Height measurement: It is necessary to measure the height of patients with either short stature or precocious puberty every month after treatment, and since the change in height within a month is small, it is necessary to measure it as accurately as possible. Accurate height measurement needs to pay attention to “four similarities”: ① the same time, because after standing or sitting up, the vertebral space of the human spine will be compressed, the height of the morning and evening will be different, the same time measurement is comparable; ② the same measuring tape; ③ the same measurer to measure the person, different people, the ruler card in the head of the tightness will be different; ④ the child the same method of standing (requiring shoes off, heels, hips, shoulders and head all against the wall, chest up, stomach in, waist as straight as possible, eyes level, head not too tilted, 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. It is not necessary to measure the specific height of each measurement, but only to distinguish the difference with the previous month. When measuring at home must pay attention to the ruler and the floor level, you need to use a right angle triangle ruler, or use a hard book, one side against the wall, the other side and the floor level. Parents often respond, “My child grew by 2cm last month, but he hasn’t grown at all this month?” The main reason is that it is still related to the measurement error. After a longer treatment time, the growth rate can be averaged over several months (Note: usually do not measure the height too often, usually once a month, otherwise it is easy to cause psychological pressure on the child, too much psychological pressure is not conducive to the growth of height. Review time and items: For those who apply growth hormone treatment, after 3~6 months of treatment, thyroid hormone (mainly check FT3, FT4 and TSH) and blood sugar need to be rechecked. Since most of the treated patients are dwarf patients, the growth rate was too slow in the past and the thyroxine requirement was low. After the growth was accelerated significantly, the thyroxine requirement increased and a few people may cause a relative deficiency of thyroxine. Inadequate thyroxine, which requires oral levothyroxine tablets for a short period of time, can affect the efficacy of growth hormone (there are also a few cases of slightly high thyroxine due to over-regulation of thyroxine, but in this case, as long as TSH is not low, there is generally no need to deal with it, and continued use of growth hormone will often automatically drop to normal). The more the growth is significantly faster than in the past, the earlier the need to review, preferably in 3 months, for precocious puberty combined with the application of growth hormone, because the growth rate is not significantly faster than in the past, can consider about 6 months to review. The review of IGF is not only an important indicator of drug safety, but also an important indicator of growth factor dose adjustment. The latest foreign data show that the treatment effect is significantly better than the traditional fixed dose if the dose of growth factor is adjusted according to the IGF results at the right time. After that, the review is usually once every six months. Growth hormone discontinuation indicators: For those who start treatment at a younger age, the treatment can be temporarily stopped when the height reaches or slightly exceeds the height of the same age (usually takes 2~3 years or longer), and then used again when the height is significantly lower than that of the same age. For those who are older, due to the limited treatment time, the indicator of discontinuation is to stop using the drug when the monthly growth rate is less than 4mm for three consecutive months (although the application may still improve 1 or 2mm per month at this time, but the available time is already very little and has no substantial significance). However, for those whose height is already close to normal adult height during the use of the drug, discontinuation of the drug can be considered, but a detailed assessment of whether the therapeutic objectives have been achieved is needed before discontinuation. Since the dosage of GnRHa treatment in patients with precocious puberty is a difficult issue, it needs to be individualized, i.e., the dosage may be different for each individual, at different times. In particular, it needs to be reviewed from time to time during the first six months to one year of treatment. One month and three months after treatment (in order to reduce the patient’s pain and financial burden, now also often used to simplify to only at about 2 months) should review height growth, sexual development control, ultrasound (girls, boys only need to measure testicular size), sex hormone levels (generally sex hormone six, at least need to include LH, FSH and E2), if necessary, review GnRH stimulation test, etc., every six months Review the bone age in order to adjust the dose when appropriate. If the dose is too high, the growth will be too slow and will not help much to improve the adult height; if the dose is too low, it will be difficult to control during puberty and will not achieve the treatment purpose. According to the guidelines of precocious puberty, it is better to evaluate the bone age in detail, because it is difficult to identify the growth of bone age without detailed evaluation because of the short interval, which is not conducive to dose adjustment. In case of combined growth hormone application, it is also necessary to review the items related to growth hormone treatment. GnRHa discontinuation indicators: application is generally not less than two years, in the bone age and age equivalent, the predicted height is slightly higher than the target height (generally to 2 ~ 3cm higher) can be considered to discontinue the drug. Because after discontinuation, there is still 2~3 months of slower bone age growth time, but after that there is often 2~4 months of faster bone age growth period, the later rapid bone age growth may reduce the predicted height. Alternatively, the drug may be discontinued when the bone age is greater than 13.5 years for girls and 14.5 years for boys, at which point even the combined use of growth hormone will not work to improve lifetime height, but growth hormone may be considered for continued use. For pseudo or partial precocious puberty oral herbal medicine, generally is every 3 months to review ultrasound, sex hormones (generally check sex hormone six, at least need to include LH, FSH and E2), if necessary, review GnRH stimulation test. Bone age is reviewed every six months. Since growth hormone is a hormone normally secreted by the body every day, rhGH is exactly the same as the body’s own growth hormone secretion, there is no need to correlate any abnormalities that occur with rhGH during the medication period. Growth hormone also will not promote sexual development or promote bone age growth as some people think (although growth hormone deficient people may originally have small bone age, after applying growth hormone to make it normal, there is the possibility of transition to normal bone age), otherwise it will not be used to improve lifetime height. If you are more ill, consider stopping the use for a few days as your own growth will be affected. If you have special circumstances, it is not much of a problem to stop using it for a few days. Since normal people also secrete growth hormone every day, the application of general medications or preventive vaccinations, etc., during the use of the drug is not affected. GnRHa is an amino acid replacement of normal human gonadotropin-releasing hormone (GnRH, a 10-peptide), making it bind more strongly to the gonadotropin-releasing hormone receptor on the pituitary gland without acting as a gonadotropin-releasing hormone to inhibit pubertal growth. Overall safety is good. Some side effects on the instruction are mainly for adults, because the adult sex hormone level is high, and the sudden suppression will cause a series of side effects such as osteoporosis and other sex hormone decline, while in precocious children, the sex hormone level should be very low, and the corresponding side effects of sex hormone reduction will not occur after suppression. During the period of medication, the application of general drugs or vaccination is not affected in case of illness, and the same applies to oral Chinese medicine in case of pseudo-precocious puberty. Special Note: After 2 months of GnRHa application, if you wish to receive guidance on the use of the drug through this website after the local review of ultrasound and sex hormones, you must write down in detail the detailed medical history, bone age, predicted height and other examination results before the use of the drug, the mode of use, the name of the drug (for those who apply Inhibiton, it is possible that the injection time will be extended without reducing the dosage) and the dosage, and the changes in height and weight, and the control of sexual development before and after the treatment. We will also provide you with the results of the post-medication examination for comparison. Since the consultation information is not usually at hand when answering inquiries (online dose adjustment is limited to 2 months after GnRHa injection, and it is difficult to make appropriate adjustments through the Internet).