Hepatocellular carcinoma (HCC) is one of the common malignant human tumors with high morbidity worldwide. Aberrant activation of the oncogenic phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) signaling is related to clinicopathological features of HCC. Emerging data revealed that microRNAs (miRNAs) have prominent implications for regulating cellular proliferation, differentiation, apoptosis, and metabolism through targeting the PI3K/AKT/mTOR signaling axis. The recognition of the crucial role of miRNAs in hepatocarcinogenesis represents a promising area to identify novel anticancer therapeutics for HCC. The present study summarizes the major findings about the regulatory role of miRNAs in the PI3K/AKT/mTOR pathway in the pathogenesis of HCC. K E Y W O R D S hepatocellular carcinoma, microRNA, PI3K/AKT/mTOR pathway

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Background: Healthcare-associated infections (HAIs) challenge modern medicine. Considering their high prevalence in Iran, we aimed to provide knowledge on the subject, and to teach about the importance of infection prevention and control (IPC) to a broad audience of pre-graduate healthcare professionals, focusing on education as the cornerstone of IPC. Main body:We invited Iranian medical students to present ideas on "how to reduce HAIs." Projects were eligible if being original and addressing the call. Accepted projects were quality assessed using a scoring system. Forty-nine projects were submitted, of which 37 met the inclusion criteria. They had a mean score of 69.4 ± 18.3 out of the maximum possible score of 115. Four reviewers assessed the 37 projects for clinical applicability, impact on patient safety, and innovation, and selected the best 12 to compete at the 2nd International Congress on Prevention Strategies for Healthcare-associated Infections, Mashhad, Iran, 2018. The competition took place in three rounds. The selected teams presented their projects in the first round and debated one by one in a knockout manner, while the jury reviewed their scientific content and presentation skills. In the second round, the top 5 projects competed for reaching the final stage, in which the teams presented their ideas in front of a panel of international IPC experts to determine the first three ranks. At the end of the contest, the participants gained valuable criticisms on how to improve their ideas. Moreover, by its motivating atmosphere, the contest created an excellent opportunity to promote IPC in medical schools. Conclusions: Using innovation contests in pre-graduates is an innovative education strategy. It sensitizes medical students to the challenges of IPC and antimicrobial resistance and drives them to think about solutions. By presenting and defending their innovations, they deepen their understanding on the topic and generate knowledge transfer in both ways, from students to teachers and vice versa.

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Breast cancer is the most common type of diagnosed carcinoma among women in Iran. 1 Tumour markers seem to play a critical role in the treatment and management of patients. Human epidermal growth factor receptor (HER2/neu or HER2) contributes to the progression of certain aggressive types of breast cancer. Overexpression of HER2 or its amplification could be observed in almost 15%-30% of breast cancers and is correlated with poor prognosis or increased disease recurrence. 2 Many studies have evaluated HER2 status in breast cancer patients with primary tumour stage, and its association with axillary lymph node status and tumour grading. Although some studies suggest that high expression of HER2 gene is an unfavourable prognosis factor, the issue remains controversial. 3 Considering the importance of lymph node involvement in prognosis and treatment of breast cancer, we examined the level of HER2 and its association with axillary lymph node involvement in breast cancer patients.By using the NCSS & PASS software, the sample size was calculated as 118 subjects.The inclusion criterion was non-metastatic breast cancer, and the exclusion criteria were presenting metastasis, T4-stage; metastatic disease at diagnosis; incomplete medical records; lack of access to patients' information.All medical records of patients with breast cancer, who referred to oncology departments of Omid and Imam Reza hospitals from 2006 to 2012, were evaluated All demographic characteristics and clinical variables were obtained and re-examined by a surgical oncology specialist. If the patient's medical record was incomplete and further examinations were necessary, we contacted the patient.SPSS was used to analyse all the obtained information. Student t test or Mann-Whitney test (the equivalent nonparametric test) was used to evaluate two independent groups. For assessing the study objectives, chi-squared and logistic regression analyses were used; also, Kolmogorov-Smirnov test was performed to evaluate the normality of quantitative data.Written informed consents were obtained from the patients.Patients were ensured about the confidentiality of the data.The mean age of the participants was 48.82 years within the age range of 24-84 years; the average weight of the subjects was 67.46 kg. We evaluated the expression of ERs, PRs, ki-67 and HER2 receptors. The minimum values of ERs, PRs and ki-67 were 0 but HER2 with a minimum value of three.The pathological findings indicated that age was not significantly associated with type of carcinoma in groups (P = 0.617). According to ANOVA test, the descriptive statistics were not significantly different between the receptor groups.Only ER and PR were significantly correlated with age (P ˂ 0.05). Chi-squared test showed no significant association between type of carcinoma and metastasis (P = 0.864). However, there was an association between ER expression and carcinoma type (P = 0.000). In addition, chi-squared test showed a significant difference between ER-/ER+ and type of carcinoma (P ˂ 0.05). A signific...

Background: Breast cancer is the first leading cause of cancer-related deaths in women. Ki-67 is being used for evaluation of the prognosis of patients with breast cancer. Objectives: The aim of the current study was to explore the association of the involvement of axillary lymph nodes status with the expression of Ki-67 in patients with breast cancer. Methods: A total of 449 patients were enrolled followed by evaluation of the association of Ki67 levels with demographic, pathologic, and survival data of patients, using Chi-square, logistic regression models, student t test and Mann-Whitney. Results: We observed a significant relationship between the expression level of Ki-67 and stage of tumor (P = 0.012), positive progesterone receptor (P = 0.003), and subtype pathologic features (P < 0.05). Also, a significant difference was detected between Her2 and expression level of Ki-67 (P = 0.015). Survival analysis showed the association for Ki-67 (P = 0.02), age (P = 0.005), stage of tumor (P < 0.05), lymph node involvement (P = 0.001), and the Her2 (P = 0.024) with clinical outcome (e.g., overall survival or disease free survival) of patients with breast cancer. Conclusions:The results of this study demonstrated that the overexpression of Ki-67 was associated with large tumors, progesterone receptor expression, and stage of tumor, but it was not related with lymph node involvement.

Aim: During the gathering of demographic data for the biobank on Buerger’s Disease (BD), we found that, after the clinical manifestation of BD, the patients usually became infertile, and the age of their last child was compatible with the time of disease diagnosis. The aim of this study was to evaluate the underlying cause of secondary infertility in BD patients.Method: Anti-sperm antibodies (ASA), testosterone, luteinising hormone (LH), and follicle-stimulating hormone (FSH) in the sera of 39 male BD patients were measured and compared with 39 age-matched Caucasian male controls.Results: Six patients declared that they suffered from impotency. The ASA level was positive in 25.6% of the patients and 2.4% of the controls (p = 0.003, CC = 6.96). The mean levels of testosterone in the patients and controls were 393.12 ± 32.9ng/dl and 354.37 ± 30.9ng/dl, respectively. The mean levels of LH in the patients and controls were 0.88 ± 0.12mIU/r and 0.85 ± 0.1mIU/r, respectively. The mean levels of FSH in the patients and controls were 4.1 ± 0.35mIU/r and 3.56 ± 0.33mIU/r, respectively. No significant difference in the serum levels of testosterone, LH, or FSH was found between the patients and controls (p > 0.05). The spermograms of three ASA-negative patients demonstrated impaired sperm motility.Conclusion: Anti-sperm antibodies, disturbed genital circulation, autonomic dysfunction and sperm motility may be responsible for secondary infertility in Buerger’s Disease. Ethical code: MUMS-941842