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Background Esophageal cancer threatens the life and health of patients due to its complex etiology and poor prognosis, and individualized combination treatment of traditional Chinese medicine and western medicine has certain advantages. Objective To observe the clinical efficacy of the combination of Xiaotan Huayu Tongyi Granules, Channel Kaijie Pills and CF regimen (fluorouracil+cisplatin) on the treatment of stage Ⅲ-Ⅳ phlegm-stasis interjunction esophageal squamous cell carcinoma. Methods A total of 99 patients with phlegm-stasis interjunction type esophageal squamous cell carcinoma diagnosed and treated in Henan Hospital of Traditional Chinese Medicine, Anyang Cancer Hospital and Henan Cancer Hospital from February 2020 to February 2021 were selected as the study objects and randomly divided into the control group, treatment groupⅠand treatment groupⅡ, with 33 cases in each group. The control group was treated with CF regimen, the treatment groupⅠwas treated with Xiaotan Huayu Tongyi Granules combined with CF regimen, and the treatment groupⅡ was treated with the combination of Xiaotan Huayu Tongyi Granules, Channel Kaijie Pills and CF regimen. A total of 4 courses of chemotherapy were administered with 21 days as a course. The differences in TCM syndrome score, quality of life score, Karnofsky Performance Status (KPS) score, lesion remission rate, carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) and toxic side effects among the three groups were observed. Results There was no significant difference in gender, age, body mass and tumor staging among the three groups (P>0.05). Compared with pre-treatment, retrosternal chest pain, nausea and vomiting, mucus and vomit, vomitus scores and total score were reduced in the three groups, dysphagia, oligophagia and dry stool scores were reduced in the control group and treatment group Ⅱafter treatment (P0.05) . Conclusion The combination of Xiaotan Huayu Tongyi Granules, Channel Kaijie Pills and CF regimen in the treatment of stageⅢ-Ⅳphlegm-stasis interjunction esophageal squamous cell carcinoma can improve clinical symptoms, reduce the levels of tumor markers, and improve the quality of life of patients.

The monosodium iodoacetate (MIA)-induced osteoarthritis (OA) may lead to cartilage degeneration and histopathological lesions. However, the correlation between inflammatory reaction and subchondral bone remodeling in a rodent osteoarthritic model is ambiguous. In this study, intra-articular injection of MIA was performed in 36 four-week-old specific pathogen-free male Wistar rats to induce OA. After 4 weeks of intervention, changes in intrinsic structural properties of the subchondral bones were measured, and the histological evaluation, as well as biochemical analysis, was conducted. We found that intra-articular injection of MIA increased chondrocyte apoptosis and promoted cartilage matrix degradation, such as cartilage surface defects and shallow or disappearing staining. MIA also induced inflammation, improved the expression of IL-1β, TNF-α, and matrix metalloproteinase, and decreased the expression of cartilage-specific proteins with the extension of modeling time. Meanwhile, the MIA also significantly accelerated the subchondral bone remodeling, as shown by the decreased subchondral bone density, thinning of trabeculae, disordered cartilage structure, and morphology. In conclusion, we have shown that MIA-induced rodent osteoarthritic model would cause decreased subchondral bone density, sparse trabecular bone, and other manifestations of osteoporosis accompanied by an inflammatory response, which would worsen with the progression of modeling time. Our results suggest that different phases of MIA-induced OA are associated with the changes in subchondral bone microstructure and the progression of local inflammation.

Levetiracetam may cause acute renal failure and myoclonic encephalopathy at high plasma levels, particularly in patients with renal impairment. The aim of this study was to develop a physiologically based pharmacokinetic (PBPK) model to predict levetiracetam pharmacokinetics in Chinese adults with epilepsy and renal impairment and define appropriate levetiracetam dosing regimen.PBPK models for healthy subjects and epilepsy patients with renal impairment were developed, validated, and adapted. Furthermore, we predicted the steady-state trough and peak concentrations of levetiracetam in patients with renal impairment using the final PBPK model, thereby recommending appropriate levetiracetam dosing regimens for different renal function stages. The predicted maximum plasma concentration (Cmax), time to maximum concentration (Tmax), area under the plasma concentration–time curve (AUC) were in agreement (0.8 ≤ fold error ≤ 1.2) with the observed, and the fold error of the trough concentrations in end-stage renal disease (ESRD) was 0.77 − 1.22. The prediction simulations indicated that the recommended doses of 1000, 750, 500, and 500 mg twice daily for epilepsy patients with mild, moderate, severe renal impairment, and ESRD, respectively, were sufficient to achieve the target plasma concentration of levetiracetam. [ABSTRACT FROM AUTHOR]