Cancer has become a significant global public health issue， severely impacting public health and societal development. Despite advances in tumor treatment methods in recent years and a gradual decline in cancer mortality rates， drug-related adverse reactions and drug resistance remain substantial challenges. Traditional Chinese medicine （TCM） has demonstrated significant clinical efficacy in cancer treatment and small side effects， making it widely applied in the field of oncology. Xuefu Zhuyutang， derived from Yilin Gaicuo， is known for its abilities to invigorate blood circulation， dispel blood stasis， promote Qi flow， and alleviate pain. It was specifically formulated by the esteemed WANG Qingren of the Qing dynasty for the "blood stasis syndrome in the blood mansion" and is commonly used to treat Qi stagnation and blood stasis syndrome. Clinical studies have shown that Xuefu Zhuyutang， when combined with conventional Western medications， produces significant effects in the treatment of malignant tumors such as liver cancer， lung cancer， and cervical cancer. It substantially reduces the incidence of adverse reactions following Western treatments， including radiation esophagitis， radiation encephalopathy， radiation-induced oral mucositis， and edema. Additionally， it alleviates cancer-related pain and fever， blood hypercoagulability， and associated complications such as depression and anxiety， and also mitigates chemotherapy-induced side effects like hand-foot syndrome. Basic research has demonstrated its potential anti-tumor mechanisms， including the inhibition of Wnt/β-catenin signaling pathway activation， suppression of mitogen-activated protein kinase （MAPK） pathway activation， and anti-tumor angiogenesis. Pharmacological studies have revealed that its active components inhibit tumor cell proliferation and migration， induce tumor cell apoptosis， suppress tumor angiogenesis， enhance the cytotoxicity of natural killer cells against tumors， improve the tumor microenvironment， and regulate immune function. This paper reviewed the latest research progress on Xuefu Zhuyutang in the treatment of malignant tumors from four aspects： theoretical exploration， clinical studies， mechanisms of action， and pharmacological basis， aiming to provide insights and methods for the clinical diagnosis and treatment of malignant tumors.

Cancer has become a significant global public health issue， severely impacting public health and societal development. Despite advances in tumor treatment methods in recent years and a gradual decline in cancer mortality rates， drug-related adverse reactions and drug resistance remain substantial challenges. Traditional Chinese medicine （TCM） has demonstrated significant clinical efficacy in cancer treatment and small side effects， making it widely applied in the field of oncology. Xuefu Zhuyutang， derived from Yilin Gaicuo， is known for its abilities to invigorate blood circulation， dispel blood stasis， promote Qi flow， and alleviate pain. It was specifically formulated by the esteemed WANG Qingren of the Qing dynasty for the "blood stasis syndrome in the blood mansion" and is commonly used to treat Qi stagnation and blood stasis syndrome. Clinical studies have shown that Xuefu Zhuyutang， when combined with conventional Western medications， produces significant effects in the treatment of malignant tumors such as liver cancer， lung cancer， and cervical cancer. It substantially reduces the incidence of adverse reactions following Western treatments， including radiation esophagitis， radiation encephalopathy， radiation-induced oral mucositis， and edema. Additionally， it alleviates cancer-related pain and fever， blood hypercoagulability， and associated complications such as depression and anxiety， and also mitigates chemotherapy-induced side effects like hand-foot syndrome. Basic research has demonstrated its potential anti-tumor mechanisms， including the inhibition of Wnt/β-catenin signaling pathway activation， suppression of mitogen-activated protein kinase （MAPK） pathway activation， and anti-tumor angiogenesis. Pharmacological studies have revealed that its active components inhibit tumor cell proliferation and migration， induce tumor cell apoptosis， suppress tumor angiogenesis， enhance the cytotoxicity of natural killer cells against tumors， improve the tumor microenvironment， and regulate immune function. This paper reviewed the latest research progress on Xuefu Zhuyutang in the treatment of malignant tumors from four aspects： theoretical exploration， clinical studies， mechanisms of action， and pharmacological basis， aiming to provide insights and methods for the clinical diagnosis and treatment of malignant tumors.

Digestive system tumors are the leading cause of cancer incidence and mortality globally， and their occurrence and development generally follow the key pathological process of inflammation-cancer transformation. Therefore， intervening in the precancerous lesion stage is an important strategy to block malignant transformation of the disease and reduce the incidence rate of tumors. Banxia Xiexin Tang-related prescriptions （including Banxia Xiexin Tang， Shengjiang Xiexin Tang， and Gancao Xiexin Tang） originated from the Shanghan Zabinglun They follow the principle of pungent dispersing and bitter descending， combination of cold and warm medicinals， and tonifying deficiency and purging excess， which aligns with the core pathogenesis of digestive system precancerous lesions characterized by cold-heat intermingling and disorder of ascending and descending. These prescriptions are widely used in the clinical treatment of various digestive system inflammatory disorders such as atrophic gastritis， ulcerative colitis， and reflux esophagitis. This review systematically summarizes the theoretical basis， clinical evidence， and therapeutic mechanisms of such prescriptions in preventing and treating the inflammation-cancer transformation process in the digestive system. Clinical studies have shown that whether used alone or in combination with modern therapies， Banxia Xiexin Tang can effectively alleviate symptoms， repair histopathological changes， and improve patients' quality of life. Basic research further reveals that their efficacy stems from multi-target systemic regulatory effects： ameliorating the chronic inflammatory microenvironment， antagonizing oxidative stress， reshaping the gut microbiota， restoring the immune balance， regulating cell proliferation and apoptosis， etc. On the basis of the convergence of traditional Chinese and Western medicine understanding of inflammation-cancer transformation， this article constructs a research framework centered on regulating the inflammatory microenvironment homeostasis to systematically elucidate the mechanism of treating different diseases with the same method （Banxia Xiexin Tang）. In view of the limitations of current research in terms of evidence level， disease-syndrome combination models， and overall mechanism analysis of compound prescriptions， this article proposes future research directions of integrating high-quality clinical research， systems biology， and cutting-edge technologies， providing a new theoretical basis and translational ideas for the precise prevention and control of digestive system tumors with traditional Chinese medicine.

BACKGROUND:Multiple myeloma is one of the most common hematological malignancies,which is difficult to treat,prone to relapse,and resistant to drugs.The endogenous transport system of exosomes plays a communication role by affecting the exchange of functional components between cells.Among them,miRNA is more easily packaged in exosomes due to its small size,so it affects cell function in many ways and over a wide range.OBJECTIVE:To summarize the mechanism of exosomal miRNA in multiple myeloma and to propose potential targets.METHODS:The terms"multiple myeloma,bone marrow mesenchyml stem cell,fibroblasts,peripheral blood,complication,progression,drug resistance,exosomal miRNA"were used as English search terms in the PubMed database.The time frame of the search was from the inception to June 2024.After reading the titles and abstracts,we excluded irrelevant or repetitive literature,and finally included 81 papers for review.RESULTS AND CONCLUSION:(1)Multiple myeloma cells participate in multiple myeloma bone lesions by regulating the balance of osteogenic and osteoclast functions through various miRNA mediated exosomes,regulating erythrocyte calcium ion efflux channels to participate in the occurrence of hypercalcemia,promoting renal epithelial mesenchymal transition leading to renal fibrosis and renal dysfunction,and upregulating bone marrow-derived mononuclear suppressor cells to promote suppression of the immune microenvironment.In addition,miRNAs in the exosomes of multiple myeloma cells are also involved in the occurrence and development of immunotherapy resistance,as well as pathological processes such as angiogenesis,cell proliferation,and cell aging.(2)Both bone marrow mesenchymal stem cells and tumor-associated fibroblasts can affect the proliferation,metastasis,and apoptosis of multiple myeloma cells through exosomal miRNA,interfere with angiogenesis,and regulate the resistance of chemotherapy drugs.(3)Peripheral blood circulating exosomal miRNAs,as cutting-edge noninvasive biomarkers,can play a key role in judging the stage and progression of multiple myeloma disease,predicting patient formation and prognosis,and evaluating drug sensitivity and drug resistance.(4)Multiple myeloma exosomes long non-coding RNA,circular RNA,miRNA,mRNA and target gene can form different combinations,and the flexible construction of new biological axes and biomolecular networks is in line with the development concept of holistic medicine.(5)Exosome miRNA has great development potential as a therapeutic target for predictive biomarkers and new drug research and development.How to maximize the use of exosome miRNA and how to accelerate the clinical transformation of related scientific research results deserve further investigation.

Tumorigenesis， invasion， and metastasis occur in the context of a persistent inflammatory microenvironment， and a variety of inflammatory factors can lead to the development of various tumors. Guided by the thought of "preventive treatment of disease" in TCM and the concept of tertiary prevention in modern medicine， it is of great significance to effectively intervene in the inflammatory stage of the disease， interrupt disease progression， prevent the occurrence of malignant tumors， and reverse the process of "inflammation-to-cancer transformation". Sinisan， a commonly used prescription in the Treatise on Febrile Diseases， has been widely applied in the treatment of precancerous lesions of the digestive system， demonstrating considerable advantages. This article reviewed literature from the past 20 years， summarizing the application of Sinisan in precancerous lesions of the digestive system from three aspects： the exploration of its prescription-syndrome relationship， clinical application， and mechanistic study. It is found that basic syndrome indications of Sinisan include harmonizing the Earth element to promote spleen-stomach transportation and transformation， soothing the liver and nourishing the Wood element to restore the smooth flow of Qi， and regulating Yin and Yang to relieve stagnation within the system. In clinical application， Sinisan has shown significant efficacy in atrophic gastritis and precancerous conditions such as intestinal metaplasia， gastric ulcer， ulcerative colitis， esophagitis， and pancreatitis. Mechanistic studies have revealed that Sinisan can inhibit inflammatory factors and improve the inflammatory microenvironment， inhibit cell proliferation and regulate apoptosis， exhibit anti-angiogenic and antitumorigenic effects， modulate immune function， and exert antioxidant effects. These mechanisms can be achieved by regulating pathways such as nuclear factor erythroid 2-related factor 2/heme oxygenase-1 （Nrf2/HO-1）， farnesoid X receptor （FXR）/Nrf2， phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， Takeda G protein-coupled receptor 5/cyclic adenosine monophosphate/protein kinase A （TGR5/cAMP/PKA）， interleukin-4/signal transducer and activator of transcription 6 （IL-4/STAT6）， Janus kinase/signal transducer and activator of transcription （JAK/STAT）， RhoA/Rho-associated protein kinase （RhoA/ROCK）， and transforming growth factor-β/Smad proteins （TGF-β/Smads）， confirming Sinisan's role in reversing the inflammation-to-cancer transformation. The current research status of Sinisan in precancerous lesions of the digestive system was thoroughly examined through the above three aspects， along with the identification of limitations and areas for improvement in current research. The aim is to provide a basis and support for future in-depth research on Sinisan， promote the development of new integrated treatment models combining TCM and Western medicine for precancerous lesions， and aid in the research and development of drugs related to precancerous lesions.

BACKGROUND:Multiple myeloma is one of the most common hematological malignancies,which is difficult to treat,prone to relapse,and resistant to drugs.The endogenous transport system of exosomes plays a communication role by affecting the exchange of functional components between cells.Among them,miRNA is more easily packaged in exosomes due to its small size,so it affects cell function in many ways and over a wide range.OBJECTIVE:To summarize the mechanism of exosomal miRNA in multiple myeloma and to propose potential targets.METHODS:The terms"multiple myeloma,bone marrow mesenchyml stem cell,fibroblasts,peripheral blood,complication,progression,drug resistance,exosomal miRNA"were used as English search terms in the PubMed database.The time frame of the search was from the inception to June 2024.After reading the titles and abstracts,we excluded irrelevant or repetitive literature,and finally included 81 papers for review.RESULTS AND CONCLUSION:(1)Multiple myeloma cells participate in multiple myeloma bone lesions by regulating the balance of osteogenic and osteoclast functions through various miRNA mediated exosomes,regulating erythrocyte calcium ion efflux channels to participate in the occurrence of hypercalcemia,promoting renal epithelial mesenchymal transition leading to renal fibrosis and renal dysfunction,and upregulating bone marrow-derived mononuclear suppressor cells to promote suppression of the immune microenvironment.In addition,miRNAs in the exosomes of multiple myeloma cells are also involved in the occurrence and development of immunotherapy resistance,as well as pathological processes such as angiogenesis,cell proliferation,and cell aging.(2)Both bone marrow mesenchymal stem cells and tumor-associated fibroblasts can affect the proliferation,metastasis,and apoptosis of multiple myeloma cells through exosomal miRNA,interfere with angiogenesis,and regulate the resistance of chemotherapy drugs.(3)Peripheral blood circulating exosomal miRNAs,as cutting-edge noninvasive biomarkers,can play a key role in judging the stage and progression of multiple myeloma disease,predicting patient formation and prognosis,and evaluating drug sensitivity and drug resistance.(4)Multiple myeloma exosomes long non-coding RNA,circular RNA,miRNA,mRNA and target gene can form different combinations,and the flexible construction of new biological axes and biomolecular networks is in line with the development concept of holistic medicine.(5)Exosome miRNA has great development potential as a therapeutic target for predictive biomarkers and new drug research and development.How to maximize the use of exosome miRNA and how to accelerate the clinical transformation of related scientific research results deserve further investigation.