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Nieuwe meta-analyses, RCTs en systematic reviews die wij dagelijks monitoren in PubMed. Onafhankelijk geïndexeerd, niet redactioneel bewerkt.
PloS one · 2025
Two infant formulas with unique combinations of 1,3-dioleoyl-2-palmitoyl-sn-glycerol sn2 palmitate, galactooligosaccharide, polydextrose, fructooligosaccharide, β-carotene, lutein, α-lactalbumin, osteopontin, and lactoferrin were evaluated for non-inferiority compared to a commercially available formula. In a randomized, controlled, parallel-arm, double-blind, multicenter, non-inferiority study, eligible infants were enrolled to receive an experimental (BBN-001 [Part 1; N = 129], BBN-102 [Part 2; N = 117]) formula or commercial formula (Brand; N = 143) for 120 days (Clinical Trials.gov NCT03331276). Infants were considered eligible if they were healthy, term (≥ 37 and ≤ 42 weeks of gestation), singleton newborns, with a birth weight of at least 2,500 g, and no more than 14 postnatal days-of-age. Anthropometric growth, formula intake, gastrointestinal tolerance, and adverse events were measured throughout the study, and fecal soap fatty acids were measured at the end. The primary endpoint was weight gain at the end of the trial, with treatment groups to be considered non-inferior if their weight gain was > -3 g/d compared to the control group. Both experimental formulas were non-inferior to the Brand formula according to anthropometric outcomes. Formula intake, total adverse events, and stool frequency and consistency were similar to Brand formulas. Some measures of gassiness and fussiness improved in the experimental formulas (P < 0.05). Fecal calcium increased and fecal palmitic acid soaps decreased in both experimental formulas (all P ≤ 0.045), and total soap fatty acids were decreased in the BBN-102 group compared to the Brand group (P = 0.020). The experimental formulas were well tolerated and deemed non-inferior to those of a Brand formula. The experimental formulas improved some measures of gastrointestinal tolerance compared to standard commercially available infant formulas. ClinicalTrials.gov NCT03331276.
Nutrients · 2026
Background/Objectives: Macular pigment optical density (MPOD) is a nutrition-responsive biomarker that indicates the antioxidant status of the macula. This study aimed to evaluate the effects of long-term supplementation with a standardized Centella asiatica (L.) Urb. extract (CA-HE50) on MPOD in a randomized, double-blind, placebo-controlled clinical trial. Methods: Eighty men and women aged 45-65 years, with baseline MPOD values between 0.2 and 0.4, were randomly assigned to receive either CA-HE50 (300 mg/day, n = 40) or a placebo (n = 40) for 6 months. Efficacy was assessed by measuring MPOD at baseline and on Days 60, 120, and 180. The primary efficacy endpoint was the change in MPOD from baseline to Day 180. Safety was evaluated through monitoring adverse events, vital signs, and clinical laboratory tests. Results: By Day 180, supplementation with CA-HE50 resulted in a statistically significant increase in MPOD compared to the placebo in the right eye, left eye, and the average of both eyes (all p < 0.001). Significant between-group differences were also observed at Day 120, indicating a time-dependent improvement in MPOD. Additionally, the proportion of responders was significantly higher in the CA-HE50 group compared to the placebo group (p < 0.001). CA-HE50 was well tolerated, with no serious adverse events or clinically relevant safety concerns identified during the intervention period. Conclusions: Long-term supplementation with C. asiatica extract significantly improved MPOD, supporting its potential role in enhancing macular nutritional status. These findings suggest that CA-HE50 may serve as a beneficial dietary intervention for maintaining macular health.
Journal of ethnopharmacology · 2024
Cordyceps sinensis (CS) is a fungus parasitic on lepidopteran larvae which is often used to treat lung diseases and regulate immune function. This review aimed to evaluate the efficacy of CS in the adjuvant treatment of lung cancer. As of June 2022, the electronic database search was conducted in PubMed, EMBASE, Cochrane Library, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Database and China Science Journal Database (VIP database). Randomized clinical trials (RCTs) that evaluated the efficacy of CS as an adjuvant treatment for lung cancer were included. After the quality evaluation, meta-analysis was performed with Stata 16.0 software. A total of 12 RCTs with 928 patients were identified for this meta-analysis, which showed that as an adjuvant treatment, CS has the following advantages in the treatment of lung cancer: (1) Improved tumor response rate (TRR) (RR: 1.17， 95%CI: 1.05-1.29，P = 0.00); (2) improved immune function, including increased CD4 (MD: 4.98, 95%CI: 1.49-8.47, P = 0.01), CD8 (MD: 1.60, 95%CI: 0.40-2.81, P = 0.01, I2 = 0.00%), NK (MD: 4.17, 95%CI: 2.26-6.08, P = 0.00), IgA (MD: 1.29, 95%CI: 0.35-2.24, P = 0.01), IgG (MD: 3.95, 95%CI: 0.98-6.92, P = 0.01) and IgM (MD: 6.44, 95%CI: 0.63-12.26, P = 0.03); (3) improved patients' quality of life based on the mean ± SD of Karnofsky Performance Status (KPS) (MD: 8.20, 95%CI: 6.87-9.53, P = 0.00); (4) reduced the incidence of adverse drug reactions (ADRs), including the incidence of myelosuppression (RR: 0.38, 95%CI: 0.19-0.75, P = 0.01), leukopenia (RR: 0.76, 95%CI: 0.63-0.92, P = 0.00), and thrombocytopenia (RR: 0.52, 95%CI: 0.31-0.86, P = 0.01) (5) reduced the incidence of radiation pneumonitis (RR: 0.74, 95%CI: 0.62-0.88, P = 0.00). However, the number of improved patients based on KPS (RR: 1.47, 95%CI: 0.98-2.20, P = 0.06) were similar between two groups, liver and renal damage (RR: 0.32, 95%CI: 0.09-1.10, P = 0.07) and gastrointestinal adverse reactions (RR: 0.80, 95%CI: 0.47-1.37, P = 0.42) as well. Subgroup analysis showed that CS could increase the TRR in the treatment with 6 g/d and 21 days/3-4 cycles. Compared with conventional treatment, adjuvant treatment with CS of lung cancer not only improve TRR, QOL and immune function, but also reduce the incidence of ADRs and radiation pneumonitis. The optimal usage may be 6 g/d and 21 days/3 to 4 cycles. CRD42022333681.
Nutrients · 2024
In the present study, we conducted a placebo-controlled, double-blind, parallel-group comparison trial in which an extract of Cordyceps militaris (CM) mycelium was administered to long-distance runners for 16 weeks during the pre-season training period and blood test markers for anemia were investigated. The results indicated that the change rates of serum ferritin levels were moderately increased in the CM group (n = 11) but decreased in the placebo group (n = 11) during the study period, and the levels were significantly increased in the CM group compared with those in the placebo group at 4 weeks and 8 weeks after the test food intake (p < 0.05). Moreover, the change rates of hemoglobin and hematocrit were significantly increased in the CM group compared with those in the placebo group at 8 weeks after the test food intake (p < 0.05). These observations suggest that the intake of test food containing Cordyceps militaris mycelium extract is expected to effectively maintain the hemoglobin and hematocrit levels in long-distance runners, possibly via the suppression of the decrease in iron storage, which is reflected by serum ferritin, during pre-season training. Furthermore, the levels of creatine kinase were increased above the normal range in both the placebo and CM groups at registration. Interestingly, the creatine kinase levels were significantly decreased in the CM group compared with those in the placebo group at 16 weeks after the test food intake (p < 0.05). These results suggest that Cordyceps militaris mycelium extract exhibits a protective action on the muscle damage observed in long-distance runners and may suppress muscle injury. Together, these observations suggest that Cordyceps militaris mycelium extract exhibits an improving effect on the markers for not only anemia, but also muscle injury in long-distance runners during pre-season training.
Pharmaceutical biology · 2024
Bailing capsule, derived from Cordyceps sinensis (Berk.) Sacc. (Clavicipitaceae), has shown potential in the treatment of chronic obstructive pulmonary disease (COPD), a prevalent respiratory disorder. This study elucidates the efficacy and mechanism of action of the use of Bailing capsules in the treatment of COPD using meta-analysis and network pharmacology. A meta-analysis of randomized controlled trials (RCTs) was performed. The treatment group received Bailing capsules alongside standard therapy, while the control group received standard therapy or in combination with other traditional Chinese medicines. Efficacy outcomes included lung function, exercise tolerance, acute exacerbation risk, and quality of life. Network pharmacology and molecular docking identified key targets of Bailing capsules. The meta-analysis of 27 RCTs showed significant improvements in the treatment group for forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, and the 6-min walk test (6MWT). Additionally, there was a marked reduction in acute COPD attacks and an improvement in quality of life. Meanwhile, network pharmacological analysis identified SRC, HIF1A, NFKB1, HDAC2, and PRKACA, as the potential core targets for Bailing capsules in the treatment of COPD. Bailing capsules have shown promising results in the treatment of stable COPD. Future studies should focus on large-scale, multicenter RCTs to confirm the long-term benefits and safety of Bailing capsules.
International journal of biological macromolecules · 2024
Cordyceps sinensis (Berk.) Sacc. (Ophiocordyceps sinensis) is an edible and medicinal fungus used as a natural superior tonic. It is considered as scarce fungus with a high market demand. Therefore, as an alternative, fermentation technology has been proposed to produce artificial cordyceps (fermented C. sinensis) to address the shortage of cordyceps resources for industrialization and commercial utilization. Numerous studies have proved that polysaccharides are the important bioactive substances in the fermented C. sinensis, but the research data lack systematic review. In this review, current relevant research data regarding the preparation (including extraction, fractionation, and purification), structural characterization (including molecular weight, monosaccharide composition, glycosidic bond type, structural and conformational features), bioactivities, structure-activity relationships (SAR) and applications of polysaccharides from different sources of fermented C. sinensis last decade were analyzed and discussed. The findings highlight that the most commonly employed methods for preparing fermented Cordyceps sinensis polysaccharides (FCSPs) involve water extraction and alcohol precipitation, combing with sophisticated chromatographic techniques such as ion exchange and gel permeation chromatography. From these processes, 34 different polysaccharides were identified including 5 glucans and 7 heteropolysaccharides that were thoroughly characterized. FCSPs exhibited a broad spectrum of biological activities, ranging from antioxidant and renal protective effects to immunomodulatory, antitumor, and hypolipidemic properties. The structure-activity relationships (SAR) demonstrated that key factors, such as molecular weight, monosaccharide composition and glucosidic bond types, play critical roles in determining the bioactivity of FCSPs. Nevertheless, there remain unknown elements that continue to influence SAR, leaving room for further exploration. Furthermore, the limitation of existing studies and some new perspectives for future investigations on FCSPs were proposed.
Frontiers in medicine · 2024
The effectiveness of using Cordyceps sinensis as an adjuvant therapy for patients with renal dysfunction (RD), especially acute kidney injury (AKI), is still a topic of debate. In response to the current conflicting data, the present meta-analysis was conducted to assess the clinical effectiveness of C. sinensis in the treatment of RD and to provide evidence for clinical practice. Several databases, including PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang, were systematically searched updated to March 25, 2024. We used the combined ratio (OR) and diagnostic ratio (DOR) to assess the therapeutic effect of C. sinensis. In addition, risk of bias was assessed by Cochrane Risk of Bias Assessment Tool. The present meta-analysis ultimately incorporated 15 studies comprising a total of 1,310 patients with RD. We pooled estimated the sensitivity, specificity as well as DOR from patient-based analyses with 0.89 (95% confidence interval [CI]: 0.84-0.93), 0.69 (95% CI: 0.59-0.77) and 18.0 (95% CI: 8.0-39.0), respectively. Moreover, we calculated the combined positive likelihood ratio (PLR) as well as negative likelihood ratio (NLR) to be 2.8 (95% CI: 2.1-3.9) and 0.16 (95% CI: 0.10-0.27), respectively. Additionally, area under the curve (AUC) of the summary receiver operating characteristic (SROC) was calculated as 0.88 (95% CI: 0.85-0.90) reflecting prognostic accuracy. Subsequently, subgroup analysis indicated that the clinical efficacy of C. sinensis in northern Chinese patients with RD was superior to that of southern. On the other hand, C. sinensis significantly reduced patients' blood creatinine levels, shortened the oliguria period, and increased urine osmolality, indicating it can improve the function of glomeruli and renal tubules. Our results indicate that C. sinensis can be considered a dependable clinical treatment for individuals with RD. It may improve the function of glomeruli and tubules, promote the recovery of tubular function, and thus enhance the clinical therapeutic effects. www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42024559042.
Pathogens (Basel, Switzerland) · 2025
Entomopathogenic fungus-based biopesticides are an excellent alternative to synthetic pesticides and are widely used in insect pest control. With the transformations of the agri-food system, it is important to consider the One Health approach, which recognizes that health threats are shared at the interface between people, animals, plants, and the environment. The safety and environmental impact of fungi-based insecticides should be assessed comprehensively, taking into account not only their effects on non-target organisms and human health but also their environmental fate. This includes how these substances degrade, persist, or dissipate in soil, water, and air and their potential to bioaccumulate or leach into groundwater. Such assessments are essential to ensure that their long-term use does not pose unintended risks to ecosystems or public health. This systematic review aims to identify and analyze available studies on the potential One Health hazards associated with fungal biopesticides. A total of 134 articles were selected: 84 bioassay articles (63%), 36 case reports (27%), 10 field studies (7%), and 4 other types of studies (3%). Of these articles, 59 were studies on vertebrate animals and 65 studies on invertebrate animals, 6 studies on diverse organisms, 2 studies focused specifically on risk assessment for non-target organisms in the environment, while 2 other studies looked at the toxicological hazards associated with human exposure to the metabolites of the fungus present in air. The United States had the highest number of publications (33). Beauveria bassiana and Metarhizium anisopliae followed by the fungi Cordyceps fumosorosea (Paecilomyces fumosoroseus) and B. brongniartii were the most prevalent fungal species in the studies. This review highlights that case reports of infections in humans and other vertebrates by fungi are not related to the use of fungal biopesticides. A predominance of studies with bees was identified due to the importance of these insects as pollinators. The findings indicate that fungal biopesticides pose minimal risks when used appropriately. Nevertheless, the necessity for standardized safety assessments is emphasized. In order to ensure greater effectiveness, it is essential to develop unified protocols and bioassays with specific risk indicators aligned with the One Health approach. This includes evaluating potential effects on pollinators, vertebrate toxicity, and the environmental persistence of metabolites. In future research, the development of integrated guidelines that simultaneously consider human, animal, and environmental health is recommended.
Journal of cosmetic dermatology · 2025
Cordyceps is a valuable Chinese herbal medicine known for its various components with antioxidant properties, which may theoretically improve melasma. This study aimed to evaluate the efficacy of a new skin-lightening cosmetic containing Cordyceps extract (referred to as Cordyceps essence) in treating female patients with melasma. Sixty-two women with melasma were enrolled and randomly assigned to two groups for 12 weeks of treatment. Group A received oral tranexamic acid (TXA) combined with topical hydroquinone cream, while Group B received oral TXA combined with topical Cordyceps essence. Changes in the Melasma Area and Severity Index (MASI), melanin index (MI), and erythema index (EI) were monitored and assessed before and after treatment. Patient-reported satisfaction and adverse events were also recorded. Additionally, a metabolomic analysis was conducted on 15 randomly selected patients from Group B. After 12 weeks of treatment, intra-group comparisons revealed that MASI scores, MI, and EI significantly decreased in both Group A and B compared to baseline (p < 0.05). However, inter-group comparisons showed no statistical differences in MASI scores, MI, or EI between the two groups after treatment (p > 0.05). Adverse reactions occurred in 4 people (13.8%) in Group A and 1 person (3.3%) in Group B. Patient satisfaction with treatment was similar in both groups. The metabolomic analysis identified significant differences in 29 metabolites and 15 metabolic pathways after treatment (p < 0.05). Our study demonstrated that both oral TXA combined with hydroquinone cream and oral TXA combined with Cordyceps essence significantly improved melasma in women. However, the incidence of adverse reactions was lower with topical Cordyceps essence than that with hydroquinone cream. Cordyceps essence appeared to be a promising alternative for patients intolerant to hydroquinone cream. Metabolomic analysis revealed that modulation of melanogenesis-related metabolites, enhanced antioxidant activity, and improved skin barrier function collectively contributed to the clinical improvement in melasma severity. The improvement of melasma with oral TXA and topical Cordyceps essence may be closely linked to changes in endogenous differential metabolites in the skin and the regulation of amino acid metabolic pathways.
Journal of evidence-based medicine · 2025
Bailing Capsules (BLC) and Yong Chong Cao Capsules (YChCC) share similar medicinal components, but Yong Chong Cao benefit from more advanced cultivation and large-scale production. This study systematically compared their therapeutic effects in patients with mild-to-severe Chronic Obstructive Pulmonary Disease (COPD). This study was designed as a multi-center, randomized, active-controlled trial. 240 COPD patients were randomized 1:1 to receive YChCC or BLC for 24 weeks, followed by a 24‑week follow‑up. The primary endpoints were number of acute exacerbations. Secondary outcomes included, time to first exacerbation, and exacerbation duration, forced expiratory volume in 1 s (FEV1), FEV1%, forced vital capacity (FVC), FVC%, FEV1/FVC%, modified Medical Research Council dyspnea scale (mMRC), Chronic Obstructive Pulmonary Disease Assessment Test (CAT), and Chronic Obstructive Pulmonary Disease Clinical Questionnaire (CCQ). A total of 208 patients completed the trial (full analysis set, FAS), and 178 comprised the per‑protocol set (PPS). Compared with BLC, YChCC significantly reduced the number of acute exacerbations (FAS: p = 0.002; PPS: p = 0.003) and prolonged time to first exacerbation. No significant between‑group differences were observed in lung function parameters or mMRC, CAT, and CCQ scores. YChCC represent a promising adjuvant therapy for patients with stable COPD, ranging from mild to severe. They significantly prolong the time to the first acute exacerbation and reduce the frequency of acute exacerbations, thereby offering potential benefits in managing COPD. This trial has been registered at ClinicalTrials.gov under the registration number NCT03745261. NCT0374526.
The British journal of nutrition · 2024
Ganoderma lucidum (a mushroom used in traditional Chinese medicine) compounds may attenuate ageing-related physiological changes and restore normal immunity. However, studies on the physiological effects of Ganoderma lucidum dry extract food supplements are few. Therefore, here, we aimed to investigate the effects of Ganoderma lucidum dry extract food supplement on the lymphocyte function of older women. This was a double-blind clinical trial (n 60) with a final 39 older volunteers, divided into two groups Ganoderma lucidum (n 23) and placebo (n 16). The Ganoderma lucidum group received 2000 mg/d of Ganoderma lucidum dry extract for 8 weeks. We used flow cytometry to determine the lymphocyte profile. CD4+ lymphocyte gene expression was evaluated by real-time polymerase chain reaction. We observed that in the Ganoderma lucidum group, concanavalin A stimulation increased lymphocyte proliferation. Further, we observed an increase in expression of Forkhead box P3, transforming growth factor-beta, IL-10, IL-6, retinoic acid receptor-related orphan receptor gamma, GATA-binding protein 3 and interferon gamma genes in the Ganoderma lucidum group. Furthermore, in the Ganoderma lucidum group, ionomycin and phorbol 12-myristate 13-acetate stimulation led to decrease in Th17+ cells and increase in Th2+ cells. Thus, in older women, Ganoderma lucidum regulates T lymphocyte function leading to a predominant anti-inflammatory action but does not induce T lymphocyte proliferation through CD28 signalling pathway.
Nutrients · 2025
Background: Ganoderma lucidum spore oil (GLSO) is widely recognized for its notable medicinal and nutritional properties. This study aimed to systematically evaluate the efficacy and safety of GLSO extract in individuals with dyslipidemia. Methods: In a randomized, double-blind, placebo-controlled trial, 110 participants were enrolled and randomly assigned to either the intervention group or the placebo group. A chi-square test of baseline characteristics confirmed no significant differences in age or sex distribution between the two groups. Results: After 12 weeks of intervention, the intervention group exhibited significantly lower levels of total cholesterol (CHO), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), alongside significantly higher levels of high-density lipoprotein cholesterol (HDL-C), compared to the placebo group, with all differences reaching statistical significance. Furthermore, the relative percentage changes in lipid parameters also demonstrated significant intergroup differences. Safety analyses revealed that the intervention had no notable effects on renal function parameters, whereas hepatic function parameters showed statistically significant improvement in the intervention group. Conclusions: This study demonstrated that GLSO extract effectively improved lipid profiles and liver function, with a favorable safety and tolerability profile. These findings strongly support the potential clinical application of GLSO extract in the management of dyslipidemia.
Carbohydrate research · 2025
Edible Fungal polysaccharides as Immunomodulators: A Systematic Review at the Crossroads of Immunology, Natural Products Chemistry, and Microbiology. The chemical structure-specifically molecular weight, branching degree, and functional group modifications-directly dictates immunological activity. For instance, high-molecular-weight β-glucans activate macrophage surface receptors through triple-helix conformations, whereas sulfation enhances electrostatic interactions with immune cells. Mechanistically, polysaccharides regulate macrophage polarization, dendritic cell maturation, and T/B cell activation, therebyengaging core signaling pathways such as TLR4/MyD88/NF-κB, NLRP3 inflammasome, and MAPK, This orchestrates synergistic enhancement of innate and adaptive immunity. Recent research further demonstrate that polysaccharides can also reshape the gut microbiota-immune metabolic axis by promoting the production of short-chain fatty acids (SCFAs) and activating receptors (e.g., GPR43), indirectly modulating systemic immune responses. Clinically, polysaccharides from Ganoderma lucidum and Lentinus edodes demonstrate efficacy in cancer adjuvant therapy by enhancing immune function and reducing radiotherapy/chemotherapy side effects. However, species-specific receptor recognition heterogeneity and lack of standardized preparation protocols impede clinical translation. Therefore,the implementing an integrated strategy of "polysaccharide structure-immunometabolic reprogramming-precision delivery" to overcome the existing bottlenecks. Combining multi-omics approaches (e.g., gut metagenomics and metabolomics) will advance therapeutics targeting microbiota-immune crosstalk. Such strategies aim to address chronic inflammatory inflammation", malignancies, and related pathologies with enhanced mechanistic specificity.
Frontiers in nutrition · 2025
Increasing interest in improving physical performance and muscle mass in adults has highlighted the potential benefits of β-hydroxy-β-methyl butyrate (HMB) supplementation. While numerous studies have been conducted in this area, the hormonal response to HMB remains unclear. We hypothesized that HMB supplementation would significantly increase anabolic hormone levels, particularly testosterone, while not affecting the cortisol, IGF-1, or growth hormone levels in adults. A comprehensive search of databases, including PubMed, Web of Science, and Scopus, was performed to identify relevant studies until January 2024. The protocol was registered with Prospero (CRD42024552074). The studies evaluated the impact of HMB supplementation on hormonal outcomes, including testosterone, cortisol, insulin-like growth factor-1 (IGF-1), and growth hormone (GH). Utilizing a random-effects model, the standardized mean differences (SMDs) and their corresponding 95% confidence intervals (CIs) were computed, and the GRADE framework was applied. A total of 15 controlled trials (CTs) comprising 712 participants were included. HMB supplementation significantly increased testosterone levels (SMD: 0.82, 95% CI: 0.35, 1.29, p = 0.001). However, no significant changes were observed in the cortisol (SMD: -0.39, 95% CI: -0.92, 0.14, p = 0.14), IGF-1 (SMD: -0.18, 95% CI: -0.54, 0.18, p = 0.33), and GH (SMD: 0.04, 95% CI: -0.73, 0.82, p = 0.91) levels. According to the GRADE criteria, the quality of evidence was rated as ranging from low to high. HMB supplementation significantly elevates testosterone levels in adults without distinct impacts on other hormonal pathways. However, it does not appear to significantly influence the cortisol, IGF-1, or GH levels.
Clinical nutrition (Edinburgh, Scotland) · 2025
Physical impairment has been gaining attention as a fundamental outcome in nutrition therapy for critically ill patients. This review aims to evaluate current evidence and identify knowledge gaps regarding nutrition therapy for physical function and muscle mass, based on 17 systematic reviews developed for the Japanese Critical Care Nutrition Guideline 2024. Literature searches were performed in MEDLINE, CENTRAL, and ICHUSHI until April 2023, with additional searches up to September 2024. Studies were categorized by nutritional intervention and key findings were summarized. Overfeeding-of both energy and protein-increased adverse outcomes including impaired physical function. Excessive energy restriction also impaired physical outcomes, even during the hyperacute phase. Although adequate energy intake is physiologically necessary during recovery phases, most studies did not report nutritional intake during this period. Protein intake above the standard level helped preserve muscle mass. Nutrition therapy combined with early rehabilitation appears to support physical function. Under the equivalent energy intake, the route and method of administration had minimal impact, but can help ensure adequate delivery. The effects of specific nutrients remain unclear due to limited studies and insufficient or unreported energy intake. Nevertheless, omega-3 fatty acids, beta-hydroxy-beta-methylbutyrate, and synbiotics showed potential benefits. Although overfeeding may be harmful during the hyperacute phase, adequate energy intake, at least in the late period of the acute phase and subsequent phases, could play an important role in supporting the recovery of muscle mass and physical function. This approach may enhance the effectiveness of nutritional interventions in improving physical outcomes.
Diagnostic pathology · 2025
Perivascular epithelioid cell tumor (PEComa) of the pancreas is a rare tumor of pancreatic mesenchymal origin with malignant potential. Critical to appropriate clinical management is determining whether the tumor is benign or malignant. Because of its rarity, morphologic and histologic characteristics and limited patient follow-up of pancreatic PEComa have precluded precise definition of malignancy. However, because malignant pancreatic PEComa appears to be distinctly uncommon, further improvements characterizing its preoperative imaging features could facilitate use of diagnostic endoscopic ultrasound biopsy and perhaps ablative treatment. This paper presents a case of pancreatic PEComa treated at the Affiliated Hospital of North Sichuan Medical College and includes a systematic literature review with special emphasis on the key imaging features of pancreatic PEComa. In February 2024, a woman in her 50s was admitted to the hospital with subxiphoid discomfort. Magnetic resonance imaging (MRI) of the upper abdomen revealed a round, solid mass in the pancreatic uncinate process. The patient underwent pancreatic mass resection and pancreaticojejunostomy, and the diagnosis of pancreatic PEComa was confirmed through pathological examination. Imaging examinations appear valuable for a tentative diagnosis of pancreatic PEComa. Key imaging features include its frequent occurrence in the pancreatic head, typically small to moderate size, "pushing" as opposed to infiltrative growth pattern with well-defined margins, and the presence of a capsule. The lesions are usually solid and often exhibit mild to moderate heterogenous enhancement during the arterial phase, with reduced enhancement in the portal and delayed phases.
Frontiers in nutrition · 2025
A growing body of evidence confirms that nutritional supplementation strategies combined with resistance training can enhance muscle strength and mass in older adults. However, the optimal supplementation approach remains unclear. This study aimed to evaluate the comparative efficacy of different nutritional interventions combined with resistance training on muscle strength and mass in healthy older adults and determine the optimal strategy. A systematic search was performed across three major biomedical databases (PubMed, Web of Science, and EMbase) to identify randomized controlled trials (RCTs) investigating the effects of nutritional supplementation combined with resistance training on muscle strength and mass in healthy older adults. A total of 19 eligible RCTs were included. The search covered literature from database inception to April 2025. Two researchers independently screened studies against predefined eligibility criteria and assessed methodological quality using the Cochrane risk-of-bias tool. Stata 18.0 was used to conduct network meta-analysis. Compared with resistance training alone, protein supplementation combined with resistance training significantly enhanced muscle strength [Standardized Mean Difference (SMD) = 0.45, 95% confidence interval (CI): 0.20,0.69; surface under the cumulative ranking curve (SUCRA) = 98.7%] and muscle mass [Mean Difference (MD) = 0.37, 95%CI: 0.04,0.70],whereas creatine supplementation demonstrated non-significant effects on muscle strength versus training alone (SMD = 0.03, 95% CI: -0.35,0.42) but yielded the most pronounced improvement in muscle mass (MD = 2.18, 95%CI: 0.92,3.44; SUCRA = 99.9%), outperforming both protein and β-hydroxy-β-methylbutyrate (HMB) interventions, with HMB supplementation critically failing to demonstrate significant benefits for muscle strength (SMD = -0.22, 95%CI: -0.57,0.12) or mass outcomes (MD = 0.05, 95%CI: -0.33,0.44). https://www.crd.york.ac.uk/PROSPERO/view/CRD420251026016.
Women's health (London, England) · 2025
Vilaprisan is a selective progesterone receptor modulator with demonstrated efficacy in the management of uterine fibroids (UFs). To evaluate the safety and efficacy of vilaprisan in Japanese women with UFs and heavy menstrual bleeding (HMB). Open-label, parallel-group, Phase 3 randomized clinical trial. Japanese women with UFs and HMB were randomly assigned 1:1 to receive vilaprisan (2 mg/day) for either four treatment periods (TPs) of 12 weeks each separated by one bleeding period (Arm A1) or two TPs of 24 weeks each separated by two bleeding periods (Arm A2). The primary endpoint was the incidence of treatment-emergent adverse events (TEAEs). Of 179 women enrolled, 151 were included in the full analysis set and 148 in the safety analysis set. TEAEs occurred in 79.1% of women, with the majority being mild; events were evenly distributed across both treatment arms. Study drug-related TEAEs were observed in 44.6% of women, and serious TEAEs were reported in 3.4% of women. During the treatment phase, the mean (standard deviation) number of bleeding days per 28 days decreased to 1.40 (1.34) days in Arm A1 and 1.42 (0.82) days in Arm A2 from respective baseline values of 5.1 (2.3) and 5.2 (2.0) days. Median time to onset of amenorrhea was 4 days in TP1 in both arms, and 4 days in TP2 in Arm A1. Absence of bleeding for the last 28 days was more common in TP1 (Arm A1: 91.89%, Arm A2: 89.19%) than TP2 (Arm A1: 80.85%, Arm A2: 85.71%). In this study, vilaprisan 2 mg/day was found to be well tolerated and efficacious in Japanese women with UFs and HMB. However, the study sponsor later terminated the overall clinical development of vilaprisan due to potential safety concerns from long-term rodent studies. The ASTEROID 8 study was registered at https://clinicaltrials.gov/ (registration number: NCT03476928).
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition · 2025
To investigate the comprehensive intervention effects of transfer energy capacitive and resistive (TECAR) therapy combined with β-hydroxy-β-methylbutyrate (HMB) nutritional supplementation in older patients with sarcopenic obesity (SO). We conducted a randomized controlled trial, enrolling 140 older patients who met the Asian diagnostic criteria for SO. Participants were randomly assigned to 4 groups, including a double-placebo group (Group A), TECAR + placebo group (Group B), sham TECAR + HMB group (Group C), and TECAR + HMB group (Group D), with 35 patients in each group. The intervention lasted 12 weeks. The primary outcome measure was the total score of the Short Physical Performance Battery (SPPB). Secondary outcome indicators included the modified Barthel Index (MBI), scores of the Mini Nutritional Assessment-Short Form (MNA-SF), handgrip strength, body mass, and body mass index (BMI). A two-way analysis of variance (ANOVA) was used to assess the interaction effects between TECAR and HMB. After the intervention, Group D (TECAR + HMB) demonstrated significant improvements across all metrics. The SPPB total score increased from 6.29 ± 1.34 to 8.06 ± 1.51 (P < 0.001), with notable enhancements in walking speed (2.71 ± 0.86 vs. 1.97 ± 0.82), chair stand (2.60 ± 0.55 vs. 2.11 ± 0.47), and balance (2.74 ± 0.74 vs. 2.20 ± 0.76). MBI improved from 71.74 ± 14.41 to 79.91 ± 10.52 (P < 0.001). Handgrip strength increased from (13.65 ± 5.05) kg to (15.72 ± 4.89) kg (P = 0.001). Body mass decreased from (81.78 ± 9.02) kg to (76.95 ± 9.89) kg (P < 0.001), and BMI reduced from (30.14 ± 1.68) kg/m2 to (28.34 ± 2.33) kg/m2 (P < 0.001). Interaction analysis revealed significant synergistic effects between TECAR and HMB in improving the SPPB total scores (F = 16.374, P < 0.001, η² = 0.107) and reducing BMI (F = 14.328, P < 0.001, η² = 0.095). TECAR therapy combined with HMB supplementation significantly enhances physical function, activities of daily living, and body composition in elderly patients with sarcopenic obesity, demonstrating a synergistic effect. 探讨电容电阻式靶向疗法（Transcutaneous Capacitive and Resistive Electric Transfer, TECAR）联合β-羟基β-甲基丁酸盐（β-hydroxy-β-methylbutyrate, HMB）营养补充对老年肌少性肥胖（sarcopenic obesity, SO）患者的综合干预效果。 采用随机对照试验设计，纳入140例符合亚洲肌少性肥胖诊断标准的老年患者，随机分为四组：A组（双安慰组）、B组（TECAR+安慰剂）、C组（假TECAR+HMB）、D组（TECAR+HMB），每组35例。干预周期为12周，主要结局指标为简易体能状况量表（SPPB）总分，次要指标包括改良的Barthel指数（modified Barthel index, MBI）、微型营养评估简表（MNA-SF）评分、握力、体质量及体质量指数（BMI）。采用双因素方差分析评估TECAR与HMB的交互效应。 干预后，D组（TECAR+HMB）各项指标较干预前差异均有统计学意义：SPPB总分从（6.29±1.34）分提高至（8.06±1.51）分（P<0.001），其中步行速度〔（2.71±0.86）分 vs. （1.97±0.82）分〕、椅子站立测试〔（2.60±0.55）分 vs. （2.11±0.47）分〕和平衡能力〔（2.74±0.74）分 vs.（2.20±0.76）分〕三个子项均有明显提高；MBI从（71.74±14.41）提高至（79.91±10.52）（P<0.001）；握力从（13.65±5.05） kg提升至（15.72±4.89） kg（P=0.001）；体质量从（81.78±9.02） kg 下降至（76.95±9.89） kg（P<0.001），BMI从（30.14±1.68） kg/m2 下降至（28.34±2.33） kg/m2（P<0.001）。交互效应分析显示，TECAR和HMB在改善SPPB总分（F=16.374，P<0.001, η²=0.107）、降低BMI（F=14.328，P<0.001, η2=0.095）等方面具有显著协同作用。 TECAR联合HMB能显著改善老年肌少性肥胖患者的躯体功能、生活能力和BMI，且两者具有协同增效作用。
Nutrients · 2025
Resistance training (RT) is a key strategy to counteract age-related declines in muscle strength and physical function. β-hydroxy-β-methylbutyrate (HMB) has been proposed as a complementary supplement to enhance these adaptations. However, the additional effects of RT plus HMB (RT+HMB) compared with RT alone remain unclear. This systematic review and meta-analysis evaluated the effects of RT+HMB versus RT alone on body composition, muscle quality (MQ), and physical function in older adults. Following PRISMA guidelines (PROSPERO: CRD420251144810), six databases (PubMed, Scopus, Cochrane Library, CINAHL, Web of Science, and ScienceDirect) were searched up to July 2025. Randomized controlled trials comparing RT+HMB with RT alone were included. Methodological quality was assessed with the PEDro scale and risk of bias using Cochrane RoB 2. Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Ten trials (n = 596) met inclusion criteria. RT+HMB produced modest and borderline significant improvements in handgrip strength (SMD 0.24; 95% CI 0.00-0.48; p = 0.05) and moderate benefits in Short Physical Performance Battery (SPPB) scores (SMD 0.54; 95% CI 0.12-0.95; p = 0.01). No significant effects were observed for gait speed, appendicular lean mass, MQ, fat mass, or body weight (p > 0.05). Five trials (50%) were rated at high risk of bias, limiting confidence in pooled estimates. HMB supplementation combined with RT may yield modest improvements in functional performance, particularly handgrip strength and overall physical function, without statically significant effects in body composition and MQ. Further high-quality RCTs are warranted to confirm its clinical relevance.