简介：Therehasbeenaparadigmshiftinmedicineawayfromtradition,anecdoteandtheoreticalreasoningfromthebasicsciencestowardsevidence-basedmedicine(EBM).Inpalliativecarehowever,statisticallysignificantbenefitsmaybemarginalandmaynotberelatedtoclinicalmeaningfulness.Thetypicaltreatmentvs.placebocomparisonnecessitatedby‘goldstandard'randomisedcontrolledtrials(RCTs)isnotnecessarilyapplicable.Thecomplexmultimorbidityofendoflifecareinvolvesconsiderationsofthepatient'sphysical,psychological,socialandspiritualneeds.Inaddition,thefieldofpalliativecarecoversaheterogeneousgroupofchronicandincurablediseasesnolongerlimitedtocancer.Adequatesamplesizescanbedifficulttoachieve,reducingthepowerofstudiesandhighattritionratescanresultininadequatefollowupperiods.Thisreviewusesexamplesofthemanagementofcancer-relatedfatigueanddeathrattle(noisybreathing)todemonstratethecurrentstateofEBMinpalliativecare.ThefutureofEBMinpalliativecareneedstobeasdiverseasthepatientswhoultimatelyderivebenefit.Non-RCTmethodologiesofequivalentquality,validityandsizeconductedbycollaborativeresearchnetworksusinga‘mixedmethodsapproach'arelikelytoposethecorrectclinicalquestionsandderiveevidencebasedyetclinicallyrelevantoutcomes.

简介：Glyceraldehyde-3-phosphatedehydrogenase(GAPDH),initiallyidentifiedasaglycolyticenzymeandconsideredasahousekeepinggene,iswidelyusedasaninternalcontrolinexperimentsonproteins,mRNA,andDNA.However,emergingevidenceindicatesthatGAPDHisimplicatedindiversefunctionsindependentofitsroleinenergymetabolism;theexpressionstatusofGAPDHisalsoderegulatedinvariouscancercells.OneofthemostcommoneffectsofGAPDHisitsinconsistentroleinthedeterminationofcancercellfate.Furthermore,studieshavedescribedGAPDHasaregulatorofcelldeath;otherstudieshavesuggestedthatGAPDHparticipatesintumorprogressionandservesasanewtherapeutictarget.However,relatedregulatorymechanismsofitsnumerouscellularfunctionsandderegulatedexpressionlevelsremainunclear.GAPDHistightlyregulatedattranscriptionalandposttranscriptionallevels,whichareinvolvedintheregulationofdiverseGAPDHfunctions.Severalcancer-relatedfactors,suchasinsulin,hypoxiainduciblefactor-1(HIF-1),p53,nitricoxide(NO),andacetylatedhistone,notonlymodulateGAPDHgeneexpressionbutalsoaffectproteinfunctionsviacommonpathways.Moreover,posttranslationalmodifications(PTMs)occurringinGAPDHincancercellsresultinnewactivitiesunrelatedtotheoriginalglycolyticfunctionofGAPDH.Inthisreview,recentfindingsrelatedtoGAPDHtranscriptionalregulationandPTMsaresummarized.MechanismsandpathwaysinvolvedinGAPDHregulationanditsdifferentrolesincancercellsarealsodescribed.

简介：Purposes:Wereportedtherolesandfunctionsofnursesinhomevisitsforbraintumorpatientsusingthefamilyhealthassessmentguideinthestudy.Methods:Onepatientofbraingliomawaschosenasthecaseillustration.Thenursesassessedthepatients’situation,theirfamiliesandlivingenvironmentindividually.Allthesefactorswereanalyzedtogether.Results:Thenursesthenimplementedtheirknowledgeandskillstoadoptdifferentmeasuresindifferentconditions,investigatedthepatients’healthproblemsandcarriedoutpersonalizedeffectiveactions.Conclusions:Nursesshouldputeffortintocommunitynursingtoallowpatientstoliveinasafeenvironment,tosatisfythehealthneedsofhumanbeingandtheirneedsforhealthknowledge,andenhancetheirself-careabilities.