فصلنامه خون
سال یازدهم شماره 4 (پیاپی 46، زمستان 1393)

Recently, circulating hematopoietic stem cells (HSC) have been used for the treatment of most types of leukemia. However, the G-CSF mechanism has not been known yet but it is believed that G-CSF is mostly effective by its indirect functions. The suppression of the nervous system affects G-CSF induced mobilization of HSC. The main gene involved in mobilization is CXCR4 that ligand to SDF-1. So, this study investigates the effect of the main catecholamine of nervous system-Epinephrin- on CXCR4 expression. In this experimental study, isolated cord blood CD34+ cell of 20 healthy newborn with MACs columns treated with 10 μM Epinephrine and 1 μM Proporanolol. Expression of CXCR4 has been investigated at 1, 3 and 5 hours with qRT-PCR. Receptors of beta adrenergic expression have been studied with RT-PCR. Beta adrenergic receptors are expressed on CD34+ cells. Epinephrine led to significantly increased CXCR4 in hours 1 (3.2 ± 0.5), 3 (2.4 ± 0.4) and 5 (2.2 ± 0.4). Cells treated with propranolol, return increased CXCR4 induced by epinephrine. It can be concluded that G-CSF affects the expression of CXCR4 through increasing secretion of epinephrine in bone marrow with on beta adrenergic receptors. Cells with increased CXCR4 mobilized to release SDF-1 in peripheral blood.

Plasma is an important product for the preparation of coagulation factor concentrates. FVIII is one of the labile coagulation factors in plasma and its activity is used as a quality marker of plasma; therefore, it is important to optimize plasma production in order to avoid a reduction of FVIII activity. In this study, the effect of the delayed interval from plasma production to freezing on factor VIII activity in FFP in Iran was evaluated. Thirty whole blood units in pediatric bags were collected and their plasma aliquotes were separated. The plasma was then divided into three parts equally. The first, second, and third parts were frozen within 1 hour, 2 hours and 6 hours of separation, respectively. FVIII activity was then measured by the one-stage clotting assays. The average rates of factor VIII activity in the first, second, and third groups were 1.78 ± 0.4 IU/mL, 1.72 ± 0.4 IU/mL, and 1.5 ± 0.3 IU/mL, respectively To provide fresh frozen plasma, it is necessary to freeze plasma within 2 hours after whole blood separation. Although any increase in this time to 6 hours is associated with the significant decline in factor VIII activity compared to 1 and 2 hours, it remains within the acceptable level.

Polymorphonuclear cell-derived myeloperoxidase (MPO) is a known agent in the progression of inflammatory disorders via the production of reactive oxygen species. In this study, we investigated the association between rs2333227 polymorphism (G-436 A) within the MPO gene promoter and coronary artery stenosis. A total of 160 Iranian subjects (patients = 86 and controls = 74) were introduced on the basis of the study criteria. DNA was extracted from white blood cells and the genotype distribution was evaluated by PCR-RFLP technique. The AA, AG and GG genotype frequencies in study population were calculated to be 6.90%, 39.4% and 53.7%, respectively (p > 0.21). There was no significant difference between the genotype distribution and the extent of coronary stenosis in patients with 1VD, 2VD and 3VD (p = 0.71). The A allele frequencies were 25.6% and 27.4% in patients and controls, respectively. In general, our results indicate that the Iranian population genotype and allele distribution do not play a role in the development and severity of coronary artery disease.

Stem cells are undifferentiated cells able to self-renew as well as to produce more differentiated daughter cells. In this study, stem cells were isolated from the endometrium and were then compared with the mesenchymal stem cells for their nature to be determined. Endometrial samples from healthy donors with informed consent after laparoscopy were collected by a gynecologist. The bone marrow samples were aspirated from femur by a hematologist. At least 5 mL of blood was removed and the tissue is at least one square centimeter. After three successive passages, the stem cell surface markers of CD90, CD105, CD146, CD34, CD73, CD44, CD133, and CD45 were analyzed using flowcytometry. The karyotype analysis was also performed for the adherent cells. Endometrial stem cells were successfully isolated from the five samples. Adherent cells in flowcytometric analysis showed the positive expression of surface markers to be CD146: 59.3%, CD105: 98.3%, CD90: 95.8%, CD34: 0.9%, CD 45: 1.1%, CD73: 96%, CD44: 84%, and CD133: 1.4% while in bone marrow mesenchymal stem cells the expression of markers were CD105: 98.6%, CD90: 98.4%, CD34: 0.5%, CD73: 97.9%, CD44: 89.3%, CD146:13%, CD45: 0.3%, and CD133: 0.6%. The morphology of endometrial cells, spindle-like mesenchymal cells, the mode of application, and 44XX karyotype were normal. Stem cells isolated from the endometrial tissue had a heterogeneous population of the cells and high levels of expression of specific surface markers of stem cells especially the mesoderm lineage.

Amplification of STR (Short Tandem Repeat) loci has become a useful tool for human identification applications. The STR polymorphisms analyses are not only useful for paternity and forensic identity testing but also for the evaluation of chimerism and engraftment after allogeneic BMT. In this descriptive study, blood samples were obtained from 100 individuals among Iranian population. In order to develop STR-PCR multiplex systems, numerous STR locus combinations and amplification conditions were evaluated; as a result, three non-overlapping triplex STR systems were developed. The first triplex (DDT) includes the co-amplification of the D4S2366, D16S539 TH01 loci; the second triplex (VFF) contains the VWA, FES/FPS, F13A01 loci; and the third triplex (DTC) contains the D13S317, TPOX, CSF1PO loci. The common statistical information used in paternity and forensic sciences such as heterozygosity (H), matching probability (MP), power of discrimination (PD), paternity index (PI), and power of exclusion (PE) as well as the allele frequency distribution were determined for the Iranian population using all three multiplex systems and their representative loci. For all loci, no deviations from Hardy-Weinberg expectations (HWE) were detected. In conclusion, the STR multiplex systems developed have a high power of discrimination (PD = 0.9999999997), and the matching probability (PM) across all nine loci was estimated as 1 in 3.6 billion, which underlines the usefulness of these systems in the forensic medicine as well as for human identity.

Natural autoantibodies (N-Auto-Abs) are a class of antibodies that are formed without any previous provocation against their own. Currently an important role has been proposed for these antibodies in immune homeostasis; as we can study them as biological markers to predict the onset of the disease. For the first time, we studied the prevalence of N-Auto-Abs against RBC antigens as well as the prevalence of cold antibodies in blood donors. hree hundred healthy individuals who donated at Tehran Blood Transfusion Center were selected randomly; their blood samples were collected including 289 (96.3%) males and 11 (3.7%) female. Their age range is within 17-64 years. EDTA plasma was evaluated for the study of N-Auto-Abs that reacted at 4C. 28 individuals (9.34%) showed positive reaction with their own cell suspension. In addition, 55 individuals (18.34%) were positive for cold antibodies. Twenty eight individuals (9.34%) showed positive reaction with their own cell suspension. In addition, 55 individuals (18.34%) were positive for cold antibodies.

Pediatric emergency departments are high-risk areas in the healthcare setting and blood transfusion is known as the unique clinical measure. This study aims to investigate the prospective risk assessment of blood transfusion in the Pediatric Emergency Department of Ghaem Hospital by the Health Failure Mode and Effects Analysis (HFMEA) methodology. A mixed method) quantitative and qualitative analysis (was used to analyze failure modes and their effects with HFMEA. For identify and analysis, the potential errors of the transfusion process were used by the “Health Failure Mode and Effects Analysis (HFMEA)” methodology. The study was undertaken using a consensus development panel to which the HFMEATM process was applied. The HFMEA team identified 8 processes, 24 sub-processes, and 77 possible failures. Thirteen failure modes (hazard score >= 8) were identified and entitled as "failures with non-acceptable risk” and were moved into the decision tree. Among the influencing factors, the most common reasons for error were related to educational factors (27.2%), and the less common reasons for error to patient factors (2%). Action types were classified as acceptance (11.6%), control (74.2%), and elimination (14.2%). Applying the re-engineering process for the required changes, standardizing and updating the blood transfusion procedures, detecting the root causes of blood transfusion adverse events, using patient identification bracelets, providing training classes and educational pamphlets to raise awareness of the personnel, and holding the monthly transfusion medicine committee have been considered as practical strategies in the work flow of Ghaem Hospital.

Blood transfusion is an important treatment procedure. Transfusion processes and procedures could be effective only if those involved have the adequate level of awareness about transfusion medicine. Therefore, the present study aimed to evaluate the effect of education on the knowledge of health care workers about blood products, blood administration, and complications of transfusion. This quasi-experimental study was conducted on 133 hospital staff. The data were collected by the valid and reliable questionnaire. Two training workshops on the blood collection, storage, and possible side effects of blood transfusion acted as the intervention. The data were analyzed by SPSS18 software, paired t-test, and descriptive statistics. The knowledge of health care workers in the field of blood transfusion was inappropriate; 36.1% of the participants were poor and 63.9% average. The results showed the intervention has a significant effect on the staff knowledge (the knowledge scores before and after the intervention were 10.65 and 13.59, respectively) which was statistically significant (p=0.0001). The results show that the improvement of education in the area of transfusion ​​medicine would improve the awareness of hospital staff. Therefore, periodical educational programs and publication of educational pamphlets are highly recommended for the hospital staff involved in blood transfusion.

The main purpose of blood transfusion is to provide adequate and safe blood products to achieve the best clinical outcome. Therefore, having enough knowledge about storage, preparation, and administration of blood products is essential. Therefore, this study aimed to determine student's knowledge about different aspects of blood transfusion in Birjand University of Medical Sciences in 2013. In this descriptive and cross-sectional study, medical and nursing students were selected by the census method. The questionnaire including demographic questions (13 items) and knowledge questions (39 items) about the procedures before, during, and after blood transfusion and the relevant complications and risks was prepared for the participants to fill out. The obtained data were analyzed by SPSS software 16 at the significant level p< 0.05. The mean score of the student's knowledge of blood transfusion was 13.9 ± 5.74 (of the total 39 points); that is, the majority of them had low knowledge of blood transfusion. No statistically significant relationship was found between demographic variables and the student's knowledge about blood transfusion. The knowledge level of the students about blood transfusion is much lower than expected. So, it is a necessity for students to receive education about blood transfusion in blood transfusion centers.ords:

Thalassemia disease is a public health problem with a large part of the annual country budget allocated. However, effective training methods can play an important role in increasing awareness and preventing thalassemia new births. This study focuses on two educational films and pamphlets and their impact on the knowledge and attitude of female students in Garmeh and Jajarm cities. In this experimental study conducted in 2011, 489 people participated. The participants were classified to three groups by multistage sampling method; one group was exposed to the pamphlet; the second group to the film, and the third was considered the control. Then, their knowledge and attitude prior and after the interventions were evaluated and compared thorugh validated and reliable questionnaires. Finally, SPSS 16, paired t-test, and variance analysis were used for data analysis. Before the interventions, the three groups had no significant differences in the level of awareness but they were different after exposure (p < 0.05). The exposed groups showed a higher level of awareness and attitude after the exposure. Given the effectiveness of such films and pamphlets, their application to increase the awareness of students is recommended to teachers and the decision makers.

Patients with thalassemia experience complex symptoms and encounter many physical and mental problems. This problems can affect their quality of life. This study is carried out to find the relationship between psychological characteristics and the quality of life of patients with thalassemia. A cross-sectional descriptive study was conducted to determine the psychological reactions and quality of life of patients with thalassemia in Kerman. The instruments for data gathering were DASS (42) and Quality of life (SF 36). Data analyses were done by central indexes, chi2, ANOVA, and t-test. The results showed that 49.3% were male and 50.7 % female. The age range varied from 15 to 22.6 years. The results of 8 domains of the quality of life indicates that the score of physical domain was higher than the mental domain (p < 0.0001). The results regarding the psychological reactions showed that the patients had levels of “depression, anxiety, and stress” with 44.9%, 53.6%, and 50.7%, respectively. The results also showed there were significant differences between the quality of life and psychological reactions of patients. The results showed the patients were at risk of psychological problems and the poor quality of life in mental domains; thus, all domains of quality of life and mental problems of patients must be considered by caregivers, and holistic care of patients also should be one of the priorities of caring and curing.