Abstract: Based on years of ancient literature research and clinical experience, Professor Pin-kang Wei developed the phlegm theory of gastric cancer. In light of the properties of gastric cancer and the method of differentiating syndromes within the traditional Chinese medicine (TCM) paradigm, it is believed that gastric cancer is closely related with phlegm. Much ancient literature regarding the relationship between phlegm and gastric cancer was reviewed to explain the rationale and academic inheritance of the phlegm theory. In this theory, gastric cancer is regarded as a form of phlegm stagnation and consists of phlegm core, phlegm collateral and phlegm contamination. In order to explain the mechanism of development, recurrence and metastasis of gastric cancer, phlegm contamination is regarded as the most fundamental cause and pathogenesis of gastric cancer. The therapy of resolving phlegm and dispersing nodules is suggested for the fundamental treatment of gastric cancer.

Objective To summarize the herbal medication in treating malignant ascites based on literature. Methods TCM literatures concerning malignant ascites from CNKI (1989.1-2013.3) were retrieved. The herbs and those category, nature, flavor and meridian distribution were summarized by frequency method. The couple herbs were analyzed by hierarchical cluster analysis. Results Fifty-five qualified documents and 56 effective prescriptions were collected. A total of 164 herbs were used (668 frequencies). Six groups of herbs, cumulative relative frequency (CRF) of 61.83%, were used frequently in order as follows:the herbs for promoting diuresis and resolving dampness, invigorating qi, invigorating the blood and removing blood stasis, regulating qi, eliminating heat and toxin, excreting drastically water. The most frequently used herbs (>6 frequencies, CRF 53.74%) had 25 species. The first three places were the herbs for promoting diuresis and resolving dampness (5 species), invigorating qi (4 species), invigorating the blood and removing blood stasis (3 species). These herbs were mostly of warm nature (260 frequencies, 38.92%). The total frequency of herb-nature was 1055 and the sweet (354 frequencies, 33.55%), bitter (284 frequencies, 26.92%) and pungent (268 frequencies, 25.40%) herbs were used more frequently. The total frequency of meridian distribution was 1747 and these herbs were mostly attributed to spleen, lung, liver, and kidney meridians (>200 frequencies). The most frequently used couple-herbs included Poria and Rhizoma Atractylodis Macrocephalae, Radix Astragali and Ramulus Cinnamomi, etc. Conclusion Invigorating qi was emphasized in treating malignant ascites, combined with promoting diuresis. The herbs of the warm and cold nature, the sweet, bitter and pungent flavor, spleen, lung, liver and kidney meridians were most frequently used.

Professor Wei Pin-kang developed phlegm theory for gastric cancer. He adopted the therapy of resolving phlegm and dispersing nodules as the fundamental therapy for gastric cancer. As the symptoms may vary due to the changes of etiology and pathogenesis at different stages of gastric cancer, he further formulated eight therapies based on the fundamental therapy, namely, resolving phlegm and regulating stomach, resolving phlegm and removing stagnancy, resolving phlegm and clearing heat toxin, resolving phlegm and relieving qi depression, resolving phlegm and dredging collaterals, resolving phlegm and removing blood stasis, resolving phlegm and promoting diuresis, and resolving phlegm to soften abdominal mass. These therapies showed satisfactory effects following the principle of simultaneous treatment of disease and symptoms.

OBJECTIVE: To observe the influence of Xiaotan Sanjie Recipe on growth of the transplanted tumor and expressions of proliferating cell nuclear antigen (PCNA) and epidermal growth factor receptor (EGFR) in tissue of the gastric carcinoma of nude mice, and to explore the mechanism of Xiaotan Sanjie Recipe in restraining the multiplication of the stomach cancer. METHODS: MKN-45 gastric carcinoma model in nude mice was established. Forty-five nude mice were randomly divided into control group, Xiaotan Sanjie group and 5-fluorouracil (5-FU) group. Drugs were given on the next day of inoculation. Mice in the control group were given normal saline, and mice in the Xiaotan Sanjie group were given Xiaotan Sanjie Recipe. Intraperitoneal injection of 5-FU was administered in the 5-FU group. The expressions of PCNA and EGFR were examined by using streptavidin peroxidase (SP) conjugate technique, and the tumor weight and pathological characteristics were also observed. RESULTS: Compared with the control group, Xiaotan Sanjie Recipe significantly restrained the growth of the transplanted tumor, and reduced the expressions of PCNA and EGFR in tissue of the gastric carcinoma of nude mice (P<0.05). CONCLUSION: Xiaotan Sanjie Recipe can disturb the synthesis of DNA and reduce the proliferous activity of cancer cells by decreasing the expressions of PCNA and EGFR.

Objective To investigate the clinical efficacy of combination of umbilical compress therapy with Xiaotan Lishui Gel and intraperitoneal chemotherapy with cisplatin in patients with gastric cancer ascites. Methods A total of 78 patients were included and divided randomly into treatment group (39 patients) and control group (38 patients). Patients of both groups received intraperitoneal chemotherapy with cisplatin, and the treatment group received additionally umbilical compress therapy of Xiaotan Lishui Gel. Two weeks were regarded as a course of treatment. All patients were followed up for 180 days. The total effective rate, puncture-free survival, interval time of puncture, median survival time, life quality, improvement of symptoms and safety of the two groups were observed. Results Finally 73 patients completed the observation. The total effective rate was 56.76%(21/37) in the treatment group and 33.33%(12/36) in the control group, with statistical significance (P=0.044). The puncture-free survival and interval time of puncture were 59 d and 62 d, respectively, and 49 d and 54 d in the control group, respectively (P<0.05). There was no difference in median survival time between the two groups. Karnofsky performance status in the treatment group was significantly higher than the control group (P=0.012), and decreased mobility, abdominal pain, abdominal distension, early satiety and urinary frequency in the treatment group were better improved than the control group (P<0.05). Conclusion Combination of umbilical compress therapy with Xiaotan Lishui Gel and intraperitoneal chemotherapy with cisplatin can postpone the ascites increasing speed of patients with gastric cancer ascites, and improve patients’ life quality.

An abnormal microenvironment which is not fit for the living of normal cells is induced and maintained due to rapid growth, abnormal energy metabolism and self-regulation of specific proteins of the tumor cells. At the same time, the abnormal microenvironment is the guarantee of the neoplastic transformation, proliferation, invasion and metastasis of tumor cells. The microenvironment mainly consists of interstitial cells and their components. There are correlations between the physiological role of body fluid and the physiological functions of microenvironment. Phlegm is the product of abnormal body fluid metabolism. So to discuss the correlations of them may contribute to clarifying the material base of phlegm and will further give new insight for integrated traditional Chinese and Western medicine in cancer research.

Objective To explore the mechanism of Xiaotansanjie recipe on MKN-45 human gastric cancer orthotopic transplantation tumor with microsatellite instability. Methods MKN-45 human gastric cancer cell line was used to establish subcutaneous tumor model in nude mice as an experimental model which passed three generations of tumor source. Then OB glue was used to establish human gastric cancer orthotopic xenograft model. Twenty model nude were divided into model group and Xiaotansanjie recipe group (treated with Xiaotansanjie recipe). After 6 weeks of treatment intervention, tumor weight was measured, inhibitory rate was calculated and microsatellite instability (D17S250, D2S123, D5S346, Bat-25 and Bat-26) was detected. Results The tumor weight in Xiaotansanjie recipe group was significantly lower than that in model group (P<0.01). The tumor-inhibition rate was 40.84%. Five microsatellite markers (D17S250, D2S123, D5S346, Bat-25 and Bat-26) were amplified in the tumor tissue of model group, and microsatellite markers D2S123, D5S346 appeared some prolong and reduction. Microsatellite markers (D2S123, D5S346) mutation was stabilized after 6 weeks treatment of Xiaotansanjie recipe. Conclusion Xiaotansanjie recipe can inhibit the MKN-45 human gastric cancer orthotopic transplantation tumor by down-regulating the microsatellite instability.

Objective: To observate the clinical effect of Saffron Multi-glycoside Tablets for cardiac angina belonging to heart blood stasis type. Methods: Saffron Multi-glycoside Tablets were administered orally three times daily, four tablets each time. Results: Not only the degree of heart impediment and chest pain but also attack times and persistent pain changed for the better obviously. The effective rate is 96.67% and the effective rate of ECG is 93.33%, the amelioration rate of Chinese medical symptom is 96.67%. The control group is 72.22%, 66.67% and 69.44%, respectively. There is significant difference between the two groups. Conclusion: There is notable effect to take Saffron Multi-glycoside Tablets for cardiac angina belonging to heart blood stasis type.

Objective To discuss the influence of Recipe Wenzhongxiaotan to S180 bearing cancer mouse interfered by cold pathogenic factor and study correlation factor index. Methods To treat S180 bearing cancer mouse by interfere in ice water with Recipe Wenzhongxiaotan, with the control of Recipe Xiaotansanjie group and chemotherapy group, the change of morphology and rectal temperature in mouse, growth velocity and volume in tumor after treatment with Recipe Wenzhongxiaotan were observed, and TXB2 in plasma of mouse was detected by RIA. Results It showed late and short in chilly morphology and rectal temperature amplitude small than other groups in Recipe Wenzhongxiaotan group. The rate to restrain tumor growth was 86.69%, 75.29%, 87.55% in Recipe Wenzhongxiaotan group, Recipe Xiaotansanjie group and chemotherapy group (FT-207), respectively. TXB2 was near in Recipe Xiaotansanjie group and chemotherapy group and the difference was significant compared cold model group (P 0.05) in Recipe Wenzhongxiaotan. Conclusions It may be restrain tumor growth which S180 tumor-bearing mice interfered by cold pathogenic factor and degrade TXB2 in Recipe Wenzhongxiaotan, the rate to restrain tumor growth was near to FT-207 and Recipe Xiaotansanjie.