Objective To evaluate the measurement of kappa and lambda immunoglobulin free light chains(FLC) in patient samples using a new enzyme-linked immunosorbent assay for early diagnosis of multiple myeloma.Methods An ELISA method for quantifying kappa and lambda free light chains were used to study serum and urine samples from patients with multiple myeloma, and the results were compared with those obtained using immunofixation electrophoresis and nephelometric immunoassay methods. Results The FLC-ELISA method had great successful rate in identifying the multiple myeloma in all 40 myeloma patients. In contrast,immunofixation electrophoresis and nephelometric immunoassay could only identify 57.5% and 85.5% of the multiple myeloma in all the myeloma patients,respectively. Furthermore, retrospective diagnosis of specimens obtained from patient indicated that the ELISA method could help early diagnosis of the disease by over two years. Conclusion The ELISA method for measuring free light chains is sensitive, accurate and reproducible. Therefore it is a useful tool for early diagnosis of multiple myeloma,monitoring the disease progression and evaluating treatment responses.

Objective To investigate the clinical features and bronchoalveolar lavage (BAL)therapy of postinfectious bronchiolitis obliterans (BO) in children. Method Ten children, who had post-infectious BO from February 2009 to February 2010, received BAL therapy, and were retrospectively analyzed. The data included pathology,chnical feature,chest HRCT scan, BALF cellular, levels of blood T cell subtypes and outcome of BAL therapy. Results Adenoviruses or mycoplasma pneumoniae were the most common etiologic agents (4/10, respectively). All patients presented persistent or recurrent dyspneic respirations and wheezing since the initial lung infection. The findings of HRCT included mosaic pattern of perfusion (6/10), accompanied by gas retention,bronchiectasis, atelectasis and bronchial wall thickening. The percentage of neutrophils in BALF was significantly increased in all cases (10/10). There were predominance of CD8+ T cell subtype (9/10) and lower ratio of CD4 +/CD8+ ( 10/10)in blood. Reduced symptoms and shortened hospital stay of BO in 9 of all 10 cases were observed after BAL therapy. Conclusions Severe adenovirus or mycoplasma pneunoniae bronchiolitis and/or pneumonia has higher risk for developing BO in children. Increased percentage of neutrophils in BALF and predominance of CD8 +T cell subtype may play an important role in the mechanism of BO. BAL therepy can reduce the respiratory symptoms of BO in children.

OBJECTIVE: To determine the clinical effect of standardized training and management of peripherally inserted central catheter (PICC) and catheter-related complications. METHODS: A total of 610 patients were divided into a control group and an observation group, the control group (n=300) were catheterized by trainees who received "short-term intensive training", the observation group (n=310) by "system standardized training and management". The clinical efficacy of catheterization and the rate of catheter-related complications were compared. RESULTS: There was significant difference in the one-time puncture success rate, one-time cannulation success rate, the time for operation and the pain score between the 2 groups (all P<0.01), and there was also significant difference in the occurrence of catheter extrusion, plug, arrhythmia, catheter-related thrombosis, phlebitis, puncture point effusion and catheter-related infection between the 2 groups (all P<0.05). CONCLUSION Standardized PICC training and management can improve the effect of catheterization and reduce the incidence of PICC-related complication.
Catheter-Related Infections ; prevention & control ; Catheterization, Peripheral ; methods ; Humans ; Incidence ; Inservice Training ; Thrombosis

Objective To investigate the application of quality control circle ( QCC) intravenous therapy to enhance the quality and reduce the PICC complication rate. Methods Established QCC team and the theme of“Reduce the incidence of PICC complications”, we surveyed, analyzed, set goals, developed and implemented measures to further confirm the effectiveness and standardization. Results After QCC application, PICC overall complication rate, the incidence of plugging and thrombosis were significantly lower than before the application, the differences were statistically significant (χ2 =21. 338,12. 032,7. 684;P<0. 01). After QCC application, quality control practices of QCC members, team cohesion, communication and coordination, degree of harmony, job motivation, self-confidence were higher than these of before activities (P <0. 01). Conclusions The application of QCC can reduce overall complication rate of PICC plugging and thrombosis, and promote continuous intravenous therapy quality improvement, improved nurses motivation, personal values, team cohesion and communication skills. It is worthy of promotion.