The serum immunoglobulin-free light chain (FLC) assay measures levels of free ? and ? immunoglobulin light chains and is an invaluable tool in the evaluation and management of multiple myeloma and related plasma cell disorders (PCD).The serum FLC assay in combination with serum protein electrophoresis (SPEL) and immunofixation yields high sensitivity of screening,and negates the need for 24 h urine studies for diagnoses other than light chain amyloidosis (AL).The baseline FLC measurement is of major prognostic value in virtually every PCD.The FLC assay allows for quantitative monitoring of patients with oligosecretory PCD,including AL,oligosecretory myeloma and non-secretory myeloma.In AL patients,serial FLC measurements outperform SPEL and immunofixation.

Objective To analyze the correlation between students' scores and master degree of knowledge points in the close examination of the unit introduction of nursing. Methods A classification decision tree model was used to analyze the relationship between students' achievement and knowledge points in 321 grade 2014 nursing students. Results There were 20 knowledge points in the paper, 7 of which had significant influence on scores; there were 27 nodes,16 of which were leaf nodes; the overall predicted percentage was 86.0%. Conclusions The total score is related to knowledge score; the total score of gifted students is higher;and for total score of medium students is medium;and for total score of poor is lower. Measures to reform teaching methods and evaluation scheme should be taken.

Autologous stem cell transplant (ASCT) is a potentially curative therapy for patients with relapsed and refractory or aggressive non Hodgkin ' s lymphoma, relapse is still common and is caused by high levels of tumour cell burden in the host and contamination of the stem cells with tumour cell. To improve effect of ASCT, ① in vivo puring with riluximab in pre transplant, depletion of B cells from the peripheral blood and clear the contamination of the malignant cells; ②the combination chemotherapy replace with rilumixab and non cross resistance drug in post transplant, killing tumour cells in the host; (3)involved field radiation therapy(IFRT) as a adjunct to pre or post transplant, reducing the relapse rate.

B-cell lymphomas(BCL) are the most frequent types of lymphoma and encompasses different entites with variable clinical behavior and diverse molecular features. In general terms, it can be subdivided into 2 main groups, low- and high-growth fraction lymphomas. In low-growth fraction lymphomas, cell accumulation can be achieved through the inhibition of apoptosis without a very severe deregulation of cell proliferation. In contrast, high-growth fraction BCL are characterized by an enhanced proliferative activity, as a result of the deregulation of oncogenes with cell cycle regulatory functions, such as Bcl 6 and c-myc. A fraction of both low- and high-growth lymphomas acquire additional alterations in cell cycle control, usually involving cyclin-dependent kinase inhibitors and evolve to highly aggressive tumors.

Acetylation of lysine residues of core histone N-terminal domains has been found correlatively associated with transcriptional activation in eukaryotes. Recent studies showed that some transcriptional regulators with histone acetyltransferase(HAT) and deacetylase(HDAC) activities may play a causative role in regulating gene expression. The link between tumorigenic processes and misregulated or mistargeted HAT and HDAC activities has been reported.

Objective: To study the protective effect of coenzyme Q_10 on red blood cell membrane and its immunity in patient during extracorporeal circulation. Method: Twenty patients under extracorporeal circulation about 30 minutes were randomly divided into control group and coenzyme Q_10 group (n=10). Coenzyme Q_10 2mg/kg was added to the priming fluid in coenzyme Q_10 group. Plasma levels of malondialdehyde (MDA), free hemoglobin (FHb), immune adhe sion ability and immune compound of red blood cell membrane were measured before extracorporeal circulation, 15 and 30 minutes after beginning of cardiopulmonary bypass, and on first day morning after operation. Result; All different periods after beginning of cardiopulmonary bypass in coenzyme Q_10, group, MDA and FHb levels were lower and im mune adhesion ability was higher than those of control group. Conclusion: Coenzyme Q_10 may protect red blood cell membrane and its immunity of patient during extracorporeal circulation.

The paper expounds the connotation of HIS troubles, the methods for determining HIS troubles and the necessity of establishing a contingency plan for clearing such troubles. It also puts forward some specific measures for managing the contingency plan: ①defining the accountability and division of work in clearing various kinds of troubles; ②doing a good job of coordination in clearing troubles; ③carrying out strict training for the relevant personnel; and ④conducting checks and supervision all the time. Establishment of the plan makes it clear to HIS managers that enough attention ought to be paid to the prevention of troubles.

Post management should replace capacity management in the reform of the personnel system in the health sector. The authors expound in the first place the connotations and the necessity of post management, and then discuss respectively three key links, viz. change of ideological concepts of people at various levels in the implementation of post management; establishment of necessary setups and mechanisms for post management; and organic combination of responsibilities, powers and interests in post management. Finally the authors put forward the following viewpoints in light of Tongren Hospital's practice in adopting post management: ①setting up a primary personnel system based on double engagements; ②setting up a system of selecting key members for posts based on a mechanism of post reward, such as the classification of chief experts into three classes; ③setting up a managerial mechanism conducive to the rational flow of personnel; ④conducting checks so as to provide basis for distributing appropriate salaries, with the elements of management, expertise and responsibilities taken into consideration in the distribution. The effects are also discussed.

Objective To investigate the changes of serum and urinary adiponectin (ADPN) levels and insulin resis-tance (IR) states in patients with chronic kidney disease (CKD), and to explore their relationship thereof. Methods A total of 487 patients with CKD stages 2-5 were enrolled in this study, and 30 healthy subjects were served as control group. The se-rum ADPN levels in urine samples were examined by ELISA. The level of fasting insulin (FINS) was detected by radioimmu-noassay. Blood routine test, liver and kidney functions, blood glucose, serum lipids, 24 h urinary protein excretion and endoge-nous creatinine clearance rate (Ccr) and body mass index (BMI) were observed and calculated. The differences of ADPN lev-els in serum and urine samples and homeostasis model assessment for insulin resistance (Homa-IR) were compared between groups. Results The serum and urine ADPN levels and Homa-IR were higher in CKD patients than those of controls (P＜0.05). With the decline in renal function, the ADPN and Homa-IR levels were increased gradually (P＜0.05). The value of se-rum ADPN was significantly higher in patients with CKD stages 3-5 and high Homa-IR. The ADPN levels and Homa-IR were positively related to lipid parameters and 24 h urinary protein, and negatively correlated with hemoglobin and serum al-bumin in patients with CKD (P ＜ 0.05). Conclusion CKD patients had higher ADPN level and more significant IR. The ADPN and IR were correlated with serum lipids, hemoglobin, albumin and urinary protein. Dynamic monitor of ADPN level may have clinical significance in judging metabolic disorders in CKD patients.

0.05).Different work environments showed a specific influence on the percentage of CD3+,CD3+CD4+,CD3+CD8+ and CD3-CD19+ cells.When the naval personnel were divided into A,B and C groups according to extent of exposure to electromagnetic radiation(A