BackgroundCommensal microbiota deteriorate in critically ill patients. The preventive effects of probiotic/synbiotic therapy on microbiota and septic complications have not been thoroughly clarified in patients with sepsis. The objective of this study was to evaluate whether synbiotics have effects on gut microbiota and reduce complications in mechanically ventilated patients with sepsis.MethodsSepsis patients who were mechanically ventilated in the intensive care unit (ICU) were included in this randomized controlled study. Patients receiving daily synbiotics (Bifidobacterium breve strain Yakult, Lactobacillus casei strain Shirota, and galactooligosaccharides) initiated within 3 days after admission (the Synbiotics group) were compared with patients who did not receive synbiotics (the No-Synbiotics group). The primary outcome was infectious complications including enteritis, ventilator-associated pneumonia (VAP), and bacteremia within 4 weeks from admission. The secondary outcomes included mortality within 4 weeks, fecal bacterial counts, and organic acid concentration. Enteritis was defined as the acute onset of continuous liquid stools for more than 12 h.ResultsSeventy-two patients completed this trial; 35 patients received synbiotics and 37 patients did not receive synbiotics. The incidence of enteritis was significantly lower in the Synbiotics than the No-Synbiotics group (6.3% vs. 27.0%; p < 0.05). The incidence of VAP was also significantly lower in the Synbiotics than the No-Synbiotics group (14.3% vs. 48.6%; p < 0.05). The incidence of bacteremia and mortality did not differ significantly between the two groups. In the analysis of fecal bacteria, the number of Bifidobacterium and Lactobacillus in the Synbiotics group was significantly higher than that in the No-Synbiotics group. In the analysis of fecal organic acids, total organic acid concentration, especially the amounts of acetate, were significantly greater in the Synbiotics group than in the No-Synbiotics group at the first week (p < 0.05).ConclusionsProphylactic synbiotics could modulate the gut microbiota and environment and may have preventive effects on the incidence of enteritis and VAP in patients with sepsis.Trial registrationUMIN, R000007633. Registered on 29 September 2011.

The unprecedented dependence of final charge separation efficiency as af unction of donor-acceptor interaction in covalently-linked molecules with ar ectilinear rigid oligo-p-xylene bridge has been observed. Optimization of the donor-acceptor electronic coupling remarkably inhibits the undesirable rapid decayofthe singlet charge-separated state to the ground state,y ielding the final long-lived, triplet chargeseparated state with circa 100 %e fficiency.T his finding is extremely useful for the rational design of artificial photosynthesis and organic photovoltaic cells towarde fficient solar energy conversion.

Concentrations of fecal SCFAs in patients with severe SIRS were significantly lower than those in healthy volunteers over a 6-week period. Maintenance of SCFAs may have therapeutic potential to prevent gastrointestinal complications in critically ill patients.

Helicobacter pylori was isolated from the gastric antrum of chronic gastritis patients. H. pylori is closely associated with gastritis and peptic ulcers and is even a bacterial risk factor for gastric cancer.1-4) Therefore, eradication of the bacteria and inhibition of the urease are important for the treatment of patients with gastroduodenal diseases.The standard treatment for H. pylori related disease is a combination of antimicrobial agents and anti-acid agent. 5)However, the drug resistant H. pylori against most effective antimicrobials, metronidazole and clarithromycin, is commonplace in many societies and is of particular concern as the major reason for treatment failure. [6][7][8] H. pylori is a spiral-shapes, strongly motile bacterium, and the motility is generally held to be a requirement for colonization of the stomach.9,10) Thus, one possible approach for prevention of H. pylori infection would be to inhibit the H. pylori motility.The Japanese apricot (Prunus mume SIBE. et. ZUCC.; Ume), a deciduous tree of the family Rosaceae, originated in the central and southern regions of China, and has now 400-500 varieties worldwide. The fruits of Japanese apricot are taken in foods as umeboshi, Bainiku-ekisu, pickled Japanese apricot, ume liquor and ume-based soft drinks. The fruit has been known to have various biological activities, and the fruit has been prescribed medicine for disorder of the stomach and intestines, quick recovery from fatigue, cough and diarrhea in Chinese traditional prescriptions.11,12) However, very few reports are available that proofs of components from Japanese apricot are effective against diseases.During the screening program to discover such compounds from natural products, Japanse apricot was found to show inhibitory activity against H. pylori motility. In this paper, we report the isolation and identification of inhibitor of H. pylori motility from unripe Japanese apricot. MATERIALS AND METHODSGeneral Melting point was measured on a Micro Melting Point Meter MP-500D. Optical rotation was measured on a Japan Spectroscopic Co. Ltd. DIP-1000 in CHCl 3 . The EI-MS were obtained on a JEOL the Tandem MStation JMS-700. The IR spectra were determined with a JASCO FT/IR-470 plus Fourier transform infrared spectrometer. Nuclear magnetic resonance (NMR) spectra were obtained with a JEOL FX-500 (500.00 MHz, 1 H; 125.65 MHz, 13 C) spectrometer.Materials Fresh Japanese apricot was obtained from Minabegawa Plum Research Center (Wakayama, Japan).Media and Bacterial Growth H. pylori (H. pylori ATCC43504, American type, culture collected Rokville MD, U.S.A.) was grown on blood agar plates (Trypticase soy agar supplemented with 5% sheep blood; Becton Dickinson, Tokyo, Japan) for 4 d at 37°C in a microaerophilic atmosphere (10% O 2 and 10% CO 2 ). The colonies developed were then suspended in brain heart infusion (BHI) broth (Difco) containing 10% fetal bovine serum (FBS) (Gibco, Gaithersburg, MD, U.S.A.), followed by incubation for 18 to 20 h at 37°C in a microaerophilic atmosphere. The bacterial ...

BackgroundWe established a multi-center, prospective cohort that could provide appropriate therapeutic strategies such as criteria for the introduction and the effectiveness of in-hospital advanced treatments, including percutaneous coronary intervention (PCI), target temperature management, and extracorporeal cardiopulmonary resuscitation (ECPR) for out-of-hospital cardiac arrest (OHCA) patients.MethodsIn Osaka Prefecture, Japan, we registered all consecutive patients who were suffering from an OHCA for whom resuscitation was attempted and who were then transported to institutions participating in this registry since July 1, 2012. A total of 11 critical care medical centers and one hospital with an emergency care department participated in this registry. The primary outcome was neurological status after OHCA, defined as cerebral performance category (CPC) scale.ResultsA total of 688 OHCA patients were documented between July 2012 and December 2012. Of them, 657 were eligible for our analysis. Patients’ average age was 66.2 years old, and male patients accounted for 66.2 %. The proportion of OHCAs having a cardiac origin was 50.4 %. The proportion as first documented rhythm of ventricular fibrillation/pulseless ventricular tachycardia was 11.6 %, pulseless electrical activity 23.4 %, and asystole 54.5 %. After hospital arrival, 10.5 % received defibrillation, 90.8 % tracheal intubation, 3.0 % ECPR, 3.5 % PCI, and 83.1 % adrenaline administration. The proportions of 90-day survival and CPC 1/2 at 90 days after OHCAs were 5.9 and 3.0 %, respectively.ConclusionsThe Comprehensive Registry of In-hospital Intensive Care for OHCA Survival (CRITICAL) study will enroll over 2000 OHCA patients every year. It is still ongoing without a set termination date in order to provide valuable information regarding appropriate therapeutic strategies for OHCA patients (UMIN000007528).