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.

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.

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.

Research progress on the mechanism of exercise fatigue and the role of probiotics in counteracting it

Exercise fatigue is a physiological phenomenon where the body cannot maintain a specific level after being stimulated by excessive exercise.Its five main theories include“energy depletion”,“accumulation of metabolites”,“homeostasis disorder of the internal environment”,“free radicals”,and“central nervous system protection inhibition”.The imbalance of intestinal flora caused by vigorous exercise can further lead to fatigue.Therefore,maintaining healthy intestinal flora is crucial for athlete health and performance.Recent studies have demonstrated that probiotics can regulate intestinal flora and alleviate exercise fatigue;however,there are no systematic reviews on the anti-fatigue effects of probiotics.Based on the mechanisms of exercise-induced fatigue,this article summarizes the effects and mechanisms by which probiotics combat exercise fatigue,aiming to provide research ideas for the development of probiotics that prevent exercise fatigue.

Corrosion fatigue crack growth mechanisms in welded joints of marine steel structures

This paper presents a model of fatigue crack growth in a welded joint and a two-dimensional model of anodic dissolution based on Donahue model and anodic dissolution mechanism,respectively.In addition,a model for predicting the corrosion fatigue crack growth rate in welded joints of steel marine structures is established and crack growth mechanisms are analyzed.The results show that during early stages of crack growth,corrosion fatigue crack growth rate in welded joints is mainly controlled by corrosion action,whereas cyclic loading becomes more influential during the later stage of crack propagation.Loading frequency and effective stress ratio can affect rupture period of protective film at the corrosion fatigue crack tip and the length of corrosion crack increment,respectively,which changes the influence of corrosion action on crack growth rate.However,the impact of stress amplitude on crack growth rate is only significant when crack propagation is caused by cyclic loading.Welding residual stress not only improves the effective stress ratio of cyclic loading,but also promotes crack closure and increases corrosion fatigue crack growth rate in welded joints.Compared to corrosion action,welding residual stress has a more significant influence on crack growth caused by cyclic loading.

MECHANISM MAP OF TORSIONAL FATIGUE FRACTURE

Studies have been made of the torsional fatigue fracture life of notched specimens,the macroscopic fractography and microscopic fracture mechanism of steel 40Cr after various tempering treatments under different stresses,With the increase of stress,the fracture model changes from normal stress fracture to longitudinal shear one,and then transversal shear one. Under same stress,with the increase of strength,the fracture mode transfers from shear to normal stress fracture.The mechanism of normal stress fracture may be:transgranular frac- ture→striation+intergranular fracture→dimple+intergranular fracture,and of shear fracture may be:transgranular fracture→shear trace→dimple.Based on the experimental results,a fracture mechanism map of torsional fatigue has been drawn up.

Coupling Mechanism of Saturated Concrete Subjected to Simultaneous Fatigue Loading and Freeze-thaw Cycles

The coupling mechanism of saturated concrete subjected to simultaneous 4-point fatigue loading and freeze-thaw cycles was, for the first time, experimentally studied by strain technology. The coupling strain, temperature strain and fatigue strain of concrete specimens were measured at the same time from one sample with stain analysis method and the relationship among these three kinds of strains was studied by fitting data to present coupling mechanism at macro level. The results showed that there was no interaction between fatigue strain and temperature strain and the coupling strain could be written by linear superposition of temperature strain and fatigue strain.

Properties and Mechanism on Flexural Fatigue of Polypropylene Fiber Reinforced Concrete Containing Slag

Properties and mechanism were investigated on flexural fatigue of concrete containing polypropylene fibers and ground granulated blast furnace slag（GGBFS）.Four polypropylene fibers’volume fractions and five slag proportions were considered.An experiment was conducted to obtain the fatigue lives at three stress levels in 20 Hz frequency and at a constant stress level of 0.59 in four frequency respectively.Mechanism and evaluation were investigated based on the experimental data.Fatigue life span models were established.The results show that the addition of polypropylene fibers improves the flexural fatigue cumulative strength and fatigue life span.It is proposed that the slag particles and hydrated products improve Interfacial Transition Zone（ITZ）structure and benefit flexural fatigue performance.A composite reinforce effect is found with the incorporation of slag and polypropylene fibers.The optimum mixture contents 55%slag with 0.6%polypropylene fiber for the cumulative fatigue stress.Fatigue properties are decreased as the stress level increasing,the higher frequency reduces the fatigue strength more than lower frequency at a constant stress level.

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.

Mechanism of cancer-induced fatigue

Cancer related fatigue(CRF)is one of the most common and painful reactions in cancer patients.Due to the negative effects of cancer itself and long-term treatment,patients often feel continuous burnout,fatigue and powerlessness in both mental and physical aspects.Fatigue related to cancer and cancer treatment will affect the physical and mental health of cancer patients for a long time and continuously,and it is hard to be relieved through rest.Nowadays,most of the researches focus on the clinical manifestations of patients with cancer,such as pain,nausea and vomiting,weight loss and so on.The fatigue feeling of cancer patients is often one of the most easily overlooked pain symptoms in the treatment process.The influence of CRF on cancer patients may be one of the reasons for reducing the survival time of cancer patients.This paper aims to summarize and explore the pathogenesis of cancer-related fatigue,in order to analyze the related factors of cancer-related fatigue from multi-dimensional and multi-angle,and provide reference for its comprehensive treatment in clinic.

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.

Study on Contact Fatigue Life and Failure Mechanism of Subquenched 42CrMo Steel

The effect of undissolved ferrite amount in subcritically quenched 42CrMo steel on contact fatigue properties and failure mechanism were studied. The amount of undissolved ferrite in the steel were 0%,3%,10%,15% and 20% in volume fraction, respectively. The experimental results show that the existence of undissolved ferrite can increase the contact fatigue life The contact fatigue life can be prolonged with increasing the amounts of undissolved ferrite The grain size can be fined by using subcritical quenching process and the area of phase boundaries can also be greatly increased. The stress relaxation and grain refinement due to occurring of plastic deformation are main reasons for improving the fatigue life. The existence of undissolved ferrite can increase the crack initiation period. Under the experiment conditions, when the amount of undissolved ferrite is 10%, the longest contact fatigue life can be the obtained.

Fatigue and Fracture Mechanisms of Aluminum-Lithium Alloy Containing Cerium

The influence of rare earth element Ce on fatigue properites and fracture toughness for Al Li 2090 alloy was studied, and the mechanism of extrinsic toughening and intrinsic toughening from Ce was explored. A significant improvement in ductility, fatigue life and fracture toughness can be achieved by adding minor Ce into 2090 alloy, which is basically attributed to intrinsic toughening effect from Ce, i.e., the role of thinning and dispersing T 1 phase. On the other hand, due to the role of restraining recrystallization by adding Ce, the fraction of recrystallized grains is decreased and the unrecrystallized grains are thinned. It is responsible for enhancing extrinsic toughening effect.

Fatigue Alleviation Mechanism of Citric Acid Determined by Gene Expression Analysis in the Mouse Liver

Citric acid has been recognized for its ability to alleviate fatigue;however, the mechanism contributing to this effect has not yet been elucidated. Our previous study suggested that the alleviation of fatigue by citric acid intake might be induced by the acceleration of gluconeogenesis. In this study, we tested this hypothesis and evaluated whether the intake of citric acid accelerates gluconeogenesis in the mouse liver through microarray analysis. Because the microarray of focus includes 200 metabolic genes, it could be used to provide information on genes related to glucose metabolism as well as other pathways such as inflammation. Eight-week-old male C57/BL6J mice were divided into the distilled water and citric acid groups (n = 6), and were administered distilled water or a citric acid solution (20 mg/30g body weight) intragastrically with a probe, respectively. Forty minutes after administration, the mice were sacrificed by decapitation. The blood glucose level of the citric acid group was significantly higher (P = 0.001) than that of the distilled water group. The expression levels of genes related to glucose metabolism (Gck, Pfkl, Pklr, Pck1, G6pc) were not changed by the intake of citric acid. On the other hand, some transcriptional differences were observed in several other genes, including those related to inflammation, blood pressure, the electron transport system, uncoupling proteins, and anti-oxidation. The expression levels of genes related to inflammation were reduced in the citric acid group;e.g., the Il6 expression level was 0.78 times lower in the citric acid group than that in the distilled water group. In conclusion, the results of this study suggest that citric acid intake could accelerate gluconeogenesis and suppresses inflammation. Therefore, the fatigue-alleviation effects of citric acid might be induced by an additive effect between the maintenance of blood glucose levels and the suppression of inflammation.

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.

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.

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.