Ginkgo Biloba (120mg)

BACKGROUND: Shuxuening injection (SXNI), a standardized injectable formulation of Ginkgo biloba leaf extract, is widely used in China for vascular cognitive impairment (VCI), However, evidence-based evaluation remains limited. METHODS: Randomized controlled trials published before 1 September 2025, were searched in eight databases. Patients had vascular cognitive impairment (VCI), with the control group receiving conventional treatment and the treatment group receiving additional SXNI therapy. The primary outcome was the Mini-Mental State Examination (MMSE), while secondary outcomes included the Hasegawa Dementia Scale (HDS), Barthel Index (BI), overall response rate, National Institutes of Health Stroke Scale (NIHSS), and adverse event incidence. Risk of bias was assessed using the revised Cochrane Risk of Bias tool. Risk ratios (RR) were used for binary variables; mean differences (MD) with 95% confidence intervals (CI) were used for continuous variables. RESULTS: Twenty-two trials (n = 2,375) were included. All trials were conducted in China between 2005 and 2025. Compared with the control group, SXNI was associated with higher MMSE (MD 3.61, 95% CI 3.06-4.17), HDS (MD 1.30, 95% CI 0.21-2.39), and BI (MD 9.06, 95% CI 4.66-13.45), a higher overall response rate (RR 1.27, 95% CI 1.21-1.33), and lower NIHSS (MD -6.17, 95% CI -7.90 to -4.45). Seven studies reported adverse events; and there was no significant difference in the incidence of adverse events (RR 0.72, 95% CI 0.36-1.44). CONCLUSION: The addition of SXNI to conventional treatment may provide additional benefits in cognition, neurological function, and activities of daily living with no significant increase in reported adverse events compared with conventional treatment. However, the certainty of evidence is limited by methodological weaknesses and uncertainty regarding the comparability of preparations from different manufacturers. Therefore, high-quality studies are needed to confirm these findings. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=557472, identifier CRD42024557472.

INTRODUCTION: Ginkgo biloba leaf extracts belong to the most popular herbal medicines for the treatment of neurological disorders, including Alzheimer's disease (AD) or stroke. EGb 761, a proprietary ginkgo leaf extract, has been shown to improve brain cell energy supply, to enhance neurogenesis and neuroplasticity, to decrease blood viscosity and improve brain perfusion. Thereby it improves cognitive performance, neuropsychiatric symptoms and activities of daily living in patients with dementia or mild cognitive impairment. It has further been shown to be beneficial for patients after ischaemic stroke. Therefore, the aim of this meta-analysis was to evaluate the treatment effects of EGb 761 in patients who had developed dementia following a cerebral infarction. METHODS: We performed a meta-analysis of pooled data from clinical trials with EGb 761 in mild to moderate dementia in the subgroup of patients who had a cerebral infarction. Four randomised, placebo-controlled trials with homogeneous patient selection and design were included. Previous stroke was diagnosed by neuroimaging. The analysis focused on the comparison of treatment effects in the domains of cognition, activities of daily living and global assessment. RESULTS: The meta-analysis included data from 488 patients. Significant treatment effects of 240 mg EGb 761 daily versus placebo were found for cognition (p = 0.0467), activities of daily living (p = 0.0230), and global clinical impression (p = 0.0371). The rates of adverse events and adverse drug reactions in the EGb 761 group were like those in the placebo group. CONCLUSION: The results of our meta-analysis of patients with mild to moderate dementia who had previously had a cerebral infarction verified by neuroimaging showed statistically significant and clinically relevant benefits of EGb 761. The drug was shown to be safe and well tolerated and is a promising treatment option for patients developing dementia after cerebral infarction. Further dedicated clinical trials are needed to confirm these results.

Acute Mountain Sickness (AMS) is a frequent condition triggered by exposure to hypobaric hypoxia at high altitude. Its pathophysiology involves endothelial dysfunction and oxidative stress, with elevated oxidative molecules identified as key contributors to its development. Antioxidant therapies such as vitamins C/E, α-lipoic acid, and Ginkgo biloba have been proposed, though results across studies remain inconsistent. OBJECTIVE: This study aims to evaluate the effects of antioxidant treatments in subjects with AMS induced by high-altitude exposure, examining their impact on clinical outcomes and oxidative stress markers. METHODS: A systematic review and meta-analysis were performed according to PRISMA2020 guidelines. Searches were conducted in PubMed, Scopus, and Web of Science through November 2025, supplemented by snowball methods, focusing on studies investigating antioxidant treatments in humans exposed to hypobaric or high-altitude hypoxia. Inclusion criteria were original research in English with full-text availability, human exposure to hypobaric hypoxia, AMS assessment using the Lake Louise Score (LLS), and explicit antioxidant interventions compared with placebo or control. A random-effects meta-analysis using the REML estimator was applied to calculate relative risk (RR), including continuity corrections for zero-event studies. Data extraction was performed in duplicate, and risk of bias was evaluated using the Cochrane tool. RESULTS: The search yielded 727 records; nineteen studies were included in the qualitative synthesis, and four trials provided comparable dichotomous data for quantitative analysis. Pooled estimates showed a non-significant trend toward reduced AMS incidence with antioxidant treatment (RR ≈ 0.73; 95% CI: 0.47-1.11; p = 0.14). Moderate heterogeneity was detected (I2 = 52%, Q p = 0.048). Although not statistically significant, all studies showed a direction of effect favoring antioxidants. Nevertheless, interpretation is limited using pre-2018 LLS diagnostic criteria, absence of studies under chronic intermittent hypobaric hypoxia, and methodological variability. CONCLUSION: Current evidence does not demonstrate a statistically sig

BACKGROUND: Growing cognitive health interest fuels 8.3% market growth. Bacopa monnieri Wettst. (Brahmi) and Ginkgo biloba L. (Ginkgo) are among the most studied natural nootropics, but their effects have not been directly compared. This study aimed to evaluate and compare their efficacy in healthy adults using a network meta-analysis. METHODS: We searched PubMed, EMBASE, Cochrane CENTRAL, and EBSCO Open Dissertations in November 2024. Randomized controlled trials (RCTs) on healthy adults receiving Brahmi or Ginkgo extracts and reported cognitive outcomes were included. Risk of bias was assessed using the Cochrane Risk of Bias version 2. Cognitive outcomes were analyzed using standardized mean differences (SMDs) with 95% confidence intervals (CI) under a random-effects model. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA). RESULTS: Twenty-nine RCTs (n = 2107) were included. High-dose Brahmi (≥600 mg/day) significantly improved working memory compared to low-dose Brahmi (300 to <600 mg/day), high-dose Ginkgo (≥240 mg/day), low-dose Ginkgo (60 to <240 mg/day), and placebo, with SMDs (95% CI) of 1.84 (1.05-2.64), 1.94 (1.10-2.77), 2.04 (1.24-2.84), and 2.03 (1.28-2.78), respectively. A SUCRA of 100% further supports the strong efficacy of high-dose Brahmi. It also demonstrated significantly greater benefits for short-term memory. For delayed memory, low-dose Brahmi outperformed both low-dose Ginkgo and placebo. No significant differences were observed in sustained attention, selective attention, or processing speed. CONCLUSION: Brahmi, particularly in high-dose formulations, shows promise as a cognitive enhancer compared to Ginkgo in healthy adults. However, the lack of direct comparisons may limit the strength of this evidence. OTHER: The authors are grateful for financial support from The Royal Golden Jubilee Ph.D. Program (RGJ-Ph.D. Program), Thailand Research Fund (TRF) (N41A670299). This study is registered with PROSPERO (CRD420251034900).

BACKGROUND: Dementia is a neurocognitive disorder that interferes with cognition and independent functioning. Common dementia subtypes include Alzheimer's disease, vascular dementia, and mixed type. Mild cognitive impairment (MCI) is a risk factor for dementia, and subjective cognitive complaints may be the earliest manifestation. Although cholinesterase inhibitors may help reduce some cognitive and behavioral symptoms, there is no established treatment that cures or slows dementia progression. Ginkgo biloba (ginkgo) is a popular herbal preparation that is used to improve brain and circulatory health, and neuroprotective effects are biologically plausible. OBJECTIVES: To assess the benefits and harms of Ginkgo biloba for the treatment of people with cognitive impairment or dementia. SEARCH METHODS: We searched the Cochrane Dementia and Cognitive Improvement Group's register, MEDLINE, Embase, four other databases, and two trials registries on 8 December 2022. The search was updated in MEDLINE, Embase, CENTRAL, and the trials registers on 18 November 2024. SELECTION CRITERIA: We included randomized controlled trials (RCTs) comparing ginkgo with placebo, usual treatment, or other treatments for cognitive problems in people with cognitive complaints or diagnoses of MCI or dementia. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials, extracted data, and assessed studies for risk of bias. Key outcomes were global clinical status, global cognitive function, activities of daily living (ADLs), adverse events (AEs), and serious adverse events (SAEs) at six months. When clinically appropriate, we pooled data using a random-effects model and expressed treatment effects as mean differences (MDs), standardized mean differences (SMDs), or risk ratios (RRs), each with its 95% confidence interval (CI). We used GRADE methods to assess the certainty of the evidence for each estimate. MAIN RESULTS: We included 82 studies with 10,613 participants; 72 studies with 9783 participants provided extractable data. Four studies were at low risk of bias in all domains. Below we present data for the comparison of ginkgo versus placebo in people with different clini

BACKGROUND: Diabetic nephropathy (DN) is one of the common complications of diabetes, which is the leading cause of end-stage renal disease worldwide. Ginkgo biloba extract (GBE) has shown effectiveness in DN animal models and represents a promising therapeutic candidate. However, a comprehensive preclinical meta-analysis remains to be conducted, and the dose-time effect of GBE in the treatment of DN has not been evaluated. OBJECTIVE: To evaluate the therapeutic effectiveness, mechanism and dose-time effect of GBE for DN by systematic review and meta-analysis. METHODS: Seven databases (PubMed, Web of science, Embase, CBM, CNKI, Wanfang and VIP databases) were searched in this systematic review up to July 2025. Study quality was assessed using SYRCLE bias risk tool. STATA 14.0 software was employed to evaluate fasting blood glucose serum creatinine (SCr), blood urea nitrogen 24-h urine protein (24 h Upro), kidney index and indicators related to inflammatory response, oxidative stress, fibrosis, and glycolipid metabolism. The dose-time effect of Ginkgo biloba extract was evaluated by three-dimensional dose-time-effect analysis. RESULTS: 30 pertinent articles were included in the meta-analysis. Comparative analysis revealed that GBE exhibited statistically significant effect in reducing FBG, SCr, BUN, 24 h Upro, and KI. Furthermore, it also improved inflammatory indicators such as interleukin 1β (IL-1β), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α), as well as oxidative stress indicators like superoxide dismutase (SOD), malondialdehyde (MDA), antioxidation capability (AOC) and glutathione peroxidases (GSH-Px). Additionally, GBE showed positive effect in alleviating fibrosis and reducing serum total cholesterol (TC) and advanced glycation end products (AGEs). The dose-time-effect diagram showed that the rational dose of GBE for DN treatment was 36-200 mg/kg/d for 8-12 weeks. CONCLUSION: GBE may delay the progression of DN through multimodal mechanisms, including inhibition of inflammatory responses, attenuation of oxidative stress, suppression of fibrotic pathways, and modulation of glycolipid metabolism. CLINICAL TRIAL REGISTRATION: https://www.crd.york

BACKGROUND: Based on recent reviews, vascular cognitive impairment (VCI) encompasses a spectrum of cognitive deficits caused by cerebrovascular disease and its risk factors, ranging from mild cognitive impairment to dementia, and often coexists with neurodegenerative conditions like Alzheimer's disease. VCI is categorized into four clinical-imaging subtypes, including post-stroke cognitive impairment (PSCI)-a common stroke complication and major VCI subtype. Current guidelines recommend cholinesterase inhibitors and NMDA receptor antagonists as first-line treatments for VCI, with expert consensus supporting donepezil and rivastigmine for PSCI. However, existing evidence primarily derives from placebo-controlled or head-to-head drug comparisons, lacking comprehensive evaluations of multiple cognitive enhancers. This study aims to systematically assess the efficacy and safety of cognitive-enhancing drugs in VCI, with a focused analysis on PSCI, to better inform clinical decision-making and improve patient outcomes. METHODS: We systematically searched four databases using predefined search strategies. Eligible studies were selected based on predetermined criteria. The included studies were analyzed with StataSE 16.0, RevMan 5.3, and Grade software to compare the efficacy and safety of cognitive-enhancing drugs to identify the optimal treatment for VCI and PSCI. RESULTS: Sixteen studies (5,599 participants) were included. In terms of cognitive outcomes, sailuotong was superior to placebo on the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog) (MD = -3.00, 95% CI: -4.50, -1.50) and ranked best (SUCRA 88.5%). Memantine was most effective on the Mini-Mental State Examination (MMSE) (MD = 1.23, 95% CI: 0.23-2.23; SUCRA 80.8%). For the secondary outcome, the MoCA assessment showed that Ginkgo biloba extract significantly improved Montreal Cognitive Assessment (MoCA) scores compared to placebo (MD = 1.29, 95% CI: 1.24, 1.35). Regarding safety, donepezil significantly increased the risk of overall adverse events compared to placebo (OR: 1.57; 95% CI: 1.19-2.06). CONCLUSION: Our network meta-analysis suggests that memantine might have the best effect for P

Acne vulgaris is a prevalent inflammatory skin disorder influenced by sebaceous gland activity, hormonal regulation, and microbial proliferation. Dietary factors, including sweetening agents, may modulate acne pathophysiology, affecting sebum production, inflammatory responses, and the skin microbiome. This systematic review summarizes the effects of nutritive and non-nutritive sweeteners on acne-related markers, with a focus on Cutibacterium acnes activity and associated inflammatory pathways. Non-nutritive sweeteners such as mannitol and xylitol show potential in regulating acne pathogenesis and exhibiting antibacterial activity against C. acnes. Strategic combinations of sweeteners with bioactive compounds, such as mannitol with bakuchiol or Ginkgo biloba extract, and xylitol with propanediol and caprylic acid, further enhance anti-inflammatory and antimicrobial effects, offering a multifaceted approach to acne management. For nutritive sweeteners, experimental evidence suggests that glucose may enhance C. acnes biofilm susceptibility when combined with certain antibiotics. These findings emphasize the importance of careful selection and formulation of sweetening agents in dermatological interventions. Incorporating sweeteners, alone or in combination with bioactive compounds, could complement conventional acne therapies, reduce microbial proliferation, modulate inflammatory pathways, and support overall skin health. This review provides a scientific basis for dietary recommendations and the development of adjunctive acne treatments, highlighting sweetening agents as emerging functional modulators of acne pathogenesis.

9. Int J Mol Sci. 2025 Oct 31;26(21):10631. doi: 10.3390/ijms262110631. Natural Products in Alzheimer's Disease: A Systematic Review of Clinical Trials and Underlying Molecular Mechanisms. Bayo Jimenez MT(1), Rivas-García L(1), Sánchez-González C(1), Grosso G(2), Lipari V(3)(4), Vera-Ramírez L(1

INTRODUCTION: Vascular cognitive impairment (VCI) is a common, heterogeneous condition, currently lacking approved treatments. METHODS: We reviewed therapeutic strategies tested in VCI and meta-analyzed efficacy data for eligible interventions to assess whether previously tested treatments warranted reconsideration. RESULTS: One-hundred seventy-three trials were extracted (22,347 participants, four VCI categories, 91 interventions, 145 outcomes). Ginkgo biloba extracts showed large to moderate improvements in cognition (Cohen's d: 0.83, 95% CI: 0.00 to 1.67) and small to moderate improvements in functional outcomes (Cohen's d: 0.50, 95% CI: 0.25 to 0.75). Small to moderate improvements in cognition were shown for acetylcholinesterase inhibitors, memantine, cerebrolysin, propentofylline, physical exercise, and cognitive rehabilitation. DISCUSSION: VCI clinical trials exhibited substantial heterogeneity. Few interventions were reproducibly tested in adequately sized and designed studies. Nonetheless, some interventions showed modest effects on global cognition and functional outcomes. To enhance the likelihood of success, future studies should focus on promising interventions with a solid rationale, target specific VCI subtypes, improve statistical power, and reduce heterogeneity. HIGHLIGHTS: Considerable methodological heterogeneity across VCI trials undermined the strength of evidence for both positive and negative findings, ultimately decreasing confidence in the possibility of treating VCI. Ginkgo biloba extracts have shown the greatest cognitive and functional benefits, though their clinical significance remains uncertain, and certainty of evidence is overall low. Future trials should focus on a single VCI subtype, prioritize interventions with a strong mechanistic rationale, standardize diagnostic criteria, ensure adequate power for chosen outcomes, test against placebo, and implement FAIR data sharing to accelerate therapeutic discovery. © 2025 The Author(s). Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

ImportanceDizziness/vertigo is a common symptom that can lead to falls and reduced confidence in daily activities. It can result from vestibular, non-vestibular, or unidentified etiologies. Effective treatments with minimal side effects are essential to improving patient outcomes.ObjectiveTo compare the efficacy and safety of Ginkgo biloba extract EGb 761® with Betahistine in patients with dizziness/vertigo of unclear etiology.Study DesignRandomized, double-blind, controlled trial conducted from October 2022 to August 2023.SettingEar, Nose, and Throat Outpatient Department at Burapha Hospital.ParticipantsEighty-six individuals aged ≥20 with dizziness/vertigo lasting >1 month without a specific etiology.InterventionPatients were randomized to EGb 761® (120 mg/day) or Betahistine (36 mg/day) with matched placebos for 12 weeks, assessed at weeks 2, 6, and 12.Main Outcome MeasuresPrimary outcome: change in dizziness severity as assessed by the 11-Point Box Scale and Dizziness Handicap Inventory (DHI) scores. Secondary outcomes: safety.ResultsRepeated-measures ANOVA showed significant improvement over time in both groups (P < .001), with no group × time interaction, indicating comparable efficacy. For DHI, Betahistine showed a transient advantage at week 2 (P < .01, Cohen's d = 0.96), but no significant difference between treatments was observed at week 12. Both treatments were well tolerated, with only mild gastrointestinal side effects.ConclusionEGb 761® and Betahistine demonstrated comparable efficacy and good safety in treating dizziness or vertigo of unclear etiology. Clinical improvement was most evident within the first 2 weeks of therapy.RelevanceEGb 761® is a safe and effective alternative to Betahistine with comparable efficacy and good tolerability.

Objective: To evaluate the effect of an electronic balance aid in balance rehabilitation training for patients with acute peripheral vestibular injury by comparing the outcomes of medication-only treatment and medication combined with vestibular rehabilitation using an electronic balance aid. Methods: This was a randomized controlled trial. The study subjects included 98 patients (40 males and 58 females, aged 25-69 years) diagnosed with idiopathic sudden sensorineural hearing loss (ISSNHL) with vertigo or vestibular neuritis, who were treated in the Department of Otorhinolaryngology-Head and Neck Surgery of Tianjin First Central Hospital from November 2022 to November 2023. All patients were randomly divided into the experimental group and the control group at a 1∶1 ratio using the sealed envelope method. Control group (conventional drug treatment): Patients received medication treatment for 2 weeks, including betahistine mesilate tablets, vitamin B1 tablets, methylcobalamin tablets, ginkgo biloba tablets, diphenhydramine hydrochloride injection (within 3 days of onset), metoclopramide hydrochloride injection, and glucocorticoids. Experimental group (conventional drug treatment+device training): On the basis of the same medication treatment as the control group, patients received vestibular rehabilitation training using an electronic balance aid (20 minutes per session, once a day,≥5 days per week, for a total of 2 weeks). SPSS software was used to compare the total scores of the Dizziness Handicap Inventory (DHI), the total scores of the Sensory Organization Test (SOT), and sensory analysis indicators between the two groups before and after treatment. Results: After treatment, vertigo symptoms significantly improved in both groups. DHI: The total DHI score in the control group decreased from 77.9±1.8 before treatment to 20.2±2.3 after treatment (P<0.001). In the experimental group, the total DHI score decreased from 73.5±2.1 before treatment to 8.6±0.9 after treatment (P<0.001). The difference in total DHI scores between the two groups after treatment was statistically significant, with the experimental group showing a lower score (t=-4.616, P<0.001). The impr

Objective:To analyze the clinical characteristics and prognostic factors of patients with acute low-frequency hearing loss（ALHL） and explore the potential role of migraine in its pathogenesis. Methods:A total of 56 ALHL patients treated at our outpatient clinic from June 2024 to January 2025 were randomly divided into two groups: a standardized treatment group and an anti-migraine treatment group. The standardized group received oral/intravenous steroids + oral/intravenous Ginkgo biloba extract, while the anti-migraine group received postauricular steroid injection/oral steroids + oral flunarizine for 2 weeks. Audiological, clinical, and psychological characteristics were collected, and statistical analysis was performed to assess clinical features and treatment outcomes, exploring the potential mechanism of migraine in ALHL. Results:The anti-migraine treatment group showed a significantly higher recovery rate than the standardized treatment group（92.86% vs 71.43%, P=0.036）. Among the anti-migraine group, 6 patients（21.43%） had a history of ALHL, 13（46.43%） had a confirmed migraine history, 26（92.86%） had anxiety, 26（92.86%） had depression, 5（17.86%） had irritable bowel syndrome, 21（75.00%） had sleep disorders, and 1（3.57%） experienced recurrence within 6 months. Conclusion:Anti-migraine therapy significantly improves the recovery rate in ALHL patients, suggesting that migraine may have a certain correlation with the pathogenesis of acute low-frequency hearing loss. Publisher: 目的：探讨急性低频听力下降（acute low-frequency hearing loss，ALHL）的临床特征及预后相关因素，并分析偏头痛在其发病中的可能作用机制。 方法：本研究纳入2024年6月至2025年1月期间在北京大学人民医院耳鼻咽喉头颈外科门诊就诊的56例ALHL患者，将其随机分为标准化治疗组（28例）和抗偏头痛治疗组（28例）。标准化治疗组接受口服/静脉激素+口服/静脉银杏叶提取物，抗偏头痛治疗组接受局部/口服激素+口服盐酸氟桂利嗪，疗程均为2周。同时收集患者的听力学、临床及心理特征资料，并对2组患者的临床特征及预后进行统计学分析。 结果：抗偏头痛治疗组患者的听力痊愈率显著高于仅采用标准化方案治疗组（92.86% vs 71.43%，P=0.036）。临床特征方面，抗偏头痛治疗组 28 例患者中，既往有ALHL病史者 6 例（21.43%），近 3 个月内伴头痛发作者 13 例（46.43%），合并焦虑者 26 例（92.86%），合并抑郁者 26 例（92.86%），伴肠易激综合征者5 例 （17.86%），伴睡眠障碍者 21 例（75.00%），半年内出现复发者 1 例（3.57%）。 结论：抗偏头痛治疗可显著提高ALHL患者的痊愈率，提示偏头痛可能与该病的发生相关。.

OBJECTIVE: This study aimed to evaluate whether adjunctive vitamin D supplementation enhances the efficacy of conventional therapy in treating sudden sensorineural hearing loss (SSNHL) in patients with vitamin D deficiency, and to assess both short-term and long-term clinical outcomes. METHODS: In this prospective randomized controlled trial, 101 SSNHL inpatients with vitamin D deficiency (serum 25-hydroxyvitamin D < 75 nmol/L) were enrolled at Yinchuan First People's Hospital (January-December 2024). Participants were randomized into a control group (n = 51, receiving conventional therapy: methylprednisolone and ginkgo biloba extract) and an experimental group (n = 50, conventional therapy + oral vitamin D3 [1500-2000 IU/day] for 10 days). Hearing and tinnitus outcomes were assessed via pure tone audiometry (PTA) and the Tinnitus Handicap Inventory (THI) at baseline, 10 days, and 3 months. RESULTS: Baseline characteristics were comparable between groups (all P > 0.05). At 10 days, the experimental group demonstrated significantly higher total effective rates for hearing recovery (82.0% vs. 52.9%, P < 0.001) and tinnitus improvement (83.3% vs. 71.1%, P = 0.007) compared to the control group. Mean PTA improvement was 29.3 dB HL vs. 14.2 dB HL (P < 0.001). At 3 months, the experimental group maintained significantly better outcomes, with a mean PTA improvement of 25.1 dB HL versus 12.5 dB HL in the control group (P < 0.001) and a greater reduction in THI scores (27.5 vs. 13.9, P < 0.001). The total effective rate for hearing remained superior in the experimental group (76.0% vs. 47.1%, P = 0.002). CONCLUSION: Vitamin D supplementation combined with conventional therapy significantly improves both short-term and sustained long-term hearing and tinnitus outcomes in SSNHL patients with vitamin D deficiency. These findings support its role as a safe and effective adjuvant treatment, warranting further validation through multicenter trials. © 2025. The Author(s).

The purpose of this research was to assess the impact of supplemental Ginkgo biloba extracts when administered in conjunction with vestibular rehabilitation training (VRT) to enhance patient outcomes in patients with vestibular neuritis (VN). A randomized controlled trial was conducted with 80 participants divided into two groups: Group A (Ginkgo biloba extracts+ VRT) and Group B (VRT only). It was established in the study that the integration of Ginkgo biloba extracts with VRT gave improved results, shorter treatment period, higher postural stability, and better quality of life than the group that received only VRT. Neuroprotective, anti-inflammatory and vasodilatory effects of Ginkgo biloba extracts were instrumental in helping compensate for the vestibular damage and therefore aid in recovery. This study has indicated that supplementing with Ginkgo biloba extracts alongside VRT is a better treatment approach when treating patients with 'persistent' VN.

Comment in Diabetes Metab J. 2026 Mar;50(2):414-415. doi: 10.4093/dmj.2025.0817. BACKGRUOUND: We conducted a prospective, randomized study to evaluate the combination of cilostazol (CTZ) and extract of Ginkgo biloba (EGb) and compare it with aspirin for the prevention of atherosclerosis progression in patients with type 2 diabetes mellitus (T2DM). METHODS: One hundred five patients with T2DM and increased carotid intima-media thickness (IMT) were randomly assigned to receive either CTZ 200 mg plus EGb 160 mg once daily or aspirin (ASA) 100 mg/day for 12 months. The primary endpoint was the change in maximum carotid IMT. RESULTS: The mean age and body mass index were 61.6±8.4 years and 25.2±3.1 kg/m2 in the CTZ/EGb group and 61.6±7.6 years and 24.5±3.3 kg/m2 in the ASA group, respectively. CTZ/EGb treatment reduced the maximum IMT in the bulb area (from 1.435±0.690 to 1.346±0.688 mm on the right; from 1.359±0.528 to 1.299±0.528 mm on the left), whereas ASA treatment did not, resulting in significant between-group differences (P<0.05). No significant differences were observed in the common carotid and internal carotid arteries. The CTZ/EGb group showed a reduction in triglycerides and an increase in high-density lipoprotein cholesterol levels. Additionally, aspartate and alanine aminotransferase levels decreased only in the CTZ/EGb group. There were no significant differences in Mini-Mental State Examination (MMSE) score changes or adverse events (ClinicalTrials.gov number: NCT05906199). CONCLUSION: Twelve months of CTZ/EGb combination therapy significantly attenuated the progression of carotid atherosclerosis compared with aspirin in patients with T2DM.

This prospective study compared the therapeutic efficacy of Ginaton alone, Ginaton combined with glucocorticoids, or Ginaton with mouse nerve growth factor (mNGF) in patients with sudden sensorineural hearing loss (SSNHL). Between January 2014 and June 2015, 101 SSNHL patients, with treatment initiated 3-10 days post onset, were randomly assigned to receive 1 of 3 2-week regimens: Ginaton alone (n = 33), Ginaton + glucocorticoid (n = 34), or Ginaton + mNGF (n = 34). Primary outcome was overall hearing improvement. Effectiveness rates were 78.79% (95% confidence interval [CI] 61.8%-89.9%) for Ginaton, 79.41% (95% CI 62.9%-90.1%) for Ginaton + glucocorticoid, and 88.24% (95% CI 72.5%-95.8%) for Ginaton + mNGF; these differences were not statistically significant (P > .05). All 3 groups showed significant post-treatment reductions in whole blood viscosity (high, medium, low shear rates; all P < .01), low-density lipoprotein cholesterol (all P < .01), and triglycerides (all P < .01). The neutrophil-to-lymphocyte ratio, an inflammatory marker, significantly decreased in the Ginaton + glucocorticoid (P < .05) and Ginaton + mNGF groups (P < .01). While all regimens demonstrated positive effects on hearing and surrogate markers, and Ginaton + mNGF showed a numerically higher hearing improvement rate, no statistically superior regimen for overall hearing was identified. This study suggests these approaches improve inner ear blood rheology and inflammation. However, larger, placebo-controlled trials are crucial to confirm efficacy and elucidate the distinct pharmacological contributions of each component, considering the study's sample size and open-label design. © 2025, The American College of Clinical Pharmacology.

Objective:This study aimed to evaluate the therapeutic effect of intratympanic injection of ganglioside in patients with refractory sudden deafness. Methods:A total of 120 patients with sudden deafness, aged 18-65 years, whose onset was within 11-42 days, failed to respond to conventional treatment, and had an average hearing threshold（500-4 000 Hz）>60 dB were selected. They were prospectively and randomly divided into a control group of 61 cases and an experimental group of 59 cases. The control group was treated according to the recommended protocol of the Chinese Medical Association（postauricular injection of methylprednisolone）, while the experimental group was treated with intratympanic injection of monosialotetrahexosylganglioside sodium+postauricular injection of methylprednisolone. Both groups were simultaneously administered oral ginkgo biloba extract and citicoline tablets. Hearing was re-examined two weeks after the completion of treatment, and the therapeutic effects of the two different treatment methods were compared and analyzed. Results:The effective rate was 29.51% in the control group and 54.24% in the experimental group（P<0.01）. The average hearing threshold improved by 11.57 dB HL in the control group and 22.50 dB HL in the experimental group（P<0.05）. Conclusion:The combination of postauricular injection of methylprednisolone and intratympanic injection of ganglioside is more effective than postauricular injection of methylprednisolone alone in the treatment of refractory sudden deafness. The earlier the treatment, the better the therapeutic effect. Publisher: 目的：本研究旨在评价鼓室注射神经节苷脂在难治性突聋患者中的疗效。 方法：入选发病在11～42 d、经常规治疗无效、平均听阈（500～4 000 Hz）>60 dB的突发性聋、年龄18～65岁的患者120例，前瞻性平行随机分为对照组61例和试验组59例，对照组按照中华医学会推荐方案（耳后注射甲泼尼龙）治疗，试验组鼓室注射单唾液酸四己糖神经节苷脂钠+耳后注射甲泼尼龙治疗，2组同时口服银杏提取物和胞磷胆碱片。治疗结束2周后复查听力，对2种不同治疗方法的疗效进行比较分析。 结果：对照组有效率为29.51％，试验组有效率为54.24％（P<0.01）。对照组平均听阈改善了11.57 dB HL，试验组平均听阈改善22.50 dB HL（P<0.05）。 结论：耳后注射甲泼尼龙联合鼓室注射神经节苷脂较单纯耳后注射甲泼尼龙治疗难治性突发性聋疗效好，并且治疗越早，疗效更佳。. A Randomized Controlled Study on the Clinical Efficacy of Ginkgo Biloba Combined with Nicorandil in Patients with HFmrEF. Gao X(1), Liu F(1), Han X(1), Tang S(1), Shen D(1), Zhang J(1), Liu C(1). Author

42. Int Heart J. 2025;66(1):74-80. doi: 10.1536/ihj.24-316. A Randomized Controlled Study on the Clinical Efficacy of Ginkgo Biloba Combined with Nicorandil in Patients with HFmrEF. Gao X(1), Liu F(1), Han X(1), Tang S(1), Shen D(1), Zhang J(1), Liu C(1). Author information: (1)Department of Ger

OBJECTIVE: Ginkgo diterpene lactone meglumine (GDLM) could improve the functional outcome after acute ischemic stroke (AIS). This study aimed to investigate the efficacy of GDLM on the quality of life in patients with AIS in China. METHODS: This is a post hoc analysis of Efficacy and Safety of Ginkgo Diterpene Lactone Meglumine in Acute Ischemic Stroke trial. The quality of life was measured using the EuroQoL questionnaire, including EQ-5D and EQ visual analogue scale (EQ-VAS). The primary outcomes were changes in EQ-5D and EQ-VAS from baseline to day 14 and day 90 after randomization. RESULTS: A total of 3219 patients with completed data on outcomes were enrolled, with median age of 63 years (interquartile range, 55-70) and 2,067 (64.2%) men. GDLM was associated with a significant decrease in scores of ED-5Q components (from 0 [no problem] to 3[extreme problem]), the mean difference between GDLM and placebo group was -0.14 for mobility, -0.11 for usual activities and self-care, -0.09 for pain/discomfort, and -0.34 for anxiety/depression on day 14, respectively. Similar results were observed on day 90. Additionally, there was statistically significant difference of changes in EQ-VAS between the GDLM group and the placebo group from baseline to day 14 (mean difference, 1.70; 95% confidence interval [CI], 0.78-2.62; P = 0.0003) and to day 90 after randomization (mean difference, 3.29; 95% CI, 2.37-4.22; P < 0.001). CONCLUSIONS: In this analysis of Chinese patients with AIS, GDLM could improve the 14-day and 90-day quality of life compared with the placebo. TRIAL REGISTRATION: URL: https://www. CLINICALTRIALS: gov . Unique identifier: NCT02526225. Registration Date: 2016-02-01. © 2024. The Author(s).

Ginkgetin (GK) is a naturally occurring biflavonoid predominantly isolated from Ginkgo biloba and has attracted increasing attention because of its broad pharmacological activities. Structurally, GK belongs to the 3'-8″-linked biflavone subclass, which distinguishes it from other biflavonoids like amentoflavone (the parent compound of this subclass) and its monomeric counterparts such as apigenin. This unique C-C linked dimeric architecture confers distinct molecular planarity and lipophilicity, contributing to its enhanced membrane permeability and multitarget engagement capabilities. GK has been shown to exert pleiotropic biological effects in preclinical studies, including anti-inflammatory, antioxidant, antifibrotic, anticancer, neuroprotective, cardioprotective, metabolic regulatory and antibacterial activities. Mechanistically, preclinical evidence indicates that GK functions as a multitarget modulator of key signaling pathways involved in oxidative stress, inflammation, cell death and tissue remodeling, such as nuclear factor erythroid 2-related factor 2/heme oxygenase-1 (Nrf2/HO-1), nuclear factor kappa-B(NF-κB), Janus kinase/signal transducer and activator of transcription(JAK/STAT), mitogen-activated protein kinases(MAPKs), AMP-activated protein kinase/mechanistic target of rapamycin(AMPK/mTOR), phosphoinositide 3-kinase/protein kinase B(PI3K/Akt) and cyclic GMP-AMP synthase-stimulator of interferon genes(cGAS-STING). Notably, GK has been observed to display context-dependent regulation of cell fate decisions, including apoptosis, autophagy and ferroptosis, thereby enabling the selective elimination of pathological cells while preserving normal tissue function. Preclinical studies further demonstrate that GK exhibits therapeutic potential across diverse disease systems, including cancer, metabolic disorders, cardiovascular diseases, neurological disorders and musculoskeletal diseases. In addition, emerging evidence highlights its antibacterial and antivirulence properties through the inhibition of biofilm formation and quorum sensing. It is crucial to note, however, that this promising profile is predominantly derived from preclinical studies, and clin

Heat stress is a major environmental stressor in poultry production that reduces growth performance and induces oxidative stress, inflammatory responses, and lung tissue injury. This study investigated the protective effects of dietary supplementation with Ginkgo biloba extract and tea polyphenols against heat stress-induced lung injury in broilers. A total of 320 one-day-old broilers were reared under standard management conditions until 21 days of age. Subsequently, 300 birds with similar body weight were selected and randomly allocated into six groups: a thermoneutral control group, a heat stress group, a heat stress group supplemented with 300 mg/kg tea polyphenols, and three heat stress groups receiving 300 mg/kg tea polyphenols combined with 100, 300, or 600 mg/kg Ginkgo biloba extract. The analysis of the results showed that heat stress significantly reduced the average daily gain and feed intake while increasing the feed conversion ratio. It also markedly increased serum lactate dehydrogenase activity and malondialdehyde levels, while decreasing antioxidant-related indicators, indicating the occurrence of oxidative stress and inflammatory responses. Histological examination revealed lung injury characterized by alveolar wall thickening, epithelial cell shedding, and disruption of the endothelial barrier, accompanied by upregulated expression of heat shock proteins and inflammation-related signaling genes. Supplementation with tea polyphenols alone partially alleviated these changes. Notably, the combined supplementation of Ginkgo biloba extract and tea polyphenols exerted more pronounced protective effects, significantly enhancing antioxidant capacity, attenuating inflammatory responses, and maintaining pulmonary barrier integrity. Among the tested levels, the groups receiving 300 mg/kg Ginkgo biloba extract in combination with tea polyphenols showed the most evident improvements. These findings suggest that the combined use of these plant-derived extracts effectively mitigates heat stress-induced lung injury in broilers.

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline. Despite significant advances in AD research, effective disease-modifying therapies remain unavailable. In recent years, ferroptosis has gained increasing attention for its potential role in the pathogenesis of AD. Accumulating evidence indicates that substantial iron accumulation, dysregulation of anti-oxidant defense systems, and elevated levels of lipid peroxidation are present in the brains of AD patients. These alterations create a conducive environment for ferroptosis and are closely associated with neuronal death and cognitive dysfunction. Therefore, targeting ferroptosis-related signaling pathways holds promise as a novel strategy to delay or halt the progression of AD. Natural products, such as flavonoids, phenolic compounds, and terpenoids, have become a focus of research in the intervention of neurodegenerative diseases due to their structural diversity, broad biological activities, and relatively low toxicity. Increasing studies have demonstrated that various herbal medicines, including Rhodiola rosea, Polygala tenuifolia, Ginkgo biloba, and Poria cocos, can effectively suppress ferroptosis through multiple mechanisms. These mechanisms include scavenging free radicals, enhancing anti-oxidant capacity, modulating iron metabolism, and restoring the function of key regulators like GPX4 or system Xc-, to thereby ameliorate AD-related neural damage. This review systematically summarizes recent advances in understanding the role of ferroptosis in AD and highlights the therapeutic potential of natural products that target ferroptotic pathways. We aim to provide theoretical support and candidate molecules for the development of novel AD treatment strategies based on ferroptosis regulation, and thus offer valuable insights for future research into new ferroptosis inhibitors.

BACKGROUND: Space exploration introduces unique health challenges for astronauts, including musculoskeletal degradation, immune dysregulation, oxidative stress, and cardiovascular alterations, primarily due to microgravity and space radiation. Conventional solutions like synthetic drugs face limitations such as side effects and storage constraints during long missions. Phytomedicine, derived from plant bioactive compounds, offers a promising alternative to address these challenges through multitargeted therapeutic actions. However, most evidence on these plant-based interventions comes from terrestrial preclinical and clinical studies, with only sparse data from microgravity or space analog environments, so their relevance to spaceflight must be interpreted cautiously. This review article explores the potential integration of phytomedicine into space health protocols to enhance astronaut well-being and mission success. METHODS: The review synthesized findings from diverse studies on the health effects of microgravity and the therapeutic potential of phytomedicines. Relevant literature was sourced from scientific databases notably Scopus and Web of Science (2012-2025). Key bioactive compounds and their mechanisms were evaluated in relation to space-relevant conditions and their feasibility for use in space environments, while noting that the vast majority of included studies were conducted under terrestrial conditions. The findings were synthesized to propose phytomedicine as a viable addition to astronaut healthcare protocols. RESULTS: Phytomedicines demonstrate significant potential in mitigating space-induced health issues. Resveratrol and curcumin support bone and muscle health, flavonoids and sterols enhance cardiovascular resilience, and compounds like Ginkgo biloba and ashwagandha provide neuroprotective and adaptogenic benefits. Phytomedicines' advantages include multitargeted actions, compact storage, and alignment with sustainable exploration goals, such as bioregenerative cultivation systems. These benefits, however, are inferred largely from Earth-based models and patient populations, and should therefore be viewed as preliminary indicators rather tha

Ginkgetin, a biflavone isolated from Ginkgo biloba, is a potent Wnt signaling inhibitor that can enhance the pharmacological effects of cisplatin on non-small cell lung cancer (NSCLC) by activating the ferroptosis pathway. However, few studies have examined the role of ginkgetin in regulating ferroptosis in breast cancer cells. In this study, ginkgetin was found to induce ferroptosis by increasing intracellular reactive oxygen species (ROS) accumulation through the downregulation of GPX4, SLC7A11, SLC40A1, and glutathione expression along with the upregulation of transferrin, glutamate, cystine, and cell-free ferroptosis markers. Ferroptotic activity was inhibited using ferrostatin-1, which interfered with ginkgetin-mediated regulation of ferroptosis-related factors, such as GPX4, SLC7A11, SLC40A1, and transferrin, and partially suppressed ginkgetin-induced activation of the ferroptosis pathway. Mechanistically, ginkgetin promoted p53 nuclear translocation and upregulated downstream YAP1 expression by inhibiting the suppressive effect of MDM2 on p53 in breast cancer cells, whereas ferrostatin-1 partially reversed these effects. Consequently, the pharmacological activity of Taxol in breast cancer cells was enhanced. Finally, using a cell line-derived xenograft (CDX) model, we found that ginkgetin induced ferroptosis and suppressed tumor growth, whereas the combined administration of Taxol and ginkgetin produced a synergistic antitumor effect in vivo. Overall, these findings indicate that ginkgetin enhances the tumor-suppressive effect of Taxol by activating ferroptosis through the MDM2-p53-YAP1 axis, suggesting a potential combination therapy for breast cancer treatment. © 2026. The Author(s).

Leaves of vascular plants exhibit a tip-to-base xylem conduit widening pattern, which minimizes hydraulic resistance as leaves expand. The extent to which different leaf vein orders conform to this pattern remains largely unexplored, particularly in species with dichotomously branching veins. In this study, we focused on Ginkgo biloba, a model species with dichotomous venation, to explore tracheid variation across leaf vein orders and its linkage with hydraulic path length. Across 108 leaves from three sites, tracheid hydraulic diameter (D) scaled significantly with hydraulic path length (L) at an overall scaling slope of 0.33 (95% CI: 0.31-0.34, r2 = 0.53, p < 0.001). Scaling exponents differed significantly among sites and vein orders, and D decreased progressively with increasing vein order. This study provides a potentially valuable approach for investigating the effects of hydraulic path length on xylem conduit diameter and offers a framework for subsequent research on plant venation and hydraulic transport networks.

Ginkgo biloba products have been used for decades for cognitive symptoms, yet the clinical evidence in Alzheimer's disease (AD) remains modest and heterogeneous. This review revisits key symptomatic and prevention trials and summarizes how systematic reviews and meta-analyses have informed ongoing clinical skepticism, often citing small effect sizes, limited patient-centered meaningfulness, short follow-up, and repeated trial designs. We suggest that long-standing ambiguity reflects multiple, overlapping sources of heterogeneity, including mixed-pathology recruitment, variable dosing and exposure duration, inconsistent outcome frameworks, and limited integration of biological readouts; differences across preparations and characterization practices may further contribute to variability. In the biomarker era, AD is increasingly defined biologically, and amyloid PET-confirmed cohorts offer a clearer test by reducing diagnostic noise and enabling mechanism-adjacent interpretation. Recent studies in amyloid PET-positive MCI/AD report clinical preservation alongside directional changes in plasma oligomerization tendency (MDS-OAβ), with decreases in treated groups compared with increases in controls. While such findings cannot, by design, establish disease-modifying effects, they provide a biologically anchored context for interpreting modest clinical signals. We conclude with practical recommendations to align cohort biology, stage, exposure certainty, duration, endpoints, and biomarker panels in next-generation trials of Ginkgo preparations in early AD-spectrum disease.

BACKGROUND: Ischemic vertigo (IV) is the main clinical manifestation of posterior circulation ischemia. Extract of Ginkgo biloba leaves injection (EGBLI) is rich in flavonoids and terpene lactones, which have antioxidant, vasodilator and neuroprotective effects. Triangle Health Management optimizes resource allocation through hierarchical intervention. OBJECTIVES: This prospective study analyzed the effect of EGBLI combined with triangle health management on IV. METHODS: First, n=177 patients with IV were included who received conventional treatment as a control group and another n=144 patients who received EGBLI as an observation group. The clinical efficacy of the two groups was compared and hemodynamics before and after treatment were examined. In addition, nutritional proteins and symptom improvement were compared between the two groups. RESULTS: Comparison showed that the clinical efficacy of the observation group was better (p<0.05). Meanwhile, hemodynamics and symptom improvement after treatment in the observation group were better than those in the control group (p<0.05). CONCLUSION: EGBLI combined with triangle health management is an excellent therapeutic regimen for IV.

ETHNOPHARMACOLOGICAL RELEVANCE: Ginkgo biloba L., a 'living fossil' with an evolutionary history spanning over 200 million years, occupies a prominent place in traditional medicine systems. Historical records, including the Chinese pharmacopoeia Ben Cao Gang Mu, document its use for treating various ailments related to the respiratory, circulatory, and cognitive systems. Modern pharmacological research has validated these traditional applications, identifying Ginkgo biloba extract (GBE) as a valuable phytomedicine for neurodegenerative, cardiovascular, and metabolic diseases. AIM OF STUDY: This comprehensive review aims to synthesize recent advances in GBE research, with a primary focus on literature from the past three years in GBE research, critically evaluating four key areas: 1) innovations in green extraction and purification technologies; 2) novel organelle-level mechanisms of action; 3) the development and application of nano-delivery systems for targeted therapy; and 4) clinical evidence and toxicological studies supporting GBE's therapeutic use and safety profile. MATERIALS AND METHODS: This holistic review was conducted through a systematic literature search (covering 2003.8.15-2026.2.22) in databases including PubMed, Web of Science, and Scopus, using keywords related to GBE's extraction technologies, nano-delivery systems, organelle-level mechanisms, and clinical applications. The retrieved literature was screened and critically evaluated to synthesize recent advances, with a focus on identifying emerging trends, convergent evidence, and knowledge gaps across the four key areas outlined in the review's aim. RESULTS: Significant improvements in the sustainability and efficiency of GBE extraction have been achieved through recent technological innovations. (Deep Eutectic Solvent) DESs have emerged as tunable platforms for the selective and efficient extraction of bioactive compounds, while physical field-assisted methods enhance yields. Mechanistic studies reveal that GBE orchestrates cellular homeostasis by synchronously modulating mitochondrial bioenergetics, endoplasmic reticulum stress, and autophagic-lysosomal activity. Nano-delivery systems, such

During boar semen cryopreservation, reduction in sperm quality and mitochondrial dysfunction are often accompanied by a pronounced increase in oxidative stress, well acknowledged as a key factor contributing to sperm functional impairment following freeze-thaw. Moreover, conventional components in freezing extenders may exert detrimental effects on sperm under certain conditions. Consequently, supplementation of antioxidants that specifically alleviate oxidative stress while maintaining both safety and efficacy represents a critical strategy for further optimization of boar semen cryopreservation. The ginkgo biloba extract (GBE) holds potent antioxidant and anti-inflammatory properties. In this study, different concentrations of GBE (0, 25, 50, 75, and 100 mg/L) were added to the freezing extender, and their effects on post-thaw porcine sperm quality were assessed. The results demonstrated that GBE at 25-100 mg/L significantly improved sperm motility and plasma membrane, acrosome, and DNA integrity. GBE also markedly increased adenosine triphosphate (ATP) content, mitochondrial membrane potential (MMP), and the protein levels of mitochondrial respiratory chain complexes (UQCRC2 and NDUFB8), while reducing reactive oxygen species (ROS) and malondialdehyde (MDA) levels and enhancing antioxidant enzyme activities. Besides, GBE significantly augmented anti-apoptotic capacity and sperm capacitation. The subsequent mechanistic exploration revealed that GBE could alleviate the porcine sperm cryodamage by suppressing KEAP1 expression, activating the NRF2/HO-1/NQO1 signaling, and upregulating AKT and ERK phosphorylation. Altogether, this study elucidates the role and mechanisms for GBE in porcine semen cryopreservation, providing novel theoretical insights and practical guidance for improvement of sperm quality and reproductive performance in pigs.