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As a widely-applied alternative therapy, acupuncture is gaining popularity in Western society. One challenge that remains, however, is incorporating it into mainstream medicine. One solution is to combine acupuncture with other conventional, mainstream treatments. In this study, we investigated the combination effect of acupuncture and the antidepressant fluoxetine, as well as its underlying mechanism using resting state functional connectivity (rsFC) in patients with major depressive disorders. Forty-six female depressed patients were randomized into a verum acupuncture plus fluoxetine or a sham acupuncture plus fluoxetine group for eight weeks. Resting-state fMRI data was collected before the first and last treatments. Results showed that compared with those in the sham acupuncture treatment, verum acupuncture treatment patients showed 1) greater clinical improvement as indicated by Montgomery–Åsberg Depression Rating Scale (MADRS) and Self-Rating Depression Scale (SDS) scores; 2) increased rsFC between the left amygdala and subgenual anterior cingulate cortex (sgACC)/preguenual anterior cingulate cortex (pgACC); 3) increased rsFC between the right amygdala and left parahippocampus (Para)/putamen (Pu). The strength of the amygdala-sgACC/pgACC rsFC was positively associated with corresponding clinical improvement (as indicated by a negative correlation with MADRS and SDS scores). Our findings demonstrate the additive effect of acupuncture to antidepressant treatment and suggest that this effect may be achieved through the limbic system, especially the amygdala and the ACC.

C. aromaticum is widely cultivated for its aromatic, medicinal, and tea-applicable properties, earning the nickname 'lavender in composite'. Terpenoids are the major compounds of C. aromaticum fragrance. To reveal the molecular mechanisms of terpenoid biosynthesis in C. aromaticum, NGS and SMRT sequencing were employed to identify the key terpene synthase genes. A total of 59,903 non-redundant transcripts were obtained by the transcriptome analysis. Twenty-nine terpene synthase genes (TPSs) were identified, and phylogenetic analysis showed that they belong to four subfamilies of terpene synthases. Five CaTPSs were successfully cloned. Subcellular localization showed they were present in the nucleus and cytosol. Structure models of five terpene synthases were predicted, and molecular docking results showed good binding affinities with FPP/GPP. In vitro enzymatic tests showed that CaTPS7, CaTPS8, CaTPS10 and CaTPS20 could catalyze substrates to produce terpenoids. CaTPS7 and CaTPS20 were both able to effectively convert the precursor FPP into caryophyllene. CaTPS8 could convert FPP to trans-nerolidol and nerolidyl acetate, while CaTPS10 could convert FPP to elemene and aristolochene. This study lays the groundwork for further research to depict the metabolism network of terpenoid in C. aromaticum. These identical terpene synthase genes could be introduced into the cultivated chrysanthemums to enhance their fragrance., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: To explore the effects of acupuncture (manual acupuncture or electroacupuncture) combined with SSRIs for moderate to severe depression improving major clinical symptoms and life quality of the patients on secondary outcomes., Design: Pragmatic, parallel, randomized controlled trial., Setting: 6 hospitals in China., Interventions: 6 weeks of manual acupuncture (MA)+selective serotonin reuptake inhibitors (SSRIs), electroacupuncture (EA)+SSRIs, and SSRIs alone., Main Outcome Measures: The primary outcome was response rate of 17-item Hamilton Depression Scale (HAMD-17) total score at 6 th week. The secondary outcomes reported in this analysis were HAMD-17 factor scores at 1 st , 2 nd , 4 th , 6 th , 10 th week and WHO Quality of Life-BREF (WHOQOL-BREF) scores at 6 th week., Results: 477 patients were randomly assigned into MA + SSRIs (n = 161), EA + SSRIs (n = 160), or SSRIs alone (n = 156) groups. For HAMD-17 (at 6 th week), the MA + SSRIs group was significantly better than the SSRIs alone group in retardation factor (p = 0.008), while the EA+SSRIs group was significantly better than the SSRIs alone group in anxiety/somatization factor (p<0.001) and sleep disturbance factor (p = 0.002). For WHOQOL-BREF (at 6 th week), the EA + SSRIs group, compared with the SSRIs alone group, produced a more significant improvement in the overall quality of life, general health, physical health, and psychological health (p<0.05). While, the MA + SSRIs group, compared to the SSRIs alone group, showed significant advantage only in psychological health (p = 0.023)., Conclusions: Either MA or EA combined SSRIs treatment could improve symptoms and quality of life for patients with moderate to severe depression. The main limitation of this trial was not using a sham control therefore the placebo effect could not be excluded., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)