1.Eucommia ulmoides promotes alveolar bone formation in ovariectomized rats
Lin ZHENG ; Wenjun JIN ; Shanshan LUO ; Rui HUANG ; Jie WANG ; Yuting CHENG ; Zheqing AN ; Yue XIONG ; Zipeng GONG ; Jian LIAO
Chinese Journal of Tissue Engineering Research 2025;29(6):1159-1167
BACKGROUND:Eucommia ulmoides has a certain osteogenic effect,which can promote the proliferation and differentiation of osteoblasts.However,it is unclear whether Eucommia ulmoides has effects on alveolar bone formation and Wnt/β-Catenin signaling pathway. OBJECTIVE:To investigate the mechanism by which Eucommia ulmoides promotes alveolar bone formation in ovariectomized rats based on the Wnt/β-Catenin signaling pathway. METHODS:Sixty female Sprague-Dawley rats were selected and randomly divided into five groups:blank control group,sham-operation group,model group,low-dose group Eucommia ulmoides group,and high-dose Eucommia ulmoides group,with twelve rats in each group.Osteoporosis animal models were constructed by bilateral oophorectomy in the model group and the low-dose and high-dose Eucommia ulmoides groups.The sham-operation group underwent the same method to remove adipose tissue of equal mass around the bilateral ovaries.Three months after surgery,the low-and high-dose Eucommia ulmoides groups were given 2.1 g/kg/d and 4.2 g/kg/d Eucommia ulmoides by gavage,respectively.The sham-operation group and model group were given the same amount of physiological saline by gavage.After 12 weeks of drug intervention,the changes in alveolar bone mass of rats in each group were observed through Micro-CT;hematoxylin-eosin staining was used to observe the pathological structural changes of alveolar bone in rats;enzyme linked immunosorbent assay was used to detect the expression levels of alkaline phosphatase and osteocalcin in the serum of rats;western blot was used to detect the expression levels of β-Catenin and Frizzled9 receptor proteins in the alveolar bone of rats;and real-time fluorescence quantitative PCR was used to detect the expression of osteocalcin,Runt-related transcription factor 2(Runx2),alkaline phosphatase,β-catenin,and frizzled9 mRNAs in alveolar bone tissues of rats. RESULTS AND CONCLUSION:Compared with the blank control group,bone volume fraction,trabecular number,trabecular thickness,and bone mineral density were reduced in the model group(P<0.05),and trabecular separation was elevated(P<0.05).Pathological observation showed that the arrangement of trabeculae was disordered and irregular,the trabeculae were thinned or broken,and the marrow cavity was enlarged in the model group,with a significant reduction in bone volume;the level of alkaline phosphatase in the serum was increased(P<0.05),and the level of osteocalcin was decreased(P<0.05);mRNA expression of alkaline phosphatase,osteocalcin,Runx2,β-catenin,and frizzled9 were decreased(P<0.05);protein expression of β-Catenin and Frizzled9 was decreased(P<0.05).Compared with the model group,the low-and high-dose Eucommia ulmoides groups showed an increase in bone volume fraction,trabecular number,trabecular thickness,and bone mineral density(P<0.05)and a decrease in trabecular separation(P<0.05).In the low-and high-dose Eucommia ulmoides groups,bone trabeculae were slightly aligned and thickened,with a significant increase in bone mass.Compared with the model group,the serum level of alkaline phosphatase was reduced(P<0.05)and the serum level of osteocalcin was elevated(P<0.05)in the low-and high-dose Eucommia ulmoides groups.Compared with the model group,the mRNA expression of alkaline phosphatase,osteocalcin,Runx2,β-catenin,and frizzled9 were increased in the low-and high-dose Eucommia ulmoides groups(P<0.05).Compared with the model group,the protein expression of Frizzled9 was increased in the low-dose Eucommia ulmoides group(P<0.05),while the protein expression of β-Catenin and Frizzled9 was increased in the high-dose Eucommia ulmoides group(P<0.05).Compared with the low-dose Eucommia ulmoides group,the high-dose Eucommia ulmoides group had a more significant improvement in the above indexes.To conclude,Eucommia ulmoides can effectively promote the alveolar bone formation,and its mechanism of action might be related to the activation of the Wnt/β-catenin signaling pathway.
2.Randomized Controlled Clinical Observation on Bushen Ruyan Formulation (补肾乳岩方) in Treating 44 Cases of Premenopausal Breast Cancer Patients of Disharmony of the Chong (冲) and Ren (任) Meridian Type under Endocrine Intensive Therapy
Zepeng WANG ; Xufeng CHENG ; Jiangshan YUAN ; Ruidong LIU ; Qi LIU
Journal of Traditional Chinese Medicine 2025;66(8):817-825
ObjectiveTo observe the clinical efficacy and safety of Bushen Ruyan Formulation (补肾乳岩方, BRF) in treating premenopausal breast cancer patients of disharmony of the chong (冲) and ren (任) meridian type under endocrine intensive therapy. MethodsA total of 88 premenopausal breast cancer patients who received endocrine intensive therapy and were diagnosed with disharmony of the chong and ren meridian by traditional Chinese medicine (TCM) were included and randomly divided into a control group and a treatment group, with 44 cases in each group. The control group received ovarian function suppression (OFS) combined with endocrine therapy, while the treatment group was given oral BRF additionally. Both groups were treated for three months. The clinical efficacy was evaluated by comparing the pre- and post-treatment results of the Functional Assessment of Cancer Therapy-Breast (FACT-B), modified Kupperman score, T cell subsets (CD3+, CD4+, CD8+, CD4+/CD8+), sex hormone levels, including estradiol (E2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), progesterone (P), testosterone (T), and prolactin (PRL), tumor markers, such as carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), and carbohydrate antigen 153 (CA153), TCM syndrome score, and TCM syndrome efficacy. Blood routine tests, liver function and kidney function were monitored to assess safety. ResultsThe FACT-B scores of each domains and the total scores of the treatment group increased, while the social/family status score of the control group decreased. The treatment group had significantly higher scores in all domains and total score compared to the control group (P<0.05 or P<0.01). The modified Kupperman score and TCM syndrome score of the treatment group decreased, and were lower than those of the control group (P<0.01). The levels of CD3+ and CD4+ in the treatment group increased, and were higher than those of the control group (P<0.05). Serum testosterone levels in the treatment group were lower than those in the control group (P<0.05). The total effective rate of TCM syndrome efficacy in the treatment group was 67.44%, significantly higher than the 23.26% in the control group (P<0.05). No significant abnormalities were observed in the blood routine tests or liver/kidney function indicators in either group before or after treatment. ConclusionBRF can effectively improve quality of life, alleviate symptoms, increase serum CD3+ and CD4+ levels, and enhance clinical efficacy in premenopausal breast cancer patients undergoing endocrine intensive endocrine therapy. It is also safe with no significant adverse effects.
3.Mechanism of Anmeidan in Improving Learning and Memory in Insomnia Model Rats by Mediating Immunoinflammation via cGAS/STING Signaling Pathway
Bo XU ; Zijing YE ; Ping WANG ; Jing CHENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):27-35
ObjectiveTo investigate the mechanism by which Anmeidan improves learning and memory in insomnia rats by regulating the cyclic guanosine monophosphate-adenosine monophosphate synthase (cGAS)/stimulator of interferon genes (STING) signaling pathway to influence immunoinflammation. MethodsSixty SD rats were randomly divided into a blank group, a model group, a suvorexant group (30 mg·kg-1), and Anmeidan low-, medium-, and high-dose groups (4.55, 9.09, and 18.18 g·kg-1), with 10 rats in each group. The insomnia rat model was induced by intraperitoneal injection of p-chlorophenylalanine (PCPA). Anmeidan decoction and normal saline were administered by gavage for 28 days at the corresponding doses. Morris water maze and new object recognition tests were used to assess learning and memory functions. Hematoxylin-eosin (HE) staining and Nissl staining were performed to observe hippocampal cell morphology. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of interleukin-1 (IL-1), interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-12 (IL-12), interleukin-18 (IL-18), and tumor necrosis factor-α (TNF-α). Western blot and Real-time quantitative polymerase chain reaction(Real-time PCR) were used to detect the relative protein and mRNA expression levels of hippocampal cGAS and STING. ResultsCompared with the blank group, the 5-HT content in the model group was significantly reduced (P<0.01). The latency to the upper platform and total distance were significantly increased (P<0.05, P<0.01), while the residence time in the target quadrant and the number of platform crossings were significantly reduced (P<0.01), and the relative recognition index for new objects was significantly lower (P<0.01). The morphology and arrangement of hippocampal neurons were loose and disordered, with a decreased number of intracellular Nissl bodies. The relative expression levels of IL-1, IL-1β, IL-6, IL-8, IL-12, IL-18, TNF-α, cGAS, and STING pathway proteins and mRNA were significantly upregulated (P<0.01). Compared with the model group, the latency to the upper platform in the high-dose Anmeidan group was significantly shortened (P<0.05). In the medium- and high-dose Anmeidan groups and the suvorexant group, the residence time in the target quadrant and the number of platform crossings were significantly increased (P<0.01). The total distance traveled was significantly reduced (P<0.01), and the relative recognition index for new objects was significantly increased (P<0.01). The hippocampal neurons were more neatly arranged, and the number of intracellular Nissl bodies increased. The expression of IL-1, IL-1β, IL-6, IL-8, IL-12, IL-18, TNF-α, and cGAS proteins and mRNA in the medium- and high-dose Anmeidan groups was significantly downregulated (P<0.05, P<0.01). ConclusionAnmeidan improves learning and memory in insomnia rats, possibly by suppressing immunoinflammation through inhibition of the cGAS/STING signaling pathway.
4.Herbal Textual Research on Euphorbiae Pekinensis Radix and Knoxiae Radix in Famous Classical Formulas
Xiaoxuan CUI ; Kaizhi WU ; Wuwei MENG ; Yapeng WANG ; Wenyue LI ; Cheng FENG ; Zhilai ZHAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):282-294
This article systematically analyzes the historical evolution of the name, origin, medicinal parts, processing and other aspects of Euphorbiae Pekinensis Radix(EPR) by referring to the herbal medicine, medical books, prescription books and other documents of the past dynasties, combined with the relevant modern research materials, so as to provide a basis for the development and utilization of famous classical formulas containing this herbal medicine. According to research, EPR was first recorded in the Shennong Bencaojing in the name of Daji, and it is the correct name of the herbal medicine in all dynasties, there are also other aliases such as Qiongju, Hongya Daji, and Xiamaxian. The dried roots of Euphorbia pekinensis from Euphorbiaceae was the mainstream of the past dynasties. Before the Ming dynasty, the above ground parts of E. pekinensis were used as Zeqi in herbal works. However, since LI Shizhen in the Ming dynasty proposed that the origin of Zeqi should be E. helioscopia, the aerial part of EPR is no longer used as medicine. Since modern times, the roots of Knoxia valerianoides has been used as EPR, and has become the mainstream of commodities, which should be corrected. Throughout history, it has been recorded that the main producing areas were Jiangsu, Anhui, Zhejiang, Shanxi and other regions, while modern botanical survey have shown that EPR is a widespread species distributed throughout the country. In ancient times, the harvesting time of EPR was mostly the twelfth lunar month, while in modern time, it is more common to harvest in autumn and winter. The main processing methods of EPR in ancient times were vinegar processing, wine processing, and stir frying, while in modern times, it is uniformly vinegar processing. In the medicinal properties and clinical aspects, the records are basically consistent throughout history, mainly characterized by bitter taste, cold and toxic nature. Its main efficacy is expelling water retention and reducing swelling. Based on the textual research, it is suggested to choose the dried roots of E. pekinensis when famous classical formulas containing EPR, processing method can be based on the original specified prescription requirements, if the processing method is not clear, it is recommended to use vinegar-processed products as medicine.
5.Exercise Regulates Structural Plasticity and Neurogenesis of Hippocampal Neurons and Improves Memory Impairment in High-fat Diet-induced Obese Mice
Meng-Si YAN ; Lin-Jie SHU ; Chao-Ge WANG ; Ran CHENG ; Lian-Wei MU ; Jing-Wen LIAO
Progress in Biochemistry and Biophysics 2025;52(4):995-1007
ObjectiveObesity has been identified as one of the most important risk factors for cognitive dysfunction. Physical exercise can ameliorate learning and memory deficits by reversing synaptic plasticity in the hippocampus and cortex in diseases such as Alzheimer’s disease. In this study, we aimed to determine whether 8 weeks of treadmill exercise could alleviate hippocampus-dependent memory impairment in high-fat diet-induced obese mice and investigate the potential mechanisms involved. MethodsA total of sixty 6-week-old male C57BL/6 mice, weighing between 20-30 g, were randomly assigned to 3 distinct groups, each consisting of 20 mice. The groups were designated as follows: control (CON), high-fat diet (HFD), and high-fat diet with exercise (HFD-Ex). Prior to the initiation of the treadmill exercise protocol, the HFD and HFD-Ex groups were fed a high-fat diet (60% fat by kcal) for 20 weeks. The mice in the HFD-Ex group underwent treadmill exercise at a speed of 8 m/min for the first 10 min, followed by 12 m/min for the subsequent 50 min, totally 60 min of exercise at a 0° slope, 5 d per week, for 8 weeks. We employed Y-maze and novel object recognition tests to assess hippocampus-dependent memory and utilized immunofluorescence, Western blot, Golgi staining, and ELISA to analyze axon length, dendritic complexity, number of spines, the expression of c-fos, doublecortin (DCX), postsynaptic density-95 (PSD95), synaptophysin (Syn), interleukin-1β (IL-1β), and the number of major histocompatibility complex II (MHC-II) positive cells. ResultsMice with HFD-induced obesity exhibit hippocampus-dependent memory impairment, and treadmill exercise can prevent memory decline in these mice. The expression of DCX was significantly decreased in the HFD-induced obese mice compared to the control group (P<0.001). Treadmill exercise increased the expression of c-fos (P<0.001) and DCX (P=0.001) in the hippocampus of the HFD-induced obese mice. The axon length (P<0.001), dendritic complexity (P<0.001), the number of spines (P<0.001) and the expression of PSD95 (P<0.001) in the hippocampus were significantly decreased in the HFD-induced obese mice compared to the control group. Treadmill exercise increased the axon length (P=0.002), dendritic complexity(P<0.001), the number of spines (P<0.001) and the expression of PSD95 (P=0.001) of the hippocampus in the HFD-induced obese mice. Our study found a significant increase in MHC-II positive cells (P<0.001) and the concentration of IL-1β (P<0.001) in the hippocampus of HFD-induced obese mice compared to the control group. Treadmill exercise was found to reduce the number of MHC-II positive cells (P<0.001) and the concentration of IL-1β (P<0.001) in the hippocampus of obese mice induced by a HFD. ConclusionTreadmill exercise led to enhanced neurogenesis and neuroplasticity by increasing the axon length, dendritic complexity, dendritic spine numbers, and the expression of PSD95 and DCX, decreasing the number of MHC-II positive cells and neuroinflammation in HFD-induced obese mice. Therefore, we speculate that exercise may serve as a non-pharmacologic method that protects against HFD-induced hippocampus-dependent memory dysfunction by enhancing neuroplasticity and neurogenesis in the hippocampus of obese mice.
6.The Refinement and Innovation of The UV Cross-linking and Immunoprecipitation
Jia-Min ZHAO ; Cheng-Jiang LU ; Ming YANG ; Nashun BUHE ; Gang WANG
Progress in Biochemistry and Biophysics 2025;52(4):1036-1052
RNA-binding proteins (RBPs) are ubiquitous components within cells, fulfilling essential functions in a myriad of biological processes. These proteins interact with RNA molecules to regulate gene expression at various levels, including transcription, splicing, transport, localization, translation, and degradation. Understanding the intricate network of RBP-RNA interactions is crucial for deciphering the complex regulatory mechanisms that govern cellular function and organismal development. Ultravidet (UV) cross-linking and immunoprecipitation (CLIP) stands out as a powerful approach designed to map the precise locations where RBPs bind to RNA. By using UV light to create covalent bonds between proteins and RNA, followed by immunoprecipitation to isolate the protein-RNA complexes, researchers can identify the direct targets of specific RBPs. The advent of high-throughput sequencing technologies has revolutionized CLIP, enabling the identification of not only the types but also the exact sequences of RNA bound by RBPs on a genome-wide scale. The evolution of CLIP has led to the development of specialized variants, each with unique features that address specific challenges and expand the scope of what can be studied. High-throughput sequencing CLIP (HITS-CLIP) was one of the first advancements, significantly increasing the throughput and resolution of RNA-protein interaction mapping. Photoactivatable-ribonucleoside-enhanced CLIP (PAR-CLIP) introduced the use of photoactivatable ribonucleosides to enhance cross-linking efficiency and specificity, reducing background noise and improving the detection of low-abundance RNA-protein interactions. Individual-nucleotide resolution CLIP (iCLIP) further refined the technique, achieving unprecedented precision by resolving individual nucleotides involved in RBP binding, which is particularly valuable for studying the fine details of RNA structure and function. Despite the remarkable progress, there remains room for improvement in CLIP technology. Researchers continue to seek methods to increase sensitivity, reduce technical variability, and improve the reproducibility of results. Advances in sample preparation, data analysis algorithms, and computational tools are critical for addressing these challenges. Moreover, the application of CLIP to more diverse biological systems, including non-model organisms and clinical samples, requires the development of tailored protocols and the optimization of existing ones. Looking forward, the field of RNA biology is poised to benefit greatly from ongoing innovations in CLIP technology. The exploration of non-canonical RNA-protein interactions, such as those involving long non-coding RNAs (lncRNAs) and circular RNAs (circRNAs), promises to reveal new layers of cellular regulation and may lead to the discovery of novel therapeutic targets. Furthermore, integrating CLIP data with other omics approaches, such as proteomics and metabolomics, will provide a more comprehensive understanding of the dynamic interplay between RNA and its binding partners within the cell. In conclusion, the continuous refinement and expansion of CLIP techniques have not only deepened our knowledge of RNA biology but have also opened up new avenues for investigating the molecular underpinnings of health and disease. As the technology matures, it is expected to play an increasingly pivotal role in both basic and applied research, contributing to the advancement of medical science and biotechnology.
7.Analysis of clarithromycin potential adverse drug interactions and establishment of refined prescription pre-review rules
Long WANG ; Li ZHANG ; Lingna ZHU ; Guanjun ZHANG ; Jun CHENG
China Pharmacy 2025;36(8):986-990
OBJECTIVE To analyze the potential adverse drug interactions (pADIs) of clarithromycin, and establish refined prescription pre-review rules. METHODS Outpatient prescriptions of clarithromycin in combination with other drugs were collected from January 1, 2024 to June 30, 2024 through hospital information system of the Third People’s Hospital of Bengbu. pADIs were identified and their risk severities were graded according to Lexicomp and Micromedex databases. Then, refined prescription pre- review rules for clarithromycin pADIs-related drugs were established according to the identification and risk level results. RESULTS Among 3 046 clarithromycin combined drug prescriptions, 946 cases of pADIs occurred in 812 prescriptions. There were 6, 415 and 525 cases classified as “contraindicated”,“ major” and “moderate”, respectively. The combination drugs with “contraindicated” levels were tamsulosin, rupatadine, domperidone and ticagrelor, while those with “major” levels were mainly theophylline, dexamethasone and amlodipine. Accordingly, 26 refined rules were established, including 4 items of “warning information→prescription interception”, 11 items of “warning information→prescription double signature” and 11 items of “attention information→prescription approval”. CONCLUSIONS There are “contraindicated” and “major” risks associated with clarithromycin and its combination drugs in the hospital, and refined prescription pre-review rules for clarithromycin combined drug prescription have been established successfully.
8.The mechanism of effective traditional Chinese medicine components and prescriptions in treatment of chronic pancreatitis by intervening against pancreatic stellate cells
Ruyang CHENG ; Weining SONG ; Xin JIANG ; Yehao WANG ; Lin LIU ; Fang LU ; Shumin LIU
Journal of Clinical Hepatology 2025;41(4):793-800
Chronic pancreatitis (CP) is a chronic disease characterized by recurrent inflammation and progressive damage to pancreatic tissue, and its deterioration may increase the risk of pancreatic cancer in patients with CP, which seriously threatens the health of patients with CP. In recent years, studies on the pathogenesis of CP have mostly focused on the activation of pancreatic stellate cells (PSCs) and its role in pancreatic fibrosis. This article elaborates on the mechanism of action of PSCs in CP, summarizes the current status of research on effective traditional Chinese medicine components and prescriptions for intervention of PSCs in the treatment of chronic CP, and proposes the future research directions for effective traditional Chinese medicine components and prescriptions, so as to provide a reference for the clinical treatment of CP patients in the future.
9.Huazhuo Jiedu Prescription Treats Ulcerative Colitis by Inhibiting Excessive Mitophagy via PINK1/Parkin Signaling Pathway
Haofeng ZHANG ; Jinye ZHOU ; Ziwei LIU ; Yican WANG ; Yirui CHENG ; Zheng ZHI ; Qian YANG ; Bolin LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):182-189
ObjectiveTo investigate the mechanism of Huazhuo Jiedu prescription in treating ulcerative colitis (UC) by regulating mitophagy. MethodsThe genes related to mitophagy and UC were retrieved from GeneCards, and then the common genes of mitophagy and UC were analyzed by metascape to identify the genes related to mitophagy in UC. Animal experiments were carried out to decipher the mechanism by which Huazhuo Jiedu prescription treated UC by regulating mitophagy. Sixty C57BL/6 male mice were randomized into normal, model, high-, medium-, and low-dose (50, 25, 12.5 g·kg-1, respectively) Huazhuo Jiedu prescription, and mesalazine (0.52 g·kg-1·d-1) groups, with 10 mice in each group. After successful modeling by the dextran sulfate sodium-free drinking method, the colonic mucosal damage was observed by hematoxylin-eosin staining, and the ultracellular structure of colon mucosa was observed by transmission electron microscopy. The expression levels of mitophagy-related proteins PTEN-induced putative kinase 1 (PINK1) and Parkin protein were determined by Western blot. The expression of prohibitin 2 (PHB2), ubiquitin-specific protease 15 (USP15), ubiquitin-specific protease 30 (USP30) in the colon tissue was detected by immunofluorescence (IF). ResultsAll the drug intervention groups showed ameliorated pathological manifestations of the colonic mucosa and improved mitochondrial structures in UC mice. Compared with the normal group, the model group demonstrated up-regulated protein levels of PINK1 and Parkin (P<0.05), enhanced average fluorescence intensity of PHB2 (P<0.05), and weakened average fluorescence intensity of USP15 and USP30 (P<0.05). Compared with the model group, the mesalazine group and the high- and medium-dose Huazhuo Jiedu prescription groups showcased down-regulated protein levels of PINK1 and Parkin (P<0.05), decreased average fluorescence intensity of PHB2 (P<0.05), and enhanced average fluorescence intensity of USP15 and USP30 (P<0.05). The low-dose Huazhuo Jiedu prescription group showed down-regulated protein levels of PINK1 and Parkin (P<0.05), weakened average fluorescence intensity of PHB2 (P<0.05), and enhanced average fluorescence intensity of USP15 and USP30 (P<0.05). ConclusionHuazhuo Jiedu prescription can attenuate the intestinal mucosal injury and improve the mitochondrial cell ultrastructure in UC mice by regulating the expression of PINK1-Parkin pathway and inhibiting excessive mitophagy.
10.Characteristic Expression of Multiple Neurotransmitters Oscillation Imbabance in Brains of 1 028 Patients with Depression
Anqi WANG ; Xuemei QING ; Yanshu PAN ; Pingfa ZHANG ; Ying ZHANG ; Jian LI ; Cheng ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(11):278-286
ObjectiveTo analyze the characteristic expression patterns of six neurotransmitters including 5-hydroxytryptamine (5-HT), dopamine (DA), acetylcholine (ACh), norepinephrine (NE), inhibitory neurotransmitter (INH), and excitatory neurotransmitter (EXC) in the whole brain and different brain regions of depression patients by Search of Encephalo Telex (SET), providing new ideas for the study of heterogeneous etiology of depression. Methods(1) A retrospective study was conducted on supra-slow signals of EEG fluctuations in 1 028 patients with depression. The SET system was used to obtain the expression information of six neurotransmitters in the whole brain and 12 brain regions: left frontal region (F3), right frontal region (F4), left central region (C3), right central region (C4), left parietal region (P3), right parietal region (P4), left occipital region (O1), right occipital region (O2), left anterior temporal region (F7), right anterior temporal region (F8), left posterior temporal region (T5), and right posterior temporal region (T6). The expression information of each neurotransmitter was compared with the normal model, and it was found that single neurotransmitter was in one of three states: increased, decreased, or normal expression. The simultaneous expression states of six neurotransmitters in the brain space were referred to as the expression pattern of multiple neurotransmitters. (2) A MySQL database was established to analyze the actual expression patterns of different neurotransmitters in the whole brain of patients with depression. (3) Factor analysis was conducted to further analyze the characteristic rules of 78 variables of neurotransmitters in the whole brain and 12 brain regions in depression patients. Results(1) The expression of single neurotransmitters in the whole brain and different brain regions of the total depression population showed one of three expression states (increased/decreased/normal), being normal in the majority. The decreased and increased expression of 5-HT, ACh, DA, INH, EXC, and NE in the whole brain occurred in 6% and 25%, 31% and 17%, 36% and 9%, 15% and 31%, 32% and 14%, and 22% and 22%, respectively. (2) The antagonizing pairs of neurotransmitters (EXC/INH, DA/5-HT, and ACh/NE) showed significant antagonistic relationships in the whole brain and different brain regions, with a strong negative correlation between EXC and INH (P<0.01, |r| values ranging from 0.69 to 0.76), a strong negative correlation between DA and 5-HT (P<0.01, |r| values ranging from 0.83 to 0.90), and a moderate negative correlation between ACh and NE (P<0.01, with |r| values ranging from 0.56 to 0.66). Meanwhile, non-antagonizing pairs of neurotransmitters in the whole brain and different brain regions also showed correlations, with DA/NE (P<0.01, |r| values ranging from 0.38 to 0.46) and NE/EXC (P<0.01, |r| values ranging from 0.56 to 0.61) showing weak and moderate negative correlations, respectively, and DA/EXC showing a weak positive correlation (P<0.01, |r| values ranging from 0.38 to 0.47). (3) The six neurotransmitters in the 1 028 patients with depression presented a total of 170 expression patterns in the whole brain. The top 30 expression patterns were reported in this paper, with a cumulative rate of 60.60%, including patterns ① INH+/5-HT-/ACh+/DA+/NE-/EXC- (9.05%), ② INH+/5-HT-/ACh↓/DA+/NE-/EXC- (4.57%), and ③ INH+/5-HT-/ACh+/DA+/NE↓/EXC- (3.31%). That is, the proportion of depression patients with normal levels of all the six neurotransmitters was 9.05%, and the patients with at least one neurotransmitter abnormality accounted for 91.95%. (4) The factor analysis extracted 22 common factors from 78 variables in the whole brain and different brain regions. These common factors showed the absolute values of loadings ranging from 0.32 to 0.86 and the eigenvalues (F) ranging from 1.03 to 13.43, with a cumulative contribution rate of 76.82%. The characteristic expression patterns included ① AChP3↓/AChW↓/AChC3↓/AChF3↓/AChO1↓/AChT5↓/AChF7↓/NEP3↑/NEW↑/NEC3↑/NEF3↑/NEO1↑/NET5↑/NEF7↑ (F=13.43, whole brain), ② 5-HTO2↑/DAO2↓/5-HTP4↑/DAP4↓/5-HTW↑/DAW↓/5-HTC4↑/DAC4↓ (F=5.94), and ③ EXCF4↓/DAF4↓/NEF4↑/INHF4↑/5-HTF4↑/AChF4↓ (F=5.33). ConclusionThe actual 170 expression patterns of 6 neurotransmitters in the whole brain of 1 028 depression patients indicate that depression is a heterogeneous disease with individualized characteristics. The 22 characteristic expression patterns in the whole brain and 12 brain regions verify the pathogenesis hypothesis of multi-neurotransmitters oscillation imbalance in brains of depression patients. In summary, this study provides new guidance for the etiology, diagnosis, and treatment of depression and establishes a methodological foundation for the effectiveness evaluation of individualized treatment of depression by traditional Chinese medicine based on the objective biological markers.

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