Etiology: ACTH-dependent, pituitary ACTH tumors or ACTH cell hyperplasia (i.e., Cushing’s disease), extra-pituitary tumors that secrete ACTH (i.e., ectopic ACTH syndrome); non-ACTH-dependent Cushing’s syndrome, adrenal adenomas, adenocarcinomas, or macronodular hyperplasia that secrete cortisol autonomously. Diagnosis: Cushing’s syndrome should be excluded in obese hypertensive patients with the following manifestations: 1. centripetal obesity, buffalo back, supraclavicular fat pad, full moon face, polycythemia, thin skin, bruising, wide purple lines, and muscle atrophy. 2, hypertension, hypokalemia, alkalosis. 3.Decreased sugar tolerance or diabetes mellitus. 4, osteoporosis, pathological fracture, urinary stones. 5.Decreased sexual function, male impotence, female menstrual disorders, hirsutism, infertility, etc. 6.Children’s growth and development retardation. 7.Nervous and mental symptoms. 8, susceptible to infection, decreased body resistance. Laboratory tests include blood cortisol (F) measurement, 24-hour urinary 17-hydroxycorticosteroid measurement, 24-hour urinary free cortisol measurement, small-dose dexamethasone suppression test, insulin hypoglycemia test, high-dose dexamethasone suppression test, blood ACTH measurement, CRH excitation test. Imaging tests for Cushing’s syndrome include B ultrasound, CT and MRI of the adrenal glands, MRI of the pterygoid saddle, and X-rays of the chest and skeletal system. Treatment: For those with clear pituitary tumors in Cushing’s disease, transnasal transsphenoidal pituitary microsurgery is preferred. For imaging, although not very certain, but other indicators are supporters, it is also worthwhile to do pituitary exploratory surgery with an efficacy of 70%-80%, and for those who do not have complete remission after surgery, add pituitary radiotherapy. The traditional approach of total adrenalectomy on one side plus major adrenalectomy on the other side, plus pituitary radiotherapy, is still being performed in China. Drug therapy can be used as an adjunct. The key to the treatment of ectopic ACTH syndrome is to find the tumor, and complete removal of the tumor is ideal. Surgical removal of adrenocortical adenoma is very effective, and corticosteroid replacement therapy should be given appropriately for a period of postoperative adrenocortical hypofunction.