Children with autism spectrum disorder (ASD) frequently exhibit pronounced difficulties in emotion regulation, manifested as excessive emotional reactivity, slow emotional recovery, and a lack of adaptive regulatory strategies, which substantially impair social adaptation and quality of life.This article focuses on emotion regulation problems in children with ASD, systematically outlining multimodal assessment approaches and integrative intervention strategies.It further proposes that future work should strengthen the integrated use of multimodal assessment data and develop a closed-loop model that links assessment to intervention, thereby advancing early screening, precise identification, and individualized intervention for emotional difficulties in children with ASD.

Dyslexia is the most common type of specific learning difficulty, affecting approximately 5% to 10% of school-age children.From the perspective of cognitive psychology, this paper systematically reviews the cognitive mechanisms, assessment tools, diagnostic criteria, and intervention research on dyslexia, and highlights that the primary focus of its assessment and intervention is decoding ability (character recognition).Future efforts should integrate advances in artificial intelligence and educational technology to promote the establishment of early screening and evidence-based intervention systems.

The metabolism of lactose primarily relies on the hydrolytic action of lactase, whose activity is regulated by genetic factors and developmental stages.Lactose intolerance can be classified into four types: primary, secondary, congenital, and developmental, with diverse clinical manifestations.Diagnostic methods include hydrogen breath test, lactose tolerance test, and genetic testing, but there is currently no simple and reliable standardized diagnostic approach.Treatment strategies encompass dietary modifications, enzyme replacement therapy, and probiotic supplementation.This article summarizes the metabolic mechanisms of lactose in the intestine, as well as recent advances in the pathophysiology, diagnosis, and treatment of lactose intolerance.A deeper understanding of lactose metabolism is crucial for improving the management of lactose intolerance.

Autism spectrum disorder (ASD), as a neurodevelopmental disorder, often co-occurs with other psychiatric conditions. Approximately 96% of children with ASD have at least one comorbid condition, such as attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder, intellectual disability, anxiety disorders, bipolar disorder, depression, and tic disorders, among which ADHD is the most common. ASD and ADHD have a high overlap in genetics, immune system, intestinal microbiota, environmental exposure and behavioral manifestations, and there is a lack of clear distinguishing markers. Since the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which permits comorbid diagnosis of ASD and ADHD, there has been a lack of expert consensus and guidelines, making the clinical differential diagnosis of ASD, ADHD, and their comorbidities challenging. Therefore, this article elucidates the similarities and differences among ASD, ADHD, and their comorbidities in terms of pathogenic mechanisms and clinical symptoms, which has potential significance for future research on biomarkers of the three and development of cross-diagnostic assessment tools.

Childhood obesity has become a major public health issue, posing clear risks to children's health and future development. Effective management requires a systematic approach that includes monitoring and assessment, intervention and treatment, and long-term maintenance. National surveillance systems are essential for tracking weight trends, while interventions focus on improving diet, increasing physical activity, and strengthening health education. Long-term maintenance relies on supportive policies, financial measures, and healthy environments that help children sustain positive behaviors. In recent years, China has introduced several national policies, including the Implementation Plan for the Prevention and Control of Overweight and Obesity in Children and Adolescents (2020), and has integrated the Healthy Weight Management Action into the Healthy China Initiative. The launch of the three-year campaign on enhancing the public's weight management has further promoted a coordinated system involving government, schools, families, communities, and healthcare institutions. While progress has been made, further efforts are still needed in policy evaluation, medical-public health coordination, individual monitoring, and basic research.

Childhood and adolescent obesity has become a major global public health challenge, with a continuously rising prevalence and a trend toward younger age of onset. The escalating rates of childhood obesity significantly increase the risk of various complications, including type 2 diabetes, hypertension, non-alcoholic fatty liver disease (NAFLD), asthma, and obstructive sleep apnea, substantially elevating the long-term risk of cardiovascular diseases. Currently, lifestyle interventions centered on nutrition, physical activity, and behavioral modification are the first-line weight management strategies recommended by both domestic and international guidelines, with exercise intervention being a critical component. However, obese children commonly face challenges such as low levels of physical activity, prolonged sedentary time, and insufficient exercise participation, which severely limit intervention effectiveness. This review systematically elucidates the core role and underlying physiological mechanisms of exercise in weight management for obese children. First, exercise directly counteracts positive energy balance and fat accumulation through multiple pathways: increasing total energy expenditure, enhancing skeletal muscle fat oxidation capacity, improving insulin sensitivity, promoting lipolysis, and regulating appetite-related hormones. Second, regular exercise effectively ameliorates obesity-related chronic low-grade inflammation by reducing levels of pro-inflammatory factors such as C-reactive protein (CRP),interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), while promoting the release of anti-inflammatory factors like IL-10 and beneficial myokines including irisin and IL-15, thereby exerting synergistic health-promoting effects at both metabolic and immune levels. In conclusion, exercise represents an indispensable non-pharmacological intervention with dual benefits for the prevention and management of childhood obesity.

Objective To investigate the effects of TAK-242, a specific Toll-like receptor 4 (TLR4) inhibitor, on autism spectrum disorder(ASD)-like behaviors and neuroinflammation in offspring rats induced by maternal immune activation (MIA), so as to provide an experimental basis for early ASD intervention. Methods Thirty pregnant SD rats were randomly divided into control group, LPS, and TAK-242 intervention group (n=10 per group).On gestational day 9.5 (G9.5), the LPS and TAK-242 groups received an intraperitoneal injection of 100μg/kg LPS, while the control group received an equivalent volume of PBS.The TAK-242 group received a pre-injection of 3mg/kg TAK-242 2 hours before LPS administration.Male offspring underwent behavioral tests at 6 - 8 weeks of age to assess their social behavior and cognitive function.Serum levels of IL-6 and TNF-α in the dams and offspring were measured using ELISA.In the offspring, the expression of inflammatory factors in the prefrontal cortex (PFC) was detected by qRT-PCR, while microglial morphology and the expression of the marker Iba-1 were examined by immunohistochemistry. Results Compared with the control group, the LPS group showed significantly elevated serum levels of IL-6 and TNF-α in both dams and offspring (P<0.001).Offspring in the LPS group exhibited ASD-like behavioral abnormalities, including increased marble burying, reduced central zone duration in the open field, decreased social index, and impaired learning and memory (F=9.811, 14.490, 31.750, 5.250, P<0.05).Furthermore, the LPS group demonstrated up-regulated mRNA expression of pro-inflammatory factors and down-regulated mRNA expression of anti-inflammatory factors in the PFC (P<0.001), along with microglial activation (characterized by enlarged cell bodies and shortened processes) and increased Iba-1 expression.TAK-242 intervention significantly ameliorated all these abnormalities (P<0.05). Conclusions TAK-242 ameliorates MIA-induced ASD-like behaviours in offspring by inhibiting the TLR4/NF-κB signalling pathway, potentially through modulating microglial polarization and attenuating neuroinflammation.

Objective To develop a culturally appropriate, standardized, and comprehensive assessment tool for evaluating the quality of family-based infant and toddler care (0 - 3 years) in China, and to examine its reliability and validity, in order to provide a scientific foundation for research on family care quality assessment tools. Methods Based on the nurturing care framework and the Guidelines for Healthy Nurturing Care of Children Under 3 Years of Age, an initial assessment tool was constructed through literature review, expert consensus, and consideration of infant and toddler developmental characteristics.The tool was refined through pilot surveys, expert discussions, and internal group revisions.Reliability was assessed using internal consistency, test-retest reliability, and split-half reliability.Validity was examined through content validity and construct validity. Results The final scale consisted of 54 items across five dimensions: safety care, health care, nutrition care, responsive care, and early learning.The questionnaire demonstrated strong reliability, with a Cronbach's α coefficient of 0.931, split-half reliability of 0.848, and test-retest reliability of 0.613.All item factor loadings were >0.4, correlations between subscales and the total scale ranged from 0.604 to 0.751, and inter-subscale correlations mostly fell between 0.501 and 0.715 (all P<0.05).Construct validity indices indicated a good model fit (χ²/df=4.584, CFI=0.901, GFI=0.912, AGFI=0.901, IFI=0.901, RMSEA=0.035). Conclusion The family infant and toddler nurturing care scale developed in this study exhibits good reliability and validity and is suitable for assessing the quality of family-based nurturing care of infants and toddlers.

Autism spectrum disorder (ASD) is a heterogeneous neurodevelopmental condition with complex etiology involving dysregulated epigenetic mechanisms arising from gene-environment interactions.This review systematically examines the contributions of natural, chemical, and biological environmental exposures to ASD risk.It further analyzes the potential role of parental factors such as parental occupation, age, and history of metabolic diseases.The review focuses on three major epigenetic mechanisms: DNA methylation, histone modifications, and non-coding RNA dysregulation, elucidating their aberrant regulation during critical neurodevelopmental windows and their associations with core ASD symptoms, including social communication deficits and restricted repetitive behaviors, which provides a theoretical basis for the in-depth analysis of the pathogenesis of ASD and the development of targeted intervention strategies.

In recent years, the incidence of childhood obesity has been rising annually, becoming a major public health concern.This condition has numerous adverse effects on children's physical and mental health.Physiologically, it can increase the burden on bones and joints and lead to metabolic disorders; psychologically, it often triggers emotional issues such as low self-esteem and anxiety.Additionally, childhood obesity significantly raises the risk of developing chronic diseases in adulthood, including cardiovascular diseases, diabetes, and hypertension.From the perspective of rehabilitation training, this review comprehensively covers key areas such as exercise assessment, exercise prescription formulation, exercise method selection, precautions, and the treatment of complications.It elaborates in detail on the correct exercise intervention strategies for childhood obesity.The aim is to enhance healthcare professionals' understanding of exercise therapy for childhood obesity, optimize clinical treatment plans, improve therapeutic effectiveness and precision, and provide scientifically sound guidance for the prevention and management of childhood obesity.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social communication deficits, restricted interests, and repetitive behaviors, exhibiting variable clinical manifestations and significant treatment challenges. As a non-invasive brain stimulation technique, transcranial direct current stimulation (tDCS) can alleviate clinical symptoms in individuals with ASD by modulating local cortical excitability. The underlying mechanisms involve correcting the abnormal excitation/inhibition (E/I) ratio, regulating levels of cerebral metabolites, optimizing functional brain connectivity, and improving cerebral hemodynamics. This article reviews the target selection, mechanisms of action, and clinical efficacy of tDCS in the treatment of ASD. It also explores its extended applications in other neuropsychiatric disorders such as ADHD and depression, as well as its safety profile.

Objective To analyze the association between childhood exposure to neonicotinoid pesticides (NEOs) and the risk of autism spectrum disorder (ASD). Methods This case-control study enrolled 30 children with ASD and 28 typically developed children from Wuhan Children′s Hospital.Serum concentrations of NEOs and their metabolites were measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS).Multivariate logistic regression models were used to assess the association between individual NEO exposure and ASD risk, and the weighted quantile sum (WQS) regression model was employed to analyze the association between mixed NEO exposure and ASD risk. Results Concentrations of 5-hydroxy-imidacloprid (5-OH-IMI), desmethyl-thiamethoxam (NTHM), and sulfoxaflor (SFX) were significantly higher in the ASD group compared to controls(t=6.964, 2.276, 2.182, P＜0.05).Multivariate logistic regression analysis revealed that 5-OH-IMI and NTHM were significantly associated with increased ASD risk (OR=47.738, 3.263, P＜0.05).WQS analysis indicated that mixed NEO exposure was positively associated with ASD risk (OR=7.83, 95% CI: 0.48 - 15.18). Conclusions This study found a significant association between NEO exposure and increased ASD risk.However, the specific mechanisms underlying this association require further investigation.

This paper explores the establishment of a "Language-Social Communication-Cognition" three-dimensional model for children′s language assessment and intervention, grounded in the clinical reasoning framework for broadly defined language disorders.First, it lists the common language and communication issues in children with neurodevelopmental disorders and outlines evidence-based early language intervention approaches that align with this three-dimensional model.As children enter the preschool and school-age years, this model aids in the differential diagnosis process by analyzing the distinct root causes of language disorders, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and intellectual disability.Neither early language intervention approaches nor linear language intervention processes are effective in advancing the critical skills these children need for academic learning and social participation.This paper emphasizes the crucial role of "Theory of Mind" ability within the three-dimensional model during this stage and dedicates a section to its detailed elaboration.Finally, the paper proposes a narrative-based language intervention system that implements the "Language-Social Communication-Cognition" model in practice, with three dimensions advancing together and synergistically, and explains its evidence-based foundation and clinical procedures.

Objective To investigate the causal relationship between subcortical brain structures and autism spectrum disorder (ASD) in children, in order to identify potential biomarkers for early ASD diagnosis. Methods The data related to children′s subcortical brain structure and ASD were extracted from the open data of the genome-wide association study (GWAS), and the two-sample Mendelian randomization method was used for causal inference.The inverse-variance weighted (IVW) method served as the primary analysis, supplemented by MR-Egger regression, weighted median, and weighted mode methods to address IVW limitations.Quality control was conducted using Cochran′s Q test, MR-PRESSO, and leave-one-out analysis. Results Three subcortical structural phenotypes showed causal associations with ASD: 1) The bilateral caudate nucleus volume was positively correlated with ASD (IVW: OR=1.220, 95%CI: 1.088 - 1.369, P=0.001); 2) the interaction between bilateral nucleus accumbens volume and prenatal stress exhibited a negative association with ASD (IVW: OR=0.850, 95%CI:0.734 - 0.983,P=0.029); 3) bilateral intracranial volum×postnatal stress interaction was negatively correlated with ASD (IVW: OR=0.878, 95%CI:0.780 - 0.988, P=0.031).Sensitivity analyses confirmed robust findings. Conclusions Increased bilateral caudate nucleus volume may represent a risk biomarker for ASD, while the protective interaction effects of nucleus accumbens volume × prenatal stress and intracranial volume × postnatal stress could mitigate ASD risk.These findings may provide potential neuroanatomical markers for early ASD detection.

Nutrition education kitchen for infants and young children is a health education place providing both feeding knowledge and practical operation for caregivers of children.Recently, nutrition education kitchen has been set up in many health care institutions in China.However, there is a lack of standardized construction and operation guidance.The Capital Institute of Pediatrics, together with experts from pediatrics, child health care and nutrition, jointly developed the Construction and Operation Standard of Nutrition Education Kitchen for Infants and Young Children, which aims to provide professional recommendations for child care professionals in different levels of health care institutions, nursery institutions, and community child growth stations.The standard includes basic requirements, construction requirements, equipment and facilities, operation management, personnel, operation services, evaluation management, which could promote the construction of nutrition education kitchen throughout the country, and standardize the operation services to strengthen infant and young child feeding.

Objective To understand the impact of the family nurturing environment on the neuropsychological development level of children, so as to provide a scientific basis for family nurturing guidance in outpatient clinics. Methods From September 2021 to June 2022, developmental screening was conducted on 631 children aged 0 - 3 years at the Child Growth and Development Clinic of Shengzhou Maternal and Child Health Hospital, along with a survey on the family nurturing environment of their primary caregivers. The survey results were analyzed using univariate and multivariate methods. Results The suspected abnormality rate of the developmental quotient (DQ) among the 631 children was 15.53%. The rate of suspected and abnormal DQ was significantly higher in children aged >1 - 3 years compared to those aged 0 - 1 year (χ²=4.21, P=0.040). In both the 0 - 1 year and >1 - 3 year groups, children with low birth weight (χ²=26.739, 6.831), higher birth order (χ²=74.047, 21.840), smaller gestational age (χ²=12.495, 11.883), and lower educational level of the primary caregiver (χ²=29.968, 11.498) had significantly lower DQ scores (P<0.01). "Often/Always swaddling the child tightly, restricting limb movement" was a risk factor for suspected developmental abnormalities in children aged 0 - 1 year (OR=5.283, 95%CI: 1.317 - 21.185). "Often/Always training the child's hand manipulation skills" was associated with higher DQ in children aged 0 - 1 year (OR=0.347, 95%CI: 0.131 - 0.916). "Often/Always allowing the child to try dressing and doing things independently" was associated with higher DQ in children aged >1 - 3 years (OR=0.475, 95%CI: 0.251 - 0.898) (P<0.05). Conclusions The suspected and abnormal DQ rates are relatively high among children aged >1 - 3 years in Shengzhou. Outpatient clinics should focus on children with low birth weight, higher birth order, smaller gestational age, and lower educational levels of primary caregivers. Guidance for family caregivers can be provided using the relevant content indicated by the family nurturing environment scale.

Objective To systematically evaluate the efficacy of home-based interventions in improving gross motor function and activities of daily living (ADL) in children with cerebral palsy (CP), so as to provide evidence for developing effective intervention strategies. Methods Literature on home-based interventions for children with CP were searched across databases including CNKI, VIP, Wanfang, CBM, PubMed, Embase, Web of Science, and Cochrane Library from inception to June 2024.Meta-analysis was performed using Review Manager 5.4 and Stata 17.0. Results A total of 28 studies were included.Meta-analysis revealed statistically significant differences between the home-based intervention group and conventional rehabilitation group in GMFM-88 scores (MD=10.87, 95% CI: 8.51 - 13.23), GMFM-88 E dimension scores (MD=4.71, 95% CI: 3.82 - 5.61), and ADLs scores (MD=7.63, 95% CI: 4.68 - 10.57) (P<0.001).However, no significant difference was observed in GMFM-66 scores (MD=4.43, 95% CI: －1.56 - 10.42, P=0.15)between the two groups. Conclusion Home-based interventions can effectively improve gross motor function and ADL performance in children with cerebral palsy.

Objective To establish percentile reference standards for body fat percentage (BFP) in Chinese children aged 3 - 6 years, and to determine BFP thresholds to complement BMI in obesity screening, so as to provide a scientific reference for the early identification of childhood obesity in China. Methods From 2020 to 2023, a stratified random sampling method was used to select 25 604 children aged 3 - 6 years from 120 kindergartens across 27 provinces in China.Physical and body composition measurements were conducted.The generalized additive model for location, scale, and shape (GAMLSS) was applied to establish percentile references for BFP.Receiver operating characteristic (ROC) curves were used to compare the sensitivity of different anthropometric indicators in reflecting BFP and to evaluate the performance of different BFP percentiles in identifying obesity.The optimal percentile for obesity screening in children aged 3 - 6 years was selected. Results 1) Boys had significantly greater height, weight, body mass index (BMI), and waist circumference than girls (P<0.01), while BFP was lower in boys (P<0.01).Height, weight, and waist circumference increased with age, whereas BFP and waist-to-height ratio generally decreased, and BMI showed minor fluctuations.2) Compared to height, weight, and waist circumference, BMI and weight-for-height (WFH) were more sensitive indicators of BFP in children aged 3 - 6 years.3) The 90th percentile of BFP (P₉₀) achieved the best balance between sensitivity and specificity and was identified as the most suitable threshold for obesity screening. Conclusions BMI and WFH are sensitive indicators of body fat levels in children.Percentile reference values for BFP specific to Chinese children aged 3 - 6 years were established.The P₉₀ percentile of BFP demonstrated the best performance in obesity screening for this age group and is recommended as a complementary threshold to BMI to improve screening accuracy and reduce misdiagnosis/underdiagnosis.

Short stature is a common reason for consultation in the field of pediatric endocrinology and genetic metabolism, and its genetic etiology has garnered increasing attention in recent years.Defects in any genes involved in the process of height growth can lead to short stature, primarily by disrupting the normal proliferation and differentiation of growth plate chondrocytes.While dysfunction of the growth hormone-insulin-like growth factor (GH-IGF) axis represents a classic mechanism, multiple other factors—such as nutritional status, inflammatory cytokines, paracrine signaling, extracellular matrix, and intracellular signaling pathways—are also jointly involved in its regulation.Affected children often present clinically with abnormal body proportions, a positive family history, multisystem malformations or functional impairments, with specific genetic variants frequently correlating with distinct phenotypic profiles.Therefore, the systematic collection of phenotypic information combined with genetic testing has become a core strategy for achieving precision diagnosis and treatment of genetic-related short stature.

Objective To investigate the correlation of advanced bone age (BA) with overweight/obesity in preschool and school-aged children from Gansu, in order to promote the nutritional intervention and health education in this region. Methods A total of 1 462 children (698 boys, 764 girls) aged 3-12 years who underwent health examinations at the Department of Child Health Care, Gansu Provincial Maternity and Child Health Care Hospital from February 2019 to October 2023 were included.Bone age was assessed using left-hand wrist radiographs, and participants were categorized into underweight, normal weight, overweight, and obese groups based on body mass index (BMI) criteria.Bone age status was analyzed across different sexes, nutritional statuses, and age groups, and the association between overweight/obesity and advanced bone age was further explored. Results In the overall study population, the proportions of underweight, overweight, and obese children were 7.11%, 8.41%, and 13.34%, respectively.The prevalence of advanced bone age and delayed bone age was 7.87% and 35.16%, respectively.Girls had a significantly higher rate of advanced bone age than boys (11.91% vs.3.44%, χ²=71.296, P<0.05).Children aged 9-12 years exhibited a significantly higher rate of advanced bone age (19.40%) compared to those aged 6-8 years (7.62%, P<0.05) and 3 - 5 years (1.01%, χ²=119.802, P<0.05).Compared to normal-weight children (5.77%), the prevalence of advanced bone age was significantly higher in overweight (17.07%) and obese children (16.92%) (χ²=99.176, P<0.05).Both overweight and obesity were identified as risk factors for advanced bone age, with odds ratios (ORs) of 2.488 (95% CI:1.435-4.314, P<0.05) and 2.330 (95% CI:1.463-3.710, P<0.001), respectively.BMI showed a significant positive correlation with bone age difference (r=0.361, P<0.001).Furthermore, the area under the curve (AUC) of BMI in predicting advanced bone age was 0.735 (95%CI:0.684-0.786, P<0.001), with an optimal cutoff value of 16.699 kg/m²(sensitivity was 0.696, specificity was 0.739, Youden index was 0.435). Conclusions Significant differences in bone age are observed among children with varying nutritional status in Gansu, with overweight and obesity strongly associated with advanced bone age.Regular bone age monitoring in overweight and obese children is recommended for early intervention to promote healthy growth and development.

Objective To explore the clinical applicability of a self-developed artificial intelligence bone age assessment model based on a North American dataset for children and adolescents. Methods Based on the Greulich-Pyle (G-P) bone age assessment method, a deep learning-based artificial intelligence bone age assessment model (AIBAA-GP) was constructed using 14 236 left-hand wrist DR images from the 2017 Radiological Society of North America (RSNA) public bone age dataset. Retrospective collection of imaging data from children who underwent left-hand wrist DR imaging at Xiamen Huli District Maternal and Child Health Hospital between September 2018 and September 2022, due to parental requests for bone age assessment, was conducted. A total of 1 709 eligible images were selected, including 867 images of boys and 842 images of girls. The AIBAA-GP model was used to assess bone age. The assessed bone age results were compared with chronological age, and the model's performance across different age groups was evaluated. Results The assessment results of AIBAA-GP model on the 1709 DR images showed statistically significant differences between bone age and chronological age (P<0.05) for boys aged 4, 5, 6, and 7 years and girls aged 3, 4, and 5 years, with mean differences within 1.6 years. By adjusting the mean differences between bone age and chronological age for each age group, the bone age assessment values for the aforementioned groups could be adjusted by -1.16, -1.14, -1.35, -1.29 years for boys and 1.59, -1.52, -1.06 years for girls, respectively. Chronological age was significantly correlated with computer-predicted bone age for boys (r=0.952) and girls (r=0.885). Conclusions The AIBAA-GP algorithm model, based on a North American population dataset, is applicable to a small portion of age groups in Chinese children and adolescents. However, adjustments are required for most age groups before it can be applied in clinical auxiliary diagnosis.

Naturalistic developmental behavioral interventions (NDBIs) represent one of the most promising groups of evidence-based approaches in the field of early intervention for children with autism spectrum disorder (ASD).Although individual intervention models differ in their specific features, they are all grounded in an integration of developmental and behavioral sciences.They are based on the well-established principles developed via the science of applied behavior analysis (ABA) and use developmentally based intervention strategies and sequences to guide goal development that is individualized to each child.Evidence from recent studies suggests that NDBIs produce relatively consistent effects in improving joint attention, social engagement, language, and adaptive behaviors in children with ASD, while also enhancing the quality of parent-child interactions and family involvement.This article reviews the theoretical foundations and shared features of NDBIs, summarizes representative models, and synthesizes the current evidence base.Considering child health-care and rehabilitation service systems in China, it further discusses contextual applicability, key implementation challenges and priorities for future research, so as to inform early intervention practice and related policy development for children with ASD.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by core symptoms such as deficits in social interaction, impairments in verbal and nonverbal communication, and restricted interests accompanied by repetitive and stereotyped behaviors.Currently, modern medicine lacks targeted pharmacological treatments for ASD, and clinical management primarily relies on educational interventions and behavioral therapies.As an essential component of traditional Chinese medicine (TCM), scalp acupuncture therapy involves the stimulation of specific acupoints and functional regions on the scalp to directly modulate cortical activity and regulate brain function.In recent years, this therapeutic approach has demonstrated unique advantages and promising potential in the rehabilitation of children with ASD.This article systematically reviews the theoretical foundations of scalp acupuncture from both TCM and Western medical perspectives, with a focus on pediatric neurorehabilitation for ASD.It examines principles of acupoint selection, technical procedures, and key considerations in clinical practice.Furthermore, it discusses the underlying mechanisms of action, aiming to establish evidence-based protocols for the clinical application of scalp acupuncture in ASD rehabilitation.

Objective To describe the prevalence and temporal trends of overweight/obesity and cardiometabolic risk indicators (blood pressure, lipids, and glucose, etc) among primary school students in Pudong New Area, Shanghai from 2020 to 2024, and to examine longitudinal associations of overweight/obesity and body mass index (BMI) with cardiometabolic risk, so as to provide evidence for early prevention of cardiovascular diseases in children and adolescents. Methods A prospective cohort was established in 2020 using stratified cluster random sampling from 13 primary schools in Pudong New Area.Children aged 6 - 7 years were assessed at baseline (2020) and followed up in 2022 (aged 8 - 9 years) and 2024 (aged 10 - 11 years).A total of 1 483 children completed all three assessments.Height and weight were measured to calculate BMI.Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured.Serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were assessed at each visit.Fasting plasma glucose (FPG) was measured in 2022 and 2024 but not at baseline.Repeated-measures analysis of variance was used to compare continuous outcomes across visits.Generalized estimating equations were used to assess temporal trends in abnormal detection rate of cardiometabolic indicators.Linear mixed-effects models were used to evaluate longitudinal associations between continuous BMI and cardiometabolic measures. Results The prevalence of overweight was 18.41%, 16.93%, and 16.79% in 2020, 2022, and 2024, respectively, whereas obesity prevalence was 18.95%, 22.25%, and 21.44%.The detection rate of elevated SBP increased from 11.94% to 19.96%, while elevated DBP decreased from 18.75% to 6.07%.Hypercholesterolemia increased from 6.61% to 17.73%.Hypertriglyceridemia decreased from 9.78% to 1.69% and then rebounded to 5.73%.Elevated LDL-C was 4.25%, 11.46%, and 7.35% in 2020, 2022, and 2024, respectively, and low HDL-C was 3.57%, 1.82%, and 4.18%, respectively.The detection rate of abnormal fasting plasma glucose was 0.47% in 2022 and increased to 10.18% in 2024.Compared with normal-weight peers, overweight/obese children had higher risk of elevated systolic blood pressure at all three visits (OR=1.621, 2.564, 2.693), as well as hypertriglyceridemia (OR=1.609, 8.151, 2.814) and low HDL-C (OR=3.001, 8.927, 3.154) (P<0.05).Differences in hypercholesterolemia, elevated LDL-C, and abnormal fasting plasma glucose were not statistically significant (P>0.05).In linear mixed-effects models, each 1 kg/m² increment in BMI was associated with higher SBP (β=1.518 mmHg) and DBP (β=0.451 mmHg), higher TG (β=0.032 mmol/L), higher LDL-C (β=0.021 mmol/L), lower HDL-C (β=-0.035 mmol/L), and higher fasting plasma glucose (β=0.015 mmol/L) (P<0.001), while the association with total cholesterol was not significant (P=0.833). Conclusions Overweight and obesity are important risk factors for cardiovascular metabolic abnormalities in children, particularly associated with elevated blood pressure, increased TG, and decreased HDL-C.Continuous monitoring of BMI changes may be more sensitive than simple overweight/obesity categorization in detecting early signs of cardiometabolic risk.

The vagus nerve (VN) originates from the brainstem, serving as a bidirectional communication bridge between the brain and the body, and is widely distributed throughout the central and peripheral nervous systems. Noninvasive vagus nerve stimulation (nVNS) is a neuromodulation technique with active regulatory functions that has been applied in the treatment of various diseases in recent years, demonstrating significant effects in conditions such as depression and epilepsy. However, there have been relatively few studies on its use in the treatment of attention deficit hyperactivity disorder (ADHD). By summarizing the pathogenesis of ADHD and the mechanism of nVNS, this article identifies associations between the two in terms of neurotransmitters, inflammation, apoptosis, and other aspects, and explore the potential mechanisms that exist between them, so as to provide a theoretical foundation for nVNS treatment of ADHD.

Childhood obesity and its associated metabolic diseases (e.g., insulin resistance, dyslipidemia, metabolic dysfunction-associated fatty liver disease, etc.) have emerged as a significant public health concern.Previous studies often focused on changes at the single organ or tissue level, making it challenging to elucidate the dynamic changes across multiple tissues and organs during the progression of obesity.Metabolic disorders related to childhood obesity are essentially complex network diseases initiated by the dysfunction or collapse of adipose tissue function, involving deep interactions among multiple systems such as immune system dysregulation and the collapse of metabolic homeostasis.This study systematically reviews current research progress on the mechanisms underlying the association between childhood obesity and metabolic diseases, with a focus on three key pathological pathways: chronic inflammation mediated by immune cells, metabolite accumulation and metabolic reprogramming, and abnormal changes in adipose tissue biomechanics microenvironment.It is reported that T cells, B cells, and macrophages exhibit altered activity in adipose tissue with obesity, establishing a bidirectional feedback loop between immunity and metabolism.Metabolites such as branched-chain amino acids and non-esterified fatty acids can interfere with insulin signaling, inducing insulin resistance.Besides, extracellular matrix stiffening and increased mechanical stress further activate inflammatory pathways, forming an immune-metabolic-matrix composite network.Metabolic abnormalities associated with childhood obesity are characterized by early onset, multi-organ involvement, and long-term persistence.Future research should enhance the integration of multi-omics technologies with investigations into the mechanisms of multi-system interactions, promoting the clinical translation of personalized intervention strategies, and thereby improving the prevention and treatment outcomes of childhood obesity-related metabolic diseases.

Reading is a cornerstone of children′s cognitive, reasoning, and socio-emotional development.In the Simple View of Reading, reading is regarded as coordinated development of two components, decoding and language comprehension.Based on this framework, this article summarizes fundamental skills and developmental trajectories relevant to each of the two components.Decoding mainly depends on children′s orthographic knowledge, phonological awareness, and efficient grapheme-phoneme correspondences.Language comprehension mostly draws on vocabulary knowledge, grammar, discourse cohesion, inferencing skills, working memory, and narrative skills.Clarifying these fundamental skills helps parents, teachers, and clinicians identify children′s specific areas of difficulties and form more targeted, effective intervention plans.

Objective To assess the physical activity (PA) levels in preschool children with Kawasaki disease (KD) during the early stages of the illness,in order to provide reference for making individualized exercise prescriptions. Methods Children hospitalized at the Children's Hospital of Capital Institute of Pediatrics between December 2023 and March 2024 were selected as the KD group. Healthy children matched by gender and age in a 1∶3 ratio served as the control group. The Preschooler Physical Activity Questionnaire (P-PAQ) was used to evaluate the PA levels of the KD group one month after the onset of the disease, focusing on their physical activity over the past week. The clinical data of KD patients were collected through the electronic medical system, including gender, age, height, weight, treatment, laboratory indicators (blood routine, C-reactive protein) and ultrasound results of coronary arteries. Results A total of 112 children were included in the study, comprising 28 KD patients and 84 healthy controls. One month after the onset of KD, the total out-of-school activity time was 99.36 (56.79, 130.18) minutes per day, the outdoor activity time was 12.86 (10.71, 14.29) minutes per day, and the moderate-to-vigorous physical activity (MVPA) time was 26.25 (7.50, 53.32) minutes per day. Compared to the healthy control group, the KD group showed significantly reduced total out-of-school activity time, outdoor activity time, and MVPA time (Z=5.491, 5.072, 3.726, P<0.01). All KD patients were followed up one month after the onset of the disease, and no coronary artery complications or adverse cardiovascular events were observed. Conclusions Preschool children with KD without coronary artery complications exhibit low levels of physical activity during the early stage of the disease. Actively exploring individualized exercise prescriptions based on evidence-based medicine during the recovery phase holds significant clinical importance.

Objective To explore the association between early screen exposure and autism spectrum disorder (ASD)-like behavior in high-risk toddlers, and to examine the mediating role of the family nurturing environment, so as to provide evidence for early intervention of ASD-like behavior. Methods A total of 377 high-risk toddlers aged 18 to 35 months, who underwent re-screening at the Hefei Women and Children′s Health Center from January to December 2024, were enrolled.Data on basic information and screen exposure were collected via questionnaires.ASD-like behavior was assessed using the Autism Behavior Checklist (ABC), and the family nurturing environment was evaluated using the 1-3 Year Old Children′s Family Nurturing Environment Questionnaire (Urban Version).Logistic regression was used to analyze the association between screen exposure and ASD-like behavior.The mediating effect of the family nurturing environment was tested using Structural Equation Modeling (SEM). Results Among the 377 high-risk toddlers, 96 (25.5%) exhibited ASD-like behavior, and 182 (48.3%) had high screen exposure.The average total score of the Family Nurturing Environment Scale is (131±19.63).Compared with children without ASD-like behavior, those with ASD-like behavior had a significantly higher rate of high screen exposure and lower scores in the social adaptation/self-care dimension of the family nurturing environment (both P<0.05).Logistic regression analysis showed that high screen exposure was a risk factor for ASD-like behavior (OR=1.710, 95%CI: 1.055 - 2.771, P=0.029).Mediation analysis revealed that the social adaptation/self-care dimension of the family nurturing environment played a full mediating role between screen exposure and ASD-like behavior (significant indirect effect, 95%CI: 0.001 - 0.042). Conclusions The social adaptation/self-care dimension of the family nurturing environment fully mediates the relationship between early screen exposure and ASD-like behavior in high-risk toddlers.Optimizing the family nurturing environment, particularly enhancing the quality of parenting in the social adaptation/self-care dimension, may help alleviate the adverse effects of screen exposure on ASD-like behavior in young children.

This study systematically reviews the progress of acupuncture in treating autism spectrum disorder (ASD), covering its historical origins, technological innovations, proposed hypotheses, mechanistic explorations, clinical validation, and pathways for translational research.Tracing back to classical Chinese medical records from the Sui dynasty that described symptoms resembling severe ASD, such as mental obstruction and delayed speech, the study focuses on how acupuncture activates peripheral-to-central neural pathways, promoting the release of pro-social neurotransmitters to improve brain development in individuals with ASD within the framework of modern neuroscience.Building upon preclinical findings, our team developed a transcutaneous electrical acupoint stimulation (TEAS) protocol as a standardized, noninvasive adaptation of traditional acupuncture.The protocol targets four key acupoints with optimized stimulation parameters, including Hegu (LI4), Neiguan (PC6), Zusanli (ST36), and Sanyinjiao (SP6).Multicenter clinical trials demonstrate that integrating TEAS to standardized behavioral therapy significantly enhances therapeutic efficacy, particularly among children with aloof/passive social phenotypes.Consistent changes in peripheral plasma levels of oxytocin (OXT) and arginine vasopressin (AVP), alongside multi-modal brain imaging (structural MRI, resting-state fMRI, and DTI) support the hypothesis that TEAS acts via the OXT pathway to promote sensory integration, enhance social motivation, and reduce anxiety.Clinical assessments and parental follow-up data confirmed the consistent and reproducible benefits.Finally, we further outline a translational roadmap integrating phenotype-based assessment, individualized stimulation parameter optimization, multimodal biomarker systems, and home-based implementation.Large-scale, multicenter, stratified, and multi-omic studies are further warranted to validate generalizability and further elucidate the causal molecular-to-network mechanisms underlying TEAS-mediated neurobehavioral improvement.

Amino acids, as the basic building blocks of proteins and important metabolic signalling molecules, play a key role in the regulation of glycolipid metabolism.Studies have shown that metabolic disorders of branched-chain amino acids (BCAAs), aromatic amino acids and sulphur-containing amino acids are closely related to the development of non-alcoholic fatty liver disease (NAFLD).BCAAs induce oxidative stress and mitochondrial dysfunction through activation of the mTOR signalling pathway, which promotes insulin resistance and hepatic lipid deposition.In addition, leucine deficiency enhances insulin sensitivity and reduces hepatic glucose production through the GCN2 pathway, while methionine deficiency regulates lipid metabolism through FGF21 signalling.Clinical studies have found that serum BCAAs levels significantly correlate with fatty liver severity, suggesting their value as potential biomarkers.Although intervention strategies targeting amino acid metabolism, including BCAA-restricted diets, Branched-Chain α-Ketoacid Dehydrogenase Kinase (BCKDK) inhibitors, have shown promising results in improving hepatic metabolism, the metabolic side effects of treatments such as mTORC1 inhibitors suggest the complexity of the amino acid perception network.Current challenges include the regulation of the dynamic balance of amino acid metabolic networks, the long-term safety validation of interventions, and the prediction of differences in response to individualised treatments.Future studies need to incorporate multi-omics techniques to elucidate the tissue-specific mechanisms of amino acid sensing signalling pathways, develop individualised treatment plans based on metabolic typing, so as to provide new ideas for the precise prevention and treatment of NAFLD.

Objective To analyze the relationship between bone mineral density (BMD) in children and factors including sex, age, body mass index (BMI), blood calcium, blood phosphorus, serum alkaline phosphatase (ALP), and serum 25-hydroxyvitamin D[25-(OH)D], in order to provide a scientific basis for promoting pediatric bone health. Methods A total of 3 024 children aged 1 - 6 years who underwent health examinations at the Child Health Care Center of the Children′s Hospital Affiliated to Zhejiang University School of Medicine from June 2018 to September 2022 were included.BMI, serum ALP, calcium, phosphorus, and 25-(OH)D levels were measured, and BMD was assessed using ultrasound bone densitometry. Results Among the3 024 participants, 578 children (19.11%) had low BMD.Male children exhibited higher BMD Z-scores than females (t=3.132, P<0.01).Significant differences in BMD Z-scores were observed across age groups (F=54.493, P<0.001).The normal BMD group had lower BMI than the low BMD group (t=7.083, P<0.001).Children with low BMD showed lower serum calcium, phosphorus, and 25-(OH)D levels compared to those with normal BMD (t=8.659, 3.479, 16.440, P<0.01).Correlation analysis revealed that BMD Z-scores were positively associated with serum calcium, phosphorus, and 25-(OH)D levels (r=0.146, 0.051, 0.240, P<0.05), negatively correlated with BMI (r=-0.128, P<0.05), and not correlated with ALP (P=0.684).Multivariate logistic regression identified BMI (OR=1.259), calcium (OR=0.025), phosphorus (OR=0.426), and 25-(OH)D (OR=0.954) levels as significant influencing factors of BMD (P<0.05). Conclusions Pediatric BMD is associated with sex, age, serum calcium, phosphorus, BMI, and 25-(OH)D, but not with serum ALP.Maintaining relatively high levels of serum calcium, phosphorus, and 25-(OH)D is crucial for sustaining normal BMD in children.

Objective To evaluate the therapeutic efficacy of virtual reality (VR)-based rehabilitation training for children with autism spectrum disorder (ASD), in order to provide a theoretical foundation for digital interventions in ASD treatment. Methods From December 2023 to April 2024, a total of 60 children diagnosed with ASD at the Department of Child Health Medicine, Shanghai Children′s Hospital were randomly assigned to either an intervention group or a control group.The control group received early family intervention guided by a rehabilitation team, while the intervention group underwent VR-based rehabilitation training once a week for one hour per session additionally.Therapeutic outcomes were assessed before and after the intervention using the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Strengths and Difficulties Questionnaire (SDQ), and Social Responsiveness Scale (SRS). Results Before the intervention, there were no statistically significant differences in ABC, CARS, SDQ, and SRS scores between the intervention and control groups (P>0.05).After the intervention, the intervention group showed significantly lower scores in the sensory, social, and motor factors of the ABC, as well as in the total ABC and CARS scores, compared to the control group (t=2.253, 2.113, 2.162, 3.364, 2.742, P < 0.05).The SDQ revealed that the intervention group had significantly lower scores in hyperactivity/inattention, peer relationship problems, prosocial behavior, and total difficulties compared to the control group (t=2.084, 3.623, 2.591, 3.074, P < 0.05).The SRS results indicated that the intervention group outperformed the control group in social cognition, social communication, autistic mannerisms, and total scores after the intervention (t =2.012, 2.546, 2.126, 3.507, P<0.05). Conclusions VR-based rehabilitation training demonstrates positive effects on improving core symptoms and social functioning in children with ASD, highlighting its potential for clinical application.However, further research is needed to validate its long-term efficacy and generalizability.

Objective To evaluate the effectiveness of a responsive feeding intervention program based on the Behaviour Change Wheel (BCW) theory among infants aged 6 - 12 months and their caregivers, in order to provide a reference for enriching specific implementation methods of responsive feeding interventions. Methods A convenience sampling method was used to select 70 infants and their caregivers from the child health clinic of a tertiary hospital in Qingdao between February and March 2024.Participants were sequentially assigned to either the intervention group (n=35) or the control group (n=35) based on enrollment time.The control group received routine feeding guidance from the child health clinic, while the intervention group additionally received a BCW-based responsive feeding intervention.The intervention effects were assessed using the Responsive Feeding Parent Assessment Tool (RFPAT), the Baby Eating Behaviour Questionnaire (BEBQ), and the infant BMI-for-age Z-score (BMI Z). Results Repeated measures ANOVA showed statistically significant differences between the two groups in responsive feeding behavior scores, BEBQ subscale scores (food responsiveness, food fussiness, slowness in eating, and satiety responsiveness), and infant BMI Z-scores across time points, with significant group, time, and interaction effects (P<0.05).At 3 and 6 months post-intervention, the intervention group exhibited higher responsive feeding behavior and food fussiness scores (P<0.05) but lower food responsiveness, slowness in eating, satiety responsiveness scores, and infant BMI Z-scores compared to the control group (P<0.05). Conclusion The BCW-based responsive feeding intervention can significantly improve caregivers' responsive feeding practices, reduce infant feeding behavior problems, and promote healthier physical growth in infants.

Objective To explore whether autism spectrum disorder (ASD) children can rely on visual feedback to improve motor learning adaptability, so as to reveal the biological basis of perceptual-motor integration in ASD children and to provide empirical evidence and theoretical support for developing motor intervention based on adaptive difficulty regulation. Methods From July 2022 to December 2023, 21 children with ASD who received rehabilitation training at the Wuhan Linjie Children′s Rehabilitation Service Center, as well as 21 typically developing (TD) children attending five primary schools and kindergartens in Wuhan, participated in a computerized visuomotor adaptation experiment.The experiment consisted of three phases: baseline, adaptation (with a 30° counterclockwise rotation of visual feedback), and post-adaptation.Directional error (DE), movement time (MT), and root mean square error (RMSE) were selected to examine visuomotor learning ability. Results During the adaptation phase, as the number of exercises increased, both ASD and TD children showed significant improvements in DE, MT, and RMSE (F=5.445, 13.473, 11.196, P<0.05), and there were no significant differences between the two groups (P>0.05).In the post-adaptation phase, ASD children showed a significantly greater improvement in RMSE compared to their baseline performance (t=2.275, P<0.05) and this improvement was significantly greater than that of TD children (t=2.112, P<0.05). Conclusions ASD children can update their internal model through visual feedback, especially in motor control ability.Future motor learning and intervention programs for children with ASD should incorporate specific visual aids to improve intervention outcomes.

Objective To investigate the ameliorative effects and potential mechanisms of breast milk-derived Lactiplantibacillus plantarum FN029 on β-lactoglobulin (β-LG)-induced food allergy in mice, in order to provide reference for the prevention and treatment of food allergy. Methods BALB/c mice were randomly divided into a control group, a food allergy group (induced by β-LG), and an FN029 intervention group.FN029 was administered by oral gavage for intervention.Allergic symptom scores were evaluated.Histopathological staining was performed to assess lung and jejunal injury as well as mast cell infiltration.Serum immunoglobulin and cytokine levels were measured.In addition, mRNA expression of Th1/Th2 cytokines in the jejunum, expression of tight junction proteins, and protein levels of the AKT/mTOR and NF-κB signaling pathways were analyzed. Results Compared with the control group, mice in the food allergy group exhibited pronounced allergic symptoms, weight loss, and increased spleen index.Lung and jejunal tissues were damaged, with increased mast cell infiltration.Serum levels of total IgE, β-LG-specific IgE, IgG1, histamine, and IL-4 were significantly elevated, accompanied by upregulated jejunal Th2 cytokine IL-4 and Th1 cytokine IFN-γ levels.Furthermore, expression of intestinal tight junction proteins (ZO-1, Occludin, Claudin-1) was decreased, and phosphorylation levels of key proteins in the AKT/mTOR and NF-κB signaling pathways were abnormally increased (P<0.05).FN029 intervention significantly ameliorated allergic symptoms and signs, alleviated tissue damage and mast cell aggregation, downregulated serum IgE, histamine, and jejunal IL-4 levels, and upregulated IFN-γ, effectively correcting the Th1/Th2 imbalance.In addition, FN029 promoted the restoration of intestinal tight junction proteins and significantly inhibited phosphorylation activation of AKT and NF-κB (P<0.05). Conclusions Lactiplantibacillus plantarum FN029 effectively alleviates food allergy symptoms in mice, and its underlying mechanisms may be related to inhibition of allergen-induced activation of the AKT/mTOR and NF-κB inflammatory signaling pathways, restoration of the intestinal physical barrier, and modulation of Th1/Th2 immune balance.

Objective To investigate the association between single nucleotide polymorphisms (SNPs) in the SPOCK1 and TMEM38B genes and early age at menarche (AAM) in girls from the Sunan region of Gansu Province, so as to provide evidence for the prevention of early AAM. Methods From January to July 2023, 159 menstruated girls aged 9 - 18 from Yugur Autonomous County, Zhangye City, Gansu Province were recruited. Participants were divided into an early AAM group (AAM<12.8 years, n=75) and a normal AAM group (n=84) based on the 25th percentile(12.8 years old)of their AAM. TagSNPs for the candidate genes SPOCK1 and TMEM38B were selected from public NCBI and the shared resources of the 1 000 Genomes Project. Haploview software was used to screen out loci with a minimum allele frequency (MAF) of >0.05, and linkage disequilibrium analysis was performed to finalize the TagSNP. Multivariate logistic regression was used to analyze the association between SNPs and the risk of early AAM under different genetic models. Results After adjusting for confounders, significant associations with early AAM risk were found for SPOCK1 gene SNPs rs1859345 (overdominant model: TC vs. TT+CC, OR=2.10, 95%CI: 1.01 - 4.42, P=0.046) and rs7701979 (overdominant model: GT vs. GG+TT, OR=2.18, 95%CI: 1.02 - 4.65, P=0.040). Significant associations were also identified for TMEM38B gene SNPs rs10453225 (codominant model: GT vs. GG, OR=2.83, 95%CI: 1.29 - 6.20, P=0.024; dominant model: GT+TT vs. GG, OR=2.38, 95%CI: 1.13 - 4.98, P=0.020; overdominant model: GT vs. GG+TT, OR=2.30, 95%CI: 1.21 - 4.40, P=0.011), rs4452860 (recessive model: AA vs. GG+GA, OR=0.43, 95%CI: 0.20 - 0.94, P=0.033; overdominant model: GA vs. GG+AA, OR=2.13, 95%CI: 1.12 - 4.07, P=0.021), and rs12684013 (overdominant model: CT vs. TT+CC, OR=1.96, 95%CI: 1.04 - 3.73, P=0.037). Conclusion The rs1859345 and rs7701979 loci of SPOCK gene, and the rs10453225 locus, rs4452860 locus and rs12684013 locus of TMEM38B gene are all correlated with AAM in girls in Sunan region, suggesting these genes may play a role in the genetic regulation of menarche and providing potential genetic markers for the early screening of early AAM.

Objective To analyze the impact of different primary caregivers on vitamin D insufficiency in children aged 0-18 years, and to provide a basis for family-based prevention and control of vitamin D insufficiency in children and adolescents. Methods A total of 12 630 children and adolescents aged 0 - 18 years from 18 regions in Hainan Province were selected as the study population between January 2021 and March 2022. Investigators used a self-designed questionnaire to collect information on caregivers' age, family type, occupation, and educational level. Fasting venous blood samples were collected from the children, and vitamin D levels were measured using electrochemiluminescence immunoassay. Chi-square tests and Fisher's exact tests were used for univariate analysis, and logistic regression was employed for multivariate analysis. Results The detection rate of vitamin D insufficiency and deficiency among children and adolescents aged 0 - 18 years in Hainan Province was 23.42% (2 958/12 630). Significant differences in vitamin D levels were observed based on the child's gender (χ²=215.284),age (χ²=1 484.55), resident area (χ²=180.202), primary caregiver (χ²=229.889), parental occupation (χ²=53.638,51.606), and educational level (χ²=87.965,91.826)and daily outdoor physical activity (χ²=71.844)(P<0.001). After adjusting for confounding factors, multivariate logistic regression analysis revealed thatchildren with grandparents as main caregivers had a higher risk for vitamin D insufficiency and deficiency in children (OR=1.225, 95%CI: 1.009 - 1.487, P<0.05). Conclusions Different primary caregivers have a significant impact on vitamin D levels in children and adolescents. Greater attention should be paid to the family environment to reduce the occurrence of vitamin D insufficiency and deficiency in this population.

Objective To characterize nutritional status of children with Williams syndrome (WS), so as to provide clinical evidence for standardized nutritional management. Methods A cross-sectional survey was conducted in children with genetically confirmed WS who attended the Children′s Hospital, Zhejiang University School of Medicine, from March to September 2023.Forty-two children were enrolled; 4 did not complete the dietary survey and 6 were excluded due to incomplete dietary records, leaving 32 children for the anthropometric and dietary analysis.Nutritional risk was assessed using STRONGkids.Height and weight were measured, and Z-scores were calculated based on the WHO 2006 growth standards using WHO Anthro/AnthroPlus, including height-for-age Z score (HAZ), weight-for-height Z score (WHZ,<5 years old), and BMI-for-age Z score (BAZ, ≥5 years old).Wasting was defined as WHZ/BAZ<-2 and stunting as HAZ<-2; either criterion indicated malnutrition.Dietary intake was assessed using 3-day food records.Daily mean energy and macronutrient intakes were calculated with nutrition software, and adequacy was expressed as intake/age- and sex-specific DRIs ×100%;<80% was considered inadequate. Results Among the 32 children, 24 (75.0%) were male and 8 (25.0%) were female, with a mean age of 3.88 years old.STRONGkids indicated moderate risk in 13 (40.6%) children and high risk in 19 (59.4%) children.Malnutrition was identified in 12 (37.5%) children.Inadequate intake was observed for energy in 27 (84.4%) children, carbohydrate in 29 (90.6%) children, fat in 23 (71.9%) children, and protein in 4 (12.5%) children. Conclusions Children with WS have a high nutritional risk and a considerable prevalence of malnutrition, along with widespread inadequacy of energy and macronutrient intake.Long-term nutritional assessment and individualized interventions are warranted to improve the nutritional outcome.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder, and early scientific intervention can significantly improve the prognosis of children with ASD. Family intervention plays an important role in the early intervention of ASD in young children. An increasing number of research teams have developed parent-mediated intervention models based on naturalistic developmental behavioral intervention (NDBI). This review summarizes the primary evidence-based family intervention models, analyzes empirical research on these models in young children with ASD, and discusses methods to enhance the feasibility and effectiveness of interventions, so as to provide reference and insights for the better implementation of family intervention practices and research in China.