Height measurement: The height must be measured monthly after treatment for dwarfism. Since the change in height within a month is relatively small, we need to measure it as accurately as possible. Accurate height measurement needs to pay attention to the “four same”: 1. the same time, because after standing or sitting up, the vertebral space of the human spine will be compressed, the height will be different in the morning and evening, the same time measurement is comparable; 2. the same measuring tape; 3. the same measurer, different people, the tightness of the tape card in the head will be different; 4. the same child Standing method (required to take off shoes, heels, hips, shoulders and head all against the wall, chest, abdomen, waist as straight as possible, eyes flat, head do not tilt too much, otherwise the highest point of the head can not be measured). If you measure at home, you can put a piece of paper on the wall and draw a line on the paper after each measurement. You don’t need to measure the specific height of each measurement, you just need to distinguish the difference from the previous month. From time to time, parents will respond, “My child grew by 2CM last month, but how come he didn’t grow at all this month?” This is mainly related to the measurement error. After a longer period of treatment, the growth rate can be averaged over several months. Note: Don’t measure height too often, usually once a month is enough, otherwise it will easily cause psychological pressure to the child, and too much psychological pressure is not conducive to the growth of height. Growth hormone treatment review time and items: For those who apply growth hormone treatment, after 3~6 months of treatment, thyroxine (mainly FT3, FT4 and TSH) and blood glucose need to be rechecked. Since most of the treated patients are dwarf patients with too slow growth rate and low thyroxine requirement in the past, the thyroxine requirement increases after the growth is significantly accelerated, and a few people may cause a relative deficiency of thyroxine. Insufficient thyroxine, which requires oral levothyroxine tablets for a short period of time, will affect the efficacy of growth hormone (there are also a few people with slightly high thyroxine due to over-regulation of thyroxine, at this time, as long as TSH is not low, there is no need to deal with it, and continued use of growth hormone will often automatically drop to normal). For those with precocious puberty who apply growth hormone in combination, since the growth rate is not significantly faster than in the past, a review in about 6 months can be considered. The review of IGF is not only an important indicator of the safety of medication, but also an important indicator of the dose adjustment of growth factors. The latest data show that timely adjustment of growth hormone dose according to IGF-1 has significantly better therapeutic effect than traditional fixed dose. Subsequent review is usually done once every six months. Growth hormone dose adjustment: Growth hormone generally does not need to be adjusted within a short period of time, and weight changes not exceeding 10% generally do not need to be adjusted, and even if adjusted, it is not only based on growth rate or weight. It is also necessary to consider different etiologies, the results of the growth hormone provocation test before the initial dosing, pubertal development, bone age size, and especially the results of IGF-1 and IGFBP-3 review. Regular review is also necessary! While the effectiveness of treatment is important, the safety of medication is even more important! The range of growth hormone doses is wide. For those with small bone age and ample treatment time, we generally start with a smaller dose within the normal range, if the small dose is more effective, the cost is relatively lower and side effects are less likely to occur, if the effect is not satisfactory, then consider adjusting the dose. For children with older bones and limited treatment time, generally start with a medium or large dose of the normal range, as time is limited and slow observation may affect the final treatment effect. Growth hormone discontinuation indicators: For those who start treatment at a younger age, they can temporarily stop for a period of time when their height reaches or slightly exceeds that of their peers (usually it takes 2~3 years or longer), and then use it again when their height is significantly lower than that of their peers. For those who are older, due to the limited treatment time, the indicator of stopping the drug is to stop when the monthly growth rate is less than 4mm for three consecutive months (although the application may still improve 1 or 2mm per month, but the available time is already very little, there is no substantial meaning). However, for those whose height has approached normal adult height during the period of use, discontinuation of the drug can be considered, but a detailed assessment of whether the therapeutic objectives have been achieved is needed before discontinuing the drug.