Background. Cardiovascular diseases (CVD) constitute major cause of death in patients with chronic kidney disease (CKD). It is well established that in decreased renal function is associated with an increased risk of arterial stiffness, so patients with end stage renal disease have a very high risk for cardiovascular events. There have been no reports of the assessment of arterial stiffness in patients at different stages of non diabetic CKD in Mongolia.Aim. The purpose of this study was to determine the correlation between an estimated glomerular filtration rate (eGFR) and cardio-ankle vascular index (CAVI) in the CKD patients. Material and Methods. From a hospital-based population, 125 patients with CKD (mean age 40.30±10.82) were recruited. CKD was evaluated by the eGFR using the Cockcroft-Gault formula. CAVI was determined as an index of arterial stiffness.Results. The mean CAVI was in CKD level l ( 6.00±0.81, p 0.0001), ll (6.90±0.77, p 0.0001), lll (7.42±0.65, p 0.0001), lV (7.63±1.22, p 0.0001) and V (8.02±1.27, p 0.0001). CAVI was negatively correlated significantly with eGFR (r=-0.596, p 0.0001) and age (r=0.543, p 0.0001). Linear regression analysis indicated that CAVI was correlated significantly with eGFR (β=-0.466, p 0.0001) and age (β=0.373, p 0.0001).Conclusion. Decreased eGFR is associated with an increased risk of arterial stiffness, and it could be a strong predictor of risk factor for CVD in CKD patients.

Background: The World Health Organization calls hypertension the number one risk factor for death in the world and it’s considered a significant risk for stroke, heart failure, and kidney failure. Hypertension is common in patients with chronic kidney disease (CKD), and high blood pressure (BP) has been associated with a decrease in kidney function. The purpose of this study was to determine the correlation between an estimated glomerular filtration rate (eGFR) and BP in the CKD patients. Methods: From a hospital-based population, 125 patients with CKD (mean age 40.30±10.82) were recruited. CKD was evaluated by the eGFR using the Cockcroft-Gault formula. Cardio-Ankle vascular index (CAVI) was determined as an index of arterial stiffness. BP was measured using a mercury sphygmomanometer after subjects had sat and rested for at least 15 minutes. Pulse pressure was calculated as the difference between systolic BP (SBP) and diastolic BP (DBP). Mean arterial pressure was calculated as DBP plus one-third (SBP-DBP).Results: When BP grows up, renal function (eGFR 113.72±57.85, 78.39±60.96, 60.56±55.71, 28.38±19.96) and arterial stiffness (CAVI 6.51±0.99, 6.90±1.05, 7.22±1.17, and 7.79±1.16) are decreased. Linear regression analysis indicated that eGFR was correlated significantly with SBP (β=-0.480, p< 0.0001) and hypertension time (β=-0.332), p<0.0001). SBP was the strongest risk factors for CKD with each SD increase in systolic blood pressure (1mmHg) associated with > 4% higher risk ( hazard ratio: 1.04; 95% Cl: 1.02-1.07).Conclusion: Increases SBP were significantly associated with CKD.

Background: High blood pressure is both a cause and a complication of chronic kidney disease. As complication, high blood pressure may develop early during course of chronic kidney disease and is associated with adverse outcomes, in particular faster loss of kidney function and development of cardiovascular disease. The purpose of this study is early detection of chronic kidney disease in patients with hypertension by defining the prevalence of microalbuminuria.Methods: The study population consisted of 169 subjects with a hypertension. Individuals were considered to have hypertension if the blood pressure measured greater than 140/90 mmHg or if they were taking blood pressure lowering medications. Microalbuminuria was defined as 20 mg/l or greater. Results: We are presenting data on 169 subjects :male 38 (22.5%) female 131 (77.5%), average age 51.6±0.89 At screening, 14.8% of all participants were smokers, 62.1 % engaged in low levels of physical activity, 72.8% - were having tea with salt (table1). Microalbuminuria and renal failure, as GFR<60 ml/ min/1.73 m2, were documented in 34.3% and 16.6% of subjects, respectively. There is positive correlation between MAU and increasing-range of blood pressure (table2). Correlation was found between albuminuria and GFR(r= -0.2 p<0.01) and serum creatinine(r=0.31 p<0.01) the regression result has shown that GFR is associated with MAU and serum creatinine (table 3).Conclusions:1. In 34.3% of patient with hypertension was found nephropathies with MAU2. Microalbuminuria is increased with decline of GFR and raise of systolic blood pressure. GFR decline is with the raise of age and serum. It is important to implement in clinical practice screening of MAU hypertensive patients.3. In 2/3 of all screened subjects was found 1 and more risk factors for CVD.

IntroductionAH is one of the widest spread diseases, as well as the leading cause of mortality in Mongolia. Even though the AH is well studied throughout the world, with no significant results in health complications caused by AH in different organs and systems, there is a necessity to study the use of other methods in hypertension treatment, such as Mongolian traditional medicine for an adequate management of hypertension, in order to extend the choices of treatments by combining harmless natural multicompound drugs prepared by ancient mongolo-tibetian prescriptions with Chinese acupuncture and other therapy methods such as massage, bloodletting, cupping etc.GoalThe authors have analyzed 260 patient records of hypertension that have been treated only with MTM treatment methods in MONGEM MTM hospital, in order to define: 1) the classification of arterial hypertension according to theory of disease in MTM ;2) the classification of arterial hypertension according to theory of cold and hot in MTM;3) The results of MTM treatments on hypertension.Methods and MaterialsWe have conducted this study by document review and case study by analyzing 260 patient records of “MONGEM” traditional medicine hospital and research center.ResultsAccording to our study almost 80% of arterial hypertension cases start as a hot disease and change into cold disease. Our research results have also shown that 90% of hypertension can be classified into congested, interdependent state of disease and that treatment by MTM methods of combined disease with consideration of changes in hot and cold states is efficient for relieving arterial hypertension.ConclusionOur study has concluded that carefully diagnosed hypertension using MTM disease and disorder classification, and treated with accordingly chosen methods of MTM treatment such as multi-compound drugs, mild and rough techniques, nutrition and behavioral lifestyle changes combined with Chinese acupuncture, gives satisfactory results in healing arterial hypertension, thus providing safe, efficient, affordable and accessible treatment choices for people.

BackgroundEarly detection of minor strokes and their treatment that aim to prevent from complications into severe strokes is a process of secondary prevention. There is a need to extensively use image diagnostics (CT, MRI) because signs are obscure, at times without focal neurological sign but can have special mental or psychological syndromes. The start of minor stroke studies in Mongolia will enable further deepening of these studies in future and give an impetus to identification of theoreticaland practical aspects together with further improvement of diagnostics, treatment and prevention of minor strokes.GoalTo develop and introduce the diagnostic criteria of ischemic and hemorrhagic minor strokes in accordance to the concepts of minor strokes and to treat minor stokes in order to prevent complications into severe strokes.Materials and MethodCurrently there are no globally accepted diagnostic criteria for minor stroke. We support the 1981 WHO criteria of minor strokes as strokes neurological signs of which disappear in relatively short period of time. There is a general notion that it should mean all light forms of stroke other than severe strokes. In cases of neurological signs of a minor stroke, complete recovery and elimination of the symptoms take up to 3 weeks. Most scholars tend to consider ischemic lacunar strokes (arising from occlusion of arteriole vessels deep in the brain and with size of 0.5-20 mm) as minor strokes. We maintained the concept that characteristic features of these strokes are their limited focal areas and the following neurological symptoms: pure motor, pure sensory, light ataxia, etc. We also duly considered a suggestion (D. German, L. G. Koshchug et al, 2008 ) to define minor hemorrhagic strokes as strokes with diameter less than 2 cm and blood volume less than 5 cm3.We identified 60 patients with minor strokes, involved in monitoring using special research template (with a term of at least 1.5years) and involved in pathogenesis treatment. In the treatment, we maintained a principle of differential diagnosis of ischemic stroke symptoms. Specifically, we differentiated the following: signs related to an atherotromb, cardio-embolic, lacunar, hemodynamic, hemorheologic pathogenesis. To verify the diagnoses, we used MRT and CT image tests. We executed paraclinic tests in order to identify risk factors: Doppler-duplex-sonography, brain angiography, blood lipid fraction, ECG, EchoCG, heart Holter, blood hemorheology test, and identified the most affecting factors (hereditary factors, excess weight, smoking etc).Results: Our study identified the following clinical forms: lacunar stroke, non-lacunar minor stroke, and hemorrhagic minor stroke. Among the minor strokes, the lacunar stroke dominates (48%), the nonlacunar stroke is the next (27.7%), and the hemorrhagic was found to be the least common 25%. From among a host of risk factors, arterial hypertension is dominant (86%) either alone or in combination with such other diseases as diabetes, atherosclerosis etc. Diabetes occurrence was 5 cases (8,3%) which is fewer than in some foreign studies.The clinic of minor stroke also varies. The strength and expression of their symptoms compared with those of severe strokes are unique in the following:- Relatively lighter and recover faster as a result of treatment even in acute forms,- Some are without specific clinical signs (“silent stroke”).- Some minor strokes have micro focal signs, for example, “pure motor”, pure sensory, ataxia etc, in other words, the signs are limited.- In cases of lacunar strokes, predominantly deep brain arterioles are damaged.- Whereas in non-lacun strokes, embolic, ateroma, thrombotic mechanisms are predominant suchas distal branches of big artery. - In cases of hemorrhagic minor strokes, arteriopathy distortions occur not only in depth of brain but also in any small lobar vessels of brain.- Focal lesions have some variations by their pathological locations and minor stroke signs.In non-lacunar strokes (25%), the focal damages predominantly occur in branches of large intra/extra cranial arteries. In cases of lacunars strokes, the focal lesion is not in branches of large intracranial vessels, but is predominantly in basal ganglia, deep white matter, thalamus, pons and in area of deep penetrating arterial vessels. However, focal infarcts in cerebella may occur in any form of minor strokes.ConclusionAccording our study there were identified 3 subtypes of minor stroke. The finding is that lacunars and hemorrhagic minor strokes are more likely to give grounds to severe strokes. From this, it can be concluded that there are specific factors in the population of Mongolia to affect the genesis of minor strokes, namely, arterial hypertension which is directly related with these forms of minor strokes. We appropriate the WHO criteria of minor stroke that is neurological signs of a minor stroke, complete recovery and elimination of the symptoms take up to 3 weeks. In treatment of minor stroke, we suggest that minor strokes should be treating by pathogenetic therapy. Namely, antihypertensive therapy for lacunar infarction, anti-aggregation therapy for nonlacunar infarction and haemostatic and antihypertensive therapy for hemorrhagic minor stroke.

Abstract: Numerous researches conducted in Russia, Bulgaria, Japan, and China on B.pubescens, B. pendula, B.rezniczenkoana (Litv) Schischk, B.humilis Schrank, B.mandshurica Rgl Nakai found that birch barks and leaves contain antioxidants and they have anti-cancer, anti-fungi, antibac- terial and anti-inflammatory properties, protect liver and promote bile secretion. Flat leaved birch (B.platyphylla Sukacz) cortex contains betulin and lupeol of triterpenoids and it’s leaves contain flavonoid and polyphenol compounds. The amounts of compounds found in the cortex are smaller than leaves. Specifically, the amount of flavonoid in leaves is more contained than the that of cortex and leaf buds. In any pharmacology study of new medicines, determination and evaluation of toxicity is the first priority. According to scientific evidences that birch leaves are considered to have less toxins. Not many studies have been conducted on determining toxicity of birch leaves in Mongolia. Therefore, the purpose of this research is to study the species of birches, hippolytii birch (B.hippolytii. Sukacz) and flat leaved birch (B.platyphylla. Sukacz), that were noted to have medical properties in traditional medications and identify their acute toxicity using dry extract and determine mortality dosage (LD₅₀) on animals. Research materials and methods: Evaluation of the acute toxicity of birch leaves was conducted in Pharmacology laboratory of Monos group’s Drug Research Institute between June 19, 2020 and August 10. In this research, 150-204 g of WISTAR breed non-linear 44 white rats were used and 20 g of B.Hippolytii’s dry extract and 20 g of B. Platyphylla ‘s dry extract were injected.
The experiments to determine the toxicity of dry extracts of B. hippolytii and B. platyphylla (LD₅₀) were conducted according to Litchfield and Wilcoxon’s method and subcutaneous injects were per formed in the pelvic area of the rats. Results of determining acute toxicity level The experiments to determine the acute toxicity level of the birch’s dry extracts followed Litchfield and Wilcoxon’s method with 2-stage. LD₅₀ level was determined from the first stage of the research using G.N.Pirshen’s method and the toxicity level was identified using K.K.Sidorov’s toxicity categorization.
From the acute toxicity research, no-observed-adverse-effect level (NOAEL), animal daily dosage and human daily dosage (experimental) were determined. LD₅₀ 2950 mg/kg was determined as a result of acute toxicity research of B.hippolytii and B.platyphilla leaves’ dry extract.

Abstract: The birch leaves were used as a substitute for birch bark, buds and chaga of birch in traditional medicine because the birch leaves are considered to be less toxic. Numerous researches conducted in Russia, Bulgaria, Japan, and China on B.pubescens, B. pendula, B.Rezniczenkoana (Litv) Schischk, B.humilis Schrank, and B.mandshurica Rgl Nakai found that birch barks and leaves contain antioxidants and they have anti-cancer, anti-yeast, antibacterial, anti-inflammatory, liver protective and bile secretion induction properties. The studies conducted on animals with diseases showed that the birch leaves had anti-inflammatory properties on the gastric mucosa during acute stress, as well as anti-biliary and giardiasis. The birch leaf phytopreparations experimentations used on animals showed reduced peripheral tissue insulin resistance and lowered blood sugar. Mongolian traditional medicinal journals noted that the birch barks are used to treat inflammatory acute diseases. Therefore, this study was performed to determine the effects of two species of birch leaves on blood sugar and antioxidant activities in diabetes-induced rats. The study materials and methods: The study was conducted in the Pharmacology Research Laboratory of the Monos Group’s Institute of Pharmacology. 40 WISTAR, non-linear white rats weighing 150-204 g were used in the experiments. Dry extract of birch leaves of the two species (Alloxan monohydrate Tokyo Chemical Industry LTD), IGM-100 3A blood glucose meter (Blood glucose test meter, Infopia LTD, Brussels Belgium) and sugar test (Blood glucose test strip only, province, China) were used for the experiment. Lenzen’s (2008) method was used to induce Alloxan diabetes in the rats and the antioxidant properties were determined by the antioxidant activity kit (Rat Malondialchehyche Elisa KIT, cat. № EKRAT- 0266, Jilin). Study Result: The blood glucose level of the control group with diabetes lowered from 31.5 mmol/l to 17.1 mmol/l in 14 days. As for the B.platyphylla Sukacz group, the blood glucose level reduced to 6.3 mmol/l and the B.hippolytii. Sukacz group’s blood glucose level reduced to 6.9 mmol/l in 14 days.
The study results showed that B.hippolytii Sukacz birch leaves and B.platyphilla Sukacz birch leaves’ extracts reduced the maximum level of MDA dilution (4.8 nmol/ml) of B.hippolytii Sukacz and B.platyphilla Sukacz groups by 33.9% and 53.5% respectively. This suggests that the birch leaves had antioxidant effect. Conclusion B.hippolytii Sukacz birch leaves and B. platyphilla (Sukacz) birch leaves lowered the blood glucose level and had antioxidant properties on diabetes.