trypsin. The EWPHs with papain for 3h displayed the strongest radical scavenging activity. The values of hydroxyl radical and superoxide free radical scavenging activity were 65.63% and 38.40% respectively. Conclusion EWPHs exhibited free radical scavenging activity and the activity of scavenging hydroxyl radical were stronger than superoxide radical.

OBJECTIVE:To explore the clinical efficacy and safety of cetuximab combined with NP regimen and radiotherapy in the treatment of advanced non-small cell lung cancer(NSCLC). METHODS:76 cases of advanced NSCLC were selected and randomly divided into control group and observation group according to different therapy methods,with 38 cases in each group. Control group received NP regimen(cisplatin 25 mg/m2+navelbine 12.5 mg/m2)+thoracic IMRT;observation group was additional-ly given cetuximab 400 mg/m2(first day),with maintenance dose of 250 mg/m2 weekly and last for 13 weeks. Short-term efficacy, survival situation were compared between 2 groups as well as the levels of T lymphocyte,Th1,Th2,immuneglobulin(Ig) and complement. The occurrence of ADR was recorded. RESULTS:The total effective rate of observation group was 86.84%,which was significantly higher than that of control group(65.79%),with statistical significance(P<0.05). Average survival period and 2-year survival rate of observation group were 18.70 months and 55.26%,which were significantly longer or higher than those of control group (14.75 months,31.58%),with statistical significance (P<0.05). The improvement rate of survival quality was 94.74% in observation group,which was significantly higher than 68.42% in control group,with statistical significance (P<0.05). After treatment,the levels of CD4+,CD4+/CD8+ and IgG were significantly increased in 2 groups,while the levels of CD8+, Th1,Th2 and Th1/Th2 were significantly decreased;the observation group was better than the control group,with statistical signifi-cance(P<0.05);there was no statistical significance in the levels of CD3+,IgA,IgM and complement 4 between 2 groups(P>0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Cetuximab combined with NP regimen and radiotherapy can improve clinical efficacy of advanced NSCLC,improve survival quality,prolong survival time and promote the recovery of Ig,complement and T lymphocyte,with good safety.

OBJECTIVE To investigate the characteristics and regulations of medication in different stages of disease by constructing a dynamic disease network and a cellular feature network spanning from myocardial infarction to heart failure.METHODS Based on transcrip-tome and single-cell sequencing data from a mouse model of left anterior descending coro-nary artery ligation,a dynamic early-middle-late network and cellular feature network were con-structed by integrating differential gene expres-sion trends and biological functions.The robust-ness of the perturbation effect of traditional Chi-nese medicine(TCM)on the disease network was calculated based on multi-target TCM,and we acquired the foundational data by analyzing the results of effectiveness.The predictive plat-form was scrutinized and assessed with regards to the functional attributes of FDA approved-drugs and compound prescriptions,in order to determine the primary stages of intervention and the drug patterns actions in the progression of heart failure.RESULTS In this study,we devel-oped a prediction and analysis platform for assessing the efficacy of drugs using a network-based approach.The accuracy of the system was validated by FDA approved-drugs.It was found that blood-activating drugs,heat-clearing drugs,and phlegm-expelling drugs exhibited favorable intervention effects during the early to middle stages of the disease by investigating the effects of single herbs and TCM prescriptions on disease progression.Similarly,phlegm-expelling drugs,spirit-nourishing drugs,and diuretic showed better intervention effects during the mid-dle to late stages.These findings were consis-tent with the clinical use of drugs.Analysis of the clustering heatmap results of TCM prescriptions revealed that the formulas aimed at qi stagnation and blood stasis had a strong effect in early stage,while the formulas for qi and yin deficiency and cardiorenal yang deficiency had a strong effect in the middle to late stages.Furthermore,analysis of the single-cell feature network demon-strated that TCM had advantages in modulating the changes in fibroblasts,myofibroblasts,endo-thelial cells,and granulocytes during the patho-logical process.Additionally,most prescriptions exhibited strong perturbation effects on the fea-ture network of NK-T cells,granulocytes,macro-phages,and myofibroblasts.CONCLUSION This platform quantitatively evaluates the primary action stages and characteristics of TCM and for-mulas involved in the dynamic process of myo-cardial infarction to heart failure based on the effective prediction of the efficacy of TCM and FDA approved-drugs.It provides reference for the precise clinical application of TCM and formu-las with multiple targets and multiple pathways.

OBJECTIVE: To compare the effects of transanal total mesorectal excision (taTME) and laparoscopic total mesorectal excision (laparoscopic TME) on patients' postoperative long-term bowel function. METHODS: A retrospective cohort study was used in this study. We analyzed the clinical data of 134 patients with locally advanced mid-low rectal cancer, who underwent transanal TME or laparoscopic TME in the TaLaR randomized controlled trial at the Sixth Affiliated Hospital, Sun Yat-sen University from April 2016 to November 2017. Inclusion criteria included age of 18 to 80 years old, distance from tumor low margin to anal edge ≤10 cm, preoperative staging of T1-3NxM0, and single rectal adenocarcinoma. Exclusion criteria included local recurrence, distant metastases, abdominoperineal resection, unreduced stoma, new stoma, less than 1 year after protectomy or stoma reduction, or preoperative poor anal function or incontinence. Patients were divided into taTME group and laparoscopic TME group. The taTME group received hybrid transanal and transabdominal approach performed simultaneously. The effects of surgical procedures on postoperative bowel function were evaluated with LARS (low anterior resection syndrome) scale, where 0-20 was defined as " no LARS" , 21-29 as " minor LARS" , and 30-42 as " major LARS" . Univariate and multivariate logistic regression analyses were performed to determine the risk factors associated with major LARS, with surgical approach as a pre-selected variate. RESULTS: A total of 107 patients were included. Of the 54 patients in the taTME group, 35 were male, median age was 57.2 (26.0-77.0) years old, and 22 cases had a tumor less than 5 cm from anal verge. Of the 53 patients in the laparoscopic TME group, 35 were male, median age was 62.0 (33.0-73.0) years old, and 25 cases had a tumor less than 5 cm from anal verge. All baseline clinical data including age, gender, preoperative staging, and tumor height were comparable between the two groups (all P>0.05). All operations in both groups were performed successfully. The operation time, intra-operative blood loss, postoperative anastomotic complication, postoperative hospital stay were comparable between the two groups (all P>0.05), except for a lower diverting stoma rate in the taTME group [37.0% (20/54) vs. 64.2% (34/53), χ²=7.866, P=0.005]. Of the 107 patients, 27 (25.2%) had no LARS, 32 (29.9%) had minor LARS, and 48 (44.9%) had major LARS, after a median follow-up of 17.2 (12.1-30.4) months. No significant difference was found between the two groups in overall bowel function [major LARS: 48.1% (26/54) vs. 41.5% (22/53), Z=-0.994, P=0.320]. Compared with the laparoscopic TME group, the taTME group experienced worse clustering of stools [68.5% (37/54) vs. 45.3% (24/53), Z=-2.354, P=0.019]. However, there were no significant differences between the two groups in terms of gas incontinence, liquid stool incontinence, frequency of defecation, and urgency (all P>0.05). Multivariate analysis identified preoperative radiotherapy (OR=5.073, 95% CI: 1.336 to 19.259, P=0.017) and anastomotic height (OR=3.633, 95% CI: 1.501 to 8.802, P=0.004) as independent risk factors for major LARS, but no impact of taTME on LARS (OR=1.442, 95% CI: 0.638 to 3.261, P=0.379). CONCLUSIONS Compared with laparoscopic TME, taTME has similar outcomes of postoperative long-term bowel function. Preoperative radiotherapy and anastomotic height, but not surgical approach, are independent risk factors for postoperative bowel function.
Adult ; Aged ; Defecation ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Postoperative Complications ; Rectal Neoplasms ; surgery ; Rectum ; Retrospective Studies ; Syndrome ; Transanal Endoscopic Surgery ; Young Adult