Objective:To investigate the application effect of a novel zipper device in wound healing after incision and drainage of cuta-neous abscesses in children,and to explore its optimal intervention timing.Methods:A total of 50 children who attended the outpatient service of Department of Pediatric surgery from September 2023 to September 2024 were enrolled and divided into two groups accord-ing to the parity of the date of visit.The 26 children with the odd date of visit were enrolled as experimental group,and the 24 children with the even date of visit were enrolled as control group.The same anti-infective dressings were used for wound dressing in both groups after incision and drainage,and when there was a significant reduction in wound exudate and the fresh granulation tissue emerged at wound base,the zipper device was used for the children in the experimental group,and dressing change was performed for the children in the control group until the wound was completely healed.The two groups were compared in terms of wound healing time,healing rate,and the total costs of dressing change,and the multiple linear regression model and the restricted cubic spline(RCS)model were used to analyze the association between the in-tervention time of the zipper device and wound healing time.Re-sults:Compared with the control group,the experimental group had a significantly shorter wound healing time,a significantly higher wound healing rate,and significantly lower total costs of dressing change(P<0.001).The multiple linear regression model showed that the infection size of skin abscess and the intervention time of the zipper device were strongly associated with wound healing time(P<0.05).After adjustment for infection size,the RCS model analysis showed a significant linear dose-response relationship between intervention time and wound healing time(Pnonlinear=0.406),and wound healing time shortened with the reduction in intervention time(P<0.001).Conclusion:The application of the novel zipper device can help with the healing of cutaneous abscesses in children,and it is recommended to apply the device as early as possible after control of wound infection,in order to promote early wound healing.

Objective:To investigate the real experience of early postoperative kinesiophobia in school-aged children after limb frac-ture surgery.Methods:A descriptive qualitative research method was used to conduct semi-structured interviews with sixteen children with limb fractures and their families in the ward of pediatric orthopedics in a grade A tertiary hospital in Chongqing,China,and a con-tent analysis was used to summarize and extract key themes from the interview data.Results:Three main themes and ten subthemes were extracted.The theme of pain cognition and catastrophic thinking included the subthemes of children's pain perception and activ-ity restriction,parents'pain perception and catastrophic reactions,and the interactive influence of pain cognition among different indi-viduals;the theme of medical education and risk perception included the subthemes of fear and concerns about refracture,the relation-ship between personality traits,help-seeking behavior,and internal-ized anxiety,and the impact of medical education on risk percep-tion;the theme of psychosocial stress and self-motivation included the subthemes of family members'attitudes toward academic inter-ruption,children's social disruption and compensatory media use,the mutual influence of compensatory indulgence and reinforced sick role behavior,and positive reinforcement enhancing children's self-driven recovery.Conclusion:Healthcare providers should closely monitor the recovery of limb motor function in the early stage af-ter surgery in children with fractures and provide personalized medical services and rehabilitation guidance to children and their fami-lies based on the pain perception,personality traits,and rehabilitation needs of children.

Objective:To investigate the effect of miR-22-3p and apoptosis-inducing factor,mitochondrion-associated 1(AIFM1)on mitochondrial homeostasis and apoptosis of pulmonary artery smooth muscle cells(PASMCs)under hypoxic conditions by establishing an in vitro model of pulmonary hypertension(PAH).Methods:PASMCs were cultured under hypoxic conditions to establish an in vitro model of PAH,and the expression levels of AIFM1 and miR-22-3p were upregulated or downregulated.Reverse transcription quantita-tive polymerase chain reaction(RT-qPCR)and Western blotting were used to measure the expression levels of AIFM1,miR-22-3p,and cleaved cysteine-aspartic protease-3(Cleaved Caspase-3).cell counting kit-8(CCK-8)assay was used to measure the prolifera-tive activity of cells,and flow cytometry was used to measure cell apoptosis.Mitochondrial superoxide indicator(mitoSOX)and adenos-ine triphosphate(ATP)assay kits were used to observe mitochondrial function and dynamics,and Mito-Tracker Red CMXRos(Mito-Tracker)was used to measure the change in mitochondrial circum-ference.Dual-luciferase reporter assay was used to validate the interaction between AIFM1 and miR-22-3p.Results:Hypoxia increased the content of mitochondrial ROS,reduced the level of ATP,promoted mitochondrial fission,and reduced cell apoptosis in PASMCs.AIFM1 overexpression improved mitochondrial homeo-stasis and increased cell apoptosis,while miR-22-3p negatively regulated AIFM1 and reversed the effect of AIFM1 overexpression.Conclusion:This study shows that miR-22-3p enhances mitochon-drial homeostasis,proliferation,and apoptosis in hypoxia-induced PASMCs by targeting AIFM1,which provides a potential theoretical basis for the prevention and treatment of PAH.

Objective To compare the efficacy and adverse reactions of doxycycline and levofloxacin in children with macrolide non-responsive mycoplasma pneumonia(MUMPP).Methods Clinical data of 240 MUMPP children admitted to our hospital from November 2023 to July 2024 were retrospectively analyzed,and they were divided into doxycycline group and levofloxacin group according to drug use,with 120 cases in each group.The efficacy of the two groups were compared,the time when body temperature dropped to nor-mal after taking antipyretics,the time when cough was reduced,the time when lung riles were resolved,the length of hospital stay,the peripheral blood indicators[WBC,neutrophilic granulocyte percentage,C reactive protein(CRP),lactate dehydrogenase(LDH),D-dimer],the lung imaging recovery and the occurrence of ad-verse reactions.Results There was no significant difference in total effective rate between doxycycline group and levofloxacin group(93.33％vs.90.00％,P＜0.05).Compared with levofloxacin group,the duration of hospital stay in doxycycline group was shorter[(6.22±2.24)d vs.(7.39±2.47)d],and the duration of lung crackles disappeared longer[(4.47±2.06)d vs.(3.50±1.79)d],with statistical significance(P＜0.05).Af-ter treatment,the neutrophil percentage,CRP and LDH levels in the two groups were lower than before treat-ment,and the differences were statistically significant(P＜0.05).There was no significant difference in the incidence of adverse reactions between doxycycline group and levofloxacin group(15.83％vs.15.00％,P＞0.05).Conclusion Both doxycycline and levofloxacin have good efficacy in MUMPP children,with low inci-dence of adverse reactions and no serious adverse reactions.

Objective To evaluate the clinical value of non-invasive ultrasound hemodynamic monito-ring in critically ill neonates in plateau area(altitude＞2 500 m).Methods A total of 205 critically ill neo-nates admitted to the NICU of Qamdo People's Hospital from September 2023 to December 2024 were ran-domly divided into the control group(n=105)and the observation group(n=100)using a random number table.There was no statistically significant difference in the baseline data between the two groups(P＞0.05).The observation group underwent noninvasive ultrasonic hemodynamic monitoring within 12 hours of admis-sion,measuring corrected flow time(FTC),stroke volume(SV),cardiac index,systemic vascular resistance index(SVRI),and myocardial contractility index(SMII).The control group received conventional monito-ring.The treatment was adjusted based on the results.The above parameters were remeasured 4-8 hours af-ter treatment adjustment.Hospital stay and 28 d survival rate were compared between the two groups.Multi-ple linear regression and binary logistic regression were used to analyze the factors influencing hospital stay and 28 d survival rate,respectively.Results Compared to pre-treatment levels,the observation group showed significant post-treatment decreases in FTC[(364.03±47.70)ms vs.(414.09±52.20)ms]and SVRI[(1 521.00±186.93)dyn·s·(cm5)-1·(m2)-1 vs.(1 720.00±347.31)dyn·s·(cm5)-1·(m2)-1].Con-versely,significant increases were observed in SV[(5.23±0.66)mL vs.(5.09±0.88)mL],cardiac index[(3.35±1.17)L·min-1·(m2)-1 vs.(3.19±0.99)L·min-1·(m2)-1],and SMII[(0.56±0.10)W/m2 vs.(0.51±0.14)W/m2](P＜0.05).The observation group had a significantly shorter hospital stay than the control group[(11.53±3.61)d vs.(13.83±2.56)d,P＜0.05].The 28 d survival rate was higher in the ob-servation group(100.0％vs.98.1％),although the difference was not statistically significant(P＞0.05).Multiple linear regression analysis revealed that both gestational age and cardiac index were negatively correla-ted with the duration of hospital stay.Binary logistic regression analysis indicated that birth weight was a sig-nificant factor influencing the 28 d survival rate(OR=4.600,95％CI:2.465-10.654,P=0.001).Conclusion Non-invasive ultrasonic hemodynamic monitoring can facilitate early identification of hemodynamic alterations in critically ill neonates in platean area,which could guide treatment and potentially reducing hospital stay.

Angelman syndrome（AS）is a neurodevelopmental disorder caused by abnormal expression or functional deficiency of the UBE3A gene in the maternal chromosome 15q11~13 region.The main clinical manifestations include developmental delay，speech impairment，motor or balance disorders，happy behaviors（frequent laughing，smiling，or excitability），microcephaly，and epilepsy.Currently，the treatment of AS is primarily symptomatic and supportive.However，significant progress is being made in the development of targeted therapies，including small-molecule compounds and gene therapy.This article reviews the advances in AS treatment from these two perspectives.

When rescuing critically sick newborns，infusion remains one of the vital interventions.The main purpose of infusion is to maintain effective circulatory volume and to improve oxygen supply of tissues，whereas fluid overload（FO）might aggravate the patients' condition.Furthermore，due to the immature functions of various organs and the early physiological weight loss in newborns，FO is prevalent among critically sick newborns，and it is highly likely to be associated with organ dysfunction and adverse clinical outcomes.At present，the management of childhood FO is still controversial，and few researches were reported on neonatal FO.This article reviews the pathogenesis，management，evaluation and intervention of neonatal FO.

In developing countries，non-cystic fibrosis bronchiectasis is more common compared to cystic fibrosis bronchiectasis. Bronchiectasis seriously affects the quality of survival and growth of children，and there is no specific treatment.Azithromycin has anti-inflammatory and broad immunomodulatory effects in addition to antibacterial effects. A number of clinical studies have shown the effectiveness of azithromycin in the treatment of children with non-cystic fibrosis bronchiectasis，but the drug resistance caused by the application of azithromycin and azithromycin-related adverse reactions during the treatment have also attracted attention.This article reviews the application of azithromycin in children with non-cystic fibrosis bronchiectasis.

Respiratory syncytial virus is the leading pathogen of lower respiratory tract infections in children under 5 years of age. Early-life respiratory syncytial virus infection is closely associated with long-term adverse outcomes，including impaired lung function，recurrent wheezing，and asthma. Metabolomics，an emerging systems biology approach，enables the quantitative analysis of dynamic changes in small-molecule metabolites within biological samples，providing critical insights into disease pathogenesis. This article reviews the metabolomic profiles of children with respiratory syncytial virus infection，with a focus on alterations in carbohydrate，lipid，and amino acid metabolism pathways. Additionally，it examines the distinct metabolomic features of children who develop recurrent wheezing following respiratory syncytial virus infection. These findings offer novel perspectives for elucidating the pathophysiological mechanisms of respiratory syncytial virus infection and improving early diagnosis and prognostic assessment.

Hypertrophic scar is common after burns, car accidents or severe trauma, and its treatment has been a major problem for burn plastic surgeons. Children are more prone to scar proliferation and contracture due to their developmental characteristics, thin skin, mobility, and poor compliance with treatment, etc. The accompanying cosmetic defects and limb dysfunction caused by contracture deformity often bring a series of psychosocial problems to the affected children. In recent years, the combination of fractional laser and glucocorticoid treatment for hyperplastic scarring has received much clinical attention. The purpose of this review is to summarize the progress of research on fractional laser combined with glucocorticoid treatment for hypertrophic scar in children in the past 5 years, to evaluate the effectiveness and safety of this treatment method, and to explore the rational application of this therapy, in order to provide more scientific guidance and suggestions for the treatment of hypertrophic scar in children.