Tumor microenvironment (TME) plays a key role in the development and progression of tumors, such as pro?moting local drug resistance, immune escape, and distal metastasis. According to the TME of different individuals, accurate evaluation and selection of clinical medication can effectively control the malignant transformation of carcinoma in situ and metastatic cancer. At present, the main method to treat cancer is chemotherapy, TME can regulate the reaction of the tumor cells to the standard chemotherapy and target drug therapy, so the combination of the targeted TME therapy and chemothera?py will achieve better clinical efficacy. In this review, we summarized the mechanisms of TME in breast cancer, including ex?tracellular matrix, carcinoma-associated fibroblasts, carcinoma-associated macrophages, regulatory T cells and bone marrow mesenchymal stem cells, which providing a theoretical basis for the development of TME targeted therapy.

Objective:To explore the clinical effect of Beling Weitong granule combined with proton pump inhibitors in senile gastroesophageal reflux disease(GERD).Methods:A total of 186 patients with GERD treated in the Second People′s Hospital of Dujiangyan from January 2020 to December 2021 were retrospectively selected as the study subjects, of which 93 patients received proton pump inhibitor (prilosec) orally (control group) and 93 patients received Beling Weitong granule combined with prilosec orally (combination group). Both groups were treated for 8 weeks. Symptom score, reflux symptom-based questionnaire (GERDQ) score, clinical efficacy, serum levels of gastrin-17 (G-17), motilin (MTL), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) before and after treatment and safety were compared between the two groups.Results:After treatment, the symptom score and GERDQ score in the combination group were lower than those in the control group: (8.28 ± 2.57) scores vs. (15.68 ± 3.69) scores, (8.15 ± 2.23) scores vs. (10.50 ± 2.45) scores, there were statistical differences ( P<0.05). The total effective rate in the combination group was higher than that in the control group: 96.77% (90/93) vs. 87.10% (81/93), there was statistical difference ( χ2 = 5.87, P<0.05). After treatment, the levels of serum G-17 and MTL in the combination group were higher than those in the control group, the levels of IL-6 and TNF-α were lower than those in the control group: (7.48 ± 0.96) pmol/L vs. (6.55 ± 0.83) pmol/L, (206.96 ± 37.83) pg/L vs. (184.75 ± 35.69) pg/L, (9.38 ± 1.92) ng/L vs. (14.13 ± 2.04) ng/L, (9.41 ± 1.85) ng/L vs. (12.01 ± 2.11) ng/L, there were statistical differences ( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Beling Weitong granule combined with proton pump inhibitor in the treatment of senile gastroesophageal reflux disease is effective, and it is safe.