Introduction:Structure and Function of the digestive organ diseases in that commonly occurred Ulcer Disease (PUD) is becoming one of the major diseases in the population furthermore it is tending to increase and peptic ulcer malignity is in the fourth leading tumor which causes to death.80% of the patients who has Gastric ulcer, 80 % of the patient who has PUD, has helicobacter pylori infections.Mongolian statistics data estimates that there are in total 355256 structures and function of the digestive organ diseases were registered in 2011. 25.2 % of stationary disease, 74.8% of is ambulatory diseases from them stationary disease of PUD are 3.74 %, ambulatory disease of PUD are 4.84%.Purpose of the study: Indicate the substantial supply of essential drugs of PUD in the stationary and ambulatory treatment.The study material and method:Diagnosis of PUD 2010-2012, The retrospective study has been done on the history of 393 stationary patients in the Gastroenterlogy Department of Orkhon, Uvur-Khangai, Khovd, Dornod’s regional center for diagnosis and, State Central Clinical Hospital, Clinical Hospital-2, Hospital-3 named after Mr. Shastin, Hospitals in Songini Khairkhan District and Nalaikh Districtbut also 107 ambulatory patient’s substantial supply of prescribed drug treatments were compiled by cross sectional studies which is specifically developed study card.WHO advised the drug supply “ Managing drug supply, the selection, the procurement, distribution and use of pharmaceuticals ” method by Jonathan D. Quick, Jamas R. Rakin, Richard O.Laing, Ronald W.O’Connor, Hans V.Hogerzell, M.N.G.Dukes, Andrew and Кобзарь л.в, дрёмова н.Б, глембоцкая г.т мнушко з.н. Statistic was developed and implemented excel, SPSS16.0 programme.Result of the study: In the study 500 people wereabove 20 and average age is 48.36±14.44.As a tertiary Level hospital 27, As a secondary Level hospital 18,Regional Center for Diagnosis 21, ambulatory treatment 22 kinds of drugs were used in PUD’s treatment. Omeprazolum 380, Metronidazolum 242, Sylcoseryl 227 were used.163380.15 tugrug (Mongolian currency) budget is required for Stationary treatment of Peptic Ulcer Disease (PUD) but 987540.95tugrug budget is required for ambulatory treatment.Conclusion:As a tertiary Level hospital 27, As a secondary Level hospital 18 and Regional Center for Diagnosis used 21 kinds of drugs for PUD.22 kinds of tablets were used for Peptic Ulcer Disease in an ambulatoryAs the result of the study 163380.15 tugrug for PUD’s stationary treatment, 987540.95 are required for PUD’s ambulatory treatment.

To study some direct fees paid by a household of a hospitalized patient during the treatment at secondary or tertiary care hospitals.The study was conducted using cross-sectional design. The data was collected from 6 specialized clinical centers, 7 hospitals of provincial and regional diagnostic and treatments centers, and 6 district hospitals using the data of 1335 in-patients hospitalized during 2012-2013. The in- patients’ medical histories were processed using descriptive research methods by using specially designed cards to register the costs for medications and medical equipment. In addition, the questionnaire was used to collect the data on direct and indirect costs associated with hospitalization paid by individuals. Statistical data was analyzed using SPSS 21.0 software. 96% (1282) of total hospitalized patients were covered by health insurance. However, 28.4% of them paid for their drug treatment out-of-pocket. 62% of in-patients who paid for their own medicines responded that the medicines were written in their medical history but the hospitals were out of stock and therefore did not provide them to the patients. 3% of in-patients who paid for their medicines were reimbursed the costs of medicines. When comparing the informal costs associated with a hospital stay to the total household income, 23% of respondents said that those expenditures were high. While 54% of total costs spent by hospitals on diagnosis and treatment of in-patients were used for medicines, the in-patients’ out-of-pocket expenditures were higher in secondary care hospitals.Due to drug supply in secondary and tertiary care hospitals is insufficient to meet the needs for drug treatment; in-patients are required to spend a part of their household income to pay for drug treatment during their hospital stay.

IntroductionStructure and Function of the digestive organ diseases in that commonly occurred Peptic Ulcer Disease (PUD) is becoming one of the majority diseases in the population furthermore it is tending to increase and peptic ulcer malignity is in the fourth leading tumor which causes to death. Mongolian statistics data estimates that there are totally 355256 structures and function of the digestive organ diseases were registered in 2011. 25.2 % of stationary disease, 74.8% of is ambulatory diseases from them stationary disease of PUD are 3.74 %, ambulatory disease of PUD are 4.84%.PurposeTo define the types and needs of drugs which are used in the stationary and ambulatory treatment of patients who are suffering from peptic ulcerMaterial and MethodDiagnosis of PUD 2010-2012, The retrospective study has been done on the history of 393 stationary patients in the Gastroenterlogy Unit of Orkhon, Uvur-Khangai, Khovd, Dornod’s regional center for diagnosis and, State Central Clinical Hospital, Clinical Hospital-2, Hospital-3 named after Mr. Shastin, Hospitals in Songino-Khairkhan District and Nalaikh District but also 107 ambulatory patient’s substantial usage of prescribed drug treatments were compiled by cross sectional studies which is specifically developed study card. “The consumption method and morbidity method” by Hogerzell H.V., Jonathan D.Quick., James R.Rakin,(2005) was used due to identify drug needs as WHO advised.ResultsIn the study 500 people were above 20 and average age is 48.36±14.44. As a tertiary Level hospital 27, As a secondary Level hospital 18,Regional Center for Diagnosis 21, ambulatory treatment 22 kinds of drugs were used in PUD’s treatment. Omeprazolum 380, Metronidazolum 242, Sylcoseryl 227 were used. Peptic ulcer disease stationary treatment drug needs are not enough.Conclusions:1. As a tertiary Level hospital27, As a secondary Level hospital18 and Regional Center for Diagnosis used 21 kinds of drugs for PUD. 22 kinds of drugs were used for Peptic Ulcer Disease in an ambulatory2. Peptic ulcer disease stationary treatment drug needs are not enough.

Introduction: Determining stages of liver fibrosis in chronic liver disease is essential for clinical practice such as decision making on medical treatment, setting the interval of follow-up examination for its complication, screening intervals for hepatocellular carcinoma. Goal: We compared non-invasive fibrosis markers among the patients with chronic hepatitis Delta. Materials and Methods: Totally 70 patients with chronic hepatitis D enrolled into this study. The blood samples were examined for complete blood count, liver function test and serum M2BPGi level. Non-invasive markers such as AAR, APRI, Fib-4 scores were calculated. Those with AAR >1, APRI >0.7, FIB-4 >1.45 were considered with advanced fibrosis. All patients underwent liver stiffness measurement using FibroScan M2 probe. The cutoff values of FibroScan for advanced fibrosis were 9 kPa for patient with normal transaminase level and 11 kPa for patients with elevated transaminase. Results: Advanced fibrosis was observed in 25.7%, 38.6% and 38.6% by AAR, APRI and Fib-4 score, respectively. When cut-off levels of serum M2BPGi for advanced fibrosis was 2.2 COI, 35.7% had advanced fibrosis. FibroScan tests showed 34.4% had advanced fibrosis. The AUROC of M2BPGi were 0.894 and 0.827 for predicting advanced fibrosis and liver cirrhosis. Conclusion Serum M2BPGi and FibroScan would be reliable diagnostic tool for identifying liver fibrosis in Mongolian patients with chronic hepatitis D.

Background: Hepatocellular carcinoma (HCC) is a primary liver cancer originating from liver cells, classified as a chronic liver disease. This cancer ranks third in the world in terms of mortality rate. The MELD (Model for End-Stage Liver Disease) and Child-Pugh scoring systems are utilized to assess the prognosis of chronic liver diseases. Based on studies suggesting that certain blood test indicators, particularly red cell distribution width (RDW), could be used to predict the prognosis of liver cancer and other cancers, as well as serve as diagnostic markers, this topic was chosen to evaluate the clinical significance of RDW in hepatocellular carcinoma. Aim: The aim is to study some blood test indicators and compare them with the MELD score and Child-Pugh score systems in order to determine the prognosis of chronic liver diseases. Materials and Methods: A retrospective, single-center, cross-sectional study was conducted at Mongolia-Japan Hospital. Among 322 patients diagnosed with HCC, 24 patients were selected for the case group, and 37 patients with liver cirrhosis were included in the control group. Results: According to the research criteria, 61 patients were selected and divided into 3 groups, and statistical analysis was performed. In the detailed blood test, platelet count and WBC count showed statistically significant differences among the 3 groups (p< 0.024). In the biochemical tests, C-reactive protein (CRP) was p< 0.018, total bilirubin p< 0.001, and the mean albumin level p< 0.015, all showing statistically significant differences among the 3 groups. A statistically significant inverse correlation was observed between RDW-CV and the clinical MELD score (r=-0.356). Conclusion Platelet count, RDW, CRP, total bilirubin, and average albumin levels are significantly different across the studied groups. RDW-CV shows a moderate inverse correlation with MELD scores, suggesting its potential as a prognostic marker in chronic liver diseases. Further research with larger sample sizes is recommended to confirm these findings.

BACKGROUND Bovine colostrums is the milk secreted by cows during the first few days after parturition. It contains many essential nutrients and bioactive components, including growth factors, immunoglobulins, lactoperoxidase, lactoferrin and cytokines ets. Lactoferrin has been reported for its multifunctional properties such as antifungal, antibacterial, antiviral antioxidant and anticancer activities. The aims of this study focused on the isolation and purification of lactoferrin from Mongolian bovine colostrums. Lactoferrin purified using HiTrap DEAE an ion exchange chromatography. Lactoferrin purification efficiency was about 60.5%. The single band of purified lactoferrin has been observed in SDS-PAGE electrophoresis. METHODS Bovine colostrum was collected at a cow farm in the Darkhan province of Mongolia. At first the cream was separated by centrifugation (10000 xg 20 min at 4oC). In order to separate the whey, the samples were precipitated with 1mol/l to pH 4.6 and centrifuged at 10000 g 20 min again. The samples of whey were stored at -18oC to the analysis. Lactoferrin was purified by HiTrap DEAE an ion exchange chromatography using 0.005 M phosphate buffer (pH 7.7) and linear gradient NaCl from 0.25M, 0.5M, 1M. During chromatography, protein in the eluents was monitored by ultraviolet absorbation at 280 nm with the instrument. Purity test done by using polyacrylamide gel electrophoresis under denaturated condition (SDS-PAGE) method by Laemmli (1970). For HPLC determination of the lactoferrin by Shimadzu Nexera X2 HPLC system with UV/ VIS detector were used. Detection was carried out at the wavelength 280 nm. Separation was performed on a chromatographic column Protein R C18 ,2.2 x 150 mm, 5 μm particle size. Linear gradient and flow rate 0.2 ml/min were used. Mobile phase a consisted of water / acetonitrile/ trifluoroacetic acid ( 95:5:0.1). The column temperature was set at 40oC and injection volume was 10 μl. Data were collected and evaluated by software Lab Solution. An external standard method for quantification analytes was used. RESULTS Purified lactoferrin in the present study had a good concentration and purification efficiency was about 60.5 %. Protein fraction from 1M NaCl gradient delivers sharp and clean peak to HPLC chromatogram that fits intensity and retention time of standard bovine lactoferrin. Ammount of lactoferrin in bovine colostrums was 0.6 mg/ml and it`s molecular weight 80 kDa as a standard sample. The retention time of lactoferrin fraction which is purified by SDS-PAGE gel electrophoresis. The peak of fraction same compared to the standard lactoferrin 5.8 minutes by HPLC analysis. CONCLUSION Ion exchange chromatography shows reliable and easy isolation of lactoferrin from Mongol bovine colostrum.