فصلنامه خون
سال دهم شماره 2 (پیاپی 40، تابستان 1392)

Umbilical cord blood is a promising alternative source of hematopoietic stem/progenitor cells (HSPCs) for allogeneic hematopoietic stem cell transplantation. Although the use of UCB for transplantation has plentiful advantages in comparison with other cell sources، the low number of HSPCs led to cell delayed recovery. Therefore، ex vivo expansion of HSPC before transfusion could induce faster cell recovery. CD34 positive cells were positively enriched using MidiMACS system and cultured on aminated PS nanofibers، aligned PCLs، and random PCLs. Cell expansion and quantification of cell apoptosis were carried out in expanded cell populations in different conditions by the flowcytometric method. Microscopic and flowcytometric analysis revealed the differentiation of CD133+ cord blood hematopoietic stem cells to erythroid lineage. Flow cytometry showed that both of the PPARγ agonists were able to diminish Transferrin receptor and glycophorin A positive cell population significantly. The inhibitory effect of PPARγ agonists on erythroid differentiation was dose-dependent. The inhibitory effect of Troglitazone on colonies formation of Erythroid was markedly higher than Bicaline. This study demonstrated that aminated PS nanofibers has positive effects on the expansion of CD34+ cells compared to 2D culture system by increasing cell expansion and cell apopotosis inhibition. However، aligned and random PCL nanofibers did not show supportive effects on cell proliferation.

Umblical cord blood (UCB) hematopoietic stem cells having high cell counts are suitable candidates for benign and malignant disease transplantation but often UCBs have low counts. In this study، ex vivo expansion of these cells was performed using suspension bioreactor with vertical agitation. UCB Mononuclear cells were cultured with 1. 07 × 106 cells/ml density in total 206 ml of culture medium in the suspension bioreactor with vertical agitator; and the static group with same density was cultured in T-flasks for 14 days. At the days 0، 3، 7 and 14 of culture، sampling was performed for further analysis. During the 3 days of culture، differentiated cells were lost and then the number of cells increased again from 0. 42 × 106 cells/ml up to 1. 2 × 106 cells/ml and from 0. 6 × 106 up to 2. 9 × 106 in bioreactor and static culture، respectively. The percentage of CD34+ cells and colony forming potential significantly increased in bioreactor. Hematopoietic stem cells in the bioreactor while retaining their self-potential are expanded. However، due to the increasing shear stress in the environment، the total number of cells did not increase. Therefore، further studies are required.

Considering infectious and non-infectious complications of blood transfusion، we decided to survey physicians’ knowledge about and their attitudes toward autologous blood and to see how education can affect them. A cross-sectional study was conducted on general physicians and specialists who ordered blood and blood products in Shiraz hospitals. A questionnaire aiming to elicit demographic characteristics، and evaluate the knowledge about collection methods of autologus blood and its benefit was used for data collection. Then، we provided education about autologus blood for participants. The rate of ordered autologus blood was compared before and after the intervention. We used chi-square، fisher and t-test for data analysis. The mean score of physicians’ knowledge about autologus blood was 14. 41 ± 3. 32 (2. 86-20) that was lower than that of specialists with the mean of 15. 95 ± 2. The most common reasons for the use and non-use of autologous blood were blood safety for the former and the lack of knowledge about preparation and prescription of autologus blood for the latter. The knowledge level of physicians was higher in pre-operative collection methods than in other fields of autologous blood collection. Physicians’ knowledge about autologus blood was evaluated to be low and despite their desire for its use، the practical rate was still low. The results showed that even education provided to physicians did not increase the ordering rate of autologus blood.

Arsenic trioxide (ATO) is an active drug in treatment of acute promyelocytic leukemia (APL)، but has adverse effects on patients. In order to enhance antileukemic effectiveness and to reduce dosage of ATO، combinatorial effect of it with Azidothymidine (AZT) in apoptosis induction was evaluated on APL cell line (NB4). The cells cultured and treated with 50 μM AZT and/or ATO for 48 hrs and then with apoptosis، cell cycle distribution، and P21 mRNA levels in comparison with untreated cells (control) were analyzed by flow cytometry and Real Time PCR، respectively. ATO led to induction of apoptosis (50. 14% ± 7. 12) in comparison with the control (3. 9% ± 2. 97) through the increment of the cell cycle arrest in G2/M. The apoptotic effect of ATO had been inhibited in cells treated with combination of AZT/ATO (24. 35% ± 4. 65). This inhibition was associated with the relative reduction of the cells in G2/M and relative increase of the cells in G1 phase. While ATO had suppressive effect on p21 gene expression (0. 27±0. 14)، AZT (1. 81 ± 0. 21) and AZT/ATO (2. 06 ± 0. 32) induced it. AZT attenuates ATO-caused apoptosis possibly through the induction of p21 expression and subsequent relative evasion from G2/M arrest and accumulation of cells in G1 phase.

Additional and more effective platelets can be gained through plateletphersis which at times equals platelets of 8 units of blood. Patients are exposed to a less number of donors through prescription of such platelets. Although side-effects of plateletphersis are low among donors but side-effects vary at different centers. Illustration of plateletphersis production side-effects at Tehran Blood Bank is the aim. This is a retrospective study on plateletphersis donors from 2005 to March 2011. Research was carried on 309 total blood donors who met Iran blood transfusion standards; CBC was carried out on all donors and those with Hb and platelet higher than 12. 5 and 150. 000 were entered into the study. Information regarding aphersis sessions was compiled in donors’ forms including side-effects during platelet donation and they were classified as mild، intermediate and severe according to definition. In the study، 302 cases of plateletphersis were carried out in which 81% of donors were male and 19% female; while the mean age of donors was 35. 3 ± 9. 8. The most occurring side-effects among donors were mild/medium vasovagal donation reaction 1. 6% and citrate poisoning 1. 6% of which 0. 3% was of the intermediate type. Plateletphersis is safe and occurrence of side-effects is low. Side-effects occur mostly among younger and first time donors.

Nanotechnology is the production، use and development of tools and materials whose dimensions are about 1 to 100 nm. Silver nanoparticles are used in packaging، cosmetics، health، medical and poultry industries. Due to the excessive application of silver nanoparticles with its broad antibacterial properties، the evaluation of biocompatibility of silver nanoparticles on biological systems appears to be necessary. The aim of this study is to investigate the effects of nanosilver on blood cells in rats. In this study، silver nanoparticles with doses of 25، 50، 100 and 200 mg/kg body weight orally administered for 28 days to 50 male rats were placed in five groups each of which with ten rats. Then، blood samples were taken from rats; finally، blood cell count was determined and blood coagulation tests were performed. In this study، no significant changes on the number of blood cells including white blood cells، red blood cells، and platelets were observed in any of the doses used. Despite normal blood clotting time at all doses tested، bleeding time test and clot retraction test showed significant changes at high doses، i. e. 200 mg/kg body weight of rats. The increased bleeding time and decreased percentage of the serum collected are the consequence of the suppressive effect of silver nanoparticles on the clotting function of platelets in high doses.

Cox regression model is one of the most common methods of survival analysis for whose application an assumption of proportional hazards needs to be established. Recently، neural network models without having certain assumptions have been shown to be suitable alternatives in predicting survival. This study aims to compare Cox regression and Artificial Neural Network (ANN) models to predict survival in acute leukemia patients. In the present retrospective study، the information on 197 patients with acute leukemia in Sayyed-O-Shohada Hospital was collected using a checklist. Firstly، the assumption of proportional hazards was tested; Cox regression model was fitted to the observations. To select an efficient ANN to compare with Cox regression model، the number of hidden layer neurons was changed. The prediction accuracy of the two models was compared using receiver operating characteristic (ROC) curve and kappa. Data analysis was performed using SPSS 19، Splus2000، and MatlabR 2009 software packages. Out of 9 ANN models with one hidden layer and 4 to 12 neurons، an ANN with 5 neurons in hidden layer was a superior model compared with Cox regression model. The areas under ROC curve for ANN model and Cox model were estimated to be 0. 0709 and 0. 458، respectively. The accuracies of prediction of survival for ANN model and Cox model were estimated as 78. 9% and 50. 3%، respectively. Due to the high predicting accuracy of ANN models، the use of different models of ANN and their development in various fields of medical science are recommended.

Biological hazards are among the major occupational hazards in blood transfusion centers. The aim of this study was to determine the exposure rate of the staff to biological hazards. This research was a cross sectional study in 2009. A standard self administered questionnaire was used for data collection. Data were analyzed by SPSS15 by using the logistic regression model. Needle stick injury during the one year ending to the time of the study was reported in 11. 9% of the staff and over their working lifetime 33%. Moucocutaneous exposure during the one year ending to the time of the study was 24% and over the working lifetime 39. 6%. Regression analysis showed that occupational exposure was higher in the age groups of 20-29 (OR: 2. 29، 95%CI: 1. 05-3. 89) and 30-39 (OR: 2. 21، 95% CI: 1. 03-3. 72)، those with the work experience lower than 5 years (OR: 1. 91، 95% CI: 1. 14-3. 20)، among the staff with elementary and secondary education (OR: 2. 29، 95%CI: 1. 09-3. 82)، and among the personnel not having participated in occupational protection training courses (OR: 0. 60، 95% CI: 0. 39-0. 92). Occupational exposure was lower among the personnel of Tehran Blood Transfusion Center compared to other medical centers in the country. Providing special training programs for different occupational groups، making improvement in managing and organizing the personnel، and exerting direct supervision over occupational protection programs can reduce working errors and hazardous exposures.

Echis carinatus venom is a complex mixture of toxins. This venom contains metalloproteinases which convert prothrombin to meizothrombin. The prothrombin activator leads to the formation of small blood clots inside the blood vessels throughout the body. To understand the effect mechanism of Iranian Echis carinatus venom، in this study we investigated the effect of EV on human plasma proteins (prothrombin and fibrinogen) and on blood coagulation. The aim was the purification and characterization of procoagulant factor from the Iranian Echis Carinatus venom and the evaluation of the procoagulant activity on human plasma. Crude venom from the Iranian snake species E. carinatus was selected. The prothrombin activator was purified from the crude venom of Echis carinatus by combination of the procedures by gel filtration، ion-exchange chromatography، and reverse phase HPLC. Electrophoresis on 12. 5% polyacrylamide gel was performed. The Iranian E. carinatus venom was able to coagulate human plasma very rapidly. The coagulation time was reduced from 13. 4 seconds (SD= ±0. 59) to 8. 6 seconds (SD= ±0. 64) when human plasma was treated with crude venom (concentraion of venom was 1 mg/ml). The venom of Iranian Echis carinatus contains procoagulant factors. It seems the fraction F1B4 isolated from IEc to be like coagulation proteins which coagulate human plasma very rapidly in vitro.

The aim of this study was to determine the effective factors on regular blood donation in donors in Isfahan province based on the theory of planned behavior in 2009. This is a descriptive-analytical study performed on 600 blood donors in blood centers scattered across Isfahan province. The sampling method was stratified random proportional to the size of the cities. Subjects were randomly selected from each center. Data were then collected by a validated and reliable questionnaire based on the theory of planned behavior. Finally، we used SPSS software V18 for data analysis in which T-Test، Fisher test، correlation tests، and Mann-Whitney applied. Out of the total number of subjects، 77 (12. 8%) returned after 6 months for blood donation and 523 (87. 2%) did not. Most of the donors were 21-30 years old. The mean of age in regular donors was significantly higher than that of non-regular blood donors. Regular blood donation has the strongest correlation with intention and self efficacy (r= 0. 577، p< 0. 001) followed by self identify (r= 0. 481)، subjective norms (r= 0. 353)، and attitude (r= 0. 355). Self efficacy is one of the effective factors on one’s intention to return for donation. So، by improving this construct we can help recruitment and retention of blood donors in the community.

The health systems all around the world are concerned about provision of safe and adequate blood. The blood donation، as a favorable social behavior، is affected by human characteristics. The present study attempted to investigate the altruistic behavior، empathy and social responsibility in two groups: voluntary versus non-voluntary blood donors. The present research is a cross-sectional comparative study having included all male voluntary blood donors in Ardabil Blood Center; 30 voluntary blood donors and 30 non-voluntary were randomly selected. The altruism questionnaire، empathy scale، and personality questionnaires were used as instruments and the data were collected. The research data were analyzed using Pearson correlation coefficient and multivariate variance analysis (MANOVA). The results show that the mean rates of social responsibility in voluntary and non-voluntary groups are 28. 93 ±4. 13 and 24. 13 ±3. 68، respectively. The variables of altruistic behavior، empathy and social responsibility are estimated to be higher in voluntary than non-voluntary donors. Also there is a positive significant relationship among altruistic behavior، empathy and social responsibility variables. Altruism، empathy and social responsibility are more motivating in voluntary blood donors than in non-voluntary. Therefore، to promote blood donation it would be helpful to recognize and engage people enjoying empathy، social responsibility، and altruism.

Thalassemia is one of the most common chronic genetic diseases whose psychological issues can affect quality of life in patients. Research has shown that regular physical activity can increase well-being in a person. This study compared the quality of life in patients with thalassemia major based on their participation in group activities in Bandar Abbas in 2011. In this descriptive analytical study، 35 patients with thalassemia major having participated in group activities were selected as the case group and 75 patients not participating as the control. Data were collected with quality of life questionnaire SF-36 and were analyzed by using SPSS13 statistical software، Mann-Whitney and Kruskal Wallis tests. The difference between the quality of life scores in the case and control groups for dimensions of general understanding of health، role limitation due to physical health problems، energy and vitality، physical functioning، emotionally related role limitations، body pain، mental health، and overall quality of life score was significant. The mean values of overall quality of life score in the case and control groups were 81. 40 ± 3. 64 and 58. 35 ± 6. 14، respectively. The relationship between the overall quality of life score and participation in group activities، starting age for desferal medication، and the number of desferal injections per month was significant in the case group. Patients should be encouraged to participate in group activities and rehabilitative centers should be constructed to improve the level of life skills so as to lead to greater patients independence.

Women population compared with men is at lower risk of blood-transmitted infections; therefore، encouraging women to donate blood is very significant. The aim of this study was to assess the level of knowledge of Arak female students and teachers about safe blood donation criteria. In this cross-sectional study، 617 female students and teachers were selected by random sampling method and the data on demographic characteristics، motivation، and individual awareness about blood donation were collected by questionnaires. Finally، the data were analysed by SPSS 16 software. Out of the total number of the female students، 6. 4% and 25% of teachers had the previous history of blood donation. The most important motivation for blood donation in both groups was to save patients and the most important barrier for blood donation was anaemia. Knowledge levels were low in both groups. The results showed a meaningful relationship between maternal education (p=0. 04) and the history of blood donation (p=0. 001) with knowledge levels. A significant percentage of females have a low knowledge about blood donation. Based on the findings of the present survey، it is recommended that training about the importance of blood donation in females be promoted extensively.