Pediatric sepsis is a life-threatening systemic infectious response syndrome. Its core pathophysiological process involves a systemic imbalance between oxygen delivery and demand, coupled with cellular energy metabolism dysfunction, which collectively contribute to high mortality rates. Parameters of oxygen metabolism serve as critical indicators reflecting tissue perfusion and cellular oxygen utilization. Consequently, these parameters hold significant value for the early identification, severity stratification, therapeutic guidance, and prognostic evaluation of pediatric sepsis. This review systematically elucidates the pathophysiological mechanisms underlying oxygen metabolism disorders in pediatric sepsis. Furthermore, it highlights the current clinical applications and significance of key monitoring indices, including blood lactate, central venous oxygen saturation, oxygen delivery, and oxygen consumption. By integrating recent research advancements, this paper also explores therapeutic strategies aimed at optimizing oxygen metabolism, such as blood purification, microcirculation-targeted therapies, and extracorporeal membrane oxygenation. Finally, we provide future perspectives on emerging biomarkers and metabolomic approaches, aiming to establish a theoretical foundation for the optimized clinical management of pediatric sepsis.

Background and Objective:Pediatric sepsis is a high-stakes, time-sensitive emergency, yet early recognition in the emergency department (ED) remains inconsistent because presenting features are heterogeneous, early signs are nonspecific, and implementation capacity varies across hospitals. At the same time, evidence for bundle-based care has expanded, but important clinical questions remain regarding which recognition approaches are most reliable in frontline ED settings, which bundle elements are best supported, and why pathway uptake remains uneven. This narrative review was undertaken to address these questions and to clarify current evidence gaps relevant to pediatric emergency practice. Methods:This structured narrative review searched PubMed on March 15, 2026 for studies published from January 1, 2010 through March 15, 2026 using terms related to pediatric sepsis, emergency care, screening, early recognition, sepsis bundles, biomarkers, quality improvement, and digital decision support. We focused on ED-relevant studies addressing recognition strategies, bundle implementation, nursing or workflow processes, and emerging technologies. Titles and abstracts were screened against predefined inclusion and exclusion criteria, and the final literature set was synthesized thematically into recognition, management, implementation, and future-direction domains. No language filter was planned at search design, but the review was limited to studies with accessible English full-text data for analysis. Key Content and Findings:Current evidence supports a layered ED recognition model that combines clinical assessment with structured screening, targeted biomarkers, and workflow-integrated digital support rather than reliance on any single tool. Evidence is strongest for bundle pathways improving process outcomes such as time to antibiotics, pathway activation, and compliance with first-hour care targets. By contrast, evidence for direct mortality benefit, stand-alone biomarker superiority, and routine use of artificial intelligence (AI)-enabled systems remains promising but inconsistent because studies are heterogeneous in definitions, populations, and implementation context. The literature also shows that success in general ED practice depends heavily on pediatric readiness, nursing-led escalation, local workflow design, and multidisciplinary coordination. Conclusions:Pediatric sepsis care in the ED should be organized around rapid recognition plus measurable, context-adapted bundle delivery. The clearest evidence gaps involve external validation of recognition tools in general EDs, more explicit evaluation of individual bundle components, harmonized operational definitions and bundle metrics, and implementation studies that test how digital support and nursing workflows can improve frontline performance.

Background and Objective:The pediatric intensive care unit (PICU) is a high-stress medical environment. Family-Centered Care (FCC), which ensures parental presence and participation, is recognized as the standard of practice to mitigate psychological distress and trauma in critically ill children. However, infection control mandates [most notably during the coronavirus disease 2019 (COVID-19) pandemic] and resource limitations often necessitate restrictive visitation policies, leaving children in an "unaccompanied" state. This separation from parents constitutes a significant deviation from the standard care model and poses a unique psychological risk. A systematic synthesis of the specific psychological impacts of this parental absence and adaptive strategies to effectively intervene within this context remains underdeveloped. This narrative review aims to analyze the primary psychological consequences of parental absence for children in the PICU and to explore the intervention strategies adapted to mitigate these effects. Methods:We reviewed journal articles from the past 15 years (2010-2024) that analyze and discuss the psychological impact and intervention strategies of unaccompanied patients in pediatric intensive care units. Key Content and Findings:Our analysis indicates that an unaccompanied state is a significant, independent risk factor for psychological morbidity in PICU patients, markedly exacerbating separation anxiety, fear, loneliness, and depressive symptoms, which may also impede physiological recovery. Effective interventions must focus on mitigating the trauma of separation. The core strategy identified is "Virtual Family-Centered Care" (e.g., re-establishing family connection and participation in rounds via video technology). Other critical interventions include alternative socio-emotional support from the healthcare team (especially Child Life Specialists), professional psychological therapies, and environmental optimization to reduce threat perception. Conclusions:We conclude that while parental presence is irreplaceable, PICUs must adopt innovative interventions, particularly technology-assisted virtual connections, to protect the psychological well-being of unaccompanied children whenever visitation is necessarily restricted.

Cystic fibrosis (CF) is an autosomal recessive disorder caused by pathogenic variants in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. It is increasingly understood through a genomics-informed framework linking variant architecture to phenotype, diagnosis, and therapeutic eligibility. This review summarizes current evidence on CFTR structure, variant interpretation, genotype-phenotype heterogeneity, diagnostic workflows, and modern management. We highlight how full-gene sequencing, curated disease-liability databases, functional testing, and organoid-informed theratyping refine diagnosis and treatment selection; how disrupted chloride and bicarbonate transport drives muco-obstructive airway disease and multisystem complications; and why modulator therapy must still be integrated with respiratory, nutritional, endocrine, hepatobiliary, reproductive, and psychosocial care. We also outline unresolved challenges in rare variants, residual organ damage, ancestry-related diagnostic gaps, and mutation-agnostic therapeutic development.

Background and Objective:Family-integrated care (FIC), grounded in the principles of family-centered care (FCC), has become an important approach for supporting children and families during pediatric intensive care. Although post-intensive care syndrome in pediatrics (PICS-p) provides one important rationale for family engagement, the scope of FIC extends beyond PICS-p to include bedside participation, communication, shared decision-making, rehabilitation, psychosocial support, and transition planning. This narrative review aims to synthesize current applications, reported benefits, implementation barriers, and future priorities for FIC in the pediatric intensive care unit (PICU). Methods:We conducted a narrative review of literature on FIC/FCC in pediatric critical care. Searches were performed in PubMed/MEDLINE, CINAHL, Embase, Web of Science, and the Cochrane Library, with emphasis on contemporary literature from 2015 to April 2026 and inclusion of selected foundational papers when conceptually necessary. Eligible evidence included observational, qualitative, mixed-methods, quality-improvement, pre-post, interventional, guideline, and review literature relevant to family participation in PICU care. Key Content and Findings:The review identifies several recurring themes: the transition from restricted visitation to partnership-based care; practical family participation in routine care, communication, shared decision-making, rehabilitation, and end-of-life contexts; patient- and family-centered outcomes; structural, cultural, linguistic, and resource-related barriers; and the role of interdisciplinary teams, institutional policy, staff education, and digital tools in supporting implementation. Conclusions:Current evidence suggests that FIC may improve family experience, communication, parental confidence, and selected psychosocial outcomes, while its effects on long-term child outcomes and PICS-p require further pediatric-specific evaluation. Future work should prioritize clearer definitions, standardized implementation models, inclusive study designs, and pragmatic outcome measures that reflect both child and family priorities.

Background and Objective:Pediatric deep vein thrombosis (DVT) is an increasingly recognized vascular condition with potentially life-threatening consequences. Despite growing clinical awareness, nursing care remains challenging due to the lack of standardized, age-appropriate protocols-often defaulting to adult-oriented approaches. This review aims to synthesize current evidence on the multifactorial etiology, diagnostic challenges, and optimal nursing strategies for pediatric DVT, with a focus on improving early detection, individualized management, and long-term outcomes. Methods:A narrative review was conducted to analyze peer-reviewed studies and clinical guidelines on pediatric DVT published in recent years, focusing on etiology, risk factors, diagnostic difficulties, and nursing interventions. Key Content and Findings:Pediatric DVT arises from a complex interplay of genetic thrombophilias, acquired triggers [e.g., central venous catheters (CVCs), infection], and immune-inflammatory mechanisms. Clinical presentation is highly variable and age-dependent, complicating early diagnosis. Effective nursing strategies include: (I) validated pediatric risk assessment; (II) individualized anticoagulation monitoring; (III) meticulous catheter care; (IV) early mobilization; and (V) nutritional support. Multidisciplinary collaboration, family-centered education, and psychological support are crucial for preventing post-thrombotic syndrome (PTS) and promoting recovery. Conclusions:A tailored, evidence-based nursing framework-grounded in pediatric physiology and centered on family engagement-is essential for optimizing DVT care in children. This review provides a practical foundation for developing standardized, high-quality nursing protocols to enhance safety, efficacy, and long-term outcomes in pediatric DVT management.

Inguinal hernia is a common condition in children, and day-case surgery has been widely implemented in pediatric specialty hospitals, benefiting patients and their families. However, overnight hospital stays pose various inconveniences to children and parents. In this study, we aimed to optimize the day-case surgery model for inguinal hernia repair, evaluate the effectiveness and safety of day-case surgery in children with inguinal hernias, and compare the effects of different surgical methods on hospitalization duration and medical cost. A retrospective cohort study was conducted to analyze surgical data from 14,197 children with inguinal hernias admitted from January 2019 to December 2023 using statistical methods, including independent sample t-tests, analysis of variance, and multiple linear regression analysis. The results showed that the day-case surgery model significantly shortened hospitalization duration and reduced medical cost. The hospitalization duration and medical cost in the laparoscopic percutaneous internal ring suturing group were significantly higher than those in the open traditional high ligation of the hernia sac group (P < 0.05). However, the recurrence rate in the laparoscopic percutaneous internal ring suturing group was 0.035

Background:Acute kidney injury is a severe complication of pediatric trauma with complex and diverse mechanisms and is associated with multiple organ dysfunction. For severely injured children, renal function should be closely monitored, and continuous renal replacement therapy should be promptly initiated if there is a risk of developing severe acute kidney injury. This case report describes the treatment process of a child with acute kidney injury due to trauma, highlighting the need to improve the rapid identification of traumatic acute kidney injury risk and actively implement resuscitation strategies to protect renal function in trauma patients. Case Description:A 3-year-old boy presented with acute kidney injury following a car accident. Multi-organ dysfunction developed, and laparotomy and liver laceration repair were performed. Continuous renal replacement therapy for 7 days, plasma exchange, antimicrobial therapy, and multi-organ support were provided. A 1-year follow-up showed no organ dysfunction. Conclusions:This case report describes the treatment process of a child with acute kidney injury due to trauma, highlighting the need to improve the rapid identification of traumatic acute kidney injury risk and actively implement resuscitation strategies to protect renal function in patients with trauma. Prompt continuous renal replacement therapy should be considered when necessary to prevent adverse outcomes.

Pediatric trauma remains a leading cause of mortality among children. This study aimed to analyze the characteristics and influencing factors of pediatric trauma across different age groups, with a focus on injury causes, anatomical injury sites, and temporal distribution patterns. Clinical data were collected from 24 hospitals across 16 provinces in China between April 1, 2021, and December 31, 2022. We conducted a comprehensive analysis to describe trends, demographic characteristics, injury patterns, and associated risk factors related to trauma hospitalizations. A total of 732 pediatric patients with trauma were included in this multicenter study. The mean age and body weight were 5.59 ± 3.86 years and 22.52 ± 12.93 kg, respectively. The leading causes of trauma were, in order, traffic accidents (45.77

Background Few studies have studied the refeeding syndrome (RS) in small-for-gestational-age SGA infants, which led to the lack of knowledge in this field. This study aimed to compressively assess the incidence, risk factors and short-term outcomes of RS in SGA infants in order to improve clinical managements of SGA infants. Methods This prospective cohort study enrolled hospitalized SGA infants who received enteral nutrition (EN) and/or parenteral nutrition (PN) within 24h upon admission and with complete clinical data from January 2019 to June 2024. RS was defined according to the ASPEN criteria and as a decrease of ≥ 10% in at least one of phosphorus, potassium and magnesium level during the first five days of EN and/or PN. Binary logistic regression analyses were performed to explore the independent risk factors of RS and associations between RS and short-term outcomes. Results 359 SGA infants were finally included in the study, comprising 175 (48.70%) males and 184 (51.30%) females. The incidence of RS was 203 (56.50%) in SGA infants. Binary logistic regression analyses revealed that high potassium level at baseline (adjusted odds ratio (OR) = 4.842, 95% confidence interval (CI): 2.947 to 7.955, P < 0.001) and premature rupture of membrane (adjusted OR = 3.292, 95%CI: 1.459 to 7.429, P = 0.004) were the independent risk factors for RS; older age (adjusted OR = 0.910, 95%CI: 0.859 to 0.963, P = 0.001) and higher albumin level (adjusted OR = 0.891, 95%CI: 0.821 to 0.966, P = 0.005) were the protective factors, and RS was the independent risk factors for neonatal sepsis (adjusted OR = 3.672, 95%CI: 1.193 to 11.301, P = 0.023) and thrombocytopenia (adjusted OR = 1.921, 95%CI: 1.023 to 3.606, P = 0.042). Conclusions There was a high RS incidence in SGA infants. High potassium level at baseline and premature rupture of membrane were the independent risk factors for RS, and RS was the independent risk factors for neonatal sepsis and thrombocytopenia. These findings suggested RS screening should be performed in routine clinical practice for all SGA infants, and timely monitoring and intervening in neonatal sepsis and thrombocytopenia in SGA infants with RS.

Bronchial rupture from penetrating,perforating,or compressive cervical or thoracic injuries can lead to complete tracheal,mainstem bronchial,or lobar bronchial detachment.Although rare in children,bronchial rupture presents significant risks,including dyspnea,respiratory failure,and potentially fatal airway obstruction,and is often overlooked or diagnosed late in clinical settings.Prompt diagnosis and intervention are prognostically crucial.[1,2]Between January 2013 and December 2023,four children(two male and two female)with bronchial rupture were admitted to the Pediatric Surgical Intensive Care Unit(ICU)at Children's Hospital,Zhejiang University School of Medicine.Here,we share our experience of patient management.

MicroRNAs (miRNAs) interact with mRNAs in various pathophysiological processes. In developmental dysplasia of the hip (DDH), the miRNA-mRNA pairs affecting acetabular cartilage (AC) development remain unknown. We investigated dynamic microstructure changes and mRNA and miRNA expression profiles in the AC proliferative zone in a DDH rat model. Abnormal chondrocyte proliferation was observed, and several differentially expressed mRNAs and miRNAs were identified. Downregulated mRNAs and target genes of upregulated miRNAs were primarily enriched in bone and cartilage development. Six hub genes were identified using the predicted miRNA-mRNA interaction network and gene expression pattern analysis. The expression levels of these hub genes and paired miRNAs aligned with our predictions, and most of the pairs were significantly negatively correlated. Excessive chondrocyte proliferation in the AC proliferative zone can delay AC ossification, which might be crucial to DDH development. Specific miRNA-mRNA interaction pairs may serve as diagnostic biomarkers and therapeutic targets.

Pediatric trauma plays a crucial role in pediatric mortality, with traffic injuries and falls frequently cited as leading causes of significant injuries among children. A comprehensive investigation, including geographical factors, is essential for developing effective strategies to prevent injuries and alleviate the burden of pediatric trauma. This study involved a retrospective analysis of clinical data from pediatric patients admitted to our hospital's intensive care unit (ICU) due to trauma over a 10-year period. Comprehensive analyses were conducted to elucidate trends, demographics, injury patterns, and risk factors associated with these admissions. This retrospective study included 951 pediatric patients (mean age: 4.79 +/- 3.24 years; mean weight: 18.45 +/- 9.02 kg; median time to ICU admission post-injury: 10.86 +/- 14.95 h). Among these patients, 422 (44.4%) underwent emergency surgery, and 466 (49%) required mechanical ventilation support, with a mean duration of 70.19 +/- 146.62 h. The mean duration of ICU stay was 6.24 +/- 8.01 days, and the overall mean hospitalization duration was 16.08 +/- 15.56 days. The predominant cause of unintentional injury was traffic accidents (47.9%), followed by falls (42.5%) and burns/scalds (5.3%). Most incidents involved children aged 0-6 years (70.7%), with males comprising 60.0% of patients. Injury incidents predominantly occurred between 12 and 6 PM (44.5%) and on non-workdays (37.6%). The most common locations where injuries occurred were roadsides (49%) and rural areas (64.35%). Single-site injuries (58.78%) were more prevalent than multiple-site injuries (41.22%), and head injuries were the most common among single- site injuries (81.57%). At ICU admission, the mean injury severity score was 18.49 +/- 8.86. Following active intervention, 871 patients (91.59%) showed improvement, while 80 (8.41%) succumbed to their injuries. Traffic injuries remain the primary cause of pediatric trauma leading to ICU admission, underscoring the importance of using appropriate child restraint systems and protective gear as fundamental preventive measures. The increased incidence of injuries among children aged < 6 years and those residing in rural areas highlights the need for targeted preventive strategies, necessitating tailored interventions and public policy formulations that address these high-risk populations.

Background Paediatric trauma is a pivotal factor contributing to paediatric mortality, with traffic injuries and falls being commonly reported as leading causes of significant injuries among children. Comprehensive investigations from multiple perspectives, including geographical considerations, are crucial to develop more effective strategies for preventing such injuries and thereby reducing the burden of paediatric trauma. Methods This study involved a retrospective analysis of clinical data from paediatric patients admitted to our hospital's intensive care unit (ICU) due to trauma over a 10-year period. Comprehensive analyses were conducted to elucidate trends, demographics, injury patterns, and risk factors associated with these admissions. Results This retrospective study included 951 paediatric patients (mean age: 4.79 ± 3.24 years; mean weight: 18.45 ± 9.02 kg; median time to ICU admission post-injury: 10.86 ± 14.95 hours). Of these patients, 422 (44.4%) underwent emergency surgery and 466 (49%) required mechanical ventilation support, with a mean duration of 70.19 ± 146.62 hours. The mean duration of ICU stay was 6.24 ± 8.01 days and overall mean hospital stay was 16.08 ± 15.56 days. The predominant cause of unintentional injury was traffic accidents (47.9%), followed by falls (42.5%) and burns/scalds (5.3%). Most incidents involved children aged 0–6 years (70.7%), with males comprising 60.0% of cases. Injury incidents predominantly occurred between 12 PM and 6 PM (44.5%) and on non-workdays (37.6%). The most common sites of injury were roadsides (49.0%) and rural areas (64.35%). Single-site injuries (58.78%) were more prevalent than multiple-site injuries (41.22%), and head injuries were the most common among single-site injuries (81.57%). At ICU admission, the mean injury severity score was 18.49 ± 8.86. Following active intervention, 871 patients (91.59%) showed improvement, whereas 80 (8.41%) succumbed to their injuries. Conclusion Traffic injuries remain the primary cause of paediatric trauma, underscoring the ongoing importance of appropriate use of child restraint systems and protective gear as fundamental preventive measures. The elevated incidence of injuries among children under 6 years old and those residing in rural areas highlights the need for targeted preventive strategies, necessitating tailored interventions and public policy formulations that specifically address these high-risk populations.

Introduction:Trauma is a significant global public health concern and the leading cause of morbidity and mortality in children. This study aimed to assess the independent predictors of trauma severity as well as mortality in pediatric patients admitted to the intensive care unit (ICU). Methods:In this cross-sectional study, following the STROBE checklist, we retrospectively analyzed the clinical and baseline characteristics of pediatric patients with trauma injuries admitted to the ICU of Children's Hospital of Zhejiang University School of Medicine, China, over a decade. Results:951 pediatric patients with a mean age of 4.79 ± 3.24 years (60.78% Boys) were studied (mortality rate 8.41%). Significant associations were observed between ISS and place of residence (p = 0.021), location of the injury (p = 0.010), year of injury (p <0.001), and injury mechanism (p <0.001). The two independent factors of trauma severity were the year of injury (β = 0.47; 95%CI: 0.28 - 0.65) and injury mechanism (β = -0.60; 95%CI: -0.88 - -0.31). Significant differences were observed between survived and non-survived regarding age (p <0.001), ISS score (p <0.001), time elapsed from injury to ICU (p <0.001), duration of mechanical ventilation (p <0.001), GCS score (p <0.001), and the proportion of patients requiring mechanical ventilation (p <0.001 ). The results of multivariate analysis indicated that age (OR = 0.805; 95%CI: 0.70 - 0.914; p = 0.001) and GCS score at ICU admission (OR = 0.629; 95%CI: 0.53 - 0.735; p < 0.001) acted as protective factors, whereas mechanical ventilation in the ICU (OR = 7.834; 95%CI: 1.766 - 34.757; p = 0.007) and ISS score at ICU admission (OR = 1.088; 95%CI: 1.047 - 1.130; p < 0.001) served as risk factors for mortality. Conclusion:Automobile-related injuries represent the leading cause of trauma in children, with escalating severity scores year over year among pediatric patients admitted to the ICU with trauma injuries. Based on the findings the independent predictors of mortality of pediatric trauma patients admitted to the ICU were age, GCS score at ICU admission; mechanical ventilation in the ICU, and ISS score at ICU admission. Also, the year of injury and injury mechanism were independent predictors of trauma severity.

Background To investigate the epidemiology of unintentional injury in children admitted to Intensive Care Unit (ICU) in China mainland. Methods A total of 39 hospitals in 19 provinces contributed to the 1-day point prevalence study of serious unintentional injury in children aged 0–16 years admitted to ICU. Results A total of 1,017 patients from the 39 participating ICUs on the study day were included. Among them, 56 pediatric patients were identified to be suffered from unintentional injury from 18 participating ICUs, accounting for 5.5% (56/1,017) of all the ICU patients. The percentage of boys was more than twice the percentage of girls. Most patients had an age of less than 6 years old (n=42, 75%). The leading cause of unintentional injury was fall (n=17, 30.4%). The patterns of unintentional injury in children were age-related. There were no urban-rural differences in our cohort. The injury happened on 12:00–18:00 PM in 27 cases (48.2%), and 28 patients (50%) had injuries happened at working day. 35 patients (62.5%) received primary treatment at local hospitals. Thirty-five patients (62.5%) needed resuscitation in the emergency department, 15 patients (26.8%) still needed resuscitation in ICU. These 56 children suffered from a total of 106 lesions corresponding to 1.89 lesions per patient. Respiratory failure was most commonly seen (n=18, 32.1%). There was no death in our cohort during the study. After effective treatment during their ICU stay, 45 (80.4%) patients showed improvement, with Glasgow Coma Scale (GCS), Pediatric Trauma Score (PTS) and Pediatric Risk of Mortality III (PRISM III) score significantly better than those before treatment (P<0.05). Conclusions Higher injury rates among children under 6 years old of age illustrate the need for preventive measures, especially programs and public policies targeting this high-risk group.

Objective:To explore current status of pediatric ambulatory surgery in mainland China and provide references for formulating an expert consensus.Methods:The literatures with such keywords as ambulatory surgery, one-day surgery and one-day operation for pediatrics were retrieved from the databases of Wanfang DATA, VIP Database for Chinese Technical Periodicals and CNKI (China National Knowledge Infrastructure). Based upon the outstanding issues, a questionnaire was designed and completed via a WeChat link. Data analysis was performed with Excel and IBM SPSS 22.0 statistical software.Results:A total of 151 articles were published by 108 organizations, including 1 (0.7%) guideline, 21 (13.9%) reviews, 123 (81.5% ) clinical trials, 3 (2.0%) dissertations and 3 (2.0%) popular science articles. However, there was no multi-center research. Since the first paper was published in 1996, 74 articles (49%) were published in recent 3 years. For institutions, 115 (76.2%) from class IIIA hospitals and 93 (61.6%) from general hospitals; For research areas, nursing (37), anesthesia (48), clinical summary (43) and management (20), especially psychology (3) and ERAS (14). A total of 72 questionnaires were received. There were 64 class IIIA hospitals (88.9%) and 43 at general hospitals (59.7%). Moreover, 59 (81.9%) hospitals set up day surgery management committees or working groups, 49(68.1%) surgeons acted as the directors of day surgery centers, 34 (47.2%) hospitals were independent day surgery centers and 58 (80.6%) operated anesthesia clinics. For management, preoperative evaluation plans were conducted at 70 (97.2%) hospitals, perioperative patient education was implemented at 69 (81.9%) hospitals, surgeon admission standards were applied at 61 (84.7%) hospitals, 62 (86.1%) operated follow-up systems, 59 (81.9%) implemented day surgery performance assessment programs, 51 (70.8%) had quality assessment program and 46 (63.9%) operated day surgery information management systems.Conclusions:With a rapid development of pediatric ambulatory surgery, safety always comes first. The system of ambulatory surgery should be strictly formulated and implemented. Class IIIA hospitals are major institutions for practicing ambulatory surgery for pediatrics. More multi-center studies and ERAS during ambulatory surgery are recommended. Promoting the formulation of standards for ambulatory surgery for pediatrics may contribute to its expansion at primary hospitals.

目的 :了解新型冠状病毒疫情期间规培医生对职业责任认知的情况,为职业精神教育提供参考.方法 :对浙江省三家医院254名规培医生进行问卷调查.结果 :规培医生对疫情认识是客观理性的,疫情的有效控制加强了规培医生对职业责任感和职业认同感的认知,公共医疗危机教育尚需加强.结论 :公共医疗危机后期是加强规培医生职业精神教育的时机,同时应加强公共医疗危机的教育.