Background: In recent years, kidney complication of diabetes became the basic cause of the end stage of renal disease in many countries around the world and then primary kidney disease goes on the 2-3 places. Due to the fact that diabetes mellitus turns more and more into non-communicable worldwide epidemic, we faced the increase in kidney complication which is one of form of micro vascular complications. So, illness of every 1-2 in three patients to undergo a renal replacement therapy has been diagnosed as diabetic nephropathy and of course nephrologists could not leave this fact without their attention. Goal: To study a change in the kidney structure with type 2 diabetic patients. Materials and Methods: Within the scope of the research 35 autopsied passed way because of the type 2 diabetes in clinical hospitals. According to Tervaert classification of diabetic kidney pathology issued by American Society of Nephrology in 2006, changes in glomerular structure were divided into 4 classes. Ordinary staining methods as hemotoxilin eosin, Van Gizonestaning connective tissue, Periodic Acid- Schiff standing have been used.Results: 35 autopsied in total, including 23 male (65.7%) and 12 female (34.3%) were covered by this research. And glomerular basement membrane thickening discovered in 51.4%, mesangial matrix expansion in 34.2%, Kimmelstiel-Wilson nodule in 20% and advanced glomerulosclerosis in 8.5% of total cases, respectively.Conclusions:1. It is found that diabetic kidney can be classified by Tervaert classification using ordinary standing and PAS reaction on the light microscope.2. However, we faced an essential necessity to be armed with immunofluorescence and electron microscope for the purpose to improve diagnostic examination and establish classes more accurately.3. Today when the medical science develops as evidence-based medicine, a starting the kidney biopsy samples assaying become the vital issue in comparative studying the clinical stage of diabetic kidney pathology.

Introduction: According to the report of World Health Organization and International Society of Hypertension, an estimated 17.5 million people died from cardiovascular diseases in 2005 representing 30% of all global deaths, 1.5 billion people had hypertension and 45% of hypertensive people were unaware of their condition in 2007. In our country, prevalence of hypertension and its risk factors are studied, but prevalence of uncontrolled hypertension that is an important criterion of hypertension control, and its influencing factors is not reported yet. Goal: The aim of our study is to evaluate prevalence of uncontrolled hypertension and to determine its some influencing factors.Materials and Methods: It was population based, cross sectional, prospective study. Participants of the study were selected by randomized method. In the study, 1111 individuals that live in Bayanzurkh and Songinokhairkhan districts of Ulaanbaatar city are participated. The study based on questionnaire and BP measurement which aimed to reveal:• Hypertension unawareness• Untreated• Treated and uncontrolledStatistical analysis was performed by using SPSS 17.0 program.Results: In the study, in total 1111 people aged ≥18 years have been involved. Mean age of all participant was 40.58±16.10 and 63.2% of them were female. We estimated that 38.4% of the population had hypertension and 28.3% of those were unaware their hypertension (unawareness). Among aware population, untreated population percent were 42.1%. We determined that age, sex, education level and visiting to physicians can be risk factors of uncontrolled hypertension.Conclusion: Of the estimated 1111 people with hypertension 28.3% were unaware of their hypertension, 29.5% were aware of their condition but were not being treated, 33.7% were being treated but their hypertension remained uncontrolled and only 8.4% were taking medications that controlled their hypertension. Factors such as young age, male gender, and not measuring BP for the last one year influence negatively on uncontrolled hypertension (p<0.005).

Background According to the report of World Congress of Cardiology in 2007, 1.5 billion people had hypertension and 45% of hypertensive people were unaware of their condition. In our country, some study had provided estimation of risk factors and prevalence of hypertension, but main characteristics presenting the early detection and control of hypertension have not been studied well and information does not exist.The quality of the control, registration and early detection of hypertension will be improved by studying this topic and complications and mortality due to the hypertension could be decreased.GoalThe aim of our study is to evaluate the current situation of the early detection, registration and control of hypertension, and to describe future strategyObjectives:1. To describe the hypertension awareness and risk factors associated with early detection of hypertension2. To evaluate the current situation of registration system of hypertension and to find out the strategies for renewing registration system3. To investigate the rates of the treatment and control of hypertension, and to survey factors associated with the control of hypertensionMaterials and MethodIt was population based, cross sectional, prospective study. Participants of the study were selected by randomized method.In the study, 1103 individuals, 133 physicians and 2 family hospitals located in Bayanzurkh, Songinokhairkhan districts, were surveyed. The study based on questionnaire and BP measurement which aimed to reveal:• Hypertension awareness (%)• Treatment (%)• Control (%)Software program name: Arterial hypertension registration and control Objectives of the program: to evaluate registration of arterial hypertension, to detect earlier, to determine control level of hypertension Users: family hospitals, family doctorsType of morbidity registration: population basedStatistical analysis was performed with SPSS-17 software program. Single- and multi-factorial analysis was explored by using simple and logistic regression and significance.ResultsIn the study, in total, 1103 people aged of ≥18 years living in Bayanzurkh and Songinokharkhan districts of Ulaanbaatar, have been involved. 37% of all participants were male and 63% were female and mean age of all participants was 40.6±16.1. According to our study, 305 individuals of 431 hypertensive participants (70.8%) were aware of their hypertension. This result was different in gender: 58.0% in male, 79.0% in female. Our research team created software program that can integrate all hypertension data to one database. We are planning to determine unawereness; aware and treated; treated and controlled; and uncontrolled levels by using this software and to introduce the program created by us to all primary level physicians in order to use routinely.Conclusions:1. Among hypertensive individuals, awareness of hypertension was 70.8%. Factors such as young age (<35), single people and not measuring BP for the last one year influence negatively on early detection of hypertension (p<0.05).2. Current method of hypertension registration is not proper at the time. Therefore, we concluded that renewing of the arterial hypertension registration database and conversion it into electronic type is convenient to control arterial hypertension and to provide integration.3. Treatment level of arterial hypertension was 39.9%, controlled arterial hypertension among all hypertensive population - 10.2% and among treated population – 25.2%.

BackgroundThere are 137 soums of 17 provinces have plague foci in Mongolia. The 51.7% of them is case, 23.4%- low, 9.5% - high, 0.7% - hyper active. Main host of plague foci is marmot in Mongolia. According last20 year’s surveillance study, about 75.5% of Y.pestis was isolated from marmot, marmot carcassesand their flea. Human plague cases has been caused illegal hunting marmot in Mongolia. Even legaldocument which prohibited marmot hunting was appeared since 2005, people has been hunting marmotfor selling marmot meat, skin and other products. It is depends economy crises and other public issues inMongolia. Also influenced increase risk of human plague and being reverse result in plague preventionactivities.Materials and MethodsStudy was used data of rodent for zoonotic diseases suspicious which tested plague in National centerfor zoonotic disease (NCZD) in 2005-2015 and 13 local center for zoonotic diseases in 1988-2015. Datawas kept in NCZD and National archival authority. For mapping we used Arc View 3.2.ResultsTotally 397 event information of suspicious rodents and other animals was received in NCZD from 8 districtsof Ulaanbaatar city in 2002-2015. Most of information was received from Songinokhairkhan-64.2%district and smallest number was from Nalaikh district-0.3%. 92.2% of them were marmot, 0.1% of themwere marmot raw products for treatment purpose. Totally 1285 animal samples were tested by plaguedisease and the result was negative. Five hundred thirty tree marmots were carried to Ulaanbaatar from10 provinces. In that time plague foci were active and Y.pestis was isolated in provinces which marmotwas carried to Ulaanbaatar.In 1988-2015, totally 257 marmots and animals of 515 event information was received in15 provinces.Including 13.2% of them were birds, 84% of them marmot, 1.6% of them were livestock, 1.2% of themother animals. About 216 marmots were tested by plague. 51.2% of them were detected positive results.We develop conclusion based laboratory investigation result even it need high cost to take earlyprevention and response measures.Conclusion1. It is high risk to spread plague by carrying suspicious animal in urban area. Therefore, it is importantto take early response measures even it high cost. In further, increase cost and support rapid test ofhigh technology.2. To organize rational advertisement and increase knowledge of population about not doing illegalhunting, not selling marmot raw products in urban area, not using marmot raw products for treatmentuse and avoid contact with marmot carcasses.3. It is important to cooperate joint response measures with policeman, inspection agency andveterinary and human health sectors in Mongolia.

BackgroundIgA nephropathy and MPGN are common glomerulonephritis in the world that progresses slowly andrenal function can even remain unchanged for decades. Clinically, it presents by isolated hematuria,proteinuria. Histologically, IgA nephropathy presents with acute glomerular damage, mesangial cellproliferation, endocapillary leucocyte infiltration, and crescent formations, these lesions can undergoresolution with sclerotic healing. Since 2013, renal biopsy has been done at the First Central Hospitalof Mongolia a few times. However, the confirmative diagnosis of IgA nephropathy and MPGN remainunknown in Mongolia by renal biopsy. Therefore, we intended to test renal biopsy techniques andconfirm its diagnosis by renal biopsy at the Second Central Hospital of Mongolia.MethodsUltrasound guided renal biopsy had been done for four patients by nephrologist at the Departmentof Nephrology of the Second Central Hospital of Mongolia. All four specimens were evaluated assatisfactory which show more than 8 glomerulus under the light microscopy. Each renal cortical tissuewas divided into two tips: one piece for routine H&E stain and special stains, including Masson’strichrome, and PAS stain; another piece for immunofluorescence by frozen section, which werestained with IgG, IgM, IgA and complement component 3 (C3). Each case was screened by threepathologists.Results:The case which shows mesengial widening, mesengial hypercellularity under the light microscopyor mesangial granular deposition of IgA and C3 by immunofluorescence was diagnosed as IgAnephropathy. We obtained crescent formation with glomerular adhesion in most cases. In addition, weobserved secondary MPGN in one case, which is caused by hepatitis C virus infection.Conclusion: Probably, it is a new step for developing pathologic diagnosis for nephrology in Mongolia.We needs further study for improving renal biopsy technique and confirming the diagnosis of IgAnephropathy and MPGN using electron microscopy and pathological report by oxford classification forIgA nephropathy.

Introduction: According to the World Health Organization (WHO) in 2020, brain and central nervous system (CNS) cancers account for 2% of all newly diagnosed cancers in the world and 1.5% in Mongolia. Approximately 85-90% of all brain and other CNS tumors were diagnosed primary brain tumor. In 2019, the average 5 year survival probability was 50% for other cancers and 11% for the primary brain tumors. There were 28 patients with primary brain tumor and 33 relatively healthy individuals in our study. Goal: To study the diagnostic value of serum aquaporin-4 and glial fibrous acidic protein in the diagnosis of primary brain cancer Material and Methods: The Department of Neurosurgery at Third central hospital included 28 patients with primary brain cancer and 33 relatively healthy people. The study was conducted under the permission of the Medical Ethics Review Committee of the Ministry of Health on June 19, 2019 №119. Serum aquaporin-4 and glial fibrous acidic protein content was determined by the ELISA kits method using the human aquaporin-4 and glial fibrous acid protein test kit of the Chinese company “Sanlong”. The level is assumed to be true if the p value is less than 0.05. Results Mean age of the all participants was 42.9±16.5, 64% female and 36% male. Serum aquaporin-4 protein levels were 175.71±13.3 pg/ml and serum glial fibrilliary acidic protein levels were 2.682±0.218 ng/ml in patient with primary brain tumor. Serum aquaporin-4 protein and glial fibrilliary acidic protein levels were statistically significant high (p<0.001) in patient with primary brain tumor. Serum aquaporin-4 protein and glial fibrilliary acidic protein level differences were statistically significant (p<0.05) in benign and malignant tumor. There was no statistically significant correlation between serum aquaporin-4 and glial fibrillary acidic protein level and primary brain tumor grade.

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.

BACKGROUND: Toll like receptors (TLRs) are a class of proteins that key role in the innate immune system. TLR7 is expressed on monocytes, macrophages and dendritic cells, T cell, B cell and eosinophiles. TLR7, originally identified as recognizing imidaquinoline, loxibrine, broprimine and ssRNA, ssRNA viruses such as vesicular stomatitis virus, influenza A virus and human immunodefiency virus. It is known that virus ssRNA affects signaling molecule of IFN-y. Objective: To determine gene and protein activation of IFN-y signal transduction by TLR7 ligand in the endothelial cells. MATERIAL: In study we used mouse aortic linear endothelial cell which is cultured (END-D) in 5% heat- inactivated fetal calf serum (FCS), medium (DMEM) containing antibiotic mix(penicillin G, streptomycin, amphotericin B) at 37°C (5% CO2). Endothelial cells treated with synthetic IFN-γ and imiquimodligands, then the NO (nitric oxide) concentration in the supernatant is determined by Griess reagent. Endothelial cells are cultured in 6 well cell culture plate and in each well 2*104cells are expected to be grown for 24 hours of culture. Then, the cells are treated with synthetic IFN-γ and имиквимод ligand for 6 hours and the NO signaling gene activation iNOS mRNA expression which is induced by IFN-γ is determined by RT-qPCR. Endothelial cells are cultured in 12 well cell culture plate and in each well 2*104 cells are expected to be grown for 18 hours of culture. Then, the cells are treated with synthetic IFN-γ and imiquimodligands for 24 hours and the NO signaling protein iNOS expression which is induced by IFN-γ is determined by western blotting. The experiment was conducted as representation mean of at least three test results. The difference between statistical probabilities is determined by the “Students” t test. The p<0.01 value is assumed to be statistically different. RESULTS: TLR7 ligand imiquimodaugmented interferon gamma induced nitric oxide production TLR7 ligand imiquimodincreased interferon gamma induced iNOS mRNA gene expression. TLR7 ilgand imiquimodup-regulated interferon gamma induced iNOS protein expression. CONCLUSIONS: TLR7 ligand imiquimod augments IFN-γ signaling in the endothelial cells. This synergistic effect has revealed in the levels of gene and protein expression.

Introduction: When human body encounters external pathogens primary/innate immunity cells are activated by recognizing them and secondary/adaptive immunity is activated consecutively. In our previous study, we revealed that there is a synergistic action between TLR9 and IFN-γ signaling in the endothelial cells. Purpose: To determine the role of negative and positive regulator proteins on the IFN-γ/TLR9 signaling pathway. Methods: In this study, murine endothelial cell (END-D) culture was used. END-D cells pre-treated with TLR9 ligand CpG DNA and then stimulated with IFN-γ. The negative (SHP-2, SOCS1, PIAS1) and positive (p38) regulator protein expression was detected by Western blotting. Results and Conclusion Treatment by TLR9 ligand CpG DNA and IFN-γ increased positive regulator p38 phosphorylation in 0.5 hour. CpG DNA inhibited IFN-γ negative regulator PIAS1 protein expression in 6 hour and SOCS1 and SHP-2 expression could not affect in 4 hour.

Introduction: Valproic acid (VPA) has been used in the treatment of seizures and bipolar disorders. In the present study, we examined how VPA affected PI3K-Akt pathway in response to LPS by using mouse RAW 264.7 macrophage cells. Material and methods: Mouse RAW 264.7 macrophage-like cells cultured and the cell viability checked by MTT and TUNEL assay. In addition, protein expression and protein interaction were detected by immune blotting and immune precipitation, respectively. TLR4 expression on cell surface studied by FACS analysis. Results: The MTT and TUNEL assays demonstrated no significant difference between VPA at 2 mM treated and untreated control cells. VPA attenuated LPS-induced phosphorylation of phosphatidylinositol 3-kinase (PI3K) and Akt, but not nuclear factor (NF)-κB and mitogen activated protein kinases (MAPKs). There was no significant difference in the TLR4 expression on the cell surface between cells treated with or without VPA. VPA inhibited LPS-induced PI3K/Akt signal transduction in a dose dependent manner. Conclusion VPA at 2mM exhibits nontoxic effect in the RAW 264.7 cells. VPA down regulates LPS-induced phosphorylation of Akt via inhibition of PI3K activation.