39 2228-7043 Iran University of Medical Sciences 3879 Clinical Psychiatry Comparison of personality factors and cognitive emotional regulation in gastric and lung cancer patients and normal subjects 1 6 2015 22 132 1 9 30 08 2015 30 08 2015 Background: Considering the role of personality and cognitive emotion regulation strategies employed in the etiology and pathogenesis of cancer, this study was conducted with the aim of comparing personality and cognitive emotion regulation strategies in patients with gastric and lung cancer with normal individuals. Methods: A comparative study of causal cancer patients, in which 100 cancer patients (50 gastric and 50 lung) and 50 healthy individuals, matched with the patient groups were selected. Data were gathered via Personality inventory (NEO-FFI) questionnaire, and cognitive emotion regulation strategies (MAI) which were analyzed using multivariate analysis of variance. Results: Based on the findings, of the three groups of variables, there were significant differences in cognitive emotion regulation and its components, such that cancer patients use to a greater extent the non- adaptive strategies (catastrophizing their casting blame, rumination and blaming others) than the normal individuals. However the three groups were not significantly different in regard to character. Conclusion: The findings of this study not only pointed to the complexity of the nature of cancer, but also to a very important confounding factor in developing different types of cancer which is cognitive emotion regulation strategies in people with cancer and normal individuals.  
3880 Biostatistics Application of semiparametric survival models in assessment of time-dependent risk factors on the rate of entered shocks to heart disease patients 1 6 2015 22 132 10 17 30 08 2015 30 08 2015 Background: One of the treatments in patients with dangerous diseases particularly heart failure, is Implantable Cardioverter Defibrillator (ICD) that is used to prevent sudden cardiac death. Regarding to the superiority of ICD rather than medical treatment, the purpose of this study is the assessment of time-dependent effective factors on the rates of entered shocks to patients with ICD. Methods: In this paper, we studied heart patients in Ghaem Hospital of Mashhad from 2005 to the first half of 2008. For various clinical reasons, ICD has been improvised for these patients. The QRS duration was measured by a digital caliper with an accuracy of a thousandth of a millimeter before we implanted ICD. Moreover, age of patients and type of ICD for each patient were recorded. Finally, we analyzed data set by a survival semiparametric statistical model through R statistical software. Results: For these patients, all mentioned variables had time-varying effects. Age, had an additive effect on the entered shocks by this device in all patients over time. Type of ICD has both an additive effect in the period of time and depressive effect in another period. Also QRS influences the shocks induced by ICD with gentle slope. Conclusion: For a specified patient, based on three explanatory variables, the introduced model could be used in reinforcement of correct diagnosis in installation of ICD. The single chamber type of ICD, entered less inappropriate shocks to the heart of patients than the two  other types of ICD i.e CRTD and two chamber. 3881 medical education Evaluation of clinical reasoning of interns and residents of Iran University of Medical Sciences, 2013 1 6 2015 22 132 18 25 30 08 2015 30 08 2015 Background: Clinical reasoning is important in any educational setting and should be included in all aspects of knowledge and skills of a student. In the clinical reasoning process the physician gains information by questioning the patient, compares this information with clinical findings and finally using his/her experience, reaches a diagnosis. Medical students at different levels show low reasoning and face many misdiagnoses. This study compared the clinical reasoning of the interns and residents in different clinical settings. Methods: This study was a cross-sectional and data gathering tool was diagnostic thinking questionnaire, which had 41 questions with 6 rating scale, developed originally by Bordage and colleagues in France. Interns and residents were randomly selected from four main sections in each hospital and asked to complete the questionnaire. A total sample size of 105 residents and 100 interns were studied in these hospitals. Collected data were entered into SPSS 16 statistical software and analyzed using descriptive statistics. Results: 205 residents and interns completed the questionnaire (response rate of %73). The findings showed that the total DTI score of interns and residents (158.13, 161.66) had no significant differences (p=0.056). Interns, in structure of memory scored 82.87 while residents scored 85.04, respectively and differences (p= 0.076) were not significant. Interns and residents scored respectively, 75.26 and 76.62 in flexibility in thinking and the difference (p= 0.108) was not significant. Conclusion: By comparing studies and research we find that interns and residents are poor in clinical reasoning. Teaching clinical reasoning requires knowledge, but knowledge alone is not enough. Rather more important than knowledge is the science of clinical practice and patient experience. Another issue that must be noted is that education of clinical reasoning must be problem-based and student-centered and the most suitable learning environment is problem-oriented education conducted in small groups. 3882 Exercise Physiology The effect of aerobic training on Clara Cell protein 16 (CC16) and cortisol in addicts 1 6 2015 22 132 26 34 30 08 2015 30 08 2015 Background: Addiction dependency presents itself as change in the level of protective proteins of airways and increase in stress. The purpose of this study was to determine the effect of aerobic training on Clara Cell protein 16 (CC16) and cortisol in addicts. Methods: In this semi-experimental study, 20 addicted men (20-33 years old) were selected after public call and divided into drug supplement (N=10) and exercise -drug supplement (N=10) groups. The former group performed exercise training to intensity of 70-75% of VO2max for twenty sessions (5 sessions per week and for 45 to 55 minutes in each session). Also they consumed 10 milligrams of methadone. The other group only consumed 10 milligrams of methadone daily. Later on CC16 and cortisol levels in addicts were evaluated. Data were entered into SPSS software for analysis. Results: Analyses show that the level of CC16 decreased significantly in training group (p=0.029, t9=2.591). In addition, level of cortisol decreased significantly in the former group (p=0.03, t9=2.573). Conclusion: We can deduce that presumably the exercise-drug supplement method in comparison to the other intervention is better for treatment of addict subjects. Also, it is a good method to enhance of pulmonary system in these subjects. However, further research is needed to confirm the results of the current study.   3883 Biology Growth inhibition of K562 cell line by extracted cell wall from Saccharomyces cerevisiae and S. boulardi as probiotic with zinc nanoparticles 1 6 2015 22 132 35 45 30 08 2015 30 08 2015 Background: Chronic myeloid leukemia is a common cancer in human, so the goal of this study was the use of natural compound such as cell wall obtained from Saccharomyces cerevisiae (S. cerevisiae) and Saccharomyces boulardi (S. boulardi) and zinc nanoparticles on the growth inhibition of K562 cell line. Methods: For cell wall preparation, both yeasts were cultured in a basic medium at aerobic condition and 28 °C. Then the medium was centrifuged and precipitately washed with sterile buffer and the cells disrupted by sunicator. Also zinc nanoparticles were prepared by biological method. Anti-cancer property of different concentrations of the yeasts’ cell wall with zinc nanoparticles were assayed by MTT and electrophoresis methods. Results: The results showed that S. boulardi cell wall significantly (p=0.029) inhibits the growth of K562 cell line compared to S. cerevisiae. Also zinc nanoparticles significantly (p=0.021) inhibit K562 cell line. Results revealed that combination the zinc nanoparticles with both yeasts’ cell wall decreased anti-cancer property but this was not significant at the level of p<0.05. Conclusion: Based on this finding it should be concluded that combination of zinc nanoparticles with Saccharomyces cell walls could inhibit the growth of K562 cell line in vitro. But these anti-cancer properties would warrant further study on the clinical application of yeast cell wall.   3884 Biostatistics Joint modelling of longitudinal and time-to-event data and its application in acute kidney injury 1 6 2015 22 132 46 55 30 08 2015 30 08 2015 Background: In many clinical trials and medical studies, the survival and longitudinal data are collected simultaneously. When these two outcomes are measured from each subject and the survival variable depends on a longitudinal biomarker, using joint modelling of survival and longitudinal outcomes is a proper choice for analyzing the available data. Methods: In this retrospective archival study, 84 patients with coronary artery bypass surgery admitted in the intensive care unit of Jamaran Hospital in Tehran were randomly selected during 2001-2008. We defined the survival event as the 25% decline in GFR from baseline and the repeated measurements of urinary output from ICU admission to time of event as the longitudinal biomarker. Results: The study showed that older age (HR=1.112), male sex (HR= 4.307), and number of bypassed grafts (HR=1.874) were significant effective factors on reducing the amount of GFR and risk stage of acute kidney injury event. Conclusion: In this study, it was concluded that decreasing urinary output can be considered as an informative medical biomarker for acute kidney injury. Moreover, joint modeling of longitudinal and survival data which considers the relationship between these two outcomes, is an efficient approach for analyzing these kinds of datasets. 3885 Educational Health The effect of BASNEF-based blended educational program on on diabetes control among type 2 diabetic patients referred to diabetes clinic of Samirom city 1 6 2015 22 132 56 62 30 08 2015 30 08 2015 Background: Glycated hemoglobin is an important indicator of long-term control of blood glucose is an important indicator of clinical research. There is a direct correlation between glycosylated hemoglobin and diabetes. The aim of this study was to evaluate the effect of BASNEF-based blended educational program on diabetes control among type 2 diabetic patients. Methods: This study is a prospective, semi-experimental study, in which 164 eligible patients were selected after the pre-test by random allocation in intervention and control groups. Questionnaire based on BASNEF structure was used for data collection. Before the intervention, demographic and health related information, disease, and check list of foot care was taken. Then, the intervention group participated in program of foot care principles using combinatorial training strategy designed based on the BASNEF’s structures. The control group continued the routine clinic education, and individually, without contacting the intervention group, completed the questionnaire and the check list. Post-test was administered at three and six months after the intervention. Data were analyzed using SPSS v.11.5 and descriptive and inferential statistical tests. Significance level was considered less than 0.05. Results: Demographic variables were not significantly different between two groups (P<0.05). HbA1c in the intervention group was statistically significant (p<0.001), but this analysis was not significant in the comparison group (p=0.18, f = 1/83). Also, in regard to blood sugar controlling behaviors the intervention group were better than the comparison group, three months and six months after the training, such that HbA1c levels of %69.8± %2.27 before training changed to %7.50 ±%1.42 three months later, and %7.44± %1.34, six months after the training and showed significant difference (p<0.001). Conclusion: The results of the study showed that blended educational training increased the awareness in regard to controlling blood sugar levels, thus decreasing the HbA1c levels in diabetic type 2 patients. 3886 Rheumatology Adult Still’s disease (ASD) 1 6 2015 22 132 63 72 30 08 2015 30 08 2015 Adult Still's Disease (ASD) is an uncommon systemic inflammatory disorder of unknown etiology and pathogenesis characterized by high quotidian fever accompanied by systemic manifestations. There is no single diagnostic test for AOSD diagnosis is often clinical, and it is always necessary to exclude common disease mimics such as infections, malignancies and other rheumatic diseases. Ferritin and glycosylated ferritin are useful adjuncts to aid in the diagnosis of ASD. Treatment aims at both minimizing inflammation and halting disease progression. Non-steroidal anti-inflammatory drugs have limited efficacy so glucocorticoids in conjunction with disease-modifying antirheumatic drugs such as methotrexate are also used. Novel therapeutic approaches such as anti-tumor necrosis factor blockade, interleukin-1 (IL-1), interleukin-6 inhibitors and monoclonal antibodies are promising. 3887 Immunology The comparison of serum TNF-α level in Isfahan and Tehran healthy residents 1 6 2015 22 132 73 78 30 08 2015 30 08 2015 Background: Leishmaniasis is a parasitic infectious disease caused by Leishmania spp with different clinical manifestations. After phagocytosis, the parasite becomes resistant to anti pathogenic mechanism of macrophages. Innate immune responses such as TNF-α have important role in enhancement of phagocyte activities against the parasite. During a performed study on the prevalence of leishmaniasis in Isfahan province, we found that a number of people living in this endemic region never show the clinical leishmaniasis despite of close exposure. While the natural resistance may contribute to some elements in innate immune response such as TNF-α levels, the present study aimed to investigate the effects of serum level of TNF-α in healthy people of Isfahan. Methods: Blood samples were obtained from 50 healthy subjects living in Isfahan and 50 healthy subjects from Tehran. Of all subjects who were referred to Iranian Blood Transfusion Organization (IBTO) written informed consent was obtained. Blood sample separated plasma was stored in the -70°c until tested. Plasma level of TNF-α was measured by Sandwich ELISA (USCN, China) according to the manufacture´s protocol. Data were analyzed using the Chi-Square and t- test through SPSS software. Results: The analysis showed that the levels of TNF-α in Isfahan healthy residents were significantly higher than those in Tehran healthy subjects (p=0.085). Conclusion: The results obtained in the present study confirmed our previous finding indicating a natural resistance to leishmaniasis in Isfahan residents. Accordingly we suggested that the assessment of serum TNF-α may be useful in the prognosis and prevention of cutaneous Leishmaniasis in the endemic regions. 3888 Internal Medicine Prevalence of fatty liver using ultrasound in male high-school pupils without history of liver disease and its relationship with liver enzymes, body mass index and waist - hip ratio 1 6 2015 22 132 79 86 30 08 2015 30 08 2015 Background: None Alcoholic Fatty Liver Disease (NAFLD) is the most common form of chronic liver disease and includes a wide range of clinical symptoms (from asymptomatic fatty liver to severe liver inflammation with fibrosis and even cirrhosis). Metabolic syndrome, obesity and type 2 diabetes, are major causes of NAFLD. As urban and sedentary lifestyle and poor diet lead to weight gain and obesity in individuals, this disease appears in an early age. Due to the reversible nature of this disease, detection and prevention of it could be useful for decreasing the onset of the diseases. This study investigated the prevalence of None Alcoholic Fatty Liver disease using ultrasound in male students without history of liver disease and its relationship with liver enzymes, Body Mass Index (BMI) and waist-hip ratio (WHR) in boys aged 15 to 18 years to estimate the prevalence of disease in this age group in order to carry out the necessary preventive tasks. Methods: For this purpose, BMI and WHR of 2028 male students were measured. 107 of these had BMI over 30 and WHR over 0.9 and of these 44 patients, who were willing to cooperate voluntary in this study, were evaluated in regard to the risk of having fatty liver using ultrasound, blood tests and liver enzymes (AST, ALT). Ultrasound was performed by the same radiologist and presence of fatty liver was graded according to the standard international definitions. Then the students were sent for blood testing (FBS, TG, CHOL, LDL, HDL, ALT, and AST) to same laboratory. Results Mean age of subjects was 15.7 years. All of them had fatty liver. In this study there was a significant relationship between WHR, BMI and weight with liver enzymes, while significant relationship was not observed between liver enzymes and FBS, TG, CHOL, LDL and HDL. Also there was significant relation between grading of fatty liver with BMI, WHR, body weight and HDL and not any significant relationship with other factors. Conclusion: Relatively high frequency of liver disease in this age group was seen and it seems the high school boys who are overweight and have a BMI over 30 are more likely to have fatty liver. For prevention of the metabolic problems in elderly one must identify these individuals early for taking actions regarding their lifestyle and proper nutrition. The results of this research suggest the conduction of further studies for prevention of obesity in this group with the aim of decreasing the risk of NAFLD with suitable physical activity and good diet. 3889 Internal Medicine Comparison of hemodynamic state and serum glucose in non-diabetic patients during non-emergency surgery 1 6 2015 22 132 87 94 30 08 2015 30 08 2015 Background: Major surgery causes hyperglycemia which could affect the outcome of patients who undergo surgery however there is little knowledge on the effect of serum glucose level on the outcome of non-diabetic patients who had surgery. The aim of the present study was to observe the correlation of serum glucose and hemodynamic state in non-diabetic patients undergoing non-emergency surgery. Methods: During this analytic cross sectional study patients who were under lower limb surgery were enrolled to our study. Inclusion criteria were age between 30 and 50 years, ASA criteria 1 to three and elective surgery also exclusion criteria were history of diabetes mellitus, use of corticosteroids and thyroids diseases. Early outcomes including blood pressure, glucose serum level and pulse rate were evaluated before and after surgery. At the end all data were analyzed through SPSS v.16. Results: A total of 160 patients with mean (±SD) age of 42.5 ± 14.9 years were evaluated. There were 103 (64.4%) male and 57(35.6%) female patients. Serum glucose was different before, during and after surgery (p<0.05). There was significant correlation between pre surgery serum glucose and pre (p=0.002, r=0.487) and post (p=0.009, r=0.412) surgery systolic blood pressure. Conclusion: Present study showed that glucose serum level could affect hemodynamic state of non-diabetic patients during surgery, thus, it seems in these patients tight control of glucose level could decrease the side effects. 3890 Immunology Assessing in vitro inhibitory effect of adipose-derived mesenchymal stem cells on C57BL/6 diabetic mouse splenocytes proliferation 1 6 2015 22 132 95 106 30 08 2015 30 08 2015 Background: Type 1 diabetes (T1D) is a T-cell mediated autoimmune disorder in which pancreas beta-cell destruction causes insulin deficiency and hyperglycemia. In addition to daily insulin treatment, allogeneic islet transplant inT1D is another therapeutic way that needs immunosuppressive drugs to control autoimmune damage and graft rejection. Since life-long application of these drugs is associated with serious side-effects, we proposed local immunomodulatory effect of mesenchymal stem cells (MSCs). The aim of this study was to investigate in vitro inhibitory influence of adipose-derived MSCs on C57BL/6 diabetic mouse splenocytes proliferation against syngeneic islet cells lysate. Methods: MSCs were extracted from abdominal fat tissue of healthy C57BL/6 mouse and cultured to prolipherate. Then, they were immunophynotyped and their differentiation to osteo- and adipocyte was approved. Diabetic C57BL/6 mouse model was prepared by administration of consecutive low-doses of sterptozotocin and diabetic state was confirmed by serum glucose (>300 mg/dL) and insulin levels, and pancreas histopathology. Pancreas islets were isolated from healthy mouse and splenocytes prepared from healthy and diabetic mice. To evaluate anti-proliferative effect of MSCs, they were co-cultured with splenocytes in the presence of islet lysate and proliferation was assayed by MTT technique. The presented data are mean SD and statistically analyzed with one way ANOVA. Results: Extraction and identification (Immunolphenotyping and differentiation) of MSCs had acceptable outcome.Diabetic state was confirmedin our model (blood glucose: 300±20 vs. 95±10 Insulin level: 4.9±0.5 vs 0.3±0.1 and lack of Langerhans islets in tissue sections). The co-culture experiments demonstrated that MSCs significantly decreased diabetic splenocytes proliferation in the presence of islet cells lysate (p<0.05). Conclusion: MSCs can effectively inhibit autoimmune response of diabetic splenocytes against islet cells lysate. Assessing MSCs immunomodulatory effects and differentiation property to insulin-producing cells may provide a new horizon for T1D treatment in the future.