Beijing Children’s Hospital

To address the current lack of standardized protocols for vestibular infant screening (VIS), this clinical consensus aims to establish a clinical consensus on VIS in infants aged 0-12 months. Given a frequent co-occurrence of vestibular dysfunction in children with sensorineural hearing loss (SNHL) and the significant impact of vestibular dysfunction on early development, early identification and management are critical. This clinical consensus was developed by a panel of 28 international experts in pediatric otolaryngology and vestibular disorders through a structured, multi-round Delphi process. Panelists were selected based on clinical and academic expertise, representing 26 institutions across Asia and Europe. A comprehensive literature review (2000-2024) informed the initial draft of consensus statements. The consensus was reached through three iterative rounds of anonymous rating and feedback, followed by virtual discussions. Statements achieving ≥ 80% agreement were retained in the final consensus, which focused on screening tools, target populations, optimal timing, and standardized cVEMP recording protocols for infants. The expert panel reached consensus on key recommendations in four domains: screening tool, target screening population, timing of vestibular function screening, and recording protocol for cervical vestibular evoked myogenic potential (cVEMP). This clinical consensus provides foundational guidance for the implementation of VIS in infants, advocating for standardized protocols to improve early diagnosis and intervention. Widespread adoption of these recommendations may enhance developmental outcomes by enabling timely detection and management of vestibular dysfunction in early childhood.

This study aimed to evaluate an animation-based caregiver-patient interaction model for postoperative pain and anxiety management in preschool children with congenital heart disease (CHD). This randomized controlled trial included 70 preschoolers undergoing CHD surgery under general anesthesia, who were enrolled in the Cardiac Critical Care Unit at Beijing Children's Hospital (June-October 2024). Participants were stratified into intervention (n=35) and control (n=35) groups. The control group received standard postoperative care, while the intervention group additionally received a structured animation-based program involving preoperative personalized animation selection, post-extubation viewing (≤30 min/session, 3-6 times/day) with nurse-guided interaction, and parental involvement. Pain (WongBaker FACES scale) and anxiety (mYPAS) were assessed at 1 h/6 h postextubation, 24 h/48 h postsurgery, during OR transport, and 24 h postsurgery.Pain was assessed at four time points: 1 h/6 h post-extubation and 24 h/48 h post-surgery. At 1 h post-extubation, there was no significant difference in pain scores between the intervention and control groups (median 9 vs 8, p= 0.462). Pain scores were significantly lower in the intervention group than in controls at 6 h post-extubation (median 6 vs 9), 24 h post-operative (3 vs 6), and 48 h post-operative (2 vs 4); all p < 0.001. Anxiety scores (m-YPAS) were also significantly lower in the intervention group, both on transport to the OR (median 76 vs 80) and at 24 h after surgery (60 vs 80), p < 0.001. Friedman tests demonstrated significant within-group changes over time in anxiety levels (intervention p < 0.001), confirming that the intervention group experienced substantially reduced anxiety at these two key perioperative time points. The interactive animation model significantly reduces postoperative pain and perioperative anxiety in preschool patients with CHD, offering a safe non-pharmacological adjuvant for pain management.

Metachronous bilateral conversion in initially unilateral retinoblastoma is uncommon but clinically consequential, potentially requiring intensified treatment and carrying worse prognosis. Clarifying how age at diagnosis refines genetic-risk stratification could enable safer, more efficient surveillance protocols. To estimate the incidence and timing of metachronous bilateral conversion in unilateral retinoblastoma and assess whether age at diagnosis and RB1 testing are associated with bilateral conversion risk. This was a retrospective cohort study at a tertiary center in Shanghai, China, including 1108 consecutive children with initially unilateral retinoblastoma diagnosed from July 2010 to October 2024 (after exclusions for short follow-up [n = 139], missing data [n = 53], or synchronous bilateral disease [n = 10]). The median (IQR) follow-up was 43.4 (24.2-67.6) months. Age at diagnosis and RB1 genetic status/subtypes assessed by next-generation sequencing and multiplex ligation-dependent probe amplification, including penetrance class (high vs low) and mosaic vs germline categorization. Time to metachronous bilateral conversion; cumulative incidence functions with death as a competing risk; spatial distribution of fellow-eye tumors. Among 1108 patients (median [IQR] age at diagnosis, 22.2 [12.0-31.4] months; 591 [53.3%] male), 24 (2.2%) developed metachronous bilateral disease. At 24 months, cumulative incidence was 2.2% (95% CI, 1.3-3.1) overall. By genetic status, the 24-month cumulative incidence was 24.8% (95% CI, 13.8-35.9) in RB1 variant-positive vs 1.6% (95% CI, 0.0-3.1) in RB1 variant-negative patients. Among RB1 variant-positive patients, risk clustered among those diagnosed before 9 months, whereas no conversions were observed among those diagnosed at older than 9 months. Four RB1 variant-negative patients who were initially diagnosed at notably late ages (20.9, 42.7, 79.6, and 118 months) subsequently converted; these cases likely represent undetected low-level mosaicism, somatic variants below detection thresholds, or rare genomic events not captured by standard sequencing panels. Fellow-eye tumors did not involve macula and showed a nasal-predominant distribution. The findings in this study suggest that age at diagnosis may refine genetic risk stratification for metachronous bilateral conversion. RB1 variant-positive patients diagnosed at 9 months or later represent a very low-risk subgroup that may warrant surveillance deescalation, while rare late conversions in RB1 variant-negative patients necessitate continued long-term monitoring.

BackgroundMajor depressive disorder (MDD) in adolescents represents a significant global public health challenge. Moreover, metacognitive dysfunction plays a critical role in its onset, progression, and prognosis, but research on the metacognitive characteristics of Chinese adolescents with MDD remains highly limited.MethodsThe study was conducted from January 2024 to January 2025 and employed a cross-sectional design with convenience sampling. The participants included 202 adolescents who were diagnosed with MDD, with a mean age of 15 years. All the subjects completed a self-administered general information questionnaire to collect demographic information. The Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), Adverse Childhood Experience Questionnaire-Revised (ACE), Rumination Response Scale Chinese Version (RRS), and Metacognitive Questionnaire-30 (MCQ) were utilized to evaluate the psychological well-being of adolescents diagnosed with MDD.ResultsMultiple linear regression analyses demonstrated the potential of the RRS total score, reflective pondering and household dysfunction as predictors of metacognitive deficits in adolescents diagnosed with MDD, with statistical significance at p < 0.05. Furthermore, the total ACE scores of adolescents diagnosed with MDD were significantly positively correlated with the MCQ (β = 0.189, p < 0.001) and RRS (β = 0.380, p < 0.001) scores. Additionally, the total RRS score was positively correlated with the MCQ score (β = 0.675, p < 0.001). Mediation analyses demonstrated that rumination mediated the association between adverse childhood experiences and metacognitive deficits, with a mediating effect value of 1.136 and a 95% confidence interval of [0.639, 1.635], explaining 57.32% of the total effect.ConclusionRumination mediates the relationship between adverse childhood experiences and metacognitive deficits in adolescents with MDD. Rumination, reflective pondering and household dysfunction in adolescents with MDD can predict metacognitive dysfunction to varying degrees. Our study highlights that interventions targeting rumination may be particularly effective in mitigating the negative impact of ACEs on metacognitive functioning in adolescents with MDD.

Despite the increasing recognition of cystic fibrosis (CF) in China, few cases have been reported in the Xinjiang Uyghur Autonomous Region (Xinjiang), which is located in China’s northwest with a diverse ethnic composition. This study aimed to describe the genotype and clinical phenotype of children with CF in Xinjiang. We recruited children diagnosed with CF at the Children’s Hospital of Xinjiang Uygur Autonomous Region between January 2012 and December 2025. The demographic data, imaging findings, laboratory test results, and genetic data were retrospectively reviewed. A total of 19 patients from 18 families were enrolled. The median age at diagnosis was 9.8 years. Among them, 15 (78.9%) were Uygur, 3 (15.8%) Kazakh, and 1 (5.3%) Mongolian. Fifteen distinct cystic fibrosis transmembrane conductance regulator (CFTR) mutations were identified, with c.1521_1523delCTT (p. F508del) being the most common (allele frequency: 36.1%). Mutations of c.1860T > G (p.H620Q), c.2991 G > C (p.L997F), del ex4-11, c.3254 A > G (p.H1085R), c.2619 + 1G > A, c.349 C > T (p.R117C), c.3909 C > G (p.N1303K), and c.1911delA > G (p.G637Hfs*26)—which have never been reported in Chinese populations—were observed. Bronchiectasis was observed in 84.2% of patients, with allergic bronchopulmonary aspergillosis noted in 36.8%. Pseudomonas aeruginosa (78.9%) and Staphylococcus aureus (47.4%) were the predominant pathogens. Additionally, 78.9% had pancreatic insufficiency, 21.1% had CF-related liver disease, 21.1% had Pseudo-Bartter syndrome, and 5.3% had diabetes. CF may be significantly underdiagnosed in Xinjiang, China. The genotypic spectrum in children with CF in this multiethnic region differs considerably from previous reports, mainly focusing on the Han population, with p.F508del as the most frequent CFTR mutation.

Heterogeneity is widely recognised across different cell types. Human oligodendrocyte progenitor cells (hOPCs), essential for myelination, exhibit considerable heterogeneity, which has not been fully characterised. In the current study, by examining the transcriptome of hOPCs at the single-cell level, three distinct subclusters were identified: PRE-OPCs, OPCs, and PRE-OLs. Single-cell RNA-sequencing and RNA-Scope detected high platelet-derived growth factor receptor alpha (PDGFRA) expression. PDGFR-α+ hOPCs exhibited greater myelination, migration, and proliferation capabilities compared to both unsorted hOPCs and PDGFR-α- hOPCs. These enhanced functions may be associated with the activation of the PI3K-AKT-mTOR and TGF-β signalling pathways, which support oligodendrocyte differentiation. hOPCs were induced by hNSCs, their characteristics were identified. RNA-Scope and single-cell RNA Seq sequencing showed PDGFRA were highly expressed at mRNA and protein level. hOPCs were sorted by MACS using PDGFR-α beads. The myelination, migration, and proliferation abilities of PDGFR-α+ hOPCs were higher than that of un-sorting hOPCs and PDGFR-α- hOPCs, possibly being associated with the activation of PI3K-AKT-mTOR and TGF-β signalling pathways, which support oligodendrocyte differentiation (Partly created with Scientific Image and Illustration Software BioRender).