Objective: To compare and analyze the antibacterial effects of platelets against five common clinical pathogenic bacteria including MRSA, SE, SA, E. coli, and CRKP, and to preliminarily explore the role of DCD sensitivity in the observed variations of antibacterial effects. Methods: The same number of platelets were used to establish co-culture systems of platelets and platelet lysates with the five pathogenic bacteria. The antibacterial effects of platelets and platelet lysates on the five pathogenic bacteria were evaluated by observing the turbidity of the bacterial solution, measuring the OD value of the bacterial solution and counting the colonies. The supernatant protein of platelets co-cultured with MRSA was collected for quantitative proteomics analysis to explore the important antibacterial proteins of platelets. The content of DCD in the supernatant after co-culture of platelets and platelet lysates with the five pathogenic bacteria was detected by ELISA to preliminarily analyze the reasons for the different antibacterial effects of platelets on the five pathogenic bacteria. Results: Compared with the control group of MRSA, SA, and SE, the turbidity of the bacterial solution decreased after co-culture of platelets and platelet lysates with MRSA, SA, and SE for 12 h, and the OD value and colony count were significantly reduced (P<0.05). The turbidity of the bacterial solution did not change significantly after co-culture of platelets and platelet lysates with E. coli for 24 h, but the OD value decreased (P<0.05), and the colony count decreased to 10 CFU/mL but the difference was not statistically significant (P>0.05). Compared with the control group of CRKP, the turbidity, OD value, and colony count of the bacterial solution did not change significantly after co-culture of platelets and platelet lysates with CRKP (P>0.05). Proteomics results showed that after co-culture with MRSA, important proteins related to platelet activation, including collagen, fibrinogen, von Willebrand factor, integrin αIIbβ3, platelet glycoprotein V and IV were significantly up-regulated. ELISA results showed that after co-culture with the five pathogenic bacteria, platelets could secrete a large amount of DCD, with the content around 3 μg/mL. Conclusion: The antibacterial effect of platelets on Gram-positive bacteria MRSA, SA, and SE is better than that on Gram-negative bacteria E. coli and CRKP, and platelets have the best antibacterial effect on MRSA. The differences in antibacterial effects of platelets on the five pathogenic bacteria may be related to the sensitivity of DCD antibacterial peptides to the five pathogenic bacteria.

Objective To preliminary investigate the clinical efficacy of whole brain simultaneous integrated boost intensity-modulated radiotherapy ( SIB-IMRT ) in patients diagnosed with brain metastases ( BM) . Methods Fifty-two cases of BM admitted to our hospital from January 2016 to December 2017 were equally recruited and randomly divided into the observation and control groups. Patients in the observation group were treated with SIB-IMRT, and those in the control group received conventional whole brain radiotherapy (WBRT).The clinical efficacy and prognosis were statistically compared between two groups. Results The ORR in the observation group was 77％, significantly higher than 27％ in the control group (P=0. 00).The median survival in the observation group was 384 d,significantly longer compared with 211 d in the control group (P=0. 00).All patients in both groups successfully completed corresponding treatment. Acute adverse reactions were mainly 1-2 grade reactions. Conclusions SIB-IMRT is an efficacious and safe treatment of BM,which yields tolerable adverse events and deserves application in clinical practice.

OBJECTIVE:To investigate the affordability of essential medicines in public health and medical institutions of Shanghai Qingpu district after the implementation of the national essential medicines,and provide the basis for subsequent formula-tion and improvement of relevant policies. METHODS:Based on the WHO/HAI standardized approach,a survey on the affordabili-ty of 30 essential medicines was conducted in public health and medical institutions of Shanghai Qingpu district in aspects of equip-ping staffing,drug availability and the relativity in different levels of public health and institutions for investigation and evaluation. RESULTS:The equipping rate of 30 essential medicines in Shanghai Qingpu District varied from 53.33%-86.67%,while the date of original drugs varied from 16.67%-53.33%,the equipping rate in secondary and tertiary hospitals was high. The availability of 30 essential medicines with Approved Drug Names in secondary and tertiary hospitals (77.78%) was generally higher than that in community health service center(63.00%),while the availability of original drugs was relatively low. The essential medicines with more than 50% relativity in community health service center and tertiary hospitals were only 6 kinds of drugs. CONCLUSIONS:The equipping rate and availability of essential medicines in primary health and medical institutions are lower than that of second-ary and tertiary hospitals in Qingpu district,as well as the relativity. It is suggested to further improve equipping policy for essential medicines from the relativity to improve match rate of production place;while further study and improvement for generic drugs from bioequivalence to improve its bioequivalence with original drugs and ensure clinical efficacy.