Developing Scales for the Assessment of Fatigue in Turkish Pediatric Oncology Patients Aged 13-18 and their Parents

Background: This study was planned in an attempt to develop scales for the assessment of fatigue in pediatriconcology patients aged 13-18 and also for their parents. Materials and Methods: In collecting the study data,we used the Child and Parent Information Form, Visual Fatigue Scale, Scale for the Assessment of Fatigue inPediatric Oncology Patients Aged 13-18 and the Scale for the Assessment of Fatigue in Pediatric Oncology PatientsAged 13-18 for Parents. We also used Pearson correlation analysis, Cronbach alpha coefficient, factor analysisand ROC analysis for the study data. Results: In this study, the total Cronbach alpha value of the parent formwas 0.99, the total factor load was 0.72-0.94 with 95% the total variance being explained. The cutoff point of theparent form is 73 points. The total Cronbach alpha value of the child form was 0.99, the total factor load was0.82-0.95, with 89.4% of the total variance being explained. The cutoff point of the child form was 75.5 points.Conclusions: This study suggests that the Scale for the Assessment of Fatigue in Pediatric Oncology PatientsAged 13-18 and the Scale for the Assessment of Fatigue in Pediatric Oncology Patients Aged 13-18 for Parentsare valid and reliable instruments in assessing the fatigue symptoms of children in Turkey.     

针刺治疗慢性疲劳综合征随机对照研究

目的:观察针刺干预对慢性疲劳综合征(CFS)患者的临床疗效.方法:将90例CFS患者随机分为观察组、对照组,每组45例.观察组针刺人迎、风府、百会;对照组采用5%葡萄糖注射液250 mL加参脉注射液20 mL静脉点注.比较两组患者治疗后疲劳量表 (Fs) 各项评分.结果:观察组治疗前后FS总评分分别为9.37±2.33...     

按揉法治疗胫骨前肌运动疲劳的表面肌电图观察及等速测试

目的:观察按揉法治疗胫骨前肌运动疲劳的疗效.方法:60名健康志愿者分为2组,每组30名.两组均采用等速测试训练进行左侧胫骨前肌疲劳造模,造模结束后,观察组进行推拿治疗5 min,对照组平躺休息5 min.用表面肌电图分别测定两组踝关节被动活动过程中胫骨前肌、腓肠肌的积分肌电、最大振幅、中位频率和斜率.结果:两组胫骨前肌...     

疲劳应激致血管内皮功能障碍与肾素-血管紧张素-醛固酮系统变化的关系及通络方药的干预

目的： 利用疲劳应激型血管内皮功能障碍动物模型,探讨过度疲劳状态下血管内皮功能障碍与肾素-血管紧张素-醛固酮系统（RAAS）及白细胞介素家族部分因子变化的关系及通络方药的干预作用。方法：健康雄性Wistar大鼠,随机分为对照组;高同型半胱氨酸（HCY）组;疲劳应激组;人参组;双参组;通心络组。放免方法检测血浆肾素活性（PRA）、血管紧张素Ⅱ（AngⅡ）、醛固酮（ALD)、白细胞介素1β（IL-1β）、白细胞介素-2（IL-2）、白细胞介素-6（IL-6）的水平及血管活性物质内皮素1（ET-1）、血栓素A2(TXA2)、前列环素I2（PGI2）、一氧化氮（NO）水平;ELISA方法检测去甲肾上腺素（NE）、白细胞介素-10（IL-10）水平。利用复杂系统分析方法分析血管内皮功能障碍与RAAS的关系。结果：与对照组比较,疲劳应激组缩血管因子ET-1、TXA2水平明显增高（P<0.01,P<0.05）,而舒血管因子PGI2、NO含量则显著降低（P＜0.01,P<0.01）;与对照组比较,疲劳应激组血浆肾素活性显著降低(P<0.01),AngⅡ、IL-1β、IL-6显著升高（P<0.01,P<0.01）,并高于HCY组（P<0.05, P<0.01, P<0.01）, NE含量也呈现升高趋势。与疲劳应激组比较,3种通络方药可显著降低血浆ET-1、AngⅡ、IL-1β、IL-6水平（P<0.01,P<0.01,P<0.05）及NE水平, 同时通心络组ALD显著升高（P<0.05）。复杂系统分析结果显示：在疲劳应激组,AngⅡ、IL-1β与ET之间,ALD与PGI2之间,ALD与NO之间分别构成3个相互独立的系统,它们之间均是按照复杂系统的最优化原则发生相互联系,并存在递变规律。而对照组、HCY组、通络方药干预组却不存在该联系。结论：长期处于过度疲劳状态,可诱发血管内皮功能障碍,并且与肾素-血管紧张素-醛固酮系统严重失平衡及植物神经功能失调有关,通络方药对此具有显著的改善作用。     

Fatigue in renal cell carcinoma: the hidden burden of current targeted therapies

Fatigue is one of the most common symptoms associated with cancer. Persistent fatigue can impair multiple aspects of daily functioning and quality of life, and patients report that treatment-related fatigue has a greater impact than other symptoms, including pain, nausea, and depression. Thus, management of fatigue is recognized as an important component of care for patients with cancer. Treatment of advanced and metastatic renal cell carcinoma (RCC) was, until recently, limited to cytokine-based therapies, which are associated with modest response rates and significant toxicity, including high rates of treatment-related fatigue. The paradigm for RCC treatment has shifted dramatically in the last 5 years with the advent of efficacious targeted therapies. These agents provide the promise of better tolerability because of their more selective mechanisms of action. However, there is considerable variation in the selectivity of targeted agents for RCC, and a review of randomized clinical trials in patients with advanced and/or metastatic disease reveals that there is considerable variation in the tolerability of these agents. Fatigue remains a prominent toxicity with current targeted therapies. Future agents that show better selectivity and potency than current targeted therapies should help to provide better efficacy and tolerability.     

消化道肿瘤患者癌因性疲乏与血清炎性因子及下丘脑-垂体-肾上腺素轴水平的相关性

目的 了解消化道肿瘤患者的疲乏水平,探讨癌因性疲乏(CRF)与血清炎性因子及下丘脑-垂体-肾上腺素(HPA)轴水平的相关性.方法 采用简易疲乏量表评估患者的疲乏水平,采用免疫比浊法测定血清C反应蛋白(CRP)水平,免疫微粒电发光法测定皮质醇水平,酶联免疫吸附试验(ELISA)测量血清中白细胞介素(IL)-6、IL-1β、肿瘤坏死因子-α(TNF-α)、促肾上腺皮质激素(ACTH)和去甲肾上腺素(NE)的水平.结果 消化道肿瘤患者CRF平均总体得分为(3.15±1.93)分,疲乏程度为轻中度,疲乏水平与血清中CRP、TNF-α水平呈明显正相关(r=0.321,P=0.000;r=0.265,P=0.000),与HPA轴中的NE、ACTH水平呈明显正相关(r=0.174,P=0.015;r=0.257,P=0.000),与皮质醇水平无关(r=0.033,P=0.652).美国东部肿瘤协作组(ECOG)得分(t=8.081,P=0.000)、文化程度(t=-4.244,P=0.000)、正在接受的治疗(t=4.563,P=0.000)、自诊断至采血日时间(t=3.453,P=0.001)、CRP(t=2.837,P=0.006)是CRF的重要影响因素.结论 消化道肿瘤患者CRF状况普遍存在,CRF与HPA轴中的NE、ACTH水平呈正相关.医务人员应重视对患者血清中炎性因子及激素水平的测定,改善患者的疲乏状况,提高生命质量.     

Post-traumatic hypopituitarism and fatigue

ABSTRACT

Post-traumatic hypopituitarism (PTH) associated with chronic cognitive, psychiatric, and/or behavioural sequelae is common following moderate to severe traumatic brain injury (TBI). More specifically, due to a cascade of hormonal deficiencies secondary to PTH, individuals with TBI may experience debilitating fatigue that can negatively impact functional recovery, as it can limit participation in brain injury rehabilitation services and lead to an increase in maladaptive lifestyle practices. While the mechanisms underlying fatigue and TBI are not entirely understood, the current review will address the specific anatomy and physiology of the pituitary gland, as well as the association between pituitary dysfunction and fatigue in individuals with TBI.     

不同输出电压对激光焊接钴铬合金焊件疲劳强度的影响

目的:探讨不同输出电压对激光焊接钴铬合金试件机械强度和疲劳强度的影响。方法:将牙科钴铬合金采用激光焊接在分别在220 V、250 V、280 V三种输出电压下焊接成哑铃形试件(n=10),以未焊接组作为对照,在材料测试机上进行三点弯曲试验,记录试件的最大压应力值和疲劳强度,并对断口进行显微晶相分析。结果:各焊接组的最大压应力值均小于未焊接组,其中220 V组最小,250 V组与280 V组的差别无显著性;各焊接组的疲劳强度随着输出电压的升高而升高,差异有显著性,但各焊接组的疲劳强度均远小于未焊接组。结论:在一定范围内,激光焊接的疲劳强度随输出电压的升高而增大。     

酸碱度对Vitallium与钴铬合金卡环疲劳强度影响的比较

目的:比较高钴铬钼合金(Vitallium 2000 plus,V)与钴铬合金(WBA,W)卡环臂在不同酸碱度下相同形变及循环次数时的疲劳衰减。方法:分别铸造V与W直型卡环臂20个,分别置于空气和pH值4.0、6.7和8.0的人工唾液中。用万能试验机进行0.8 mm变形的循环加载20000次,得到载荷-时间曲线算出试件的衰减百分数。扫描电镜观察表面。结果:W各组衰减均高于V,在空气中衰减最小,随实验组pH值增大试件衰减增大;V在pH=4组衰减最多。结论:使用Vitallium 2000 plus铸造可摘局部义齿的卡环可保持更长时间的初始修复效果。     

Lactate is a metabolic substrate that sustains extraocular muscle function

Lactic acid is considered the end product of glycolysis and is a major cause of muscle fatigue. However, the lactate dehydrogenase (LDH) reaction is bidirectional: Lactate can be oxidized to pyruvate and used as a substrate for the Krebs cycle. Therefore, our hypothesis was that lactate sustains the contractile function of rat extraocular muscles during periods of increased activity. The study used extraocular and extensor digitorum longus (EDL) muscles from adult Sprague–Dawley rats to determine LDH isoform expression, total LDH activity, and contractile function in vitro. To evaluate the role of lactate on fatigue, we tested the effect of cinnamate, a blocker of lactate transport, and exogenous lactate on fatigue resistance. Cinnamate accelerated fatigue in the extraocular muscles: Endurance and residual force decreased significantly. Conversely, cinnamate did not affect the endurance or residual force of EDL muscles. Replacing glucose with exogenous lactate increased EDL fatigability but had no effect on the extraocular muscles. However, the extraocular muscles fatigued faster when exposed to exogenous lactate combined with cinnamate. The LDH-A and LDH-C isoforms were expressed at lower levels in extraocular muscle; LDH-B was equally abundant in the EDL and extraocular muscles. Total LDH activity in the extraocular muscles was only approximately 32% of the level in EDL. These results support the hypothesis that lactate sustains the contractile performance of the extraocular muscles.