Definition of short stature: Short stature is defined as individuals of the same race and age of the same sex whose height is less than 2 standard deviations (-2SD) or less than the 3rd percentile (-1.88SD) of the mean height of the normal population under similar life circumstances, some of which are normal physiological variants. For proper diagnosis, appropriate clinical observations and laboratory tests must be performed in children with growth retardation. Etiology: There are many factors leading to short stature, including many interactions, and the mechanism of short stature due to many diseases has not been elucidated so far. Diagnosis: A thorough examination must be performed to identify the cause of the disease in order to facilitate treatment. History: Pregnancy of the child’s mother, birth history of the child, length and weight at birth, growth history, parental puberty and short stature in the family. Physical examination: Proper measurement and recording of the following: (1) current height and weight measurements and percentile; (2) annual growth rate of height (observed for at least 3 months); (3) target height measured from the height of the parents; (4) BMI; (5) sexual developmental staging. Laboratory tests: should? Blood and urine tests and liver and kidney function tests should be routinely performed; blood gas and electrolyte analysis are recommended for suspected renal tubular acidosis; karyotype analysis is required for all girls; to exclude subclinical hypothyroidism, thyroid hormone levels should be routinely tested. Bone age (BA) is a good indicator for assessing the development of an organism, as the development of bones is a process of growth and development, and is determined by observing the growth and development of each ossification center in the orthopantomograph of the left wrist, palm and finger bones. At present, the most used methods at home and abroad are G-P method (Atlas method) and TW3 method (Tanner-Whitehouse), and the G-P method is mostly used in our clinic. Under normal circumstances, the difference between the bone age and the actual age is between +-1 year, and it is abnormal if it is too far behind or too far ahead. Special tests: Indications: (1) height below the normal reference value of -2SD (or below the 3rd percentile); (2) bone age more than 2 years below the actual age; (3) height growth rate <7cm/year for children <2 years old; <5cm/year for children 4-5 years old to adolescence, and <6cm/year for adolescence; 1: Growth hormone-insulin-like growth factor I axis (GH-IGF- I) functional assay: drug provocation test: insulin, arginine, colistin, levodopa, etc.; GH peak <5ug/L is considered complete growth hormone deficiency (GHD); between 5-10ug/L is considered partial deficiency (pGHD); 2: IGF-I and IGF-BP3 assay; 3: IGF-I production test; 4: imaging of hypothalamus and pituitary gland; 5. Karyotype analysis. Differential diagnosis: e.g., chondrodysplasia, hypothyroidism, Prader-Willi syndrome, etc. Treatment: Growth hormone: genetically recombinant human growth hormone (rhGH). Since 1985, when the FDA approved rhGH for the treatment of growth hormone deficiency, the diseases approved one after another include chronic renal failure (1993), congenital ovarian hypoplasia (1996-1997), Prader-Willi syndrome (200), small for gestational age (SGA 2001), idiopathic short stature (ISS 2003), and hypothyroidism. Idiopathic short stature (ISS 2003). Dosage form: domestic? Available are rhGH powder and aqueous, with the latter having a slightly better growth effect. Dose: Currently, the commonly used dose in China is 0.1-0.15U/(kg.d) (0.23-0.35mg/kg per week); for children with pubertal growth, Turner, SGA, ISS and some children with partial growth hormone deficiency, the applied dose is 0.15-0.20U/(kg.d) (0.35-0.46mg/kg per week) (WHO Standard growth hormone 1mg=3.0U) Usage: 1 subcutaneous injection every night before bedtime, the injection site is the outer and anterior flank of the middle 1/2 of the thigh, the injection site should be changed for each injection to avoid repeated injections in a short period of time causing degeneration of the subcutaneous tissue; Course: The course of growth hormone treatment for short stature depends on the need, usually should not be shorter than 1-2 years, when too short, the child's benefit is not significant for his lifelong height. Side effects? : Common side effects are; (1) Hypothyroidism: Occurs every 2-3 months after the start of injection and can be corrected by giving L-thyroxine tablets as needed. (2) Altered glucose metabolism: long-term, higher doses of growth hormone may? occur as insulin resistance, with elevated fasting glucose and insulin levels, but rarely above the high normal limit, which can be recovered after several months of growth hormone discontinuation. (3) Idiopathic benign cranial hypertension; mostly occurs in chronic renal? failure, Turner, children with growth disorders caused by GHD, GH treatment can be suspended and small doses of dehydrating agents can be added; (4) slippage and necrosis of femoral head; because the growth of epiphysis is accelerated and muscle strength is increased after treatment, when movement increases, it is easy to cause slippage and aseptic necrosis of femoral head, resulting in lameness, and also causes knee and hip pain, GH treatment can be suspended and treated with vitamin D and calcium tablets. (5) Possibility of tumor induction: The analysis of a large amount of epidemiological data shows 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 tendency of tumor occurrence in families and malformation syndrome. The IGF-I level should be closely monitored during the treatment process and should be temporarily discontinued if it exceeds the normal reference value +2SD. Follow-up: All children with diagnosed short stature should be followed up for a long time. A follow-up visit should be conducted once every 3 months after treatment with growth hormone to measure height, assess growth rate, and also to test IGF-I, IGF-BP3, T4, TSH, glucose and insulin. Bone age should be checked once a year. Sexual development should be observed during the course of treatment and treated as needed. Repeat cranial MRI scans should be performed periodically for suspected intracranial lesions.