Research On The Etiological Mechanism Of Cancer-related Fatigue

Objectives: Cancer is the major diseases to current human healt- h. Cancer-Related Fatigue is one of the most common subjective symp- toms in these patients.CRF's coming is because of cancer or the Cancer treatment results.CRF's incidence is of 34%-76% and in the patients who has been chemotherapied is of 75%-96%.Cancer-related fatigue (CRF) is one of the most prevalent symptoms patients with cancer experience, both during and after treatment. CRF is pervasive and affects patients'quality of life considerably. It is important,thereofre, to understand the underlyi- ng pathophysiology of CRF in order to develop useful strategies for prev- ention and treatment. At present, the etiology of CRF is poorlyunderstoo- d and the relative contributions of the neoplastic disease, various forms of cancer therapy, and comorbid conditions (e.g., anemia, cachexia, sleep di- sorders, depression) remain unclear. In any individual,the etiology of CR- F probably involves the dysregulation of several physiological and bioch- emical systems.Mechanisms proposed as underlying CRF include 5-HT neurotransmitter dysregulation, vagal afferent active- tion, alterations in muscle and ATP metabolism,hypothalamic– pitui- tary– adrenal axis dy- sfunction, circa- dian rhythm disruption, and cytokine dysregulation. Cur- rently, these hypotheses are largely ba- sed on evidence from other con- ditions in which fatigue is a charact- eristic, in particular chronic fatigue syndrome and exercise-induced fatigue. The mechanisms that lead to fa- tigue in these conditions provide a theoretical basis for future research in- to the complex etiology of this distressing and debilitating symptom. An understanding of relevant mechanisms may offer potential routes for its prevention and treatment in patients with cancer.Method:1 The establishment of animal models for the CRF: BALB/C nude mice 20,human's gastric cancer cell strain BGC-823.Making water maze ex- periment, The tail hanging experiment, experiment of unable to Swimm- ing and open field test to tests animal models'behavioral.2 The effect of ATP in CRF:Putting the nude mice into the control group- (10), the model group(30),and the treatment group(90).In the treatment group,there are three group:the mild fatigue group(30),the moderate fatigue group(30)and the severe fatigue group(30).In every treatment gr- oup there are three team:shenqifuzhengye injection group(10), shenqifu zhengye and 5-Fu injection(10),5-Fu injection(10). HPLC is the way to determine the content of serum ATP.Musculus gastrocnemius'ultr- astructure is observed by electron microscope.3 The role of cortisol levels in CRF: Putting the nude mice into the control group(10), the model group(30),and the treatment group(90).In the treatment group,there are three group:the mild fatigue group(30),the moderate fatigue group(30)and the severe fatigue group(30).In every treatment group there are three team:shenqifuzhengye injection group(10), shenqifu zhengye and 5-Fu injection(10),5-Fu injection(10). HPLC is the way to determine cortisol levels. Adrenal cortex'ultrastructure is observed by electron microscope.4 The change of ATP in CRF's patients: 120 patients was selected who had been three months after radical operation for carcinoma of stomach.these patients were divided into four groups: shenqifuzhengye injection group, shenqifu zhengye and 5-Fu injection, 5-Fu injection and fatigue group. HPLC is the way to determine the content of serum ATP.5 The change of cortisol levels in CRF's patients: 120 patients was selected who had been three months after radical operation for carcinoma of stomach.these patients were divided into four groups: shenqifuzhengye injection group, shenqifu zhengye and 5-Fu injection, 5-Fu injection and fatigue group. HPLC is the way to determine cortisol levels.Results:1 Models of nude mice establishing:The mild fatigue group is higher than the moderate fatigue group in food taking and weight,the moderate fatigue group is higher than the severe fatigue group P<0.05.After making models three degrees fatigue mice compared with the control group. In water maze experiment, the time of leaving water maze in the control group was shortest in the test P<0.05,the severe fatigue group was the longest,the moderate fatigue group was shorter than the severe fatigue group, the mild fatigue group was shorter than the moderate fatigue group P<0.05.In the tail hanging experiment, the time of unable moving in the control group was shortest in the test P<0.05, the severe fatigue group was the longest,the moderate fatigue group was shorter than the severe fatigue group, the mild fatigue group was shorter than the moderate fatigue group P<0.05. In the experiment of unable to Swimming, the time of unable to Swimming in the control group was longest in the test P<0.05or P<0.01, the severe fatigue group was the shortest , the moderate fatigue group was longer than the severe fatigue group, the mild fatigue group was longer than the moderate fatigue group P<0.05.In open field test,the result was the same as the above all three tests.2 The content changing of serum ATP in nude mice and the change of Musculus gastrocnemius'ultrastructure2.1 The content changing of serum ATP in nude mice :Shenqifuzhengye injection group was?less than the control group P<0.05or P<0.01 ,was more than shenqifu zhengye and 5-Fu injection P<0.05, was more than 5-Fu injection P<0.01, was more than the model group P<0.05;shenqifu zhengye and 5-Fu injection was more than 5-Fu injection P<0.05, was more than the model group P<0.05, was?less than the control group P<0.01; 5-Fu injection was?less than the control group P<0.01, was?less than the model group P<0.05; the model group was?less than the control group P<0.01.2.2 The change of Musculus gastrocnemius'ultrastructure: The change of shenqifuzhengye injection group was smaller than shenqifu zhengye and 5-Fu injection; the change of shenqifu zhengye and 5-Fu injection was smaller than the model group; the change of he model group was smaller than 5-Fu injection.3 The content changing of cortisol levels in nude mice and the change of adrenal cortex'ultrastructure:3.1 The content changing of cortisol levels in nude mice: Shenqifuzhengye injection group was?less than the control group P<0.05or P<0.01 ,was more than shenqifu zhengye and 5-Fu injection P<0.05, was more than 5-Fu injection P<0.01, was more than the model group P<0.05;shenqifu zhengye and 5-Fu injection was more than 5-Fu injection P<0.05, was more than the model group P<0.05, was?less than the control group P<0.01; 5-Fu injection was?less than the control group P<0.01, was?less than the model group P<0.05; the model group was?less than the control group P<0.01.3.2 The change of adrenal cortex'ultrastructure: The change of shenqifu -zhengye injection group was smaller than shenqifu zhengye and 5-Fu injection; the change of shenqifu zhengye and 5-Fu injection was smaller than the model group; the change of he model group was smaller than 5-Fu injection.4 The change of ATP in CRF's patients: The content of serum ATP in the control group was the biggest,;Shenqifuzhengye injection group was?less than the control group P<0.05or P<0.01 ,was more than shenqifu zhengye and 5-Fu injection P<0.05, was more than 5-Fu injection P<0.01, was more than the fatigue group P<0.05;shenqifu zhengye and 5-Fu injection was more than 5-Fu injection P<0.05, was more than the fatigue group P<0.05, was?less than the control group P<0.01; 5-Fu injection was?less than the control group P<0.01, was?less than the fatigue group P<0.05; the fatigue group was?less than the control group P<0.01.5 The change of cortisol levels in CRF's patients: The cortisol levels in the control group was the biggest,;Shenqifuzhengye injection group was?less than the control group P<0.05or P<0.01 ,was more than shenqifu zhengye and 5-Fu injection P<0.05, was more than 5-Fu injection P<0.01, was more than the fatigue group P<0.05;shenqifu zhengye and 5-Fu injection was more than 5-Fu injection P<0.05, was more than the fatigue group P<0.05, was?less than the control group P<0.01; 5-Fu injection was?less than the control group P<0.01, was?less than the fatigue group P<0.05; the fatigue group was?less than the control group P<0.01.Conclusions:1 The change of ATP in CRF's patients was the same as that in nude mice.This indicated the content of serum ATP has effect on the taking place and development of CRF.So the ATP is one of the etiological mechanism of cancer-related fatigue.2 The change of cortisol levels in CRF's patients was the same as that in nude mice.This indicated the serum cortisol levels has effect on the taking place and development of CRF.So the cortisol levels is one of the etiolo- gical mechanism of cancer-related fatigue,the HPA is one of the etiolo- gical mechanism of cancer-related fatigue.