Thyroid nodular lesions are the common clinical problem in the world. A variety of tests have been employed to separate benign from malignant thyroid nodules. These tests include isotope scanning and fine needle aspiration cytology (FNAC). Our research was based on the fact that the comparison of FNAC and thyroid isotope scan in thyroid nodule was not researched in Mongolia. Therefore, we want to evaluate the specimen adequacy of FNAC, and compare its result to thyroid isotope scanning in patients with thyroid nodule. The research was conducted on archive materials of FNAC and thyroid isotope scanning of patients with thyroid nodule who were treated in surgical department of The First Central Hospital from 2012 to 2015, and the statistic analyze was done by using SPSS 20 under the auspices of School of Pharmacy and Bio-Medicine,Department of pathology, Mongolian National University of Medical Sciences. We have collected the FNAC of 807 patients, including 34 patients (4.2%) were males and 773 patients (95.8%) were females. FNA cytology results were interpreted as benign in 495 cases (61.3%), follicular lesion of undetermined significance in 31 cases (3.8%), follicular neoplasm in 9 cases (1.1%) suspicious in 17 cases (2.1%), malignant in 3 cases (0.4%), and unsatisfactory in 252 cases (31%). We have got the result of thyroid isotope scanning of 43 (5.32%) patients out of 807 cases. On thyroid scan, 18 patients (41.9%) having cold nodule were labeled as suspicious for malignancy, 25 patients (58.1%) had hot nodule. The FNA diagnosis of 25 patients with a hot nodule following: 1 patient (4%) with neoplasm, 17 patients (68%) with benign results, 6 patients (24%) had non-diagnostic. The FNA diagnosis of 18 patients (41.9%) with cold nodule following: 1 patient (5.5%) with follicular lesion of undetermined significance, 10 patient (55.5%) with benign, 5 patient (27.7%) with non-diagnostic, 2 patient (11.1%) had malignant. The FNAC results were interpreted as benign in 495 cases (61.3%), malignant in 3 cases (0.4%), and unsatisfactory in 252 cases (31%). Two patients out of 18 patients with cold nodule diagnosed as malignancy by FNAC. The sensitivity and specificity of thyroid isotope scanning was 96% and 16.6%, respectively.

Introduction: A considerable proportionof adult living donor liver transplantation(LDLT) recipients experience biliarycomplication (BC), but there are few reportsregarding BC based on long-term studies ofa large LDLT population.Methods: The present study examinedBC incidence, from 16 adult and pediatricpatients (14 right liver and 2 left liver graft )between 2011 and 2016 First Central Hospitalof Mongolia.Results: The mean follow-up period was36±1 months. First Central Hospital has DDanastmosis (n=22) double DD (n=2) singlehepaticojejunostomy (n=3). There 3 caseshave biliary stricture after operation. One ofthe 3 cases has biliary laek 2 months laterafter the operation.Conclusion: Close surveillance for BCappears necessary for at least the first 3 yrafter LDLT. In terms of anastomotic stenosisrisk, HJ appears a better choice than DD forright liver grafts involving ducts less than 4mm in diameter.

Introduction: The training of traditional medicine is closely related to its origin.However, the great number of Mongolian and foreign scientists have been conducting the scientific papers during the last years and getting the fundamental contribution to develop the education system of Traditional Mongolian Medicine.Goal: Therefore, we conducted the research paper with the purpose to properly determine the education system of tradition medicine.• To clarify the historical development of education development of Traditional Mongolian Medicine• To compare and clarify the training of Traditional Mongolian Medicine with the modern education system.• To clarify the education level of Traditional Mongolian Medicine.Materialsand Methods:Books including the origins relevant to the history of Traditional Mongolian Medicine kept in The State Central Library of Mongoliaand Natsagdorj’s library, creaturesfor academic degree related to the Traditional Mongolian Medicine kept in the Mongolian foundation for Science and Technology library of were used and based on the following methodology, the research paper was conducted, herein1. Study of original manuscript and source materials: Method expressing the transformation legitimacy of information based on a particular traditional historical bibliography and original manuscript by M.Otgonbayar (1995).2. Method of historical comparision: We tried to conclude history of Mongolian education system and actual process of historical development from ancient time to modern days based on the proper evidences.3. Supposition method:In order to determine the document, information and historical activities in a particular age, the method of the research paper to recite them, was used.Result: In order to reach the main purpose of our research paper, we determined the training system of the education system of Traditional Mongolian Medicine based on the historical frequency of Traditional Mongolian Medicine and clarify whether the Traditional Mongolian Medicine were in every frequency or not by researching and finding the books and teachings. Furthermore, with the purpose to clarify the level of high education, the following result has been reached when comparing the modern medical level with the provisions of (Law on higher education). In accordance with the Mongolian Law on Education, and provisions of Law on High Education, and historical books and writings, present research paper was conducted.Conclusions:1. The total of 8 frequency of ages of traditional medicine development, including the basics of the education system of Traditional Mongolian Medicine, was originated from BC 209 to AC 1206 or the training of traditional medicine was established, the education system of Traditional Mongolian Medicine was consisted from 1206 to 1578, the training of traditional medicine was developed fromХYI century to the middle of ХIХ century, the education system of Traditional Mongolian Medicine was formed from the middle of ХIХ century to 1921, the traditional medicine was developed with the foundation of modern medicine from 1921 to 1942, the starting of traditional medicine of socialism age was developed from 1942 to 1990, restoration of the education system of Traditional Mongolian Medicine from 1990 to1996, and new age of the education development of Traditional Mongolian Medicine was started from 1996 to nowadays.2. The training system of Traditional Medicine for physicians was formed with several stages3. Depending on the stage in which physicians of Traditional Medicine studies, the education degree was conferred similar to the modern days’ education system.

ObjectiveThis study aimed to assess the prevalence of the total aflatoxin in peanuts, and their concentration level.Material and MethodThis cross-sectional survey was conducted in seven district of Ulaanbaatar, the capital city of Mongolia,from March to December 2015.A total of 41 samples of peanuts were randomly collected from the survey area, from March to December2015. An ELISA test was used for detection the total aflatoxins(B1+B2). The relative humidity andtemperatures of the storage areas were measured at the time of sampling the peanut.ResultsThe Frequency statistics analysis showed that 61% of all analyzed peanut samples had detectablelevels of the total aflatoxinat 0.05 μg kg-1. The prevalence of samples contaminated with the totalaflatoxins(B1+B2) were higher among analysed samples of the tree nuts, peanuts imported from China,and canned nuts (P<=0.01). Levels of the total aflatoxins were less than the maximum permissible limitsof 15 μg kg by the regulation of European Union and worldwide. The mean values of the storage relativehumidityat the time of sampling peanuts were higher than the recommended storage relative humidity incorn cereals (<13%). Furthermore, the mean values of the storage temperatures at the time of samplingpeanuts were higher in groundnut peanuts, cedar’s nut and peanuts imported from China than therecommended level of the storage temperature in corn cereals (10°C-21°C).Conclusion:The prevalence of the total aflatoxin in peanuts was higher. The level of the total aflatoxins were less thanthe maximum permissible limits of 15 μg kg-1 by the regulation of European Union and worldwide. Thestorage relative humidity and temperatures of peanuts may encourage the growth of fungi-producingaflatoxins. Thus, a national strategy for the elimination of aflatoxin in foods is needed in Mongolia.

Aflatoxins are the secondary metabolites of the fungi namely, Aspergillus flavus and A. parasiticus. They can colonize and contaminate grain before harvest or during storage. There are about twenty related secondary forms of aflatoxins, and subtypes B₁, B₂, G₁, G₂. These aflatoxins frequently contaminate the foods and feeds (Yu J et al, 2000, Imanaka BT et al, 2007). Aflatoxin B1, the most toxic, is a potent hepatocarcinogenic and genotoxigenic metabolites that have been classified as group I carcinogens by International Agency of Research on Cancer (International Agency for Research on cancer, 1993). Aflatoxin M1 is found in milk of lactating cows that have consumed feeds contaminated with aflatoxin B₁. Aflatoxin M₁ was originally classified as a Group 2B human carcinogen in 1993, but subsequent evidences of its cytotoxic, genotoxic and carcinogenic effects led to a new categorization of aflaoxin M1 as Group I (International Agency for Research on cancer, 2002). Aflatoxins can affect a wide range of commodities, including crops, cereals, oilseeds, spices, tree nuts, milk, meat, and dried fruit (Wilson DM et al, 1994, Bao L et al, 2010). Mongolia has been imported foods about 60 percent of food demands including wheat, flour, rice, milk, dairy products, peanuts and maize. This situation is required to study aflatoxin contamination in food in Mongolia. Epidemiological studies have found that dietary exposure to aflatoxin and chronic infection with hepatitis B, C virus are three major risk factors for HCC (Viviani et al. 1997; Hall et al. 2003). HCC as a result of chronic aflatoxin exposure has been well documented, presenting most often in persons with chronic hepatitis B virus (HBV) infection (Wild and Gong, 2010). The risk of liver cancer in individuals exposed to chronic HBV infection and aflatoxin is up to 30 times greater than the risk in individuals exposed to aflatoxin (Groopman et al., 2008). According to the WHO, the national liver cancer incidence rates was 54.1 per 100.000 population, the prevalence of HBV and HCV infection in 11.8%, 15.6% were respectively (J.Abarsanaa, 2012). This situation is a serous public health problem in Mongolia. Thus, we aimed to carry out the monitoring surveillance survey on the aflatoxin contamination level in some food.

Afl atoxins are a type of mycotoxin produced by Aspergillus species of fungi, such as A. fl avus andA.parasiticus. Afl atoxins are the most potent hepatocarcinogen and mutagen among mycotoxins.Afl atoxins can effects a wide range of commodities, including crops, cereals, peanuts, maize, beans,and milk and fruits. Thus, we carried out a monitoring surveillance survey on the afl atoxins level in somefood commodities. In early stage of this survey we tested a total of 112 samples of foods including fl our,rice, peanuts, maize, dried fruits, milk, and cereals. According to the preliminary results of this survey,59 (52.7%) samples of foods including fl our, rice, peanuts, maize, dried fruits, milk, and cereals’ sampleswere positive for a total afl atoxins (AFB1+AFB2+AFG1+AFG2). Although levels of total afl atoxins in allsamples were at permissible limits by the commission regulation of EU, the strategies for the preventionand control of mycotoxin are required in Public health system and Agricultural organization in Mongolia.Since afl atoxins is the most well-known mycotoxin ever thoroughly studied and its prevention and controlhas been most successfully practiced in various countries, therefore, this paper will focus on the strategyfor the prevention and control of afl atoxins’s mycotoxin contamination food in Mongolia.

This cross-sectional survey was conducted in seven district of the capital city Ulaanbaatar ofMongolia, and border post in Zamiin-Uud, and Altanbulag province from March to December 2015.A total of 380 samples including 70 flours, 114 rice’, 41 various peanuts, 15 maize and maizeproducts, 24 milks, 6 yoghurts, 39 beers, 27 dried fruits and 44 herbal teas were randomly collectedfrom supermarkets, hypermarkets, department stores, factories, and bazaars in Ulaanbaatar city,and Zamiin-Uud, and Altanbulag province.HPLC (High performance liquid chromatography), and enzyme-linked immunosorbent assay (ELISA)were used for the total aflatoxins (B1+B2) and aflatoxin M1 detection.The survey found that (148) 38.9% of all analysed food samples were contained aflatoxins (B1+B2),and aflatoxin M1 were ranging from 0.0094 μg kg-1to 2.4μg kg-1. The levels of aflatoxins (B1+B2)were below the maximum tolerance limit in EU and worldwide regulations. Mean concentrationlevel of aflatoxins (B1+B2) was 0.17 μg kg-1 in all positive samples. Mean daily low and high foodintake were respectively, 63 g and 245 g. Based on the daily food consumption data, estimatedexposure dose of aflatoxins (B1+B2) was 0.16734 mg kg-1bw day-1 in individuals with a daily low foodintake, and 0.65078 mg kg-1bw day-1 in individuals with a daily high food intake (95th percentile). Theexposure dose of aflatoxins from daily high food intake exceeds the estimated provisional maximumtolerable daily intakes, 0.4 μg kg-1 body weight day-1 for adults with hepatitis B (Kuiper-Goodman,1998). Furthermore, estimated excess cancer risk values to liver cancer incidence by ingestion ofthese foods for aflatoxins (B1+B2) and aflatoxin M1were calculated to be 0.0448 mg kg-1bw day-1forindividuals negative for hepatitis Band 1.344 mg kg-1bw day-1 for individuals positive for hepatitis B.Thus, the findings of our survey showed that the potential hazard associated with aflatoxin in foodin Mongolia has not been serious. However, most researchers suggested that no level of aflatoxinexposure is considered safe.Conclusion: Currently, the levels of the total aflatoxins and aflatoxin M1 were lower than the maximumpermissible levels in UE and the USFDA, and worldwide regulations. Currently, estimated exposuredose of the total aflatoxins and M1aflatoxin through daily high food intake was risked in populationwith hepatitis B virus. However, in Mongolian population has not been excess liver cancer risk.

Background:Echinococcosis is from animals to humans and cause cestode zoonoses. Genetic variations within of echonoccocus and their genotypes may cause a disease as well as can indicate transmission dynamics to human and pets. At present, there are no available data for the typing of echinococcosis isolated in MongoliaMaterials and Methods:A total of 50 human hydatid samples from collected from State Centre on Maternal and Child Health, Oncology Centre of Mongolia. All samples were examined by PCR using cox1. The PCR products with a molecular size of 578 bp were amplified from human hydatid samples. Also we used RFLP method.Results:Genotype and strains of E. multilocularis and Е. granulosus were identified by RFLP. PCR products were digested using Ssp I, Hind III, Bgl II endonucleases. PCR products were digested by Ssp I endonuclease we found E. multilocularis. PCR products were digested by Bgl II endonuclease. Two major bands were seen in human hydatid sample. The bands have molecular weight of 420 and 158 bp respectively. It was infected by E. granulosus G6. Digestion with Hind III revealed two major bands within samples from human hydatids. These bands have molecular weight of 168, 410 bp respectively. These samples were infected by E. granulosus G1. Most of E. granulosus materials obtained from human patients by surgery confirmed the presence of sheep strain G1 (Bowles and McManus, 1993 a & c). In 24 cases of human hydatid echinococcosis in Mongolia sheep strain was found to be infective to humans.Conclusions:1. Echinococcosis caused by E. granulosus, E. multilocularis in human.2. G1, G6 genotypes of E. granulosus found in human hydatids.

mmon clinical scenario [1]. The prevalenceof thyroid nodules is ~18-40% in Chineseadults [2]; however, only 5-10 percent of allthyroid nodules are malignant. Although withthe development of the ultrasound technique,several ultrasonographic characteristics havebeen associated with thyroid malignancy[3], individual ultrasound features arenot accurate predictors of thyroid cancer.Thyroid fine-needle aspiration [FNA] hasbeen recommended by various organizationsfor the more precise preoperative diagnosisof thyroid nodules [4]. Non-diagnostic rateof FNA comparison and estimate betweenthe other studiesMaterials and Мethods: We performedover 100 FNA using one pass of the 21-Gneedle attached to a 10 ml syringe withoutlocal anesthesia in 2015. All the FNAswere performed without the guidance ofultrasound. Recent study 100 cases of themwere not selected for a specific method.Results: In total there were 100 patientsrecruited in the study with a mean ageof 45.94±13.13 years and 83.0% femalepatients.The Non-diagnostic rate was comparedbetween groups with different needlesizes and methods. In the 22 G group,non-aspiration showed a decreased NDrate as compared to aspiration [44.21 vs.76.76%, P<0.001;]. In the non-aspirationgroup, a lower ND rate was revealed in the25-G needle group compared to the 22-Gneedle group [34.97 vs. 44.21%, P=0.032;].Notably, the ND rate in the 25 G group wassignificantly lower than in the all 22 G group[34.97 vs. 58.13%, P<0.001;]. In the 21 Ggroups, aspiration showed a decreased NDrate as compared to aspiration [44.21 vs.76.76%, P<0.001;]. 21G aspiration groupshowed decrease twofold ND rate ascompared 22G aspiration group [31.63 vs.76.76%, P<0.001;]Conclusion: There have been studiesusing various needle types [regular needle,needle with a stylet or spinal needle [5]and different needle sizes from [21 G to27 G] with or without aspiration duringthe procedure. Numerous factors influencethe diagnostic rate in thyroid FNA, amongwhich the nodule component is an extremelyimportant factor [6]. In general, the morecystic the percentage of each nodule, thehigher the rate of non-diagnostic, with the lowest ND rate in the solid nodule using a25-G needle at 26.77% and the highest inthe cystic nodule using 22 G aspiration at85.19%. A similar trend was found in eachgroup with lowest rate of ND in the 25 Gnon-aspiration group and highest in the 22G aspiration group.

Introduction: Biliary Atresia is a fibroobliterativedisorder of the intra andextrahepatic bile ducts in infancy, which isgoing progressively cholestatic liver disease.The failed Kasaiportoenterostomy requiresliver transplantation. The goal of this studyis to show the outcome of Kasai operation,recent improvement and correlation the datato overseas.Methods and Materials: This study wasconducted in the department of generalsurgery of National Center for Maternal andChild Health of Mongolia between 2010 and2016 on a total of 66 infancies with biliaryatresia.Results: Patient diagnosed with biliaryatresia, which performed Kasai operationwithin first 2 months the outcome is verygood early and late post-operation period.There were 3 patients with 10 year survival, 4patients with 5-10 year and 28 patients with5 year survival after Kasai operation. The mostcomport age for liver transplantation is 1 yearlater after Kasai operation in Mongolia. Livertransplantation programme is necessary forMongolian pediatric surgery, and we thoughtour team was assembled.Conclusion: The children with biliary atresiaperform the Kasai operation within 2 monthsthe outcome is very good. Children with biliaryatresia often experience long wait times fortransplant unless exception points are grantedto reflect severity of disease.In Mongolia livertransplantation done in 2 child.