Acupuncture methods for acute migraine attack: a Bayesian network meta-analysis protocol.

INTRODUCTION: Migraine is a primary cause of disability worldwide, particularly affecting young adults and middle-aged women. Although multiple clinical trials and systematic reviews have suggested that acupuncture could be effective in treating acute migraine attacks, the methodologies in academic studies and commonly applied practices vary greatly. This study protocol outlines a plan to assess and rank the effectiveness of the different acupuncture methods in order to develop a prioritised acupuncture-based treatment regimen for acute migraine attacks. OBJECTIVE: To compare the efficacy of different acupuncture methods and conventional medicinal methods in the treatment of acute migraine attacks. METHODS AND ANALYSIS: Six databases will be searched, including MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database and Wanfang Database from inception to 31 August 2019. The primary outcomes will be assessed using metrics for intensity and duration (in hours) of pain post-treatment. Bayesian network meta-analysis will be conducted using WinBUGS V.1.4.3. Finally, we will use the Grading of Recommendations Assessment, Development and Evaluation System to assess the quality of evidence. ETHICS AND DISSEMINATION: The results will be disseminated through peer-reviewed publication. Since no private and confidential patient data will be contained in the reporting, there are no ethical considerations associated with this protocol. PROSPERO REGISTRATION NUMBER: CRD42019126472.

Bifidobacterium Supplementation of Colostrum and Breast Milk Enhances Weight Gain and Metabolic Responses Associated with Microbiota Establishment in Very-Preterm Infants.

BACKGROUND: Postnatal growth restriction in very-preterm infants (VPIs) may have long-lasting effects. Recent evidence suggests that developmental problems in VPIs are related to abnormalities in intestinal microbial communities. OBJECTIVE: To investigate the effect on growth outcomes in VPIs of supplementation with Bifidobacterium along with mother's colostrum and breast milk. METHODS: A randomized controlled study was performed on 35 VPIs, born between 24 and 31 weeks of gestation with birth weights <1,500 g. The patients received either daily Bifidobacterium breve supplementation (Bifid group) or vehicle supplement only (placebo group). Parenteral nutrition was initiated with glucose, amino acids, and fatty acids for all of the infants soon after birth. Each infant received their own mother's colostrum within 24 h of birth, and breast milk on subsequent days. Fecal bacteria, organic acids, pH, bile acids, and plasma fatty acids were analyzed. RESULTS: Seventeen infants were allocated to the Bifid group and 18 to the placebo group; the birth weights and gestational ages did not differ significantly between the two groups. Compared to the placebo group, the Bifid group showed significantly greater and earlier weight gain by 8 weeks; significantly higher total fecal bacterial counts, including bifidobacteria; higher levels of total fecal short-chain fatty acids and nominally (but not significantly) higher concentrations of plasma n-3 fatty acids; and lower levels of total fecal bile acid. CONCLUSIONS: Bifidobacterial supplementation of maternal colostrum and breast milk yielded the establishment of a beneficial microbiota profile, leading to favorable metabolic responses that appeared to provide improved growth in VPIs.

Association between Yogurt Consumption and Intestinal Microbiota in Healthy Young Adults Differs by Host Gender.

Human intestinal microbiota are influenced by various factors viz. diet, environment, age, gender, geographical, and socioeconomic situation, etc. among which diet has the most profound impact. However, studies investigating this impact have mostly included subjects from diverse geographic/socioeconomic backgrounds and hence the precise effects of dietary factors on gut microbiota composition remain largely confounded. Herein, with an aim to evaluate the association between dietary habits, specifically yogurt consumption, and the gut microbiota in healthy young adults sharing similar age, lifestyle routine, geographical setting, etc., we conducted a cross-sectional study wherein 293 collegiate freshmen answered a questionnaire about their frequency of yogurt consumption over the last 2 months and provided stool specimens for microbiota analysis. Fecal microbiota were analyzed by highly sensitive reverse-transcription-quantitative-PCR assays targeting bacterial 16S rRNA molecules. Fecal organic acids were measured by HPLC. Overall, the gut microbiota were predominated (97.1 ± 8.6%) by Clostridium coccoides group, Clostridium leptum subgroup, Bacteroides fragilis group, Bifidobacterium and Atopobium cluster. Interestingly, after adjusting the data for yogurt consumption, females were found to have higher total bacterial (P = 0.013) and Bifidobacterium (P = 0.046) count and fecal pH (P = 0.007) and lower fecal concentration of total organic acids (P = 0.030), succinic acid (P = 0.007) and formic acid (P = 0.046) as compared to males. Altogether, yogurt consumption showed positive linear association with Lactobacillus and Lactobacillus gasseri subgroup in both male and female subjects; however, several gender-specific disparities were also detected in this yogurt-microbiota association. Yogurt consumption demonstrated a negative association with L. sakei subgroup, Enterobacteriaceae and Staphylococcus in males but shared a positive association with L. casei subgroup and succinic acid in female subjects. The study manifests the association between yogurt consumption and gut microbiota in a healthy homogeneous cohort and show how this association can differ by host gender. The findings should be helpful for prospective studies investigating the diet-microbiome interaction in human health and disease.

The Effectiveness of Lactobacillus Beverages in Controlling Infections among the Residents of an Aged Care Facility: A Randomized Placebo-Controlled Double-Blind Trial.

BACKGROUNDS/AIMS: To clarify the usefulness of Lactobacillus casei strain Shirota (LcS)-fermented milk in the normalization of bowel movements and improvement of infection control for the elderly residents and staff of facilities for the elderly. METHODS: A randomized placebo-controlled double-blind test was performed among the elderly residents (average age, 85) and staff members (average age, 37) of facilities for the elderly. The participants randomly received either LcS-fermented milk or a placebo beverage once daily for 6 months. Clinical data and enteric conditions were compared between the 2 groups. RESULTS: A significantly lower incidence of fever and improved bowel movements were seen in the LcS-fermented milk group (n = 36) in comparison to the placebo group (n = 36). The numbers of Bifidobacterium and Lactobacillus were significantly higher (p < 0.01), the numbers of destructive bacteria such as Clostridium difficile were significantly lower (p < 0.05), and the fecal acetic acid concentration and total acidity were significantly higher in the LcS group. A significant difference in the intestinal microbiota, fecal acetic acid, and pH was also observed between the LcS and placebo groups among the facility's staff members. CONCLUSIONS: The long-term consumption of LcS-fermented milk may be useful for decreasing the daily risk of infection and improving the quality of life among the residents and staff of facilities for the elderly.

Intestinal Microbiota Profiles of Healthy Pre-School and School-Age Children and Effects of Probiotic Supplementation.

OBJECTIVES: This study aims to establish the baseline profile of intestinal microbiota in pre-school and school-age Japanese children and to investigate the effects of a probiotic on the microbiota. METHODS: We analyzed the intestinal microbiota and investigated the effects (before, during and after the ingestion period) on intestinal microbiota and the environment of 6 months of daily ingestion of a probiotic (Lactobacillus casei strain Shirota (LcS)-fermented milk). RESULTS: We performed an open trial in 23 children (14 boys, 9 girls; age 7.7 ± 2.4 years (mean ± SD); BMI 19.6 ± 4.6). The composition of intestinal microbiota of healthy pre-school and school-age children resembled that of adults. During probiotic supplementation, the population levels of Bifidobacterium and total Lactobacillus increased significantly, while those of Enterobacteriaceae, Staphylococcus and Clostridium perfringens decreased significantly. A significant increase in fecal concentrations of organic acids and also a decrease in fecal pH were observed during the ingestion period. However, the patterns of fecal microbiota and intestinal environment were found to revert to the baseline levels (i.e. before ingestion) within 6 months following the cessation of probiotic intake. CONCLUSION: Regular intake of an LcS-containing probiotic product may modify the gut microbiota composition and intestinal environment in pre-school and school-age children while maintaining the homeostasis of the microbiota.

[An analysis on Pf60.1 gene polymorphism of Plasmodium falciparum from imported cases].

One hundred and one imported falciparum malaria cases in Wuhan City were confirmed by microscopy and Nest-PCR, and the blood samples were collected. The Pf60.1 gene was amplified by PCR. Among 101 blood samples, three Pf60.1 fragments [313 bp (56.5%, 52/92), 340 bp (37.0%, 34/92), 313 bp+340 bp (6.5%, 6/92)] were amplified from 92 samples. Among 83 blood samples from patients returning from Africa, 313 bp fragment were found in 46 samples (55.4%, 46/83), 340 bp fragment were found in 31 samples (37.1%, 31/83), and 7.2% (6/83) was mixed-fragment (313 bp+340 bp). Among 9 samples from southeast Asia, 6 samples were with 313 bp fragment and 3 samples with 340 bp fragment. The results indicated that the most common genotype was 313 bp-genotype, and there would be polyclonal P. falciparum infections.

[Two cases of African imported Plasmodium malariae malaria].

The process of diagnosis, epidemiological survey and treatment of two cases of African imported quartan malaria is reported in this paper.

[Analysis of K76T Pfcrt genetic polymorphism in imported Plasmodium falciparum].

OBJECTIVE: To identify the incidence of the K76T mutation in Pfcrt genes of imported Plasmodium falciparum. METHODS: The blood samples were collected from returnees infected with P. falciparum in endemic areas of Southeast Asia and Africa from 2008 to 2012. According to the Pfcrt gene sequence of P. falciparum, nested PCR primers were designed. Nested PCR-RFLP was applied with falciparum DNA in the blood samples as templates. RESULTS: Among 92 blood samples of P. falciparum, the mutant Pfcrt alleles were found in 50 samples (54.3%), and the wild type Pfcrt alleles were found in 42 samples (45.7%). There were 33 samples (47.1%) with mutant Pfcrt alleles and 37 samples (52.9%) with wild type, respectively, from Africa. There were 17 samples (77.3%) with mutant Pfcrt alleles and 5 samples (22.7%) with wild type, respectively, from Southeast Asia. There was a significant difference between the Africa group and the Southeast Asia group (Chi(2) = 6.12, P < 0.05). CONCLUSION: The incidence of Pfcrt gene mutation is different among P. falciparum isolates from different regions. Therefore, Pfcrt K76T has an application value in the surveillance of the imported falciparum chloroquine-resistance.

[Analysis of Pfcrt gene polymorphism in Plasmodium falciparum from imported cases].

OBJECTIVE: To identify the incidence of the K76T mutation in Pfcrt gene of imported Plasmodium falciparum and study the Pfcrt gene polymorphism in Plasmodium falciparum. METHODS: Seventy-two blood samples were collected from patients infected with P. falciparum returning from Africa (Nigeria, Equatorial Guinea, Congo, Liberia, Angora and Mali) and Southeast Asia (Myanmar and Indonesia) from 2008 to 2012. According to Pfcrt gene sequence of P. falciparum, nested PCR primers were designed, and the reaction was applied with P. falciparum DNA in the blood samples as templates. PCR products were identified by Apo I digestion. RESULTS: Among 72 blood samples of P. falciparum, mutant Pfcrt alleles were found in 41 samples (57.7%, 41/71) and wild type Pfcrt alleles were found in 30 samples (42.3%, 30/71). There were 25 samples (50%, 25/50) each with mutant Pfcrt alleles or wild type that were from Africa, while 16 samples (76.2%, 16/21) with mutant Pfcrt alleles and 5 samples (23.8%, 5/21) with wild type that were from Southeast Asia, respectively. CONCLUSION: The incidence of Pfcrt gene mutation is different in P. falciparum isolates from different regions.

[Application of nested PCR in diagnosis of imported malaria].

OBJECTIVE: To evaluate the usefulness of nested PCR method in the diagnosis of imported malaria. METHODS: A total of 210 blood smears and blood samples on filter paper were taken from persons returned from highly malaria endemic countries. The results of both nested PCR and microscopy for 210 samples were compared. RESULTS: Among the 210 persons, 43 were hospitalized due to malaria, and positive by nested PCR test Among the rest 157 people at high risk of getting malaria, 3 were found plasmodium-positive by microscope (1.91%), and 5 were positive by nested PCR (3.18%). In four samples with discrepancy between the two methods, 1 was microscopy positive and PCR negative, and 3 were microscopy negative and PCR positive. Positive and negative coincidence rate between the two tests was 66.7% and 98.1%, respectively. The coincidence between the two methods was 97.5%. CONCLUSION: Nested PCR is useful for monitoring, identification and diagnosis of imported malaria.

Effect of the continuous intake of probiotic-fermented milk containing Lactobacillus casei strain Shirota on fever in a mass outbreak of norovirus gastroenteritis and the faecal microflora in a health service facility for the aged.

For conducting effective risk management in long-stay elderly people at a health service facility, we performed an open case-controlled study to evaluate the effect of the intake of probiotic-fermented milk containing Lactobacillus casei strain Shirota (LcS-fermented milk) on norovirus gastroenteritis occurring in the winter season during the intake period. A total of seventy-seven elderly people (mean age 84 years) were enrolled in the study. During a 1-month period, there was no significant difference in the incidence of norovirus gastroenteritis between the LcS-fermented milk-administered (n 39) and the non-administered (n 38) groups; however, the mean duration of fever of >37°C after the onset of gastroenteritis was 1·5 (SD 1·7) d in the former and 2·9 (SD 2·3) d in the latter group, showing a significant shortening in the former group (P < 0·05). RT-quantitative PCR analysis targeting ribosomal RNA showed both Bifidobacterium and Lactobacillus to be significantly dominant, whereas Enterobacteriaceae decreased in faecal samples from the administered group (n 10, mean age 83 years), with a significant increase in faecal acetic acid concentration. Continuous intake of LcS-fermented milk could positively contribute to the alleviation of fever caused by norovirus gastroenteritis by correcting the imbalance of the intestinal microflora peculiar to the elderly, although such consumption could not protect them from the disease.

Well-controlled proinflammatory cytokine responses of Peyer's patch cells to probiotic Lactobacillus casei.

SUMMARY: In order to clarify the probiotic features of immunomodulation, cytokine production by murine spleen and Peyer's patch (PP) cells was examined in response to probiotic and pathogenic bacteria. In spleen cells, probiotic Lactobacillus casei induced interleukin (IL)-12 production by CD11b(+) cells more strongly than pathogenic Gram-positive and Gram-negative bacteria and effectively promoted the development of T helper (Th) type 1 cells followed by high levels of secretion of interferon (IFN)-gamma. Although the levels of IL-12 secreted by PP cells in response to L. casei were lower in comparison with spleen cells, Th1 cells developed as a result of this low-level induction of IL-12. However, IFN-gamma secretion by the L. casei-induced Th1 cells stimulated with a specific antigen was down-regulated in PP cells. Development of IL-17-producing Th17 cells was efficiently induced in PP cells by antigen stimulation. Lactobacillus casei slightly, but significantly, inhibited the antigen-induced secretion of IL-17 without a decrease in the proportion of Th17 cells. No bacteria tested induced the development of IL-10-producing, transforming growth factor-beta-producing or Foxp3-expressing regulatory T cells, thus suggesting that certain probiotics might regulate proinflammatory responses through as yet unidentified mechanisms in PP cells. These data show probiotic L. casei to have considerable potential to induce IL-12 production and promote Th1 cell development, but the secretion of proinflammatory cytokines such as IL-12 and IL-17 may be well controlled in PP cells.

Anti-infectious activity of synbiotics in a novel mouse model of methicillin-resistant Staphylococcus aureus infection.

The anti-infectious activity of synbiotics against methicillin-resistant Staphylococcus aureus (MRSA) infection was evaluated using a novel lethal mouse model. Groups of 12 mice treated with multiple antibiotics were infected orally with a clinical isolate of MRSA at an inoculum of 10(8) CFU on day 7 after starting the antibiotics. A dose of 400 mg/kg 5-fluorouracil (5-FU) was injected intraperitoneally on day 7 after the infection. A dose of 10(8) CFU Bifidobacterium breve strain Yakult and 10 mg of galactooligosaccharides (GOS) were given orally to mice daily with the antibiotic treatment until day 28. The intestinal population levels of MRSA in the mice on multiple antibiotics were maintained stably at 10(8) CFU/g of intestinal contents after oral MRSA infection and the subsequent 5-FU treatment killed all the mice in the group within 14 days. B. breve administration saved most of the mice, but the synbiotic treatment saved all of the mice from lethal MRSA infection. The synbiotic treatment was effective for the treatment of intestinal infection caused by four MRSA strains with different toxin productions. There was a large difference among the six Bifidobacteria strains that were naturally resistant to the antibacterial drugs used. B. breve in combination with GOS is demonstrated to have valuable preventive and curative effects against even fatal MRSA infections.

[Effect of continuous probiotic fermented milk intake containing Lactobacillus casei strain Shirota on fever in mass infectious gastroenteritis rest home outbreak].

As part of medical risk management in a long-term stay facility for the elderly, we introduced probiotic fermented milk containing Lactobacillus casei strain Shirota (LcS-fermented milk) in an open case-control study of its effect of (1 bottle a day) on winter-time norovirus gastroenteritis. During the 1 month from December 1 to 31, 2006, norovirus gastroenteritis occurred in 21 (55%) of 38 cases in the nonmilk group, and in 27 (64%) of 39 cases in the milk group, showing no statistically significant difference. The mean duration of >37 degrees C fever after disease onset, however, was 2.9+/-2.3 days in the non-milk group and 1.5+/-1.7 days in the milk group, showing significant shortening (p<0.05). The duration of > 38 degrees C fever after disease onset also tended to be shorter. No significant differences were seen in age, gender, days of antipyretic use, or stool-free days. These results suggested that continuous intake of LcS-fermented milk could aggravate fever duration in elderly long-term rest home residents although it probably did not prevent noroviral gastroenteritis onset.

Effects of oral administration of bifidobacterium breve on fecal lactic acid and short-chain fatty acids in low birth weight infants.

OBJECTIVES: Short-chain fatty acids (SCFAs) are known to provide energy to colonocytes, whereas overproduction of SCFAs can cause mucosal injury in premature infants. Our objective was to investigate the effects of the oral administration of Bifidobacterium breve M-16V (B breve) on fecal lactic acid and SCFAs in low birth weight (LBW) infants. PATIENTS AND METHODS: Fecal lactic, acetic, propionic, and butyric acids from 66 premature infants were analyzed by high-performance liquid chromatography at 0, 2, and 4 weeks after birth. The subjects included 22 extremely LBW (ELBW, <1000 g), 22 very LBW (VLBW, <1500 g), and 22 LBW (<2500 g) infants. The infants were divided into two groups: those with and those without B. breve supplementation. RESULTS: In the control groups, fecal acetic acid and total SCFA concentrations were significantly increased at 2 weeks in the VLBW and LBW infants (P < 0.05) and at 4 weeks in the ELBW, VLBW, and LBW infants (P < 0.01 for each) compared with those at week 0. Fecal lactic acid concentrations showed a similar pattern during follow-up, but the differences were not significant. Four weeks after B breve administration, the fecal butyric acid concentrations were significantly decreased in the ELBW and VLBW infants (P < 0.05 each), and the ratio of the acetic acid concentrations to the total SCFAs was significantly increased compared with those of the control groups in the ELBW (P < 0.05), VLBW (P < 0.05), and LBW infants (P < 0.01). CONCLUSIONS: Oral administration of B breve reduces the production of butyric acid, which may be helpful in protecting LBW infants from digestive diseases such as necrotizing enterocolitis.