Lactobacillus paracasei HD1.7 used as a starter modulates the bacterial community and metabolome profile during fermentation of Chinese cabbage.

The effects of Lactobacillus paracasei HD1.7 on the bacterial community and metabolome profile during the fermentation of pickled Chinese cabbage (Brassica rapa var. pekinensis) were investigated using high-throughput sequencing and gas chromatography-mass spectrometry (GC-MS). The HD1.7-inoculated samples showed a consistently higher acidity and larger colony forming units until the middle stage of fermentation. The operational taxonomic units and bacterial richness and diversity declined. Lactobacillus was consistently the most abundant followed by Lactococcus, while Lactococcus was initially dominant and then replaced by Lactobacillus in control samples. The HD1.7 starter significantly promoted the growth of more acid-resistant Lactobacillus, inhibited the growth of pathogens and accelerated and enhanced the consumption of free sugars. Eleven categories and 109 kinds of metabolites were identified using GC-MS. Esters and aldehydes were the most abundant categories. Principal component analysis plots showed a similar metabolome shift route but a faster fermentation process due to HD1.7 inoculation. SIGNIFICANCE AND IMPACT OF THE STUDY: Pickled Chinese cabbage is a very traditional and popular food in Asia and where Asians migrate. High-throughput sequencing and GC-MS have been used to investigate the effects of Lactobacillus paracasei HD1.7 as a starter on the bacterial community and metabolome during pickled Chinese cabbage fermentation. Lactobacillus paracasei HD1.7 accelerated acidification and resulted in server acidity. Lactobacillus dominated the entire fermentation process. Lactobacillus paracasei HD1.7-inoculated fermented cabbage had several advantages over naturally fermented cabbage, including a shorter fermentation process, fewer pathogens and more plentiful flavours. This research suggested that L. paracasei HD1.7 would be a desirable starter in the fermentation of other vegetables.

Efficacy and Safety of Outpatient Treatment Based on the Hestia Clinical Decision Rule with or without N-Terminal Pro-Brain Natriuretic Peptide Testing in Patients with Acute Pulmonary Embolism. A Randomized Clinical Trial.

RATIONALE: Outpatient treatment of pulmonary embolism (PE) may lead to improved patient satisfaction and reduced healthcare costs. However, trials to assess its safety and the optimal method for patient selection are scarce. OBJECTIVES: To validate the utility and safety of selecting patients with PE for outpatient treatment by the Hestia criteria and to compare the safety of the Hestia criteria alone with the Hestia criteria combined with N-terminal pro-brain natriuretic peptide (NT-proBNP) testing. METHODS: We performed a randomized noninferiority trial in 17 Dutch hospitals. We randomized patients with PE without any of the Hestia criteria to direct discharge or additional NT-proBNP testing. We discharged the latter patients as well if NT-proBNP did not exceed 500 ng/L or admitted them if NT-proBNP was greater than 500 ng/L. The primary endpoint was 30-day adverse outcome defined as PE- or bleeding-related mortality, cardiopulmonary resuscitation, or intensive care unit admission. The noninferiority margin for the primary endpoint was 3.4%. MEASUREMENTS AND MAIN RESULTS: We randomized 550 patients. In the NT-proBNP group, 34 of 275 (12%) had elevated NT-proBNP values and were managed as inpatients. No patient (0 of 34) with an elevated NT-proBNP level treated in hospital (0%; 95% confidence interval [CI], 0-10.2%), versus no patient (0 of 23) with a post hoc-determined elevated NT-proBNP level from the direct discharge group (0%; 95% CI, 0-14.8%), experienced the primary endpoint. In both trial cohorts, the primary endpoint occurred in none of the 275 patients (0%; 95% CI, 0-1.3%) subjected to NT-proBNP testing, versus in 3 of 275 patients (1.1%; 95% CI, 0.2-3.2%) in the direct discharge group (P = 0.25). During the 3-month follow-up, recurrent venous thromboembolism occurred in two patients (0.73%; 95% CI, 0.1-2.6%) in the NT-proBNP group versus three patients (1.1%; 95% CI, 0.2-3.2%) in the direct discharge group (P = 0.65). CONCLUSIONS: Outpatient treatment of patients with PE selected on the basis of the Hestia criteria alone was associated with a low risk of adverse events. Given the low number of patients with elevated NT-proBNP levels, this trial was unable to draw definite conclusions regarding the incremental value of NT-proBNP testing in patients who fulfill the Hestia criteria. Clinical trial registered with www.trialregister.nl/trialreg/admin/rctview.asp?TC=2603 (NTR2603).

[Acrodermatitis chronica atrophicans: late manifestation of Lyme borreliosis]. / Acrodermatitis chronica atrophicans: late manifestatie van lymeborreliose.

A 71-year-old man was referred to our outpatient clinic because of arthralgia and swelling of his right hand. He also showed a subcutaneous nodule on his left knee. A second patient, a 57-year-old woman, was referred because of painful skin of her legs. Dermatologic examination revealed erythematous livid discoloration on both feet and legs. There were reticular varices, corona flebectatia paraplantaris medialis and minimal pitting oedema. Serology tested positive in both patients for Borrelia and they both recalled tick bites. A third patient, a 73-year-old woman, was referred because of erythema and maculae located at her lower legs and positive Borrelia serology. Pathologic examination was typical for acrodermatitis chronica atrophicans, a late skin manifestation of Lyme borreliosis. In all patients, symptoms improved after treatment with doxycycline for four weeks. A lack of familiarity with this skin condition may lead to unnecessary vascular investigations and considerable delay in adequate treatment.

Effects of thalidomide on DMBA-induced oral carcinogenesis in hamster with respect to angiogenesis.

BACKGROUND: Thalidomide has been shown to have anti-angiogenic effects in pre-clinical models as well as a significant antitumor effect in hematologic tumors. However, the effects of thalidomide on oral pre-malignant lesions and oral carcinogenesis remain unexplored. The authors aimed to investigate the chemopreventive effect of thalidomide on 7,12-dimethylbenz[a]anthracene (DMBA)-induced oral carcinogenesis in hamsters with respect to angiogenesis. METHODS: Seventy male Syrian golden hamsters were randomly divided into five groups, with two of 20 and three of 10. DMBA solution (0.5% in acetone) was applied topically to the left cheek pouch of male Syrian golden hamsters in group A and B, while animals in group C were painted with acetone, three times a week for 6 weeks. For the next 18 weeks, animals in group B and D received thalidomide daily (40 mg/kg body weight/day) by gavage, animals in group A and C received same volume of saline. Animals in group E received no treatment and served as blank control. At the end of the experiment, animals were killed and tissue samples were collected for examinations. RESULTS: Thalidomide significantly decreased the squamous cell carcinoma (SCC) incidence from 57.9 to 11.8%; angiogenesis was inhibited in dysplasia and SCC. The gene expression of vascular endothelium growth factor and tumor necrosis factor (TNF)-alpha was downregulated. CONCLUSIONS: Thalidomide has inhibitory effect against the malignant transformation of oral pre-cancerous lesion and angiogenesis during oral carcinogenesis. Such inhibition is related to its modulation of TNF-alpha.

Procyanidin induces apoptosis and necrosis of prostate cancer cell line PC-3 in a mitochondrion-dependent manner.

Our objective was to study the effects of procyanidin on the cell death of human hormone-resistant prostate carcinoma cell line PC-3 and its mechanism. PC-3 cells were treated with procyanidin of different concentrations. The cell apoptosis rates were detected by annexin V-FITC and propidium iodide double staining followed by flow cytometry (FCM) analysis. Mitochondrial membrane potential (Deltapsim) was analyzed by FCM with rhodamine 123 staining. After 24 hours of treatment with 300 microg/mL procyanidin, the apoptosis rate of PC-3 cells was 44.86%, and Deltapsim was significantly decreased by 87.30%. With the extending of procyanidin treatment, the apoptosis rate decreased whereas the necrosis rate increased. Procyanidin could induce apoptosis and necrosis in PC-3 cells, which might be related to down-regulation of Deltapsim.

Simple and safe exclusion of pulmonary embolism in outpatients using quantitative D-dimer and Wells' simplified decision rule.

A safe and effective management strategy is pivotal in excluding pulmonary embolism (PE). The combination of Wells' simplified dichotomous clinical decision rule and D-dimer test is non-invasive and could be highly efficient, though its safety has not been widely studied. We evaluated safety and efficiency of this combination in excluding PE. Wells clinical decision rule was performed in 941 consecutive patients with suspected PE and, if patients had a score