Propranolol (English name: propranolol , Chinese trade name: 心得安) is a first-line drug for the treatment of hemangioma in infants and children, and its effectiveness and safety have been proven. The drug has mild side effects and can be used safely on its own. The first report was published in the New England Journal of Medicine (NEJM) in June 2008, and was also presented at the International Society for the Study of Vascular and Angiomatous Diseases (ISSVA) Congress in Boston, making it one of the most significant discoveries in the history of hemangioma treatment. It is one of the most significant discoveries in the history of hemangioma treatment. Pre-dose physical examination: electrocardiogram, cardiac ultrasound, complete biochemical and routine blood tests. Exclude arrhythmia, severe conduction block, congenital heart disease and other disorders; exclude bronchitis, pneumonia, asthma. Contraindications: Propranolol, a traditional drug that has been used for decades, is indicated with contraindications including cardiac lesions (conduction block), airway sensitivity disorders, ventilation difficulties, or other pulmonary diseases. Drug Specification: 100 tablets/bottle, 10mg/tablet. Dosing method: Day 1: 0.5mg/kg body weight per dose, once in the morning and once in the evening at 8:00 a.m. Day 2: 0.75mg/kg body weight per dose, once in the morning and once in the evening at 8:00 a.m. Day 3: 1.0mg/kg body weight per dose, once in the morning and once in the evening at 8:00 a.m. Day 3: 1.0mg/kg body weight per dose, once in the morning and once in the evening at 8:00 a.m. Day 4: 1.0mg/kg body weight per dose, once in the morning and once in the evening at 8:00 a.m. On the second day, take 3.75mg per dose, measured precisely with a syringe, once in the morning and once in the evening at 8:00 a.m.; on the third day, take 5mg per dose, i.e. half a tablet, once in the morning and once in the evening). Note to parents: Take the weight once a week and set the dosage for the week. The tablets can be ground into a powder or dissolved in water or milk (formula) for precise dosage. Take the tablets half an hour after eating (do not take them on an empty stomach) to avoid hypoglycemia. If children have vomiting and other conditions, do not arbitrarily increase the amount of medicine, rather less than more. Take the medicine does not affect the normal vaccination, 4 hours after taking the medicine can be normal vaccination. Diarrhea, hypotension, bradycardia, hypoglycemia, tracheospasm and other complications may occur after taking the drug. During the whole course of treatment, the child’s breathing, heart rate (measure the heart rate half an hour after taking the medicine and record it), mental status, diet, whether there is milk spillage, sleep, urine and stool, skin rash, especially the respiratory condition, should be closely observed, and if there is any discomfort such as shortness of breath and shortness of breath, the medicine should be stopped immediately and the child should be treated in the emergency room of the nearest pediatric hospital, and the medicine should not be continued. In case of severe diarrhea, the drug should be stopped and taken again after adaptation. Hypotension, bradycardia and hypoglycemia generally have no subjective symptoms and do not require treatment. Other special cases need to be reviewed at any time. Children taking the drug for the first time are recommended to be hospitalized on the first day, while monitoring their vital signs. After 1 month of medication, the child will be registered for a follow-up visit to the hemangioma clinic on Tuesday, and the doctor will judge the treatment effect and formulate a follow-up treatment plan. Adverse effects: Common adverse effects include hypoglycemia, hypotension, slowed heart rate, diarrhea, sleep changes, and asthma attacks, while others such as chills in the hands and feet, irritability, sweating, constipation, convulsions, lethargy, and hypothermia are rare. They usually occur at the beginning of treatment and most of them do not require special treatment or only symptomatic treatment and can recover after a few days without affecting the continuation of treatment. There was no significant difference in blood glucose, liver and kidney function and thyroid function before and after treatment. The efficacy of propranolol on proliferative hemangiomas in infants and children is significantly better than that of glucocorticoids. From the current clinical treatment results, together with the detailed evaluation of safety and side effects established over 40 years of propranolol use in the treatment of cardiovascular diseases in infants and children, propranolol is a safer and more convenient drug for the treatment of hemangiomas in infants and children. Post-treatment response: 1 week after oral administration of propranolol, the tumors began to lighten in color and shrink and soften. After 3 months of treatment, most of the tumors shrank significantly. By the age of 1 year, the tumor is largely regressed, but capillary dilatation may remain on the surface. Significant changes are seen in the first 8 weeks and at 6 months of age, with a >20% decrease in heart rate being an early indicator of onset of action. The effects of propranolol on angiodysplasia are most pronounced during the first week, followed by a slow rate of improvement and sometimes a period of stagnations. The reason for this may be the early presumed vasoconstrictive effect, while the effect of the drug on molecular markers of hemangioma is not clinically evident. However, drug therapy must be continued for at least 6 months, as premature discontinuation can lead to rebound. Discontinuation criteria: complete regression of the hemangioma, or age over 1 year and end of the proliferative phase of the hemangioma. Discontinuation method: halve the number of times in the first 2 weeks, halve the dose in the second 2 weeks and stop the medication. Observe for 1 month, if there is no rebound, complete discontinuation; if rebound, continue to take the drug for 1 month or longer according to the original regimen.