Childhood and adolescent obesity has become a global challenge in public health.Its high weight regain rate and risks of metabolic complications highlight the limitations of traditional intervention strategies.This review systematically explores individualized intervention strategies for obesity in children and adolescents in the context of precision medicine,breaking the traditional "one-size-fits-all" model.It integrates multi-omics technologies with intelligent management methods,proposing a multidimensional framework for precise intervention.First,a precise diagnosis and evaluation system is constructed based on multi-modal data,including genomics,radiomics,and gut microbiomics,to identify genetic susceptibility,metabolic phenotypes and microbiome characteristics,laying the foundation for stratified interventions.Secondly,individualized intervention plans are developed based on genetic risk scores,epigenetic regulatory mechanisms,and gut microbiome-targeted therapies:gene-guided strategies aim to optimize dietary structure through multi-gene risk assessments; epigenetic interventions aim to regulate DNA methylation and histone modification by taking advantage of nutrients (such as methyl donors and short-chain fatty acids),reversing metabolic dysregulation; microbiome remodeling aims to improve energy metabolism balance through probiotics and synbiotics.Furthermore,artificial intelligence and wearable devices are employed for dynamic monitoring in multiple scenarios.By collaborating with multidisciplinary teams in nutrition,sports medicine,and psychology,a smart management model of "hospital-family-community" network is established.While precision medicine offers groundbreaking directions for childhood obesity treatment,challenges such as biomarker validation,data integration,and long-term efficacy evaluation remain to be addressed.This review provides theoretical foundations and practical pathways for the improvement in the effectiveness and sustainability of interventions,emphasizing the need to integrate interdisciplinary innovative technologies in the future in order to promote the transformation of childhood obesity management toward precision and intelligence.

Zhimu-Huangbai is a commonly used medicine pair in clinical practice,and the compatibility of the two drugs has the effects of nourishing yin and clearing heat,purging fire and detoxifying.Modern studies have found that Zhimu-Huangbai has anti-inflammatory,antioxidant,hypoglycemic,and lipidemic regulation effects because of its main active ingredients such as quercetin,kaempferol,barmatine,stigmasterol,mangiferin,berberine,etc.It is widely used in clinical practice,mainly for the treatment of precocious puberty,diabetes,diabetic nephropathy and other diseases in children.From the perspectives of chemical composition,pharmacological effects and clinical application,this paper expounds the application research of Zhimu-Huangbai in precocious puberty in recent years,in order to provide a theoretical basis for the scientific application of the drug in precocious puberty and for the research and development of new drugs.

Since the 1970s,it has been believed in traditional Chinese medicine (TCM) that the pathogenesis of precocious puberty is primarily associated with yin-deficiency and fire-excess,and the treatments that nourish yin and purge fire are advocated.Therefore,an integrated treatment strategy combining TCM and western medicine has gradually been formulated.Modern medical research indicates that precocious puberty results from the interplay of genetic and environmental factors,involving heredity,diet,chemical substance interference,and psychological factors.TCM emphasizes the combined influence of internal and external factors,such as dietary irregularities and emotional disturbances,and focuses on therapeutic methods like nourishing yin,purging fire,soothing the liver,and relieving stagnation.The integrated approach of TCM and western medicine offers a more comprehensive treatment plan for precocious puberty.The TCM theory of "preventive treatment of disease" underscores the importance of prevention,reducing risk factors and performing proactive treatment to avoid long-term complications.

When children enter puberty,they will experience prominent changes mainly in the morphology of their reproductive organs,and development of function and secondary sexual characteristics.The main manifestation of precocious puberty is the earlier development of secondary sexual characteristics and the premature maturation of sexual organs,which is an endocrine disease characterized by abnormal growth and development of children.With the development of economy and society,the advancement of the onset age of precocious puberty and the increase in incidence rate have triggered increasing social attention.Multiple factors can have an impact on precocious puberty,and modern researches have confirmed a correlation between the daily diet of children before puberty and precocious puberty.This article reviews domestic and foreign researches in common dietary patterns and various dietary nutrients related to adolescent sexual development in children,represented by high calorie diet patterns,Mediterranean diet patterns,and vegetarian diet patterns,and it summarizes the influence of different dietary patterns on precocious puberty in children.The article respectively summarizes the potential regulatory mechanisms of high protein diet,high-fat diet and high sugar diet in high calorie diet patterns,as well as the main dietary components (vegetables,fruits,olive oil,grains,nuts,beans,and dairy products) in Mediterranean diet patterns and vegetarian diet patterns in sexual development.The aim is to provide theoretical basis for the prevention and treatment of precocious puberty in children from the perspective of dietary intervention,and to provide new ideas for future researches on the relationship between dietary nutrition structure and sexual development.

Fecal microbiota transplantation (FMT), as a method to treat intestinal and extra-intestinal diseases by regulating intestinal flora dysbiosis, has attracted widespread attention in recent years. Its effect in the treatment of children's neurodevelopmental disorders (NDDs) has gradually been verified, showing great application prospects, which provides new strategies for the treatment of NDDs. This article explores its clinical efficacy, development prospects and some technical limitations that still exist at present by summarizing the relevant animal and clinical studies on FMT treatment for NDDs, aiming to provide relevant references for the subsequent clinical treatment of NDDs.

Objective To explore the effect of Jingling oral liquid on improving memory function and promoting myelination in young spontaneously hypertensive rats (SHR) of ADHD animal model.Methods A total of 24 SHR were randomly divided into model group,tomoxetine group,Jingling oral liquid equal-dose group［11.15 g/（kg·d)］ and high-dose group［29.5 g/（kg·d)］,with 6 rats in each group,and 6 Wistar Kyoto rats (WKY) were included as control group.The improvement in working memory of the rats was observed by water maze after 6 weeks of treatment.The prefrontal lobes of the rats in each group were separated,and the structures of myelin sheath were observed by luxol fast blue（LFB）.The expressions of Nogo-A,MRF,FGF17,NG2 and MBP in the frontal lobe of rats were determined by western blot.Results （1） After 6 weeks of treatment,compared with the tomoxetine group,both the Jingling oral liquid equal-dose group and high-dose group demonstrated a more stable promotion of body weight gain in rats.（2）Compared with the model group,the finding time in water maze of SHR in tomoxetine group and Jingling equal-dose and high-dose groups was shortened after 6 weeks of treatment.（3） Compared with model group,myelin in brain tissues of rats in equal-dose and high-dose groups was tightly arranged with intact structure(P<0.05).（4） Compared with model group, NG2 and MRF protein expressions were increased in both Jingling oral liquid  equal-dose group and high-dose group，MBP expression was elevated in the high-dose group, while the FGF17 expression decreased in the equal dose-group, with all differences being statistically significant (P<0.05).Conclusion Jingling oral liquid can improve the memory and learning ability of SHR,and promote myelin regeneration and maturation.

Objective To observe the toxic reactions of the maximum dose of Huangying Kechuan syrup and whether it is addictive,in order to provide experimental evidence for its safe clinical application.Methods (1) Acute toxicity experiment:40 Balb/c young mice,half male and half female,were randomly divided into male blank group,female blank group,male drug administration group and female drug administration group,with 10 mice in each group.The drug administration groups were given Huangying Kechuan syrup at the maximum concentration of 33.25 g/kg (equivalent to 100 times of the clinical dose) by gavage at 40 mL/kg,twice a day,at a 6-hour interval.The blank groups were given the same volume of distilled water at the same frequency.Toxic reactions,death,body weight and food intake within 14 days of administration were observed and recorded.Gross dissection was performed on the dead animals and those still alive at the end of the observation period to observe the changes in major organs,and the ratios of organ weight to body weight of the young mice were calculated to obtain the lung index and spleen index.(2) Addiction experiment:50 Balb/c young mice were randomly divided into blank control group,low,medium and high-dose Huangying groups (comparable to 0.5,1 and 2 times of the clinical equivalent dose),and compound glycyrrhiza tablet group.The drugs were administered by gavage at 10 mL/kg once a day for 7 consecutive days.Two hours after the last administration,naloxone hydrochloride solution (0.013 mg/kg) was injected intraperitoneally to induce withdrawal in the young mice.The corresponding withdrawal symptoms (jumping response,upright behavior,grooming frequency,whether there was tooth grinding,chewing,tearing,salivation,rapid breathing,writhing,death,etc.) within 30 minutes were observed,and the body weight of the young mice before and 30 minutes after withdrawal was measured.At the same time,the appearance of the young mice,whether there was secretion,fecal color and traits were examined.The detection indicators included:histopathological examination and blood biochemical indicators related to liver and kidney function (alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,urea nitrogen,total proteinase,creatinine).Results (1)In the acute toxicity experiment,no obvious toxicity was observed after administration of Huangying Kechuan syrup by gavage.There were no abnormal signs of the appearance of the animals or behaviors,and no abnormal secretions were found in the eyes,nose,mouth or anus; no abnormalities were observed in the shape of the feces.There was no statistically significant difference in body weight or food intake between the two groups of young mice on the 1st,5th,10th and 14th day of administration (P>0.05).The lung and spleen indices of the drug administration groups showed no statistically significant difference compared with those of the blank groups (P>0.05).（2）In the addiction experiment,within 30 minutes after injection of naloxone,there were no symptoms such as tooth grinding,chewing,tearing,salivation,rapid breathing,writhing and death.The grooming frequency and upright behavior in the high,medium and low-dose Huangying groups and the compound glycyrrhiza tablet group compared with the blank control group,the difference was not statistically significant(P>0.05).No jumping response occurred in the 30 minutes after administration in the high,medium and low-dose Huangying groups.In the compound glycyrrhiza tablet group,8 times of jumping phenomena occurred.No obvious histopathological abnormalities were found in the tissues of the young mice after dissection.There was no statistically significant difference in the blood biochemical indicators of the young mice in the Huangying groups and compound glycyrrhiza tablet group compared with the blank control group (P>0.05).Conclusion At 100 times of the clinical dose,no toxic symptoms are observed in the young mice after administration of Huangying Kechuan syrup,which is not addictive under the premise of clinical dosage and administration period.

By searching CNKI, China biomedical literature service system, Wanfang data knowledge service platform, Weipu Chinese science and technology journal full-text database, Pubmed, Embase and other databases, as well as Yimaitong, NICE,NGC,GIN and other websites, clinical practice guidelines and diagnosis and treatment norms for pediatric pneumonia were sorted out, and literature was independently screened by researchers. After extracting the data, the AGREE Ⅱ tool is used to evaluate the quality of the formulation methodology of the guidelines and diagnosis and treatment norms, and the recommended level is obtained, in order to grasp the formulation methods and quality status of clinical practice guidelines for childhood pneumonia at home and abroad, and to provide reference for the future formulation of high-quality clinical practice guidelines in professional fields.

Objective To measure serum uric acid(SUA) levels in children of different ages(0 to 14 years),investigate the incidence of high level of uric acid in those regions,and analyze its association with gender,age,body size-body mass index(BMI),and living habits［including consumption of seafood,consumption of long-boiled soup/stew,consumption of vegetables,consumption of beverages,consumption of sweets,daily water intake(mL) and daily exercise (min)］.Methods Totally 1 209 children visiting Kaiping City Centre Hospital and Kaiping Maternal and Child Health Hospital from January 2022 to September 2023 were enrolled in the study.Height/length,weight and SUA of the children were measured,and the children were grouped according to age and gender in order to investigate the SUA levels of children in different age groups and genders.In addition,the children were grouped according to the SUA level to investigate the current situation of uric acid and the incidence of hyperuricaemia in the region.In the meantime,the relationship between hyperuricaemia(HUA) in the children and their gender,age,body size-BMI and living habits were also investigated.Results The distribution of SUA levels showed no statistically significant difference between different genders(P>0.05). In children of different ages and body types, SUA levels exhibited a trend of gradual increase with age and body type growth. The overall detection rate of hyperuricemia was 20.18%(244/1 209), and the comparison of the detection rates of hyperuricemia between different genders showed no statistically significant difference(P>0.05). However, the comparison of hyperuricemia detection rates among different ages and body types showed statistically significant differences(P<0.01). Logistic regression analysis revealed that seafood consumption, beverage intake, and a preference for sweet foods were risk factors for hyperuricemia, while increased vegetable intake, fluid consumption, and appropriate exercise were protective factors for uric acid levels. Conclusion The level of SUA in children in Kaiping City increases with age and changes in body type, with no specific relation to gender; high-purine and high-sugar foods are risk factors for hyperuricemia.

Objective To analyze the risk factors for malnutrition in children with pertussis.Methods Totally 124 children with pertussis hospitalized for treatment in Hunan Children′s Hospital from March 2023 to March 2024 were selected as the research subjects.The children were grouped according to whether they had malnutrition,and the indicators with statistical significance in the single factor were included in Logistic regression analysis.Results The malnutrition assessment score for 124 children with pertussis was (3.59±1.74),including 38 cases (30.65%) with malnutrition and 86 cases (69.35%) with normal nutrition.The results of Logistic regression analysis showed that age,severity of disease,presence of other diseases,uncertainty about disease,and sleep status were risk factors for malnutrition in the children (P<0.05).Conclusion Severe malnutrition exists in hospitalized children with pertussis,and low age,severe illness,comorbidities,high levels of uncertainty about disease in family members and poor sleep conditions are all independent risk factors for malnutrition in children.Scientific and reasonable feeding should be carried out to reduce the incidence of malnutrition in children.

Objective To explore the distribution of traditional Chinese medicine(TCM) constitution in children with attention deficit hyperactivity disorder(ADHD) (syndrome of heart and liver fire hyperactivity),and its relationship with symptoms and social function of the children.Methods A total of 70 children aged 7 to 14 years with ADHD (syndrome of heart and liver fire hyperactivity) were included in the study,who were treated in Yixing Traditional Chinese Medicine Hospital from January 2023 to May 2024.The TCM syndrome scoring,SNAP-Ⅳ and CGAS were used to evaluate the severity of the symptoms and the impact on social function of the children,and the TCM constitution distribution was divided according to the TCM constitution scale.Results TCM syndrome score was (18.54 ± 2.84) in ADHD children (syndrome of heart and liver fire hyperactivity).The average SNAP-Ⅳ score of the boys was (41.02±8.56),the average SNAP-Ⅳ score of the girls was (41.19±8.46),the average CGAS score of the boys was (63.12±6.83),and the average CGAS score of the girls was (63.75±6.65),which significantly affected the children′s social function and normal life activities; the severity of the disease was not related to gender(P>0.05).Unbalanced constitution was the main type of TCM constitution,totaling 42 cases (60%),and 28 cases (40%) were with balanced constitution.Among the children with unbalanced constitutions,the number of children with qi-stagnation constitution,yin-deficiency constitution and qi-deficiency constitution was the highest (≥10%); the children with yin-deficiency constitution had the longest course of disease ［(4.25±0.41) years］,and the children with balanced constitution had the shortest course of disease ［(1.74±0.33) years］.Conclusion The TCM syndrome score of the 70 children with ADHD(syndrome of heart and liver fire hyperactivity) in Yixing area included in this study is high,which has a significant impact on the social function of the children,but there is no gender difference.Unbalanced constitution is the main type in the distribution of constitution,and the disease course of ADHD (syndrome of heart and liver fire hyperactivity) is different in children with different constitutions.

The function of the spleen in children is often insufficient, and improper feeding, or disease damage may cause the fact that food can't be digested, which is food accumulation。Although it is a disease of the spleen, Professor Sun Liping believes that long time of food accumulation can form internal heat syndrome, thereby inducing a variety of pediatric diseases. Attention should be paid to the physical changes caused by congenital abnormality and acquired dystrophy. Based on the physiological and pathological characteristics of children, Yin and Yang theory, five-element theory and constitution theory, and through combination with more than 30 years of clinical experience of Professor Sun Liping, this paper explores the etiology and pathogenesis of children's diseases caused by "food", the disease outcome transformed by "heat", the diagnosis experience from "observation", and the treatment method by "elimination". A new line of thinking of "same treatment for different diseases" is provided for the diagnosis and treatment of abdominal pain, cough, asthma and tic disorders caused by food accumulation.

In Xu's pediatrics of Shanghai traditional Chinese medicine, it is believed that the pathogenesis of children's insomnia lies in the rise of yang and the weakness of yin, so the treatment is as follows: on the basis of warming the lower and suppressing yang, Huanglian Ejiao decoction is used to warm yang and nourish yin and to control water and fire and yin and yang to restore its normal state, thus forming a treatment with the characteristics of Shanghai traditional Chinese medicine. Based on the warming and suppressing method of Xu's pediatrics of Shanghai traditional Chinese medicine, this paper explores Xu's understanding of etiology and pathogenesis of insomnia in children, and analyzes the characteristics of prescription and medication of tranquilizing method by suppressing yang through the combination with the development characteristics of etiology and pathogenesis in children. A case is included here to provide some references for clinical practice.

Pediatric rhinitis is a common nasal disorder in children. TCM practitioners throughout history have extensively discussed its etiology and pathogenesis. This article traces the literature and historical origins of treatment for pediatric rhinitis from the perspectives of deficiency and cold syndromes. It is pointed out that external cold is a common cause. The root cause of its recurrence is the deficiency and damage of the lungs, spleen and kidneys. The pathogenesis involves lung-qi deficiency and coldness, leading to insufficient defense of the exterior; kidney-yang deficiency results in a lack of warmth and nourishment; spleen and stomach weakness leads to the failure of ascending clear yang; all of the above factors contribute to the development of pediatric rhinitis. Additionally, the article delves into Xu's pediatrics theory of supporting yang and its application, aiming to provide assistance for clinical practice.

Refractory nephropathy in children is one of the difficulties that need to be urgently addressed in clinical practice. Based on years of clinical experience, Professor Li Xinmin believes that "dysfunction of the pivot of the triple energizer" is the core pathogenesis, and advocates the basic treatment principle of "dredging and regulating the qi movement of the triple energizer, with particular emphasis on the spleen and stomach in the middle energizer". Clinically, he is good at restoring the qi transformation of the triple energizer by coordinating the ascending and descending of the qi movement of the "lung, spleen, stomach and liver" thereby normalizing the water and fluid metabolism function. Meanwhile, he advocates treating the disease based on stages. In the acute recurrence stage, emphasis is placed on clearing and dispersing the lung qi in the upper energizer, and Yinqiao Silian decoction with modification is often used. In the remission stage, attention is paid to dredging and promoting the spleen and stomach in the middle energizer, and Weiling decoction with modification is commonly employed. In the protracted stage, focus is on dredging and regulating the qi movement of Shaoyang, and Chaihu Linggui Zhugan decoction with variation is often administered. Professor Sun Liping emphasizes moderation and balance in the prescription and medication, and he is particularly skilled in using the combination of bitterness with acridity to unfold and regulate the pivot. The clinical therapeutic effect is significant.

This paper explores the application value of Traditional Chinese Medicine (TCM) theory of "lungs governing skin and hair" and the thinking method of "analogy and classification" in the treatment of pediatric pulmonary diseases.Both "lungs governing skin and hair" and "analogy and classification" are traditional TCM theoretical approaches guiding clinical differential diagnosis and treatment.By discussing the correlation between the lungs and the skin and hair,and then employing the method of analogy and classification,this paper explores the feasibility and efficacy of treating pulmonary diseases by the "skin"-cortex (the character of skin and cortex is the same in Chinese).Starting from the physiological characteristics of children,such as "lung deficiency" and loose cutaneous layers,the paper argues that "cortex-related" herbal medicines (e.g.,Baixian Pi,Hou Po,and Chan Tui) can improve the pathological features of being easily invaded by external pathogens in children.Through case studies,this paper demonstrates a formula containing cortex-related herbs in the treatment of cough (wind-phlegm obstructing the lung) in a 4-year-old child,which is very effective.The results confirm the clinical feasibility of this approach.By integrating traditional TCM theories with modern scientific validation,this paper provides new insights into the diagnosis and treatment of pediatric pulmonary diseases,highlighting the unique advantages of TCM in the field of pediatrics.

Pediatric cough variant asthma (CVA) is a common chronic respiratory disease primarily characterized by chronic cough. The exact etiology of CVA is not yet fully understood, but it is widely believed that the progression of the disease is influenced by various pathological factors, and is closely related to the patient's individual constitution, seasonal changes, and regional environmental characteristics. Traditional Chinese medicine (TCM) categorizes CVA under "wind cough", "wheezing cough", and "spasmodic cough", and pediatric CVA is managed according to the principle of "San Yin Zhi Yi"(three-cause adaptation), which involves personalized adjustments of the treatment plan based on the patient's constitution, seasonal changes and regional environment, reflecting the holistic treatment concept and syndrome-differentiation treatment of TCM. Therefore, this article discusses the etiology and pathogenesis of pediatric CVA from the perspectives of both TCM and modern medicine, based on the TCM principle of "San Yin Zhi Yi". It comprehensively considers the impact of factors such as constitution, season and environment on the onset and progression of the disease, exploring the application of San Yin Zhi Yi treatment for pediatric CVA from the three aspects of adapting to the season, region and individual. The aim is to provide a better theoretical foundation and practical guidance for the future TCM treatment of pediatric CVA.

Pediatric enuresis is a common clinical disease in pediatrics.Long-term enuresis can affect children 's sleep quality,learning and social life,as well as mental health.This article discusses the pathogenesis and clinical application of Wuling powder in the treatment of enuresis in children from the perspective of bladder qi transformation.Based on the physiological basis of bladder being responsible for urine excretion,the pathogenesis is mainly attributed to the failure of bladder qi transformation,and the common causes are dampness,heat,cold and so on.Wuling powder can help qi transformation and bladder contraction by warming yang,transforming qi and promoting water,that is,the normal function of bladder qi transformation is restored and the symptoms of enuresis are relieved by regulating water and fluid metabolism.The curative effect of Wuling powder in the treatment of enuresis in children has also been clinically verified by many modern doctors.Here,one case of Wuling powder with modification in the treatment of enuresis in children is introduced.

Objective To evaluate the clinical efficacy of Xiaoer Dingchuan granule in the intervention of respiratory syncytial virus pneumonia (syndrome of phlegm-heat blocking the lung) in children.Methods A total of 72 children with respiratory syncytial virus pneumonia (syndrome of phlegm-heat blocking the lung) admitted to the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Liaoning Maternal and Child Health Hospital and Benxi Manzu Autonomous County Hospital of Traditional Chinese Medicine from June 2023 to June 2024 were selected as the study subjects,who were randomly divided into control group and observation group with 36 cases in each group.The control group received basic treatment,and the observation group received Xiaoer Dingchuan granule in addition to the treatment for the control group.After 7 days of treatment,the clinical efficacy,TCM syndrome efficacy,single symptom remission time,disappearance time and adverse reactions were compared between the two groups.Results After treatment,the clinical effect and TCM syndrome effect of the observation group were better than those of the control group.The remission time of wheezing,cough,gurgling with sputum and fever in the observation group was shorter than that in the control group,and the differences were statistically significant(P<0.05).No adverse events occurred in the observation group.One case in the control group had nausea and vomiting,which disappeared after treatment.Conclusion Xiaoer Dingchuan granule has a positive therapeutic effect in the treatment of respiratory syncytial virus pneumonia (syndrome of phlegm-heat blocking the lung);the clinical effect is good,accelerating the disappearance of symptoms,and clinical application safety is high,which is worthy of clinical promotion.