A clinical and laboratory analyrsis of the dYnamlc change of plasma cortisol level in tw0 groups of chiIdren with neDhrotic syndrome has been made-a combined treatment group and a control group. The former was given long-term large dosage prednisone co rnbined with "Z1 Yin Jiailg Huo" and "Wen Bu Shen Yang" drugs, while the latter received no traditionaI medieine during pred-nisone administration The aim of the present study is to find Out whether tra-ditional medicines can protect the adrenal cortex. and antagonize the negative feed-back action Of exogenous steroid, thereby providing a theoretical and labora tory basis for dinical use of traditional medicines in reducing severe side effects of large dosage of steroid. Our results show: 1. Large dosage prednisone, either given daily in diVided doses or once every other day, can significantly suppress the adrenocortical activity, and the suppressive action decreases along with taper-ing off of the dosage of prednisone. 2. "Wen Bu Shen Yang" drugs can remark ably protect the adrenal eortex and antagonize the negative feed-back action of exogenous glucocorticosteroid. 3. "Zi Yin Jiang Huo" drugs possess no significant influence on plasma cortisoI level during long-term large dosage steroid therapy.

本文检测了四种先天性心肚病患儿各9例矫活手术前后的血浆皮质醇。结果表明患儿肾上腺皮质在术后出现了强烈的应激反应，直至术后七口尚未完全恢复，且血浆皮质醇升高的程度与机体对手术应激反应的强度密切栩关。据此并结合对术后并发症发生率及激素使用情况的分析，认为对于大多数施行体外循环的先心病患儿，木中、术后不宜常规预防性地应用皮质激素药物。

我们测定了42例单纯性肥胖症小儿的肾上腺皮质功能，结果显示：①1/3的患儿血浆总皮质醇(PTC)昼夜节律正常，而其余2/3的患儿存在不同程度、不同类型的异常；②展游离皮质醇(UFC)的含量在正常范围；③地塞米辁抑制筛查试验正常。表明多数单纯性肥胖症患儿的肾上腺皮质功能活动水平较高，但对地塞米松的反馈抑制作月仍十分敏感，与正常小儿及柯兴综台征患者均有显著不同。

对处于青春发育不同阶段的57例女性特发性真性性早熟患儿进行了下丘脑-垂体-卵巢轴功能及子宫卵巢容积的测定，并将各项指标与性早熟的程度做相关分析，结果表明：（1）性早熟的程度与患儿的病程长短、骨骼生长加速的程度、子宫卵巢容积大小以及下丘脑-垂体-卵巢轴功能亢进的程度密切相关，而与起病年龄无关；（2）特发性性早熟患儿的下丘脑-垂体-卵巢轴提前发动，功能亢进。其GnRH兴奋试验的反应曲线具有特征性的改变；（3）特发性性早熟患儿与正常青春发育相比，其内生殖器官的发育较不成熟，体积相对较小。

目的：观察滋阴泻火中药改善性早熟儿童骨骼发育的作用并探讨其作用机理。方法：女性特发性性早熟患儿，50例采用滋阴泻火中药与甲地孕酮联合治疗，32例单纯采用甲地孕酮治疗，疗程为一年。对照组25例不用药物治疗。于治疗前后分别进行生长速率和X线骨龄的测算、桡骨骨密度和血清骨钙素水平的测定以及最终身高的预测。结果：对照组于1年后骨龄差/年龄差（△BA/△CA）值从1.39±0.24上升为1.54±0.20(P<0.01)，最终身高预测值从154.2±5.3cm下降至149.4±4.8cm(P<0.01).单纯使用甲地孕酮治疗，对患儿骨龄提前及最终身高预测值下降的这种趋势无明显的影响。联合治疗的患儿生长速率减慢，△BA/△CA值从1.36±0.19下降为0.65±0.16(P<0.001)。骨密度从0.585±0.052g/cm2（P<0.05），血清骨钙素从16.85±3.16μg/L下降为10.06±3.37μg/L（P<0.001）。最终身高的预测值从153.6±3.8cm增加至158.8±4.4cm(P<0.001)。结论：滋阴泻火中药可明显减慢性早熟儿童的骨骼生长，延缓其骨骼成熟，从而防止骨骺过早融合并改善最终身高。滋阴泻火中药对成骨细胞过度亢进的功能活动有明显的抑制作用，这可能是其改善性早熟儿童骨骼发育的主要作用环节及作用机理之一。

目的：从证的客观化及证效关系两个方面探讨性早熟女童肾阴虚相火旺证的物质基础。方法：对75例真性性早熟女孩的阴虚火旺证象作了临床中医辨证，并进行了下丘脑-垂体-卵巢轴功能的测定及子宫卵巢容积的测定。经滋阴泻火中药的治疗获临床缓解后，再重复中医辨证及上述测定，并与治疗前对比分析。结果：每例患儿均呈现不同程度的阴虚火旺证象，且大多十分显著。下丘脑-垂体-卵巢轴的功能测定显示患儿的血清FSH、LH及E2水平均较正常同龄儿显著升高，LHRH兴奋试验呈现功能亢进的特征性变化，表明患儿的下丘脑-垂体-卵巢轴提前发动、功能亢进。经滋阴泻火中药治疗病情缓解后，随着临床上阴虚火旺证象的显著改善，其下丘脑-垂体-卵巢轴功能亢进的程度显著好转，子宫卵巢显著回缩，第二性征明显消退。结论：下丘脑-垂体-卵巢轴提前发动、功能亢进很可能是真性性早熟女童肾阴虚相火旺证的物质基础。

Objective: To find effective therapeutic approach f。r treating true idi。pathic precocious pubertv suitable to OU F national condilion and different from gonadotrophin releasing hormone aIlalogue Metbs: Onc hundred and SIX gifts with idiopathic precocious puberty were divided into 3 groups The 51 girls in the TCM WM group were treated with Chinese herbal medicine combined with megestr. l acctatc(MA), 35 girls in the MA group treated with megestrol acetate alone, and 20 girls were taken 8s control group and given n. trea LIncnt at all Luteinizing hormone releasing hormone (LHRH) sticau]ating test were performed before and after treat ment, and the size ol the uterus and ovary, linear growth rate, X-ray bone age measurement and final heighy prediction were also observed simultaneously Results：Aher t reared with TCM WM for 27 years in average, the luteinizing hormone (LH) peak value of LHRH stimulating test was reduced front 48.5±5.2 IU/L FO 12 2±1.3IU/L, size of uterus and Ovary decreased, secondary sexual characteristics rezressed, the bone age difterence/chronoIogical age difference value (ABA/ACA) reduced from 1.35±0.09 to 0.65+0.05 and predictive final height increased front 153.3±0.5cm to 158.5+0.6cm. Conclusion: TCM-WM therapy could not only modulate the function of hypothalamic-pltuitary-ovarian axis and the development of internal, genhalia. but also cluld decelerate skeletal growth, delay skeletal maturation, and thereby prevent premature epiphyseal fusion and increase the final height of patiehts.

In recent ten-odd years the pathogenetic regularity of female idiopathic precocious puberty was researched in our hospital, in terms of the function of hypothalamic-pituitary-gonadal axis and the status of skeletal development as indicators. The regime of the therapy with a predominance of Chinese herbal medicine (CHM) was formulated, according to recognition for the regularity of differential diagnosis with method of traditional Chinese medicine (TCM). It has been clinically verified that the regime could successfully modulate the course of pubertal development and optimize skeletal development in children with precocious puberty. The mechanism of effectiveness of the drugs has been further researched focusing of the neuroendocrine regulation and gene expression with modern medical technique.