نشریه دانشور پزشکی
پیاپی 135 (تیر 1397)

Cardiac ischemia-reperfusion (IR) is one of the main causes of death in the world. Since exercise training is one of the practical ways to improve cardioprotection against these injuries, the purpose of the present study was to investigate the effect of preconditioning with a short term of high-intensity interval training on cardioprotection, left ventricular function and possible mechanisms.
In this study, 48 male rats (8-10 weeks and 250-300 g) were randomly divided into 5 groups: control (C), high-intensity interval training (H), sham (Sh), control談ⅺ梚reperfusion (CIR) and high-intensity interval training談ⅺ梚reperfusion (HIR). The high-intensity interval training protocol consisted of 5 consecutive treadmill running in 6×2 min high intermittence with 85-90% vo2max and 5×2 min slow intermittence with 55-60% Vo2max. Rats in CIR and HIR groups were exposed to cardiac IR injury. Infarct size, lactate dehydrogenase, creatine kinase, Kloth, and TRPC6 expression were measured and data were analyzed by one way ANOVA and Tukey's post-hoc tests.
The results of this study showed a significant decrease in infarct size and enzymes of cardiac injury in the training group during IR. Also, the results demonstrated that the reduction of ventricular function in the training group (HIR) was less than CIR group. As well, the results showed the significant increase in Klotho levels after training and lower expression of TRPC6 channels during IR in training group.
Short-term high-intensity interval training could reduce infarct size by one-third compared with the untrained group (CIR) (a decrease of 33.45%) and it could prevent noticeable reduction of cardiac function in IR injury. Based on the results, an increase in klotho following training and, consequently, lower expression of TRPC6 during IR, could be a mechanism for increasing cardioprotection and to reduce cardiac dysfunction.

Female heads of households stand as a vulnerable group who are exposed to various psychological and social harms. The purpose of this study was to determine the mental health and coping skills of female heads of households in Birjand in 2017.
This cross-sectional study incorporated 200 women (age range: 20-50 years) that were covered by the Relief Committee. They were selected by cluster sampling method where participants were selected via proportional allocation from each region in Birjand. The data were collected by Lazarus’ Ways of Coping Questionnaire and the standard General Health Questionnaire. Data were analyzed in SPSS 19 using Chi-square, independent t-test, one-way ANOVA and Kruskal-Wallis tests.
The mean age of women was 38.5 ± 36.7 years old. They acted as heads mainly because of divorce (48.5% of them). Only 11.6% had a satisfactory mental health and 77.5% had problem-oriented coping skills. There was no significant relationship between mental health and coping skills. Among demographic variables, only employment status and education correlated with mental health, so that social dysfunction was significantly greater in employed women. Women with higher education levels had higher depression. Employment status was also significantly associated with coping styles where unemployed women were more emotion-oriented than the employed ones.
The female heads of households in this study fail to have proper mental health. Thus, there is the need for planning effective interventions and consequently improving living conditions and mental health of these women.

It is well-documented that oxidative stress leads to neurodegeneration in multiple sclerosis (MS). The purpose of this study was to evaluate the effect of combined (aerobic-resistance) training on antioxidant enzymes in women with MS and regular sexual cycle.
In this research study, 30 women with MS (age=35.19±9.15, body weight=59.21±13.62 kg, Expanded Disability Status Scale (EDSS)=3.21±0.64) were randomly assigned to the experimental (n=15) and control (n=15) groups. The experimental group received a combined (aerobic-resistance) training program for 8 weeks (3 sessions per week). In both groups, serum levels of SOD, MDA, GPX, TAC and VO2MAX were measured before and after the training protocol. Serum levels of SOD, MDA, GPX and TAC were measured using high-sensitive immunoassay and enzymatic methods. The data were analyzed using independent t-test and paired sample t-test (p Data showed that serum levels of SOD and VO2max significantly increases in experimental group versus control group (p=0.001). However, there was no significant differences in serum levels of MDA, GPX, TAC and the degree of disability between two groups (p>0.05).
It seems that regular combined training can improve antioxidant enzymes system andVO2max and has no effect on lipid peroxidation and EDSS in women with multiple sclerosis.

Cardiac ischemia-reperfusion (IR) is one of the main causes of death in the world. Since exercise training is one of the practical ways to improve cardioprotection against these injuries, the purpose of the present study was to investigate the effect of preconditioning with a short term of high-intensity interval training on cardioprotection, left ventricular function and possible mechanisms.
In this study, 48 male rats (8-10 weeks and 250-300 g) were randomly divided into 5 groups: control (C), high-intensity interval training (H), sham (Sh), control談ⅺ梚reperfusion (CIR) and high-intensity interval training談ⅺ梚reperfusion (HIR). The high-intensity interval training protocol consisted of 5 consecutive treadmill running in 6×2 min high intermittence with 85-90% vo2max and 5×2 min slow intermittence with 55-60% Vo2max. Rats in CIR and HIR groups were exposed to cardiac IR injury. Infarct size, lactate dehydrogenase, creatine kinase, Kloth, and TRPC6 expression were measured and data were analyzed by one way ANOVA and Tukey's post-hoc tests.
The results of this study showed a significant decrease in infarct size and enzymes of cardiac injury in the training group during IR. Also, the results demonstrated that the reduction of ventricular function in the training group (HIR) was less than CIR group. As well, the results showed the significant increase in Klotho levels after training and lower expression of TRPC6 channels during IR in training group.
Short-term high-intensity interval training could reduce infarct size by one-third compared with the untrained group (CIR) (a decrease of 33.45%) and it could prevent noticeable reduction of cardiac function in IR injury. Based on the results, an increase in klotho following training and, consequently, lower expression of TRPC6 during IR, could be a mechanism for increasing cardioprotection and to reduce cardiac dysfunction.

Expressing relationship between financial payments and performances’ results in health system could be explained by performance-based financing presentation. This study aimed to indicate differences in budget efficiencies amongst the Iranian provinces by comparative means, using performances data on public health sector in the provinces, and results of computing provinces’ relative budget efficiencies.
in this study, statistical-descriptive analysis method was used and operational or performance-based budget efficiency indicators in the Iranian provinces using record data from the Health Ministry and the Iranian Health Insurance Organization were used. Presenting a simple picture of performance-based budgeting, by health expenditure, manpower and physical resources for outpatient and inpatient performances in the provinces, the comparative indicators of efficiencies were computed, using Data Envelopment Analysis (DEA) method.
The country average of budget efficiencies for performances maximization in 2011 and 2013 were 0.55 and 0.58 for outpatient services, respectively, and 0.82 and 0.86 for inpatient services, respectively. The efficiency indicators in the public sector showed provinces, despite having the same conditions on revenue collecting and performance regulating, are classified with considerable differences in service maximization and expenditure or budget minimization
This study is the first research, introducing efficiency indicators in operational or performance-based budgeting scheme in the public health sector. Efficiency differences amongst provinces, and declining efficiency in some provinces in the second year could be considered sources of efficiency unsustainability and inequalities and limiting access to health sector goals.

Migraine is a neurovascular disorder that decreases the quality of life. The purpose of this study was to evaluate the effect of aerobic training and a combination of herbal supplements including Valeriana wallichii and Melissa officinalis on serotonin, nitric oxide and headache indices.
The present study was a semi-experimental and applied research. Eighteen female patients with migraine who were eligible to participate in the study were randomly divided into two groups: aerobic training (n=9) and herbal supplements (n=9). Patients in the aerobic exercise group performed the exercise for eight weeks, three sessions per week and each session was 75 minutes of moderate-intensity aerobic activity (15 minute warm-up, 45 workouts, 15 minute cool-down). The combination of herbal supplement group received herbal capsules for eight weeks and each capsule was included 200 mg of valerian and 80 mg of Melissa officinalis. They used it twice daily in the first four weeks and three times a day in the next four weeks. Blood samples were taken in the fasting state to determine the serotonin and nitric oxide levels of the subjects before and after the intervention. Headache indexes were also assessed by a headache questionnaire. Data were analyzed by Kolmogrov-Smirnov, independent and paired T-tests and Covariance analysis at a significance level of p Results showed that in the complementary combination group, taking eight weeks of capsule significantly increased blood serotonin levels and headache frequency and intensity significantly decreased. In addition, nitric oxide levels and duration of headache did not significantly differ as compared to before the study. In the aerobic training group, eight weeks of activity significantly increased serotonin and nitric oxide levels and significantly decreased headache frequency and headache intensity, but did not change the duration of the headache. Also, by comparing the variables between the two groups, other than serum nitric oxide and aerobic power, the changes of the other variables were similar at the end of the study, and no significant difference was observed between them.
Aerobic training and a combination of herbal supplements including valerian and Melissa officinalis can be a good complement therapy for women with migraine.

This study was conducted to evaluate the effect of a period of high-intensity interval training (HIIT) on myocardial collagen-1 and TGF-β1 and cardiac function in post ischemia-reperfusion rats.
Thirty two (32) rats were anaesthetized by thiopental sodium. Intubation and connecting to ventilator and LAD ligation after thoracotomy was conducted. The ischemia was by 30 minutes and reperfusion was performed after ischemia. Rats were randomly divided into four groups: control-ischemia, Ischemia-HIIT, HIIT, and sham (HIIT groups without surgery, Sham groups without training). After 4 weeks of recovery, exercise training was performed (8 weeks, 3 days per week) 40 min including 5 min warm- up and cool- down and 30 min interval running at 85-90 % VO2max and separated by interval recovery at 50-60 % VO2max. 48 hours after last training session, rats were anesthetized and heart was removed. The gene expression of collagen-I and TGF-β1 was measured with PCR-RT method.
Data analyzed showed that collagen 1 expression was significantly lower in Ischemia-HIIT group compared with control-ischemia group (p HIIT is an efficiency factor for decreasing TGF-β1 and collagen-1 and increasing cardiac function.

Tumor cells express antigens that can be recognized by immune system as foreign particles. Heat shock proteins (HSPs) are molecular chaperones that bind to tumor antigens and mediate their uptake into antigen presenting cells.
This articles is a review article and its data has been collected and categorized from the articles in the field of cancer immunotherapy. All the articles were valid and searched from science engines like ScienceDirect, Elsevier, Springer and so on) and it has been tried to refer to the information of the most recent articles in these fields.
HSP antigen complexes are then directed toward either the MHC class I pathway through antigen cross presentation or the conventional class II pathway, leading to activation of T cell subsets. The processes involved in internalization of HSP–antigen complexes differ somewhat from the mechanisms determined for single antigens. Accordingly these complexes can be used as component of tumor vaccines and participate in antitumor immunity. Such vaccines generate impressive immune responses and elicit specific, protective immunity.
When purified from a tumor, certain HSP-peptide complexes can function as effective vaccines against the tumor from which the complexes were isolated.