Gastric ulcer can undergo malignant transformation.

　　I. Environmental and dietary factors

　　The significant differences in incidence rates in different countries and regions indicate that environmental factors are related, among which the most important is dietary factors. The intake of excessive salt, high-salt preserved foods, smoked fish, and nitrosamine compounds in food are related factors for the induction of gastric cancer. In addition, moldy foods contain more fungal toxins, and the outer surface of processed rice is coated with talc. In addition, some studies also show that gastric cancer is related to the imbalance of nutrients. Regularly eating moldy foods, pickled vegetables, smoked and cured food, and excessive salt intake can increase the risk. Eating more fresh fruits and vegetables. Using refrigerators and proper food storage can reduce the incidence of gastric cancer.

　　II. Helicobacter pylori infection

　　Helicobacter pylori is a spiral-shaped, microanaerobic bacterium with very strict growth conditions. It was first isolated from the gastric mucosal biopsy tissue of patients with chronic active gastritis in 1983 and is currently the only known microorganism that can survive in the human stomach. Helicobacter pylori disease includes gastritis, gastrointestinal ulcers, lymphoproliferative gastric lymphoma, and other diseases caused by Helicobacter pylori infection. The adverse prognosis of Helicobacter pylori disease is gastric cancer. Gastric cancer may be the result of long-term infection with Helicobacter pylori and the combined action of other factors, among which Helicobacter pylori may play a leading role.

　　III. Genetic factors

　　Gastric cancer incidence is higher in some families. The incidence rate of gastric cancer in relatives of gastric cancer patients is four times higher than that of normal people. Some data show that gastric cancer occurs more frequently in people with blood type A than in those with blood type O.

　　IV. Immune factors

　　People with low immune function have a higher incidence of gastric cancer.

　　V. Precancerous changes

　　The so-called precancerous changes refer to certain lesions with a strong tendency to malignancy. If these lesions are not treated, they may develop into gastric cancer. Precancerous changes include precancerous conditions (precancerous conditions) and precancerous lesions (precancerous lesions).

　　1. Precancerous state of the stomach:

　　(1) Chronic atrophic gastritis: There is a significant positive correlation between the incidence of chronic atrophic gastritis and gastric cancer.

　　(2) Pernicious anemia: 10% of patients with pernicious anemia develop gastric cancer, and the incidence rate of gastric cancer is 5 to 10 times higher than that of the normal population.

　　(3) Gastric polyps: Adenomatous or villous polyps, although accounting for a low proportion of gastric polyps, have a cancerous transformation rate of 15% to 40%. The cancerous transformation rate is even higher for those with a diameter greater than 2cm. Hyperplastic polyps are more common, but the cancerous transformation rate is only 1%.

　　(4) Residual stomach cancer: Cancerous tumors that occur in the residual stomach after benign gastric lesion surgery are called residual stomach cancer. The incidence rate increases significantly after surgery, especially after 10 years postoperatively.

　　(5) Benign gastric ulcer: Gastric ulcer itself is not a precancerous state. However, the mucosa at the edge of the ulcer is prone to intestinal metaplasia and malignant transformation.

　　(6) Gigantic gastric mucosal fold syndrome (Menetrier's disease): Serum protein leaks through gigantic gastric mucosal folds, and clinically, there is hypoalbuminemia and edema, about 10% may become cancerous.

　　2, Precancerous lesions of the stomach:

　　(1) Atypical hyperplasia and anaplasia: The former is also known as atypical hyperplasia, which is a reversible pathological cell proliferation caused by chronic inflammation, and it may not lead to cancer in a few cases. Gastric anaplasia (anaplasia) has a higher chance of cancerous transformation.

　　(2) Intestinal metaplasia: There are two types, intestinal type and colonic type. The intestinal type (complete type) has the characteristics of intestinal mucosa and is well differentiated. The colonic type (incomplete type) is similar to colonic mucosa and can be divided into two subtypes: Ⅱa type, which can secrete non-sulfated mucin; Ⅱb type, which can secrete sulfated mucin, and this type is closely related to the occurrence of gastric cancer.

　　Common complications of gastric cancer:

　　1, When there is concurrent gastrointestinal bleeding, symptoms such as dizziness, palpitations, tarry stools, and vomiting coffee-colored matter may occur.

　　2, When gastric cancer metastasizes to the abdominal cavity, if the common bile duct is compressed, jaundice may occur, and the stool may turn clay-colored.

　　3, The combination of pyloric obstruction can cause vomiting, with the appearance of an expanded gastric shape in the upper abdomen and the sound of water sloshing.

　　4, Perforation of the tumor leads to diffuse peritonitis, which may cause peritoneal irritation symptoms such as stiff abdominal muscles, abdominal tenderness, and so on.

　　5, Formation of gastrointestinal biliary duct, see the excretion of indigestible food.

　　One, Symptoms of gastric cancer in different stages

　　1, More than 70% of early gastric cancer has no obvious symptoms. As the disease progresses, non-specific symptoms similar to gastritis or gastric ulcer may gradually appear, including upper abdominal fullness or hidden pain, acid regurgitation, belching, nausea, occasional vomiting, decreased appetite, dyspepsia, occult blood in feces or black stools, fatigue for no apparent reason, weight loss, or progressive anemia, and so on.

　　2, Advanced stage gastric cancer (i.e., middle and late stage gastric cancer) symptoms include pain in the stomach area, often described as gnawing, and it is not related to eating. It may also resemble the pain of peptic ulcer, which can be relieved after eating. Symptoms may include upper abdominal fullness, weight, loss of appetite, abdominal pain, nausea, vomiting, diarrhea, weight loss, anemia, edema, fever, and so on. Cancer of the cardia mainly manifests as discomfort or pain under the xiphoid process or behind the sternum, accompanied by a sensation of obstruction or difficulty swallowing; cancer in the fundus and subcardia area often has no obvious symptoms until the tumor becomes large and causes necrosis and ulceration, leading to upper gastrointestinal bleeding, or when the tumor invades the cardia and causes difficulty swallowing, attention is paid to it. Cancer in the gastric body is more common in the type of expansion, and pain and discomfort appear later; cancer in the lesser curvature of the gastric antrum is most common in the type of ulcer, so the symptoms of upper abdominal pain appear earlier. When the tumor extends to the pyloric orifice, it can cause symptoms of pyloric obstruction such as nausea and vomiting. The spread and metastasis of the tumor can cause ascites, liver enlargement, jaundice, and metastasis to the lungs, brain, heart, prostate, ovaries, bone marrow, and other organs, leading to corresponding symptoms.

　　Symptoms of gastric cancer patients

　　The majority of gastric cancer patients have no obvious signs, with some patients experiencing mild upper abdominal tenderness. In advanced gastric cancer located in the antrum or body of the stomach, a palpable mass may be felt, which is often nodular and hard. When the tumor infiltrates adjacent organs or tissues, the mass is often fixed and cannot be moved. In female patients, the palpation of a mass in the lower abdomen often suggests the possibility of a Krukenberg tumor. When gastric cancer causes liver metastasis, nodular masses can be felt in the enlarged liver. When abdominal metastatic masses compress the common bile duct, obstructive jaundice may occur. In patients with pyloric stenosis, an expanded gastric type can be seen in the upper abdomen, and galloping sounds can be heard. Metastasis through the thoracic duct can lead to enlargement of the lymph nodes above the left clavicle. In advanced gastric cancer with pelvic implantation, nodules can be felt in the vesicouterine pouch of the rectum during rectal examination. Abdominal fluid may appear in cases of peritoneal metastasis. Small bowel or mesenteric metastasis can cause narrowing of the intestinal lumen, leading to partial or complete intestinal obstruction. Perforation of the tumor can lead to diffuse peritonitis, presenting with symphysis of the abdominal muscles, abdominal tenderness, and other peritoneal irritation symptoms. The tumor can also infiltrate adjacent cavity organs to form internal fistulas.

　　A young man diagnosed with gastric ulcer was pushed onto the operating table due to recurrent gastric bleeding. When the doctor opened his abdomen, he found that the ulcer had become cancerous and there was widespread metastasis in the abdominal cavity. Despite the doctor's best efforts, the patient died from systemic failure two months later. Traditionally, it was believed that gastric cancer is more common in middle-aged and elderly people, while it is rare in young and middle-aged individuals. However, recent clinical observations have shown that gastric cancer in young and middle-aged individuals is not uncommon, especially with a twofold increase in the incidence rate among young people aged 19 to 35 compared to the 1970s. Due to the high malignancy and rapid development of gastric cancer in young people, along with the ease of misdiagnosis, the prognosis is often poor.

　　The effectiveness of gastric cancer treatment depends on early diagnosis. If radical surgery can be performed before the cancer has metastasized, the prognosis is generally good, especially if the cancer tissue has not yet invaded the muscularis propria or the serosa. The five-year survival rate is highest in such cases. Therefore, for patients clinically diagnosed with or highly suspected of having gastric cancer, except for those with distant metastasis or poor general condition who cannot tolerate surgery, laparotomy should be performed. For advanced cancer, even if radical resection is not possible, efforts should be made to resect the entire or most of the primary tumor to alleviate symptoms, as long as the overall condition and technical conditions permit. For patients with inoperable cancer accompanied by pyloric stenosis, a bypass surgery such as gastrojejunostomy or gastrostomy can be performed to alleviate symptoms.

　　1, The following measures are helpful for the prevention, early detection, and timely treatment of gastric cancer.

　　1, Pay attention to food hygiene, eat less smoked, salted, and fried food, quit smoking and drinking, eat more vitamin E-rich foods such as fruits and vegetables, store food properly, process and cook properly;

　　2, For chronic atrophic gastritis, especially those with intestinal metaplasia and atypical hyperplasia, gastric ulcer, malignant anemia, gastric polyps, etc., active treatment and regular follow-up gastroscopy should be carried out to detect cancer changes in time and treat them.

　　Cancer, cancer is the most representative endogenous disease, cancer cells will not die like normal cells because of environmental acidification in fact, cancer cells are normal cells that actively mutate to grow in an acidic environment and continue to proliferate, and there are two theories about the production of cancer cells. One is the theory of hypoxia proposed by German biochemical doctor Kopp, and the other is the acidic体质 theory proposed by Japanese Aiha. Dr. Kopp's theory points out that healthy cells can become cancer cells in an oxygen-deficient environment, and body fluid acidification can cause a decrease in oxygen content. He has proven this point with experiments and won the Nobel Prize. Aiha's theory mentions that cells with weak alkalinity near the accumulation of acidic waste products usually die, but some are willing to change the chromosomes to survive in an acidic environment, which is the beginning of cancer. Even if all the cancer cells are removed by surgery, cancer will regrow because the acidic environment still exists, and the cells that do not want to die still exist, so it is not as difficult to get cancer as people think.

　　3, Diet: Related individuals should pay attention to their diet in their daily life. Fresh fruits and vegetables, coarse grains should be the staple food, meat should be eaten less, and a reasonable diet should be maintained to prevent body fluids from becoming too acidic. The diet should be 'two acids and eight bases' to make the body fluid slightly alkaline. Many foods in food have inhibitory effects on cancer cells, such as calcium ions and garlic, scallions, and green tea containing sulfhydryl groups have clear protective effects, among which the protective effects of garlic are highly valued. Change the diet structure: eat more vegetables and fruits. Increase legumes and milk appropriately. Reduce the intake of salt. Eat less or no smoked and salted foods, reduce the intake of nitrosamines. Food preservation is best done with refrigerator cold storage. advocate eating garlic and green tea.

　　4, Changing unhealthy eating habits: Avoid overeating, irregular meals; eat slowly, not too hot, not too hard.

　　5, Unhealthy habits: Smoking, drinking, and other unhealthy habits need to be changed.

　　6, Psychological factors: In today's society, people face excessive pressure in their daily lives. When this pressure is too great and not released, it can cause harm to the body.

　　7. Other注意事项:

　　(1) Do a good job of grain mold prevention and removal, and protect the sanitation of drinking water.

　　(2) Actively treat precancerous lesions. Patients with chronic gastric disease should receive timely treatment and regular observation.

　　(3) Actively protect the environment and reduce environmental pollution.

　　(4) Conduct general health check-ups and treatments for gastric cancer and precancerous lesions in high-risk areas and populations.

　　8. Eradicate HP infection in the stomach. Patients with gastric ulcer that is not responsive to long-term treatment or gastric polyps larger than 2cm should receive timely surgical treatment. Patients with atrophic gastritis should have regular follow-up gastroscopy, which has a certain preventive significance.

　　Since gastric cancer is related to 'eating', does there exist any food that can help prevent gastric cancer? The answer is affirmative.

　　Secondly, eating the following foods regularly can prevent or reduce the occurrence of gastric cancer.

　　1. Garlic

　　It is a recognized anti-cancer food with obvious anti-cancer effects. Epidemiological studies have shown that the incidence of gastric cancer is very low in people who eat raw garlic, because garlic can significantly reduce the content of nitrites in the stomach, reduce the possibility of nitrosamine synthesis, and thus play a preventive role in cancer.

　　2. Onions

　　Eating onions can reduce the content of nitrites in the stomach. It is important that onions contain a substance called quercetin, which is a natural anti-cancer substance. Studies have shown that people who eat onions regularly have a 25% lower incidence of gastric cancer than those who eat less or do not eat onions, and the mortality rate from gastric cancer is also 30% lower.

　　3. Fungi

　　These foods include mushrooms, shiitake mushrooms, enoki mushrooms, and black fungus. Scientists have found that many fungi in food contain anti-cancer substances and can play a preventive role in cancer. For example, the polysaccharides in mushrooms have a very high anti-cancer rate. The polysaccharides contained in black fungus and white fungus are also effective anti-cancer substances. The coarse fibers and calcium in fungi have anti-cancer effects and can also enhance the body's immunity.

　　4. Broccoli

　　Broccoli contains a lot of trace elements molybdenum, which can block the synthesis of carcinogenic substances nitrosamines, and can play a role in anti-cancer and cancer prevention. Some research reports indicate that broccoli also contains an enzyme called dimethyl sulfide, which can stimulate cell activity and can prevent the formation of cancer cells. Eating broccoli can have a certain effect on preventing esophageal cancer, gastric cancer, and other diseases.

　　Gastric cancer must be differentiated from gastric ulcer, gastric simple息肉, benign tumors, sarcomas, chronic inflammation in the stomach. Sometimes it is also necessary to differentiate from hypertrophy of gastric folds, megafolds, gastric mucosal prolapse, pyloric muscle hypertrophy, and severe gastric fundus varices. The main methods of differential diagnosis rely on X-ray barium meal examination, gastroscopy, and pathological examination of biopsied tissue.

　　1. Laboratory examination for early suspected gastric cancer includes low levels or absence of free gastric acid, such as a decrease in hematocrit, hemoglobin, and red blood cells, occult blood in stool (+). The total hemoglobin level is low, and there is an inversion of the white/blood cell ratio. Abnormal laboratory results may include electrolyte imbalance, acid-base balance disorders, and other abnormalities.

　　2. X-ray double-contrast examination of barium can clearly show the outline, peristalsis, mucosal morphology, and emptying time of the stomach, as well as whether there are filling defects, ulcer shadows, and other phenomena. The accuracy of the examination is nearly 80%.

　　3. Fiberoptic endoscopy is the most direct, accurate, and effective diagnostic method for diagnosing gastric cancer.

　　4. Cytological examination Some scholars advocate this examination when clinical and X-ray examinations suspect gastric cancer.

　　5. Ultrasound can understand whether there is metastasis in surrounding solid organs.

　　6. CT examination to understand the invasion of gastric tumor, its relationship with surrounding organs, and whether resection is possible.

　　1. Change in the nature and regularity of pain Pain is the most common and main symptom of ulcer disease. The pain is usually localized in the upper abdomen as a hidden pain, burning pain, or dull pain. The pain of typical ulcer disease has a certain regularity and is closely related to diet, such as duodenal ulcers are often painful before meals (i.e., empty stomach pain); typical gastric ulcers are painful after meals, often occurring 1-2 hours after eating, lasting for one or two hours, and then gradually diminishing. However, some ulcer patients may not have a clear regularity of pain, and the nature of pain may vary from person to person. In addition, the pain of ulcer disease often intensifies due to cold weather, eating cold and hard food, fatigue, staying up late, and emotional fluctuations. If the pain loses its original regularity, becomes irregular, or becomes a persistent hidden pain, or if the nature of the pain changes significantly compared to before, one should be vigilant of malignancy and go to the hospital for further examination.

　　2. Decreased therapeutic effect of ulcer disease Although ulcer disease is prone to recurrence, symptoms are always relieved after taking anti-ulcer drugs during each attack. If a person with a history of ulcers does not relieve pain or the effect is not obvious according to routine treatment, it suggests that malignancy may have occurred.

　　3. Progressive weight loss and anemia Chronic ulcer patients may be weak, but not necessarily thin. Unless the ulcer bleeds for a long time or in large amounts, the patient generally does not have obvious signs of anemia. Gastric ulcer patients over the age of forty or fifty who have a decrease in appetite, poor digestion, nausea, vomiting, vomiting of food or dark red food, and overall fatigue and progressive weight loss may also be one of the signs of ulcer malignancy.

　　4. Generally, fixed masses do not form in gastric or duodenal ulcers. If malignancy occurs, the ulcer will become larger and harder, and a mass can be felt in the upper left abdomen in the later stage. The mass is hard, the surface is often nodular, uneven, and gradually increases in size, and is painful when pressed. The pain can radiate to the back, left腰部, umbilicus, chest, precordial area, and even behind the sternum.

　　Due to the improvement in the diagnosis and treatment of gastric cancer, the indications for surgery have been expanded accordingly. Currently, except for patients with large primary lesions, fixed lesions, widespread metastasis of abdominal organs, and blood ascites presenting with cachexia, all patients should strive for laparotomy, resection of the primary tumor, and alleviation of symptoms. According to the statistics of 11,734 gastric cancer surgeries in China, the surgery rate is 81.8%, and the total resection rate is 49.7%. In recent years, the resection rate of cancer has increased to about 75%, mainly due to the improvement in the resection rates of stage II and III gastric cancer.

　　1. Types of gastric cancer surgery include:

　　1. Radical resection:

　　Radical resection surgery has two types: radical resection and extended radical resection.

　　(1) The radical resection range should include the primary tumor, along with the distal 2/3 or 4/5 of the stomach, all the greater and lesser omentum, the first part of the duodenum, regional lymph nodes, and the whole resection of locally infiltrated organs, with no residual cancer cells at the gastric or duodenal stump.

　　(2) The extended radical resection range, in addition to the above content, also requires the resection of the whole stomach or adjacent invaded transverse colon, left liver lobe, spleen, body and tail of pancreas, left cardia and splenic hilar lymph nodes, etc. The selection of the above two surgical methods has not been unified until now, and the main point of divergence is the range of gastric resection and the range of lymph node dissection.

　　In order to improve the cure rate of gastric cancer, surgery should be selected according to the specific condition, and cannot be rigidly specified. If the tumor is located in the pyloric antrum and distal lesser curvature, radical gastrectomy is recommended; when the disease is advanced with deep lymph node metastasis or cancer of the gastric body, diffuse infiltrative cancer, it should be considered to perform extended radical surgery. Although extended radical surgery can improve the efficacy to a certain extent, the mortality and postoperative complications are still higher than those of radical surgery. This operation cannot replace radical surgery.

　　2. Palliative resection:

　　For patients with gastric cancer with extensive peritoneal or lymph node metastasis, but the primary tumor can be resected, and the patient's general condition can tolerate surgery, palliative gastrectomy can be performed. This operation can alleviate the patient's toxic symptoms, eliminate complications such as obstruction, hemorrhage, or perforation caused by the tumor. Postoperative adjuvant chemotherapy and traditional Chinese medicine treatment can extend the patient's survival period.

　　3. Short-circuit surgery:

　　Applicable to patients with advanced gastric cancer who cannot be surgically resected and are accompanied by obstruction.

　　For patients with cancer of the pyloric antrum and pyloric obstruction, a precolonic or postcolonic gastrojejunal anastomosis can be performed. For patients with gastric cardia cancer complicated with obstruction, a side-to-side jejunoesophageal anastomosis can be performed, which often requires thoracotomy to complete the operation, and the surgical indications should be stricter than the former. Generally, shortcut surgery cannot improve the efficacy, but can alleviate the pain of patients and improve their quality of life.

　　Although surgery can remove the tumor, there are still residual cancer, or regional lymph node metastasis, or cancer thrombus in blood vessels, etc., with a very high probability of recurrence and metastasis. Long-term treatment with traditional Chinese medicine after surgery can prevent recurrence and metastasis.

　　2. Radiotherapy

　　There are many radiation complications, which can even lead to the loss of some functions; for patients with advanced tumors, the efficacy of radiotherapy is not perfect. At the same time, patients with poor constitution and advanced age will only lead to more dangerous lives by continuing radiotherapy, accelerating the death of patients. The radiosensitivity of gastric adenocarcinoma is low, and only 60% of patients with tumor shrinkage of more than 50% after combined radiotherapy or chemotherapy, and only 10% of patients have complete tumor disappearance. Therefore, radiotherapy cannot be used alone to cure gastric cancer, and the role of radiotherapy in the treatment of gastric cancer is mainly auxiliary or palliative. It is often used in comprehensive treatment, and the main forms of radiotherapy include preoperative radiotherapy, intraoperative radiotherapy, postoperative radiotherapy, and palliative radiotherapy. According to literature reports, preoperative radiotherapy can increase the resection rate of radical surgery by about 2%, and increase the 5-year survival rate of advanced and middle-late gastric cancer by 1% to 2.5%.

　　3. Chemotherapy

　　After gastric cancer surgery, except for a few patients, most patients need postoperative chemotherapy. The reason is that there may be residual cancer cells after surgery, or some gastric cancer surgeries are difficult to completely remove, or there are metastatic lesions in the lymphatic or blood system. Practice has proven that postoperative chemotherapy combined with surgery is better than simple surgery, with a longer survival period and less recurrence. This is why doctors often arrange chemotherapy for patients before surgery.

　　1. There are many chemotherapy regimens for gastric cancer, the following regimen is provided for reference.

　　(1) Taxol 210mg/m2 i.v. (infusion for 3 hours)

　　(2) ECF Epirubicin 50mg/m2 i.v. (infusion for 3 hours) d1 * Cisplatin 60mg/m2 i.v. d1 * 5-Fu 200mg/m2/d (continuous infusion) for 21 days * repeat every 21 days

　　(3) FAMTX Methotrexate 1000-1500mg/m2 i.v. d1, 5-Fu 1500mg/m2 i.v. d1 one hour after Methotrexate, Doxorubicin 30mg/m2 i.v. d15, Leucovorin 15mg/m2 p.o. every 6 hours, a total of 12 times, starting 24 hours after Methotrexate administration. Repeat every 4 weeks

　　(4) ELF Etoposide 20mg/m2 i.v. (infusion for 50 minutes) d1-3, Tetrahydrofolic acid 300mg/m2 i.v. (infusion for 10 minutes) d1-3, 5-Fu 500mg/m2 i.v. (infusion for 10 minutes) d1-3, repeat every 3-4 weeks (5) TAXOL + 5-Fu + DDP Paclitaxel 175mg/m2 i.v. (infusion for 3 hours) d15, 5-Fu 750mg/m2 i.v. (continuous infusion for 24 hours) d1-5, DDP 20mg/m2 i.v. (infusion for 2 hours) d1-5, repeat every 4 weeks.

　　2. Advantages and disadvantages of chemotherapy

　　Chemotherapy differs from surgical treatment and radiotherapy in that it has an overall effect on the human body, acting throughout the body through oral and intravenous administration. Cancer, on the other hand, is a local manifestation of a systemic disease. The greatest threat to patients is the spread and metastasis. Chemotherapy has unique advantages in eliminating distant metastases of certain cancers or preventing recurrence, and is an indispensable part of cancer treatment methods.

　　Chemotherapy is being used more and more widely in tumor treatment. It has been proven that at least 10 types of tumors can be cured by chemotherapy alone, such as choriocarcinoma, acute lymphoblastic leukemia, testicular seminoma, and some malignant lymphomas; about 20 or more types of tumors can be relieved by chemotherapy alone, especially for systemic tumors such as leukemia and multiple myeloma, and for tumors that have metastasized and spread, chemotherapy can be the preferred treatment method. More than half of all cancer patients need chemotherapy at different stages of the disease; when combined with other treatment methods, chemotherapy greatly improves the effectiveness of treating malignant tumors and effectively controls the spread and metastasis of cancer.

　　Chemotherapy is the fastest progressing treatment method in tumor treatment in recent years. However, chemotherapeutic drugs often 'cannot differentiate between friend and foe', and while killing tumor cells, they also kill normal cells in the human body.

      Chemotherapy may cause the following toxic effects and adverse reactions:

　　(1) During intravenous injection of chemotherapeutic drugs, if the medication leaks out due to improper operation, it can cause local tissue necrosis and thrombophlebitis. Therefore, medical staff must be very careful and take careful precautions;

　　|(2) They can suppress the hematopoietic system of the bone marrow, mainly leading to decreased white blood cells and platelets. Before each chemotherapy session, a blood count should be performed. If the white blood cell count is below (2.5-3) × 10^9/L and the platelet count is (50-80) × 10^9/L, chemotherapy should be temporarily stopped, and medication to increase blood cells should be taken according to the doctor's advice. In addition to the existing squalene, leucovorin, nucleotides, and vitamin B6, as well as traditional Chinese medicine for invigorating the body and enriching the blood, some colony-stimulating factors produced by recombinant DNA technology in recent years have a significant effect on promoting the proliferation of blood cells. These drugs should be used promptly after chemotherapy to prevent a significant decrease in white blood cells;

　　(3) They can cause varying degrees of damage to liver cells, leading to increased alanine aminotransferase, rising bilirubin, liver enlargement, pain in the liver area, jaundice, and in severe cases, liver cirrhosis and coagulation mechanism disorders. Therefore, liver function should be checked before and during medication, and problems should be identified and resolved promptly, and chemotherapy should be stopped if necessary;

　　(4) Some chemotherapeutic drugs have toxic effects on the cardiovascular system, and severe cases can lead to heart failure. Therefore, electrocardiograms should be checked before and during medication, and medication should be stopped immediately if abnormalities are found, and treatment should be provided promptly. Patients with heart disease should avoid using chemotherapeutic drugs that are toxic to the heart;

　　(5) Chemotherapeutic drugs with toxic effects and adverse reactions on the respiratory system can cause acute chemical pneumonitis and chronic pulmonary fibrosis, and even respiratory failure. Therefore, when using pulmonary toxic drugs (i.e., chemotherapeutic drugs that are toxic to the respiratory system), such as kanamycin, regular lung checks should be conducted during medication, and follow-up should be paid attention to after discontinuation of medication. If pulmonary toxic reactions are found, chemotherapy should be stopped immediately and hormone therapy should be administered;

　　(6) The toxic effects and adverse reactions of the urinary system include proteinuria, oliguria, or anuria, and some may develop hematuria. In order to clearly understand kidney function, regular checks should be conducted before and during medication, and problems should be treated promptly. During treatment, one should drink plenty of green tea water and take diuretic and analgesic herbal medicine to ensure daily urine output of 2000 to 3000 milliliters. Experience has shown that this can reduce the toxic effects and adverse reactions of the urinary system;

　　(7) Some drugs can affect fertility and lead to teratogenesis. During chemotherapy, male patients should practice contraception, and female patients with pregnancy should discontinue or avoid chemotherapy. Generally, after stopping the medicine, the reproductive function can be restored;

　　(8) Hair loss and skin reactions are not experienced by all patients, and even if they occur, there is no need to worry excessively, because generally, after the patient stops taking the medicine, the hair that has fallen out will grow back, and the skin rash, eczema, and hyperpigmentation will improve or disappear;

　　(9) Among the systemic reactions of chemotherapy, the toxic effects and adverse reactions of the digestive system are the most troubling to patients, such as nausea, vomiting, loss of appetite, abdominal pain, diarrhea, as well as oral mucosal ulcers, pharyngitis, etc.

　　In view of the above issues, chemotherapy is generally combined with traditional Chinese medicine, chemotherapy combined with biological immunotherapy, which has effects on survival quality and anti-cancer effects similar to those of simple chemotherapy.

　　Four, immunotherapy

　　The indications for immunotherapy include:

　　1. Early gastric cancer根治术后适合全身应用免疫刺激剂；

　　2. In cases that cannot be resected or palliative resection, immunostimulants can be directly injected into the residual cancer.

　　3. Patients in the late stage with ascites are suitable for intraperitoneal injection of immunostimulating drugs.

　　The new cause of traditional Chinese medicine treatment for gastric cancer requires the regulation of the result of long-term fasting with a reasonable life rhythm. The long-term fasting artificially slows down the working rhythm of the stomach, which should be running at high speed. The food reaching the stomach is only a little, and it does not require much work to complete the small amount. Over time, their operating capacity will also gradually decrease, and they can no longer withstand even a little training and challenge. At the same time, our stomach has to endure the torment of being soaked in excess gastric acid. In the long run, the damage to the organs is more worthy of attention than the obvious problems of nutrition and vitality, and severe cases may lead to cancer. Of course, this is not to say that eating more is better, but to learn how to eat intelligently and correctly. So-called intelligent eating is to understand that the ultimate goal of weight loss is to control body weight, and the key to controlling body weight is to accelerate the speed of calorie burning. In addition to accelerating the metabolism within the body through exercise, we can also choose foods that can be burned quickly. Some anti-cancer foods should also be consumed more in daily life, such as sweet potatoes, asparagus, celery, broccoli, etc. For those who really love beauty and are accustomed to long-term fasting, it is best to consume a certain amount of food every day to prevent a repeat of tragedy. Have three meals a day as usual, but each meal can be more refined. This helps to maintain stable blood sugar levels, which means you won't be so hungry for high-fat or high-sugar foods to maintain blood sugar levels, and it can also promote digestion. We know that the more you eat, the harder it is to digest; this is because the digestive enzymes produced within our bodies are limited, and if the amount of food to be dealt with exceeds the limit, of course, it cannot be digested. Filling your intestines and stomach with indigestible food is not only harmful to the immune system, of course, but also has no benefit to our main goal -- maintaining a healthy body shape.

　　V. Traditional Chinese Medicine Treatment

　　Traditional Chinese medicine believes that the cause of cancer is first the imbalance of Yin and Yang in the human body, and the mutation of tissue cells under the long-term action of different carcinogenic factors, which is mainly manifested as abnormal and excessive proliferation of tissue cells. In fact, cancer tissue is also part of the human body. Only when the human body's Yin and Yang balance is disturbed, the immune monitoring system of the human body will lose its monitoring power over it. Over time, cancer cells multiply increasingly, the tumor forces become increasingly strong, and finally erode the surrounding normal tissues, consume a large amount of energy and nutrition, affect the normal physiological metabolism of the human body, and cause the body to gradually fail. Therefore, traditional Chinese medicine insists on 'harmony' as the right way to treat cancer, harmonizing Yin and Yang, improving immunity, and enhancing organ function.

　　Traditional Chinese medicine takes the theory of dialectical treatment as the foundation, combines the theories of acupuncture, cancer health induction, immune anti-cancer, and other theories, and produces a treatment method that combines anti-cancer and life-saving with treating the root cause. It fights cancer by improving the function of tumor stromal cells; it saves life by regulating Qi and blood, adjusting the balance of Yin and Yang, and maintaining normal vital signs; it treats the root cause by reinforcing the body's vital energy, producing antibodies, and clearing the 'toxin source'. Among various cancer treatment methods, traditional Chinese medicine is the only technical means with almost no adverse reactions. The defect of traditional Chinese medicine lies in its slow effect, inability to quickly alleviate and control the condition; the variety of traditional Chinese medicine for tumors is numerous, and choosing the best prescription combination has also become a difficult point; the bitter and astringent taste of traditional Chinese medicine decoction makes it difficult for patients to take it for a long time.