Human epidermal growth factor receptor 2 (HER2)-positive breast cancer is an aggressive subtype. While trastuzumab plus pertuzumab significantly improves outcomes, cardiotoxicity remains a major limitation. Traditional Chinese Medicine (TCM) posits that Platycodon grandiflorus A. DC. (PG) may offer cardioprotection by addressing “Qi deficiency” and “blood stasis”. This study aims to investigate the efficacy and safety of PG granules (PGG) in preventing anti-HER2 therapy-associated cardiotoxicity. In this double-blind, randomized, placebo-controlled trial, approximately 120 patients with HER2-positive early breast cancer initiating trastuzumab and pertuzumab will be randomly assigned (1:1) to receive either PGG or placebo granules for 18 weeks (6 cycles of 3 weeks). The primary outcome is left ventricular ejection fraction (LVEF) measured within 3 days after completing anti-HER2 therapy. Secondary outcomes include: (1) incidence of cardiotoxicity (LVEF decline to < 55

Abstract Background Targeting the neuro-immune microenvironment to suppress triple-negative breast cancer (TNBC) represents a critical strategy in tumor immunotherapy. Methods A syngeneic 4T1 orthotopic TNBC model in Balb/c mice was employed. EA was applied at ST36 (Zusanli) using systematically optimized parameters (2/15 Hz, 3 mA, 30 min, every other day). Multi-dimensional immunophenotyping by flow cytometry, immunofluorescence, and Western blot was performed across tumor, blood, and splenic compartments. Transcriptome sequencing coupled with KEGG/GSEA pathway analysis was used to identify downstream signaling networks. The NGF/Hippo/YAP axis and adrenergic receptor subtype specificity were validated through pharmacological intervention in vitro, while EA synergy with αPD-L1 was assessed in a CD8 + T cell-depletion model. Results ST36 stimulation at 3 mA preferentially suppressed TNBC tumor growth and augmented intratumoral immune infiltration, characterized by elevated CD8 + T cells, NK cells, and M1-polarized macrophages. EA significantly enhanced CD8 + T cell effector capacity, upregulating perforin, granzyme B, CD69, and ZAP70 phosphorylation, and synergized with αPD-L1 in a CD8 + T cell-dependent manner. Mechanistically, EA activated c-Fos + /ChAT + cholinergic neurons in the dorsal motor nucleus of the vagus (DMV) and reduced norepinephrine (NE) output in both circulation and tumors. Transcriptomic profiling identified NGF downregulation and Hippo pathway activation as central events. EA upregulated AMOT, driving YAP phosphorylation at Ser127, cytoplasmic sequestration of YAP, and suppression of downstream IL-6 secretion. In vitro, exogenous NGF suppressed YAP phosphorylation and promoted TNBC malignant behavior, effects fully reversed by the YAP inhibitor verteporfin. α2-adrenergic receptor (α2-AR) antagonism with yohimbine abrogated NE-induced NGF upregulation, pinpointing α2-AR as the receptor subtype linking sympathetic signaling to the NGF/Hippo axis. Conclusion EA at ST36 recalibrates neuro-sympathetic tone in TNBC by activating vagal cholinergic outflow, reducing NE-driven α2-AR/NGF/Hippo signaling, and thereby relieving immunosuppression while amplifying CD8 + T cell-mediated cytotoxicity. These findings establish a neuro-immune mechanistic framework for EA-based adjuvant immunotherapy in TNBC.

OBJECTIVE:To explore the mechanism of Wenshen Zhuanggu Fang (, WSZG) against breast cancer bone metastasis from the perspective of macrophage polarization through bioinformatics and experiments. METHODS:Bioinformatics study was used to explore the mechanism underlying the effect of WSZG on breast cancer bone metastasis. Cell viability, migration, invasion and apoptosis assays were performed to detect the influence of WSZG on breast cancer cell MDA-MB-231BO promoted by macrophages. The protein expression level and cytokine content were detected by western blot and enzyme-linked immunosorbent assay kit in vitro. Tumor growth in vivo were performed to evaluate the effects of WSZG on breast cancer bone metastasis. M2/M1 ratio and the maker protein expression were detected by flow cytometry analysis, immun-ohistochemistry and immunofluorescence double staining. RESULTS:M2 macrophages associated with poor prognosis and may lead to secondary bone metastasis in patients with triple-negative breast cancer. WSZG could treat breast cancer bone metastasis through regulating macrophage polarization by signal transducers and transcription signaling activators (STAT) signaling pathway. WSZG downregulated STAT6, CD206 and Arginase-1, while upregulated STAT1 and Inducible Nitric Oxide Synthase, thus inhibited the M2 macrophage-promoted invasion and migration capabilities of MDA-MB-231BO cells. WSZG treatment suppressed the bone metastasis of breast cancer, and the M2/M1 ratio was reduced by regulating STAT expression in bone metastatic tissue. CONCLUSION:WSZG inhibited breast cancer bone metastasis by adjusting the promoting effect of macrophages on MDA-MB-231BO breast cancer cells and decreasing M2 polarization by downregulating STAT signaling.

This case report presents the first occurrence of Pneumocystis jirovecii pneumonia in a patient with breast cancer during CDK4/6 inhibitor therapy. Abemaciclib serves as a first-line therapeutic option for hormone receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer. However, there are no documented cases in the literature linking abemaciclib to Pneumocystis jirovecii pneumonia. Notably, although rare, abemaciclib-induced severe lymphopenia may predispose patients to potentially life-threatening opportunistic infections. Optimal patient management requires multidisciplinary collaboration and strict compliance with American Society of Clinical Oncology/European Society for Medical Oncology guidelines to optimize the balance between therapeutic efficacy and infection risk mitigation. Critical strategies include early intervention and proactive surveillance to mitigate morbidity and mortality in this high-risk cohort. Consequently, the present case advocates for serial monitoring of lymphocyte counts and CD4+ levels during abemaciclib treatment, with implementation of primary prophylaxis protocols for patients exhibiting elevated risk profiles.

Granulomatous lobular mastitis (GLM) is a rare inflammatory breast disease with unknown etiology, characterized by non-caseous granulomatous inflammation of the lobules, which infiltrate lymphocytes, neutrophils, plasma cells, monocytes, and eosinophils may accompany. GLM is often misdiagnosed as breast cancer due to the lack of specificity in clinical and imaging examinations, and therefore histopathology is the main basis for confirming the diagnosis. This review provides an overview of the pathological features of granulomatous lobular mastitis and cystic neutrophil granulomatous mastitis (CNGM, a pathologic subtype of GLM). As well as pathologic manifestations of other breast diseases that need to be differentiated from granulomatous lobular mastitis such as breast tuberculosis, lymphocytic mastopathy/diabetic mastopathy, IgG4-related sclerosing mastitis (IgG4-RSM), nodular disease, Wegener’s granulomatosis, and plasma cell mastitis. Besides, discusses GLM and CNGM, GLM and breast cancer, emphasizing that their relationship deserves further in-depth exploration. The pathogenesis of GLM has not yet been clearly articulated and needs to be further explored, pathology enables direct observation of the microscopic manifestations of the disease and contributes to further investigation of the pathogenesis.

BACKGROUND:Granulomatous mastitis (GM) an inflammatory disease of the breast that usually affects women of childbearing age, occurs very rarely in males.CASE SUMMARY:We present a case study of a 50-year-old male patient with GM. The patient developed a breast lump following the cleaning of a previously embedded dirt-filled nipple. While an initial improvement was noted with antibiotic therapy, a recurrence occurred a year later, showing resistance to the previously effective antibiotics. Subsequently, the lesion was excised. The histopathological examination confirmed the diagnosis of GM.CONCLUSION:GM should be considered a possible diagnosis of male breast masses.

Triple negative breast cancer (TNBC) is an aggressive and immunogenic subtype of breast cancer. The absence of biomarker has given immune checkpoint inhibitors (ICIs) a broad prospect in this type of breast cancer. The infiltration of regulatory T cells (Tregs) expressing transcription factor forkhead box P3 (Foxp3) in the tumor microenvironment (TME) is the key factor leading to ICIs resistance. Therefore, elimination of tumor antigen-specific Tregs may be an important aspect of improving ICIs efficacy. In this study, it based on the Gene Expression Omnibus and The Cancer Genome Atlas database, along with in vivo and in vitro experimental models, to verified that the high expression of integrin-linked kinase (ILK) in TNBC is the key differential factor leading to the high infiltration of Foxp3+-Tregs in the TME. Then, we selected ILK-specific inhibitor, OSU-T315, to intervene in vitro and vivo. Importantly, we found that OSU-T315 blocked the secretion of CCL17/CCL22 in tumor cells by inhibiting the ILK/NF-κB pathway, resulting in the apoptosis of Foxp3+-Tregs and decreased programmed cell death-1 (PD-1) expression. Therefore, our findings indicate a novel mechanism of OSU-T315 with potential therapeutic application in TNBC.

Diffuse glioneuronal tumor with oligodendroglioma-like features and nuclear clusters (DGONC) is a rare brain tumor of the central nervous system (CNS). Although only a few cases of DGONC have been reported following the initial description of the tumor, they have a distinct DNA methylation pattern and share a recurrent chromosomal finding of monosomy 14. We encountered a seven-year-old boy who presented with seizures and was found to have a left frontal and suprasellar mass. The tumor was grossly totally resected; histopathologic evaluation showed a cellular glioneuronal tumor with brisk mitotic activity. A near-tetraploid chromosome complement was detected, with associated diploidy of chromosome 14. Methylation pattern analysis revealed findings consistent with DGONC. Initially, we observed the patient without additional therapy. Due to the patient's non-metastatic relapse, resection of the relapse tumor consistent with DGONC and adjuvant radiotherapy were then initiated. The natural history and optimal post-surgical adjuvant therapy are unknown. This case adds to the limited number of DGONC cases previously reported, with a unique pattern of chromosomal abnormalities.

Background Breast cancer, particularly the Human epidermal growth factor receptor 2 (HER2) positive subtype, poses a significant health challenge for women worldwide. Trastuzumab plus Pertuzumab therapy has shown efficacy in treating HER2-positive breast cancer, but its use is limited by associated cardiotoxicity. Traditional Chinese Medicine (TCM) suggests that Platycodon grandiflorus A. DC. (PG) may have cardioprotective effects due to its ability to nourish qi and blood. This study aims to investigate the effective and safety of PG in preventing cardiotoxicity associated with anti-HER2 therapy. Method In this double-blinded, randomized, placebo-controlled trial, approximately 120 patients will be randomly assigned to either the PG or placebo groups, alongside undergoing 12 months of dual anti-HER2 therapies in a 1:1 ratio. Cardiotoxicity will be assessed at a median follow-up of 1 year. The primary outcome measure is left ventricular global longitudinal strain, with secondary outcomes including: (1) changes in left ventricular ejection fraction, (2) the occurrence of cardiotoxicity, (3) the occurrence of trastuzumab plus pertuzumab interruption, and (4) event free survival and overall survival rates among patients. Discussion This will be the first clinical study to determine whether PG can reduce the cardiotoxicity induced by trastuzumab plus pertuzumab treatment in HER2-positive early breast cancer patients. Trial registration Chinese Clinical Trial Registry (Registration Number ChiCTR2200061011)

Zuska病是一种罕见的乳房良性疾病,1951年由ZUSKA首次命名,其病理特征为乳晕下的乳管组织原有的被覆上皮出现鳞状上皮化生,多伴角化[1].输乳管的急慢性炎症可蔓延输乳管周围软组织,形成以输乳管为中心的乳晕下脓肿.由于人们对这种疾病知之甚少,导致其常被误诊和治疗不当.笔者总结1例老年Zuska病患者诊治经过,现报道如下.

Doxorubicin (Dox) is a first-line chemotherapeutic agent applied in cancer treatment. Its long-term anticancer efficacy is restricted mainly due to its subsequent cardiotoxicity for patients. Platycodon grandiflorum (PG), an important traditional Chinese herb, has been reported to eliminate phlegm, relieve cough, and reduce inflammatory diseases. Previous clinical studies found that PG has cardioprotective effects for early breast cancer patients who received Dox-based chemotherapy. However, the cellular and molecular mechanisms underlying PG-mediated cardiotoxic rescue remain elusive. This study aimed to explore the protective role and potential molecular mechanisms of PG on Dox-induced cardiac dysfunction in a mouse model of breast cancer. PG significantly alleviated myocardial damage and prevented cardiomyocyte apoptosis induced by Dox. The expression levels of cytochrome C and cleaved caspase-3 significantly decreased, and the levels of Bcl-XL and B-cell lymphoma-2 (Bcl-2)/Bcl-2-associated X protein increased following PG treatment. Furthermore, PG remarkably enhanced the antimetastatic efficacy (versus the Dox group) by regulating the balance of matrix metalloproteinases/tissue inhibitors of metalloproteinases.

Doxorubicin (Dox) is a first-line chemotherapeutic agent applied in cancer treatment. Its long-term anticancer efficacy is restricted mainly due to its subsequent cardiotoxicity for patients. Platycodon grandiflorum (PG), an important traditional Chinese herb, has been reported to eliminate phlegm, relieve cough, and reduce inflammatory diseases. Previous clinical studies found that PG has cardioprotective effects for early breast cancer patients who received Dox-based chemotherapy. However, the cellular and molecular mechanisms underlying PG-mediated cardiotoxic rescue remain elusive. This study aimed to explore the protective role and potential molecular mechanisms of PG on Dox-induced cardiac dysfunction in a mouse model of breast cancer. PG significantly alleviated myocardial damage and prevented cardiomyocyte apoptosis induced by Dox. The expression levels of cytochrome C and cleaved caspase-3 significantly decreased, and the levels of Bcl-XL and B-cell lymphoma-2 (Bcl-2)/Bcl-2-associated X protein increased following PG treatment. Furthermore, PG remarkably enhanced the antimetastatic efficacy (versus the Dox group) by regulating the balance of matrix metalloproteinases/tissue inhibitors of metalloproteinases. Keywords doxorubicin , cardiotoxicity , (PG) , breast cancer

文章总结中药配合瘘管切除缝合术治疗男性浆细胞性乳腺炎的经验,为男性浆细胞性乳腺炎治疗提供新的思路.对于男性浆细胞性乳腺炎患者,急性期予中药辨证治疗将炎症局限,缩小肿块,待炎症局限,肿块红肿消退后予以瘘管切除术,术后配合中药疏通乳络、活血消脂治疗.运用中药配合瘘管切除术治疗男性浆细胞性乳腺炎能够明显缩短病程,疗效显著,临床值得推荐.

Sanyin formula (SYF) is used as a complementary treatment for triple-negative breast cancer (TNBC). The purpose of this study was to identify the potential functional components and clarify the underlying molecular mechanisms of SYF in TNBC. High-performance liquid chromatography–tandem mass spectrometry (HPLC-MS/MS) was used to identify the main components of SYF extracts. Network pharmacology and bioinformatic analyses were carried out to identify potential candidate targets of SYF in TNBC. Cell proliferation was determined with a Celigo imaging cytometer. Wound-healing and Transwell assays were adopted to evaluate cell migration. A Transwell cell-invasion assay was performed with Matrigel-coated membranes. In vivo bioluminescence imaging (BLI) and pathological analyses illustrated the effect of SYF on cancer cell metastasis in tumour-bearing mice. The inhibitory mechanism of SYF was investigated via quantitative PCR (qPCR) and Western blotting. We found that 3,4-dihydroxyphenyllactic acid, kaempferol, p-coumaric acid, and vanillic acid may be the active components of SYF. Molecular docking confirmed that kaempferol, p-coumaric acid, vanillic acid, and 3,4-dihydroxyphenyllactic acid bound stably to proteins such as AKR1C3, MMPs, and STAT3. SYF extract suppressed TNBC cell proliferation, migration, invasion, and metastasis by inhibiting JAK/STAT3 signalling and then regulating downstream genes, such as MMP-2/MMP-9. SYF regulates the expression of genes involved in cell proliferation, migration, and invasion by regulating the JAK/STAT3 signalling pathway and finally inhibits tumour cell metastasis in TNBC. The present study clarifies the mechanism by which SYF inhibits TNBC metastasis and lays an experimental foundation for the continued clinical development of SYF targeting the JAK/STAT3 pathway.

Objective To investigate the clinical treatment of patients with refractory plasma cell mastitis by fistulectomy combined with nipple correction,observe its clinical efficacy,and analyze its clinical practicability.Methods Nine patients with refractory plasma cell mastitis were treated from August in 2020 to March in 2022.Before operation,fistulectomy and nipple correction were performed after the local inflammation was controlled by oral Chinese medicine.After operation,routine surgical dressing changes were performed,and the clinical efficacy,satisfaction evaluation of postoperative breast appearance and recurrence rate were observed.Results All the nine patients were cured after operation and they were satisfied with their breast shape,and there was no recurrence within one year after operation.Conclusion Fistulectomy combined with nipple correction is a safe and effective method for the treatment of patients with refractory plasma cell mastitis.

目的 评价火针联合柴葵清消方治疗脓肿期热盛肉腐证非哺乳期乳腺炎的临床疗效.方法 将门诊纳入的脓肿期热盛肉腐证非哺乳期乳腺炎患者60例,采用区组随机、临床对照试验方法,按1:1分为试验组及对照组.每组30例,2组均内服柴葵清消方,试验组加用火针排脓引流法(简称火针疗法),对照组加用手术切开排脓引流法(简称切排疗法),疗程2个月.每2周测量脓腔及肿块面积,填写视觉模拟评分(VAS)疼痛量表.结果 试验组治疗6周时总有效率为86.7％(26/30),优于对照组[56.7％(17/30)],差异有统计学意义(x2=6.851,P＜0.05).与本组治疗前比较,两组治疗2、4、6、8周后脓腔面积和肿块面积逐渐减少,差异均有统计学意义(P＜0.05,P＜0.01);对照组治疗第8周与第6周比较,脓腔面积差异均无统计学意义(P＞0.05).与对照组同期比较,试验组治疗第2、4周时的脓腔面积及第4、6周肿块面积均减少,差异亦有统计学意义(P＜0.05,P＜0.01).试验组脓腔愈合平均时间为(57.67±16.78)d,优于对照组[(68.07±18.63)d],差异有统计学意义(t=-10.4,P＜0.05).治疗后2组患者VAS较治疗前均下降(t分别为-5.33、-5.46,P＜0.01),试验组明显优于对照组(t=-1.3,P＜0.01).Logistic多因素回归分析表明,初始乳房脓腔面积[OR=4.291,95％CI(1.124,21.479),P＜0.05]和肿块面积[OR=4.330,95％CI(1.185,23.106),P＜0.05]与疗效相关.优效性分析结果表明,初始脓腔面积＜20 cm2时,火针疗法优于切排疗法[RR=0.37,95％CI(0.01,0.81),P=0.03].结论 火针联合柴葵清消方治疗脓肿期热盛肉腐证非哺乳期乳腺炎可有效促进脓腔愈合,减轻患者痛苦.

目的:观察乳癖散结胶囊及红金消结胶囊在肉芽肿性小叶性乳腺炎(GLM)恢复期降低复发率的疗效.方法:本研究为回顾性队列研究,共纳入 GLM恢复期服用乳癖散结胶囊或红金消结胶囊的GLM患者173例,其中乳癖散结组129例,红金消结组44例.根据患者服用中成药的治疗时间,分别将其分为2周~6个月及≥6个月两个亚组,比较各组患者复发率差异.结果:乳癖散结组患者复发率为6.98%(9/129),红金消结组患者复发率为9.09%(4/44),两组患者复发率比较无明显差异(P ＝0.087).各组间亚组比较显示,乳癖散结组及红金消结组两组间在2周~6个月及≥6个月两个亚组均无显著性差异(P＝0.135,P＝0.670).乳癖散结组内亚组比较,与2周~6个月患者人群相比,≥6个月GLM患者复发率明显降低,差异具有统计学意义(P＝0.001);红金消结组内两亚组比较,复发率无明显差异(P＝0.139).结论:在GLM恢复期,乳癖散结胶囊及红金消结胶囊均为有效的降低复发率治疗方案.

Ethnopharmacological relevance: Epimedium brevicornu Maxim. and Cullen corylifolium (L.) Medik. are part of a traditional Chinese medicine (TCM) drug pair (ECDP) widely used in the clinical treatment of breast cancer (BC). Both drugs have been proven to have anti-tumor effect. However, the active ingredients and molecular mechanism of ECDP remain to be explored.Aim of the study: To explore the efficacy and potential mechanisms of actions of herb pair through network pharmacology and in vitro and in vivo experiments.Materials and methods: The active ingredients of ECDP were identified using high-performance liquid chromatography. The corresponding potential target genes for ECDP components and BC were extracted from established databases, and the protein-protein interaction network of shared genes was constructed using STRING database. The effective ingredients and targets of ECDP for BC were obtained through the TCMSP database and GeneCards database. The potential targets and pathways were selected through the protein interaction network and enrichment analysis. Proliferation and migration experiments in vitro and tumor growth in vivo were performed to evaluate the effects of Anhydroicaritin (AHI) on BC. Results: AHI is the potential candidate active ingredient of ECDP through TCMSP. Molecular docking revealed that AHI has excellent binding ability with TP53, VEGFA, MMP2, and Met. In vitro experiment results showed that AHI inhibits the growth of MDA-MB-231, 4T1, MCF-7, and SK-BR-3 BC cells. The inhibitory effect of AHI on triple-negative BC cells is more obvious. With the increase of AHI concentration, the colony-forming, migration, and metastasis abilities of the MDA-MB-231 and 4T1 cells gradually decreases. In addition, Western blot and reverse transcription polymerase chain reaction analyses results indicated that AHI downregulates HIF-1 alpha/ VEGFA signaling in triple-negative BC cells. AHI inhibits tumor growth and lung metastasis while down regulating the expression of HIF-1 alpha and VEGFA.Conclusion: AHI may play an anti-BC effect by inhibiting cancer cell proliferation, invasion, and metastasis. The results of this study may provide a theoretical basis for AHI research and the clinical application of ECDP in BC.

Abstract Background Ruai-sanyin formula (RASYF) is composed of a variety of anticancer herbs. It is widely used in the treatment of triple negative breast cancer (TNBC) and has proved to inhibit tumor growth and lung metastasis in animal models, but there is no evidence for clinical application in the real world. Methods We conducted this prospective cohort study at 5 research centers in China from November 2016 to December 2018. RASYF was set as an exposure factor. TNBC patients within 3 months after completion of standard adjuvant treatment were included. The exposed group received RASYF treatment, while the non-exposed group received observation. The primary end point was disease-free survival (DFS). Secondary end points included, overall survival (OS), distant disease-free survival (DDFS), relapse-free survival (RFS), QLQ-BR23 assesses quality of life in patients and adverse events. Results A total of 613 eligible patients with operable TNBC were enrolled, of which 588 were included in the Full Protocol Set. At a median follow-up of 48 months, DFS time was longer in those assigned to RASYF compared with observation (3-year DFS, 89.6% vs. 83.5%, [HR = 0.61, 95%CI (0.39-0.95)]; P = 0.03). Similar outcomes were observed for RFS (3-year RFS, 92.1% vs. 85.9%, HR = 0.55, [95% CI, 0.34-0.91]; P = 0.02). However, there was no statistically significant difference in OS and DDFS between the groups. In exploratory subgroup analysis, RASYF benefits were greater in patients with age under the 40 (3-year DFS, 88.4% vs. 76.1%, [HR = 0.45, 95%CI (0.21-0.95)]; P = 0.03). And RASYF is helpful to the improvement of postoperative quality of life. Comparing to the observation group, RASYF increased the mean CFB of BR23 scores in body image (12.34 vs. 8.76, P = 0.03)，sexual function (11.79 vs. 9.23, P <0.01) , future perspective (9.90 vs. 6.53, P= 0.04), and decreased the scores of systemic therapy side effects (-12.41 vs. -9.24, P = 0.01). Safety analysis showed that RASYF caused major adverse reactions including impaired liver function (4.0%) and stomach pain (6.1%), but the overall security is controllable. Conclusion RASYF supplementation for 2 years after standard adjuvant chemoradiotherapy has certain clinical significance in preventing recurrence and metastasis and improving the quality of life of patients with early TNBC. Trial registration ClinicalTrials.gov: NCT03332368 Registered 6 November, 2017 (retrospectively registered)

Traditional Chinese tongue diagnosis plays an irreplaceable role in disease diagnosis. This study aimed to describe the tongue characteristics of patients with granulomatous lobular mastitis (GLM). Forty GLM patients and 40 non-GLM controls were evaluated using the Traditional Chinese Medicine subjective clinical interpretation and a TDA-1 Tongue Diagnostic and Analysis system. The associations between the image features of the tongue body and coating and the profiling of immune-inflammatory parameters were analyzed. GLM patients were prone to a reddish tongue bodies with thick, white, and greasy coatings. Thick and greasy tongue coating features are risk factors for GLM. GLM patients had higher levels of white blood cells (WBC), platelets, C-reactive protein, interleukin-2, and transforming growth factor-β (TGF-β) than non-GLM controls (P < .05). Also, tongue coating contrast and entropy values were significantly correlated with WBC or TGF-β levels in GLM patients (r < −0.310 andP < .05). We demonstrated that the hot evil and phlegm-dampness constitutions are the main characteristics of GLM. This might provide a reference for GLM diagnosis.