Pediatric intracranial non-germinoma Tous germ cell tumors (NGGCTs) are a group of rare,highly heterogeneous malignant tumors,encompassing subtypes such as immature teratoma,embryonal carcinoma,yolk sac tumor,choriocarcinoma,and mixed germ cell tumors.The management of NGGCTs requires the integration of multidisciplinary approaches including surgery,chemotherapy,and radiotherapy;however,significant controversies persist regarding treatment sequence,surgical timing,and the selection of chemoradiotherapy regimens.Currently,most international mainstream strategies recommend platinum-based chemotherapy combined with postoperative radiotherapy.In contrast,Asian researchers have proposed an individualized surgery-prioritized strategy based on clinical practice,emphasizing that tumors containing teratomatous components or measuring ≤3 cm should undergo direct surgical resection.

Pediatric glioma,the most common central nervous system tumor in children,has undergone transformative changes in diagnosis and treatment due to advances in molecular biology.The 2021 WHO classification now recognizes pediatric gliomas as distinct entities,highlighting differences in driver mutations,epigenetics,and tumor microenvironment compared to adults.This review summarizes recent progress in molecular subtyping,surgical management,targeted therapy,and immunotherapy.Molecular profiling of BRAF,H3K27M,IDH,and other alterations enables prognostic stratification and guides targeted interventions.Surgical innovations,including advanced imaging and intraoperative monitoring,have improved resection rates and safety for thalamic and brainstem tumors.Targeted agents such as tovorafenib and vorasidenib are expanding treatment options for young children and delaying radiation.Emerging immunotherapies,including GPC2-CAR T cells,show promising efficacy.However,challenges such drug delivery barriers,resistance mechanisms,and research on rare subtypes remain.Multidisciplinary collaboration and precision medicine are steadily enhancing survival and quality of life for young patients.

Objective  Traditional classification systems for skull base lesion surgeries fail to accurately reflect the differences in surgical difficulty.This study aims to establish and validate a multi-dimensional grading sclae for skull base tumor surgical difficulty,to guide clinical decision-making and resource optimization.Methods A total of 131 patients with skull base tumors who underwent surgery at West China Hospital of Sichuan University in 2018 were included in this study.Based on the selfdeveloped “grading scheme for surgical difficulty of skull base tumors” (encompassing nine dimensions such as involved regions,arteries,nerves,and tumor characteristics),patients were categorized into grades Ⅰ-Ⅳ.The baseline data,imaging features,surgical indicators and postoperative outcomes of each group were analyzed to verify the clinical applicability of the scale.Results The surgical difficulty increased progressively from grade Ⅰ to Ⅳ,with significant differences observed in core dimensions such as involved regions,arteries,and nerves (all P<0.05).As the difficulty level increased,the intraoperative blood transfusion rate (0→38.1%),operation time [(1.6±1.5)h →(7.3±4.2)h],hospital stay [(7.6±2.7)d→(15.9±15.2)d],and postoperative complication rates (15.5→52.4%) also increased significantly (all P<0.05).Conclusion This system enables quantitative evaluation-based surgical difficulty gradient classification,compensating for the limitations of the traditional classification system.It provides a scientific foundation for personalized surgical approach selection,DRG-based fine payment,physician training,and promotes the standardized development of the skull base subspecialty.

Objective  To analyze the clinical effect of conservative treatment of 218 cases of simple epidural hematoma (SEDH) in children and establish the prediction model of hematoma absorption.Methods The clinical data of 218 children with SEDH who were treated conservatively in our hospital from August 2023 to March 2025 were analyzed retrospectively.According to the status of hematoma absorption after conservative treatment,the patients were divided into slow hematoma absorption group (n=82) and fast hematoma absorption group (n=136).The clinical data of children with slow hematoma absorption group and fast hematoma absorption group were compared.Logistic regression analysis was used to explore the risk factors of hematoma absorption in children with conservative treatment of SEDH.A nomogram model based on the prediction of hematoma absorption in children with SEDH treated conservatively was constructed and verified internally by Bootstrap method.To analyze the predictive efficacy of risk nomogram model for hematoma absorption in children with SEDH treated conservatively.Results 21 days after injury,37.61%（82/218） of SEDH patients had a hematoma absorption rate of < 0.62ml/d after conservative treatment.The  slow hematoma absorption  group had an average age of (10.43±1.93)years,hematoma volume of (22.09±3.96 )ml,maximum hematoma thickness of (5.92±1.48) mm,admission Glasgow Coma Scale (GCS) score of (13.33±0.55),activated partial thromboplastin time (APTT) of （30.96±8.94） seconds,and fibrinogen level of （2.14 ± 0.58 ）g/L.In contrast,the fast absorption group showed corresponding values of （7.60±1.53 ）years,（12.30±4.13 ）ml,（3.18±1.06） mm,（14.48±0.48）,（28.63±7.46） seconds,and （2.33±0.62 ）g/L.The differences between the two groups were statistically significant (P<0.05).Logistic regression analysis identified age,hematoma volume,and maximum hematoma thickness as risk factors influencing hematoma absorption (P<0.05).According to the results of multi-factor analysis,the nomogram model was constructed,and the calibration curve shows that the model has good fitting degree.The sensitivity of the nomogram model for predicting hematoma absorption in children with SEDH was 89.02% (95%CI:79.71%94.55%),the specificity was 91.91% (95%CI:85.65%~95.69%),and the area under curve (AUC) was 0.958 (95%CI:0.923~0.981).Conclusion The nomogram model based on factors such as age,hematoma volume,and maximum hematoma thickness of hematoma has a good predictive effect on hematoma absorption in SEDH children.