Patients with gastric cancer undergoing postoperative chemotherapy often develop myelosuppression due to direct injury to the spleen and stomach caused by surgery， depletion of healthy qi by chemotherapy， impaired generation of ying （荣） qi due to spleen and stomach deficiency， and the accumulation of drug toxicity， which prevents ying qi from reaching and nourishing the bone marrow. Consequently， the bone marrow loses its nourishment and becomes unable to generate blood， leading to myelosuppression. This paper proposes that the core pathogenesis involves failure of the middle jiao （焦） pivot function， dysfunction of ying qi circulation， and insufficient nourishment of essence and marrow. Accordingly， Shengxian Decoction （升陷汤） combined with Danggui Buxue Decoction （当归补血汤） is used as the principal prescription to tonify the middle jiao and uplift center qi， thereby remedying the fundamental insufficiency of ying qi. Modified Compound Danshen Decoction （复方丹参饮） is applied to promote qi circulation， resolve stasis， remove toxin， and unblock collaterals， thereby resolving the obstruction preventing ying qi from reaching the bone marrow. Modified Dabuyuan Decoction （大补元煎） combined with Erzhi Pill （二至丸） is taken as the foundational formula to cultivate the root， replenish marrow， thereby modulating hematopoiesis in bone marrow.

Tumor-associated macrophages(TAMs)are critical components of the tumor microenvironment(TME)and represent an import-ant class of immune cells.Under the influence of various signaling factors,TAMs can be polarized into two major phenotypes:classic activa-tion of macrophage(M1)and alternative activation of macrophage(M2).M1-polarized TAMs predominantly exert pro-inflammatory and an-titumor effects,whereas M2-polarized TAMs are primarily associated with anti-inflammatory and tumor-promoting activities.Owing of their phenotypic plasticity,strategies aimed at reprogramming M2-type TAMs to adopt the M1 phenotype have emerged as promising and novel approaches in cancer therapy.Significant progress has been made through multifaceted investigations that include in vitro studies,use of an-imal models,and clinical research.This review summarizes the plasticity of TAMs,their functional roles in different types of cancers,and re-cently reported therapeutic strategies targeting TAM polarization.

Tumor-associated macrophages(TAMs)are critical components of the tumor microenvironment(TME)and represent an import-ant class of immune cells.Under the influence of various signaling factors,TAMs can be polarized into two major phenotypes:classic activa-tion of macrophage(M1)and alternative activation of macrophage(M2).M1-polarized TAMs predominantly exert pro-inflammatory and an-titumor effects,whereas M2-polarized TAMs are primarily associated with anti-inflammatory and tumor-promoting activities.Owing of their phenotypic plasticity,strategies aimed at reprogramming M2-type TAMs to adopt the M1 phenotype have emerged as promising and novel approaches in cancer therapy.Significant progress has been made through multifaceted investigations that include in vitro studies,use of an-imal models,and clinical research.This review summarizes the plasticity of TAMs,their functional roles in different types of cancers,and re-cently reported therapeutic strategies targeting TAM polarization.