1.Erratum to ‘Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: Insights from the IMbrave150 trial’ Clin Mol Hepatol 2024;30:807-823
Sun Young YIM ; Sung Hwan LEE ; Seung-Woo BAEK ; Bohwa SOHN ; Yun Seong JEONG ; Sang-Hee KANG ; Kena PARK ; Hyewon PARK ; Sunyoung S. LEE ; Ahmed O. KASEB ; Young Nyun PARK ; Sun-Hee LEEM ; Michael A. CURRAN ; Ji Hoon KIM ; Ju-Seog LEE
Clinical and Molecular Hepatology 2025;31(2):669-670
2.Correspondence to editorial 2 on “Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: insights from the IMbrave150 trial”
Sun Young YIM ; Sung Hwan LEE ; Ji Hoon KIM ; Sunyoung S LEE ; Ahmed O KASEB ; Ju-Seog LEE
Clinical and Molecular Hepatology 2025;31(1):e84-e86
3.Correspondence to editorial 1 on “Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: insights from the IMbrave150 Trial”
Sung Hwan LEE ; Sun Young YIM ; Ji Hoon KIM ; Sunyoung S. LEE ; Ahmed O. KASEB ; Ju-Seog LEE
Clinical and Molecular Hepatology 2025;31(1):e81-e83
4.Correspondence to letter to the editor on “Genomic biomarkers to predict response to atezolizumab plus bevacizumab immunotherapy in hepatocellular carcinoma: Insights from the IMbrave150 trial”
Sung Hwan LEE ; Sun Young YIM ; Ji Hoon KIM ; Sunyoung S LEE ; Ahmed O KASEB ; Peng WEI ; Ju-Seog LEE
Clinical and Molecular Hepatology 2025;31(1):e110-e112
5.Effects of flavanone on cancer cells viability
Jadamba Ch ; Erdenezaya O ; Iderjavkhlan S ; Burnee M ; Gurbadam A ; Temuulen D ; Darambazar G ; Oldokh O ; Enkhmaa D ; Giimaa N
Mongolian Journal of Health Sciences 2025;88(4):28-32
Background:
In recent years, scientists have found that certain natural compounds have significant potential in cancer
prevention and early-stage cancer treatment. Flavanones, a class of polyphenolic compounds found in plants, vegetables,
seeds, fruit peels, and flowers, have been identified to possess anticancer, antioxidant, anti- inflammatory, and antibacterial bioactivities. Cancer has become a major global challenge in terms of both economic and public health concerns.
Global statistics indicate that 22.8% of deaths are attributed to non-communicable diseases, and 16.8% are caused by
cancer, accounting for one in four and one in six deaths, respectively.
Aim :
To investigate anticancer effects of Iris Tenuifolia-derived flavanone on cancer cell lines.
Materials and Methods :
The study was conducted at the Bio-Medical Research Institute of the Mongolian National Uni
versity of Medical Sciences, investigating the effect of flavanones on cancer cell viability under in vitro conditions using
the MTT assay. In the study, colon, liver, and lung cancer cells were cultured, stabilized, and used for the experiments.
Colorectal cancer cells (MC38), liver cancer cells (HepG2), and lung cancer cells (A549) were revived, cultured, and
stabilized for use in the experimental procedures. Statistical analysis of the results was performed using Microsoft Excel
2010, and graphs were generated using GraphPad Prism 8. Differences between groups were analyzed using Student’s
t-test, and a p-value of <0.05 was considered statistically significant.
Results :
We treated MC38, HepG2, and A549 cancer cells with different concentrations of flavanone (2.5 µM, 5 µM, and
10 µM) for 24 to 48 hours to evaluate cell viability. Flavanone inhibited A549 cell viability by 2.5 μM-10%, 5 μM-25%,
and 10 μM-38%, respectively. For HepG2 cells, flavanone treatment at concentrations of 5-10 µM reduced cell viability by 28–58%. No statistically significant effect on the viability of MC38 cells was observed following treatment with flavanone at concentrations ranging from 2.5 to 10 µM. Additionally, although MC38 inhibited cell viability in a dose-de
pendent manner in cell cultures, it had a statistically significant effect at higher concentrations of 30-200 μM (p<0.01).
Conclusion
Flavanone inhibits the cancer cell viability in a dose and time dependent manner
6. Impact of Individual Temperament on the Immune Response After COVID-19 Vaccination
Burenjargal B ; Dashpagam O ; Shatar Sh ; Khongorzul T ; Ariunzaya B ; Zolmunkh N ; Gansukh Ch ; Ulziisaikhan B ; Chimidtseren S ; Baasanjargal B ; Enkh-Amar B ; Nomin-Erdene Ts ; Davaalkham D ; Tsogtsaikhan S ; Batbaatar G
Mongolian Journal of Health Sciences 2025;88(4):47-51
Background:
The first confirmed case of COVID-19 in Mongolia was reported on November 11, 2020. In response, the
government imposed a nationwide lockdown, which significantly impacted the population’s mental health. Heightened
levels of stress, anxiety, loneliness, and depression during the pandemic altered individuals’ psychological stability and
behavior. Personality traits—defined as relatively stable patterns of emotion, cognition, and behavior—play a key role in
stress responses and emotional regulation under pressure. Emerging evidence suggests that these psychological factors
may influence the immune system’s responsiveness, including vaccine-induced antibody production.
Aim:
To evaluate the association between post-vaccination antibody responses and personality types following two doses
of COVID-19 vaccines.
Materials and Methods:
A total of 738 participants who received two doses of COVID-19 vaccines (AstraZeneca
ChAdOx1, n=29; Pfizer-BioNTech, n=119; Sinopharm BBIBP, n=590) and had no prior SARS-CoV-2 infection were enrolled. Serum samples were collected 21–28 days after the second dose, and SARS-CoV-2 RBD (S) IgG antibodies
were measured using ELISA (Proteintech Inc., USA). Personality types were assessed using a 56-item temperament
questionnaire developed by A. Belov, categorizing individuals into classical temperament types (choleric, phlegmatic,
sanguine, melancholic). Logistic regression and ROC analysis were used to examine associations between personality
types and antibody response.
Results:
The presence of an antibody response was significantly higher among individuals with a melancholic temperament, and significantly lower among those with a phlegmatic temperament. Furthermore, antibody titers were higher in
participants with melancholic and sanguine temperaments and lower in those with a phlegmatic type.
Conclusions
1. During the early period following the second dose of COVID-19 vaccination, the antibody response was higher
in individuals with a pure melancholic temperament, while it was lower in those with a phlegmatic temperament.
2. After the second dose of the Sinopharm BBIBP COVID-19 vaccine, antibody titers were higher in individuals with
pure melancholic and sanguine temperaments, and lower in those with a phlegmatic temperament.
7.Study on the anticancer effect of apigenin on leukemia cells
Erdenezaya O ; Enkhkhishig O ; Egshiglen A ; Ulziisaikhan B ; Nomiungerel R ; Enkhmaa D ; Uugangerel E
Mongolian Journal of Health Sciences 2025;88(4):52-55
Background:
The study of small-molecule compounds with antitumor activity involves several crucial steps. These
include determining their selective effects on cancer cells, understanding the type of cell death they induce, identifying
the activated signaling pathways, pinpointing the target molecules, and elucidating the mechanisms of action. Among the
plant-derived compounds with anticancer properties, flavonoids are notable for their ease of isolation and their abundance
in food. Apigetrin, a representative flavonoid, is a secondary metabolite found in plants, and our previous study indicated
that its anticancer selectivity index was 13.1. However, the specific mechanism by which apigetrin inhibits leukemia cell
growth remains unclear.
Aim:
To study of the inhibitory action of apigenin on leukemia cell culture
Materials and Methods:
In this study, we evaluated the apoptosis of cells using flow cytometry and investigated the in
volvement of the caspase pathway through the use of pancaspase inhibitors to explore the effects of apigetrin on leukemia
cell growth.
Results:
After incubating leukemia RAW264.7 cells with 30 μM apigetrin for 24 and 48 hours, we did not detect any apoptosis through Annexin V and PI staining by flow cytometry. We compared the number of viable cells using the MTT
assay after 24-hour treatment of apigetrin with or without pretreatment of Z-VAD, a pancaspase inhibitor, for 30 minutes. The results indicated that the pancaspase inhibitor did not reduce the inhibitory effect of apigetrin on the growth of
RAW264.7 cells. In contrast, the positive control group, treated with doxorubicin—which induces apoptosis—showed
not only significant apoptosis but also a reduction of the pancaspase inhibitor on the cell growth inhibition. Therefore,
these data suggested that apigetrin likely has a cytostatic effect or inhibits the cell cycle rather than being cytotoxic. Future
research should focus on determining which stage of the cell cycle RAW264.7 cells treated with apigetrin are in, as well
as studying the signaling pathways involved in the cell cycle.
Conclusions
Apigetrin inhibits the proliferation of RAW264.7 leukemia cells in a caspase-independent and non-apoptotic
manner.
8.The assessment of the current situation of laboratory diagnostic services among family health centers in Ulaanbaatar
Narantsatsral G ; Baljinnyam B ; Myagmartseren D ; Zesemdorj O
Mongolian Journal of Health Sciences 2025;88(4):154-159
Background:
Mongolia’s long-term development policy, Vision 2050, aims to ensure that every citizen has full access
to primary health care services and to increase the country’s average life expectancy. According to the “Primary Health
Care Service Quality and Accessibility Survey,” the diagnostic capacity of family health centers (FHCs) in Mongolia
was 42.1%. There is a need to further identify issues related to laboratory human resources, equipment supply, quality
assurance, and monitoring.
Aim:
To assess the current status of laboratory diagnostic services in family health centers in Ulaanbaatar city.
Materials and Methods:
The study collected data using a questionnaire developed based on resources such as the
WHO’s Service Availability and Readiness Assessment (SARA), USAID’s Laboratory Assessment Tools, the Ministry
of Health’s 2023 Order No. A/283 on updated guidelines for services provided by family, soum, and bagh health centers,
and the national standard “Structure and Operation of Family Health Centers (MNS 5292:2017).” A total of 46 FHCs in
Ulaanbaatar were randomly selected for the study.
Results:
The average population served by the participating FHCs was 10,228±4043, with 73.9% (n=34) serving over
8,000 people. On average, each center employed 5±2 physicians and nurses. A clinical pathologist was employed at 50.0%
(n=23) of the centers, of which 26.1% (n=6) were full-time and 73.9% (n=17) were contract-based. Availability of laboratory equipment was as follows: Complete blood count (CBC) analyzers: 60.9% (n=28) Biochemistry analyzers: 50.0%
(n=23) Urinalysis equipment: 97.8% (n=45) The availability of laboratory equipment was not significantly associated
with the size of the population served (p=0.54; p=0.63; p=0.74). Among FHCs with laboratory equipment: 82.1% (n=23)
performed CBC tests 87.0% (n=20) performed biochemistry tests 97.8% (n=44) conducted urinalysis tests. Participation
in internal and external quality control programs was significantly higher among centers with specialized laboratory staff
compared to those without (p=0.008; p=0.08). The number of tests and biochemistry parameters performed was also significantly higher in centers with specialized laboratory personnel (p=0.001, p=0.001). However, the availability and use of
rapid diagnostic tests did not differ based on population size or the presence of specialized laboratory staff (p=0.8; p=0.6).
Conclusion
1. In Ulaanbaatar, only half of the family health centers have specialized laboratory personnel.
2. Laboratory equipment availability was between 50.0% and 60.9%. Centers with specialized laboratory staff showed
significantly better performance in internal and external quality control and broader diagnostic testing services.
3. Differences in diagnostic services were associated with both the population size served and the availability of specialized laboratory staff, indicating the need to strengthen primary health care accessibility and capacity.
9. Results of a comparative study on Non-alcoholic fatty liver induced and microstructural fibrotic changes
Suvd M ; Badrakh M ; Enkhee O ; Onon B ; Gan-Erdene B ; Nomiungerel R ; Avirmed A ; Khongorzul B
Mongolian Journal of Health Sciences 2025;88(4):188-192
Background:
In recent years, the incidence of liver diseases due to complications of non-alcoholic fatty liver disease
(NAFLD) has shown a significant upward trend in Southeast Asian countries. NAFLD is a hepatic disorder characterized
by lipid accumulation in the microstructure of the liver in individuals who consume little to no alcohol. It is often associated with insulin resistance and is diagnosed when steatosis affects more than 5% of hepatocytes histologically, or when
the fat signal intensity on MRI exceeds 5.6%, based on fat-to-water ratio measurements. In Mongolia, histological studies
using frozen liver sections with routine and special staining techniques are limited, highlighting the necessity of this study.
Aim:
To determine and compare the degree of steatosis and fibrosis in frozen liver tissue samples of patients with NAFLD
through histological analysis.
Materials and Methods:
This study was conducted at the the Department of Anatomy, School of Biomedicine and Bio
medical Research Institute of MNUMS in collaboration with the Second State Central Hospital. Ethical approval was
obtained from the Research Ethics Committee of MNUMS (Protocol No. 2024/3-06). All procedures adhered strictly to
laboratory biosafety protocols. Participants were selected among patients undergoing elective laparoscopic cholecystectomy, from whom informed consent was obtained. Based on inclusion criteria, five participants were grouped as follows:
healthy control (n=1), NAFLD without fibrosis (n=2), and NAFLD with fibrosis (n=2). Liver biopsies (approx. 1 cm in
size) were obtained intraoperatively, immediately deep-frozen in liquid nitrogen, and prepared for histological evaluation.
Results:
In patients with NAFLD compared to the healthy liver group, disruption of hepatocyte columnar architecture and
mild periportal lymphocytic infiltration were observed. Oil Red O staining revealed 34–66% micro- and macrovesicular
steatosis, corresponding to grade 2 steatosis. Masson’s trichrome staining showed no fibrotic changes in perivenular or
periportal areas (Ishak grade 0/4) at this stage. However, upon progression to grade 3 steatosis, early-stage fibrosis was
observed in both perivenular and periportal regions (Ishak grade 1/4). Further progression to stage 4 fibrosis was characterized by the development of connective tissue septa, although no significant changes in droplet size were observed.
Conclusions
1. Increasing stages of fibrosis are not directly influenced by the severity of hepatic steatosis in NAFLD.
2. Although the degree of steatosis increases, the absence of corresponding fibrotic changes in early stages indicates a
complex progression pattern of NAFLD requiring further investigation.
10.Assessment of Knowledge, Skills, and Attitudes of Pharmacy Technicians in Community Pharmacies Regarding Pharmaceutical Waste Management
Bat-Erdene G ; Khatanbold O ; Myagmarsuren B ; Davaadagva D ; Munkhbat S
Mongolian Journal of Health Sciences 2025;88(4):193-199
Background:
Among the total healthcare waste generated from health-related activities, 10–20% is considered haz
ardous, posing significant threats to both the environment and human health. Approximately 3% of healthcare waste is
pharmaceutical waste. In Ulaanbaatar city, an estimated 2.65 tons of healthcare waste is generated daily (0.78 tons of
medical waste and 1.87 tons of general waste). With the continuous increase in pharmaceutical consumption, the improper disposal of pharmaceutical waste has emerged as a major environmental concern, adversely affecting nature, animals, and
the food chain. Contamination from pharmaceutical waste, such as the development of antibiotic resistance, is closely
linked to inadequate public awareness of waste management.
Aim:
This study aimed to assess the knowledge, skills, and attitudes of pharmacy technicians in community pharmacies
regarding pharmaceutical waste management.
Materials and Methods:
A cross-sectional survey was conducted among pharmacy technicians across Mongolia. As of
2023, there are 4,959 licensed pharmacy professionals in the country. Using a representative sampling method, data were
collected from 360 pharmacist and pharmacy technicians. Data were analyzed using MS Excel and SPSS version 26.
Results:
A total of 360 pharmacists from both urban and rural areas participated in the study. The assessment was based
on a 5-point Likert scale, with scores of 1-2 considered negative and 3–5 considered positive. The average scores for
knowledge, skills, and attitudes were 3.3, 3.06, and 3.25 respectively. While individual scores were satisfactory, the results of questions targeting social awareness were relatively low.
Conclusion
The knowledge, skills, and attitudes of pharmacy technicians regarding pharmaceutical waste management
were found to be satisfactory. However, to further improve knowledge levels, it is recommended to implement additional
training programs related to pharmaceutical waste management among pharmacy technicians.

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