1.What is precocious puberty? Precocious puberty is a kind of abnormal development of youth, which is manifested by the early appearance of pubertal characteristics such as sudden increase in growth, maturation of reproductive organs and sexual characteristics. It is generally considered that precocious puberty can be diagnosed when sexual characteristics appear before the age of 8 for girls and 9 for boys, or when menstruation appears before the age of 10 for girls. In recent years, the incidence has increased significantly, and it has become one of the most common pediatric endocrine diseases, and the incidence of girls is 4~5 times higher than that of boys. 2.What are the adverse effects of precocious puberty on the affected children? (1) Early puberty and early appearance of sexual characteristics, girls have early breast development and even menstruation, but they cannot take care of themselves in life, and their intelligence and sexual psychology are not yet mature, which can easily cause social problems and impose mental and life burdens on parents; (2) Due to accelerated bone growth and early epiphyseal closure, although they are temporarily taller than other children of the same age, they are often shorter than normal in adulthood. In typical children with true precocious puberty, about half of them tend to end up with a height of less than 150cm, which will adversely affect their future education, employment and even choice of spouse. The actual type of sexual precociousness can be divided into true, pseudo and partial sexual precociousness. True precocious puberty, also known as central precocious puberty, is due to the early activation of the regulatory system that controls the development of youth in the body, and the process of puberty development and reproductive ability also appears in advance. The majority of these patients are due to abnormalities in the neuroendocrine regulation of the brain, and those without organic lesions are called idiopathic precocious puberty, accounting for about 85% of true precocious puberty in girls and 40% of true precocious puberty in boys. A small number of true precocious puberty is caused by organic lesions of the central nervous system, commonly tumors, inflammation, trauma, etc. Pseudosexual precocious puberty, also known as peripheral precocious puberty, is caused by gonadal tumors, adrenal hyperplasia or tumors that produce large amounts of sex hormones, and also by the intake of more drugs or foods containing sex hormones. For example, taking contraceptive pills by mistake, or taking long-term supplements containing royal jelly, pollen, chicken embryo, silkworm pupae or animal colostrum, which contain more sex hormones or components of sex hormone-like structure, or even gonadotropic factors, can cause the manifestation of precocious puberty, but not reproductive ability, and this type is called pseudo-precocious puberty. Partial precocious puberty mainly refers to the early development of breast only, not accompanied by other sex characteristics development and growth acceleration. (1) First of all, for children with precocious puberty, we should take medical history to find out whether they have taken health care products or taken drugs containing sex hormones (contraceptive pills by mistake) and come into contact with articles containing sex hormones (cosmetics containing estrogen), whether they have central nervous system diseases (encephalitis, trauma, etc.), and the developmental age of their parents. (2) Physical examination, measurement of height and weight, physical development; measurement of breast and testicular size, making a judgment of the severity of the condition based on the development and degree of secondary sexual characteristics and external genitalia, selecting items for laboratory examination, and identifying the type of precocious puberty through special examination. (3) Bone age film, an X-ray of the hand and wrist bones is taken to determine the age of bone development called bone age. In children with true precocious puberty, the bone age is often ahead of the actual age due to the abnormal acceleration of bone growth and development; based on the size of the gap in the epiphysis on the X-ray, the growth potential of the child can be determined and the future height can be predicted. (4) Ultrasound of the uterine ovaries, (1) to determine the volume and development of the uterine ovaries, the size and number of follicles, and to determine the degree of development of the child; (2) also after treatment, by observing the size of the uterine ovaries, to determine the efficacy of medication and to guide the adjustment of the treatment plan; (3) also to accurately determine the presence of occupying lesions such as ovarian cysts or solid tumors. (5) Determination of endocrine function, blood sex hormones and gonadotropins, and diagnostic tests of gonadotropin-releasing hormone excitation test if necessary. (6) Magnetic resonance or CT of the pituitary gland of the head to exclude true precocious puberty due to organic diseases.