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With a global rise in morbidity rates， obesity has become a pressing public health issue. With increased adipocyte number and volume as the main characteristics， obesity is also manifested by metabolic disorders to varying degrees. At the same time， obesity is a risk factor for diabetes， hypertension， stroke， cancer， and cardiovascular diseases， imposing burdens on society and families. Influenced by lifestyle， environment， behavior， and genetics， obesity is caused by the interaction of many factors， and its pathological process is complex， involving inflammation， autophagy， and intestinal dysbiosis. The mitogen-activated protein kinase （MAPK） cascade reaction， a pivotal signaling pathway， plays a crucial role in cellular processes such as proliferation， differentiation， apoptosis， and stress responses. Both Chinese and international studies indicate that the MAPK signaling pathway can effectively regulate obesity through various pathways， including the modulation of adipocyte differentiation and apoptosis， appetite control， and inflammation improvement. Moreover， traditional Chinese medicine （TCM） has demonstrated significant efficacy in preventing and treating obesity， leveraging advantages such as multiple targets， diverse components， and minimal adverse effects. Research indicates that the MAPK signaling pathway is a primary focus of TCM regulation in this context， although a systematic review in this field is currently lacking. Therefore， this paper， by reviewing the latest Chinese and international research， provided a concise overview of the basic structure of the MAPK pathway， with a specific emphasis on recent progress in TCM interventions targeting the MAPK pathway for obesity treatment. The results indicate that regulating adipose tissue formation， differentiation， and thermogenesis， reducing inflammation and oxidative stress levels， and improving insulin sensitivity and metabolic disorders seem to be the main ways for TCM to regulate the MAPK pathway to prevent and treat obesity. However， it is necessary to find more research methods and explore potential mechanisms underlying TCM formulations based on the MAPK pathway for obesity prevention and treatment.
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Objective:To establish the normal reference value of lumbar bone mineral density (BMD) under quantitative CT (QCT) in Chinese healthy adult females and to explore the regional differences.Methods:Total of 35 431 healthy women who met the inclusion criteria of Chinese health quantitative CT big data program were selected in this study. The BMD of the central plane of L 1 and L 2 vertebrae was measured by Mindways′s QCT system, and the mean value was taken. One-way analysis of variance was used to compare the BMD differences of lumbar vertebrae in women of different ages and regions. The subjects were grouped by an age interval of 10 years, and the level of BMD in different regions of the same age group were compaired. Results:The peak BMD of Chinese healthy adult women appeared in the age group of 20-29 years (Northeast China(183.01±24.58) mg/cm 3, North China (188.93±24.80) mg/cm 3, East China (187.54±27.71) mg/cm 3, South China (186.22±33.72) mg/cm 3, Central China (176.33±24.91) mg/cm 3, Southwest China(182.25±28.00) mg/cm 3), and then it decreased with age. The level of BMD in different regions decreased with the age. Before the age of 70 years, BMD in Central and Southwest China was always at a low level((176.23±24.91) to (90.38±28.12) mg/cm 3, 182.25±28.00 to (88.55±25.68) mg/cm 3), lower than those in Northeast China ((183.01±24.58) to (99.69±27.85) mg/cm 3), North China ((188.93±24.80) to (95.89±26.12) mg/cm 3), East China ((187.54±27.71) to (95.65±27.86) mg/cm 3). After 70 years of age, BMD tended to be the same in different regions ( P>0.05). The BMD values in Central China and Southwest China were similar in the age group of 40-60 years ( P>0.05). The BMD values in the health adult femles in the age group of 60 years in different regions of Chinawere all lower than those of bone mass abnormality (all P<0.05). The detection rate of osteoporosis in females over 50 years was the highest in Southwest China (25.65%) and it was the lowest in North China (17.30%). Conclusions:This study establishes reference values of BMD under QCT in healthy Chinese women, which can be used as a reference basis for identifying women with low BMD who are at risk of osteoporosis. The BMD value is the lowest in Southwest China and the highest in South China.
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Objective:This study aimed to analyze the influencing factors of cerebral hemodynamics index (CVHI) and provide evidence on early warning of stroke in ethnic minorities (Tujia, Buyi, Dong, Miao).Methods:From April 2017 to April 2019, ethnic minorities were examined in the Health Management Center of the Affiliated Hospital of Guizhou Medical University to determine the nationality, age, sex, medical history (such as hypertension, hyperlipidemia, and diabetes) and menstruation in women; measure physiological indexes, such as height and weight, and biochemical indexes, such as blood glucose, blood lipid, and serum uric acid levels; and conduct CVHI and bilateral arm ankle pulse wave conduction velocity (baPWV) detection. The CVHI integral was calculated and divided into normal CVHI group (≥75 points) and abnormal CVHI group (<75 points) to describe the characteristics of population distribution and analyze the related influencing factors of CVHI.Results:A total of 1 236 individuals belonging to ethnic minorities [age, 52.0±9.0 years; 575 men (46.52%) and 661 women (53.48%)]were included in the study. In ethnic minorities, 35.11% had abnormal CVHI. There was no significant difference in abnormal CVHI among ethnic groups, from highest to lowest, in Buyi nationality (38.22%), Miao nationality (37.93%), Dong nationality (32.70%), and Tujia nationality (32.36%). Minority women, menopausal patients, and patients with history of hypertension, diabetes, and hyperlipidemia more frequently had abnormal CVHI than men and non-menopausal and normal women (43.57%, 47.48%, and 57.66%, 76.19%, and 54.00% vs. 25.39%, 39.51%, and 32.30% 35.31%, and 34.74%, P<0.05). The mean BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), and FPG and TG levels, baPWV in the abnormal CVHI group were higher than those in the normal CVHI group, and height was lower the abnormal CVHI group than that in the normal group ( P<0.05). The correlation analysis showed that height ( r=0.309) was positively correlated with CVHI integral and SBP ( r=-0.239), DBP ( r=-0.189), and baPWV ( r=-0.184) were negatively correlated with CVHI integral ( P<0.001). The higher the height, the higher the CVHI and the lower the risk of stroke, and the higher the SBP, DBP, and baPWV, the lower the CVHI score and the higher the risk of stroke. The factor logistic regression analysis showed that old age ( OR, 1.992; 95% CI, 1.405-2.825); female sex ( OR, 2.240; 95% CI, 1.750-2.866); history of hypertension ( OR, 3.363; 95% CI, 1.665-6.791), menopause ( OR, 1.384; 95% CI, 1.016-1.885), and high SBP ( OR, 1.031; 95% CI, 1.019-1.044), BMI ( OR, 1.091; 95% CI, 1.048-1.135), FPG level ( OR, 1.169; 95% CI, 1.017-1.344), and baPWV ( OR, 1.002; 95% CI, 1.001-1.002) were risk factors for abnormal CVHI, and increased height ( OR, 0.936; 95% CI 0.920-0.952) was the protective factor. Conclusion:Individuals in ethnic minorities frequently have abnormal CVHI. The main risk factors of CVHI are the elderly, female, history of hypertension, menopause, systolic blood pressure, body mass index, fasting blood glucose and baPWV. It is necessary to strengthen the health management of ethnic minority gathering places, controling body weight, regularly monitoring of blood pressure and blood glucose and lipid levels, and examing cerebral vascular hemodynamics.
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Objective@#This study aimed to analyze the influencing factors of cerebral hemodynamics index (CVHI) and provide evidence on early warning of stroke in ethnic minorities (Tujia, Buyi, Dong, Miao).@*Methods@#From April 2017 to April 2019, ethnic minorities were examined in the Health Management Center of the Affiliated Hospital of Guizhou Medical University to determine the nationality, age, sex, medical history (such as hypertension, hyperlipidemia, and diabetes) and menstruation in women; measure physiological indexes, such as height and weight, and biochemical indexes, such as blood glucose, blood lipid, and serum uric acid levels; and conduct CVHI and bilateral arm ankle pulse wave conduction velocity (baPWV) detection. The CVHI integral was calculated and divided into normal CVHI group (≥75 points) and abnormal CVHI group (<75 points) to describe the characteristics of population distribution and analyze the related influencing factors of CVHI.@*Results@#A total of 1 236 individuals belonging to ethnic minorities [age, 52.0±9.0 years; 575 men (46.52%) and 661 women (53.48%)]were included in the study. In ethnic minorities, 35.11% had abnormal CVHI. There was no significant difference in abnormal CVHI among ethnic groups, from highest to lowest, in Buyi nationality (38.22%), Miao nationality (37.93%), Dong nationality (32.70%), and Tujia nationality (32.36%). Minority women, menopausal patients, and patients with history of hypertension, diabetes, and hyperlipidemia more frequently had abnormal CVHI than men and non-menopausal and normal women (43.57%, 47.48%, and 57.66%, 76.19%, and 54.00% vs. 25.39%, 39.51%, and 32.30% 35.31%, and 34.74%, P<0.05). The mean BMI, systolic blood pressure (SBP), diastolic blood pressure (DBP), and FPG and TG levels, baPWV in the abnormal CVHI group were higher than those in the normal CVHI group, and height was lower the abnormal CVHI group than that in the normal group (P<0.05). The correlation analysis showed that height (r=0.309) was positively correlated with CVHI integral and SBP (r=-0.239), DBP (r=-0.189), and baPWV (r=-0.184) were negatively correlated with CVHI integral (P<0.001). The higher the height, the higher the CVHI and the lower the risk of stroke, and the higher the SBP, DBP, and baPWV, the lower the CVHI score and the higher the risk of stroke. The factor logistic regression analysis showed that old age (OR, 1.992; 95%CI, 1.405-2.825); female sex (OR, 2.240; 95%CI, 1.750-2.866); history of hypertension (OR, 3.363; 95%CI, 1.665-6.791), menopause (OR, 1.384; 95%CI, 1.016-1.885), and high SBP (OR, 1.031; 95%CI, 1.019-1.044), BMI (OR, 1.091; 95%CI, 1.048-1.135), FPG level (OR, 1.169; 95%CI, 1.017-1.344), and baPWV (OR, 1.002; 95%CI, 1.001-1.002) were risk factors for abnormal CVHI, and increased height (OR, 0.936; 95%CI 0.920-0.952) was the protective factor.@*Conclusion@#Individuals in ethnic minorities frequently have abnormal CVHI. The main risk factors of CVHI are the elderly, female, history of hypertension, menopause, systolic blood pressure, body mass index, fasting blood glucose and baPWV. It is necessary to strengthen the health management of ethnic minority gathering places, controling body weight, regularly monitoring of blood pressure and blood glucose and lipid levels, and examing cerebral vascular hemodynamics.
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Objective:The present study was designed to explore the role of ER stress in cardiac hypertrophy of adult APPswe /PS1dE9 transgenic mice.Methods:10 adult APPswe/PS1dE9 transgenic mice and 10 C57BL/6 wild type (WT) mice were divided into the transgenic experimental and control group,WT experimental and control group,respectively,with 5 mice in each group.Experimental groups received a low dose ofIsoproterenol (ISO) (2 mg/kg) once a day for 4 weeks to induce cardiac hypertrophy,while control groups received the same volume of normal saline.After 4 weeks,the mice were anesthetized,followed by,electrocardiogram (ECG) recording and the measurement of the heart rate and body weight before being sacrificed.The heart was dissected out,and the masses of heart and the left ventricle were measured,the left ventricule mass index (LVW/BW) and the whole heart weight ratio (HW/BW) were calculated.HE staining was used to observe the pathological and morphological changes of cardiomyocytes,and Western Blot and immunohistochemistry were used to detect the expressions of ER stress relevant proteins-GRP78,JNK,P-JNK and CaMKII.Results:Compared with WT experimental mice,the ventricular wall in the APPswe/PS1dE9 transgenic experimental mice was apparently hypertrophic after the induction by low doses of ISO,and the HW/BW and the LVW/BW were also significantly increased in the APPswe/PS1dE9 transgenic experimental mice than those in the transgenic control mice,WT experimental and control mice (P＜0.05).HE staining showed that compared with the transgenic control mice,WT experimental and WT control mice,in the adult APPswe/PS1dE9 transgenic experimental mice,the cardiomyocyte diameter was obviously increased,cell density was decreased,the capillary density was decreased,the intercellular substance was increased,and the intercellular space was increased.Western blot showed that the expression of GRP78,p-JNK and CaMKII in the experimental group of adult APPswe / PS1dE9 transgenic mice were significantly higher than those in the transgenic control mice and WT mice (P＜0.05,P＜0.01).There were no significant difference among the control group oftransgenic mice and the two groups of WT mice.Immunohistochemistry showed that the positive rates of GRP78 and CaMKII in the cytoplasm of cardiomyocytes of the APPswe/PS1 dE9 transgenic experimental mice were significantly higher than those of experimental WT mice (80％&40 ％)(P＜0.05),and the expressions in the two control groups were negative.The positive rates of p-JNK and JNK in the APPswe/PS1dE9 transgenic experimental mice were 90％ and 40％ respectively,and the expressions were negative in other three groups.Conclusions:The adult APPswe/PSldE9 transgenic mice are more prone to cardiac hypertrophy than WT mice after the induction with a low dose of ISO.ER stress is involved in the formation of cardiac hypertrophy in adult APPswe/PS1dE9 transgenic mice.
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Objective To investigate the effect of Zingiber corallinum oil ( ZCO ) on apoptosis and proliferation of cervical carcinoma cell line HeLa. Methods HeLa cells were treated with different concentrations of ZCO(5-80 mg·L-1)in vitro. Cytotoxicity rate was determined by CCK-8 assay. The morphological changes was observed using inverted microscope after AO/EB staining. Caspase-3 activities were measured with a colorimetric method. Protein level of hsp-70 were detected by Western blotting. Cell cycle and apoptosis were analyzed by flow cytometer ( FCM ) . Results ZCO exhibited effect of proliferation inhibition and apoptosis-inducing on the growth of HeLa cells in a dose-dependent manner. Caspase-3 activities increased in a dose-dependent manner while the expression of hsp-70 decreased. Cell cycle was arrested in G2/M phase. Conclusion ZCO exhibites a marked effect of proliferation inhibition and apoptosis-inducing on HeLa cells. The mechanism of ZCO might be activating the key enzyme in apoptotic pathway, so that the expression of hsp-70 is down-regulated, and cell cycle is arrested in G2/M phase.
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Objective To evaluate effects of simultaneous inhibition of mammalian target of rapamycin complex 1(mTORC1)kinase and glycogen synthase kinase-3β(GSK-3β)on phosphorylation of 4E-binding protein-1(4EBP1), cap-dependent translation, as well as survival and apoptosis of melanoma cells. Methods Cultured A375 cells were classified into several groups to be treated with dimethyl sulfoxide (DMSO group), the mTORC1 kinase inhibitor everolimus at a concentration of 5 nmol/L (everolimus group), the GSK-3β kinase inhibitor AR-A014418 at a concentration of 10 μmol/L (AR-A014418 group), or 5 nmol/L everolimus and 10 μmol/L AR-A014418(combined treatment group). After additional culture, Western-blot analysis was performed to measure protein expressions of phosphorylated 4EBP1 (p4EBP1)and survivin in A375 cells, m7GTP pull down assay to estimate interaction between eukaryotic initiation factor-4E (eIF4E)and eIF4G, cell counting kit 8 (CCK8)assay to evaluate cell proliferation, and flow cytometry to detect cell apoptosis. Results Both everolimus and AR-A014418 had inhibitory effects on 4EBP1 phosphorylation and survivin expression. The expressions of p4EBP1-65 and survivin were both significantly decreased in the everolimus group (0.74 ± 0.05 and 0.71 ± 0.06 respectively), AR-A014418 group (0.62 ± 0.06 and 0.58 ± 0.07 respectively)and combined treatment group (0.14 ± 0.04 and 0.09 ± 0.05 respectively)compared with the DMSO group (1.00 ± 0.07 and 1.00 ± 0.06, respectively, all P < 0.001), with the most significant decrease observed in the combined treatment group. As m7GTP pull-down assay showed, the everolimus group, AR-A014418 group and combined treatment group all showed significantly lower relative expression levels of eIF4G(0.72 ± 0.04, 0.67 ± 0.05 and 0.12 ± 0.05 vs. 1.00 ± 0.06, all P < 0.001), but significantly higher relative expression levels of 4EBP1 (1.98 ± 0.16, 2.32 ± 0.17 and 7.58 ± 0.25 vs. 1.00 ± 0.08, all P < 0.001)than the DMSO group, and the combined treatment group showed the lowest eIF4G expression but highest 4EBP1 expression. After 24-hour culture, the proliferation of A375 cells was inhibited by 18.5% ± 1.3% in the everolimus group, 19.8% ± 1.8% in the AR-A014418 group, and 61.2% ± 2.1% in the combined treatment group compared with the DMSO group, with the strongest inhibition noted in the combined treatment group. The inhibitory effects of everolimus and AR-A014418 on cell proliferation increased over time, and showed the same trend at 48 hours. Flow cytometry showed that the apoptosis of A375 cells was accelerated by the 24-hour treatments with everolimus and AR-A014418 alone or in combination, with the apoptosis rate being 14.28% ± 2.18%, 14.57% ± 2.35% and 55.18% ± 6.27% in the everolimus group, AR-A014418 group and combined treatment group respectively, and the combined treatment showed the strongest accelerating effect. Conclusion The combined treatment with everolimus and AR-A014418 can evidently inhibit 4EBP1 phosphorylation and eIF4F complex formation in A375 cells, which then suppress cap-dependent translation and promote apoptosis of melanoma cells.
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Objective To study the awareness of perimenopausal hormone replacement therapy (HRT) among a part of the medical care personnel in Guiyang . Methods A survey was conducted among 500 medical staff members in 4 hospitals of Guiyang by cluster random sampling using questionnaire about HRT. Results The survey showed that 74.6% (373/500) medical staff thought that the hormone replacement therapy was necessary to perimenopausal women; 96.7% (87/90) of obstetrics and gynecology doctors believed that it was necessary for perimenopausal women to use HRT,which was significantly higher than the doctors of other specialties 68.6% (166/242) and the nurses group 71.4% (120/168) (χ2=28.509, 23.537, P<0.01). Only 5.8%(29/500) of the medical personnel were willing to recommend HRT. In light of the attitude for recommending HRT, the obstetricians and gynecologists group was more significantly higher than the other specialties doctors group (χ2=86.781, P<0.01). Conclusion The knowledge of hormone replacement therapy in part of Guiyang medical personnel is not sufficient;the recommending rate of HRT was low;the side effects of HRT was still a concern. There are differences between obstetrics and gynecology doctors and doctors other specialties and nurses in HRT knowledge.
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@#Transcranial direct current stimulation is one of the non-invasive brain-stimulation techniques. Based on the introduction of the origin and development, this article gave an overview of the mechanisms emphatically, the current view is that the transcranial direct current stimulation may exert effect on neuromodulation by changing cortical excitability, increasing synaptic plasticity, impacting cortical excitation/ inhibition balance, altering regional cerebral blood flow, modulating the activity within and between different cortical networks. In this review, clinical studies and analysis findings were compared, and then 2 problems should be discussed for ideal effects: choice of stimulating parameters and timing of the stimulation in relation to task performance.
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Transcranial direct current stimulation is one of the non-invasive brain-stimulation techniques. Based on the introduction of the origin and development, this article gave an overview of the mechanisms emphatically, the current view is that the transcranial direct cur-rent stimulation may exert effect on neuromodulation by changing cortical excitability, increasing synaptic plasticity, impacting cortical exci-tation/inhibition balance, altering regional cerebral blood flow, modulating the activity within and between different cortical networks. In this review, clinical studies and analysis findings were compared, and then 2 problems should be discussed for ideal effects:choice of stimu-lating parameters and timing of the stimulation in relation to task performance.
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@# Transcranial direct current stimulation is one of the non-invasive brain-stimulation techniques. Based on the introduction of the origin and development, this article gave an overview of the mechanisms emphatically, the current view is that the transcranial direct current stimulation may exert effect on neuromodulation by changing cortical excitability, increasing synaptic plasticity, impacting cortical excitation/ inhibition balance, altering regional cerebral blood flow, modulating the activity within and between different cortical networks. In this review, clinical studies and analysis findings were compared, and then 2 problems should be discussed for ideal effects: choice of stimulating parameters and timing of the stimulation in relation to task performance.
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Objective To investigate the effect of short-term constraint-induced aphasia therapy on chronic aphasia after stroke. Meth-ods 30 stroke patients with chronic aphasia accepted speech therapy for a total of 30 hours. The control group (n=15) accepted routine speech training and the treatment group (n=15) accepted constraint-induced aphasia therapy 3 hours a day. They were assessed with the Western Aphasia Battery (WAB) and the Communicative Activity Log (CAL) before and after treatment. Results The treatment group im-proved significantly in oral expression, naming and repetition function of WAB after treatment (P<0.001), but not significantly in listening understanding (P=0.066);while the control group improved significantly in oral expression (P<0.001). The treatment group also significant-ly improved in CAL (P<0.001). Conclusion Constraint-induced aphasia therapy can significantly improve the speech for stroke patients with chronic aphasia in the short term.
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Objective To evaluate the effect of short-wave ultraviolet combined with millimeter-wave irradiation on pressure ulcers.Methods Fifty-three patients with 87 pressure ulcer wounds were randomly divided into 3 groups.Group A consisted of 17 patients with 28 pressure ulcers,group B had 18 patients with 29 ulcers and group C had 18 patients with 29 pressure ulcers.All the patients in the 3 groups accepted routine care.Group B was treated with short-wave ultraviolet radiation in addition,and group C received millimeter-wave combined with short-wave ultraviolet radiation.Braden's scale was used to evaluate the integrity of the patients' skin before treatment,and the pressure sore status tool (PSST) was used to evaluate exudation and skin recovery before and after treatment.Results Before treatment the patients demographics and pressure sores of the three groups had no significant differences.In group A there was no significant difference in the average PSST-5 score between before and after treatment.Compared with the scores before therapy,the average scores of groups B and C decreased significantly.They were also significantly lower than in group A after treatment.The effect in group C was better than in group B.With regard to improvement rate,the improvement percentages of groups B and C were significantly higher than that of group A,while there was no statistically significant difference between groups B and C.The rate of excellent recovery of group C was better than that of group A or B,but there was no significant difference between groups A and B.Conclusions Combining short-wave ultraviolet irradiation with millimeter-wave irradiation has remarkable effects on exudation from and the recovery of pressure ulcers.
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@# Objective To explore the correlation between fatigue and depression after cerebral infarction. Methods 112 cases were assessed with Zung Self-rating Depression Scale (SDS), depression dimension of Symptom Checklist 90 (SCL-90d) and Checklist Individual Strength (CIS). The data were analyzed with Spearman correlation analysis. Results The correlation coefficient between SDS and SCL-90d was 0.822 (P<0.01), and were 0.671 (P<0.01) and 0.640 (P<0.01) between CIS and SDS, CIS and SCL-90d, respectively. Conclusion The fatigue and depression after cerebral infarction is correlated.
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@#Objective To analyze the instruments for post stroke fatigue, Fatigue Severity Scale (FSS)，Checklist Individual Strength (CIS) and Fatigue Impact Scale (FIS). Methods The FSS，CIS and FIS were applied in 214 cases with cerebral infarction. They were combined together at the (sub)scale level, and evaluated with Mokken Scale Analysis for Polytomous Items, for validity and reliability. Results and Conclusion Three scales were and The combined scale proved to be acceptable (H>0.5). 3 components were extracted in factor analysis, and the their total cumulative contribution was 77.504%, with reliability (α) of 0.8097，0.7094 and 0.8019 respectively. FSS put emphasis on the fatigue experiences of stroke patients, CIS on the influence of fatigue on, and FIS on the social function.
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@# Objective To introduce Checklist Individual Strength(CIS)into China,and evaluate its reliability and validity.Methods CIS was translated into Chinese language and the reverse translation was done by several experts.Validity and reliability were implemented in 214 cases with cerebral infarction.Results 4 components were extracted in factor analysis,and the total cumulative contribution was 78.984%.By correlation analysis,the twenty items were divided into 4 domains:subjective feeling of fatigue,concentration,motivation and physical activity,it was same as in the English version.Cronbach α of four domains were 0.9256,0.9072,0.7598,and 0.9157,respectively.Conclusion Psychometric properties(reliabilities and validities)of CIS Chinese version is met with satisfaction and seems to be adaptable to Chinese cerebral infarction patients.
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@#Poststroke fatigue is not a single etiology disorder.As a kind of central fatigue,the basal ganglia,thalamencephalon,limbic system and the high grade cortical area man be involved,but none of them can be identified as the fatigue area.Some literature suggest the interrelationship between the proinflammatory cytokines,such as IL-1,TNF-α,IL-6,and fatigue.Since the pathologic process of stroke involving cytokines,the researchers proposed that poststroke fatigue may be related to sickness behavior promoted by proinflammatory cytokines ultimately.The physical fatigue may be associated with the proinflammatory cytokines's activation to hypothalamic-pituitary-adrenal axis,and the psychological fatigue may involve that proinflammatory cytokines decreased the clearance of extracellular glutamate by astroglia.