OBJECTIVE To study the effect of epipolythiodioxopiperazine compound C87 on tumor cell proliferation and explore the potential mechanisms. METHODS Tumor cells were exposed to C87 0.05-1 μmol.L-1 for 24, 48 and 72 h, cell viability was determined by sulforhodamine B (SRB) assay and the half growth inhibition (Gl50 ) was calculated. After treatment with C87 0.1-2.5 μmol.L-1 for 6 h, or C87 2.5 μmol.L-1 for 0-6 h, the generation of reactive oxygen species (ROS) was measured using the compound 2′,7′-dichlorofluoresceindiacetate and flow cytometry analysis. After treatment with C87 2.5 μmol.L-1 , either alone or with antioxidant N-acetylcysteine (NAC), for 6 h, the generation of ROS was measured by flow cytometry analysis. Tumor cells were exposed to C87 0.05-1 μmol.L-1 , either alone or with NAC, for 24 and 48 h, while cell viability was determined by SRB assay. RESULTS The cell viability was significantly reduced following exposure to C87 0.05-1 μmol.L-1 for 24, 48 and 72 h in a concentration-dependent manner in A549, HCT116, HeLa and SMMC7721 cells(P<0.05). At 72 h, the value of r2 was 0.946, 0.989, 0.973 and 0.984(P<0.05), respectively. The cell viability was significantly reduced following exposure to C87 1 μmol.L-1 for 24 - 72 h in a time-dependent manner in A549, HCT116, HeLa and SMMC7721 cells(P<0.05). The value of r2 was 0.983, 0.956, 0.951 and 0.873(P<0.05), respectively. The generation of ROS was increased after exposure to C87 0.25-2.5 μmol.L-1 in a concentration-dependent manner in HCT116 and HeLa cells for 6 h (r2 = 0.760, P = 0.045: r2 = 0.987, P=0.001), and after exposure to C87 2.5 μmol.L-1 in a time-dependent manner in HCT116 and HeLa cells for 0.5-6 h (r2 = 0.886, P = 0.017: r2 = 0.994, P = 0.000).The C87-induced ROS generation could be blocked by NAC in HCT116 and HeLa cells(P<0.05). The C87 induced cell death could be blocked by NAC 5 and 10 mmol.L-1 , and the Gl50 value was 1.446 and 1.134 μmol.L-1 for 24 h (the Gl50 value of C87 group was 0.513 μmol.L-1 ), and 0.882 and 1.166 μmol.L-1 for 48 h (the Gl50 value of C87 group was 0.333 μmol.L-1 ). CONCLUSION The novel epipolythiodioxopiperazine derivative C87 exerts potent antitumor activity in vitro, possibly via triggering ROS production.

Objective:To investigate the clinical efficiency of gastrocnemius muscle flap combined with antibiotics loaded calcium sulfate in the treatment of postoperative infection and plate exposure of tibial plateau fracture in elderly patients.Methods:From January, 2015 to May, 2019, 21 elderly patients with postoperative infection and plate exposure of tibial plateau fracture were treated, including 14 males and 7 females with an average age of 72.6 years, ranging from 61 to 82 years. The average course of disease was 22.7 days, ranging from 6 to 91 days. The site of wound infection was at medial in 8 cases, lateral in 9 cases and bilateral in 4 cases. The size of wound ranged from 2.0 cm×3.5 cm to 5.0 cm×12.0 cm. All wounds were implanted with antibiotics loaded calcium sulfate and repaired by gastrocnemius muscle flap combined with skin graft after debridement. Muscle flap survival, wound healing, inflammatory index, fracture healing and knee joint function were recorded. The curative effect was evaluated by McKee infection treatment criteria and the knee joint function was evaluated by HSS scoring criteria.Results:All 21 muscle flaps survived. In 1 case, skin graft necrosis occurred in a small area, and the wound healed well after dressing change. One case had exudation which was clear and the bacterial culturing was negative, and the wound healed after 2 weeks of dressing change. The other incisions were healed in stage I, and the healing rate was 90%. All patients were followed-up for an average of 28.7(16-39) months. The redness and swelling occurred in 1 case without exudation after 2 months which disappeared after anti-infection treatment and didn't recur again. The infection recurred in 1 case after 5 months, and it which was controlled after debridement and plate removal. According to McKee criteria, 19 cases were cured, 1 improved and 1 recurred with an effective rate of 95.2%. The fracture healing time was from 3 to 7 months, with an average of 4.6 months. According to HSS scoring criteria, the knee joint function was excellent in 12 cases, good in 7 cases and moderate in 2 cases.Conclusion:After thorough debridement, gastrocnemius muscle flap combined with antibiotic loaded calcium sulfate can effectively control the infection, repair the wound, promote fracture union and restore limb function in the treatment of postoperative infection and plate exposure of tibial plateau fracture in elderly patients.

Objective:In order to further enrich and improve the pricing strategy of chronic disease health management services in China.Methods:A discrete choice test was used to investigate the willingness to pay for personalized health service packages for chronic disease patients in Wuhou District,Chengdu City,as a representative of personalized health service packages for primary healthcare institutions,with integration as a utility indicator and blood pressure/glucose control rate as an effect indicator,which was used as a basis for pricing.Results:A total of 238 valid questionnaires were considered.According to conditional logit regression analysis,respondents were willing to pay 147.13 yuan/year to improve service package integration from low to high,and 177.12 yuan/year to improve blood pressure/blood sugar from one day a week(low level)to seven days a week(high level),but there was no significant willingness to pay for other improvements.Conclusion:It is discovered that there is a comparable willingness to pay for health management services to patients with chronic diseases in Chinese community in terms of service utility and effect,and it is proposed that the value of service experience be included in primary health management pricing.

Objective:In order to further enrich and improve the pricing strategy of chronic disease health management services in China.Methods:A discrete choice test was used to investigate the willingness to pay for personalized health service packages for chronic disease patients in Wuhou District,Chengdu City,as a representative of personalized health service packages for primary healthcare institutions,with integration as a utility indicator and blood pressure/glucose control rate as an effect indicator,which was used as a basis for pricing.Results:A total of 238 valid questionnaires were considered.According to conditional logit regression analysis,respondents were willing to pay 147.13 yuan/year to improve service package integration from low to high,and 177.12 yuan/year to improve blood pressure/blood sugar from one day a week(low level)to seven days a week(high level),but there was no significant willingness to pay for other improvements.Conclusion:It is discovered that there is a comparable willingness to pay for health management services to patients with chronic diseases in Chinese community in terms of service utility and effect,and it is proposed that the value of service experience be included in primary health management pricing.

Objective:In order to further enrich and improve the pricing strategy of chronic disease health management services in China.Methods:A discrete choice test was used to investigate the willingness to pay for personalized health service packages for chronic disease patients in Wuhou District,Chengdu City,as a representative of personalized health service packages for primary healthcare institutions,with integration as a utility indicator and blood pressure/glucose control rate as an effect indicator,which was used as a basis for pricing.Results:A total of 238 valid questionnaires were considered.According to conditional logit regression analysis,respondents were willing to pay 147.13 yuan/year to improve service package integration from low to high,and 177.12 yuan/year to improve blood pressure/blood sugar from one day a week(low level)to seven days a week(high level),but there was no significant willingness to pay for other improvements.Conclusion:It is discovered that there is a comparable willingness to pay for health management services to patients with chronic diseases in Chinese community in terms of service utility and effect,and it is proposed that the value of service experience be included in primary health management pricing.

Objective:In order to further enrich and improve the pricing strategy of chronic disease health management services in China.Methods:A discrete choice test was used to investigate the willingness to pay for personalized health service packages for chronic disease patients in Wuhou District,Chengdu City,as a representative of personalized health service packages for primary healthcare institutions,with integration as a utility indicator and blood pressure/glucose control rate as an effect indicator,which was used as a basis for pricing.Results:A total of 238 valid questionnaires were considered.According to conditional logit regression analysis,respondents were willing to pay 147.13 yuan/year to improve service package integration from low to high,and 177.12 yuan/year to improve blood pressure/blood sugar from one day a week(low level)to seven days a week(high level),but there was no significant willingness to pay for other improvements.Conclusion:It is discovered that there is a comparable willingness to pay for health management services to patients with chronic diseases in Chinese community in terms of service utility and effect,and it is proposed that the value of service experience be included in primary health management pricing.

Objective:In order to further enrich and improve the pricing strategy of chronic disease health management services in China.Methods:A discrete choice test was used to investigate the willingness to pay for personalized health service packages for chronic disease patients in Wuhou District,Chengdu City,as a representative of personalized health service packages for primary healthcare institutions,with integration as a utility indicator and blood pressure/glucose control rate as an effect indicator,which was used as a basis for pricing.Results:A total of 238 valid questionnaires were considered.According to conditional logit regression analysis,respondents were willing to pay 147.13 yuan/year to improve service package integration from low to high,and 177.12 yuan/year to improve blood pressure/blood sugar from one day a week(low level)to seven days a week(high level),but there was no significant willingness to pay for other improvements.Conclusion:It is discovered that there is a comparable willingness to pay for health management services to patients with chronic diseases in Chinese community in terms of service utility and effect,and it is proposed that the value of service experience be included in primary health management pricing.

Objective:In order to further enrich and improve the pricing strategy of chronic disease health management services in China.Methods:A discrete choice test was used to investigate the willingness to pay for personalized health service packages for chronic disease patients in Wuhou District,Chengdu City,as a representative of personalized health service packages for primary healthcare institutions,with integration as a utility indicator and blood pressure/glucose control rate as an effect indicator,which was used as a basis for pricing.Results:A total of 238 valid questionnaires were considered.According to conditional logit regression analysis,respondents were willing to pay 147.13 yuan/year to improve service package integration from low to high,and 177.12 yuan/year to improve blood pressure/blood sugar from one day a week(low level)to seven days a week(high level),but there was no significant willingness to pay for other improvements.Conclusion:It is discovered that there is a comparable willingness to pay for health management services to patients with chronic diseases in Chinese community in terms of service utility and effect,and it is proposed that the value of service experience be included in primary health management pricing.

Objective:In order to further enrich and improve the pricing strategy of chronic disease health management services in China.Methods:A discrete choice test was used to investigate the willingness to pay for personalized health service packages for chronic disease patients in Wuhou District,Chengdu City,as a representative of personalized health service packages for primary healthcare institutions,with integration as a utility indicator and blood pressure/glucose control rate as an effect indicator,which was used as a basis for pricing.Results:A total of 238 valid questionnaires were considered.According to conditional logit regression analysis,respondents were willing to pay 147.13 yuan/year to improve service package integration from low to high,and 177.12 yuan/year to improve blood pressure/blood sugar from one day a week(low level)to seven days a week(high level),but there was no significant willingness to pay for other improvements.Conclusion:It is discovered that there is a comparable willingness to pay for health management services to patients with chronic diseases in Chinese community in terms of service utility and effect,and it is proposed that the value of service experience be included in primary health management pricing.

Objective:In order to further enrich and improve the pricing strategy of chronic disease health management services in China.Methods:A discrete choice test was used to investigate the willingness to pay for personalized health service packages for chronic disease patients in Wuhou District,Chengdu City,as a representative of personalized health service packages for primary healthcare institutions,with integration as a utility indicator and blood pressure/glucose control rate as an effect indicator,which was used as a basis for pricing.Results:A total of 238 valid questionnaires were considered.According to conditional logit regression analysis,respondents were willing to pay 147.13 yuan/year to improve service package integration from low to high,and 177.12 yuan/year to improve blood pressure/blood sugar from one day a week(low level)to seven days a week(high level),but there was no significant willingness to pay for other improvements.Conclusion:It is discovered that there is a comparable willingness to pay for health management services to patients with chronic diseases in Chinese community in terms of service utility and effect,and it is proposed that the value of service experience be included in primary health management pricing.