Rationale: Effective healthcare starts with an accurate diagnosis, and laboratory plays an important role in this. All health laboratories, be it clinical, animal health, food safety, or environmental health laboratory, contribute to health care and public health security. Therefore, many public health programs are conducting laboratory assessments. The assessment findings can be used for identification of areas in which efforts should be directed in order to strengthen the national laboratory system and health laboratories. Goal: The goal of the project was to assess the national laboratory system and health laboratories of Mongolia. Methods and materials: Laboratory assessment tool (LAT) developed by WHO was used for the assessment of two areas: 1. strategic organization at the national level, and 2. specific technical capacities at the laboratories level. The national laboratory system was assessed using LAT System questionnaire with the participation of MOH officers, and the assessment of laboratories was conducted using LAT Facility questionnaire with the involvement of laboratories representing public and private sectors, all three levels of urban and rural health care organizations, and clinical and public health areas of laboratory services. Results: The strongest areas of the national laboratory system at the policy and regulatory level were “Coordination and management” and “Laboratory information system”. The weaker (below 75%) areas were “Structure and organizations”, “Regulations”, “Infrastructure” and “Human resources”. The insufficient infrastructure score was due to the lack of financing. The main problems detected in the area of Human resources were insufficient financial and organizational support of continuous education of laboratory workers, shortage of trained personnel and incomplete national registration system of laboratory professionals. The results of the laboratory capacities showed that the assessed laboratories were strong in “Data and information management”, “Specimen collection and handling” and “Consumables and reagents”. The testing performance of most laboratories was excellent but the external quality assurance was not available in some test disciplines. The weaker areas of the laboratories were “Facilities”, “Public health functions” and “Biorisk management”. The module “Organization and management” showed lower score mainly due to insufficient budget. The same was with “Facilities”. Although the general safety management of laboratories was very good, the biosafety component was not incorporated in it. Conclusions and recommendations: 1.A national regulatory body needs to be established for the registration of all laboratories and laboratory professional staff. 2.Each laboratory should formally designate an appropriately trained Quality manager, 3.Set-up a formal professional development/ continuous education system for laboratory professionals. 4.Develop biosafety policy and implementation plan. 5.Establish a comprehensive national laboratory information management system (LIMS).

Background. Puerperal infection following caesarean section remains a major cause of maternalmorbidity and mortality. It is still one of actual problems in Obstetrics and has incidence rate 2-10%. It isestimated 150 000 maternal deaths due to infection worldwide, despite tendency to decline septicemiaafter C-section due to wide usage of antibiotics in the obstetric practice, postpartum infection hasincreased last decade. Post-Caesarean sepsis incidence rate is above 20%. An assortment of pathologicagents may cause puerperal infection including bacteria, virus and parasites. In 30-40s of last centurymain reason of infection was Streptococcus, then in 40-60s major role was played by Staphylococcus,later in 70-80s Gram-Negative Aerobic Bacteria took its place.Objective. To improve prevention and treatment of post-caesarean sepsis by detection of its causes andantibiotic sensitivity. Materials and methods: We reviewed patients admitted to First Maternity Hospitaland National Center for Maternal and Child Health and who had post-caesarean sepsis between 2011-2013. Statistics analysis had been performed by SPSS-17 software programme, whereas statisticsprocess by X2 test, Fisher test, and t-test. Confi rmation rate was 95%. P<0, 05.Results. The clinical course of 361 post-caesarean patients with septicemia was reviewed prospectively.Primary dysfunctional labour (P<0.033), preterm rupture of the membranes (P<0.0001), ineffectivelabour induction (P<0.001) are risk factors for infectious morbidity. Considerations should be given toprophylactic antibiotic therapy by choosing correct medicine at the correct time. E.coli 29,4%, Intestinalbacteria 9,1%, Staphylococcus epidermis’s 8,9%, Staphylococcus aureus 7,2%, Gram-NegativeBacteria 6,6%, Streptococcus 5,3%, Gram-Positive Bacteria 2,8%, Candida albicans 1,4%, Micoplasma1,1% were responsible for bacteremia, respectively.Conclusion. Bacteriology of all patients diagnosed with post-caesarean sepsis in 74, 7% was positivefor pathologic bacterial cultures. Infection caused by 1 bacteria in 141 cases (39, 1%), by 2 bacteria in 56cases (15, 5%), by 3 bacteria in 2 cases (0, 6%), without any detection of bacteria 162 cases (44, 9%).

Abstract: Type 2 diabetes is one of the non communicable diseases which are cause of mobility and mortality of world population. By the study of other researchers in our country early diagnosis of type 2 diabetes is more than 10%, in total of 84.3% of all diagnosed patients, vascular complication has been revealed. In this study we involved 64 people to reveal renal complication which is one of the microvascular of diabetes mellitus and did statistical analyses. We estimated renal complication according to the classification of 5 phases of clinical and laboratory indices. We defined amount of creatinine by fully automatic analyzer CHEMIX-180, amount of urine protein microalbumin and creatinine by CABOY 720 analyzer and proportion was accounted according to terminology. From all participants, 53.1% was male, 46.9% was female, average age was 54.2 years. 29,7% of the all participants had the first and second phase of nephropathy, 14.1% had the third phase, 12.5% had the fourth stage or clinical nephropathy. There wasn’t any participant whom chronic renal failure was revealed. Microalbuminuria analyze is important to reveal renal complication of type 2 diabetes and determine the phase in detail.

BACKGROUNDThe use of stem cells for various clinical applications is highly expected and the production of good quality stem cells is very critical for basic studies. In the bone marrow, hematopoietic and mesenchymal stem cells form a unique niche in which the oxygen tension is low. Hypoxia may have a role in maintaining stem cell fate, self renewal and multi-potency. We investigated whether low oxygen culture would be beneficial for hematopoietic stem cell stemness.METHODSBone marrow cells from 8-10 week aged mice were subjected to hypoxic conditioning by culture for 7days in 20%, 3% and 1% oxygen. For culture,1x105 cell/ml were seeded in colony forming assay in each dish. During the culturing, cell colonies were checked once every three days. Compared to normoxic cells, hypoxic cells weremorphologicallyundifferentiated and counted by Olympus IX71 microscope.RESULTSMore colonies were observed at 3% and 1% oxygen. Statistical significances were identified with granulocytes and macrophage colony (p<0.05) in hypoxic condition.CONCLUSIONSOur data suggests low physiological oxygen culture could improve the stemness of macrophage and granulocytes colony. Long term culture will be necessary to confirm whether low physiological oxygen levels also improve genomic stability.

IntroductionWe organized the 4th Mongolian External Quality Assessment Survey (MEQAS) for Clinical Chemistry testing on basis of the Cooperation agreement between the Ministry of Health Mongolia and Sysmex Corporation in the establishment of the clinical chemistry external quality control, and reference laboratory system in 2011-2013.MethodIn 4th survey, the following survey material we used: Mtrol 1 (Level 1), Mtrol 2 (Level 2). To evaluate participant laboratories we divided into peer groups: full automated analyzer, semi automated analyzer and also divided analyzers by manufacturers and calculate standard deviation index (SDI), precision index (PI). We used absolute evaluation and scoring methods.ResultsThe number of participant laboratories increased in number by 133 instruments from 3rd MEQAS and became 139 instruments, but there were no significant improvements in most all items. The comparison transition of CV 4th MEQAS to 3rd MEQAS we found that there were not much differences between before the 3rd and 4th MEQAS, except some items like total protein, Lactate dehydrogenase (P-L), γ-Glutamyl transferase, potassium, bilirubin direct in which CV % have decreased in number by about 3% from 10% in both levels. We found out the difference results between full automated analyzer, semi automated analyzer groups and manufacturer analyzers and methods in both levels. To improve the results in the future to establish national standards for the reporting units and suggested reagents for clinical chemistry tests, which will be the directions for standardization.

Rationale: Effective healthcare starts with an accurate diagnosis, and laboratory plays an important role in this. All health laboratories, be it clinical, animal health, food safety, or environmental health laboratory, contribute to health care and public health security. Therefore, many public health programs are conducting laboratory assessments. The assessment findings can be used for identification of areas in which efforts should be directed in order to strengthen the national laboratory system and health laboratories.Goal:The goal of the project was to assess the national laboratory system and health laboratories of Mongolia.Methods and materials:Laboratory assessment tool (LAT) developed by WHO was used for the assessment of two areas: 1. strategic organization at the national level, and 2. specific technical capacities at the laboratories level. The national laboratory system was assessed using LAT System questionnaire with the participation of MOH officers, and the assessment of laboratories was conducted using LAT Facility questionnaire with the involvement of laboratories representing public and private sectors, all three levels of urban and rural health care organizations, and clinical and public health areas of laboratory services. Results: The strongest areas of the national laboratory system at the policy and regulatory level were “Coordination and management” and “Laboratory information system”. The weaker (below 75%) areas were “Structure and organizations”, “Regulations”, “Infrastructure” and “Human resources”. The insufficient infrastructure score was due to the lack of financing. The main problems detected in the area of Human resources were insufficient financial and organizational support of continuous education of laboratory workers, shortage of trained personnel and incomplete national registration system of laboratory professionals.The results of the laboratory capacities showed that the assessed laboratories were strong in “Data and information management”, “Specimen collection and handling” and “Consumables and reagents”. The testing performance of most laboratories was excellent but the external quality assurance was not available in some test disciplines. The weaker areas of the laboratories were “Facilities”, “Public health functions” and “Biorisk management”. The module “Organization and management” showed lower score mainly due to insufficient budget. The same was with “Facilities”. Although the general safety management of laboratories was very good, the biosafety component was not incorporated in it.Conclusions and recommendations:1.A national regulatory body needs to be established for the registration of all laboratories and laboratory professional staff.2.Each laboratory should formally designate an appropriately trained Quality manager, 3.Set-up a formal professional development/ continuous education system for laboratory professionals. 4.Develop biosafety policy and implementation plan.5.Establish a comprehensive national laboratory information management system (LIMS).

Background:Mesenchymal stem cells derived from bone marrow and adipose tissue are being applied to tissue engineering and cell therapy. The use of stem cells of various clinical applications is highly expected and the production of good quality stem cells is very critical for basic studies. In the bone marrowmesenchymal stem cells from an unique niche in which the oxygen tension is low. Hypoxia may have a role in maintaining stem cell fate, self renewal and multi-potency. We investigated whether low oxygen culture would be beneficial for mesenchymal stem cell. Results:BMCs from 8-10 week aged, 6 mice were subjected to hypoxic conditioning by culture for 7 days in 20%, 3%, 1% oxygen. For culture 1x106 cell/ml were seeded in media with L-glutamine in each dish. During the culturing, cell colonies were checked once in three days. After cell culture, we stained cells by CD90 then counted CD90 positive cells by fluorescence microscope. More colonies and mesenchymal cells were observed at 3%, 1% oxygen and also colonies were bigger in hypoxic condition. Statistical significances were identified mesenchymal cells (p<0.05) in hypoxic condition. Conclusions:Our data suggests low physiological oxygen culture could improve the differentiation of mesenchymal cells. Long term culture will be necessary to confirm whether low physiological oxygen levels also improve genomic stability.

Introduction:When a central nervous system disorder (meningitis, encephalitis, hemorrhage, leukemia infltration and other neoplasma) is present, cerebrospinal fluid (CSF) shows various changes that reflected the condition. Therefore it is essential to test CSF. Different types of CSF tests include cell count; cell differentiation; chemistry; immunology; microbiology and molecular biology. CSF cell count and cell differentiation in particular, are crucial in differentiating diagnosing various CNS disorder needing immediate care and in evaluating the treatment. The patient’s prognosis largely depends on how accurate diagnosis was done and how early treatment was provided. There for CSF test require high precision and accuracy. In Mongolia until now 2st and 3st level hospital using manual method for CSF cell count and cell differentiation test. In this test has 2 actual problems, which is depends on the analytical techniques, skills and sample stability specific problem. But in Japan in 2011 newly designed Sysmex XN Series hematology analyser with body fluid mode (CSF,pleural effusion, peritoneal and synovial fluid). On The First Central Hospital of Mongolia In 2013 frst timeinstalled Sysmex XN-2000 hematology analyser andpossible use of body fluid automatic testing methods.Materials and methods:We evaluated the basic assay performance of the body fluid mode on the automated hematology analyzer XN-2000, which is used for analysis of CSF fluid. We compared between the manual method and XN-2000 analysis for nucleated (WBC), mononuclear (MN) and polymorphonuclear (PMN) cells was also randomly studied using 10 CSF samples of inpatient section our hospital.Results:In CSF samples the coeffcient correlation(r) for WBC/µl, MN%, PMN% were respectively 0.83, 0.95 ба 0.95.Discussion:The correlation for MN%, PMN% were between automate and manual method was good, that is similar to the other researchers. Whereas the correlation for WBC/µl slightly low, this was probably correlation relatively weak or show discrepancies. In introduction inscriptive in analysis accuracy can to affect analytical techniques skills, sample stability and specifc many problems. Therefore scientifc studied and proven ability specifcity, sensitivity, reproducibility, quality, personnel low cost and spend less time, automatically Sysmex XN series hematology analyzer is desirable to domesticate an appropriate level of medical laboratories.