Increased monocytic myeloid-derived suppressor cells in type 2 diabetes correlate with hyperglycemic and was a risk factor of infection and tumor occurrence.

To investigate the frequency of monocytic myeloid-derived suppressor cells (M-MDSCs) in type 2 diabetes mellitus (T2DM) patients and explore the potential associations between M-MDSCs, glycemic control, and the occurrence of infections and tumor. 102 healthy and 77 T2DM individuals were enrolled. We assessed the M-MDSCs frequency, levels of fasting plasma glucose (FPG), haemoglobin A1c (HbA1c), and other relevant indicators. Each patient underwent a follow-up of at least 6 months after M-MDSCs detection. The M-MDSCs frequency was significantly higher in patients with poor glycemic control (PGC) compared to the healthy population (P < 0.001), whereas there was no significant difference between patients with good glycemic control and the healthy (P > 0.05). There was a positive correlation between the M-MDSCs frequency and FPG, HbA1c (R = 0.517 and 0.315, P < 0.001, respectively). T2DM patients with abnormally increased M-MDSCs have a higher incidence of infection and tumor (48.57% and 11.43% respectively). Our results shed new light on the pathogenesis of T2DM, help to understand why T2DM patients are susceptible to infection and tumor and providing novel insights for future prevention and treatment of T2DM.

Development of a supportive care needs eHealth application for patients with cervical cancer undergoing surgery: a feasibility study.

PURPOSE: To inform the development of an eHealth application for patients with cervical cancer for monitoring supportive care needs, perceived care supply and quality of life. METHODS: A mixed-method design was used. The 19-month process involved five phases: (1) a literature review to screen the components of applications, (2) a cross-sectional needs assessment for patients with cervical cancer to define the needs and application program frame, (3) expert consultation to refine the draft, (4) software development, and (5) pilot testing and user comment collection. Patients in the intervention group received a 7-day application intervention combined with usual care. Supportive care needs, perceived care supply, quality of life and user's additional comments were collected. RESULTS: The literature review results in phase 1 revealed the importance of full preparation, especially a supportive care needs assessment, before application development. Subsequent supportive care needs investigation in phase 2 revealed that the most urgent needs were informational needs and privacy protection. In phase 3, 43 expert recommendations for application improvement were refined. The new application contained the patient and the health care professional portal in phase 4. Then, on Day 7, there existed score changes of the outcome measures in both intervention and control group. Users had a positive experience with the application. CONCLUSIONS: This study demonstrates the feasibility of applications targeting access to supportive care, which may be effective for improving the outcome measures but needed to be evaluated in future studies.

Symptom cluster trajectories and sentinel symptoms during the first cycle of chemotherapy in patients with lung cancer.

PURPOSE: To investigate symptom severity, symptom cluster trajectories and sentinel symptoms during chemotherapy cycle 1 in patients with lung cancer. METHODS: Patients with lung cancer were recruited to complete the MD Anderson Symptom Inventory (MDASI) and First Appearance of Symptoms Time Sheet daily during the first week of chemotherapy cycle 1. Latent class growth analysis was performed to examine symptom cluster trajectories. The Apriori algorithm combined with the time of the first appearance of symptoms after chemotherapy was used to determine the sentinel symptoms of each symptom cluster. RESULTS: A total of 175 lung cancer patients participated in the study. Five symptom clusters were identified: class 1 (difficulty remembering-numbness-hemoptysis-weight loss), class 2 (cough-expectoration-chest tightness-shortness of breath), class 3 (nausea-sleep disturbance-drowsiness-constipation), class 4 (pain-distress-dry mouth-sadness-vomiting), class 5 (fatigue-lack of appetite). Sentinel symptoms were found to be cough (class 2) and fatigue (class 5), while none were found for other symptom clusters. CONCLUSION: The trajectories of five symptom clusters were observed during the first week of chemotherapy cycle 1 and the sentinel symptoms of each cluster were explored. The study has important significance for the effective management of symptoms and the quality of nursing care for patients. At the same time, alleviating sentinel symptoms may reduce the severity of the whole symptom cluster, reducing medical resources and improving quality of life for lung cancer patients.