ObjectiveTo investigate the methodological and reporting quality of clinical trials involving Xiaoyao San for chronic fatigue syndrome. MethodsWe searched PubMed, CBM, CNKI, VIP and WanFang Data to identify randomized controlled trials (RCTs) about Xiaoyao San for chronic fatigue syndrome. The methodological and reporting quality of included RCTs was respectively evaluated according to the assessment tool of risk of bias of the Cochrane Handbook 5.1.0 and the CONSORT 2010 statement, combined with complementary assessment by the characteristic indicators of traditional Chinese medicine (TCM). The methodological and reporting quality of included case series study was respectively assessed by the methods recommended by the Britain's National Institute for Clinical Excellence (NICE) and the STROBE statement. ResultsA total of 27 clinical trials were included, involving 11 RCTs and 16 case series studies. According to the assessment tool of risk of bias of the Cochrane Handbook, 54.5% of the RCTs performed proper random method, 9.1% conducted allocation concealment and blinding, 72.7% selected intention-to-treat (ITT) analysis without the report of loss to follow-up, and no RCT existed selective reports. Corresponding to the characteristic indicators of TCM, 54.5% of the RCTs did not conduct TCM syndrome diagnosis, the curative effect standard of TCM syndrome was discrepant, and no RCT was multi-center study. The CONSORT 2010 statement indicated that no RCT explained sample size estimation, implementation details of randomization, flow diagram of participant, use of ITT and clinical trial registration. According to the items recommended by Britain's NICE, 6.25% of the case series studies were multi-center, 81.25% did not report clear inclusion and exclusion criteria, and no case series study performed continuous patient recruitment and stratification analysis of outcome. The STROBE statement indicated that no case series study reported research design, sample size, flow chart, bias, limitations and generalizability. ConclusionThe quality of clinical trials about Xiaoyao San for chronic fatigue syndrome is still low in methodological and reporting aspects. It is suggested that the future clinical trials should be conducted with references of CONSORT statement and STROBE statement, to propel the modernization and internationalization of TCM.
Heart rate variability (HRV) is an important point to judge a person’s state in modern medicine. This paper is aimed to research a person’s fatigue level connected with vagal nerve based on the HRV using the improved Welch method. The process of this method is that it firstly uses a time window function on the signal to be processed, then sets the length of time according to the requirement, and finally makes frequency domain analysis. Compared with classical periodogram method, the variance and consistency of the present method have been improved. We can set time span freely using this method (at present, the time of international standard to measure HRV is 5 minutes). This paper analyses the HRV’s characteristics of fatigue crowd based on the database provided by PhysioNet. We therefore draw the conclusion that the accuracy of Welch analyzing HRV combining with appropriate window function has been improved enormously, and when the person changes to fatigue, the vagal activity is diminished and sympathetic activity is raised.
ObjectiveTo systematically review the clinical features of chronic fatigue syndrome (CFS) cases with pathogens infection. MethodsWe electronically searched databases including VIP, WanFang Data, CNKI, CBM, PubMed, MEDLINE, EMbase, The Cochrane Library, Web of Science, Elsevier and Google Scholar from 1994 to 2014 for CFS-related studies. Two reviewers independently screened literature and extracted data. Then we systematically reviewed and analyzed the information on demographic characteristics, clinical manifestations, types of infected pathogens, and results of some biochemical examinations. ResultsA total of 84 studies (case reports and case series) involving 2 565 CFS cases from 18 countries were included. The major infected pathogens of included CFS cases were mycoplasma, EB virus, intestinal virus, Bernat rickettsia, human-herpes virus, and Gram-negative intestinal bacteria. Fifty-seven studies reported that there might be associations between the pathogenic infection and CFS pathogenesis. Although there were different types of CFS-related pathogens, almost all the studies inferred that pathogens infection linked with immune dysfunction, which might cause CFS symptoms. ConclusionThere may be associations between the pathogenic infection and CFS pathogenesis.
This study investigated the effect of prolonged walking with load carriage on body posture, muscle fatigue, heart rate and blood pressure of the tested subjects. Ten healthy volunteers performed 30 min walking trials on treadmill (speed=1.1 m/s) with different backpack loads [0% body weight (BW), 10%BW, 15%BW and 20%BW]. The change of body posture, muscle fatigue, heart rate and blood pressure before and after walking and the recovery of muscle fatigue during the rest time (0, 5, 10 and 15 min) were collected using the Bortec AMT-8 and the NDI Optotrak Certus. Results showed that the forward trunk and head angle, muscle fatigue, heart rate and blood pressure increased with the increasing backpack loads and bearing time. With the 20%BW load, the forward angle, muscle fatigue and systolic pressure were significantly higher than with lighter weights. No significantly increased heart rate and diastolic pressure were found. Decreased muscle fatigue was found after removing the backpack in each load trial. But the recovery of the person with 20%BW load was slower than that of 0%BW,10%BW and 15%BW. These findings indicated that the upper limit of backpack loads for college-aged students should be between 15% BW and 20%BW according to muscle fatigue and forward angle. It is suggested that backpack loads should be restricted to no more than 15%BW for walks of up to 30 min duration to avoid irreversible muscle fatigue.
Objectives To explore the quality of the reporting of randomized controlled trials (RCTs) of traditional Chinese medicine (TCM) for chronic fatigue syndrome (CFS).Methods We searched the Cochrane Central Register of Controlled Clinical Trials (CENTRAL) (The Cochrane Library, Issue 4, 2006), PubMed, EMbase, the Chinese Biomedical Database (CBMdisc), VIP Information, and China National Knowledge Infrastructure (CNKI) (from establishment to February 2007). We also checked the reference lists of included studies. The quality of the reporting of RCTs was assessed using the 22-item checklist of the CONSORT Statement and other self-established criteria. Results Thirty-eight RCTs were included. The word “randomization” was not present in any of the trials, and only 17 reports used a structured abstract. All trials did not report the scientific background and the rational for the trial, the estimation of the necessary sample size, the methods of allocation concealment and blinding, participant flow chart, ITT analysis, and ancillary analyses. Some authors misunderstood the diagnostic criteria and inclusion criteria, some selected inappropriate control interventions, and some did not clearly describe their statistical methods or used incorrect methods. All 38 trials reported positive outcomes, few reported adverse effects. No report included a general interpretation of the new trial’s results in the context of current evidence in their discussion section, and none mentioned the limitations of the study, the clinical and research implications or the external validity of the trial findings. Conclusion The overall reporting quality of RCTs of TCM for CFS is poor. Defects are found in each section of the reports. Researchers and journal editors should learn and use the principles and methods of evidence-based medicine—especially the use of a transparent prospective clinical trial register and the CONSORT Statement—to improve the design, conduct and report TCM trials.
In the present paper, the contribution of the largest principal component and the number of principal component needed for accumulative contribution 95% are selected as indices of electroencephalogram (EEG) in mental fatigue state in order to investigate the relationship between these parameters and mental fatigue. The experimental results showed that the contribution of the largest principal component of EEG signals increased in the prefrontal, frontal and central areas, while the number of principal component needed for accumulative contribution decreased by 95% with the increasing mental fatigue level. The parameters of singular system of EEG signals can be regarded as useful features for the estimation of mental fatigue and have larger application value in the study of mental fatigue.
Total hip replacement (THR) is replacing the prosthesis stem similar to human bone that takes advantage of the material with both good mechanical properties and biocompatibility to the damaged articular surface. Thus it can not only alleviate or even eliminate the pain but also effectively maintain the joint stability and freedom and restore its normal performance. Finite element analysis was used in this study to establish a 3D model of artificial hip stem, and explore its fatigue properties of different materials to ensure the safety and reliability. The calculating obtained two results of different metal hip prosthesis, including lifetime and deformation. The minimum service life of titanium prosthesis reaches 568 million times, which satisfies ISO standards, while the stainless steel does not suit to be a prosthesis material.
Objective To explore the current situation and influencing factors of self-regulatory fatigue in maintenance hemodialysis (MHD) patients, so as to provide good dialysis treatment for MHD patients, reduce their level of self-regulated fatigue and improve their quality of life. Methods The convenient sampling method was used to select the MHD patients in the Wenjiang Hemodialysis Center of West China Hospital of Sichuan University between April 12 and April 30, 2022. The patients were investigated by self-made basic information scale and self-regulatory fatigue scale. Results A total of 131 patients were included. The average score of self-regulatory fatigue was 53.47±6.45, cognitive dimension was 20.21±2.39, emotional dimension was 20.85±2.85, behavioral dimension was 12.40±3.63. The results of multiple linear stepwise regression analysis showed that age, duration of dialysis and educational background could inversely predict the score of self-regulatory fatigue (P<0.05). Conclusions MHD patients have a high level of self-regulatory fatigue. Clinical nurses can make individual dialysis programs according to the actual situation of MHD patients, improve their self-regulated level and physical and mental health, and improve the quality of life of MHD patients.
Objective To identify, describe, and evaluate the evidence of traditional Chinese medicine (TCM) interventions for cancer-related fatigue (CRF) using an evidence mapping approach. Methods The CNKI, WanFang Data, VIP, SinoMed, PubMed, Web of Science and Embase databases were electronically searched to collect studies on TCM interventions for CRF from inception to June 4, 2024. Evidence mapping was employed to present the characteristics of study populations, interventions, studies included in systematic review/meta-analysis (SR/MA), and conclusions. Results A total of 94 randomized controlled trials (RCT) and 17 SR/MA/network MA were included. The number of publications has shown an overall fluctuating upward trend in the past 15 years. The RCT included literature with a high focus on mixed cancers, involving a total of 51 TCM therapeutic measures, including 40 herbal treatments, 5 external TCM treatments, and 5 TCM integrative therapies. The outcome indicators were classified into 14 categories, with the most frequent ones being CRF scores, TCM syndrome scores, clinical efficacy, quality of life scores, immune function indicators, adverse event rates, and serum indicators. The SR/MA included 7-81 original studies with sample sizes of 551-7 547 cases, involving 5 intervention measures: herbal medicine (9 studies), moxibustion (3 studies), TCM injection (2 studies), moxibustion (2 studies), and acupuncture (1 study). The quality of RCT and SR/MA was generally low, and the evidence quality was low. Most studies showed that TCM interventions for CRF had potential efficacy, but there was still a lack of definitive clinical evidence. Conclusion The results suggest that TCM interventions for CRF have advantages but also problems. There is still a lack of high-quality research. More large-sample, multicenter RCT and high-quality SR/MA are needed to further explore the advantages of TCM interventions for CRF and provide strong support for the effectiveness and safety of TCM interventions for CRF.
ObjectiveTo assess the fatigue in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and analyze the factors caused fatigue and the relationship between quality of life (QOL) and fatigue. MethodsOne hundred and sixty-nine patients with OSAHS and 78 subjects without OSAHS diagnosed by polysomnography (PSG) between December 2010 and March 2011 in West China Hospital were recruited in the study. Fatigue was assessed by using multidimensional fatigue inventory (MFI), excessive daytime sleepiness by Epworth sleepiness scale(ESS), QOL by functional outcomes of sleep questionnaire (FOSQ). ResultsFatigue in the patients with OSAHS was more severe than that of the controls (51.06±13.39 vs. 44.82±9.81, P < 0.001), but no difference was revealed in the patients with different degree of OSAHS. Fatigue was positively correlated with ESS score(r=0.210), total sleep time intervals(r=0.156), and the ratio of time of SpO2 below 90% in total sleep time(r=0.153)(P < 0.05), and was negatively correlated with the average oxygen saturation(r=-0.171, P < 0.05) and all subscales of FOSQ(P < 0.01). ConclusionsFatigue in patients with OSAHS is more severe than that of controls. Fatigue can significantly reduce QOL, and the impact is greater than that of excessive daytime sleepiness.