[Applying Swanson's Theory of Caring to Manage a Patient With Cellulitis].

This case report describes a nursing care experience that applied Swanson's Caring Theory to a patient who was suffering from the rapid progression of cellulitis, which had impaired physical mobility and induced anxiety. The associated health problems, including infection, impaired physical mobility, and anxiety, were affirmed after an integrated physical, psychological, social, and spiritual assessment was conducted during the nursing care period, which lasted between March 8th and March 22nd, 2020. After Applying Swanson's Caring Theory through five caring processes, the therapeutic relationships with the patient and his family members were established and their concerns and care needs were well known. Emotional support was provided through listening and accompaniment. In addition, the patient was encouraged to participate in strength training to improve physical mobility and maintain a positive outlook. In line with this, diaphragmatic breathing, muscle relaxation, shoulder massage, and divided attention were used to reduce anxiety and to assist the patient to face life after discharge positively and optimistically. It is hoped that this case report provides medical staffs with a reference for providing care to patients suffering from cellulitis, physical impairment, and anxiety.

Crystal structures of Bacillus cereus NCTU2 chitinase complexes with chitooligomers reveal novel substrate binding for catalysis: a chitinase without chitin binding and insertion domains.

Chitinases hydrolyze chitin, an insoluble linear polymer of N-acetyl-d-glucosamine (NAG)(n), into nutrient sources. Bacillus cereus NCTU2 chitinase (ChiNCTU2) predominantly produces chitobioses and belongs to glycoside hydrolase family 18. The crystal structure of wild-type ChiNCTU2 comprises only a catalytic domain, unlike other chitinases that are equipped with additional chitin binding and insertion domains to bind substrates into the active site. Lacking chitin binding and chitin insertion domains, ChiNCTU2 utilizes two dynamic loops (Gly-67-Thr-69 and Ile-106-Val-112) to interact with (NAG)(n), generating novel substrate binding and distortion for catalysis. Gln-109 is crucial for direct binding with substrates, leading to conformational changes of two loops with a maximum shift of ∼4.6 Šalong the binding cleft. The structures of E145Q, E145Q/Y227F, and E145G/Y227F mutants complexed with (NAG)(n) reveal (NAG)(2), (NAG)(2), and (NAG)(4) in the active site, respectively, implying various stages of reaction: before hydrolysis, E145G/Y227F with (NAG)(4); in an intermediate state, E145Q/Y227F with a boat-form NAG at the -1 subsite, -1-(NAG); after hydrolysis, E145Q with a chair form -1-(NAG). Several residues were confirmed to play catalytic roles: Glu-145 in cleavage of the glycosidic bond between -1-(NAG) and +1-(NAG); Tyr-227 in the conformational change of -1-(NAG); Asp-143 and Gln-225 in stabilizing the conformation of -1-(NAG). Additionally, Glu-190 acts in the process of product release, and Tyr-193 coordinates with water for catalysis. Residues Asp-143, E145Q, Glu-190, and Tyr-193 exhibit multiple conformations for functions. The inhibitors zinc ions and cyclo-(l-His-l-Pro) are located at various positions and confirm the catalytic-site topology. Together with kinetics analyses of related mutants, the structures of ChiNCTU2 and its mutant complexes with (NAG)(n) provide new insights into its substrate binding and the mechanistic action.

Increased incidence of allergic rhinitis, bronchitis and asthma, in children living near a petrochemical complex with SO2 pollution.

This study aims to investigate incidence of allergic rhinitis, bronchitis and asthma, in children living near a petrochemical complex with SO2 pollution obtained by air monitoring stations. A total of 587 children aged 11 to 14 were recruited and classified into high and low exposure groups based on a radius of 10km from the complex. To study the influence of health on children since the operation of complex in 1999 and observe the difference of these diseases' short-term and long-term impact, we obtained the incidence rates of allergic rhinitis (ICD-9: 477), bronchitis (490-491) and asthma (493) from the Taiwan Health Insurance Database for three periods: 1999-2002, 1999-2006, and 1999-2010. Since 2001, the mean and 99th percentile of SO2 concentrations in the high exposure area have been significantly higher than those in low exposure area. There were significant differences between the high and low exposure groups in the percentage of smoking, alcohol consumption, passive smoking exposure and incense burning habits. The incidence rates of three intervals were 26.9%, 35.7%, 41.7%; 8.3%, 8.8%, 10.2%; 18.5%, 25.0%, 26.9% for allergic rhinitis, bronchitis and asthma in high exposure group. Significant differences were found between groups for allergic rhinitis in all periods, bronchitis in the first two periods, and asthma in the first period using Student's t-test. After we adjusted age, gender, group, living near roads, incense burning and passive smoking exposure, the hazard ratios between exposure groups were 3.05, 2.74, and 1.93 for allergic rhinitis with significant difference in three periods, and 2.53, 1.92 and 1.72 for bronchitis with significant difference in first period and 1.60, 1.28 and 1.29 for asthma with significant difference in first period by Cox regression. The higher incidence of allergic rhinitis was related to boys and living near roads and the higher incidence of asthma was also related to younger children, boys, and passive smoking exposure.

Induction of primitive pigment cell differentiation by visible light (helium-neon laser): a photoacceptor-specific response not replicable by UVB irradiation.

Solar lights encompass ultraviolet (UV), visible, and infrared spectrum. Most previous studies focused on the harmful UV effects, and the biologic effects of lights at other spectrums remained unclear. Recently, lights at visible region have been used for regenerative purposes. Using the process of vitiligo repigmentation as a research model, we focused on elucidating the pro-differentiation effects induced by visible light. We first showed that helium-neon (He-Ne) laser (632.8 nm) irradiation stimulated differentiation of primitive pigment cells, an effect not replicable by UVB treatment even at high and damaging doses. In addition, significant increases of mitochondrial DNA copy number and the regulatory genes for mitochondrial biogenesis were induced by He-Ne laser irradiation. Mechanistically, we demonstrated that He-Ne laser initiated mitochondrial retrograde signaling via a Ca(2+)-dependent cascade. The impact on cytochrome c oxidase within the mitochondria is responsible for the efficacy of He-Ne laser in promoting melanoblast differentiation. Taken together, we propose that visible lights from the sun provide important environmental cues for the relatively quiescent stem or primitive cells to differentiate. In addition, our results also indicate that visible light may be used for regenerative medical purposes involving stem cells.