change in living habits and the increase in social pressure,the number of CVA cases in children is increasing year by year,which has a great impact on the physical and mental development of children and their social activities.Modern medicine is effective in treating CVA,but the treatment course is long and the compliance of children is low,which significantly increases the side effects.Traditional Chinese medicine treatment has the obvious advantages of definite curative effect and few side effects.Professor Qin Yanhong believes that the occurrence of CVA is the result of internal and external causes:the external evil is dominated by wind evil,and the internal cause is often the deficiency of lung and spleen in children.The key pathogenesis is the internal accumulation of wind sputum and the upward reversal of lung qi,and the pathological factors are mainly wind,sputum and qi,so the treatment emphasizes on dispersing wind,eliminating phlegm and regulating qi,and the self-designed "Zhike decoction" with modification is used to treat the disease.Due to the long course of CVA disease,and because the pathological focus of different periods is different,the treatment by stage is emphasized in clinical practice,the main treatment is to remove the evil during the attack period and to reinforce the deficiency and remove the evil during the recovery period.The effect is significant,and it is well recognized by parents.

Adolescent depression is a common mental and psychological disorder in adolescence,and although its symptoms have their own characteristics,it is inseparable from the overall theory of Chinese medicine in terms ofetiology and pathogenesis.Based on the theory of the five viscera and the analysis of the "five viscera","five spirits" and "five elements",this paper explores its correlation with the occurrence of depression in order to perform differential treatment,which provides a new direction for the treatment of depression in TCM and enriches the treatment system of emotional diseases in TCM.