[Microwave ablation versus radiofrequency ablation for solid or predominantly solid benign thyroid nodules: a randomized controlled clinical trial].

Objective: To compare the short-term efficacy and the safety of microwave ablation (MWA) and radiofrequency ablation (RFA) in the treatment of benign thyroid nodules (BTNs). Methods: This prospective randomized controlled trial, performed from December 2019 to September 2021, included 36 patients with solid or predominantly solid BTNs who met the eligibility criteria and provided written informed consent at the Nanjing sub-center (Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine). Patients were assigned to either the MWA group or the RFA group (18 patients in each group) at a ratio of 1∶1 using a block randomization design and allocation concealment using sealed envelope randomization. The independent-sample t-test and χ2 test were used to compare the volume reduction rates (VRRs), effective rates (VRRs≥50%), cosmetic scores, and complication rates at 1, 3, and 6 months after treatment between the two groups. Results: The clinical characteristics of the two groups of patients were comparable. After ablation, the nodule volume was significantly reduced in both groups. At 1, 3, and 6 months, there was no significant difference in the volume between the two groups (all P>0.05). At 3 months, the RFA group had a larger VRRs than that in the MWA group (62.08%±12.46% vs. 46.90%±23.16%, t=-2.45, P=0.021). However, at 1 and 6 months, no statistical significance was observed (both P>0.05). No significant difference was observed in the effective rates at the last follow-up (14/18 vs. 18/18, P=0.104). However, the RFA group had a lower cosmetic score than that in the MWA group (1.78±0.43 vs. 2.17±0.51, t=-2.47, P=0.019). There was no statistically significant difference in the complication rates between the two groups (all P>0.05). Conclusions: Both MWA and RFA were effective and safe treatments for BTNs, with no significant differences in short-term efficacy and safety. In addition, the RFA group showed slightly more favorable outcomes than the MWA group in terms of cosmetic improvement.

The therapeutic effect of decitabine combined with HAG in acute myeloid leukemia: a retrospective case-control analysis.

OBJECTIVE: Explore the efficacy of decitabine combined with homoharringtonine + cytarabine + granulocyte colony-stimulating factor (HAG) in the treatment of acute myeloid leukemia (AML). PATIENTS AND METHODS: A retrospective analysis of clinical data of 125 patients with AML was done. Of them, 61 patients received a simple HAG treatment (HAG group), and 64 received decitabine combined with an HAG regimen (combined group). Treatment efficacy, immune function before and after the treatment, levels of basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), and incidence of adverse reactions in the two groups were compared. RESULTS: The total response rate of the combined group (84.38%) was higher than that of the HAG group (65.63%) (p < 0.05). After the treatment, levels of CD4+ and CD4+/CD8+ in both groups increased and were significantly higher in the combined group compared to the HAG group. Levels of CD8+, bFGF and VEGF decreased compared to pre-treatment levels and were significantly lower in the combined group than in the HAG group (p < 0.05). There was no significant difference in the rate of adverse reactions between the two groups (p > 0.05). CONCLUSIONS: Compared to HAG treatment alone, the combination of decitabine and HAG in the treatment of AML is safe, can significantly improve the immune function of the patients, regulate bFGF and VEGF levels, and improve overall treatment efficacy.

[Effect of equal temperature bladder irrigation in patients with transurethral resection of prostate: A meta-analysis].

OBJECTIVE: To evaluate the effect of equal temperature bladder irrigation on bladder spasm, postoperative bleeding, vital signs and discomfort of chills in patients of transurethral resection of prostate using meta-analysis. METHODS: Several electronic databases included Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biology Medicine (CBM) were searched systematically for published randomized controlled trial about equal temperature bladder irrigation in patients with transurethral resection of prostate before November 20, 2019. Two reviewers selected independently the literature in the light of the inclusion and exclusion criteria, assessed the risk of bias by quality assessment and extracted data which were consisted of clinical efficacy indexes, such as incidence of bladder spasm, severity of bladder spasm, incidence of tube plugging, amount of bladder flushing fluid, time of bladder flushing, heart rate, systolic pressure, diastolic pressure, and incidence of chills. Data were pooled using fixed-effects model or random-effects model, and the summary effect measure was calculated by risk ratio (RR) or mean difference (MD) and 95% confidence interval (95%CI). Meta-analysis was performed by Review Manager 5.3 Software. RESULTS: In the study, 13 randomized controlled trails met the requirement with a total of 2 033 patients of transurethral resection of prostate were included, of whom 1 015 were carried out with equal temperature bladder irrigation and 1 018 with room temperature bladder irrigation. The results of meta-analysis showed that incidence of bladder spasm [RR=0.51, 95%CI (0.45, 0.57), P < 0.001], severity of bladder spasm [MD=-1.61, 95%CI (-2.00, -1.23), P < 0.001], incidence of urinary blockage [RR=0.29, 95%CI (0.19, 0.44), P < 0.001], dosage of bladder irrigation [MD=-6.75, 95%CI (-7.33, -6.17), P < 0.001], time of bladder rinse [MD=-7.60, 95%CI (-11.91, -3.29), P < 0.001], heart rate [MD=-13.68, 95%CI (-15.19, -12.17), P < 0.001], systolic pressure [MD=-29.26, 95%CI (-31.92, -26.59), P < 0.001], diastolic pressure [MD=-29.36, 95%CI (-31.75, -26.98), P < 0.001], incidence of chills and discomfort [MD=0.37, 95%CI (0.31, 0.44), P < 0.001] in equal temperature group of the patients with transurethral resection of prostate had significantly statistical difference compared with room temperature group. CONCLUSION: Based on current available evidence, equal temperature bladder irrigation reduced the incidence of bladder spasm and urinary blockage, relieved bladder spasm, reduced dosage and time of bladder irrigation, and hardly affected normal vital signs and increased the patient' s comfort.

Postoperative pulmonary complications in older patients undergoing elective surgery with a supraglottic airway device or tracheal intubation.

The two most commonly used airway management techniques during general anaesthesia are supraglottic airway devices and tracheal tubes. In older patients undergoing elective non-cardiothoracic surgery under general anaesthesia with positive pressure ventilation, we hypothesised that a composite measure of in-hospital postoperative pulmonary complications would be less frequent when a supraglottic airway device was used compared with a tracheal tube. We studied patients aged ≥ 70 years in 17 clinical centres. Patients were allocated randomly to airway management with a supraglottic airway device or a tracheal tube. Between August 2016 and April 2020, 2900 patients were studied, of whom 2751 were included in the primary analysis (1387 with supraglottic airway device and 1364 with a tracheal tube). Pre-operatively, 2431 (88.4%) patients were estimated to have a postoperative pulmonary complication risk index of 1-2. Postoperative pulmonary complications, mostly coughing, occurred in 270 of 1387 patients (19.5%) allocated to a supraglottic airway device and 342 of 1364 patients (25.1%) assigned to a tracheal tube (absolute difference -5.6% (95%CI -8.7 to -2.5), risk ratio 0.78 (95%CI 0.67-0.89); p < 0.001). Among otherwise healthy older patients undergoing elective surgery under general anaesthesia with intra-operative positive pressure ventilation of their lungs, there were fewer postoperative pulmonary complications when the airway was managed with a supraglottic airway device compared with a tracheal tube.

[Effectiveness and safety of ultrasound-guided microwave ablation for the treatment of primary hyperparathyroidism in 12 patients with parathyroid adenoma].

To investigate the effectiveness and safety of ultrasound-guided microwave ablation (MWA) in treatment of primary hyperparathyroidism (PHPT). A total of 12 PHPT patients with parathyroid adenoma were treated with MWA in Nanjing University of Chinese Medicine Affiliated Hospital of Integrated Traditional Chinese and Western Medicine from May 2019 to February 2021. The patients were followed up once every 3 months for 3-12 months. Levels of serum parathyroid hormone (PTH), calcium and phosphorus were detected before and 20 min, 4h and 1day after ablation, and during follow-up period. The volume and volume reduction rate of parathyroid lesion were compared before the treatment and at the end of follow-up. The technical and clinical success of MWA were assessed as well. At the end of follow-up, median serum PTH [66.60 (42.21,80.03) ng/L vs.169.90 (89.01,396.50) ng/L] and calcium [2.39 (2.32,2.49) mmol/L vs. 2.75 (2.57,2.96) mmol/L] levels in 12 patients decreased significantly (all P<0.05). A complete response in terms of PTH and calcium levels was achieved in 6 of the 12 patients, while 4 of the patients had slightly elevated PTH levels just above the upper limit of normal reference range, and 2 of the patients remained abnormal PTH and calcium levels. The clinical cure rate was 50%. The volumes of all lesion after ablation were significantly decreased (P<0.05), with the technical success rate reaching 92.3%. No serious complications were observed. Ultrasound-guided MWA, thus, is safe and effective in the treatment of PHPT.

[Study on the sensitivity of multi-slice spiral CT in diagnosis of lymph node metastasis in different lymph node stations of gastric cancer].

Objective: To study the sensitivity of multi-slice spiral CT in the diagnosis of lymph node metastasis in different lymph node stations of gastric cancer. Methods: A retrospective series of case study was employed in the research. Inclusion criteria: (1) patients undergoing preoperative abdominal CT scan plus enhanced examination, and data in the image archiving and communication system of Sun Yat-sen University Cancer Center; (2) patients undergoing total or subtotal gastrectomy plus D2 or D1+ lymphadenectomy, with more than 15 harvested lymph nodes and more than 1 metastatic lymph node confirmed by postoperative pathology; (3) WHO pathological classification defined as gastric adenocarcinoma; (4) no history of lymph node tuberculosis, giant lymph node hyperplasia, lymphoma or other diseases resulting in enlarged lymph nodes; (5) no history of gastrectomy; (6) no preoperative neoadjuvant therapy. Clinicopathologic data of gastric cancer patients at the Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center from January 2009 to December 2012 were retrospectively analyzed. Using the pathologically positive lymph nodes as a reference, the sensitivity of CT-positive lymph nodes was calculated (total number of positive image lymph nodes/total number of positive pathological lymph nodes) and complete coincidence rate (number of case defined as complete coincidence/number of case with positive pathologic lymph nodes; complete coincidence indicated that the number of positive image lymph nodes was consistent with the number of positive pathologic lymph nodes in each lymph node station). The χ(2) test was used to compare the sensitivity of CT in the diagnosis of lymph node metastasis in each lymph node station. Results: A total of 228 patients with pathology-proven gastric cancer were enrolled in the study, including 147 male and 81 female. The overall sensitivity of CT in diagnosis of metastatic lymph nodes in gastric cancer was 68.7% (1769/2576). The sensitivity of CT in diagnosis of lymph node metastasis of groups 1 to 8 from high to low was group 3 [81.1% (506/624)], group 7 [73.9% (246/333)], group 2 [70.3% (111/158)], group 6 [68.7% (248/361)], group 4 [68.1% (262/385)], group 8 [60.4% (116/192)], group 1 [53.8% (155/288)], group 5 [47.1% (82/174)]. The CT diagnostic sensitivity of group 3 was significantly higher than the overall level (χ(2)=37.689, P<0.001). The CT diagnostic sensitivity of group 5 was significantly lower than the overall level (χ(2)=34.387, P<0.001). The CT diagnostic sensitivity of group 1 was also significantly lower than the overall level (χ(2)=25.918, P<0.001). Significant differences were not found in the CT diagnostic sensitivity of group 2, 4, 6, 7, 8 compared with the overall level (all P>0.05). The complete coincidence rate was 56.9% (536/942) between pathological positive lymph nodes and CT positive lymph nodes. The highest complete coincidence rate was observed in group 3 (68.0%, 123/181) and the lowest was in group 1 (41.4%, 46/111), whose difference was statistically significant (χ(2)=9.673, P=0.002). Conclusion: The sensitivity of CT in diagnosis of lymph nodes in different lymph node stations of gastric cancer is different.

MiR-485-5p inhibits metastasis and proliferation of osteosarcoma by targeting CX3CL1.

OBJECTIVE: To investigate the potential effect of miR-485-5p on the development of osteosarcoma (OA) and its relevant mechanism. PATIENTS AND METHODS: The expression level of miR-485-5p was detected in OA tissues and cells (MG-63) comparing with corresponding adjacent normal tissues and normal human osteoblastic cell lines (Hfob1.19), respectively. Luciferase assay was performed to evaluate the interaction between miR-485-5p and CX3CL1, the effects of miR-485-5p on MG-63 cells were determined by subsequent experiments including cell proliferation, expression level of CX3CL1, detection of invasion and migration capacities. RESULTS: In our present research, miR-485-5p was down-regulated in OA tissues and we got the same result in OA cells. In order to obtain potential target of miR-485-5p, we checked it in three publicly available algorithms, TargetScan, miRDB and microRNA. We found that CX3CL1 is a direct target of miR-485-5p, and Luciferase assays confirmed our hypothesis. The results showed that decreased expression of CX3CL1 resulting from the up-regulation of miR-485-5p could decelerate cell proliferation, invasion and migration in OA cells. CONCLUSIONS: We showed the suppressor function of miR-485-5p in OA by targeting CX3CL1, indicating that miR-485-5p/CX3CL1 axis might be a potential therapeutic target for the treatment of OA.

N-acetylcysteine attenuates subcutaneous administration of bleomycin-induced skin fibrosis and oxidative stress in a mouse model of scleroderma.

BACKGROUND: Several lines of evidence suggest that the generation of reactive oxygen species (ROS) is of major importance in the pathogenesis of scleroderma, and thus antioxidant therapy may be useful for patients with an impaired oxidative defence mechanism. AIM: To examine the effect of N-acetylcysteine (NAC) on skin fibrosis and oxidative stress in a bleomycin (BLM)-induced mouse model of scleroderma. METHODS: We used this mouse model to evaluate the effect of NAC on skin fibrosis and oxidative stress. Skin fibrosis was evaluated by histopathological examination and hydroxyproline content. To measure lipid peroxidation, we used a thiobarbituric acid-reactive species, malondialdehyde (MDA). Oxidative protein damage (carbonyl content) and the activities of catalase (CAT) and superoxide dismutase (SOD) were determined to evaluate oxidative stress in the skin tissue. RESULTS: Treatment with NAC attenuated the skin fibrosis induced by BLM, significantly reducing the MDA and protein carbonyl content in these mice. SOD activity in BLM-only mice and BLM plus NAC-treated mice was increased compared with control mice. However, there was no significant difference in skin SOD activity of mice treated with both BLM and NAC compared with those treated with BLM only. In addition, CAT activity was not altered in the BLM plus NAC mice. CONCLUSIONS: NAC treatment attenuates skin fibrosis in a BLM-induced mouse model of scleroderma, and this is associated with diminished oxidative stress. The results suggest that NAC may be a potential therapeutic agent for patients with scleroderma.

Insight into hepatocellular carcinogenesis at transcriptome level by comparing gene expression profiles of hepatocellular carcinoma with those of corresponding noncancerous liver.

Human hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. In this work, we report on a comprehensive characterization of gene expression profiles of hepatitis B virus-positive HCC through the generation of a large set of 5'-read expressed sequence tag (EST) clusters (11,065 in total) from HCC and noncancerous liver samples, which then were applied to a cDNA microarray system containing 12,393 genes/ESTs and to comparison with a public database. The commercial cDNA microarray, which contains 1,176 known genes related to oncogenesis, was used also for profiling gene expression. Integrated data from the above approaches identified 2,253 genes/ESTs as candidates with differential expression. A number of genes related to oncogenesis and hepatic function/differentiation were selected for further semiquantitative reverse transcriptase-PCR analysis in 29 paired HCC/noncancerous liver samples. Many genes involved in cell cycle regulation such as cyclins, cyclin-dependent kinases, and cell cycle negative regulators were deregulated in most patients with HCC. Aberrant expression of the Wnt-beta-catenin pathway and enzymes for DNA replication also could contribute to the pathogenesis of HCC. The alteration of transcription levels was noted in a large number of genes implicated in metabolism, whereas a profile change of others might represent a status of dedifferentiation of the malignant hepatocytes, both considered as potential markers of diagnostic value. Notably, the altered transcriptome profiles in HCC could be correlated to a number of chromosome regions with amplification or loss of heterozygosity, providing one of the underlying causes of the transcription anomaly of HCC.

Identification of genes expressed in human CD34(+) hematopoietic stem/progenitor cells by expressed sequence tags and efficient full-length cDNA cloning.

Hematopoietic stem/progenitor cells (HSPCs) possess the potentials of self-renewal, proliferation, and differentiation toward different lineages of blood cells. These cells not only play a primordial role in hematopoietic development but also have important clinical application. Characterization of the gene expression profile in CD34(+) HSPCs may lead to a better understanding of the regulation of normal and pathological hematopoiesis. In the present work, genes expressed in human umbilical cord blood CD34(+) cells were catalogued by partially sequencing a large amount of cDNA clones [or expressed sequence tags (ESTs)] and analyzing these sequences with the tools of bioinformatics. Among 9,866 ESTs thus obtained, 4,697 (47.6%) showed identity to known genes in the GenBank database, 2, 603 (26.4%) matched to the ESTs previously deposited in a public domain database, 1,415 (14.3%) were previously undescribed ESTs, and the remaining 1,151 (11.7%) were mitochondrial DNA, ribosomal RNA, or repetitive (Alu or L1) sequences. Integration of ESTs of known genes generated a profile including 855 genes that could be divided into different categories according to their functions. Some (8.2%) of the genes in this profile were considered related to early hematopoiesis. The possible function of ESTs corresponding to so far unknown genes were approached by means of homology and functional motif searches. Moreover, attempts were made to generate libraries enriched for full-length cDNAs, to better explore the genes in HSPCs. Nearly 60% of the cDNA clones of mRNA under 2 kb in our libraries had 5' ends upstream of the first ATG codon of the ORF. With this satisfactory result, we have developed an efficient working system that allowed fast sequencing of 32 full-length cDNAs, 16 of them being mapped to the chromosomes with radiation hybrid panels. This work may lay a basis for the further research on the molecular network of hematopoietic regulation.

Inhibitory effects of low-dose polymyxin B on hemorrhage-induced endotoxin/bacterial translocation and cytokine formation in rats.

The current experiments were performed to determine the effects of a subtherapeutic dose of polymyxin B sulfate on gut origin endotoxemia/bacterial translocation, and tumor necrosis factor (TNF) and interleukin-1 (IL-1) release following hemorrhagic shock (30 mm Hg, 90 min) in rats. The results showed that significant portal and systemic endotoxemia took place in the control group (portal, 0.269 to 0.845 endotoxin units (EU)/mL; systemic, 0.164 to 0.655 EU/mL), but not in the treatment group (except 0.5 hour in portal blood: 0.207 +/- 0.094 EU/mL). Concomitantly, the incidence of bacterial translocation to the mesenteric lymph nodes and viscera were reduced significantly at 0.5, 2, 6, and 24 hours postresuscitation in animals receiving polymyxin B (p < 0.05 to 0.01), whereas there were no differences with respect to number of translocating bacteria between the two groups (p > 0.05). Marked elevation of plasma TNF levels and IL-1 activities of peritoneal macrophages were also found in untreated controls at 0.5 to 2 hours (p < 0.05) and 6 to 24 hours (p < 0.05 to 0.01), respectively, but prevented by administration of low-dose polymyxin B. The 48-hour survival rate was improved from 41.7% in the control group to 75.0% in the treatment ones (p > 0.05). These data suggest that pretreatment with a subtherapeutic dose of polymyxin B is effective to inhibit hemorrhage-induced endotoxin/bacterial translocation from the gut and excessive TNF and IL-1 production.

The potential etiologic role of tumor necrosis factor in mediating multiple organ dysfunction in rats following intestinal ischemia-reperfusion injury.

Endogenous inflammatory cytokines may function as mediators in the development of remote organ damage in response to local ischemic insult. This study was designed to (a) explore the potential role of tumor necrosis factor (TNF) formation in the pathogenesis of systemic tissue injury, (b) determine the relationship between induction of TNF and gut-derived endotoxemia and/or bacterial translocation, and (c) evaluate the protective effect of anti-TNF monoclonal antibody (MoAb) for vital organs following intestinal ischemia-reperfusion in rats. Animals were subjected to superior mesenteric artery occlusion (SMAO) for 45 min. Systemic plasma TNF levels increased rapidly after the onset of reperfusion, reaching a peak value 2 h later (P < 0.01). TNF elevation was found to be associated with gut origin endotoxemia, where the maximal TNF levels occurred approximately 2 h after the initial appearance of endotoxin in portal vein. Prophylactic treatment with anti-TNF MoAb markedly blunted the elevation in plasma TNF levels and afforded protection from the development of hypotension, vital organs dysfunction, and metabolic acidosis. Significant improvement in 48-h survival rate was observed by administration of anti-TNF MoAb prior to inducing ischemia (P = 0.007). These findings suggest that intestinal ischemia-reperfusion could result in TNF production, which may play a key role in mediating subsequent septic response and systemic tissue injury. It seems likely that passage of endotoxin and bacteria from the gut can be responsible for the TNF formation

[The antimetastatic effects of BJA-II on nude mice with highly metastatic human ovarian carcinoma].

Nude mice with highly metastatic human ovarian carcinoma were treated with BJA-II. This new agent was made in our institute. Twenty-four experimental mice were divided into 4 groups with 6 mice each. The mice, according to the treatment given them, were designated as: the BJA-II group, the cisplatin group, the group with combination therapy and the control group. Treatment began on the 2nd day after tumor transplantation. For BJA-II, a dose of 16 mg per mouse per day was administered orally. The total dose each mouse received by the 53rd day was 848mg. The tumor growth inhibition rate was found to be 63.7% in the BJA-II group; the transplanted tumors disappeared in 2 mice. No significant difference in average tumor weight was found between the BJA-II group and the control group (P < 0.05). The antimetastatic effect of BJA-II (1 mouse with metastasis) was higher than that of the control group (4 mice with metastasis). The influences on the immunofunction of the host were observed: the increase of the peripheral WBC count, the increase of NK cell activity, the increase in the ratio of spleen weight to body weight, and the histiocyte increase in the lymph node sinuses, etc. All of these findings were better demonstrated in the BJA-II group than in the cisplatin group. The results indicate that BJA-II is provided with the effectiveness of inhibiting tumor growth, is antimetastatic and is capable of increasing the immunofunction of the host.

Nationwide survey of human parasite in China.

A nationwide survey of human parasites in China was conducted during 1988-1992, with a coverage of 30 provinces/autonomous regions/municipalities (P/A/M). A total of 2,848 pilot sites in 726 counties were selected by random sampling, and 1,477,742 individuals residing on were surveyed by fecal examination. The status of paragonimiasis, hydatid diseases, cysticercosis and trichinellosis were summarized through data review. The overall infection rate of intestinal parasites was 62.6% whereas at provincial level, the highest infection rate (94.7%) was recovered in Hainan, and the lowest (17.5%) in Heilong-jiang. A high proportion (43.3%) of polyparasitism among the infected population (882,080) was revealed. Altogether 56 species of parasites comprising protozoa (19), trematode (16), cestodes (8), nematodes (12) and thorny-headed worm (1) were discovered. During the survey a new species and several new records were documented. The number of the population infected with common intestinal parasites was estimated. The diversities of parasite distribution were noted in different nationalities as well as in varied occupations.

[The establishment of human ovarian carcinoma cell line HO-8910 and its characteristics].

A cell line designated HO-8910 was established in vitro from the ascitic fluid of a patient with poorly-differentiated ovarian papillary serous cyst-adenocarcinoma. The cell line grew well through 130 passages and showed malignant epithelial morphology under light and electron microscopes. The chromosome number varied widely from 45 to 300 and its model was 54(42%); The DNA index was 1.45 as measured by FCM method; Both of them showed aneuploidy. The cell line has the ability to secrete steroid sex hormones and also has hormone receptors. When transplanted into nude mice, the xenograft has similar pathological characteristic to the original. It is expected that this cell line would be of great help in the future study on ovarian carcinoma.

Malaria and its control in the People's Republic of China.

Malaria is one of the major parasitic diseases in China. During the past 40 years, large scale malaria control activities were conducted in the country relying on primary health care nets and community participation. The control of malaria was implemented according to the principles of adopting integrated measures and repeated practices which are characterized by time- and locality-oriented approaches. As a result, remarkable success has been achieved. By the end of 1990, there were 117,000 malaria cases in China, with a morbidity of 0.0106%, which dropped by 95% in comparison with that in the 1950s. Most of the original hyper-endemic areas became meso- or hypo-endemic and for most of the previously meso- or hypo-endemic areas, the disease became sporadic. Malaria distribution and epidemic patterns also demonstrated great changes. The major experience comprises the integration of the malaria control program into the overall national health program, the mobilization of various sectors, including the community, the investigators and technical personnel in research institutions and control services to participate and cooperate in solving problems and difficulties encountered.

Prospective evaluation of the use of antigen-specific immune complexes in predicting the development of recurrent melanoma.

We previously demonstrated that the antigen-specific immune complexes captured by the monoclonal antibody MAb JSI in a sandwich enzyme-linked immunosorbent assay were associated with recurrent melanoma. To determine the potential use of antigen-specific immune complex analysis in predicting the development of recurrent melanoma, we prospectively analyzed serum obtained from patients with melanoma following surgical treatment. Two hundred fifty-three patients have been followed up for a median of 25 months (range, 17 to 29 months). Seventy-seven patients (30%) have developed recurrent melanoma. Antigen-specific immune complexes correlated with the stage of disease at time of entry into the study. The absence of antigen-specific immune complexes in postoperative serum samples is predictive of a disease-free status. Long-term follow-up will define the false-positive rate of antigen-specific immune complex analysis. Continued refinement of this approach should lead to clinically useful methodology to monitor human melanoma.