Objective:To analyze the clinical characteristics and nutritional treatment of malnutrition in infants with botulism.Methods:A retrospective analysis was conducted on 25 infant botulism patients admitted to Beijing Children's Hospital Affiliated to Capital Medical University，from May 1，2019 to October 31，2024.The nutritional risk and malnutrition incidence were assessed，nutritional therapy methods，formulations，tolerance status, energy intake rate, secondary infections and prognosis were analyzed.Results:A total of 25 pediatric patients were included, 19 males and 6 females, with a median age of 5(4,6) months. Twenty-five cases (100%) showed reduced food intake, with a weight of 7.3 (7.0, 9.0) kg upon admission. Twenty-four cases (96%) were assessed as high-risk for nutrition screening, and one case was diagnosed with malnutrition. Twenty-four cases (96%) received nasogastric tube feeding, with an early enteral nutrition implementation rate of 84% (21 cases) and intermittent infusion in 25 cases (100%). Fourteen cases used whole protein formula milk,eight cases used hydrolyzed protein formula milk and three cases were given 5% sugar solution. Nine cases were treated with intravenous nutrition, with a duration of 9 (5, 12) days. Five cases (20%) developed enteral feeding intolerance, and all five cases had secondary infections and were treated with parenteral nutrition. All 25 patients had good prognosis. At discharge, 17 cases (68%) were fed orally, and eight cases (32%) were fed through nasogastric tubes, with a median weight of 7.5 (7.0, 9.0) kg. Fifteen patients (60%) had weight gain, and the nutritional screening assessment was all low-risk.Conclusion:Infants with botulism are mostly in a state of high nutritional risk when they are admitted to hospital. Early enteral nutrition through a gastric tube has a high implementation rate. Some children may experience feeding intolerance,combined with timely use of parenteral nutrition replacement and symptomatic treatment can improve prognosis.

The standard therapy bundle for septic shock includes antibiotics,fluid resuscitation,vasopressors and inotropes. Given the high mortality rates associated with septic shock,there is an ongoing need for active research into potential therapies to improve outcomes. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is an acceptable and beneficial therapeutic modality for patients who fail conventional management and have decreased left ventricular ejection fraction. Up to now,the benefits of ECMO in pediatric sepsis remain unclear. Whether ECMO is the rescue therapy or is appropriately utilized in the early stage (window forward) remains controversial. At the present stage,it is necessary to strictly screen patients and make individualized decisions based on dynamic hemodynamic monitoring and biomarkers.

Gastrointestinal bleeding is one of the gastrointestinal emergencies. Small bowel bleeding is defined as bleeding in the gastrointestinal tract between the main duodenal papilla and the ileocecal valve,accounts for 5%-10% of all sources of gastrointestinal hemorrhage. The management for small bowel bleeding has been significantly improved because of widely applicated capsule endoscopy and device-assisted enteroscopy. The review introduced the etiology,examinations,diagnosis and treatment of suspected small bowel bleeding in children.

The diagnosis of obscure gastrointestinal bleeding in children faces many challenges,including the complexity of etiology and the limitations of diagnostic techniques. This article explored current diagnostic strategies,highlighted the importance of multidisciplinary collaboration,and assessed the potential of emerging technologies such as capsule endoscopy and double balloon enteroscopy.While these technologies offer new diagnostics,cost and operational complexity remain barriers to adoption. Future research directions should include improving access to technology and developing integrated diagnostic pathways to optimize the management of obscure gastrointestinal bleeding in children.

Gastrointestinal bleeding in children is one of the most common pediatric diseases，with a variety of causes that vary with age.Early and adequate evaluation of children with gastrointestinal bleeding，early identification of risk factors for aggravation of gastrointestinal bleeding，and active treatment measures have an important impact on the outcome of gastrointestinal bleeding.This article summarized the relevant literature，clinical guidelines and expert consensus at home or abroad and expounded the assessment strategies of pediatric gastrointestinal bleeding from the aspects of clinical diagnosis，disease assessment and risk prediction of gastrointestinal bleeding in children.

Gastrointestinal bleeding is one of the pediatric emergency.Endoscopy is the main method for identification of the source of gastrointestinal bleeding and an important treatment for active gastrointestinal bleeding in children.The timing of endoscopy is closely related to clinical outcomes.The timing of endoscopy for gastrointestinal bleeding varies in different parts and severity levels.Further clinical research is needed to determine the optimal timing for endoscopy in some disease conditions.This article elaborated on the timing of endoscopy for gastrointestinal bleeding in different parts of the gastrointestinal tract in children，in order to provide better clinical decision-making for pediatricians.

Refractory gastrointestinal bleeding in children is one of the acute and critical diseases in the department of gastroenterology, which is difficult to diagnose and treat in clinic. Clinically，refractory gastrointestinal bleeding is defined as bleeding that remains uncontrollable after conventional hemostatic measures and requires further management by surgical or interventional vascular surgery.The therapeutic efficacy of refractory gastrointestinal bleeding largely depends on the comprehensive diagnostic and treatment capabilities of the medical institution，as well as on the multidisciplinary collaboration among endoscopy，surgery，anesthesia，and interventional vascular surgery in terms of diagnostic and therapeutic management.This article systematically discussed the advancements on the diagnosis and treatment of pediatric refractory gastrointestinal bleeding，aiming to provide a reference for clinical practice.

The number of children's emergency patients has increased in recent years，yet only a tiny proportion are in a true emergency. As a result，it is very necessary to implement a children's triage system to promptly assess the patient's health and prioritize them for emergency treatment，ensuring that critically ill patients are treated promptly and medical resources are efficiently utilized. As an emerging technology，the integration of artificial intelligence and medicine has been used in emergency care aids in the rapid and accurate assessment of the patient's condition. Machine learning-based triage models for children's emergencies have been shown to aid triage decision-making，optimize resource allocation，and reduce emergency department crowding；however，there are still issues such as a lack of data and imperfect models. In this review，we provided an overview of advancements in using artificial intelligence algorithms in children's emergency triage.

Sodium taurocholate cotransporting polypeptide（NTCP）is a carrier protein expressed on the cell membrane transporting most of the plasma bound bile acids and a small amount of unbound bile acids into liver cells.It is an important transporter involved in enterohepatic circulation of bile acid.Sodium taurocholate cotransporting polypeptide deficiency（NTCPD）is caused by a mutation in its coding gene， SLC10A1，which affects the expression and/or function of NTCP.It leads to persistent hypercholanemia，temporary hyperbilirubinemia and cholestasis in early infancy.The disease lacks obvious clinical manifestations and diagnosis typically requires gene sequencing analysis.There is no large-scale epidemiological statistics，but due to the widespread development of clinical gene sequencing projects，the number of diagnosed children is increasing，indicating that the NTCPD is not rare in our country. At present，most clinicians have limited awareness of NTCPD，and often intervene excessively，leading to anxiety among parents.To improve clinicians' understanding of NTCPD,this article reviewed its pathogenesis,clinical consequences,diagnosis,treatment and prognosis.

Vasopressin is a non-catecholamine agent that induces vasoconstriction via V1 receptors. It is currently regarded as a second-line vasopressor in the treatment of septic shock. According to the Surviving Sepsis Campaign Guidelines for the Management of Sepsis and Septic Shock in Adults,vasopressin is recommended when norepinephrine doses reach 0.25–0.50 μg/（kg·min）and normal blood pressure cannot be maintained. However,hemodynamic alterations in pediatric septic shock differ significantly from those observed in adults,and there is currently insufficient evidence to support the use of vasopressin in pediatric septic shock. This review,in conjunction with recent clinical research data,explored the optimal timing of initiation,methods of administration,and clinical evaluation criteria for vasopressin in septic shock,aiming to provide valuable references for the optimization of septic shock management.