Iranian Journal of Public Health
Volume:52 Issue: 4, Apr 2023

Atrial fibrillation (AF) is the most common cardiac arrhythmia. AF is associated with an in-creased risk of stroke. We aimed to review systematically the cost-effectiveness of screening strategies for pa-tients with AF.

To find related research and articles, articles published in Iranian and international databases by us-ing a combination of MeSH (Medical Subject Headings) terms and based on inclusion and exclusion criteria were searched and revieweduntil Dec 2020. The main outcome measures of the final articles were incremental cost-effectiveness ratios (ICER) per gained or additional quality-adjusted life years (QALYs), additional case detected, and avoided stroke.

Out of 3,360 studies found, finally, fifteen studies were included in the research. The lowest ICER numerical value was 78.39 for AF screening using ECG for 65-85 yr old Japanese women. The highest value of this index is equal to 70864.31 for performing ECG monitoring for more than 60 d for Canadians over 80 yr without AF history. In two studies, the results were expressed with the years of life gained (YLG measure. Of course, in one study, the results were not reported with this measure, and in one study, the results were report-ed with ICER.

Most of the studies acknowledged the cost-effectiveness of different AF screening strategies. However, studies that confirmed the cost-effectiveness of population-based screening were more than studies that confirmed the cost-effectiveness of other screening strategies.

Because of functional and structural similarities between the cochlea and vestibular sensory receptors, vestibular dysfunction could be accompanied by noise-induced hearing loss (NIHL) due to occupational noise exposure. We aimed to evaluate the occurrence of vestibular dysfunction (VD) in individuals with NIHL and occupational noise exposure.

 A systematic literature research was carried out within the databases of PubMed, Scopus, Science Direct, and Web of Science for published articles between 1980 and Jan 5, 2023 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The methodological quality of the included systematic reviews was assessed with the Joanna Briggs Institute (JBI) checklist. Vestibular system dysfunction parameters were considered as primary outcomes in subjects with NIHL.

 We reviewed the evidence (from 19 eligible articles) for VD from noise-induced damage to peripheral vestibular structures. VD can occur after occupational noise exposure or concomitantly with NIHL. Furthermore, this study showed that the saccular organ has a higher susceptibility to noise damage than the vestibular organs of the utricle and semicircular canals (SCCs).

 Our results support the role of occupational noise exposure and NIHL as risk factors for developing VD. Further research is needed to investigate the association between the occurrence of VD due to occupational noise exposure or concomitantly with NIHL.

Determining the pregnancy outcomes with independent prognostic factors in the first trimester combined screening test and thyroid stimulating hormone (TSH) is a concern for practitioners. We aimed to evaluate the correlation between TSH and first trimestercombined screening test levels and examine their ef-fects on pregnancy outcomes in healthy pregnant women.

A total of 349 pregnant women in Izmir Ataturk Training and Research Hospital,Turkey with nor-mal TSH values in the first trimester between 2015 and 2020 were enrolled. Patients were divided into two groups as 274 and 75 patients according to TSH values with 2,5 as cut-off value; their birth weights and weeks were compared. Patients were also divided into three groupsaccording to gestational weeks; their TSH values and combined tests were compared.

When grouped based on the TSH threshold value (2.5uIU/ml), no significant relationship was found between the combined test parameters and TSH levels. In the combined test, after grouping according to the week of gestation, a negative correlation was observed between free beta-human chorionic gonadotropin (β-hCG) and TSH measured at 11 weeks (P=0.040, r=-0.189). A significant negative correlation was found be-tween free β-hCG and newborn birth weight (P=0.032, r=-0.199), TSH and delivery time (P=0.011, r=-0.235).

Free β-hCG and TSH levels could guide practitioners for birth weight and early delivery, respec-tively. Postponing the combined test for patients with elevated serum TSH levels to between the 12th and 13th weeks of gestation may reduce false positives.

Fragile X syndrome (FXS) is a genetic disease with intellectual disabilities. FXS is often caused by the CGG-repeat expansion mutation in the FMR1gene with suppressed FMR1transcription and decreased protein levels in the brain of the patients. The RNA-guided CRISPR/Cas9system is a promising targeted ge-nomic editing tool in gene therapy of FXS. In order to evaluate its feasibility, the present study used CRISPR/Cas9system to target the FMR15’-UTR sites in cultured human neuroblastoma cells.

PCR and DNA clone were used to construct plasmids. CRISPR function was tested by Western blot and flow cytometry. Data were analyzed by a two-tailed unpaired Student’s t-test using GraphPad software. This research was conducted from 2020 to 2022 in the Second Affiliated Hospital of Soochow University, Suzhou, China.

Cell cycle analysis showed significant differences in G1, S and G2/M phases between the two groups (P<0.05). In the knockout cells, apoptosis was accelerated (P<0.05) with a significantlydown-regulated (P<0.05) expression of FMRP as compared with the control group.

This study provides further understanding about the FMRP function and molecular mechanism of FMR1gene in nerve cells, and suggests the feasibility of gene therapyin FXS by CRISPR/Cas9gene editing system.

Prevalence of metabolic syndrome with aging is higher in women than in men, and it increases after menopause. Interventions to reduce the risk of metabolic syndrome in women are important. A low-carbohydrate, high-fat diet is effective in weight loss and improvement cardiovascular risk factors including abdominal circumference, blood pressure, and blood lipid profile. We aimed to determine the relationship between a low-carbohydrate, high-fat diet and the risk of metabolic syndrome in Korean women.

This cross-sectional study was conducted using secondary data from the 2014–2018 Korean National Health and Nutrition Examination Survey. Overall, 8,222 women aged >19 yr were included. The effect of a low-carbohydrate, high-fat diet on the risk of metabolic syndrome was analyzed by multiple logistic regression analysis using a complex sampling procedure.

The diet significantly reduced the likelihood of metabolic syndrome development (P=0.044). In addition, regardless of the fat type, the diet significantly reduced the likelihood of low high-density lipoprotein cholesterolemia (low-carbohydrate, high-total fat, P=0.013; low-carbohydrate, high-unsaturated fat, P=0.006; low-carbohydrate, high-saturated fat, P=0.006).

A low-carbohydrate, high-fat diet is an important intervention that can reduce the risk of metabolic syndrome, and the reduced consumption of carbohydrates can decrease the risk of low high-density lipoprotein cholesterolemia regardless of fat type. Therefore, it is necessary to actively explore the potential of this diet, targeting Asians, including Koreans.

We aimed to explore catalpol and NF-k. The role of antidepressant and anti-inflammatory effects of b inhibitor in depression induced by chronic unpredictable mild stress (CUMS).

Under the guidance of Qiqihar Medical University, from January 2020 to January 2021, the weight, sucrose consumption and rest time of mice during swimming were monitored, the neurobehavioral changes of rats under CUMS were used to determine the experimental model; ELISA detection of iNOS, ROS, caspase-1, IL-1 β And IL-18 expression level; Western blotting detection of TLR4, MAPK and NF-κB expression level; LPS-induced cell model. INOS, NLRP3, caspase-1, IL-1 in RT-qPCR and ELISA detection models β And IL-18 expression level;the TLR4, MAPK and NF-κB level were detected by Western blotting.

CUMS can make rats lose weight, reduce sucrose consumption rate and prolong rest time. Catapol can enhance this effect; In the depression model, ROS, NLRP3, NF-κ B and iNOS were up-regulated Catalpol group MAPK, NF-κ Reduced expression of B and TLR4; ROS, caspase-1, IL-1β, IL-18 and iNOS protein increased. Cell model group TLR4, MAPK and NF-κ. The high protein content of B decreased in catalpol group.

Catalpol acts as anti-depressant and anti-inflammatory molecule indepression induced by CUMS. Combination of catalpol with NF-κB inhibitor might play a role in the treatment of depression through regulating the neuroinflammation.

Several studies show the relationship between chronic hyperglycemia and the appearance of macroangiopathy, microangiopathy and neuropathy. The major objective of this study was to investigate the serum lipids, renal function tests and inflammatory markersin type 2 diabetes patients.

The study lasted eight years between Feb-2013 and Mar-2021 (Mascara, Algeria). Overall,197 patients and 197 controls were selected during general medicine examinations;enzymatic and immunoturbidimetric colorimetric methods were used to determine the serum levels offasting glycaemia, total cholesterol, highdensity lipoprotein cholesterol, triglycerides, low-density lipoprotein cholesterol, fibrinogen, urea, acid uric, albumin and creatinine, C protein reactive; the glomerular filtration rate is calculated according to the MDRD equation; the glycatedhaemoglobin levels were determined by an ion-exchange resin separation method.

Patients had 2.44 times higher fasting glycaemia, 1.71 times higher HbA1c, 1.23 times higher body mass index, 1.30 times higher waist circumference and 1.25times higher systolic blood pressure than control subjects; the findings of the present study also indicate that a significant differences between patients and controls were observed regarding triglycerides (P=0.008), LDL-cholesterol(P=0.011), HDL-cholesterol (P=0.009), urea (P=0.013), uric acid (P=0.015), creatinine (P=0.007), glomerular filtration rate (P=0.006), albumin (P=0.018),fibrinogen (P=0.023) and C protein reactive (P=0.019).

All this metabolic disordercould facilitate the appearance of serious complications in future.

We aimed to explore the effect of humanistic care time checklist on nursing quality of intensive care unit (ICU) patients.

Overall, 230 patients hospitalized in ICU of Tongji Medical College ofHuazhong University of Sci-ence and Technology, Wuhan, China from June 2018 to May 2019 were included in this retrospective study . Overall, 115 patients were included in the control group. Another 115 patients were included in the observation group. The nurses communicated routinely with the patients in thecontrol group, and communicated with the patients in the observation group according to the self-designed humanistic care time checklist. The results of the implementation of humanistic care measures were evaluated by "ICU patients' humanistic care time satisfac-tion questionnaire".

The satisfaction of humanistic care in the observation group was significantly higher than that in the control group (P<0.05).

Communication between nurses and patients according to the requirements of humanistic care time checklist can improve patients' satisfaction with nursing care.

Although it is recognized that social and environmental factors influence healthy eating behaviors, few studies have investigated the association between environmental factors and healthy eating among rural adults in Korea. We aimed to identify individual and neighborhood environmental factors influencing adherence to fruit and vegetable intake among adults living in rural areas using an ecological approach.

The study sample comprised 1,582 adults from 38 rural areas from Chungbuk Province, South Korea in 2017 who provided individual- and neighborhood-level data. Neighborhood-level data were obtained by aggregating individual-level responses measured for each residential town resulting in an average value for each neighborhood-level variable for the 38 rural areas. The data were merged and used for a series of multilevel logistic regression analyses.

Among the individual-level factors, age, alcohol drinking, physical activity, self-efficacy for healthy eating, and social support for healthy eating were significantly associated with adherence to fruit and vegetable intake. Among the neighborhood-level factors, social cohesion and perceived neighborhood safety were significantly associated with adherence to fruit and vegetable intake.

Multifaceted intervention strategies to increase consumption of fruits and vegetables should include behavioral modification, social support, and improvement of neighborhood environments.

Local anesthetic lidocaine is one of the most common pain therapies, but high concentration of lidocaine induced neurotoxicity and its mechanism is unclear. Exosomal microRNAs (miRNAs) is implicated in neuronal diseases, but its role in lidocaine induced neurotoxicity remains to be elucidated.

All the experiments were performed at Huzhou Key Laboratory of Molecular Medicine, Huzhou City, Jiangsu Province, China in 2022. Lidocaine was used to induce apoptosis of SH-SY5Y cells. Exosomes isolated from bone marrow mesenchymal stem cells (BMSC-exos) were used to co-treat SH-SY5Y cells with lidocaine. Cell apoptosis was measured using a flow cytometer. PKH-67 Dye was used for exosome uptake assay. miR-21-5p mimics/inhibitors, or negative controls were transfected with Lipo2000 to study its effect on lid-induced injury. Interactions between miR-21-5p and PDCD4 was analyzed by luciferase reporter assay.

Administration of BMSC-exo protected SH-SY5Y cells against lidocaine induced apoptosis. Suppressing miR-21-5p dramatically enhanced PDCD4, but miR-21-5p overexpression sharply down-regulated PDCD4. Mechanism study showed that miR-21-5p bound to 3’-UTR of PDCD4 to inhibit it. Suppressing miR-21-5p reversed the effect of BMSC-exo on Lid-induced injury. Results also indicate that miR-21-5p regulated lidocaine-induced injury through targeting PDCD4.

BMSC-exos protected SH-SY5Y cells against lidocaine induced apoptosis through miR-21-5p by targeting PDCD4, which may develop new strategy in the management of lidocaine-induced neurotoxicity.

The aim of the present study was to evaluate the use of tobacco products and associated factors in Turkey based on the Turkey Health Survey 2019 data conducted by the Turkish Statistical Institute (TUIK).

The study was designed as a cross-sectional research. It was conducted by utilizing the “Turkey Health Survey 2019” microdata set from the Turkish Statistical Institute. The data of 17,084 people aged 15 years and over were evaluated.

The study examined the data of 17,084 individuals aged ≥15 years surveyed by the TUIK. 27.2% of the participants used tobacco products every day, 3.4% used occasionally, and 54.2% never used them. Furthermore, 15.8% of the participants were exposed to secondhand smoking for ≥1 hour every day, while 7% were exposed to secondhand smoking for <1 hour every day in a closed environment. The reasons for starting to use tobacco products were friend influence for 33.4% of the participants, wannabe for 25.2%, and curiosity for 18.6%.

More than a quarter of people aged ≥15 years in Turkey smoke every day. The frequency of using tobacco products every day, the daily number of cigarettes smoked, and the frequency of exposure to tobacco products in closed areas were higher among men.

We aimed to investigate the epidemiological characteristics of hand, foot and mouth disease (HFMD) and provide recommendations for its control and prevention.

A descriptive epidemiological analysis was designed for HFMD in children through direct network report from 2015 to 2019.

From 2015 to 2019, a total 27,395 HFMD cases were reported at Infection Clinic of Shanghai Children’s Hospital, Shanghai, China, accounting for 79.24% of the number of reported notifiable infectious disease cases (34,573). The cases number increased since May and reached a peak from June to September, then decreased from October to December with a second small peak in some years. The proportion of cases in boys is higher than in girls (59.7% vs. 40.3%). The cases number of stay-at-home children was higher in 2016 and 2018 (60.07% and 60.95%) than in 2019 (33.47%), and that of kindergarten children and students in 2019 (51.73% and 9.75%) was significantly higher than in other years. Overall, 22606 cases were reported in <5 years group, accounting for 82.52% of the total number of cases during 2015-2019. The proportion of the cases in 5-10 and >10 years groups increased year by year from 2015 to 2019, which is statistically significant. (χ2=71.105, P=0.00；χ2=78.413，P=0.00)

The epidemiological characteristics of HFMD had changed during 2015-2019. Analysis of these data can provide helpful evidence to prevention and early treatment of the HFMD, and identification severe cases and handling the outbreaks.

We aimed to apply the intelligent pressure ulcer information management system software to hospitalized patients with pressure ulcer and to evaluate its application effect.

Fifty patients hospitalized in the Third Xiangya Hospital of Central South University, Changsha, China, a grade-A tertiary hospital from March 2021 to May 2021 were grouped into the control group. For these subjects, conventional electronic forms were used to report and manage pressure ulcer information. Another 50 patients with pressure ulcer were selected as the experimental group who were hospitalized the same hospital from June 2021 to August 2021.They were managed with Intelligent Pressure Ulcer Information Management System Software.

The effects of the two management methods were assessed by comparing the reporting time, the degree of pressure ulcer healing 1 week after the occurrence of pressure ulcer and after discharge, and the nurse satisfaction. The reporting time and Design-R scores 1 week after the occurrence of pressure ulcer and after discharge were significantly lower than those of the control group (P<0.05).

The pressure ulcer information management system makes the reporting process simple and convenient, which saves the reporting time, improves the accuracy of the pressure ulcer staging. It achieved the guidance for various stages of pressure ulcer treatment program, the use of dressing guidance, improved the accuracy of pressure ulcer treatment program, which is worthy of clinical reference.

We aimed to examine the effect of ethical sensitivity on doping attitude and dispositions for Taekwondo athletes, as well as whether there was a difference depending on the athlete's career and national team status.

Overall, 331 Korean adult Taekwondo athletes were enrolled. Data were collected using sports ethical sensitivity and Performance Enhancement Attitude Scale (PEAS) tools as the research tools. For data processing, frequency analysis was performed to confirm demographic characteristics, and the fitness index was calculated by applying the Rasch model to confirm the validity and reliability of ethical sensitivity and PEAS. An independent sample t-test was performed to confirm the difference between ethical sensitivity and doping attitude and dispositions according to demographic characteristics. Pairwise parameter comparison values ​​were used using multi-group analysis of path analysis to confirm the effect of ethical sensitivity on PEAS and the moderating effect was calculated.

First, according to the demographic characteristics of Taekwondo athletes, there were statistically significant differences in ethical sensitivity and PEAS only by gender. Second, as ethical sensitivity factors, both intentional behavior factors and intentional collusion factors had statistically significant effect on PEAS. Third, in the effect of ethical sensitivity on doping attitude and dispositions, there was no moderating effect of athlete experience and national representative status.

Ethical sensitivity has a positive linear correlation with PEAS. In other words, enhancing the ethical sensitivity of sports players will enhance athletes’ ethical consciousness and prevent unethical behavior, and furthermore, doping.

Ovarian cancer (OC) is the 7th most common cancer, with 239,000 new cases per year. In Iran, it is the 8th most common cancer, with an ASIR of 3.9/100,000 women. The 5-year overall survival in Iran based on previous studies is about 61% which in comparison with eastern countries has better survival.

The study included patients from the Iran National Cancer Registry from 2009-2014. Several steps were taken to control data quality. This study used a Kaplan-Meier survival curve to compare OC survival rates across geographical, pathological, and other variables. All analyses were done in R (4.02) and SPSS (26), with a 0.05 P-value considered statistically significant.

The study enrolled 7977 cases of OC. OC's ASIR was 4.10/100,000. In epithelial and non-specific OC, ASIR was >0.5. Five-year survival was 55% and 10-year survival was 45%.

OC is the 8th most common cancer in Iran, with lower age-specific incidence and better overall survival than East Asia and North America. In Iran, as in Eastern Europe, OC incidence correlated with reduced total fertility rate and population aging. Five and 10-year overall survival rates were 55% and 44%, respectively, higher than the West. This may be because late stage OC patients are excluded from pathology and classified as “undiagnosed” in death certificates or hospitalization files.

West Nile virus (WNV) is a mosquito-borne virus that causes a febrile disease and may cause a fatal neurological illness in humans. We aimed to investigate the geographic distribution of Culicinae mosquitoes and their possible infection with WNV in Hormozgan Province, southern Iran.

Field studies were carried out from June 2017 to May 2019. Different mosquito sampling methods were used monthly to collect mosquitoes from 22 sites. The Real-Time PCR technique was used to detect the virus infection in the mosquitoes.

Overall, 6165 mosquitoes were caught. The species were Culex theileri (33.25%), Cx. pipiens (20.45%), Cx. quinquefasciatus (10.51%), Aedes caspius (6.33%), Cx. tritaeniorhynchus (5.82%), Ae. vexans (4.10%), Cx. sinaiticus (3.62%), Cx. antennatus (3.29%), Culiseta longiareolata (2.81%), Cx. perexiguus (2.03%), Cs. subochrea (1.95%), Cx. mimeticus (1.49%), Cx. pusillus (1.38%), Cx. univittatus (1.27%), Cx. modestus (1.14%), and Cx. sitiens (0.57%). The molecular detection of virus infection in mosquitoes found to be negative for WNV.

The presence of many species of mosquito vectors and high population traffic increase the risk of disease transmission is very high. Therefore, the way to restrict WNV infection factors is increasing the knowledge for personal protection measures to prevent mosquito bites.

The liver flukes of the Fasciola species and Dicrocoelium spp. are recognised as parasites of domestic and wild herbivores. Both species of F. hepatica and F. gigantica as well as D. dendriticum are distributed in Iran. The present study aimed to identify Fasciola spp. and Dicrocoelium spp. using mitochondrial Cox1 (cytochrome c oxidase I) gene by HRM method.

Totally, thirty infected liver specimens were collected from the sheep (n:23) and cattle (n:7) at the abattoirs of Qazvin Province, northwest Iran in 2022. DNA extraction and PCR amplification of Cox1 gene were conducted by HRM technique. DnaSP v.5.0 was used for compression of diversity indices of ribosomal 28S rDNA and mitochondrial Cox1 markers of Dicrocoelium spp. The taxonomic status of Dicrocoelium spp. was performed by sequencing and phylogenetic analysis.

Overall, 26 and 4 isolates were identified as F. hepatica and F. gigantica, respectively. D. dendriticum was the sole infecting species of Dicrocoelium revealed by HRM analysis. Genomic analysis showed a moderate (28S rDNA genes: 0.600±0.215) to high (Cox1: 0.733±0.155) haplotype diversity for D. dendriticum.

The parasite-dependent mitochondrial gene (Cox1) could identify a higher genetic diversity of D. dendriticum compared to nuclear 28S rDNA gene. HRM technique in the present study found to be a reliable technique for identification and genetic diversity of liver flukes but more comprehensive and in-depth studies in different parts of the country are needed.

Obesity is one of the major public health concerns, and its prevalence is increasing worldwide. This study aimed to investigate the effect of human development index on the prevalence of obesity across 152 countries.

Country-level data on obesity prevalence and its influencing variables related to 152 countries were obtained during 2000-2019 from several sources. A Spatial Bayesian Hierarchical model was employed in this research, and the analyses were performed using R statistical software (version 3.6.1).

We found a positive relation between HDI and obesity prevalence, in such a way if low HDI countries advance to high HDI countries, the obesity rate is expected to increase significantly by 7.45%. Moreover, the association between obesity prevalence and the percentage of people aged 40-59 (β=0.07), urbanization rate (β=0.11), percentage of internet users (β=0.01), percentage of alcohol users (β=0.16), milk consumption per capita (β=0.15) and Percentage of depression (β=0.58) was significantly positive. Conversely, per capita consumption of fruits and vegetables (β=-0.15), and smoking rate (β=-0.02) was negatively associated with obesity prevalence.

The prevalence of obesity is growing across all countries, especially in the countries with high and very high HDI. Therefore, policymakers must also pay attention to the negative effects of development when trying to improve the welfare of society.

Many studies have been done to identify the factors that influence the development and progression of osteoporosis. One genetic factor is polymorphisms of LRP4 gene. Regarding the lack of comprehensive study on polymorphisms of LRP4 gene in the north of Iran, mainly Mazandaran Province, we decided to investigate the polymorphism of this gene in postmenopausal women with osteoporosis.

This case-control study has been conducted at GhaemShahr Valiasr Hospital on 100 female patients with osteoporosis (average age of 58.1) and 90 healthy females without osteoporosis (average age of 55.2). After sampling and extraction of genomic DNA via of the salt deposition method, the genotype and SNP (rs9667108) polymorphism of LRP4 gene were evaluated with the PCR-RFLP method. Restriction enzymes cut the PCR products. In order to identify patients, their bone mineral density was tested by the DEXA method .The results of digestion (digestion enzyme) were analyzed by MedCalc, SPSS software, Hardy-Weinberg equilibrium, and Chi2.

The statistical analysis has shown the significant relationship between SNP (rs9667108) polymorphism and the risk of osteoporosis disease in patients and control groups (P<0.05). In SNP (rs9667108), the GC genotype, compared to GG, increased the risk of disease significantly (1.556 time). Similarly, CC genotype, compared to GG genotype, increased the risk of this disease by 2.091 time.

The existence of mutation in the LRP4 gene could increase susceptibility to osteoporosis disease. Moreover, determining this patient's genotype in SNP (rs9667108) can be used to identify individuals who are in endanger osteoporosis.

Cancer stem cells (CSC), as responsible issues to cancer development and progression, play a crucial role in tumorigenesis, recurrence, metastasis, and chemoresistance. Both hyperthermia and photodynamic therapy (PDT) may be effective for cancer treatment, particularly when combined with other therapeutic approaches. This study aimed to evaluate the effect of hyperthermia combined with PDT on colorectal CSC and the gene expression of the CSC markers, presenting a more effective approach for cancer therapy.

The study was conducted in the Pasteur institute of Iran, Tehran, Iran in 2018. We evaluated the anticancer role of hyperthermia, Gold nanoparticles coated with curcumin (Cur-GNPs) in PDT and combination of the two approaches on cell viability and the expression of CSC markers, Nanog and Oct4 in colorectal cancer cell line HT-29. The cytotoxicity effect of Cur-GNPs against the cells was assessed in vitro. The cell viability was assessed using MTT assay, and the expression analysis of the CSC genes was evaluated using a q-real-time PCR.

Cell viability was decreased by PDT (P=0.015) and the combination therapy (P=0.006) but not by hyperthermia alone (P=0.4), compared to control. Also, the expression of CSC markers, Nanog and Oct4 was shown to significantly down-regulate in all hyperthermia, PDT and combination groups.

Hyperthermia combined with PDT was indicated to be more efficient in eliminating tumors than hyperthermia or PDT alone.