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.
目的:研究缺氧预处理对老年大鼠子宫及双附件切除术后疲劳是否有改善作用,并通过对比观察超氧化物歧化酶及丙二醛水平的变化,初步探讨缺氧预处理的作用机制。方法:将老年大鼠分为空白对照组、对照组、缺氧预处理三组。空白对照组为假手术组,对照组为子宫及双附件切除术组, 缺氧预处理组为缺氧预处理加子宫及双附件切除术组。对比观察缺氧预处理对大鼠体力活动及血清超氧化物歧化酶和丙二醛水平的影响。结果:空白对照组、对照组、缺氧预处理三组大鼠悬尾不动时间分别为:(21±3)s,(83±10)s,(44±5)s,各组间比较Plt;0.05。三组SOD活性分别为:(131.23±5.31)U/L,(36.12±9.68)U/L,(73.01±9.82)U/L,各组间比较Plt;0.05。三组MDA水平分别为:(9.78±1.26)μmol/L,(29.87±3.13)μmol/L,(15.98±2.21)μmol/L,各组间比较Plt;0.05。结论:缺氧预处理可提高老年大鼠的抗氧化能力,对老年大鼠子宫及双附件切除术后疲劳综合征有明显的改善作用。
Aiming at the human-computer interaction problem during the movement of the rehabilitation exoskeleton robot, this paper proposes an adaptive human-computer interaction control method based on real-time monitoring of human muscle state. Considering the efficiency of patient health monitoring and rehabilitation training, a new fatigue assessment algorithm was proposed. The method fully combined the human neuromuscular model, and used the relationship between the model parameter changes and the muscle state to achieve the classification of muscle fatigue state on the premise of ensuring the accuracy of the fatigue trend. In order to ensure the safety of human-computer interaction, a variable impedance control algorithm with this algorithm as the supervision link was proposed. On the basis of not adding redundant sensors, the evaluation algorithm was used as the perceptual decision-making link of the control system to monitor the muscle state in real time and carry out the robot control of fault-tolerant mechanism decision-making, so as to achieve the purpose of improving wearing comfort and improving the efficiency of rehabilitation training. Experiments show that the proposed human-computer interaction control method is effective and universal, and has broad application prospects.
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.
The objective of this study is to combine troponin and indicators of cardiac acoustics for synthetically evaluating cardiac fatigue of rabbits, analyzing exercise-induced cardiac fatigue (EICF) and exercise-induced cardiac damage (EICD). New Zealand white rabbits were used to conduct a multi-step swimming experiments with load, reaching an exhaustive state for evaluating if the amplitude ratio of the first to second heart sound (S1/S2) and heart rate (HR) during the exhaustive exercise would decrease or not and if they would be recovered 24-48 h after exhaustive exercise. The experimental end point was to complete 3 times of exhaustions or death from exhaustion. Circulating troponin I (cTnI) were detected from all of the experimental rabbits at rest [(0.02±0.01) ng/mL], which, in general, indicated that there existed a physiological release of troponin. After the first exhaustive swim, cTnI of the rabbits increased. However, with 24-hour rest, S1/S2, HR, and cTnI of the tested rabbits all returned toward baseline levels, which meant that the experimental rabbits experienced a cardiac fatigue process. After repeated exhaustion, overloading phenomena were observed, which led to death in 3 out of 11 rabbits, indicating their cardiac damage; the troponin elevation under this condition could be interpreted by pathological release. Evaluation of myocardial damage can not be based on the troponin levels alone, but can only be based on a comprehensive analysis.
The automatic recognition technology of muscle fatigue has widespread application in the field of kinesiology and rehabilitation medicine. In this paper, we used surface electromyography (sEMG) to study the recognition of leg muscle fatigue during circuit resistance training. The purpose of this study was to solve the problem that the sEMG signals have a lot of noise interference and the recognition accuracy of the existing muscle fatigue recognition model is not high enough. First, we proposed an improved wavelet threshold function denoising algorithm to denoise the sEMG signal. Then, we build a muscle fatigue state recognition model based on long short-term memory (LSTM), and used the Holdout method to evaluate the performance of the model. Finally, the denoising effect of the improved wavelet threshold function denoising method proposed in this paper was compared with the denoising effect of the traditional wavelet threshold denoising method. We compared the performance of the proposed muscle fatigue recognition model with that of particle swarm optimization support vector machine (PSO-SVM) and convolutional neural network (CNN). The results showed that the new wavelet threshold function had better denoising performance than hard and soft threshold functions. The accuracy of LSTM network model in identifying muscle fatigue was 4.89% and 2.47% higher than that of PSO-SVM and CNN, respectively. The sEMG signal denoising method and muscle fatigue recognition model proposed in this paper have important implications for monitoring muscle fatigue during rehabilitation training and exercise.
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.
Mental fatigue is the subjective state of people after excessive consumption of information resources. Its impact on cognitive activities is mainly manifested as decreased alertness, poor memory and inattention, which is highly related to the performance after impaired working memory. In this paper, the partial directional coherence method was used to calculate the coherence coefficient of scalp electroencephalogram (EEG) of each electrode. The analysis of brain network and its attribute parameters was used to explore the changes of information resource allocation of working memory under mental fatigue. Mental fatigue was quickly induced by the experimental paradigm of adaptive N-back working memory. Twenty-five healthy college students were randomly recruited as subjects, including 14 males and 11 females, aged from 20 to 27 years old, all right-handed. The behavioral data and resting scalp EEG data were collected simultaneously. The results showed that the main information transmission pathway of the brain changed under mental fatigue, mainly in the frontal lobe and parietal lobe. The significant changes in brain network parameters indicated that the information transmission path of the brain decreased and the efficiency of information transmission decreased significantly. In the causal flow of each electrode and the information flow of each brain region, the inflow of information resources in the frontal lobe decreased under mental fatigue. Although the parietal lobe region and occipital lobe region became the main functional connection areas in the fatigue state, the inflow of information resources in these two regions was still reduced as a whole. These results indicated that mental fatigue affected the information resources allocation of working memory, especially in the frontal and parietal regions which were closely related to working memory.
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 explore the effect of spiritual care on improving the psychological stress levels of relatives of patients with terminal cancer. MethodsDuring January 2013 and January 2014, 220 relatives of patients with terminal cancer were selected. Convenience sampling method was adopted to select 100 relatives out of 190 who were agreed to be participated in the investigation, who were divided into the trial group and the control group with 50 in each according to the random alphabet method. The control group was given routine care and psychological counseling, and the trial group was given spiritual care intervention additionally. Before intervention, all of the individuals in both of the two groups should conduct the questionnaire of general demographic data, caregiver stress scale, fatigue rating scale, quality of life scale (QLS), social support scale (SSS), and relatives stress scale (RSS). ResultsAfter one month's intervention, caregiver stress scale score (52.14±4.75), fatigue rating score (76.75±8.69), RSS score (15.71±3.97), SSS score (22.59±2.22), the QLS score (66.9±7.5) in the trial group were significant better than those in the control group (P < 0.05). After intervention, all the scores in the trial group were significant better than whose before the intervention (P < 0.05). ConclusionFor the relatives of the patients with terminal cancer, spiritual care can reduce the occurrence rate of stress and fatigue, relieve the psychological stress level, and improve the social support and quality of life.