What conditions need to be taken care of during long-term oral hormone therapy and under what circumstances should hormones be discontinued? The following is an introduction to the situations that require discontinuation of hormone use. 1. When live attenuated virus vaccination is required. Note that not all vaccines cannot be administered during oral hormone therapy. Protein vaccines and peptide vaccines are perfectly acceptable, such as pneumococcal vaccine and influenza vaccine. These vaccines are also recommended to be given regularly. However, live vaccines cannot be administered during oral hormone therapy, such as varicella vaccine, which is why emphasis is placed on completing varicella vaccination before treatment begins. If live attenuated vaccine is necessary for various reasons after hormone therapy, it is necessary to discontinue hormone use before vaccination. 2. After the diagnosis of tuberculosis is confirmed. If Mycobacterium tuberculosis infection develops before or during the start of oral hormone therapy, it is necessary to discontinue hormones. Oral hormones can make it more difficult to kill and control Mycobacterium tuberculosis. Because of the refractory nature of Mycobacterium tuberculosis, treatment cycles are long and taking hormones after the disease is controlled may still cause Mycobacterium tuberculosis to resurface. Therefore, tuberculosis is a “roadblock” to oral hormone therapy, and it is important to avoid contact with tuberculosis patients as much as possible to prevent cross-contamination. 3.Serious refractory bacterial and viral infections. Here I would like to remind you that you should not stop using hormones once you have a cold or fever. On the contrary, there is no need to stop oral hormone treatment in general infections, but to go to the hospital as soon as possible and give antibiotics and other targeted treatment, which usually will control the disease quickly. Only when the doctor determines that the infection is a serious refractory bacterial or viral infection should the hormone treatment be stopped under the guidance of the doctor. 4, when the fungal infection. Fungal (mold) infection is a rare infectious disease that rarely occurs. However, if a fungal infection is diagnosed, oral hormone therapy needs to be discontinued due to the complexity and difficulty of its treatment. 5. when surgery is required. patients with DMD may require surgical treatment because of the combination of other diseases. Several of our patients have undergone hernia surgery, orthopedic surgery and even cardiac surgery with no special risk. Since oral hormone therapy is not conducive to infection control and wound healing after surgery, in many cases, surgeons will ask patients to stop taking oral hormones or reduce the dose to the lowest dose before performing surgery. 6. In case of severe fracture. Hormone therapy is not conducive to bone regeneration and healing at the fracture site, so discontinuation of oral hormone therapy will be considered in the case of severe fractures. However, it is also necessary to distinguish the specific situation. If the fracture or bone fracture is only minor, it is not necessarily necessary to discontinue the hormone. Other medications, such as diphosphonates, may be used to help the fracture heal. Besides, other common side effects of hormones, such as elevated blood pressure, diabetes, and peptic ulcers, are rare in children with DMD receiving oral hormone therapy from our long-term observations and need not be of particular concern.