Background. A large number of longitudinal studies indicate significantly increased risk of cardiovascular events and death in people with the MetSyn and high plasma levels of triglycerides are an independent risk factor for the development of cardiovascular disease. Apolipoprotein A5 (APOA5) gene, a new member of the APOA1/C3/A4 gene cluster, was identified by comparative sequencing of human and mice DNA by Pennacchio and co-workers in 2001. Since this discovery, variants of ApoA5 gene have been independently assiociated with level of plasma triglyceride in many countries. Human ApoA5 is expressed in the liver then appears in plasma in association with VLDL and HDL and plays a major role in TG catabolism. Variant at ApoA5 gene locus, 1177C>T is located in 3’ UTR which often contains regulatory regions that influence post-transcriptional gene expression. One alteration can be responsible for the altered expression of many genes. Materials and Methods. 152 people with MS for case group and 152 people for control group were selected in this study. MS was diagnosed according to IDF criteria and serum triglyceride levels were determined. DNA from both case and control subjects were extracted from blood samples (200 ml) using “G-spin™ Total DNA Extraction Kit”(iNtRON Biotechnology, Inc). To detect the 1177C>T variation of ApoA5 gene, using High Pure PCR Template Preparation Kits, a forward primer 5’-CTCTGAGCCTCTAGCATGGTTGAGT- 3’ and the mismatch reverse primer 5’-GAGCATTCCCAAATGAGCAC-3’ were used to create the HinfI restriction site. Results. There were 304 total subjects included males 50.3% (153) and female 49.7% (151) in our study. Incident of CC genotype was 71.1% (216), CT genotype was 25% (76) and TT genotype was 3.9%, TAG level was higher in males than females in both groups (p=0.016, ð=0.001) for CC genotype and also, higher with MS in males for CT genotype (p=). But, TAG level was no significant difference among three genotypes in group with MS subjects (male p=0.236, female p=0.881). Conclusion: The TT genotype of the ApoA5 gene 1177C>T polymorphism frequency was 2.9% in control subjects and 4.9% in subjects with MS. However, TG level was not differ in both groups for TT genotype, TAG level in males was higher compared with females (p=0.016 in control, p=0.001 in group with MS).

IntroductionAround for the last 70 years, an annual average temperature in Mongolian territory has been increasedby 2.14°Ñ which is 3 times more rapid than the global average warming rate. Also, the number of heatwave days have been increased [1, 2].Heat wave day’s leads to heat related morbidity and mortality. Espesially, stroke [3-5], cardiovascular [3-13] and respiratory [3, 5, 10, 12] mortalities are prevelant. Cardiovascular mortality has been determinedas a leading cause of mortality in our population while it takes the 3rd place [14] as a cardiovascularmorbidity.As the city of Ulaanbaatar houses 46% of Mongolian population, heat effects on health in the area andits trend need to be assessed, analyzed and identifi ed.PurposeTo identify heat risk days to health of the population of Ulaanbaatar city between the years of 1985through 2015Materials and MethodUnder the requirements set to sample, heat risk days with temperatures above 21.10C or 700F refl ectedon weather forecasts broadcasted from 1985 through 2015 by the Information And Research InstituteOf Meteorology, Hydrology And Environment, Mongolia have been selected. The afore mentioneddata have been translated into the heat index of National Weather Service of USA and processed andconcluded [15] according to the special formula and tables.ResultsIt is shown that heat risk days for the health of population of the Ulaanbaatar city had been 201 from1985 through 1995, 385 from 1996 through 2005 and 373 from 2006 through 2015. The average heatrisk days per given year varied in numbers from 4 through 56 and trended to increase. The largest heatwave days in number happened in the year of 2010 which is 56.According to health impacts of heat risk days, we had 0-47 Cautions, 0-17 Extreme Cautions and 2Dangers in the each of 1999 and 2005 and 1 in 2007 whilst no Extreme Danger has not been recordedyet.Conclusions:1. The number of heat risk days in the area of Ulaanbaatar tends to increase2. The number of Caution and Extreme caution days of Ulaanbaatar is observed to increase. Increaseof “Danger” tagged days, happening of “Extreme” tagged days and heat intense will depend onclimate change.

This abstract is a brief summary of results of studies on climate change related potential health risks.Climate change is a phenomenon, which is resulted by a direct and indirect human-induced change inthe earth’s atmospheric composition during its natural course of variation.The main source of climate change is greenhouse gas emission in the atmosphere which is associatedwith human-related activities.One of the climate change’s effect is elevated atmospheric temperature or global warming which directlyaffects human health. There has been a direct link between a raise in the ambient temperature andcardiovascular morbidity cases sought medical assistances and increased cardiovascular mortality ratedetected. It is found to be that elderly; children and outdoor workers are susceptible to heat-stress duringhigh heats and heat waves. Also, media that, in terms of locations, tropical and sub-tropical countries arefound to be vulnerable to heat effects has pointed it out.Cardiovascular, respiratory and cerebrovascular diseases are commonly reported as the underlyingcause of death, because persons with these preexisting diseases are more susceptible to death duringheat waves and high temperature.Hypertensive, ischemic heart disease and stroke are prevalent contributors to cardiovascular mortality.Cardiovascular morbidity lines up in the 3rd place among the most common causes of the world humanmortality.Identifi cation of vulnerable groups during climate change is the most effective public health action whichis equally being critical in prevention. Therefore, initiate a public alert procedure on extreme heat eventssuch as high ambient temperature and consecutive heat wave days, as well as preventive measurestargeted on vulnerable groups are considered to be effective.

Purpose: Kidney function assessment method is improving gradually. New biomarkers are studied and started using in clinical practice, such as beta 2 microglobulin. Beta 2 microglobulin is improving diagnostic and prognosis in CKD patients. We aimed to assess convenience usage of B2MG alone and B2MG based eGFR in Mongolian patients. Materials and method: We included 116 patients diagnosed with CKD and 55 donors whom with normal kidney function. We collected participant's blood sample by venipuncture in plain vacutainer. Creatinine, urea, cystatin C, B2MG were tested by Roche Cobas C311 equipment in serum. eGFR was calculated by online calculation from NKF. B2MG based eGFR was calculated by eGFR=133*B2M^-0.852 Result: Assessment of kidney biomarkers and eGFR was significantly correlated in both groups. Measured serum creatinine was 3.37 mg/dl in CKD patients and 0.87 mg/dl in donors. Serum urea was 97.6 mg/dl, 31.1 mg/dl, cystatin C 3.05 mg/L, 1.49mg/L and beta 2 microglobulin 10.65 mg/L, 2.43 mg/L respectively. Estimated GFR was 21.5-28.4 ml/min/1.73m2 in CKD patients and 47.7-103.9 ml/min/1.73m2 in donors. Assessing kidney function by biomarkers (r=0.720-0.918, p<0.05), and eGFR (r=0.495-0.996, p<0.05) were significantly correlated in both groups. Conclusion B2MG can be used in clinical practice in Mongolia. B2MG is optional with creatinine, urea, cystatin C for assessing and improving kidney function.

Purpose; To control acupuncture of essential hypertension. Method;The design of the SHARP trial balanced rigorous clinical trial methodology with principles of TCM. Eligible participants had systolic blood pressure 140-179 mm Hg and diastolic blood pressure 90-109 mm Hg in the absence of antihypertensive therapy. Acupuncture was delivered twice a week for 6 weeks.Follow –up visits were every 2 weeks. Result;At weeks 2, 4 and 6 ;both pre-acupuncture and post- acupuncture blood pressure were measured. Those time pre- acupuncture blood pressure decline than post –acupuncture(p<0.0001) . Conclusion;Acupuncture treatment had a significant negative influence reduction blood pressure.

Background: Membranous nephropathy (MN) is among the most common causes of nephrotic syndrome in adults. MN is diagnosed in one third of cases of nephrotic syndrome on kidney biopsy. Kidney biopsy is the gold standard for diagnosing MN and plays an important role in determining the severity of the disease and in determining treatment decisions and regimens. Therefore, the lack of research on kidney biopsy in Mongolia is the reason for this study. Aim: The aim of this study was to investigate the pathological features in the kidney tissues of patients with primary membranous nephropathy diagnosed by kidney biopsy. Materials and Methods: A retrospective study was conducted on 51 cases of MN diagnosed in kidney biopsies performed at the First Central Hospital of Mongolia (FCHM) over a period of 12 years. Renal function was calculated using the CKD-EPI (2021) formula and classified into the stage of CKD by eGFR. Histopathological findings were examined using 4 light microscopy (LM) stains (Hematoxylin-Eosin, Masson-Trichrome, PAS, and Methenamine silver staining) and 8 immunofluorescence (IF) microscopy stains (IgG, A, M, complement C3, C4, C1q, and kappa, lambda). The study excluded secondary MN based on viral markers, tumor markers, and serological tests. Statistical analysis was performed using SPSS and STATA 15.0 software, using t-tests, Pearson’s chi-square tests, and multiple group comparisons were performed using ANOVA and Kruskal-Wallis methods. The study design was approved by the Ethics Committee of the MNUMS, Mongolia. (№ 2023/3-07) Results: A total of 305 kidney biopsies performed at the Kidney Center of the FCHM between 2011 and 2023 resulted in the diagnosis of 51 cases of primary MN. The mean age of patients with membranous nephropathy was 40.6±9.3 years, with the oldest age of 65 and the youngest of 22 years, and 36 (70.59%) were male and 15 (29.41%) were female. In the kidney biopsy, the average number of glomeruli was 16.51±7.82 (min-max, 3-54), and by LM, 33.3% showed global sclerosis of glomeruli by hematoxylin-eosin staining, 94.12% showed thickening of the glomerular basement membrane (GBM), 31.2% showed double counter staining of subepithelial immune complexes by methenamine-silver staining, 88.24% showed holes in the GBM, and 54.9% showed spike-like changes by Masson-Trichrome staining. IF showed IgG 3+ in 37.3%, 2+ in 39.2%, 1+ in 13.7%, and trace staining in 9.8%, while 74.5% of the cases were positive for C3, 93.1% for kappa, and 79.5% for lambda. LM showed thickening of the GBM (OR 23.5, 95% CI 0.093-0.53, p value= 0.007) and interstitial fibrosis (95% CI 6.98-31.07, p value= 0.003) contributing to the decrease in eGFR. The mean time from the onset of the first symptoms of kidney disease to the time of kidney biopsy was 35.35±61.54 months. Patients who underwent biopsy later (in months) after the diagnosis of the disease had a higher incidence of interstitial fibrosis (74.6 ± 98.43, 95% CI -90.52-20.68, p value = 0.002). Conclusion The histopathological features of MN confirmed by kidney biopsy showed thickening of the GBM in 94.12%, global sclerosis in 33.3%, and holes in 88.2%. Immunofluorescence microscopy showed 100% IgG staining, while C3, kappa, and lambda were positive in 74.5%, 93.1%, and 79.5%, respectively.