Effects of Astragalus membranaceus on Energy Metabolism and Expression of CNTF Protein in Skeletal Muscle of Exercise-induced Fatigue Rats

[Objectives]This study was conducted to investigate the effects of Astragalus membranaceus in different groups on energy metabolism and CNTF protein expression in skeletal muscle of exercise-induced fatigue rats.[Methods]Thirty-five clean male SD rats were randomly divided into a normal group,and low-,meddle-and high-dose groups of A.membranaceus aqueous solution,with 7 rats in each group.The low-dose,medium-dose and high-dose groups were given by gavage at 0.65,1.3 and 2.6 g/kg,respectively,while the normal group and the model group were given normal food and water.The weight of rats was observed.The contents of serum urea,lactate,muscle glycogen,liver glycogen and CNTF expression were detected.[Results]After modeling,compared with the normal group,the serum lactate and urea contents of rats in the model group significantly increased(P<0.01),while the muscle glycogen content(P<0.01)and liver glycogen content(P<0.05)of the skeletal muscle significantly decreased.Compared with the model group,the low-,meddle-and high-dose groups of A.membranaceus significantly reduced the levels of lactate and urea in serum(P<0.01),while the levels of muscle glycogen and liver glycogen in the skeletal muscle significantly increased(P<0.01,P<0.05).[Conclusions]This study provides a good research foundation for the treatment of exercise-induced fatigue using traditional Chinese herb A.membranaceus in modern clinical practice.

Advances of studies on relieving of exercise-induced fatigue by transcutaneous electrical acupoint stimulation

The occurrence of exercise-induced fatigue can be delayed and exercise endurance can be strengthened by removing lactic acid, decreasing serum creatine kinase, elevating hemoglobin, maintaining blood glucose, eliminating free radical, regulating amino acid metabolism and retaining heart rate with transcutaneous electrical acupoint stimulation （TEAS）. Problems in the above researching field are generalized in this paper. For instance, the point selection is relatively simple; the selection of wave band, frequency and duration during the application of TEAS apparatus are not unified; and observation indices mainly remained in the aspect of biochemistry. It also prospects the future directions of TEAS relieving exercise-induced fatigue including selecting acupuncture point by differentiation of symptoms and signs, setting uniform standards for TEAS, and studying the mechanisms of TEAS relieving exercise-induced fatigue by testing gonadal axis, adrenal axis, gene and protein .

Effectiveness of Moxibustion for Exercise-Induced Fatigue——A Systematic Review for Randomized Controlled Trials

Objective：To review and assess the effect of single moxibustion for exercise-induced fatigue（EIF）.Methods：Computer-search for 8 medical databases and 5 clinical trail registries were conducted for randomized controlled trials（RCTs）,added with hand-search for 10 Chinese acupuncture-moxibustion journals and additional references.Data from included RCTs were pooled by RevMan5.1.Methodology quality of RCTs was judged by Cochrane Collaboration assessment tool while quality of primary outcomes was evaluated by GRADE3.2.Results：Five RCTs were finally included,all reported in small sample size with high risk of bias.Comparisons on single moxibustion and rest relief（without treatment） were studied.Six outcomes were reported,all favored moxibustion to rest relief for EIF.Primary outcomes showed as rating of perceived exertion（RPE） with mean difference（MD）=-0.49,95%confidence interval（CI）[-0.80,-0.19],800-m race performance with MD=^-2.21,95%CI[-3.57,-0.85],and Harvard Step Index（HSI） with MD=14.75,95%CI[8.35,21.15].Moreover,all primary outcomes as RPE,800-m race performance and HSI were rated low quality.Conclusions：Single moxibustion might be considered effective for EIF.However,due to small samples of included RCTs,high risk of bias among studies and poor quality of primary outcomes and subjects restricted to Chinese athletes only,these results present limitation,and should be taken with caution for practice.More large-size studies with rigorous design are warranted to further test effectiveness of moxibustion for EIF.

Acupuncture-moxibustion for exercise-induced fatigue:advances and review

The article has introduced research advances and clinical trials in recent years on treatment of exercise-induced fatigue with acupuncture, especially in its functions of scavenging oxygen free radicals and inhibiting lipid-peroxidation, regulating immunity, preventing exercise-induced dysfunction of hypothalamus-pituitary-gonadal axis, improving energy metabolism, maintaining the stability of internal environment, alleviating delayed-onset muscle soreness （DOMS） and preventing mental fatigue and central fatigue etc. It is intended to explain that acupuncture has great potential against exercise-induced fatigue from the views of safety, less side-effects and not involving in stimulants etc. However, divergences still exist in acupoint selection, manipulations and selection of indicators in relative researches. Therefore, further studies are necessary to give a full play of advantages of acupuncture against exercise-induced fatigue.

Natural bioactive flavonoids as promising agents in alleviating exercise-induced fatigue

Exercise-induced fatigue is a common phenomenon caused by prolonged strenuous exercise and physical labor as a feeling of exhaustion and reduction of muscle performance,which seriously affects people’s health,work efficiency and quality of life.Meanwhile,numerous studies have shown that natural flavonoids can be an excellent source for preventing and treating exercise-induced fatigue due to their extraordinary antioxidant and antiinflammatory properties.However,the review of flavonoids in alleviating exercise-induced fatigue is still limited.Therefore,this review systematically summarizes recent studies on natural bioactive flavonoids that can alleviate exercise-induced fatigue and improve physical performance,including their plant sources,structure types and features,pharmacological effects and underlying mechanisms against exercise-induced fatigue.Also,the clinical trials have also been reviewed.Flavonols,isoflavones,anthocyanins,and their corresponding glycosides are the major bioactive flavonoids in alleviating exercise-induced fatigue.The current data and the further molecular docking evidently support the potential anti-fatigue effects of these flavonoids mainly involving the inhibition of oxidative stress and inflammatory response,as well as the regulation of energy metabolism.Activation of the Keap1/Nrf2/ARE and AMPK/PGC1-αpathways are responsible for the improvement of flavonoids against exercise-induced fatigue.Hence,this review is expected to contribute to the further research and development of anti-fatigue flavonoids in the functional food and nutraceutical industry.

Effect of Moxibustion on Cardiac Remodeling and Myocardial Function in Rats with Exercise-Induced Fatigue

Objective:To explore the effect of moxibustion at Shenque(CV8)on myocardial structure and function in rats with exercise-induced fatigue.Methods:A 12-week treadmill training program was used to establish a rat model of exercise-induced fatigue.Fifty-six male SD rats removed six rats that did not reach the molding condition,Remaining rats were randomly divided into the following five groups:a normal group(n=10)that did not under go the exercise routine and were not treated,a control group(n=10)that did not under go the exercise routine,but received a mild dose of moxibustion at"Shenque"(CV 8)for 15 min,an untreated group(n=10)that received no treatment after exercise,a CV 8 group(n=10)that received a mild dose of moxibustion at"Shenque"(CV 8)for 15 min after exercise,a non-acupoint(tail)group(n=10)that received a mild dose of moxibustion at"non-acupoint"for 15 min after exercise.At one hour after the end of the 12-week training program,the left ventricular diastolic volume(LVDV),left ventricular systolic volume(LVSV),peak early diastolic mitral blood flow velocity(E),and peak late diastolic mitral blood flow velocity(A)were measured,and the E/A ratio were calculated.The serum myoglobin(Mb),creatine kinase-muscle/brain(CK-MB),and cardiac troponin-I(cTnI)levels were detected using an automatic biochemical analyzer.Results:When the values obtained before and after treatment were compared within the same groups,the LVDV,LVSV,E,and A were increased(P<0.05 or P<0.01),and the E/A were decreased(P<0.01)in the untreated group and the tail group.Regarding inter-group comparisons,the LVDV,LVSV,E,and A were increased(P<0.05 or P<0.01),and the E/A were decreased(P<0.01)in the untreated group and the tail group compared to the normal group and control group.Compared to the untreated group and the tail group,the LVDV,LVSV,E,and A were decreased(P<0.01)and the E/A were increased(P<0.01)in the CV 8 group.Compared to the normal group and the control group,the serum Mb,CK-MB,and cTnI levels were increased(P<0.01)in the untreated group and the tail group,and the serum Mb and CK-MB levels were also increased(P<0.01)in the CV 8 group.Compared to the untreated group and the tail group the serum Mb,CK-MB,and cTnI levels in the CV 8 group were decreased(P<0.01).Conclusions:Moxibustion at Shenque(CV8)can effectively prevent cardiac structural changes caused by exercise-induced fatigue and enhance heart function.This treatment does not have side effects in healthy rats and is a safe and effective technique..

Exercise-induced muscle fatigue in the unaffected knee joint and its influence on postural control and lower limb kinematics in stroke patients

This study aimed to investigate the effects of exercise-induced muscle fatigue in the unaffected knee joint on postural control and kinematic changes in stroke patients. Forty participants（20 stroke patients, 20 age-matched healthy participants） were recruited. To induce fatigue, maximum voluntary isometric contractions were performed in the unaffected knee joint in a Leg Extension Rehab exercise machine using the pneumatic resistance. We measured static and dynamic balance and lower-limb kinematics during gait. Changes in postural control parameters anteroposterior sway speed and total center of pressure distance differed significantly between the stroke and control groups. In addition, changes in gait kinematic parameters knee and ankle angles of initial contact differed significantly between stroke（paretic and non-paretic） and control groups. Muscle fatigue in the unaffected knee and ankle impaired postural control and debilitates kinematic movement of ipsilateral and contralateral lower limbs, and may place the fatigued stroke patients at greater risk for falls.

Experimental study on the effect of moxibustion at Shenque(CV 8) for long-term exercise-induced fatigue

Objective:To investigate the effect of moxibustion at Shenque(CV 8)on fatigue in rats with chronic exercise-induced exhaustion.Methods:Thirty male Sprague-Dawley(SD)rats were randomly divided into a blank group,a model group and a moxibustion group,10 rats in each group.Except rats in the blank group,the remaining rats were subjected to create long-term exhaustion models by repeated swimming.After successful modeling,rats in the moxibustion group received mild moxibustion at Shenque(CV 8)for 15 min,once every other day with a total of 10 times.Rats in the model group and the blank group did not receive moxibustion.At the end of the treatment,the exhausted times,and the body weight of rats before and after the experiment were compared among groups.The levels of blood malondialdehyde(MDA)and urea nitrogen(BUN),as well as the activities of aspartate transarninase(AST),alanine aminotransferase(ALT)and lactate dehydrogenase(LDH)were also measured by the automatic biochemical analyzer,24 h after the exhausting excise.Results:The 10 th swimming time was significantly longer in the moxibustion group than that in the model group(P〈0.01).The increase rate of the body weight was lower in the rats of the moxibustion group than that in the model group before the 7 th and the 10 th exhausting excise(P〈0.05,P〈0.01).The levels of serum MDA and BUN,as well as the activities of AST,ALT and LDH in the model group were higher than those in the blank group(all P〈0.01).The levels of serum MDA and BUN,as well as the activities of AST,ALT and LDH in the moxibustion group were lower than those in the model group(P〈0.01).Conclusion:Moxibustion at Shenque(CV 8)can decrease the serum levels of MDA and BUN,as well as activities of AST,ALT and LDH in the long-term fatigue rats,thus to improve the symptoms of fatigue.

Effect of Moxibustion Therapy plus Cupping on Exercise-induced Fatigue in Athletes

Objective： To observe the effect of moxibustion therapy plus cupping on perceived exertion and blood biochemical indicators in athletes with exercise-induced fatigue. Methods： A total of 30 gymnasts were randomized into two groups. After intensive physical training, 15 cases in the treatment group were treated by mild moxibustion and cupping, whereas the other 15 cases in the control group took a 30-rain break. After that, the Creatine Kinase （CK）, Blood Urea Nitrogen （BUN）, routine urinalysis, Rating of Perceived Exertion （RPE） and changes in Self-report Symptom Checklist 90 （SCL-90） were observed before and after one and periodic exercises. Results： After intensive physical training, athletes in the treatment group obtained a faster recovery of elevated CK levels than those in the control group. Analysis on the SCL-90 has shown that athletes in the treatment group had better interpersonal relations than those in the control group. Additionally, RPE analysis has also indicated that athletes in the treatment group had milder fatigue than those in the control group. Conclusion： Combined moxibustion with cupping is an effective and easy-to-operate method for exercise-induced fatigue.

Real-time surface electromyography in Parkinson's disease patients during exercise-induced muscle fatigue

To explore the mechanisms underlying exercise-induced local muscle fatigue in patients with idiopathic Parkinson＇s disease （PD）,we used surface electromyography to record myoelectric signals from the tibialis anterior muscle during isometric contraction-induced fatigue until exhaustion.The results revealed no significant differences between patients with idiopathic PD and healthy controls in maximum voluntary contraction of the tibialis anterior muscle.The basic characteristics of surface electromyography were also similar between the two groups.The duration of isometric contraction at 50% maximum voluntary contraction was shortened in PD patients.In addition,PD patients exhibited a stronger increase in mean square amplitude,but a weaker decrease in median frequency and mean power frequency compared with healthy controls during isometric contraction.The skeletal muscles of PD patients revealed specificity of surface electromyography findings,indicating increased fatigability compared with healthy controls.

Influence of Acupuncture on Exercise-induced Fatigue of Middle-long Distance Runners

Objective： To observe the influence of acupuncture on the restoration of body functions of the middle-long distance teenage runners after half Marathon. Methods： Six cases of middle-long distance teenage runners at the age of 18-22 were selected. Acupuncture treatment was given 4 h after an international half Marathon. One month later, another small scale half Marathon was taken for the control study. By the biochemical and radioimmunological experiments, the peripheral blood urea nitrogen （BUN）, creatine kinase （CK）, testosterone （T） and cortisol （C） were tested respectively 4 h and 28 h later after training and two half Marathon matches. Results： Four hours after two half Marathon matches, serum BUN and CK were elevated in varying degrees and T value was decreased, indicating the decline of the physical ability and the appearance of exercise-induced fatigue. Acupuncture can help to restore the indexes, more sensitive in T/C ratio reaction. Conclusion： Acupuncture treatment can help the middle-long distance runners to restore the physical ability after match.

Effect of Transcutaneous Electrical Acupoint Stimulation on Rats with Chronic Exercise-induced Fatigue

Objective： To observe the effect of transcutaneous electrical acupoint stimulation （TEAS） on the rats with exercise-induced fatigue. Methods： Rat model of chromic exercise-induced fatigue was established with increasing load treadmill walking method. The TEAS therapy was operated immediately and 3 h after the exercise from the sixth week. Hippocampal morphology and hypothalamic morphology were observed with HE staining and the expressions of 5-hydroxytryptamine （5-HT） in hippocampus and hypothalamus were tested with immunohistochemical （IHC） staining after 2-week treatment. Results： TEAS released the damage of hippocampal morphology and hypothalamic morphology induced by exercise significantly and reduced the expression of 5-HT in hippocampus and hypothalamus. The difference between the therapy operated immediately and 3 h after exercise was not significant. Conclusion： TEAS could improve the fatigue recovery and athletic ability. The improvement of TEAS on the rats with exercise-induced fatigue was related with the decreased expression of central 5-HT and the reduction of damaged nerve cells.

Influence of Acupuncture on Biochemical Parameters in Exercise-induced Fatigue Rats

Objective： To observe the effect of acupuncture on some biochemical parameters in rats with exercise-induced fatigue and to explore the mechanism of acupuncture for exercise fatigue. Methods： The rat model of chronic exercise-induced fatigue was established by a 4-week increasing swimming training method The rats were randomly divided into a control group, a model group, a scalp acupoint group, and a body acupoint group. Preventive acupuncture methods were used. Changes of exhaustive swimming time, whole blood lactic acid （LA）, creatine kinase （CK）, blood urea nitrogen （BUN）, hemoglobin （Hb） and free tryptophan/branched chain amino acid （F-TRP/BCAA） of rats in each group before and after treatments were observed. Results： Compared with the body acupoint group, there were obvious advantages of the scalp point group in increasing Hb levels and lowering BUN and LA levels （P〈0.05）, as well as in aspects of lowering CK and F-TRP/BCAA levels （P〈0.01）. Conclusion： Scalp point acupuncture can improve the biochemical parameters in rats with exercise-induced fatigue, meanwhile, decrease the F-TRP/BCAA level, inhibit the 5-HT Droducine. and improve the rats＇ fatieue conseouentlv.

Effect of moxibustion at Shenque(CV 8)on myocardial remodeling and function in exercise-induced fatigue rats

Objective To explore the effect of moxibustion at Shenque(CV 8)on myocardial structure and function in exercise-induced fatigue rats.Methods A 12-week treadmill running training was performed to create an exercise-induced fatigue rat model.Sixty eligible male specific-pathogen-free grade Sprague-Dawley rats were randomly divided into a blank group,a control group,a model group,a non-meridian non-acupoint group,a Zusanli(ST 36)group and a Shenque(CV 8)group,with 10 rats in each group.Rats in the blank group did not receive treadmill running training or moxibustion.Rats in the control group did not receive treadmill running training but received mild moxibustion at Shenque(CV 8).Rats in the model group received treadmill running training but no moxibustion.Rats in the non-meridian non-acupoint group,the Zusanli(ST 36)group and the Shenque(CV 8)group received moxibustion at the non-meridian non-acupoint points,Zusanli(ST 36)or Shenque(CV 8)immediately after each treadmill running training,15 min each time,once a day for 5 consecutive days a week at a 2-day interval,60 times of moxibustion in total.Left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),left ventricular diastolic volume(LVDv),left ventricular systolic volume(LVSv),ejection fraction(EF),stroke volume(SV),early diastolic peak flow velocity of mitral valve(E)and late diastolic peak flow velocity of mitral valve(A)of each group before and after the last treadmill running training were measured.Blood was collected 6 h after the last treadmill running training,and serum C-reactive protein(CRP),myoglobin(Mb),creatine kinase-myocardial band(CK-MB),cardiac troponin I(cTnI)and cardiac troponin T(cTnT)levels were detected.Finally,the heart was separated,the heart mass(HM)was measured,the cTnT level of the myocardial tissue was detected,the ultrastructural changes of the left ventricular myocardium were observed by transmission electron microscope,the left ventricular fraction shortening(LVFS),E/A and heart mass index(HMI)were calculated.Results Compared with the same group before treatment,the rat cardiac LVEDd,LVESd,LVDv,LVSv,SV,E and A were significantly increased(all P<0.01),and the rat LVFS,E/A and EF were significantly decreased(all P<0.01)in the model group and the non-meridian non-acupoint group after treatment;the rat cardiac SV,LVDv,LVSv,E and A were all increased(all P<0.01),while E/A and EF were decreased(all P<0.01)in the Zusanli(ST 36)group after treatment;the rat cardiac LVDv,E and A were significantly increased(P<0.01 or P<0.05),and E/A was significantly decreased(P<0.01)in the Shenque(CV 8)group after treatment.After treatment,compared with the blank group,the rat cardiac LVEDd,LVESd,SV,LVDv,LVSv,E,A,the serum CRP,Mb,CK-MB,cTnI,cTnT and HMI,and the myocardial cTnT were increased(all P<0.01),and the LVFS,E/A and EF were all reduced(all P<0.01)in the model group;compared with the model group and the non-meridian non-acupoint group,rats in the Zusanli(ST 36)group and the Shenque(CV 8)group showed decreased LVEDd,LVESd,SV,LVDv,LVSv,E,A,serum CRP,Mb,CK-MB,cTnI,cTnT and HMI,and myocardial cTnT(P<0.01 or P<0.05),along with increased LVFS,E/A and EF(all P<0.01);compared with the Zusanli(ST 36)group,Mb and A of the Shenque(CV 8)group were decreased(both P<0.01),while both E/A and EF were increased(P<0.01,P<0.05).Transmission electron microscopy examination showed that myofibrils in the blank group and the control group were neatly arranged with clear light and dark bands;the model group and the non-meridian non-acupoint group showed different degrees of myofibril disintegration and breakage,increased and aggregated mitochondria of different sizes,and increased electron density.The myofibrils in the Shenque(CV 8)group and Zusanli(ST 36)group were arranged neatly with clear light and dark bands,and compensatory hyperplasia of mitochondria.Conclusion Moxibustion at Shenque(CV 8)and Zusanli(ST 36)both can effectively improve the occurrence of myocardial remodeling in exercise-induced fatigue rats,and the effect of moxibustion at Shenque(CV 8)is better in improving cardiac function.

Effect of Point Sticking Therapy on Biochemical Markers and Rating of Perceived Exertion in Athletes with Exercise-induced Fatigue

Objective： To observe the effect of point sticking therapy on biochemical markers and Rating of Perceived Exertion （RPE） in athletes with exercise-induced fatigue. Methods： A total of 35 football players were randomly allocated into a blank group, a control group and an observation group. The athletes in the blank group received no treatment, those in the control group take Xi Yang Shen （Radix Panacis Quinquefolii） orally and those in the observation group were treated by point sticking therapy. The athletes＇ RPE, hemoglobin （Hb）, red blood cell count （RBC）, blood urea nitrogen （BUN） and blood glucose （BG） were recorded every day for analysis. Results： The RPE value in the blank group tends to increase, while that in the treatment and the blank groups tend to increase first but decrease afterwards, and the corresponding RPE value in the observation group was smaller than that in the control group. After treatment, athletes in the blank group showed a decrease in Hb, RBC and BG, but an increase in BUN in the blank group; while athletes in the observation and the control groups showed increases in Hb, RBC and BG, but a decrease in BUN. Conclusion： Point sticking can alleviate clinical symptoms induced by exercise-induced fatigue.

Meta-analysis of acupuncture intervening exercise-induced fatigue

Objective:To systematically evaluate the impact of acupuncture on exercise-induced fatigue(EIF).Methods:Scopus,Springer Link,Web of Science,PubMed,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Academic Journal Full-text Database(Wanfang),Chongqing VIP Database(CQVIP),and China Biology Medicine Disc(CBM)were systematically searched to identify randomized controlled trials(RCTs)studying acupuncture treatment of EIF from the inception till August 2020.The risk of bias in the included studies was assessed using the Cochrane handbook.RevMan 5.3 was used to conduct statistical analysis on the extracted data.Results:A total of 11 RCTs were included for meta-analysis,involving 531 patients.It was revealed that acupuncture produced more significant effects in alleviating subjective fatigue[standardized mean difference(SMD)=-3.08,95%confidence interval(CI)(-4.35,-1.81),P<0.001],increasing the hemoglobin content[weighted mean difference(WMD)=3.89,95%CI(1.37,6.42),P=0.003],reducing the lactate dehydrogenase content[WMD=-10.63,95%CI(-17.67,-3.59),P=0.003],reducing the blood lactic acid content[SMD=-2.65,95%CI(-4.47,-0.83),P=0.004],and down-regulating the levels of serum creatine kinase[SMD=-0.79,95%CI(-1.10,-0.48),P<0.001]and blood urea nitrogen[WMD=-1.47,95%CI(-1.84,-1.11),P<0.001]than the control groups.Conclusion:Based on the existing evidence,acupuncture can be recognized as effective in improving EIF and is worthy of promotion in clinical settings.

Frequency Domain Fatigue Evaluation on SCR Girth-Weld Based on Structural Stress

The Steel Catenary Riser(SCR)is a vital component for transporting oil and gas from the seabed to the floating platform.The harsh environmental conditions and complex platform motion make the SCR’s girth-weld prone to fatigue failure.The structural stress fatigue theory and Master S-N curve method provide accurate predictions for the fatigue damage on the welded joints,which demonstrate significant potential and compatibility in multi-axial and random fatigue evaluation.Here,we propose a new frequency fatigue model subjected to welded joints of SCR under multiaxial stress,which fully integrates the mesh-insensitive structural stress and frequency domain random process and transforms the conventional welding fatigue technique of SCR into a spectrum analysis technique utilizing structural stress.Besides,a full-scale FE model of SCR with welds is established to obtain the modal structural stress of the girth weld and the frequency response function(FRF)of modal coordinate,and a biaxial fatigue evaluation about the girth weld of the SCR can be achieved by taking the effects of multi-load correlation and pipe-soil interaction into account.The research results indicate that the frequency-domain fatigue results are aligned with the time-domain results,meeting the fatigue evaluation requirements of the SCR.

Impact of comorbid subthreshold depressive symptoms on cancerrelated fatigue and complications in adults with leukemia

BACKGROUND Patients not only experience symptoms caused by cancer but also suffer from the accompanying psychological pain.Therefore,these patients do not have high quality of life.According to the World Health Organization,the incidence of leukemia in China in 2020 was 5.1/100000,the mortality rate was 3.3/100000,and the prevalence rate was 16.7/100000.Therefore,it is important to examine the influence of comorbid subthreshold depressive symptoms on leukemia patients.AIM To determine the impact of comorbid subthreshold depressive symptoms on cancer-related fatigue and complications in leukemia patients,thereby providing a basis for early diagnosis and treatment in clinical practice.METHODS A questionnaire survey was conducted among leukemia patients admitted to a tertiary hospital in Xi'an,Shaanxi Province,China,from August 2022 to December 2023.Patients with a score>16 on the Chinese Classification of Mental Disorders(CCMD-3)and a Hamilton Depression Rating Scale score of 8-17 were classified as the subthreshold depressive group(n=95),while 100 leukemia patients admitted during the same period were classified as the control group.Data were collected using Epidata 3.1 software,and comparisons were made between the two groups regarding general clinical data,the Piper Fatigue Scale(PFS),the Pittsburgh Sleep Quality Index(PSQI),the Numeric Rating Scale for pain assessment,laboratory indicators,and the occurrence of complications.RESULTS In this survey,120 leukemia patients with depression were preliminarily screened,95 patients with subthreshold depression were ultimately selected as the subthreshold depression group,and 100 leukemia patients admitted during the same period were enrolled as the normal group.Comparison of basic clinical data between the two groups revealed no significant differences in age,sex,body mass index,cognitive function,or comorbidity with other chronic diseases.However,there were statistically significant differences in the use of radiotherapy and regular exercise between the two groups(P<0.05).Comparisons of scales and laboratory indicators revealed no significant differences in albumin or PSQI scores between the two groups,but there were statistically significant differences in pain scores,PSQI scores,PFS scores,hemoglobin levels,and C-reactive protein levels(P<0.05).Spearman’s correlation analysis indicated that cancer-related fatigue was correlated with age,hemoglobin levels,C-reactive protein levels,pain,and regular exercise among leukemia patients with subthreshold depression.Multivariate regression analysis revealed that advanced age,combined radiotherapy,pain,and low hemoglobin levels were risk factors for cancer-related fatigue in leukemia patients with comorbid subthreshold depression,while regular exercise was a protective factor against cancer-related fatigue.Follow-up comparisons revealed a significantly lower overall incidence of complications in the control group(4%)than in the depressive group(24.21%;P<0.001).CONCLUSION Leukemia patients with comorbid subthreshold depressive symptoms experience more severe cancer-related fatigue and a higher incidence of complications.These findings may be related to advanced age,combined radiotherapy,pain,and low hemoglobin levels,while regular exercise may effectively alleviate symptoms.

A comparative study of the anti-fatigue activity of extracts from different parts of Cistanche tubulosa(Schenk)Wight

Objective:To evaluate the anti-fatigue effects of different extracts from Cistanche tubulosa(Schenk)Wight(C.tubulosa,Rou Cong Rong),focusing on central and exercise-induced fatigue in mice.This study investigated the pharmacological effects of the total oligosaccharides,polysaccharides,and phenylethanoid glycosides(CPhGs)extracted from C.tubulosa.Methods: Models of sleep deprivation and forced swimming fatigue were established to simulate central and exercise-induced fatigue.The mice were treated with different extracts of C.tubulosa,and their effects were assessed using behavioral tests to measure exercise capacity,learning,and memory function.Biochemical analyses were performed to evaluate the changes in serum and brain neurotransmitter levels,liver and muscle glycogen storage,and various fatigue-related biomarkers.Results: This study found that treatment with C.tubulosa extract improved exercise capacity,learning,and memory in mice.Total oligosaccharides from C.tubulosa enhanced adrenocorticotropic hormone,cholinesterase,and thyroid-stimulating hormone levels,reduced cortisol levels in central fatigue models,and ameliorated biochemical markers of exercise-induced fatigue,including lowering lactic acid,blood urea nitrogen,and malondialdehyde levels.Among the tested extracts,the total oligosaccharides showed the most comprehensive anti-fatigue effects.Conclusion: The anti-fatigue effects of C.tubulosa,particularly those of its total oligosaccharides,are pronounced in both central and exercise-induced fatigue.These effects are mediated by the regulation of neurotransmitter levels,enhancement of glycogen storage,and improvement of antioxidant enzyme activity,suggesting potential therapeutic benefits in fatigue-related conditions.

The Effect and Mechanism of Fructus lycii on Improvement of Exercise Fatigue Using a Network Pharmacological Approach with in vitro Experimental Verification

Objective This study aimed to investigate the effect and underlying mechanism of Fructus lycii in improving exercise fatigue.Methods A network pharmacological approach was used to explore potential mechanisms of action of Fructus lycii.Skeletal muscle C2C12 cells and immunofluorescence were employed to verify the effect and mechanism of the representative components in Fructus lycii predicted by network pharmacological analysis.Results Six potential active components,namely quercetin,β-sitosterol,stigmasterol,7-Omethylluteolin-6-C-beta-glucoside_qt,atropine,and glycitein,were identified to have potency in improving exercise fatigue via multiple pathways,such as the PI3K-Akt,neuroactive ligand-receptor interaction,IL-17,TNF,and MAPK signaling pathways.The immunofluorescence results indicated that quercetin,a significant active component in Fructus lycii,increased the mean staining area of 2-NBDG,TMRM,and MitoTracker,and decreased the area of CellRox compared to the control.Furthermore,the protein expression levels of p-38 MAPK,p-MAPK,p-JNK,p-PI3K,and p-AKT markedly increased after quercetin treatment.Conclusion Fructus lycii might alleviate exercise fatigue through multiple components and pathways.Among these,quercetin appears to improve exercise fatigue by enhancing energy metabolism and reducing oxidative stress.The PI3K-AKT and MAPK signaling pathways also appear to play a role in this process.