مجله علمی دانشگاه علوم پزشکی کردستان
سال بیست و دوم شماره 5 (پیاپی 91، آذر و دی 1396)

One of the indicators of recovery in the patients admitted to intensive care units is improvement of the level of consciousness. Various factors, including the type of care are effective in the changes of consciousness level of the patients. This study was conducted to determine the effect of nursing care plan based on “Roy adaptation model” in physiologic aspect on the level of consciousness of the patients in the intensive care unit.
Material and This triple-blind clinical trial included 100 patients in the intensive care unit in 2017. Two ICU units in Sanandaj hospitals were selected randomly as intervention and control groups. Eligible patients in each unit were randomly assigned to intervention and control groups. The intervention group received nursing care plan based on "Roy adaptation model” and the control group received routine care. We measured level of consciousness for every patient based on the GCS for 7 days, twice a day. We used SPSS version 21 for data analysis.
The mean level of consciousness in the first three days and nights did not show any significant difference between the intervention and control groups. But there was a significant difference between the mean levels of consciousness from the fourth day and night on, between intervention and control groups (p Roy adaptation model was effective in increasing the level of consciousness after three days in the patients in the intensive care unit. Therefore, we recommend organized nursing care based on standard nursing models for all of the patients in the intensive care units.

Exercise training is one of the contributing factors in appetite changes. The purpose of this study was to investigate the effect of folate supplementation on serum levels of ghrelin and leptin during 10 weeks of high intensity interval training in male Wistar rats.
After a period of familiarization for one week, 27 male Wistar rats (weight= 203/94 ± 27/34gr, Age: 9 weeks), were randomly divided into four groups: control (n=6), folate supplementation (n=6), high intensity interval training (n =7) and HIIT纉媵 supplementation (n =8). HIIT training protocol started with speed of 30 m/min for 1 min with 10 reps and 2 min active rest in the first week and reached to 75-80 m/min for 1 min with 7 reps and 3 min active rest in the last week. Folate supplementation carried out by dissolving folate tablets in drinking water. 48 hrs after the last training session, animals were anesthetized, serum samples were collected and ghrelin and leptin levels of serum were measured by using ELISA kit.
The results of this study showed that serum ghrelin level increased significantly (P=0/01) in folateᲂ group compared to those in HIIT groups. Also, there was a significant decrease (P=0/35) in serum leptin levels in the folate, HIIT and folateᲂ groups compared to that in the control group but, we found no such significant (P=0/955) differences between folateᲂ and HIIT groups.
According to our results, folate supplementation during high intensity interval training resulted in increased serum ghrelin level. Therefore folate supplementatian can prevent loss of appetite in the athletes who perform high intensity interval training.

In the last decades, experimental studies have shown that aberrant activation of phosphatidylinositol 3-kinase (PI3K) pathway is an essential step for both initiation and maintenance of tumorgenesis in a wide range of human cancers, such as, acute promyelocytic leukemia (APL). In this study, we investigated the cytotoxic effect of BKM120, a pan-PI3K inhibitor, on APL-derived NB4 cells.
Material and To evaluate the inhibitory effect of BKM120 on PI3K/AKt pathway, we analyzed the expression and phosphorylation level of Akt using western blot. Using western blot, phosphorylation rate of Akt was evaluated. In order to evaluate the effect of the inhibitor on the metabolic activity, apoptosis index and alteration of the expression of apoptotic-related genes, we used MTT assay, annexin-V/PI staining and RT-PCR analysis respectively. Using SPSS 17 software data were analyzed by t-test.
We found that inhibition of PI3K/Akt pathway by BKM120 resulted in reduction of metabolic activity of APL-derived NB4 cells in a dose- and time-dependent manner (p≤ 0.001). Moreover, the results obtained from flowcytometry and RT-PCR analysis showed a significant increase in BKM120 induced apoptotic cell death in the inhibitor-treated cells (p≤ 0.001). We found BKM120 increased iBax/Bcl-2 transcriptional ratio (p≤ 0.001).
BKM-120 exerts a favorable apoptotic effect on NB4 cells through inhibition of the PI3K/Akt signaling pathway.

The technology of using spermatogonial stem cells (SSCs) has been limited due to lack of an ideal culture system for growth and proliferation. The aim of this study was to investigate the effects of different doses of vitamin C on SSCs colony formation in vitro.
The cells were isolated from testes of prepubertal lambs by two enzymatic digestions, purified by differential platting, and then treated for 10 days by using 4 Simple culture including SSCs in DMEM containing 1% antibiotic and 5% FBS as our control group and for the three other cultures we used the same culture medium as that in control group plus 20, 40 and 60 µg/ml of vitamin C respectively. Culture media were refreshed every 72h and colony numbers and diameters were determined on the 4th , 7th and 10th days after the beginning of culture by using inverted microscope. Spermatogonial cells were identified by immunocytochemistry staining against PGP9.5. Using R software, the results obtained from 5 repeats were evaluated by ANOVA. P On the 7th day, we found a significant difference between the culture No. 2 (0.41 mm2) and culture No. 3 (0.08 mm2) in regard to spermatogonial colonies surface areas (P The results of this study showed that vitamin C with a dose of 40 (μg/ml) was effective in increasing the surface area of spermatogonial colonies. But it had no effect on spermatogonial cell number.

Various methods are used to analyze the data in survival studies. The aim of this study was to compare the analysis results of penalized splines in Cox model and Cox proportional hazards model in relation to the effects of prognostic factors related to the survival of renal transplant patients.
Material and This retrospective study included data of 876 renal transplant patients in Kermanshah, in Iran, from 2001 to 2015. Cox proportional hazards model and penalized splines in cox model were used. We used R version 3.3.2 for data analysis. The significance level was set at 0.05 and Akaike information criterion was used to compare the efficacy rates of these models.
Using Cox proportional hazards model, one, three and five year survival rates of the patients were 94.9, 92.3 and 90.2 percent, respectively. But the corresponding figures for penalized spline model were 95.6, 93.3 and 91.4 percent. The recipient's age, postoperative creatinine, urea after surgery and underlying diabetes were significantly associated with the patient's survival rates (p Considering lower Akaike information criterion and suitability of penalized spline model for continuous variables affecting the survival of renal transplant patients, this model can be used instead of Cox proportional hazards model for more accurate estimate of survival rate of the renal transplant patients.

In recent years, biophysical forces especially microgravity increasingly has been used for cell manipulation, in particular cell differentiation and tissue engineering. Microgravity, as a mechanical factor, has been demonstrated to stimulate cell proliferation and differentiation. In this study, we investigated the impact of simulated microgravity condition generated by one-axis clinostat, on cell cycle and apoptosis rate of adipose derived stem cells (ADSCs).
Material and After isolation and characterization of human ADSCs, they were exposed to simulated microgravity condition generated by one-axis clinostat, for 3 days. After 3 days of clinorotation, control and microgravity samples were stained with PI, then, we evaluated cell cycle and apoptosis rate.
Isolated cells expressed mesenchymal markers and were able to differentiate into adipocytes and osteocytes. Our results showed that 3 days of simulated microgravity induced by one-axis clinostat had no statistically significant effects on the cell cycle and apoptosis rate.
Previous studies have shown that simulated microgravity induced by 3-axis clinostat or RPM altered cell cycle and increased apoptosis rate. Based on our data, it seems that shear stress generated by one-axis clinostat is much less than that generated by three-axis clinostat. Therefore, we recommend use of one-axis clinostat for evaluation of cell differentiation and cell therapy under microgravity conditions for the future studies.

From 2011 to 2013 some efforts had been made in Iran to implement urban family physician program. The aim of this study was to determine the viewpoints of managers, providers, and clients of health care services about the problems in the implementation of urban family physician program in Iran.
This study was a qualitative study. Data were collected through holding 21 sessions of focus group discussions and 37 individual interviews with managers, providers, and clients of health care services in Alborz, West Azerbaijan, and Kurdistan Provinces in 2014. Data were analyzed by means of content analysis method.
According to the results of this study, the problems on the implementation of urban family physician program in Iran can be classified into seven categories including: financial, cultural, educational, motivational, structural, administrative, and contextual problems.
We propose definition and stabilization of the financial resources and establishment of appropriate rules for payments to solve financial problems, and also training of general population and staffs and involvement of the mass media in training to solve the cultural problems. In order to solve the educational problems reforms in medical curriculum are recommended. Motivational problems can be solved via encouraging the private sector and experts to take part in the program and also through guaranteeing the continuity of the program. Establishment of appropriate organizations and provision of protocols are recommended to solve the structural problems. Finally, to overcome the contextual problems it is suggested to promote cross-sectoral and inter-sectoral coordination and also attract support from policy-makers.

In order to enhance in vivo stem cell viability and considering similar anti-inflammatory and anti-apoptotic effects of human adipose derived stem cells (hADSCs) and astaxanthin (AST) and their ability to cross the blood-brain barrier, we investigated the effects of (AST) on hADSCs proliferation and viability to provide a supplement for cell based therapy in MS patients.
After isolation of hADSCs and assessment of CD markers, they were cultured in DMEM-F12 medium in the presence of AST at various concentrations (1, 5, and 10 ng/ml) for 72 h. Finally, we assessed cell proliferation and cell viability by MTT and Tryphan Blue methods.
The results revealed that a high percentage of hADSCs expressed CD90 and CD44 markers and a low percentage of them expressed hematopoietic cell markers. In addition, in the group cultured in the presence of 5 ng/ml AST the mean percentage of cell viability increased significantly compared to other groups (p = 0.04). Tryphan Blue results also revealed significant effect of AST on stem cell proliferation and culture of these cells in the presence of 5 ng/ml of AST, led to significant increase in the mean percentage of cell count compared to the results of the control group (p = 0.03).
Astaxanthin can increase hADSCs proliferation and survival and this agent can be used in the cell-based therapies in MS patients.

Multiple sclerosis (MS) is an autoimmune demyelinating disease which affects central nervous system (CNS). The aim of this study was to provide a simple, short term and efficient method for differentiation of human adipose tissue-derived stem cells (hADSCs) into oligodendrocyte precursor cells in order to provide a homogeneous population of these cells.
After stem cell isolation, cell differentiation was performed by two methods using embryoid body and ectodermal-like cells. The cell viability was evaluated by MTT assay and the mean percentage of differentiated cells expressing Olig2 and A2B5 markers was determined by using immunocytochemistry techniques. Data were analyzed by independent- samples t- Test.
The results showed that a high percentage of stem cells expressed CD90 and CD105 markers and a low percentage of them expressed CD14 and CD45 markers (hematopoietic cell markers). In addition, the mean percentages of the cells which expressed oligodendrocyte progenitor cells markers (Olig2 and A2B5) were different in the two groups (P=0.031). Moreover, comparison of cell viability showed significant light absorbance by the cells differentiated from embryoid body compared to the other groups (p = 0.044).
The differentiation of human adipose derived stem cells into oligodendrocyte progenitor cells using embryoid body is a rapid and efficient method in order to provide a homogeneous population of these cells.

The results of many studies have shown that free radicals are cause of more than 60 diseases and antioxidant system (antioxidant) can stop the damaging process induced by free radicals in the body. One of the most important factors which can increase the production of free radicals is heavy breathing during physical activity. The aim of this study was to investigate the effect of a period of high intensive interval training on plasma total antioxidant capacity and malondealdehyde level in liver tissue of male Wistar rats.
In this study, 16 adult male Wistar rats (195-220 g) were randomly divided into control (n = 8) and training (n=8) groups. The training protocol consisted of running on treadmill 5 days a week, for 8 weeks. Standard meal and water were provided and the subjects were allowed to choose their food freely. 48 hours after the last session of training and 8 hours of overnight fasting, blood and tissue samples were collected to measure the total antioxidant capacity and MDA level by using colorimetric method. We used independent T test for data analysis.
The results showed that 8 weeks of intensive interval exercise had no significant effect on the plasma antioxidant activity and capacity and also tissue level of MDA (p>0.05).
Since 8 weeks of high intensive interval training had no effect on the total antioxidant capacity and malondialdehyde level, it can be said cautiously that exercise at regular intervals can induce useful adaptation in antioxidant system which can lead to resistance against oxidative stress.

Influenza A virus is an important respiratory pathogen which can cause high rates of morbidity and mortality during seasonal epidemics and pandemics. Current vaccines are not capable of producing effective immunity against different influenza virus subtypes. Designing universal vaccines using conversed domains of influenza virus antigens can overcome this limitation. The ectodomain of influenza M2 protein (M2e), the hemagglutinin stalk domain (HA2), and nucleoprotein (NP) are the most conserved sequences among subtypes of influenza A viruses. The aim of this study was to attach part of the NP gene into the binary structure of 3M2e-HA2 and assessment of expression of a chimer trimer protein in prokaryotic system. This recombinant protein is considered as a promising antigenic candidate for a universal vaccine production.
First, part of the NP gene segment of human influenza A/H1N1(PR/8/34)was amplified by PCR using designed specific primers. This amplified gene was cloned into pGEM-TEasy cloning vector. Then, the confirmed segment of NP gene was subcloned into PET28a/3M2e-HA2 recombinant expression vector, downstream of the HA2 segment. After confirmation of cloning, the chimer protein was expressed in E.coli BL21(DE3).
The results of colony PCR, restriction enzyme digestion and sequencing indicated that the NP gene segment was correctly cloned into PET28a/3M2e-HA2. Chimer protein expression was analyzed by SDS-PAGE and confirmed by Western blotting.
Design and production of recombinant protein (3M2e-HA2-NP) could be an important step towards the development of a universal influenza vaccine.

Marital satisfaction is a psychological variable and considered as an individual characteristic for couples. Various factors affect marital satisfaction. Personality traits are among the most important factors affecting marital satisfaction. This study aimed to investigate the relationship between personality traits and marital satisfaction based on five factors model of personality.
In this study, we searched all Iranian and non-Iranian articles published between 2005 and 2016 in both Persian and English languages in the Sciencedirect, Web of Sience, Pubmed, SID, Magiran, Google Scholar, Iranmedex, Irandoc databases. To find relevant articles, we used the key words of "marital satisfaction", "personality characteristics", "personality factors", "five factor model of personality", willingness to accept responsibility, agreeableness, extroversion, neuroticism, openness and combination of them.
We found 6508 articles. The findings of the articles indicated significant negative correlation between neuroticism and marital satisfaction. But willingness to accept responsibility, extroversion, agreeableness and openness traits had positive correlation with marital satisfaction.
Based on the results of the articles used in our study, neuroticism can affect the marital satisfaction negatively. Determination of different aspects of personality traits in the pre-marriage programs is necessary to increase the stability of marriage and family.