The efficacy and safety of pharmacotherapy for girls with central precocious puberty or early normal puberty: a retrospective cohort study.

The Chinese Expert Consensus on central precocious puberty (CPP) defines girls' rapid sexual development before age 8 as CPP; while after age 8 as early normal puberty (ENP). And the use of recombinant human growth hormone (rhGH) for CPP and ENP is off-label and lacks reliable evidence for clinical practice. This study only included girls due to the low prevalence among boys.

The effects of L-carnitine in children with kidney failure undergoing dialysis: a systematic review.

Background: Patients on dialysis often suffer from carnitine deficiency due to reduced intake, reduced synthesis in the kidneys, and clearing through dialysis. Carnitine deficiency may lead to anemia, cardiomyopathy, hypotension, and so on. Several studies have shown that supplementing with L-carnitine can diminish the above symptoms in adult dialysis patients, but whether children can benefit from L-carnitine remains unclear.

The Efficacy of Zinc Supplementation Alone or in Combination for Improving Pregnancy and Infant Outcomes: A Systematic Review and Meta-Analysis.

Objective: To evaluate zinc supplementation's efficacy in pregnancy, addressing gaps in previous reviews regarding high-risk subgroups and combination therapies.

Methods: Systematic review of six databases through March 27, 2025 for randomized controlled trials (RCTs) on prenatal zinc supplementation. Risk of bias was assessed using the Cochrane Risk of Bias 2.

Pharmacotherapy for children with central precocious puberty or early puberty: A systematic review and meta-analysis.

Background: The intervention of gonadotropin-releasing hormone agonist or in combination with recombinant human growth hormone (rhGH) is still controversial for children with central precocious puberty (CPP) or early puberty (EP). This study aimed to systematically review and compare the efficacy and safety of current therapeutic regimens for CPP or EP based on different timings of intervention.

Methods: We searched 7 databases and 2 registers for available studies from inception until December 2023.

Evaluating the Impact of the COVID-19 Pandemic on Telepharmaceutical Service Effectiveness: Systematic Review and Meta-Analysis.

Background: Telepharmaceutical services (TPS) led by pharmacists, an emerging telehealth service, improve access to medical services and enable patients to receive specialized services in areas with limited resources. With a lower risk of infection and no restriction of isolation measures, TPS showed great potential during the COVID-19 pandemic. However, whether the effectiveness of TPS changed before and after the outbreak of the COVID-19 pandemic remained unclear.

Core GRADE 7: principles for moving from evidence to recommendations and decisions.

This seventh article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach for moving from evidence to recommendations or policy decisions. Core GRADE users make strong recommendations for an intervention versus a comparator when the desirable consequences clearly outweigh the undesirable consequences, and a conditional (weak) recommendation when the balance is less clear. Primary considerations in deciding on recommendations considering an individual patient perspective include balance of benefits, harms, and burdens; the certainty of evidence; and values and preferences.

Core GRADE 6: presenting the evidence in summary of findings tables.

This sixth article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to summary of findings tables. These tables provide essential information about the effects of interventions on patient important outcomes, including relative and absolute effects, certainty of evidence, and a plain language summary. For binary outcomes calculating absolute effects requires applying relative risk estimates to baseline risks from studies representative of the target population.

Effects of children's criteria for identifying potentially inappropriate prescribing on prescription review by pharmacists: a before-after study.

Background: We previously developed the children's potentially inappropriate prescribing (PIP) criteria to help detect and prevent inappropriate drug prescriptions in children.

Aim: To evaluate the impact of implementing the children's PIP criteria on pharmacists' pediatric prescription review processes.

Method: The prospectively before-after study was conducted in tertiary hospitals across China.

Core GRADE 5: rating certainty of evidence-assessing indirectness.

This fifth article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to systematic reviews, clinical practice guidelines, and health technology assessments and addresses issues of indirect evidence. Guideline developers and health technology assessment practitioners must carefully specify the population, intervention, comparison, and outcome (PICO)—their target PICO—and consider the extent to which the best available evidence matches their target. When target and study PICOs differ substantially, studies provide indirect evidence and Core GRADE users may rate down the certainty of evidence as a result of this indirectness.

Core GRADE 2: choosing the target of certainty rating and assessing imprecision.

This second article in a seven part series presents the Core GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to deciding on the target of the certainty rating, and decisions about rating down certainty of evidence due to imprecision. Core GRADE users assess if the true underlying treatment effect is important or not in relation to the minimal important difference (MID) or, alternatively, if a true underlying treatment effect exists. The location of the point estimate of effect in relation to the chosen threshold determines the target.

Core GRADE 1: overview of the Core GRADE approach.

This first article in a seven part series presents an overview of the essential elements of the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach that has proved extremely useful in systematic reviews, health technology assessment reports, and clinical practice guidelines. GRADE guidance has appeared in many articles dealing with both core issues and more specialised and complex guidance, and it has evolved over time. This series of articles presents GRADE essentials, Core GRADE, focusing on the core judgments necessary to summarise the comparative evidence about alternative care options and to make recommendations that apply to the care of individual patients.

Development of a generalised tool for evaluating success of clinical practice guidelines implementation (A-GIST).

Objectives: To develop a generalised tool to evaluate the success of implementation of clinical practice guidelines (CPGs).

Design And Setting: Systematic review, group brainstorming discussion and modified Delphi method.

Participants: A steering group (3 members) was assembled responsible for the guidance and ensuring stakeholder's involvement.

Azithromycin for eradication of and prevention of bronchopulmonary dysplasia in preterm infants: a meta-analysis.

Objective: To evaluate the efficacy and safety of azithromycin in eradicating and preventing bronchopulmonary dysplasia (BPD) in preterm infants.

Design: Six literature databases and three clinical trial registration platforms were searched for studies up to 22 July 2024. The meta-analysis was performed using RevMan V.

Rating certainty when the target threshold is the null and the point estimate is close to the null.

When one initially targets the null effect and the point estimate falls close to the null, two challenges exist in rating certainty of evidence. First, when the point estimate is near the null and the data, therefore, suggests little or no effect, rating certainty in a benefit or harm is misleading. Second, since in general the narrower the confidence interval (CI) the more precise the estimate, if the CI is narrow, rating down for imprecision due simply to crossing the null is inappropriate.

Diazepam exposure associated with an increased risk of acute kidney injury in children: an observational cohort study.

Background: Potentially nephrotoxic drugs play an important role in acute kidney injury (AKI) in children. In the previous pharmacovigilance study, we found a statistical correlation between diazepam and AKI in children, but the causality needs to be further verified.

Methods: An observational cohort study was conducted to investigate the association between diazepam exposure and the risk of AKI in hospitalized children.

Addressing challenges in pediatric thrombosis: a comprehensive guideline development.

Background: Pediatric thrombosis is a relatively rare but severe condition in the field of pediatrics, with far-reaching consequences. Recent studies have indicated a rising incidence of this disease in children over the years. Additionally, the pharmacological treatment of thrombotic diseases in children faces numerous challenges.

Adrenocorticotropic Hormone versus Prednisolone for Infantile Epileptic Spasms Syndrome: A Systematic Review and Economic Evaluation.

Background: Infantile epileptic spasms syndrome (IESS) is the most common epileptic encephalopathy in infancy and early childhood. At present, adrenocorticotropic hormone (ACTH) and prednisolone are commonly used as drug treatment regimens for IESS. However, evidence of efficacy and economics remains controversial.

Effectiveness of a Pharmacist-Led Intervention to Reduce Acid Suppression Therapy for Stress Ulcer Prophylaxis in ICUs in China: A Multicenter, Stepped-Wedge, Cluster-Randomized Controlled Trial.

Objectives: This study aimed to evaluate the effectiveness of a pharmacist-led intervention in decreasing the overuse of stress ulcer prophylaxis (SUP) compared with the usual care for adult patients in Chinese ICUs.

Design: Pragmatic, multicenter, stepped-wedge, cluster-randomized controlled trial.

Setting: Twenty-six ICUs in China from October 2022 to March 2023.

No difference in outcomes with early vs late antibiotic prophylaxis for term premature rupture of membranes: a multicenter analysis.

Background: Although guidelines suggest administering antibiotics 12 to 18 hours after the rupture of membranes in women with term premature rupture of membranes, in practice, clinicians tend to initiate prophylactic antibiotics as soon as possible to avoid risk of infection.

Objective: This study aimed to assess whether early administration of prophylactic antibiotics for term premature rupture of membranes reduces the incidence of maternal and neonatal infections.

Study Design: This multicenter prospective cohort study included women with term premature rupture of membranes.

Correlation of cyclosporine A blood concentration with kidney injury for pediatric patients after hematopoietic stem cell transplantation: a retrospective cohort study.

Background: The potential nephrotoxicity of cyclosporine A (CsA) has been a problem for treating graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the relationship between CsA blood concentration and acute kidney injury (AKI) in pediatric patients after allo-HSCT remains unclear.

Methods: We performed a retrospective study including pediatric patients who received allo-HSCT in West China Second Hospital of Sichuan University from 2000 to 2022 and collected their clinical data.

The Change in Child Sexual Abuse Victimization Among Chinese Children and Adolescents (2000-2022): A Cross-Temporal Meta-Analysis.

Limited meta-analytical research has examined the epidemiology of child sexual abuse (CSA) victimization among Chinese children and adolescents over the past two decades. It is crucial to evaluate how the incidence of CSA has changed over time in response to the significant policy and sociocultural changes since 2013. This study employed a cross-temporal meta-analysis to explore the trend of CSA victimization among Chinese children and adolescents from 2000 to 2022.

Data mining in FAERS: association of newer-generation H1-antihistamines with nervous system disorders.

Background: H1-antihistamines are widely used to treat symptoms depending on histamine release in a variety of conditions. However, neurological adverse events have been reported in post-marketing surveillance studies and there are limited literatures comparing the neurological disorders associated with newer-generation H1-antihistamines from real-world datasets.

Aims: We performed a comparative analysis of nervous system disorders and several newer-generation H1-antihistamines including: cetirizine, loratadine, levocetirizine, desloratadine and fexofenadine.

Effect of adding heparin to parenteral nutrition on catheter intraluminal obstruction based on scanning electron microscopy in preterm neonates: A non-inferiority, randomized controlled trial.

Objectives: This study aimed to assess the need for adding heparin to parenteral nutrition (PN) on reducing catheter intraluminal obstruction based on scanning electron microscopy (SEM) of peripherally inserted central catheter (PICC) in preterm neonates.

Methods: In this randomized controlled blinded non-inferiority trial, neonates with gestational age <32 weeks requiring PICC to receive PN were enrolled and randomly divided into two groups. In the heparin group, 0.