When the body fat and protein decrease, and the weight loss exceeds 10% of the normal standard, it is called wasting. The wasting referred to here is generally progressive in the short term, with weight loss measured before and after the weight value control, and there is obvious evidence of looser clothes, looser belt, larger shoes and reduced subcutaneous fat, thin muscles, loose skin, prominent bones, etc. What is the diagnosis of generalized wasting type? 1, hypothalamic syndrome Patients show wasting, anorexia and refusal to eat, mental abnormalities, hypogonadism, abnormal thermoregulation and symptoms related to the etiology (see section on hypothalamic syndrome). 2, hypopituitarism wasting (1) uremia: refers to the syndrome caused by insufficient secretion of antidiuretic hormone (ADH) (pituitary uremia) or defective renal response to antidiuretic hormone (nephrogenic uremia). Pituitary uremia of unknown origin (also known as primary) accounts for 1/3 to 1/2, genetic (familial) uremia is rare (accounting for 1%), secondary is more common because of tumors, such as craniopharyngioma, pituitary tumor, pineal tumor. Glioma and meningioma, etc. Craniocerebral trauma, post-surgery is the next most common, others such as inflammation, sarcoidosis, blood disorders (leukemia), nodular disease. Yellow tumors, etc. Clinical manifestations are polyuria, irritable thirst, excessive drinking, low relative density of urine <1.006, partial enuresis up to 1.010 in severe dehydration, urine osmolality mostly <200 min/kg. more severe patients have anxiety, wasting, lack of sleep, lack of appetite, weakness, etc. The diagnosis is based on the section on abnormal urine output. (2) Anterior pituitary hypofunction (Simmonds disease) due to postpartum hemorrhage is called Sheehan syndrome and is the most common one. Other causes include pituitary tumors, cranial trauma and surgical injury, infection or infiltrative lesions, and after radiation therapy. Due to insufficient or lack of secretion of anterior pituitary prohormone, it causes hypofunction of its target glands a secondary group of Russian gland, thyroid, and hyperaldosteronism. Postpartum hemorrhage caused by Sheehan. syndrome manifested as postpartum anamnesis, amenorrhea, hair loss, genital atrophy, etc., followed by hypothyroidism and hypoadrenocorticism, the patient lack of appetite, emaciation, cold, weakness, low blood pressure, slow pulse rate, thin and pale skin, severe cases of hypoglycemia, shock, coma. It is called pituitary crisis. Psychiatric symptoms may be present. Headache and hemianopia may be caused by pituitary tumor. X-ray cranial film may show enlargement of the pterygoid saddle, and CT and MRI may show the presence of tumor. Laboratory tests show that the anterior pituitary hormone level is reduced, thyroid function test, adrenocortical function test and gonadal function test are lower than normal. 3.Primary chronic hyperalgesia Primary chronic hyperalgesia: also known as Adison's disease. It is caused by adrenal atrophy (autoimmune) and tuberculosis. The main manifestations include skin and tympanic membrane pigmentation, wasting, weakness, marked loss of appetite, nausea, and low blood pressure. Diagnosis based on: ① characteristic manifestations: ② urinary 17-OHCS and urinary 17-KS levels decreased original free cortisol levels, plasma ACrIH levels increased (morning normal value of 4.6~30.6 pmol/L i.e. 21~13qpg/ml), ACTH excitation test plasma cortisol levels remained below normal (<413.85nmol/L i.e. <15mg/ dl). In some patients, calcifications were seen in the adrenal region on abdominal x-ray. 4, hyperthyroidism Typical hyperthyroidism includes proptosis, goiter with vascular murmur, hyperphagia, fever, sweating, palpitations, frequent bowel movements and weight loss, etc. There is no difficulty in diagnosis. 5, diabetes mellitus Insulin-dependent diabetes mellitus (IDDM, type l) has a more rapid onset, often with obvious polyhydramnios, polyuria, polyphagia, weakness and wasting; non-insulin-dependent diabetes mellitus (NIDDM, type 2) develops to a large number of diabetes mellitus when weight loss is faster, early triglycerides symptoms are not obvious, often due to large and medium-vessel atherosclerosis and other complications first. Diagnosis is mainly based on fasting blood glucose (≥ 7.8 mmol/L) and postprandial 2b blood glucose ≥ 11.1 mmll/L, (see section on diabetes) 6, chromophobe cell carcinoma occurs in the adrenal medulla, sympathetic ganglion or other parts of the chromophobe tissue tumors, due to its paroxysmal or persistent secretion of catecholamines, causing paroxysmal or persistent hypertension, headache, sweating, metabolic disorders syndrome, basal metabolic rate increased (hyperthyroidism), weight loss, etc., but normal thyroid function tests.