1.Proteomic Analysis of Danlou Tablet in Improving Platelet Function for Treating Coronary Heart Disease with Phlegm-stasis Intermingling Syndrome in Minipigs
Ziyan WANG ; Ying LI ; Aoao WANG ; Hongxu MENG ; Yue SHI ; Yanlei MA ; Guoyuan ZHANG ; Lei LI ; Jianxun LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):41-53
ObjectiveThis paper aims to observe the role of Danlou tablet in treating coronary heart disease (CHD) with phlegm-stasis intermingling syndrome in minipigs by improving platelet function and explore the potential pharmacological mechanism of Danlou tablet in regulating platelet function by using proteomics technology. MethodsThirty Bama minipigs were randomly divided into a normal control group (6 pigs) and a high-fat diet group (24 pigs). After 2 weeks of high-fat diet feeding, the high-fat diet group was randomly subdivided into a model group, an atorvastatin group (1 mg·kg-1), and Danlou tablet groups (0.6 g·kg-1 and 0.3 g·kg-1). All groups continued to receive a high-fat diet for 8 weeks after the procedure. The normal control group was given a regular diet, underwent only coronary angiography, and did not receive an interventional injury procedure. The model group and each administration group were fed a high-fat diet. Two weeks later, they underwent a coronary angiography injury procedure. After the procedure, drugs were mixed into the feed every morning for 8 consecutive weeks, with the minipigs maintained on a continuous high-fat diet during this period. Quantitative proteomics technology was further used to study platelet proteins, and differential proteins were obtained by screening. Bioinformatics analysis was performed to analyze key regulatory proteins and biological pathways involved in the therapeutic effect of Danlou tablet on CHD with phlegm-stasis intermingling syndrome. ResultsCompared with the normal control group, the model group showed a significant increase in total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) of minipigs' serum (P<0.01), a significant shortening in prothrombin time of (PT) (P<0.01), a coagulation function index, and an increase in whole blood viscosity (P<0.01) and platelet aggregation rate (P<0.01). Moreover, the platelet morphology was altered, and the contents of endothelin-1 (ET-1) and nitric oxide (NO) were significantly increased (P<0.01). Hemodynamic parameters were obviously abnormal, including significantly decreased systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), and left ventricular maximal positive dp/dt (LV+dp/dtmax) (P<0.01). Left ventricular maximal negative dp/dt (LV-dp/dtmax) was significantly increased (P<0.01). Besides, there were myocardial cell hypertrophy, obvious edematous degeneration, massive interstitial inflammatory cell infiltration, high degree of fibrosis, and coronary endothelial atherosclerosis. TC and TG levels in minipigs' serum were significantly reduced in Danlou tablet groups with 0.6 g·kg-1 and 0.3 g·kg-1 (P<0.05, P<0.01), compared with those in the model group. LDL-C was decreased in the Danlou tablet group with 0.6 g·kg-1 (P<0.05). The whole blood viscosity under low and high shear conditions was significantly reduced in the Danlou tablet group with 0.6 g·kg-1 (P<0.05). In groups with all doses of Danlou tablet, maximum aggregation rate (MAR) and average aggregation rate (AAR) were significantly decreased (P<0.05, P<0.01), and platelets' morphological changes such as pseudopodia extension were reduced. ET-1 levels in the serum were significantly reduced. In the Danlou tablet group with 0.6 g·kg-1, NO level in the serum was reduced (P<0.05). In groups with all doses of Danlou tablet, DBP and MAP were significantly increased (P<0.05). In the Danlou tablet group with 0.6 g·kg-1, LVSP and LV+dp/dtmax were significantly increased (P<0.05, P<0.01), and LV-dp/dtmax was significantly decreased (P<0.05). In groups with all doses of Danlou tablet, edematous degeneration in myocardial tissue was milder, and coronary artery lesion degree was significantly alleviated. Compared with the normal control group, there were 94 differentially expressed proteins in the model group, including 81 up-regulated and 13 down-regulated proteins. Compared with the model group, the Danlou tablet group with 0.6 g·kg-1 showed 174 differentially expressed proteins, including 100 up-regulated and 74 down-regulated proteins. A total of 30 proteins were reversed after Danlou tablet intervention. Bioinformatics analysis revealed that its pharmacological mechanism may exert anti-platelet activation, aggregation, and adhesion effects through biological pathways such as regulation of actin cytoskeleton, platelet activation pathway, Fcγ receptor-mediated phagocytosis, as well as proteins such as growth factor receptor-bound protein 2 (GRB2), Ras-related C3 botulinum toxin substrate 2 (RAC2), RAC1, and heat shock protein 90 alpha family class A member 1 (HSP90AA1). ConclusionDanlou tablet can effectively reduce platelet activation and aggregation, exerting a good therapeutic effect on CHD with phlegm-stasis intermingling syndrome in minipigs. Its pharmacological mechanism may involve regulating biological pathways such as actin cytoskeleton and platelet activation pathway, as well as proteins like GRB2, RAC2, RAC1, and HSP90AA1, thereby exerting a pharmacological effect in anti-platelet activation, aggregation, and adhesion.
2.Effect and Mechanism of Schisandrae Chinensis Fructus Lignans on Behavior of Schizophrenic Mice
Jiaqi LI ; Xi CHEN ; Siwei WANG ; Qi WANG ; Yiting LIU ; Ziyan GUO ; Zilong LUN ; Chengyi ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(5):65-71
ObjectiveTo investigate the effects of Schisandrae Chinensis Fructus lignans on schizophrenia induced by dizocilpine maleate (MK-801) in mice and to clarify its mechanism. MethodsMale mice of 4-6 weeks old were randomized into blank, model, positive drug, and low-, medium-, and high-dose (40, 80, 160 mg·kg-1, respectively) Schisandrae Chinensis Fructus lignans groups. The blank group was administrated with distilled water, and the other groups were injected with 0.5 mg·kg-1 MK-801 to induce schizophrenia symptoms. Meanwhile, risperidone was injected at 0.2 mg·kg-1 in the positive drug group, and mice in the intervention groups were injected with corresponding drugs for 14 consecutive days. The behavioral changes of mice were observed by autonomous activity test, open field test, forced swimming test, and water maze test. The levels of dopamine (DA) and 5-hydroxytryptamine (5-HT) in the brain and tumor necrosis factor-α (TNF-α) and nuclear factor-κB (NF-κB) in peripheral blood were quantified by enzyme-linked immunosorbent assay (ELISA). The changes in the prefrontal lobe of mice were observed by hematoxylin-eosin staining, and the changes of the hippocampal tissue were observed by Nissl staining. The protein levels of silencing information regulatory factor 1 (SIRT1) and forkhead box protein O3a (FoxO3a) in the hippocampus of mice were determined by Western blot. ResultsCompared with the model group, low, medium, and high doses of Schisandrae Chinensis Fructus lignans reduced the total number of autonomous activities, total distance in the open field test, immobile time in the forced swimming test, and levels of TNF-α and NF-κB in peripheral blood (P<0.05), while increasing the number of platform crossings in the water maze test and DA and 5-HT levels in the brain tissue (P<0.05). Compared with the model group, risperidone and low, medium, and high doses of Schisandrae Chinensis Fructus lignans improve the neural cell morphology in the CA1 region, with full cells in neatly dense arrangement and exhibiting clear membrane boundary. Schisandrae Chinensis Fructus lignans inhibited the expression of SIRT 1 and FoxO3a in the hippocampus (P<0.05). ConclusionTo sum up, Schisandrae Chinensis Fructus lignans may improve the behavior of schizophrenic mice by activating the SIRT1/FoxO3a signaling pathway to exert neuroprotective effects.
3.Ancient Literature Analysis and Textual Research of Classic Formula Zhishi Shaoyaosan
Chenyu LI ; Cong OUYANG ; Rou ZENG ; Ziyan LIU ; Ye ZHANG ; Jie LIN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):234-243
Zhishi Shaoyaosan is the 34th prescription in the Catalogue of Ancient Classic Formulas (Second Batch) published by the National Administration of Traditional Chinese Medicine in 2023. It is widely used in clinical practice and has a definite curative effect. However, there is currently a lack of its ancient literature analysis and textual research, and there is no corresponding Chinese patent medicine preparation. By consulting and combing the relevant ancient books of traditional Chinese medicine, this paper analyzes and conducts textual research of the origin, composition, measurement, administration, and efficacy of Zhishi Shaoyaosan. The results show that Zhishi Shaoyaosan is derived from Essentials from the Golden Cabinet written by Zhang Zhongjing in the Eastern Han Dynasty. It is mainly recorded in the name of Zhishi Shaoyaosan in the literature of the past dynasties. The prescription is composed of Aurantii Fructus Immaturus and Paeoniae Radix Alba. The processing method is stir-frying Aurantii Fructus Immaturus to scorch and using raw Paeoniae Radix Alba. The dose of the prescription recorded in the ancient books is mainly an equal amount of Aurantii Fructus Immaturus and Paeoniae Radix Alba in one square-cun spoon, taken three times a day, which is converted into a modern dose of 1.5 g each time (0.75 g Aurantii Fructus Immaturus and 0.75 g Paeoniae Radix Alba each time). The components of the prescription are ground into powder and taken with barley porridge, three times a day. The efficacy is to break stagnated Qi, harmonize blood, and relieve restlessness and pain. It is mainly used to treat postpartum abdominal pain, acute pelvic inflammatory disease, acute cholecystitis and intestinal diseases, stroke sequelae, and other diseases. This study combs and analyzes the ancient literature recording Zhishi Shaoyaosan and clarifies the key information of the prescription, which provides a basis for promoting the research and development of its patent medicine.
4.Gradient artificial bone repair scaffold regulates skeletal system tissue repair and regeneration
Yu ZHANG ; Ruian XU ; Lei FANG ; Longfei LI ; Shuyan LIU ; Lingxue DING ; Yuexi WANG ; Ziyan GUO ; Feng TIAN ; Jiajia XUE
Chinese Journal of Tissue Engineering Research 2025;29(4):846-855
BACKGROUND:Gradient artificial bone repair scaffolds can mimic unique anatomical features in musculoskeletal tissues,showing great potential for repairing injured musculoskeletal tissues. OBJECTIVE:To review the latest research advances in gradient artificial bone repair scaffolds for tissue engineering in the musculoskeletal system and describe their advantages and fabrication strategies. METHODS:The first author of the article searched the Web of Science and PubMed databases for articles published from 2000 to 2023 with search terms"gradient,bone regeneration,scaffold".Finally,76 papers were analyzed and summarized after the screening. RESULTS AND CONCLUSION:(1)As an important means of efficient and high-quality repair of skeletal system tissues,gradient artificial bone repair scaffolds are currently designed bionically for the natural gradient characteristics of bone tissue,bone-cartilage,and tendon-bone tissue.These scaffolds can mimic the extracellular matrix of native tissues to a certain extent in terms of structure and composition,thus promoting cell adhesion,migration,proliferation,differentiation,and regenerative recovery of damaged tissues to their native state.(2)Advanced manufacturing technology provides more possibilities for gradient artificial bone repair scaffold preparation:Gradient electrospun fiber scaffolds constructed by spatially differentiated fiber arrangement and loading of biologically active substances have been developed;gradient 3D printed scaffolds fabricated by layered stacking,graded porosity,and bio-3D printing technology;gradient hydrogel scaffolds fabricated by in-situ layered injections,simple layer-by-layer stacking,and freeze-drying method;and in addition,there are also scaffolds made by other modalities or multi-method coupling.These scaffolds have demonstrated good biocompatibility in vitro experiments,were able to accelerate tissue regeneration in small animal tests,and were observed to have significantly improved histological structure.(3)The currently developed gradient artificial bone repair scaffolds have problems such as mismatch of gradient scales,unclear material-tissue interactions,and side effects caused by degradation products,which need to be further optimized by combining the strengths of related disciplines and clinical needs in the future.
5.Effect of aconite decoction on the activity and polarization of mouse RAW264.7 macrophages
Mingcong SHAO ; Hubo CHEN ; Yidan ZHANG ; Ziyan LI ; Lina WANG
Journal of Pharmaceutical Practice and Service 2025;43(7):329-334
Objective To investigate the effects of Aconite decoction (AD) on the viability and polarization of murine RAW264.7 macrophages induced by lipopolysaccharide (LPS) or interleukin-4 (IL-4). Methods Cytotoxicity of AD was assessed by the CCK-8 assay. RAW264.7 cells were polarized toward M1 phenotype by LPS or M2 phenotype by IL-4, followed by treatment with varying concentrations of AD. Macrophage polarization was analyzed by flow cytometry. Quantitative PCR was performed to measure mRNA expression of polarization-associated markers (IL-6, iNOS, Arg1, and Ym1). ELISA was used to quantify secreted cytokines (TNF-α and IL-10)in the supernatant. Results At non-toxic concentrations, IL-6 and iNOS mRNA levels in LPS-stimulated cells were significantly upregulated while Arg1 and Ym1 expression in IL-4-treated groups were downregulated by AD. Concurrently, TNF-α secretion in LPS-induced M1 polarization was enhanced but IL-10 production in IL-4-induced M2 polarization was suppressed by AD. Conclusion AD could promote macrophage proliferation and viability, augments LPS-driven M1 polarization, and inhibit IL-4-mediated M2 polarization, which provided experimental evidence for the potential application of AD in tumor immunotherapy.
6.New diterpenoids from Euphorbia wallichii with antioxidant activity.
Yali WANG ; Juan CHEN ; Wenshuo ZHENG ; Ziyan GAO ; Yuxin GAN ; Hua LI ; Lixia CHEN
Chinese Journal of Natural Medicines (English Ed.) 2025;23(10):1248-1258
Thirteen novel diterpenoids, comprising seven tiglianes (walliglianes G-M, 1-7), four rhamnofolanes (wallinofolanes A-D, 8-11), and two daphnanes (wallaphnanes A and B, 12 and 13), together with two known rhamnofolane diterpenoids (euphorwallside H and euphorwallside I, 14 and 15), were isolated and characterized from Euphorbia wallichii(E. wallichii). The chemical structures of these compounds were elucidated through nuclear magnetic resonance (NMR), mass spectrometry (MS), and quantum chemical calculations. Compounds 9 and 11 demonstrated protective effects against H2O2-induced BV-2 microglial cell damage. Molecular docking analyses indicated that compound 9 exhibited binding affinity to the anti-oxidant-related targets HMGCR, GSTP1, and SHBG.
Euphorbia/chemistry*
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Antioxidants/isolation & purification*
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Diterpenes/isolation & purification*
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Molecular Structure
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Mice
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Molecular Docking Simulation
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Animals
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Hydrogen Peroxide/toxicity*
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Cell Line
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Microglia/drug effects*
7.Soil carbon and nitrogen dynamics affect bacterial and fungal communities and their interactions: a review.
Xinyuan LIU ; Yue LI ; Ziyan WEI ; Zhujun WANG
Chinese Journal of Biotechnology 2025;41(10):3701-3718
The escalating pressure from global population growth, climate change, and resource consumption is intensifying the burden on traditional agricultural production. Against this backdrop, soil degradation and pollution present increasingly severe challenges, creating a vicious cycle with rising food demands. Maintaining soil health and its ecosystem services has thus become a critical prerequisite for achieving sustainable agriculture in the future. This review explores the impacts of soil carbon (C) and nitrogen (N) dynamics on soil microbial communities and their interactions. Soil C and N are key determinants of microbial diversity and community structure, intrinsically linked to soil C/N cycling, crop productivity, and ecological balance. Environmental factors such as nitrogen fertilizer application, organic matter amendment application, litter decomposition, elevated CO2 concentrations, and nitrogen deposition significantly influence soil C and N dynamics. Changes in soil C and N content regulate microbial community dynamics and the synergistic, competitive, and antagonistic interactions among microorganisms. Meanwhile, microbial communities actively respond to alterations in soil C and N availability. The resulting shifts in microbial communities and their interactions subsequently regulate soil C/N cycling and ecosystem stability, ultimately influencing ecosystem functions. By elucidating the mechanisms underlying soil carbon-nitrogen-microbial interactions, this review significantly advances our understanding of soil ecosystem responses and feedback mechanisms in the context of global change, while also providing crucial practical guidance for enhancing soil fertility and promoting sustainable agricultural development through microbial regulation.
Soil Microbiology
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Nitrogen/metabolism*
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Carbon/metabolism*
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Soil/chemistry*
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Bacteria/growth & development*
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Fungi/metabolism*
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Ecosystem
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Fertilizers
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Agriculture
8.Development and validation of a nutrition-related genetic-clinical-radiological nomogram associated with behavioral and psychological symptoms in Alzheimer’s disease
Jiwei JIANG ; Yaou LIU ; Anxin WANG ; Zhizheng ZHUO ; Hanping SHI ; Xiaoli ZHANG ; Wenyi LI ; Mengfan SUN ; Shirui JIANG ; Yanli WANG ; Xinying ZOU ; Yuan ZHANG ; Ziyan JIA ; Jun XU
Chinese Medical Journal 2024;137(18):2202-2212
Background::Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer’s disease (AD). This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional mechanism.Methods::This retrospective study included 165 patients with AD from the Chinese Imaging, Biomarkers, and Lifestyle (CIBL) cohort between June 1, 2021, and March 31, 2022. Data on demographics, neuropsychological assessments, single-nucleotide polymorphisms of AD risk genes, and regional brain volumes were collected. A multivariate logistic regression model identified BPSD-associated factors, for subsequently constructing a diagnostic nomogram. This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1, 2022, and February 1, 2023. Area under receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to assess the discrimination, calibration, and clinical applicability of the nomogram.Results::Factors independently associated with BPSD were: CETP rs1800775 (odds ratio [OR] = 4.137, 95% confidence interval [CI]: 1.276-13.415, P = 0.018), decreased Mini Nutritional Assessment score (OR = 0.187, 95% CI: 0.086-0.405, P <0.001), increased caregiver burden inventory score (OR = 8.993, 95% CI: 3.830-21.119, P <0.001), and decreased brain stem volume (OR = 0.006, 95% CI: 0.001-0.191, P = 0.004). These variables were incorporated into the nomogram. The area under the ROC curve was 0.925 (95% CI: 0.884-0.967, P <0.001) in the internal validation and 0.791 (95% CI: 0.686-0.895, P <0.001) in the external validation. The calibration plots showed favorable consistency between the prediction of nomogram and actual observations, and the DCA showed that the model was clinically useful in both validations. Conclusion::A novel nomogram was established and validated based on lipid metabolism-related genes, nutritional status, and brain stem volumes, which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD.Registration::Chictr.org.cn, ChiCTR2100049131.
9.Antioxidant and Anti-tumor Effect and Mechanisms of Andrographis paniculata Polysaccharide on Human Cervical Cancer HeLa Cells
Lijin HUANG ; Zilin LI ; Ziyan YANG ; Han WANG ; Guiyuan CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(18):80-88
ObjectiveTo explore the antioxidant and anti-human cervical cancer HeLa cell effect and mechanisms of Andrographis paniculata polysaccharide (APP). MethodCell function assays were conducted to assess the effects of APP (400, 450, 500 mg·L-1) on the proliferation, migration, and invasion of HeLa cells using the cell counting kit-8 (CCK-8) assay, scratch assay, and Transwell assay. Molecular mechanism experiments were conducted to detect the effects of APP on HeLa cell apoptosis and cell cycle-related mRNA and protein expression using flow cytometry, real-time fluorescence-based quantitative polymerase chain reaction (Real-time PCR), and Western blot analysis. The antioxidant activity of APP was tested using DPPH+, OH-, and reducing power assays. ResultCompared with the blank group, APP (400, 450, 500 mg·L-1) significantly inhibited the migration, proliferation, and invasion abilities of HeLa cells in a time- and dose-dependent manner (P<0.05, P<0.01). Flow cytometry with propidium iodide (PI) single staining was used to detect cell cycle. The results showed that compared with the blank group, the proportion of HeLa cells in the G2/M phase increased after 48 hours of treatment with APP (400, 450, 500 mg·L-1), indicating that APP can arrest HeLa cells in the G2/M phase. Flow cytometry with fluorescein isothiocyanate (Annexin V-FITC)/PI apoptosis kit was used to detect cell apoptosis. Compared with the blank group, the proportion of early and late apoptotic HeLa cells increased in a dose-dependent manner after 48 hours of APP (400, 450, 500 mg·L-1) treatment (P<0.05, P<0.01), indicating that APP promotes HeLa cell apoptosis. The results of Real-time PCR and Western blot assay showed that compared with the blank group, after 48 hours of APP (400, 450, 500 mg·L-1) treatment resulted in decreased mRNA and protein expression of cell cycle-dependent kinase-1 (CDK-1), Cyclin B1, and B-cell lymphoma-2 (Bcl-2), and increased mRNA and protein expression of cysteine aspartate protease (Caspase)-3, Caspase-8, Caspase-9, and Bcl-2-associated X protein (Bax) (P<0.05, P<0.01). These findings were consistent with the flow cytometry results and showed a dose-dependent effect. In vitro antioxidant tests demonstrated that different concentrations of APP (50-1 000 mg·L-1) were able to scavenge DPPH+ and OH- radicals, indicating certain antioxidant activity. ConclusionAPP possesses antioxidant activity and can inhibit the viability of HeLa cells while promoting their apoptosis.
10.The Common Somatic Symptoms of Bipolar Disorder and Their Relationships with Five-State Personality and Emotional Symptoms Based on Complex Networks and Linear Regression
Ziyan LI ; Xinzi LIU ; Dongqing YIN ; Hong ZHU ; Hongxiao JIA
Journal of Traditional Chinese Medicine 2024;65(14):1464-1468
ObjectiveTo analyze the relationship between somatic symptoms, five-state personality and emotional symptoms of bipolar disorder (BD), and to provide a reference for the clinical diagnosis and treatment of BD. MethodsThe basic information of the BD patients was collected, and the self-administered somatic symptom questionnaire was used to investigate the somatic symptoms with a frequency of >20%, which were scored as the somatic symptom scores; the 24-item Hamilton Depression Scale (HAMD) was used to evaluate the patients' depressive symptoms, the Young Mania Rating Scale (YMRS) was used to evaluate the patients' manic symptoms, the Hamilton Anxiety Scale (HAMA) was used to evaluate the patients' anxiety symptoms, and Five-State Personality Test was used to evaluate the patients' five-state personality (including taiyang personality, shaoyang personality, yin-yang balance personality, shaoyin personality, and taiyin personality). Network analysis and linear regression were used to analyse the correlation between the somatic symptom scores and the five-state personality scores, HAMD scores, YMRS scores, and HAMA scores. ResultsThere were 269 patients with BD included, and 19 somatic symptoms with a frequency of >20%, the top three being lack of strength (152 cases, 56.51%), dry mouth (137 cases, 50.93%), and preference for cold drinks (112 cases, 41.64%), and the somatic symptom scores were [7.0 (0,10.0)] points; the YMRS scores were [3.0 (0, 7.5)] points; the HAMD scores were [11.0 (5.0, 18.0)] points; and HAMA score was [6.0 (2.0, 10.0)] points. Among the five-state personalities, taiyang personality [10.0 (7.0, 13.0)] score; shaoyang personality [10.0 (7.5, 13.0)] score; yin-yang balance personality [5.0 (3.0, 7.0)] score; shaoyin personality [13.0 (10.0, 16.0)] score; and taiyin personality [14.0 (9.0, 18.0)] score. Complex network analysis showed that BD somatic symptoms were positively correlated with taiyin personality score (r = 0.23), HAMD score (r = 0.21), and YMRS score (r = 0.13); taiyin personality score was positively correlated with HAMD score (r = 0.17) and negatively correlated with YMRS score (r = -0.03). Linear regression analyses showed that somatic symptom scores were positively correlated with HAMD score (β = 0.138, P = 0.003), YMRS score (β = 0.128, P = 0.006), and taiyin personality scores (β = 0.182, P<0.001). ConclusionDepression, mania, and taiyin personality are independent risk factors for somatic symptoms in patients with BD, and taiyin personality is strongly associated with somatic symptoms in patients with BD.

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