Influence of Standardized Nursing Intervention Combined with Mindfulness Stress Reduction Training on the Curative Effect, Negative Emotion, and Quality of Life in Patients with Chronic Gastritis and Gastric Ulcer.

OBJECTIVE: To explore the curative effect of standardized nursing intervention combined with mindfulness stress reduction training in patients with chronic gastritis and gastric ulcer and its influence on negative emotion and quality of life. METHODS: Total of 146 patients with chronic gastritis and gastric ulcer admitted to our hospital from August 2018 to February 2020 were collected and divided into the control group (n = 73) and study group (n = 73) according to patients' wishes and the random number method. The control group received traditional nursing measures. The study group received standardized nursing intervention combined with mindfulness stress reduction training. The general data, nursing efficiency, negative emotions, self-efficacy, quality of life, and nursing satisfaction of the two groups were recorded. RESULTS: The nursing effective rate of the study group (91.78%) was higher than the control group (79.45%) (P < 0.05). After intervention, the self-rating anxiety scale score and self-rating depressive scale score of the study group were lower than the control group (P < 0.05). After intervention, the general self-efficacy scale score and the generic quality of life inventory-74 scores of the study group were higher than the control group (P < 0.05). The nursing satisfaction rate of the study group (89.04%) was higher than the control group (75.34%) (P < 0.05). CONCLUSION: Standardized nursing intervention combined with mindfulness stress reduction training has a good curative effect in patients with chronic gastritis and gastric ulcer, which is beneficial to reduce negative emotions, increase self-efficacy, improve quality of life, and improve nursing satisfaction.

Bidentate and tridentate metal-ion coordination states within ternary complexes of RB69 DNA polymerase.

Two divalent metal ions are required for primer-extension catalyzed by DNA polymerases. One metal ion brings the 3'-hydroxyl of the primer terminus and the α-phosphorus atom of incoming dNTP together for bond formation so that the catalytically relevant conformation of the triphosphate tail of the dNTP is in an α,ß,γ-tridentate coordination complex with the second metal ion required for proper substrate alignment. A probable base selectivity mechanism derived from structural studies on Dpo4 suggests that the inability of mispaired dNTPs to form a substrate-aligned, tridentate coordination complex could effectively cause the mispaired dNTPs to be rejected before catalysis. Nevertheless, we found that mispaired dNTPs can actually form a properly aligned tridentate coordination complex. However, complementary dNTPs occasionally form misaligned complexes with mutant RB69 DNA polymerases (RB69pols) that are not in a tridentate coordination state. Here, we report finding a ß,γ-bidentate coordination complex that contained the complementary dUpNpp opposite dA in the structure of a ternary complex formed by the wild type RB69pol at 1.88 Å resolution. Our observations suggest that several distinct metal-ion coordination states can exist at the ground state in the polymerase active site and that base selectivity is unlikely to be based on metal-ion coordination alone.

Structural insights into complete metal ion coordination from ternary complexes of B family RB69 DNA polymerase.

We have captured a preinsertion ternary complex of RB69 DNA polymerase (RB69pol) containing the 3' hydroxyl group at the terminus of an extendable primer (ptO3') and a nonhydrolyzable 2'-deoxyuridine 5'-α,ß-substituted triphosphate, dUpXpp, where X is either NH or CH(2), opposite a complementary templating dA nucleotide residue. Here we report four structures of these complexes formed by three different RB69pol variants with catalytically inert Ca(2+) and four other structures with catalytically competent Mn(2+) or Mg(2+). These structures provide new insights into why the complete divalent metal-ion coordination complexes at the A and B sites are required for nucleotidyl transfer. They show that the metal ion in the A site brings ptO3' close to the α-phosphorus atom (Pα) of the incoming dNTP to enable phosphodiester bond formation through simultaneous coordination of both ptO3' and the nonbridging Sp oxygen of the dNTP's α-phosphate. The coordination bond length of metal ion A as well as its ionic radius determines how close ptO3' can approach Pα. These variables are expected to affect the rate of bond formation. The metal ion in the B site brings the pyrophosphate product close enough to Pα to enable pyrophosphorolysis and assist in the departure of the pyrophosphate. In these dUpXpp-containing complexes, ptO3' occupies the vertex of a distorted metal ion A coordination octahedron. When ptO3' is placed at the vertex of an undistorted, idealized metal ion A octahedron, it is within bond formation distance to Pα. This geometric relationship appears to be conserved among DNA polymerases of known structure.

Base selectivity is impaired by mutants that perturb hydrogen bonding networks in the RB69 DNA polymerase active site.

To investigate the molecular basis for the selective utilization of nucleoside triphosphates complementary to templating bases, by RB69 DNA polymerase (RB69 pol), we constructed a set of mutants that we predicted would perturb the "floor" of the nascent base-pairing interface in the enzyme. We then determined the pre-steady-state kinetic parameters for the incorporation of complementary and noncomplementary dNTPs by the exo(-) form of RB69 pol and its mutants. We found that the Y567A mutant had the same K(d) and k(pol) values for incorporation of C versus G as the wild-type exo(-) enzyme; however, the k(pol)/K(d) ratio for G versus G incorporation with the Y567A mutant was 10 times higher than the k(pol)/K(d) efficiency of G versus G incorporation using the exo(-) RB69 pol. The reduced level of discrimination by the Y567A mutant against incorporation of mismatched bases was also seen with the Y391A mutant. Stopped-flow fluorescence was also employed to monitor rates of putative conformational changes with the exo(-) RB69 pol and its mutants using a primer-template complex containing 2-aminopurine. The rates of fluorescence changes were equal to or greater than the rates of the rapid chemical quench, indicating that we were monitoring a process occurring before or during the phosphoryl transfer reaction. We have interpreted our results within the context of the crystal structure of the RB69 pol ternary complex [Franklin, M. C., et al. (2001) Cell 105, 657-667].