Thirteen novel diterpenoids, comprising seven tiglianes (walliglianes G-M, 1-7), four rhamnofolanes (wallinofolanes A-D, 8-11), and two daphnanes (wallaphnanes A and B, 12 and 13), together with two known rhamnofolane diterpenoids (euphorwallside H and euphorwallside I, 14 and 15), were isolated and characterized from Euphorbia wallichii(E. wallichii). The chemical structures of these compounds were elucidated through nuclear magnetic resonance (NMR), mass spectrometry (MS), and quantum chemical calculations. Compounds 9 and 11 demonstrated protective effects against H₂O₂-induced BV-2 microglial cell damage. Molecular docking analyses indicated that compound 9 exhibited binding affinity to the anti-oxidant-related targets HMGCR, GSTP1, and SHBG.
Euphorbia/chemistry* ; Antioxidants/isolation & purification* ; Diterpenes/isolation & purification* ; Molecular Structure ; Mice ; Molecular Docking Simulation ; Animals ; Hydrogen Peroxide/toxicity* ; Cell Line ; Microglia/drug effects*

Objective:To evaluate the economy of recombinant human thrombopoietin(rhTPO)combined with conventional therapy compared with conventional therapy in the treatment of sepsis-associated thrombocytopenia(SIT)from the perspective of China's health service system.Methods:The decision tree model was constructed,and the minimum cost analysis and cost-effectiveness analysis were used to evaluate the economy based on the characteristics of sepsis.The economy was judged by two willingness to pay thresholds,and then the stability of the results was tested by sensitivity analysis.Results:rhTPO combined with conventional therapy can save 520.58 yuan for each 1％increase in survival rate compared with conventional therapy alone,which is an absolute advantage program.The single factor sensitivity analysis showed that the daily cost of ICU medical service and the duration of CRRT in the control group and the daily cost of ICU medical service in the experimental group had a great influence on the results,and the stability of the parameter outcome was good.The probability sensitivity analysis showed that when the willingness to pay threshold changes ranged 0～268 074 yuan,rhTPO has a 100％economical probability.Conclusion:Under the existing evidence,rhTPO combined with conventional treatment for SIT treatment is more economical on the basis of improving survival rate and equal safety.

Objective:To evaluate the economy of recombinant human thrombopoietin(rhTPO)combined with conventional therapy compared with conventional therapy in the treatment of sepsis-associated thrombocytopenia(SIT)from the perspective of China's health service system.Methods:The decision tree model was constructed,and the minimum cost analysis and cost-effectiveness analysis were used to evaluate the economy based on the characteristics of sepsis.The economy was judged by two willingness to pay thresholds,and then the stability of the results was tested by sensitivity analysis.Results:rhTPO combined with conventional therapy can save 520.58 yuan for each 1％increase in survival rate compared with conventional therapy alone,which is an absolute advantage program.The single factor sensitivity analysis showed that the daily cost of ICU medical service and the duration of CRRT in the control group and the daily cost of ICU medical service in the experimental group had a great influence on the results,and the stability of the parameter outcome was good.The probability sensitivity analysis showed that when the willingness to pay threshold changes ranged 0～268 074 yuan,rhTPO has a 100％economical probability.Conclusion:Under the existing evidence,rhTPO combined with conventional treatment for SIT treatment is more economical on the basis of improving survival rate and equal safety.

Objective:To evaluate the economy of recombinant human thrombopoietin(rhTPO)combined with conventional therapy compared with conventional therapy in the treatment of sepsis-associated thrombocytopenia(SIT)from the perspective of China's health service system.Methods:The decision tree model was constructed,and the minimum cost analysis and cost-effectiveness analysis were used to evaluate the economy based on the characteristics of sepsis.The economy was judged by two willingness to pay thresholds,and then the stability of the results was tested by sensitivity analysis.Results:rhTPO combined with conventional therapy can save 520.58 yuan for each 1％increase in survival rate compared with conventional therapy alone,which is an absolute advantage program.The single factor sensitivity analysis showed that the daily cost of ICU medical service and the duration of CRRT in the control group and the daily cost of ICU medical service in the experimental group had a great influence on the results,and the stability of the parameter outcome was good.The probability sensitivity analysis showed that when the willingness to pay threshold changes ranged 0～268 074 yuan,rhTPO has a 100％economical probability.Conclusion:Under the existing evidence,rhTPO combined with conventional treatment for SIT treatment is more economical on the basis of improving survival rate and equal safety.

Objective:To evaluate the economy of recombinant human thrombopoietin(rhTPO)combined with conventional therapy compared with conventional therapy in the treatment of sepsis-associated thrombocytopenia(SIT)from the perspective of China's health service system.Methods:The decision tree model was constructed,and the minimum cost analysis and cost-effectiveness analysis were used to evaluate the economy based on the characteristics of sepsis.The economy was judged by two willingness to pay thresholds,and then the stability of the results was tested by sensitivity analysis.Results:rhTPO combined with conventional therapy can save 520.58 yuan for each 1％increase in survival rate compared with conventional therapy alone,which is an absolute advantage program.The single factor sensitivity analysis showed that the daily cost of ICU medical service and the duration of CRRT in the control group and the daily cost of ICU medical service in the experimental group had a great influence on the results,and the stability of the parameter outcome was good.The probability sensitivity analysis showed that when the willingness to pay threshold changes ranged 0～268 074 yuan,rhTPO has a 100％economical probability.Conclusion:Under the existing evidence,rhTPO combined with conventional treatment for SIT treatment is more economical on the basis of improving survival rate and equal safety.

Objective:To evaluate the economy of recombinant human thrombopoietin(rhTPO)combined with conventional therapy compared with conventional therapy in the treatment of sepsis-associated thrombocytopenia(SIT)from the perspective of China's health service system.Methods:The decision tree model was constructed,and the minimum cost analysis and cost-effectiveness analysis were used to evaluate the economy based on the characteristics of sepsis.The economy was judged by two willingness to pay thresholds,and then the stability of the results was tested by sensitivity analysis.Results:rhTPO combined with conventional therapy can save 520.58 yuan for each 1％increase in survival rate compared with conventional therapy alone,which is an absolute advantage program.The single factor sensitivity analysis showed that the daily cost of ICU medical service and the duration of CRRT in the control group and the daily cost of ICU medical service in the experimental group had a great influence on the results,and the stability of the parameter outcome was good.The probability sensitivity analysis showed that when the willingness to pay threshold changes ranged 0～268 074 yuan,rhTPO has a 100％economical probability.Conclusion:Under the existing evidence,rhTPO combined with conventional treatment for SIT treatment is more economical on the basis of improving survival rate and equal safety.

Objective:To evaluate the economy of recombinant human thrombopoietin(rhTPO)combined with conventional therapy compared with conventional therapy in the treatment of sepsis-associated thrombocytopenia(SIT)from the perspective of China's health service system.Methods:The decision tree model was constructed,and the minimum cost analysis and cost-effectiveness analysis were used to evaluate the economy based on the characteristics of sepsis.The economy was judged by two willingness to pay thresholds,and then the stability of the results was tested by sensitivity analysis.Results:rhTPO combined with conventional therapy can save 520.58 yuan for each 1％increase in survival rate compared with conventional therapy alone,which is an absolute advantage program.The single factor sensitivity analysis showed that the daily cost of ICU medical service and the duration of CRRT in the control group and the daily cost of ICU medical service in the experimental group had a great influence on the results,and the stability of the parameter outcome was good.The probability sensitivity analysis showed that when the willingness to pay threshold changes ranged 0～268 074 yuan,rhTPO has a 100％economical probability.Conclusion:Under the existing evidence,rhTPO combined with conventional treatment for SIT treatment is more economical on the basis of improving survival rate and equal safety.

Objective:To evaluate the economy of recombinant human thrombopoietin(rhTPO)combined with conventional therapy compared with conventional therapy in the treatment of sepsis-associated thrombocytopenia(SIT)from the perspective of China's health service system.Methods:The decision tree model was constructed,and the minimum cost analysis and cost-effectiveness analysis were used to evaluate the economy based on the characteristics of sepsis.The economy was judged by two willingness to pay thresholds,and then the stability of the results was tested by sensitivity analysis.Results:rhTPO combined with conventional therapy can save 520.58 yuan for each 1％increase in survival rate compared with conventional therapy alone,which is an absolute advantage program.The single factor sensitivity analysis showed that the daily cost of ICU medical service and the duration of CRRT in the control group and the daily cost of ICU medical service in the experimental group had a great influence on the results,and the stability of the parameter outcome was good.The probability sensitivity analysis showed that when the willingness to pay threshold changes ranged 0～268 074 yuan,rhTPO has a 100％economical probability.Conclusion:Under the existing evidence,rhTPO combined with conventional treatment for SIT treatment is more economical on the basis of improving survival rate and equal safety.

Objective:To evaluate the economy of recombinant human thrombopoietin(rhTPO)combined with conventional therapy compared with conventional therapy in the treatment of sepsis-associated thrombocytopenia(SIT)from the perspective of China's health service system.Methods:The decision tree model was constructed,and the minimum cost analysis and cost-effectiveness analysis were used to evaluate the economy based on the characteristics of sepsis.The economy was judged by two willingness to pay thresholds,and then the stability of the results was tested by sensitivity analysis.Results:rhTPO combined with conventional therapy can save 520.58 yuan for each 1％increase in survival rate compared with conventional therapy alone,which is an absolute advantage program.The single factor sensitivity analysis showed that the daily cost of ICU medical service and the duration of CRRT in the control group and the daily cost of ICU medical service in the experimental group had a great influence on the results,and the stability of the parameter outcome was good.The probability sensitivity analysis showed that when the willingness to pay threshold changes ranged 0～268 074 yuan,rhTPO has a 100％economical probability.Conclusion:Under the existing evidence,rhTPO combined with conventional treatment for SIT treatment is more economical on the basis of improving survival rate and equal safety.

Objective To compare image quality of 5.0T and 3.0T non-contrast MRI for displaying insulinoma.Methods Twelve patients with insulinoma were prospectively enrolled,and non-contrast abdominal T1WI,T2WI as well as diffusion-weighted imaging(DWI)were acquired using 5.0T and 3.0T MR scanners,respectively.The subjective scores of image quality of each sequence of 5.0T and 3.0T MRI,also of tumor-pancreas parenchyma contrast scores were compared.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of insulinomas were observed,and the displayed rate of insulinoma by each sequence and overall MRI were compared.Results The subjective scores of 5.0T T1WI and DWI were higher than those of 3.0T T1WI and DWI(both P＜0.05),but not significantly different between 5.0T and 3.0T T2WI(P=0.166).Furthermore,the tumor-pancreas parenchyma contrast score of 5.0T T1WI was higher than that of 3.0T T1WI(P=0.023),but not significantly different between 5.0T and 3.0T T2WI,nor between 5.0T and 3.0T DWI(both P＞0.05).SNR of insulinomas on 5.0T T2WI were higher than on 3.0T T2WI(P=0.015),however,no significant difference of SNR was found between 5.0T and 3.0T T1WI,nor between 5.0T and 3.0T DWI(both P＞0.05).CNR of insulinomas on all 5.0T MRI were not significantly different with those on 3.0T MRI(all P＞0.05).The displayed rate of insulinoma on 5.0T T1WI,T2WI and DWI was 100％(12/12),66.67％(8/12)and 83.33％(10/12),respectively,on 3.0TT1WI,T2WI and DWI was 75.00％(9/12),58.33％(7/12),66.67％(8/12),respectively.The overall displayed rate of insulinoma on 5.0T and 3.0T MRI was 100％(12/12)and 83.33％(10/12),respectively.Conclusion Compared with 3.0T MRI,5.0T MRI was superior for displaying insulinoma,hence being helpful for diagnosis.