مجله علوم پزشکی رازی
سال بیست و ششم شماره 9 (پیاپی 186، آذر 1398)

Spermatogonial Stem Cells (SSCs) differentiate into adult germ cells during spermatogenesis and cause male fertility. Maintenance of SSCs and induction of spermiogenesis in vitro may provide a therapeutic strategy to treat male infertility. Moreover, it is possible to use the SSCs for research in the field of biotechnology and regenerative medicine through differentiation of them into other cell lines.

SSCs were isolated enzymatically from digested testicular tissue and then were cultured. The identity of SSCs were confirmed by anti-OCT4, anti-PLZF through immunocytochemistry. SSCs were cultured in differentiated culture medium. Then, expression level of SCP3, Boule, Crem, Protamine 2 genes and also expression level of SCP3, Protamine2 proteins was determined by Real-time PCR and immunocytochemistry, respectively. In addition, the potency of SSCs differentiation into osteoblasts and adipocytes was evaluated by Alizarin Red and Oil Red staining, respectively.

The results showed that SSCs can differentiate into adult germ cells in in vitro condition. Also, under differentiation conditions, these cells can be distinguished from other cell lines.

The results of this study showed that, given the differentiation potency of SSCs, these cells can be used for the treatment of male infertility, as well as cell therapy and regenerative medicine.

Governance has a critical impact on health systems’ performance and achieving sustainable health goals. This research aimed to compare the health system governance of countries with good health system performance and propose a model for health system governance of Iran.

This comparative study was conducted using scoping review in 2016. The health sector governance of 11 countries (i.e. Australia, Germany, USA, England, Iran, Turkey, Japan, Singapore, Sweden, Canada and Cuba) was examined in 7 dimensions including structure, communication, regulation, policy making and planning, stewardship, evaluation and accreditation, and customer protection.

The current health system governance produces challenges in achieving health system goals. Developing an integrated health system model comprising health system enablers (building blocks) and results, reducing the number of directorates in ministry of health, developing communications with other external organizations, using evidences in policy making and planning, enhancing leadership, management and stewardship and developing comprehensive standards for evaluation and accreditation of healthcare organizations are recommended to enhance the health system governance of Iran. Indicators such as transparency, democracy, and corruption control, rule of law, ethics, accountability, effectiveness, efficiency, equity, sustainability and resiliency can be used for evaluation of Iran health system governance.

The health system governance of Iran faces numerous challenges. Benchmarking good performing countries’ experience help to reduce the challenges and achieve health system goals.

Because of its malignancy and poor prognosis, esophageal cancer is the sixth cause of death around the world. MiR-34a is a tumor suppressor. The miRNA-34 family is involved in suppressing the tumor and oncogenic pathways in some cancers. The purpose of this research is to determine the changes in the expression of the Vimentin gene after the replacement of miR-34a, on the other hand the effect of replacing this micro-RNA on cell proliferation is determined.

After cultivating the TE-8 cell line, miR-34a was replaced in esophageal cancer cells and after miR-34a replacement, Vimentin gene expression was evaluated using qRT-PCR method. Cell proliferation in the TE-8 cell line was evaluated in effective time and dose after the replacement of mir-34a by the MTT method.

Replacing miR-34a in the TE-8 cell line significantly reduced the expression of Vimentin (p<0.0001). Mir-34a could (at an effective dose) within 24 hours significantly reduce cell proliferation (p<0.0001).

Possibly, the replacement of miR-34a could have a therapeutic role in esophageal cancer.

Antibiotic-resistant forms of Enterococcus faecalis, the second leading cause of severe nosocomial infections, have begun to emerge worldwide. Evidences have shown that the Esp expression is related to the primary adherence and biofilm formation of E. faecalis. The present study investigated the effect of curcumin nanoparticles on the Enterococcal surface protein, Esp, involved in biofilm formation of antibiotic-resistant forms of enterococcus faecalis. 

In this study, 60 clinical specimens collected from patients admitted to major hospitals of Tehran, Iran and all specimens were identified by standard bacteriological and biochemical methods. The strains were evaluated for the presence of Esp in E. faecalis by PCR method. After treatment, broth microdilution method and Real-time PCR were used to assess the inhibitory activity of curcumin nanoparticles on biofilm formation and the expression level of Esp gene, respectively.

Twelve E. faecalis harboring Esp gene strains were included. The result of MIC testing and gene expression assay showed that curcumin nanoparticles did not show any inhibitory activity against biofilm formation in clinical isolates of E. faecalis and no significant changes in transcription were observed.

Considering the high prevalence of Esp gene among E. faecalis strains, molecular identification might serve as a potent drug-resistant marker of E. faecalis, as essential elements of E. faecalis for effective infection control program. No significant changes in transcription were detected when the minimal medium was supplemented with curcumin nanoparticles, suggesting that these nanoparticles contribute very little, if at all, to inhibition of the Esp operon.

Psychological inflexibility, as a new theoretical model for psychopathology, has been related with a range of psychological issues. Therefore, this study was conducted with aim explaining of general anxiety disorder, social anxiety disorder and major depression disorder based on psychopathological model of acceptance and commitment therapy.

This is a descriptive-correlational study. Study population comprised of all college students of Tabriz University of Medical Sciences during academic year 2017-18. 408 students were selected by multistage cluster sampling method. The required information was collected by demographic characteristics questionnaire, social anxiety disorder scale (SPIN), general anxiety scale (GAD-7), beck depression inventory-second edition (BDI-II), and comprehensive assessment of acceptance and commitment therapy processes) compACT). Descriptive statistics (frequency, percentage, mean, standard deviation) and structural equation technique were utilized to analyze the data.

The results of structural equation modeling showed that the cognitive fusion and experiential avoidance pathway to social anxiety disorder, generalized anxiety disorder, and major depressive disorder; and the pathway of attachment to conceptualized self and dominance of past and future to generalized anxiety disorder are meaningful at the level of p<0/01. However, the component of lack of values and committed actions has no meaningful pathway and eliminated from final model.

The present study with identification of psychopathological processes of acceptance and commitment therapy among emotional disorders, supports dimensional approach to diagnosis and therapy.

Circadian rhythm as an important factor in the change in hormone levels is considered. This study aimed to investigate the effect of circadian rhythm on blood lactate concentration and salivary cortisol after one session of exhausting exercise in trained girls.

In this semi-experimental study 15 trained girls with an average weight 58.66 ± 4.6 and body mass index 23/3±2/6 were selected randomly and at 7 Am and 7 Pm in the laboratory were present. Samples of blood and saliva were measured before and immediately after one session of exhausting exercise on a ergometer. Data were analyzed using repeated measures ANOVA and Bonferonian post hoc test at a significance level of 0.05.

There was a significant difference in blood lactate level before and after exercise in the morning (p=0.001) and evening (p=0.001), but there was a significant difference in post -test lactate Blood was not observed in the morning and evening. Also, although there was no significant difference in salivary cortisol levels before and after exercise in the morning and evening, but there was a significant difference in salivary cortisol pre -test in morning and evening times at resting levels (p=0.025).

In general, according to the results of this study, it seems that the circadian rhythm does not affect the response of blood lactate and salivary cortisol in athlete's girls after one session of exhausting exercise.

Hypothyroidism and diabetes mellitus are two incident human diseases that occur simultaneously in frequent cases. There are conflicting reports regarding hypothyroid effect on blood glucose and insulin levels. In the present study by caring glucose tolerance test, measuring fasting insulin level and assessing histological alterations in Langerhans islets of experimentally hypothyroid rats, we investigated if hypothyroidism can induce diabetes mellitus?

In the present study, twenty male wistar rats were divided into two groups of control and hypothyroid. In order to induce hypothyroidism, this group was drank tap water containing 0.02% PTU (propylthiouracil) and the control group was given tap water. At five weeks of experiment glucose tolerance test was performed and three weeks later blood samples were prepared for T4, T3, TSH and Insulin hormones measurement. The pancreas tissue then extracted for histological assessment.

Our results indicate that 5 week consumption of 0.02% PTU does not affect glucose tolerance test significantly while 8 week consumption decrease hormones levels of T3, T4 and insulin and increase TSH significantly (p<0.01). Histological findings show no changes in Langerhans architecture in hypothyroid rats contrast to control group.

Based on our findings we can conclude that hypothyroid disease through unknown mechanism decreases insulin level significantly and it can lead to histological changes in Langerhans islets and consequently to prevalence of diabetes mellitus.

Perilunate dislocation and fracture-dislocation are rare injuries. Treatment of these injuries can be more challenging in old and neglected cases. In this study we report the outcomes of a two- stage treatment of old and neglected cases of these injuries by applying a distracting external fixator (first stage) and open reduction 3-4 weeks later (second stage).

In this retrospective study, seven patients who underwent the two-stage treatment were included. Outcome measurements included Visual Analogue Scale (VAS) for pain, functional evaluation of the wrist by Disabilities of the Arm, Shoulder, and Hand (DASH), power and pinch grip assessment, radiocarpal range of motion and arthrosis in the radiocarpal and mid carpal joints.

Mean time interval between the injury and surgery was 7±4.9 months. Mean follow up period was 16.8±10.7 months. Grip strength of the injured hand was 82.1% of the contralateral hand. Pinch strength of the involved hand was 82.5% of the contralateral hand. Range of motion in the radiocarpal joint of the injured hand was 49.6% in flexion/extension and 64.6% in ulnar/radial deviation of the uninjured hand, respectively. Mean VAS and DASH score were 4.1 and 28.5, respectively. Scaphoid nonunion was seen in one patient and radiocarpal joint arthrosis occurred in another one.

According to the acceptable result of this study, we recommend two-stage treatment for the management of old perilunate injuries.

Multiple sclerosis (MS) is a neurological disorder with negative effect on many areas of functional activity. The purpose of this study was to evaluate the effectiveness of neurofeedback on quality of life and anxiety in patients with MS.

This study was quasi-experimental that carried out with pre-test-post-test design with control group. The research population included MS patients referred to specialized clinics that 30 of whom had criteria for entering the research were randomly assigned into experimental and control groups. The quality of life scale (SF-36) and the anxiety-Spielberger scale were used as research tools. The subjects underwent a one-day trial under neurofeedback intervention in a 15-session period, 40 minutes with the alpha / theta protocol, and the control group did not receive intervention.

The results of covariance analysis showed that neurofeedback exercises were successful in increasing the subscales of quality of life and reducing anxiety (p<0.01), while not having a significant effect on the reduction of the constraints caused by playing role.

Based on these findings, it can be concluded that the neurofeedback exercises used in this study can be used as a complementary and effective treatment to improve the quality of life and reduce the anxiety of MS patients.

One of the most approaches to coping with medical laboratory errors is the FMEA. The purpose study was to determine the effect of clinical laboratory error on the basis of FMEA on patient safety in laboratories in Markazi province.

The present study was an applied-objective type in terms of quasi-experimental interventional method and for collecting pre-lateral data. The instrument was a standard questionnaire of the WHO patient safety checklist. The statistical population of the study was technical experts of clinical laboratories, which were counted in two groups of intervention and control groups and 71 persons in each group. Data were analyzed by descriptive statistics and Spearman correlation test for correlating variables before, after intervention and Wilcoxon test to determine the effect of clinical laboratory error control on patients' safety.

Using SPSS22 software and according to Spearman, there is a significant correlation between the dimensions of patient's safety before and after intervention (p<0.05). According Wilcoxon test, the effect of clinical laboratory error control on patients' safety and its dimensions, ie, governance and safety of patients (p=0.001, z=6.73), involvement of patients and society (z=-5.83, p=0.001), safe and evidence-based clinical services (p=0.001, z=-6.60) and safe environment (p=0.001, z=-6.109) were approved.

Regarding the effect of controlling laboratory errors on patients' safety, it is suggested that the managers of the laboratories of Markazi province focus on the implementation of the FMEA in order to achieve significant results in long run.

Regarding the reported abnormalities in the immune system of people with autism, it is likely that these people do not respond appropriately to the hepatitis B vaccine or do not become immune to the hepatitis B virus following the injection of hepatitis B vaccine. There is no information available on the quality and response of the hepatitis B vaccine in children with autism. The purpose of this study was to investigate the effect of primary hepatitis B vaccine in children with autism in preventing of hepatitis B 3-15 years after primary vaccination and investigate the of HBs-Ab waning along with age and the existence of an immune memory against hepatitis B vaccine in these children compared with the healthy control child as contrl.

Total 254 HBsAg-negative objective with ages between 3-15years. from ASD and normal population were recruited, HBV seromarkers (HBc-Ab & HBs-Ag & HBs-Ab) were assessed and subsequently, molecular tests were employed on all subjects for detection of hepatitis B virus DNA in the serum samples and positive cases were investigated for mutations in the HBs-Ag coding region. A booster dose of vaccine was injected for those who showed low levels (<10 mIU/mL) of anti-HBs and their antibody levels was measured 4 weeks afterwards.

The mean ages for ASD and control groups were 7.14±2.42 and 8.68±1.96 respectively. In ASD group 7 (6.5%) of children were positive for anti-HBc and one child was positive for occult hepatitis B infection (HBsAg negative, HBV DNA positive). From the normal control group, nobody was found to be positive for this parameter. There was no mutation in the HBS-Ag coding region. In ASD and Control groups 49.6% had low anti-HBs levels (HBs-Ab < 10 mIU/mL), One month After injection of a booster dose for all children with low antibody, 100% of ASD and 92% (59 of 64) of control pupils contained >10 mIU/mL of antibody, respectively. In both groups, the HBs-Ab titer increased similarly in response to the booster injection (P<0.05).

According results, vaccine-induced immunity should be checked until puberty and thereafter. Despite previous investigations regarding immune impairment in individuals with autism, the immune system of these individuals was able to manage the hepatitis B vaccine challenge.

Chitosan, a biodegradable polymer, has no toxic effects, is also considered as DNA vector. In this study, the effects of lysozyme enzyme on chitosan / plasmid nanoparticles was investigated.

In this study, a gelatinization method was used to construct nanoparticles. After examining the percentage of plasmid loading in chitosan nanoparticles, as well :as char:acterizing nanoparticles, the nanoparticles were exposed to lysozyme enzyme treatment and the effects of enzymatic digestion was investigated.

The results of this study showed that the percentage of plasmid loading in nanoparticles was 100%. The size, dispersion index and zeta potential of nanoparticles were 173 nm, 292.0 and 10.08 mv, respectively. The results of the enzymatic digestion showed that the solution containing lysozyme at a concentration of 10 μg / ml and enzymatic activity of 100 u / ml after 4 hours was capable of Incomplete digestion of chitosan nanoparticles but did not cause complete release of the plasmid but after 24 hours, it completely releases plasmid from nanoparticles.

By reviewing the results of this study and comparing it with the findings of other studies on chitosan, it is shown that in addition to the favorable conditions for lysozyme function, time factor for lysozyme enzyme activity is important for complete release of DNA from chitosan/plasmid nanoparticles.

Based on epidemiological studies, 60-85% of postmenopausal women suffer from menopausal vasomotor symptoms, including hot flashes and night sweats. Drug and hormonal treatments have had unwanted side effects and increased cancer risk. The purpose of this study was to determination the effectiveness of Gratitude meditation on menopausal vasomotor symptoms.

A quasi-experimental design with pre-test, post-test and control group was coducted.one month after the intervention, a follow-up phase was performed. The research population consisted of women aged (45-55) who had filed in the health centers of Tonekabon and reported themselves a postmenopausal. After initial screening, thought “Goldberg General Health Questionnaire"30 women with qualification and inclusion criteria who signed the informed consent form were selected and then randomly assigned to two groups of experimental and control (15 subjects). Gratitude meditation was conducted on the basis of the Greenburg meditation instruction and the Islamic gratitude pattern. During 8 sessions (2-hour group sessions once a week and 25-minute solitary exercises every night before bed). Data was entered into the SPSS22 software.

Results of analysis of variance with repeated measurements indicated that Gratitude meditation in the experimental group had a significant relationship with decrease in the frequency and duration of vasomotor symptoms after intervention up to the follow-up stage.

According to the results of this study, we can use the Gratitude meditation in the postmenopausal care program and reduce their vasomotor symptoms in similar communities.

Brain tumors are rare and yet a significant cause of mortality and morbidity in adults. Surgical resection has been treatment of choice for brain tumors. Despite its effectiveness, surgical resection may cause various post-operatives complications such as infections, neurological deficits, and vascular damages that can lead to decrease in quality of life and survival rate and can impose great medical expenses. This study was aimed to assess related factors of medical and surgical complications after surgical brain tumors resection.

This was a descriptive and retrospective study performed on patients that underwent brain surgical tumor resection at Rasoul Akram Hospital of Iran University of medical science in Tehran, 2016. Age, sex, extent of resection, pathology of tumor, post-operative symptoms and complications, duration of surgery, blood loss volume during surgery, and duration of admission were collected, and analyzed with SPSS.

Of 179 patients, 47.5% (85) were male, and 52.5% (94) were female. Mean patient age was 45.8 years old, and mean admission duration was 4.6 day before and 9.7 day after surgery. The most common surgical complications were hydrocephalus (13.4%) and ICH (9.5%). The most common medical complication was electrolyte disorder (13.4%). Mean surgery duration was 1 hour 40 min and mean blood loss during surgery was 542 ml.

Based on our study, extent of brain resection was correlated with surgical and medical complications. Older age, longer duration of admission, and longer duration of surgery were correlated with medical complications, but it was not correlated with surgical complications. Older age was correlated with higher mortality rate. Blood loss volume during surgery had no correlation with surgical or medical complications.