Lifestyle management (LSM) is a fundamental aspect of Type 2 diabetes mellitus (T2DM) management. Intensifying LSM beyond basic nutritional and exercise advice has been challenging for most doctors as LSM in diabetes is complex. To help navigate through the complexity of LSM in diabetes care, this article introduces an acronym DESMM as an easy-to-remember guide that encompasses most if not all the components of diabetes LSM. DESMM stands for Diet, Exercise, Support/Stress, Monitoring and Medicine. DESMM offers a structured guidance to enable consistent evaluation of the lifestyle of the patient with the intention of intensifying LSM.

MicroRNAs (miRNAs) are a class of non coding small RNAs. MiRNAs can regulate cell signal transduction and gene expression, affect cell proliferation, apoptosis and other cell physiological processes, and play a crucial role in maintaining normal biological metabolism and homeostasis of the intracellular environment. In addition, miRNAs are widely involved in the occurrence and progress of cancer. Studies have shown that miRNA27a, a member of the miRNAs family, can play the role of oncogene or tumor suppressor gene in different cancer disease models. This article will review the expression, mechanism and potential clinical application of miRNA27a in different malignant tumors.

BACKGROUND:Liver cancer pathogenesis and intervention have attracted increasing attentions. Mesenchymal stem cel s become a popular tool for cel cancer research, because of their low immunogenicity and tumor tropism. At present, mesenchymal stem cel s have been applied to the study of liver cancer.
OBJECTIVE:To summarize the advances of mesenchymal stem cel s used in liver cancer in basic and clinical research.
METHODS:An online retrieval of CNKI and Pubmed database was performed by the first author for the articles about mesenchymal stem cel s and effect of modified mesenchymal stem cel s on hepatoma carcinoma cel s published from January 2004 to January 2013. The key words were“mesenchymal stem cel , liver cancer, tumor”in Chinese and English. Repetitive research was excluded, and 47 studies met the inclusion criteria.
RESULTS AND CONCLUSION:Stem cel s are seldom reported in liver cancer, and the limited present study show that mesenchymal stem cel s may have a certain influence on the hepatoma carcinoma cel proliferation, invasion and biological behavior. However, due to the differences of cel lines used by the various laboratories, experimental conditions, animal models, as wel as infusion means of stem cel s, experimental results are also inconsistent. Scholars have conducted a series of studies on the mechanism of the Wnt pathway and tumor necrosis factor-related apoptosis-inducing ligand pathway. Tropism of mesenchymal stem cel s to tumor cel s, including liver cancer is widely recognized, so scholars imported therapeutic genes and drugs into mesenchymal stem cel s to interfere with the development of liver cancer, and have achieved some progress. This evidence provides new avenues for cel therapy for liver cancer. Less safety studies in vivo and clinical trials of mesenchymal stem cel s are available, therefore security risks deserve further research.

Delivery of Health Care, Integrated ; trends ; Diabetes Mellitus ; epidemiology ; therapy ; Health Promotion ; Health Surveys ; Humans ; Singapore ; epidemiology

Objective To call attention to the diagnosis and treatment of prostate sarcoma. Me thods From Jan 1984 to May 2000,7 cases of prostate sarcoma were treated,2 cases by radical cystoprostatectomy and detenia cecocolon continent urinary reservoir,1 case by suprapubic prostatectomy,3 cases by radiotherapy whereas 1 case underwent needle biopsy only. Results Of the 2 cases underwent radical cystoprostatectomy,one has been still surviving after 5 years whereas the other one died of lung metastases after 9 months.The other 5 patients all died within 13 months. Conclusions Early dignosis and radical cystoprostatectomy are mandatory to prolong survival.

ObjectiveTo evaluate transcatheter arter ia l embolization(TAE) on congenital renal arteriovenous malformation(RAVM).MethodsFive cases of RAVM,diagnosed on digital substraction a ngiography have been treated between March 1995 and May 2002 by transarterial em bolization (TAE) with different embolic agents (ethanol,iodised oil,gelform part icles or metalic coils).The efficacy was evaluated.ResultsIn all the 5 cases,gross hematuria was controlled immediately after TAE,th e urine turned clear in 24 h and urinalysis became normal in 7 days.The patients have been followed up for 6～12 months with an average of 10 months with hematu r ia well controlled in all.There has been no hypertension or apparent renal funct ion damage.Bilateral renal emission computed tomography (ECT) reveated only some local loss of the renal cortical function on the concerned side.ConclusionsAt present renal arteriography is still the most reliable method in the diagnosis of RAVM.TAE has the benefits of less inva sive, a low incidence of complications, early resumption of normal activities an d shorter hospital stay,and can avoid renal resection and correlative surgical c omplications.The renal function could be well protected from harm.

Objective To study the therapeutic effects of pedicled greater omentum displacement for complex posterior urethral stricture. Methods This study included 6 cases (all males) of complex posterior urethral stricture.Their age ranged from 14 to 45 years with a mean of 26 years.In these cases,traffic accident injury occurred in 5 and falling injury in 1.The course of diseases ranged from 6 months to 5 years with a mean of 2.5 years.The length of stricture segment was from 3.0 to 5.5 cm.All cases were surgically treated via transpubic approach and pedicled greater omentum displacement. Results Good operative results were achieved in all 6 cases.Each of them could urinate when the catheter was taken out 4 weeks later,and no urinary incontinence,urinary tract infection were observed.All were followed up for a median period of 26 months (ranged from 6 to 38 months).4 patients had normal micturition with no need of urethral dilatation and 2 patients reencountered dysuria in 3 months and were all cured by the administration of urethral dilatation for 3 to 24 months. Conclusions This procedure has a higher success rate.It is suitable for those with complicated posterior urethral stricture,such as longer posterior urethral stricture,urethra-rectal fistula, false passage, and especially those having experienced failure of urethra repair via perineal approach. It can be regarded as one of the ideal and effective therapeutic methods for complex posterior urethral stricture.

Objective To improve the differential diagnosis between benign renal mass and renal cell carcinoma(RCC) so as to lower the misdiagnosis rate. Methods This study included 12 cases of renal mass,whose age ranged from 35 to 69 years with a mean of 52 years.Among the 12 cases,flank pain occurned in 9,2 of whom had gross hematuria.Three clinically asymptomatic cases were detected incidentally by ultrasound in physical examination.All the 12 cases underwent imaging examinations such as B-ultrasound and CT scan,and all of them were preoperatively diagnosed as RCC. Results All the cases were surgically treated.Seven underwent enucleation or simple nephrectomy because of the diagnosis of benign renal mass by intraoperative frozen section.Five underwent radical nephrectomy.None developed recurrence during follow-up of 1 to 3 years. Conclusions Clinicians should not overestimate the diagnostic significance of imaging examinations such as CT and ultrasonography.For cases who have no definite diagnosis,surgical exploration can be performed.Intraoperative frozen section by pathologic study can increase correct diagnostic rate. Most of the misdiagnosed benign renal masses have different imaging features from those of RCC.

Objective To improve the prevention and treatment level of child traumatic posterior urethral stricture. Methods This series included 22 male children (mean age 9 years) with pelvic fracture complicated by posterior urethral disruption.A medical nylon string was indwelled after uretheral reunion operation.Urethral stricture recurred in 9 patients 3 months after the operation,and they were all cured by performance of urethra dilatation with self-designed single J tube under the guidance of the medical nylon string. Results All of the 9 were doing well during the operation.The medical nylon string was not taken out until dysuria disappeared completely.The cure rate was 100%.All the cases were followed up for a mean period of 15 months(range,3 to 24 months).All had normal urination. Conclusions Application of self-designed single J tube and medical nylon string is effective,simple and economical for the treatment of child traumatic posterior urethral stricture.It is easy both for the doctors' training and for the children's cooperation.Thus,it provides a new approach for the prevention and treatment of child traumatic posterior urethral stricture.

Initiation of insulin therapy is challenging in the primary care setting without nursing support. Doctors have to prepare their practices to deal with these challenges in order not to delay insulin therapy when needed.