Efficacy of ginseng-based Renshenguben oral solution for cancer-related fatigue among patients with advanced-stage hepatocellular carcinoma:A prospective multicenter cohort study

Background:Cancer-related fatigue(CRF)is a common and debilitating symptom experienced by patients with advanced-stage cancer,especially those undergoing antitumor therapy.This study aimed to evaluate the efficacy and safety of Renshenguben(RSGB)oral solution,a ginseng-based traditional Chinese medicine,in alleviating CRF in patients with advanced hepatocellular carcinoma(HCC)receiving antitumor treatment.Methods:In this prospective,open-label,controlled,multicenter study,patients with advanced HCC at BCLC stage C and a brief fatigue inventory(BFI)score of≥4 were enrolled.Participants were assigned to the RSGB group(RSGB,10 mL twice daily)or the control group(with supportive care).Primary and secondary endpoints were the change in multidimensional fatigue inventory(MFI)score,and BFI and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)scores at weeks 4 and 8 after enrollment.Adverse events(AEs)and toxicities were assessed.Results:A total of 409 participants were enrolled,with 206 assigned to the RSGB group.At week 4,there was a trend towards improvement,but the differences were not statistically significant.At week 8,the RSGB group exhibited a significantly lower MFI score(P<0.05)compared to the control group,indicating improved fatigue levels.Additionally,the RSGB group showed significantly greater decrease in BFI and FACT-Hep scores at week 8(P<0.05).Subgroup analyses among patients receiving various antitumor treatments showed similar results.Multivariate linear regression analyses revealed that the RSGB group experienced a significantly substantial decrease in MFI,BFI,and FACT-Hep scores at week 8.No serious drug-related AEs or toxicities were observed.Conclusions:RSGB oral solution effectively reduced CRF in patients with advanced HCC undergoing antitumor therapy over an eight-week period,with no discernible toxicities.These findings support the potential of RSGB oral solution as an adjunctive treatment for managing CRF in this patient population.

Identifying relevant factors influencing cancer-related fatigue in patients with diffuse large B-cell lymphoma during chemotherapy

BACKGROUND Diffuse large B-cell lymphoma(DLBCL)is a rapidly growing malignant tumor,and chemotherapy is one of the treatments used to combat it.Although advancements of science and technology have resulted in more and more patients being able to receive effective treatment,they still face side effects such as fatigue and weakness.It is important to thoroughly investigate the factors that contribute to cancer-related fatigue(CRF)during chemotherapy.AIM To explore the factors related to CRF,anxiety,depression,and mindfulness levels in patients with DLBCL during chemotherapy.METHODS General information was collected from the electronic medical records of eligible patients.Sleep quality and mindfulness level scores in patients with DLBCL during chemotherapy were evaluated by the Pittsburgh Sleep Quality Index and Five Facet Mindfulness Questionnaire-Short Form.The Piper Fatigue Scale was used to evaluate the CRF status.The Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to evaluate anxiety and depression status.Univariate analysis and multivariate regression analysis were used to investigate the factors related to CRF.RESULTS The overall average CRF level in 62 patients with DLBCL during chemotherapy was 5.74±2.51.In 25 patients,the highest rate of mild fatigue was in the cognitive dimension(40.32%),and in 35 patients the highest moderate fatigue rate in the behavioral dimension(56.45%).In the emotional dimension,severe fatigue had the highest rate of occurrence,34 cases or 29.03%.The CRF score was positively correlated with cancer experience(all P<0.01)and negatively correlated with cancer treatment efficacy(all P<0.01).Tumor staging,chemotherapy cycle,self-efficacy level,and anxiety and depression level were related to CRF in patients with DLBCL during chemotherapy.CONCLUSION There was a significant correlation between CRF and perceptual control level in patients.Tumor staging,chemotherapy cycle,self-efficacy level,and anxiety and depression level influenced CRF in patients with DLBCL during chemotherapy.

Effect of Individualized Exercise Therapy on Cancer-related Fatigue and Negative Emotion in Patients with Gastrointestinal Tumor during Perioperative Period

[Objectives]To investigate the effect of exercise therapy in gastric cancer patients during perioperative period.[Methods]100 patients with gastric cancer who underwent elective operation in the Department of Gastrointestinal Surgery of Taihe Hospital Affiliated to Hubei University of Medicine were divided into observation group and control group by convenience sampling.The control group received routine nursing measures,and the experimental group received exercise therapy intervention measures on the basis of the control group.The patients were evaluated by the General Information Questionnaire,Self-Rating Anxiety Scale,Self-Rating Depression Scale and Cancer-related Fatigue Scale at the time of admission,the second week and the sixth week after operation.[Results]The time effect,intervention effect and interaction effect of anxiety score,depression score and cancer-related fatigue score were significant(all P<0.05)and the index of enhanced recovery after surgery was significant(P<0.05)in the two groups at the second and sixth week after operation.[Conclusions]Exercise therapy is beneficial to promoting the enhanced recovery after surgery in advance,reduce cancer-related fatigue,negative emotion and accelerate rehabilitation in patients with gastrointestinal tumors.

Jianpi Fuzheng Decoction in the Treatment of Gastric Cancer-Related Fatigue

Objective:To observe the clinical effects of Jianpi Fuzheng Decoction in patients with gastric cancer and cancer-related fatigue(CRF).Methods:Using the random number table method as a reference,68 cases of gastric CRF were randomly divided into two groups.One group served as the control group and received basic treatment,while the other was the observation group.The observation group,in addition to the control group’s treatment,received Jianpi Fuzheng Decoction.The clinical treatment effectiveness,fatigue scores,immune function indicators,and treatment safety were compared between the two groups.Results:The total clinical treatment effectiveness of the observation group and the improvement in immune function indicators after treatment were higher than those of the control group.The fatigue score after treatment was lower in the observation group than in the control group(P<0.05).No serious adverse reactions occurred during the treatment in either group.Conclusion:Jianpi Fuzheng Decoction can enhance the clinical treatment effectiveness for gastric cancer patients with CRF.It facilitates the acceleration of fatigue symptom improvement and immune function enhancement.The medication’s safety is guaranteed,making it worthy of promotion.

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.

Progress of Traditional Chinese Medicine Treatment for Cancer-Related Fatigue in Patients with Colorectal Cancer

Cancer-related fatigue,which is a common symptom among colorectal cancer patients,has a high incidence and it affects the quality of life of these patients.Western medicine still lacks effective treatment means.However,with various methods of intervention and treatment,Chinese medicine has made certain progress in this area,where辻has good curative effect in improving fatigue and the quality of life of patients.This article briefly summarizes the main TCM treatment methods for cancer-related fatigue in patients with colorectal cancer in order to provide reference and suggestions for clinical practice.

Experimental study of fatigue degree quantification for multi-feature fusion identification

A comprehensive quantification method of fatigue degree is proposed concerning subjective and objective quantifications.Using the fatigue degree test software,fatigue degree is objectively quantified by analyzing the reaction and operation abilities of drivers about traffic signals.By comparison experiment with that EEG signal based,multivariate statistical analysis and fusion identification based on BP neural network(BPNN) results show that the experimental procedure is simple and practical,and the proposed method can reveal the correlation between fatigue feature parameters and fatigue degree in theory,and also can achieve accurate and reliable quantification of fatigue degree,especially under the associated action of multiple fatigue feature parameters.

Symptom experience in patients with cancer-related fatigue:A systematic review and meta-synthesis

To understand the real experiences of patients with cancer-related fatigue and to promote quality of life,the researchers used computer searches of PubMed,EMbase,CINAHL,PsycINFO,Web of Science,and China National Knowledge Infrastructure,China Biology Medicine disc,Wanfang Data,China Science and Technology Journal Database for relevant qualitative studies from the inception to November 1,2021.The results showed that a total of 16 papers were included,and 57 outcomes were distilled into 9 categories,which were pooled into four integrated outcomes,such as somatic,psychological and social support and so on.It is concluded that patients with cancer-related fatigue are not only in the midst of multidimensional,unspeakable somatic experiences,and complex psychological experiences,they are also hindered in coping with fatigue symptom and social life.Therefore,healthcare professionals should provide health interventions and psychological support to those patients whenever possible.

Effects of moxibustion on cancer-related fatigue: a meta-analysis

Objective: To systematically evaluate the efficacy of moxibustion in the treatment of cancer-related fatigue (CRF). Methods: Randomized controlled trials (RCTs) using moxibustion to treat cancer-related fatigue in Cochrane Library, PubMed, China Knowledge Network, Wanfang and VIP databases was searched. Two reviewers independently searched, reviewed the literature, extracted data, and evaluated the methodological quality. RevMan5.3 software was used for meta-analysis. Results: A total of 942 patients were included in 11 randomized controlled trials. The meta-analysis results showed that moxibustion can reduce fatigue score [MD =-2.04, 95% CI (-4.06,-0.33), P < 0.001], improve the score of quality of life QLQ-C30 [(MD = 8.44, 95% CI (1.85, 15.03), P < 0.001], also could boost the number of important immune-system cellular, such as CD3 [MD = 7.82, 95% CI (3.14, 12.49), P = 0.01], CD8 [MD =-3.15, 95% CI (-11.36, 5.06), P < 0.001], NK cells [MD=5.88, 95% CI (3.56, 8.20), P = 0.01];Conclusion: Moxibustion can improve the degree of cancer-related fatigue, improve the quality of life and enhance immune function.

Application of external treatment of traditional Chinese medicine in the treatment of cancer-related fatigue

External treatment of traditional Chinese medicine(TCM),also known as external treatment of internal diseases,has many advantages,such as simple,easy to operate,cost-effective and so on.Therefore,external treatment of TCM is favored by the majority of medical workers.By consulting the domestic literature reports on the treatment of cancer-related fatigue(CRF),it is found that the external treatment of TCM has a significant effect on the intervention of CRF,and has a good effect on reducing fatigue,improving the quality of life and prolonging the survival time.The purpose of this paper is to summarize the application of several external treatments in this disease,and to provide a variety of references for clinical treatment of CRF.

Non-drug interventions for cancer-related fatigue: an updated review

Non-drug interventions are easy operation, no damage and with significant effects treatment for cancer-related fatigue, which also can reduce the economic burden of cancer patients and improve the quality of life. This article reviews the effects of non-drug interventions on cancer-induced fatigue including exercise intervention, long distance healthy education, cognitive behavior intervention, traditional Chinese medicine intervention and emotional intervention to provide reference for clinical medical staff and relevant scholars.

Effect of mindfulness therapy on the intervention of cancer-related fatigue in patients with lung cancer: a meta-analysis

Objective:To systematically evaluate the effects of mindfulness therapy on oncogenic fatigue in patients with lung cancer.Methods:Computer searching was conducted in the Cochrane Library,PubMed,Embase and other databases.Combined with manual search,randomized controlled trials about the effect of mindfulness therapy on the cancer-related fatigue in patients with lung cancer were collected.The search time was from the establishment of the database to December 2019.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included study.RevMan 5.3 software was used for meta-analysis.Results:A total of 448 patients were included in 6 randomized controlled trials.Meta-analysis results show that mindfulness therapy can help reduce carcinogenic fatigue in patients with lung cancer(standardized mean difference(SMD)=−1.67,95%confidence interval(CI)(−2.09,−1.24),P<0.001),and improve anxiety(SMD=−1.33,95%CI(−2.53,−0.13),P=0.03),relieve depression(SMD=−1.43,95%CI(−2.13,−0.73),P<0.001).Conclusion:There is limited evidence that mindfulness therapy can improve cancer-related fatigue,anxiety,and depression in patients with lung cancer.Limited by the number and quality of included studies,the above conclusions need to be further validated by high-quality clinical trials.

Progress research on non-drug therapy in cancer-related fatigue

Cancer-related fatigue is the most prevalent and persistently symptom in cancer survivors than any other symptom,which is caused by both the disease and its treatment.Patients with cancer show a severe symptom of fatigue,which cannot be relieved by general rest or sleep.Cancer-related fatigue negatively impacts a patient's physical and emotional function,social ability and even patients’prognosis.At present,the mechanism of cancer-related fatigue remain unclear despite much research,and a variety of mechanisms may contribute to its occurrence and development,including inflammatory reaction,metabolism dysregulation,immune activation,hormonal changes,central nervous system dysfunction,etc.Now a broad variety of drugs and non-drugs interventions are used against cancer-related fatigue.The intervention of conventional western medicine mainly contains hematopoietic stimulants,hormones,mental stimulants,and antidepressants,but their widely clinical application is limited by their effectiveness and possible side effects to a certain degree.There are also many forms of non-drug interventions for managing cancer-related fatigue,such as exercise intervention,psychological intervention,sleep intervention,nutrition intervention,bright white light therapy,etc.The aim of this review is to provide recommendations of non-drug interventions for patients with CRF during and after cancer treatment,in order to provide an evidence-based guideline for clinicians.

Interventional effect of cognitive behavioral therapy on cancer-related fatigue in breast cancer patients: A systematic review

Objective:To evaluate the effect of cognitive behavioral therapy on cancer-related fatigue in breast cancer patients.Methods:Computer search for CNKI,VIP,Wanfang database,CBM,PubMed,Embase,CINAHL,The Cochrane library as of 2019 randomized controlled trials on October 20 for cognitive behavioral therapy intervention for breast cancer due to fatigue.Results:A total of 6 RCTs were included,472 patients.Cognitive Behavioral Therapy has a strong effect on cancer related fatigue compared with the usual care[SMD=-1.19,95%CI(-1.86,-0.53),P=0.0004].Results:Available evidence suggests that CBT can alleviate cancer-related fatigue in breast cancer patients,and the above studies still need to continue to conduct relevant studies for validation.

Changes of serum endocrine hormone levels in patients with cancer-related fatigue and their correlation with anti-tumor immune response and tumor load

Objective: To study the changes of serum endocrine hormone levels in patients with cancer-related fatigue (CRF) and their correlation with anti-tumor immune response and tumor load. Methods: A total of 137 patients who were diagnosed with primary lung cancer in West China Hospital, Sichuan University between June 2014 and November 2016 were selected and then divided into CRF group and control group according to their self-reported symptoms, serum was collected to determine the levels of endocrine hormones and tumor markers, and peripheral blood was collected to detect the levels of immune cells. Results: Serum ACTH and TSH levels of CRF group were significantly higher than those of control group while Cor, FT3 and FT4 levels were significantly lower than those of control group;peripheral blood CD11b+CD15-CD33+CD14+M-MDSC, CD11b+CD15-CD33+CD14-G-MDSC, CD4+CD25+CD127lowTreg and CD19+CD5+CD1d+Breg levels as well as serum CEA, Cyfra21-1, SCC-Ag, HE4, GDF-15 and PCNA levels of CRF group were significantly higher than those of control group, positively correlated with serum ACTH and TSH levels, and negatively correlated with Cor, FT3 and FT4 levels. Conclusion: The changes of thyroid hormone and adrenal cortical hormone levels in patients with cancer-related fatigue are closely related to the inhibited anti-tumor immune response and increased tumor load.

Network Pharmacology-based Analysis on Determining the Mechanisms of Yishen Qutong Granules(益肾祛痛颗粒)in Alleviating Cancer-related Fatigue

Cancer-related fatigue(CRF)is associated with cancer-related anemia(CRA).As the common comorbidities of cancer,both of them can seriously affect the quality of patient life.Yishen Qutong Granules(益肾祛痛颗粒,YSQTG)have achieved good curative effects in the treatment of CRA.However,the mechanism of whether it can alleviate CRF needs further confirmation.We used network pharmacology and molecular docking to investigate the molecular mechanism and the effective compounds of the prescription.Through the analysis and research in this paper,we obtained 76 effective compounds and 76 drug-disease intersection targets to construct a network,indicating that quercetin,luteolin,baicalein,β-sitosterol and stigmasterol were possibly the most important compounds in YSQTG.The key targets of YSQTG for CRF were mainly enriched in IL-17 and TNF pathways.816 GO entries and 113 pathways were obtained by GO and KEGG enrichment,respectively,which proved that YSQTG might have a comprehensive therapeutic effect on CRF mainly through regulating IL-17,TNF,MAPK,NF-κB and chemokines,as well as cholinergic synapse and 5-HT synapse pathways.The results of molecular docking showed thatβ-sitosterol and stigmasterol could form PI-Alkyl or Alkyl hydrophobic interactions with CXCL8 and ESR1 at residues LEU25,ARG26,PHE65,ALA69 and LEU346,ALA350,LEU391,PHE404,LEU525,VAL533,respectively.In conclusion,the therapeutic effect of YSQTG on CRF is based on the comprehensive pharmacological effect of multicomponent,multitarget,and multichannel pathways.This study provides a theoretical basis for further experimental research.

Fatigue Defect of Layer Steel Fiber Reinforced Concrete

An experimental study is carried out on fatigue defect of layer steel fiber reinforced concrete (LSFRC). Based on experimental data,the various relation curves are given corresponding to different stress levels 0.9, 0.85, and 0.8. Furthermore, the fatigue defect degree is defined, and the strain cycle ratio equations and defect cycle ratio equations with the correlation coefficients very close to 1, are regressed in terms of the cubic polynomial,of which the fittings are preferable.In addition,the results show that the fatigue defect of LSFRC presents three phase development regularity too.And in comparison with the plain concrete,the third phase of the fatigue defect of LSFRC is longer, therefore the fatigue failure of LSFRC is more ductile.The mechanism of the fatigue defect is discussed too.

团体接纳与承诺疗法联合有氧运动对血液透析患者的影响

目的:探讨团体接纳与承诺疗法联合有氧运动对血液透析患者的影响。方法:选取2021年2月—2022年2月厦门大学附属第一医院肾内科血透室收治的94例血液透析患者。根据随机数表法将其分为对照组和研究组,各47例。对照组实施常规护理,研究组在对照组基础上给予团体接纳与承诺疗法联合有氧运动。比较两组干预前后疲乏情况、希望水平、应对方式、睡眠质量。结果:干预后,两组积极态度、积极行动、亲密关系评分均升高,研究组积极态度、积极行动、亲密关系评分均高于对照组,差异有统计学意义(P<0.05)。干预后,两组多维度Piper疲乏修订量表(PFS-R)、匹兹堡睡眠质量指数量表(PSQI)评分均降低,研究组PFS-R评分、PSQI评分均低于对照组,差异有统计学意义(P<0.05)。干预后,两组面对应对评分升高,回避、屈服应对评分均降低,研究组面对应对评分高于对照组,回避、屈服应对评分均低于对照组,差异有统计学意义(P<0.05)。结论:团体接纳与承诺疗法联合有氧运动能够有效缓解血液透析患者的疲乏程度,改善患者的心理状态,提高患者的希望水平,使患者积极应对疾病,改善睡眠质量。

基于快速康复理论的55A模式干预在老年肺鳞状细胞癌手术患者中的应用效果

目的探讨基于快速康复理论的5A模式干预在老年肺鳞状细胞癌患者中的应用效果。方法根据干预方法的不同将98例老年肺鳞状细胞癌手术患者分为对照组(n=46)和观察组(n=52),对照组患者采取常规干预,观察组患者在对照组的基础上采取基于快速康复理论的5A模式干预。比较两组患者的术后恢复指标、疲乏程度[Piper疲乏量表(PFS)]、自我护理能力[自我护理能力测定量表(ESCA)]、肺功能指标[用力肺活量(FVC)、通气时间、第1秒用力呼气容积(FEV_(1))]及术后并发症发生情况。结果观察组患者肛门排气时间、引流管留置时间、首次下床时间及住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。干预后,两组患者PFS评分均低于本组干预前,ESCA评分均高于本组干预前,观察组患者PFS评分低于对照组,ESCA评分高于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者FVC、FEV_(1)均高于本组干预前,通气时间均短于本组干预前,观察组患者FVC、FEV_(1)均高于对照组,通气时间短于对照组,差异均有统计学意义(P﹤0.05)。观察组患者的术后并发症总发生率低于对照组(P﹤0.05)。结论基于快速康复理论的5A模式干预应用于老年肺鳞状细胞癌手术患者,可促进患者术后康复,降低疲乏程度和术后并发症发生率,提高自我护理能力,改善肺功能。

基于改进剩余强度模型的复合材料疲劳寿命预测

复合材料强度退化规律对研究结构疲劳寿命具有重要意义,然而现有剩余强度模型均需利用剩余强度试验数据确认模型参数,模型构建成本较高。通过探究复合材料疲劳寿命和剩余强度的关系,以疲劳寿命累积分布函数为出发点,构建具有明确物理意义的损伤度,进而提出改进剩余强度模型。改进剩余强度模型不需要剩余强度试验数据,仅需初始静强度和疲劳寿命数据。在改进剩余强度模型基础上,构建S-N-φ疲劳寿命预测模型,该模型可以考虑初始静强度对疲劳寿命的影响。算例结果表明,改进剩余强度模型的预测精度是满意的,S-N-φ模型相比经典S-N曲线模型具有更好的预测精度。