肉芽肿性小叶性乳腺炎(granulomatous lobular mastitis,GLM)是一种罕见的良性炎症性乳腺疾病.目前,临床上关于GLM出现反应性关节炎、结节性红斑的报道较为少见,近日浙江省宁波市中医院甲乳外科收治了GLM伴反应性关节炎和结节性红斑患者 1 例,通过系统的中西医结合治疗,疗效满意,现报告如下.

肉芽肿性小叶性乳腺炎(granulomatous lobular mastitis,GLM)是一种相对罕见的乳腺良性慢性炎症性疾病,以形成乳腺组织肉芽肿为主要病理表现.糖皮质激素是治疗该病的手段之一,常用的方式包括口服、静脉滴注、局部封闭等.本文通过分析1例中药联合糖皮质激素外用治疗GLM的临床资料,为该病的治疗提供新的临床思路和用药经验.

Objective To observe the effect and mechanism of Formula plus platycodon grandiflorum,an herb guiding others to the lungs,in the treatment of lung metastasis of breast cancer in nude mice.Methods MDA-MB-435HM breast cancer lung metastasis was established in nude mice and then randomized into 5 groups: Ruyiping,Ruyiping plus platycodon grandiflorum,Ruyiping plus radix cyathulae,control group and doxorubicin group.The long and short diameters of the tumor were measured during the administration;the tumor weight was weighed to calculate inhibition rate of tumor after treatment;the lung metastasis was assessed in lung tissues.mRNA expression of CXCL12,CXCR4 and HER-2 genes in tumor and lung tissue with in situ hybridization method.Results Ruyiping,Ruyiping plus platycodon grandiflorum and doxorubicin group showed some inhibition effects on tumor growth and lung metastasis in MDA-MB-435HM breast cancer metastatic lung model.Compared with Ruyiping group,Ruyiping plus platycodon grandiflorum group further improved the inhibiton rates of tumor weight(3.79%) and lung metastasis(26.44%).ISH assay indicated that Ruyiping and Ruyiping plus platycodon grandiflorum groups both downregulated the CXCR4 mRNA expression in tumor and CXCL12 mRNA expression in lung tissue(compared with control group);compared with Ruyiping,Ruyiping plus platycodon grandiflorum group could further downregulate the CXCL12 mRNA expression in tumor(P0.01) and HER-2 mRNA expression in lung tissue(P0.05).Conclusion Compared with Ruyiping,Ruyiping plus platycodon grandiflorum can further inhibit the progression of lung metastasis via regulating CXCL12/CXCR4 biolgical axis and HER-2 oncogene.

刘胜教授应用膏方调治乳腺癌术后3年以上患者的经验,其最大特点是先辨病后辨证,辨病辨证相结合,扶正祛邪为根本,调摄冲任显独特。不仅提高患者的生存质量,而且有效防止乳腺癌复发转移。

Professor Liu-sheng's experiences of the prevention and cure for the relapse and metastasis of breast cancer were summarized in Syndrome Differentiation and Treatment,the principle of treatment and prescription,experiences of medication,academic characteristics of reconstruction of the differential diagnosis of diseases,main of the strengthening body resistance,being expert in supplement and warm,consideration of deteriorated case were emphasized.

In this paper,the authors summarize and analyze the theory of transformation.The authors advocate that on the basis of deep understanding and mastering of it the theory should be applied in the clinical treatment of breast cancer metastasis and the drugs should be administered according to the changes of patterns.

OBJECTIVE:To explore the effects of different proportions of Fructus Cnidii (Shechuangzi) and Psoralea corylifolia (Buguzhi) on highly metastatic human breast cancer cell line MDA-MB-231BO and bone marrow stromal cell line ST-2 in vitro. METHODS:Thirty-six female SD rats were randomly divided into 6 groups to prepare the drug-medicated sera by administering with different proportions of Fructus Cnidii and Psoralea corylifolia, including 4:0 group, 3:1 group, 1:1 group, 1:3 group, 0:4 group and control group. MDA-MB-231BO cells and ST-2 cells were cultured in Dulbecco's modified Eagle's medium containing drug-medicated serum. Inhibition rates of MDA-MB-231BO cells and ST-2 cells were measured by methyl thiazolyl tetrazolium (MTT) method; migration ability of MDA-MB-231BO cells was tested by a cell migration experiment; alkaline phosphatase activity (ALP) of ST-2 cells was measured by using 4-nitrophenyl phosphate disodium salt, and mineralized nodule formation of ST-2 cells was measured by alizarin red staining. RESULTS:Sera contaning different proportions of Fructus Cnidii and Psoralea corylifolia inhibited the migration activity of MDA-MB-231BO cells as compared with the blank serum, and serum contaning Fructus Cnidii and Psoralea Corylifolia at proportion of 1:1 had the best function (P<0.01). Fructus Cnidii and Psoralea corylifolia at ratio of 1:1 also enhanced the ALP activity of ST2 cells (P<0.05) and increased the number of mineralized nodules of ST2 cells (P<0.01). CONCLUSION:Kidney-warming recipe of Fructus Cnidii and Psoralea corylifolia can inhibit proliferation and migration of MDA-MB-231BO cells and increase the activity of ST-2 cells.

Objective To discuss the inhibitory effect and mechanism of Bazhen Decoction (Eight Precious Ingredients Decoction) for the angiogenesis in breast cancer patients. Methods Ninety breast cancer patients were randomized into 3 groups:Group Ⅰ (chemotherapy applied before operation),Group Ⅱ (Bazhen Decoction and chemotherapy applied before operation),and Group Ⅲ (control group,not treated before operation). Short term effect,serum vascular endothelia growth factor (s-VEGF) before and after treatment,tumor micro-vessel density (MVD) and VEGF protein after treatment were observed. Results Compared with group Ⅲ,the short term total effective rate was significantly increased (P0.05),the progress rate decreased (P0.01) in group Ⅰ and Ⅱ. After treatment,s-VEGF in Group Ⅱ was significantly decreased (P0.05) and lower than that of the Group Ⅲ (P0.05). Before treatment the concentration of s-VEGF of all patients was in positive correlation with the size of tumor,lymphatic metastasis,and TNM staging. In Group Ⅱ,the tumor MVD and VEGF protein were both significantly decreased in comparing with Group Ⅲ (P0.05). After treatment there was a positive correlation between the s-VEGF and the tumor VEGF as well as MVD. Conclusion Bazhen Decoction can inhibit the angiogenesis in breast cancer,and the mechanism may be concerned with its inhibitory function on VEGF expression of breast cancer tissues.

In this paper,the application of Platycodon Root in breast cancer was discussed through literature records of the function of Platycodon Root in past dynasties and the results of modern pharmacology researches.As a traditional and classical meridian-guiding herb,Platycodon Root helped other herbs to play efficacy on upper body.Besides,Platycodon Root played a positive role in the treatment of breast cancer,such as direct anti-cancer activity and immune regulatory effects.We believed that Platycodon Root was the potentially effective anti-breast cancer Chinese herb which had not been recognized by clinicians.This article would helpful for broadening the application of Platycodon Root.