Introduction: Over 800,000 people in the world contract HCC each year and approximately 700,000 die from the disease. HCC is the 6th most common cancer in the world. HCC is the 3rd leading cause of cancer deaths in the world. 2/3 of liver cancer deaths are caused by hepatitis. In the U.S, HCV infection is the more common cause of HCC, while in Asia and Africa, HBV is more common. Mongolia ranks first in the world in mortality from liver cancer, indicating the need for early detection and treatment of cirrhosis. Sysmex Corporation has introduced for HISCL series analyser, a new cirrhosis marker M2BPGi of non-invasive, blood-testing. In 2016, the test was introduced at Medipas Hospital in Orkhon province. It is possible to study the advantages and significance of the marker for use in clinical practice. Materials and methods: From a total of 385 patients who underwent M2BPGi marker testing in 2016-2017Medipas hospital laboratory, data from a total of 283 patients tested for hepatitis B and C virus and M2BRGi markers were selected. A comparison of age, sex, and test parameters of a total of HCVab and HBsAg positive 172 patients tested for Total bilirubin, GPT, GOT, GGT, AFP and M2BPGi. HCV Ab, HBsAg, AFP, M2BPGi markers were analyzed by SysmexHISCL-5000 fully automated immunological analyzer, Liver function tests were performed with a fully automatic biochemical analyzer JEOL Biomajesty BM6010/C. Results: Of the M2BPGi marker tested 283 patients 94 (33%) were infected with the C virus, 78 (28%) were with the B virus,11 (4%) were co-infected with B and C viruses, 100 (35%) no any viral infection. Of the 172 patients diagnosed with hepatitis B and C virus infection, 97 (56%) were male, 75 (44%) were female. In terms of age, 72% of the population is over 45 years old.
Of the 172 patients, 115 (67%) had M2BPGi marker abnormal or > 1.0 COI. Of the M2BPGi marker abnormal patients, 47 (41%) were infected with the B virus and 68 (59%) with the C virus. In terms of age, 27.7% of hepatitis B patients and 10.3% of hepatitis C patients were under 45 years of age, 72.3% of hepatitis B patients and 89.7% of hepatitis C virus patients were over 45 years of age.
Hepatitis B and C viruses are slightly more common in men than in women. The majority of patients infected with the hepatitis virus over the age of 45. The majority of patients with hepatitis virus have abnormal liver function. Increased M2BPGi markers in people under the age of 45 with hepatitis B virus infection are relatively higher for hepatitis B virus infection than for C virus infection. Conclusions The M2BPGi marker was abnormal in 67% of hepatitis virus infected patients. It has been observed that the probability of an increase in M2BPGi marker is slightly higher in hepatitis C virus infection than in hepatitis B virus infection.

Purpose: To evaluate colorectal cancer localization in preoperative patients in Mongolia using CECTand endoscopyMaterials and Methods: Totally 10575 optic colonoscopy examinations were performed at UlaanbaatarSongdo Hospital between January 2009 and December 2012. From these examinations, colorectal cancerwas detected in 218 cases; from them 175 had CT examinations. From patients with CT examinations,111 underwent surgery at UBSH, National Cancer Center, State Central Hospital. (64MDCT SiemensSomatom). Only 86 patients with colorectal carcinoma proved by endoscopic or operative pathologywere included into this study. We retrospectively reviewed from the UBSH’ database their preoperativeCT, colonoscopy, surgical and pathohistologic reports using PACSPLUS, OCS operation systems. Toclassify colorectal tumor localization, we divided colon into 8 anatomic parts. The size of tumor wasmeasured as longest dimension visible on CT examination.Results: Study population’s age range was 25-87 age (mean 61.3years ±13.7SD). F: M= 48 (55.8%):38 (44.2%). Urban residents composed 58 (67.4%), rural- 27 (31.4%), foreigner- 1 (1.2%). Tumor sizerange on CT was 0-13 ñì (mean 6.5±2.2 ñì) . Colonoscopy and CT detected colorectal cancer in rectumin 30(34.9%) and 31 (36.1%), in sigmoid colon in 21(24.4%)’’’ and 19(22.1%), in hepatic flexure- 9(10.5%) and 9(10.5%), retrospectively. Double (synchronous) colorectal cancer was detected in 1(1.1%)at colonoscopy and in 2 (2.2%) at CT.Conclusions: The 60-69 age group composed the largest group (38.4%) in colorectal cancer patients,with slight predominance of urban residents over rural and higher female predilection. Sigmoid andrectum are shown to have highest incidence in colorectal cancer. To our best knowledge, it is firstpublication on detection of synchronous colorectal cancer in Mongoliaby both CT and colonoscopy.CT examination is less risky and reliable method to evaluate the entire colonic length in patients withcolorectal cancer suspicion, if observers are skilled in detection of CT signs of colorectal cancer.

In Europe, colorectal cancer (CRC) is the second most frequent malignancy and the second commonest cause of death from cancer. -The prognosis of CRC patients is dependent on the stage of disease at the time of diagnosis. Contrast-enhanced computed tomography (CT) examinations allows simultaneous assessment of tumor’s local staging, estimation of its possible invasion into neighboring organs, and detection of nodal and distant metastases; which is essential for appropriate treatment planning and estimation of its outcomes. The lack of reports on CT findings in CRC in Mongolia, increase in CRCmorbidity, and significant potential benefits of early detection served as background for this study.We investigated subjects with histologically proven adenocarcinoma who underwent CRC-related operative treatment either at National Cancer Center, First State Central Hospital, or Ulaanbaatar Songdo Hospital (UBSH) in 2009-2012. We retrospectively reviewed and analyzed from the UBSH’ database their preoperative CT, colonoscopy, surgical and pathohistologic reports using PACSPLUS,OCS operation systems. CECT examinations were performed at Siemens Somatom 64 multidetector scanner.Countrywide, 111 patients underwent surgery for colorectal cancer in 2009-2012. Totally, we involved86 subjects, whose age ranged from 25 to 87 years (mean 61.3years ±13.7SD). The F: M= 48 (55.8%) :38 (44.2%).The CECT determined T2 staging in 10/86 (11.6%),T3 in 61/86 (70.9%); T4 in 15/86 (17.4%);a significant difference in T-staging between CECT and histopathological examination (х2=41.28, p=0.00 (p<0.05)) was found. The CECT detected no peritumoral lymphadenopathy (N0) in 39/86 (45.3%), N1 in 18/86 (20.9%) and N2 in 29/86 (33.7%) patients; there was a significant difference in N-staging between CT and histopathological evaluation (х2=17.74, p=0.007(p<0.05)). For T-staging, CECT evaluation yielded sensitivity of 50% in T2 , 83.6% in T3, 71.4% in T4 staging; Diagnostic accuracy of CT for T2 staging was 89.7%, for T3- 78.2%, for T4- 88.7%. For N-staging, CECT had sensitivity of 88.2%, specificity of 64% and accuracy of 73.8%.Preoperative colorectal cancer patients in Mongolia receive initial MDCT in late stage. The similarsensitivity in staging of T-parameter to that of the international comparable studies. Nodal heterogeneity on CECT was more sensitive for nodal metastases than the size.

Background: We organized the MEQAS (Mongolian External Quality Assessment Scheme) since 2008, on basis of the Cooperation agreement between Ministry of Health and Sysmex Corporation in the establishment of Hematology external quality control and reference laboratory system.
Therefore, since 2017 year we have set up from 1^st to 4^th External Quality Assessment (EQA) for blood morphology testing. Method: This EQA for blood morphology testing included 177 clinical pathologists, 57 technologists, and 36 technicians (270 participants in total). We assessed their ability to distinguish the blood cells on a real-time basis online. Result, discussion: Out of all participants, the clinical pathologists got marks ranging 70.1%, technologists got 59.0%, technicians got 58.2%. Continual trainings should be organized by different programs for laboratory specialists. A real-time online method was adopted in an EQA for the first time. This allowed the participants to know their results immediately after completing the assessment.
The overall results of the participants were generated in form of graphs immediately after the completion of the EQA. This allowed for visualization of areas where the percentage of correct answers were low, which were explained extensively during the discussion of answers.
As the results directly reflect the knowledge and skills of each participants, this form of EQA is suggested to be an extremely useful mean for determining the future education platform. Conclusions
1. The ability of clinical pathologists to distinguish blood cells and to interpretation are unsatisfactory.
2. The ability of biomedical technologists and technicians to distinguish blood cells are unsatisfactory.

Purpose: To investigate the outcomes of ROP screening of retinopathy of prematurity (ROP). Methods: This was a prospective of prematurity infants screened ROP from 2020 April 13th to April 28th 2020 and from 2020 June 08 th to June 22th 2020 and prospective cohort study of premature infants with treatment-requiring ROP who received intravitreal injections, laser surgery. Demographic factors, diagnosis and clinical course were recorded. Indirect ophthalmoscopy and Retinal imaging was performed using RetCam (Natus Medical, Pleasanton, CA) and images were taken. Each eye was evaluated by the pediatric ophthalmologist and aimag’s ophthalmologist for the presence or absence of ROP, zone of vascularization, stage, plus disease, and aggressive posterior ROP (AP-ROP). The diagnosis and classification of ROP for this current study were determined by examination using indirect ophthalmoscopy, and treatment plans were determined according to the International Classification for ROP and the Early Treatment for ROP Study (ET-ROP).^2,13 Results: A total of 90 premature infants with BW ≤ 2000g and/or GA ≤ 34 weeks were screened for ROP during the study period. 8 (8.8%) of the 90 infants screened required treatment. The 8 infants who received ROP treatment had a mean GA of 28.5 ± 1.7 weeks, mean BW of 1237.5 ± 125.42g, mean PMA of 36 weeks and mean follow-up time of 2 months. Conclusion After treatment, resolution of ROP was noted in approximately 100 % of the patients who had treatment-requiring ROP.

Introduction: Rhodiola rosea L. (R.rosea) is a popular plant in traditional medicine of the Nordic countries, Eastern Europe, and Asia. R.rosea plants are successfully cultivated in Mongolia. The Botanical Garden of Medicinal Plants under the “Monos” Group started to cultivate R. rosea since May 2015. Objective: The aim of this research was to study the salidroside contents of R.rosea collected from Zavkhan and Khuvsgul province, Mongolia, and cultivated in the Botanical Garden of Medicinal Plants, Drug research Institute, Monos group. Material and Methods: The underground parts of wild roseroot plants were collected from April to May 2020 from Jargalant soum, Khuvsgul province, and Nomrog soum, Zavkhan province, 3-years and 4-years-old cultivated R.rosea gathered from the Botanical Garden of Medicinal Plants in April 2020. For comparison, 4-year-old Rhodiola grenulata (R. grenulata) was ordered from Shanxi Zhendong Genuine Medicinal Materials Development Co., Ltd, China, and used for the study. The quantity of the salidroside constituents of the underground parts were compared and the sourcing of roseroot raw material was evaluated. Chemical analysis of roots and rhizome of R. Rosea namely the appearance, identification, moisture, organic impurities, mineral impurities, residue on ignition, water-soluble extractives, fresh weight of roots, and salidroside content were determined according to the National Pharmacopoeia of Mongolia (NPhM) 2011. Microbiological analysis was performed in accordance with the requirements of grade 3b specified in Annex 1 of the Order No. A / 219 of the Minister of Health dated May 30, 2017 to determine the degree of microbiological purity in medicinal products of roots and rhizome raw materials. Result: The content of salidroside, the main biologically active substance of R.rosea plant, was 1.57% in samples collected from Zavkhan province, 1.45% in samples collected from Khuvsgul province, 1.7% in samples grown in China and 0.25% for 3-years-old samples and 1.89% for 4-years-old samples grown in the Botanical Garden of Medicinal Plants, Monos group, Mongolia. In addition, these raw materials meet the general requirements for plant raw materials and microbiological parameters. Conclusion Samples of underground parts of R.rosea cultivated for 4 years in the Botanical Garden of Medicinal Plants have the highest content (1.89%) of the salidrosde. Therefore, it is suggested that the roots and rhizomes of R.rosea planted in the future can be standardized and used as a raw materials for medicines.

Introduction: Helianthus tuberosus L. is main source of inuline in pharmaceutical and food industry. Pharmacological studies of the plant have showed some important therapeutic properties such as anti-diabetic, anti-osteoporosis, anti-cancer and strengthening cardiovascular system, immune system. Material and method: Helianthus tuberosus L., which has been cultivated in Botanical Garden of Medicinal Plants of Drug Research Institute, Monos Group, was used as a research raw material. The aerial and below ground parts of the plants were harvested in September 2020. The content of inulin, the main active ingredient in the plant, was determined by spectrophotometry. Raw materials of the plant were processed in several ways and prepared for further use as a pharmaceutical raw material. Result: Inulin content in Sample 1 was 34.5 ± 0.76%, Sample 2 was 70.31 ± 1.25%, Sample 3 was 78.43 ± 0.44% and Sample 4 was 75.36 ± 1.42%. The inulin content and yield were the highest in samples prepared by heat and cold cutting methods. Conclusion According to the results of appearance, yield, inulin content and moisture contents during the different processings of plant materials, it can be considered that the most suitable method for preparing Helianthus tuberosus L. as a pharmaceutical raw material is the cutting followed by freeze-drying.