Probiotics have shown excellent application prospects in preventing and treating many diseases. However, their sensitivity to the harsh environment in vivo always leads to a massive loss of viability and insufficient therapeutic effect. Fortunately, modified probiotics have emerged and provide multiple possibilities for their use in various diseases. Modification not only endows probiotics with extra capacity to resist severe environments but also gives them exogenous characteristics, such as prolonged retention time and improved therapeutic effects. Modified probiotics could combine with other therapies, which has opened up new avenues to enhance the efficacy of probiotic-based therapy. In this review, we have summarized the current physicochemical and biological modification strategies of probiotics. In addition, the progress of research on probiotic-based combination therapy has also been extensively reviewed, which contributes to the enhanced delivery of probiotics or other active constituents and provides new ideas for disease treatment, bioimaging, and diagnosis.

Objective:To evaluate and compare the efficacy and safety of Shugan Jieyu capsules and hydrochloride Venlafaxine capsules in the treatment of depression. Methods:Totally 50 cases of patients with depression were randomly divided into the observa-tion group (n=26) and the control group (n=24). The observation group was treated with 2 Shugan Jieyu capsules in the morning and in the evening, while the control group was treated with hydrochloride Venlafaxine capsules at the dose of 75-150 mg·d-1,six weeks as a course of treatment. Hamilton Depression Scale ( HAMD) and Treatment Emergent Symptom Scale ( TESS) were used in the evaluation before the treatment and 2, 4 and 6 weeks after the treatment. Results:HAMD scores of the two groups were significant-ly decreased after the treatment (P<0. 01), and the scores were gradually decreased with the treatment, and there were no significant differences between the two groups (P>0. 05). The total efficacy of Shugan Jieyu capsules and hydrochloride Venlafaxine capsules was 88. 46% and 87. 5%, respectively, and there was no significant difference (P>0. 05). TESS scores of the observation group were significantly lower than those of the control group after the 2, 4 and 6-week treatment (P<0. 01). The incidence of adverse reactions of Shugan Jieyu capsules (42. 31%) was obviously lower than that of hydrochloride Venlafaxine capsules (70. 83%, P<0. 01). Con-clusion:Shugan Jieyu capsules are safe and effective in the treatment of depression.