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Background Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic condition characterized by capillary hyperpermeability which can be predicted by preovulatory ovarian responses such as number of follicles. A variety of cytokines are thought to be involved in pathophysiology of this syndrome. Methods A prospective cohort study invloving sixty intracytoplasmic sperm injection (ICSI) patients. On the day of hCG injection, we explored the threshold of larger follicles ≥11 mm diameter with a count of ≥18 follicles for the high-risk moderate-to-severe OHSS and 13–18 follicles for the low-risk moderate-to-severe OHSS. Whereas larger follicles count of less than 13 were classified as normoresponders. Pooled follicular fluid (FF) samples of each patient were collected on the day of oocyte retrieval. Magnetic multiplex immunoassay was explored to measure the concentrations of some intrafollicular cytokines including: GM-CSF, INF-γ, TNF-α, IL-10, CXCL8/IL-8, IL-6, IL-5, IL-4, IL-2, and IL-1β. All sixty patients underwent controlled ovarian hyperstimulation (COH) with either GnRH agonist or antagonist protocols. Results Intrafollicular TNF-α concentration was significantly different (p < 0.05) in the high-risk moderate-to-severe OHSS patients compared to low-risk moderate-to-severe OHSS patients and normoresponders. TNF-α in FF had a negative correlation with the chance of high-risk moderate-to-severe OHSS. The differences in the risk of OHSS between patients who received GnRH agonist or antagonist were not significant (p > 0.05). Conclusions In accordance to the negative correlation of TNF-α and high risk of early OHSS, we did not expect TNF-α to play a role in increasing vascular permeability in ovarian tissues. In addition, the risk of early moderate-to-severe OHSS was not affected by different GnRH superovulation protocols.

Objectives: Polycystic ovary syndrome (PCOS) is the most common cause of female infertility. The aim of this study was to compare the oocyte and embryo quality between the PCOS women with the control group candidate for in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI). Materials and Methods: The present study was designed at the Infertility Research Center of Milad in the prospective cohort format and was carried out on 100 cases of infertile women with confirmed PCOS (case group) and the male factor (control group) as the first IVF cycle candidates. Both groups underwent the ovary stimulation cycle and ICSI under the standard antagonist protocol. The collected data were then processed and analyzed using the SPSS software, version 16. Results: The average age of study cases was 35±3, and oocyte necrosis was the underlying pathological factor in both groups (28% and 26% in the PCOS and control groups, respectively). In addition, most embryones belonged to either grade 1 or 2 or were 8-cell embryos. Furthermore, the highest number of transferred embryos among the patients was related to the 8-cell and grade 1. The occurrences of biochemical pregnancy in the PCOS and control groups were up to 31.91% and 22%, respectively, leading to 72.73% and 60% childbirth in cases of both groups. Finally, there were no significant differences observed with respect to the quality and the quantity of the embryones, the oocyte, the transferred embryo, the germinal vesicle oocytes, and the rate of pregnancy among the two groups (P>0.05). Conclusions: According to the results of the present study, no differences were found concerning the oocyte quality, embryo, and the pregnancy rate between PCOS cases and any other patients requiring ICSI. Therefore, such cases can similarly benefit from ICSI methods as well.

Ethnopharmacological relevance Saffron petal has traditionally been used to treat a variety of diseases, such as gynecological disease such as primary dysmenorrhea and premenstrual tension. Polycystic Ovary Syndrome (PCOS) is a form of gynecological disease that causes amenorrhea, infertility, menopausal and urogenital disorders. This disease may be treated with saffron petals. Aim of the study In this study, the effects of saffron petal extract (SPE) and saffron petal anthocyanins (SPA) on ovarian hormones, steroidogenic enzymes, ovarian dysfunction, regulation of anti-inflammatory genes, and antioxidant factors in female PCOS mice were studied. Methods and results The PCOS mouse model was induced by testosterone enanthate (TE), and an in vivo evaluation of whether the dietary consumption of SPE and SPA improved the PCOS-like symptoms was conducted. The luteinizing hormone (LH), testosterone, and estrogen levels increased in PCOS mice, but decreased following SPE and SPA treatment. In the PCOS mice, the reduced follicular-stimulating hormone (FSH) progesterone levels were restored to that of normal controls with SPE and SPA treatment in serum. The transcription level(s) of gonadotropin receptors (Fshr and Lhr), steroid receptors (Pgr, and Esr1), inflammatory markers (TNFα, IL1s, IL6 and IL18), inflammatory-related factors (NF-κB, NF-κB p65, IκB) and antioxidant enzymes (GPx, SOD, CAT, GST, and GSH) changed under the PCOS condition. Moreover, they were regulated by SPE and SPA treatment in PCOS mice ovaries. The reproductive tissues of TE induced PCOS mice were restored into estrogenic conditions from androgen environments. The study of antioxidant activity of SPE and SPA using FRAP and DPPH tests showed high antioxidant activity. Conclusion These results suggest that SPE and SPA ameliorates symptoms of PCOS by improving dysregulation of ovarian steroids, steroidogenic, antioxidant enzymes and inflammatory markers in PCOS mice.

Background: Epstein–Barr virus (EBV) is a DNA virus from human herpes virus that associates with many of the human cancers including gastric cancer (GC). Aims: The aim of the present study was to report infection of EBV in adult patients with GC in Northeast of Iran and the correlation between a number of clinicopathology factors with EBV status. Materials and Methods: In a case–control study in 2016, 56 GC patients and 56 controls were selected for the analysis. All patients had gastric adenocarcinoma untreated patients with age >18 years. EBV status detected by the polymerase chain reaction method. Results: Out of 56 GC patients, 35 (62.5%) were EBV positivity and out of 56 controls 3 (5.4%) were EBV positivity (P < 0.001). There is not a significant correlation between the variables with the EBV status (P > 0.05). Furthermore, the progression-free survival rate for the patients with EBV negativity was 95.2% compared with 82.9% for EBV positivity (P = 0.174). Conclusions: This study reported a very high prevalence of EBV-associated GC in the Northeast of Iran compared with other areas of the World and showed a significant correlation between EBV infection and incidence of GC.

Background: Male infertility rate has increased over the recent years across the globe. Intracytoplasmic sperm injection (ICSI) is mainly used to treat male infertility; however, in this method, sperm selection plays a critical role in improving ICSI outcome. Objectives: The aim of this study was to evaluate the efficiency of three sperm selection techniques on ICSI outcomes in oligoasthenozoospermic men. Methods: This randomized clinical trial study was performed on 80 oligoasthenozoospermic (OAS) couples receiving ICSI in Milad Infertility Center, Mashhad, Iran from October 2016 to June 2017. The couples were randomly assigned to the three groups of control, hypo-osmotic swelling test (HOST) and hyaluronic acid (HA) according to the sperm selection technique for ICSI. Fertilization rate, embryo development (ED), embryo quality (EQ) and implantation rate (IR) were evaluated and compared among the groups. Results: Our results showed that there was no significant difference in fertilization rate between the studied groups. ED rate was increased in the HOST and HA groups compared to the control group, but this difference was not significant. EQ was increased in the HOST (P = 0.001) and HA groups (P = 0.001) compared to the control group. IR was enhanced in the HA group in comparison with the control group (P = 0.021), but there was no significant difference between the HOST and HA groups. Conclusions: The results of this study showed that for achieving successful clinical outcomes and improved embryo quality and implantation rate in oligoasthenozoospermic males undergoing Intracytoplasmic sperm injection, effective sperm selection through either the HOST or HA technique is necessary.

To determine the prognostic value of intrafollicular concentrations of some cytokines from women undergoing ovarian stimulation in the outcome of intracytoplasmic sperm injection/embryo transfer (ICSI/ET) cycles.A total of 80 patients were included in this study following ovarian stimulation and ICSI. Follicular fluids (FF) were collected at the day of oocyte retrieval. Ten cytokines including: tumor necrosis factor- alpha (TNF-α), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, CXCL8/IL-8, IL-10, granulocyte-macrophage colony stimulating factor (GM-CSF), and interferon gamma (IFN-γ) were measured using magnetic multiplex immunoassays.Only the concentration of IL-5, IL-4, and GM-CSF in FF were significantly different (p 0.05) between ICSI cycles that resulted in pregnancy and those that failed. Elevated FF IL-5 levels were associated with poor oocyte quality, which decreases the chance of both biochemical and clinical pregnancy. Higher FF GM-CSF associated with decrease of mature oocytes, while higher FF IL-4 concentrations were linked to good ICSI outcome through increased fertilization rate.The elevated intrafollicular concentrations of IL-5 seem to be a negative predictor to the pregnancy outcome in ICSI cycles.

Background: Gastric cancer has a highmortality rate and often has a poor treatment outcome. The HER2/neu gene target therapy has been known as a potential way for treatment. Objectives: The goal of our study was assessment the relation between chromogenic in situ hybridization (CISH) and immunohis- tochemistry (IHC)methods in determining the best diagnosticmethod for gastric cancer. Methods: In this historical cohort study, 50 gastric cancer samples were analyzed by CISH and IHC. The relation between clinical- pathological parameters of HER2/neu was also analyzed. Alive patients were followed from 2009 through 2012 for the main out- comes (mortality). The results of these twomethods, in terms of sex, age, tumor size, grading, staging, tumor location,metaplasia, presence of necrosis and ulceration, vascular invasion, the TNM system, mucin or signet producing adenocarcinoma cells and pa- tient survival rates were compared. Results: There was no significant difference between IHC and CISH regarding the sex, age, tumor size, grading, staging, tumor lo- cation,metaplasia, presence of necrosis and ulceration, vascular invasion, the TNMsystem,mucin or signet producing adenocarci- noma cells and patient survival rates. Comparison of TNMscores by these twomethods showed no significant relationship between IHC and staging, but a statistically significant difference between CISH and different N staging, (P < 0.05) was assessed. Conclusions: Comparison between IHC and CISH showed the only significant relationship between CISH and different N staging. Therefore, low amplified CISH was a better diagnosticmethod for gastric cancer, compared to low expression in IHC.

Objective The present study attempts to compare the immunohistochemistry (IHC) of von Willebrand factor (vWf) , endothelial cadherin, Caveolin and endothelial Nitric Oxide Synthase (eNOS) in VasoView Endoscopic Vein Harvesting (EVH) versus traditional Open Vein Harvesting (OVH) techniques for Coronary Artery Bypass Graft (CABG) Surgery performed in Javad al Aemeh Hospital of Mashhad, Iran in 2013,. Methods and materials Forty-seven patients were scheduled for CABG (30 EVH and 17 OVH) among whom patients with relatively same gender and similar age were selected. Three separate two cm vein samples were harvested from each patient’s saphenous vein. Each portion was collected from distal, middle and proximal zones of the saphenous vein. The tissues were deparaffinized, and antigen retrieval was done using EZ-retriever followed by an immunohistochemistry evaluation with vWf, e-cadherin, Caveolin and eNOS. In addition, demographic questioner as of Lipid profile, FBS, BMI, and cardiovascular risk factors were collected. Data analyses, including parametric and nonparametric tests were undertaken using the SPSS 16 software. A P value 0.05). Qualitative report of vWf, e-cadherin, Caveolin and eNOS reveals no significant difference between the EVH and OVH (P > 0.05). Conclusion This study indicates that VasoView EVH technique causes no endothelial damage in comparison with OVH. This study could be a molecular confirmation for the innocuous of EVH technique.

The purpose of this study was to investigate the prognostic significance of intratumoral immune cell counts in Iranian gastric cancer patients. A historical cohort study was conducted on fifty patients with non-metastatic intestinal-type gastric adenocarcinoma who underwent curative gastrectomy during 2004-2008 in Imam-Reza Hospital, Mashhad University of Medical Sciences. Immunohistochemistry (IHC) staining for CD56, CD68, CD117 and CD1a was performed to detect natural killer cells, macrophages, mast cells and Langerhans cells, respectively. The immune cells were counted, and the patients were then stratified into low or high immune cell counts. The prognostic significance of this grouping was analyzed using the Kaplan Meier method and Cox proportional hazards regression modeling. Thirty eight (76%) male and twelve (24%) female patients were enrolled in the study with a mean (±SD) age of 66.0 (±9.2) years. The median survival time was 15.0 (95%CI: 5.5-24.5) months. Natural killer cells, mast cells and Langerhans cells showed a positive effect on survival, whereas the reverse was true for macrophages. Multivariate analysis showed that the independent prognostic factors were location of the tumor (cardia/non-cardia), stage, the presence of extra-cytoplasmic mucin, tumor associated macrophage status (low/high), and tumor associated Langerhans cell status (low/high). In the studied population, gastric carcinoma proved to have a very poor prognosis. Multivariate analysis showed that the prognostic effect of natural killer and mast cells in tumoral tissue were dependent on the Langerhans cell count, defending the theory that dendritic cells mediate other immunocytes activities.