The treatment measures for children with short stature depend on their etiology The growth rate of height of children with psychosomatic and renal tubular acidosis will be increased after the relevant factors are eliminated. Since the FDA approved rhGH for growth hormone deficiency in 1985, the approved diseases include chronic renal failure (1993), congenital ovarian hypoplasia (1996-1997), Prader-Willi syndrome (2000), small for gestational age (2001) and idiopathic short stature (2003). Since most of the younger-than-gestational-age children show catch-up growth within 2-3 years after birth, and their height can reach a growth curve proportional to their target height, the younger-than-gestational-age children should be regularly followed up and observed. In 2003, the FDA approved GH for idiopathic short stature, i.e.: (1) those with unknown causes of non-GH deficiency; (2) those whose height is lower than the normal reference value of 2.25 SD or more for children of the same sex and age; and (3) those who are expected to have a lifetime height of -2SDS or less in adulthood. (1) Dosage form Domestic options include rhGH powder and water, with the latter having a slightly better growth effect. (2) Dose The dose of growth hormone has a wide range and should be adjusted individually according to the need and the observed efficacy. At present, the commonly used dose in China is 0.1-0.15IU/kg・d, 0.23-0.35mg/kg per week; for children with pubertal development, Turner children, children younger than fetal age, children with idiopathic short stature and some children with partial growth hormone deficiency, the applied dose is 0.15-0.20IU/(K.d) 0.35-0.46(J.K) per week (Note: The WHO labeled growth hormone 1J=30): (WHO labeled growth hormone 1J=30U) (3) Usage: 1 subcutaneous injection every night before bedtime, the common injection site is the outer and anterior side of the middle 1/2 of the thigh, and the injection site should be changed for each injection to avoid short-term repetition and degeneration of the subcutaneous tissue. (4) Course of treatment: The course of growth hormone treatment for short stature depends on the need, usually should not be shorter than 1-2 years, too short when the child’s benefit to its lifelong high effect is not great. (5) Side effects: The common side effects are: (1) hypothyroidism: it often occurs 2-3 months after the start of injection and can be corrected by giving L-thyroxine tablets as needed; (2) changes in glucose metabolism: long-term use of large amounts of growth hormone may cause insulin resistance in children. Fasting blood glucose and insulin levels may rise, but rarely exceed the normal high limit, which can be recovered after several months of growth hormone discontinuation, and should be monitored during the course of treatment, especially for those with a family history of diabetes and obese children, The growth disorders caused by chronic renal failure, Turner syndrome and GH deficiency may lead to suspension of GH therapy and addition of small doses (e.g., hydrochlorothiazide) to reduce intracranial pressure; ④ Antibody production: Due to the continuous improvement of preparation purity, the current antibody production rate has been reduced, and the aqueous preparation is even less; ⑤ Femoral head slippage and necrosis: Because of the accelerated growth and muscle strength of the bones after treatment, increased movement may cause femoral head Slip, aseptic necrosis, lameness, knee and hip pain, external rotation pathology, temporary discontinuation of GH and supplementation of vitamin D and calcium tablets 6) local redness or rash of injection: usually disappears within a few days, can continue to use, now rarely seen 7) the possibility of tumor induction: international organizations have conducted relevant research, according to the National Cooperative Growth Group and drug treatment The results show that GH treatment does not increase the risk of leukemia and tumor recurrence in children without potential tumor risk factors, but caution should be exercised in the application of long-term supraphysiological doses of GH in children with previous tumors, genetic predisposition to tumor development in families, and malformation syndromes. The serum IGF-1 level should be monitored closely during the treatment process and should be temporarily discontinued if it exceeds the normal reference value +2SD. Guidelines for the diagnosis and treatment of children with short stature (from Chinese Journal of Pediatrics 2008,46(6)428-430)Guidelines for the diagnosis and treatment of children with short stature (from Chinese Journal of Pediatrics 2008,46(6)428-430)