Background: In recent years, the incidence of liver diseases due to complications of non-alcoholic fatty liver disease (NAFLD) has shown a significant upward trend in Southeast Asian countries. NAFLD is a hepatic disorder characterized by lipid accumulation in the microstructure of the liver in individuals who consume little to no alcohol. It is often associated with insulin resistance and is diagnosed when steatosis affects more than 5% of hepatocytes histologically, or when the fat signal intensity on MRI exceeds 5.6%, based on fat-to-water ratio measurements. In Mongolia, histological studies using frozen liver sections with routine and special staining techniques are limited, highlighting the necessity of this study. Aim: To determine and compare the degree of steatosis and fibrosis in frozen liver tissue samples of patients with NAFLD through histological analysis. Materials and Methods: This study was conducted at the the Department of Anatomy, School of Biomedicine and Bio medical Research Institute of MNUMS in collaboration with the Second State Central Hospital. Ethical approval was obtained from the Research Ethics Committee of MNUMS (Protocol No. 2024/3-06). All procedures adhered strictly to laboratory biosafety protocols. Participants were selected among patients undergoing elective laparoscopic cholecystectomy, from whom informed consent was obtained. Based on inclusion criteria, five participants were grouped as follows: healthy control (n=1), NAFLD without fibrosis (n=2), and NAFLD with fibrosis (n=2). Liver biopsies (approx. 1 cm in size) were obtained intraoperatively, immediately deep-frozen in liquid nitrogen, and prepared for histological evaluation. Results: In patients with NAFLD compared to the healthy liver group, disruption of hepatocyte columnar architecture and mild periportal lymphocytic infiltration were observed. Oil Red O staining revealed 34–66% micro- and macrovesicular steatosis, corresponding to grade 2 steatosis. Masson’s trichrome staining showed no fibrotic changes in perivenular or periportal areas (Ishak grade 0/4) at this stage. However, upon progression to grade 3 steatosis, early-stage fibrosis was observed in both perivenular and periportal regions (Ishak grade 1/4). Further progression to stage 4 fibrosis was characterized by the development of connective tissue septa, although no significant changes in droplet size were observed. Conclusions 1. Increasing stages of fibrosis are not directly influenced by the severity of hepatic steatosis in NAFLD. 2. Although the degree of steatosis increases, the absence of corresponding fibrotic changes in early stages indicates a complex progression pattern of NAFLD requiring further investigation.

Background: Alloxan is a chemical compound commonly used in experimental animal models of diabetes. In 1943, Shaw Dunn and Mc- Letchie reported that alloxan causes specific necrosis of pancreatic β-cells in experimental animals, which led to the study of alloxan in relation to diabetes. In this study, we evaluated the structural changes in the pancreatic tissue of diabetic mice induced by alloxan. Aim: To study the structural changes in the pancreatic tissue of diabetic mice induced by alloxan. Materials and Methods: According to the protocol for establishing a diabetic model, alloxan monohydrate was injected intraperitoneally into 6- to 8-week-old C57BL/6 mice to develop a diabetic model and evaluate the structure of pancreatic tissue. Results: Alloxan induced severe degenerative changes in the centers of the pancreatic islets of mice in the diabetic group. The islet shape was irregular, and the central part was relatively sparse; dead (karyolysis) cells were observed. In the exocrine part of the pancreas, the acinar structure was preserved; the nuclei of acinar cells were stained bright blue. The plasma-particle ratio of some acinar cells was lost, the plasma contained vacuoles, and the interstitial spaces were enlarged and appeared pale. On the 7th day of the experiment, the positive expression of β-cells in the pancreatic islets of mice in the diabetic group was reduced compared to the control group, and a necrotic area was observed. On the 28th day, the positive expression of β-cells was visible in the central part of the islet. When the qualitative characteristics of the positively stained cells of the islets of Langerhans were converted into quantitative values, the percentage of the area of insulin-positive stained cells was 13.37% ± 0.89% in the control group and 6.01% ± 0.39% in the diabetic group. The percentage of glucagon-positive stained cells in the control group was 15.27% ± 1.11%, and in the diabetic group was 5.01% ± 0.58%. The islet area of the pancreatic islets of Langerhans in the diabetic group was observed to be increased compared to the control group. This is thought to be due to the swelling of the islet cells and the formation of empty spaces created by necrotic cells. Conclusion The results of the functional assay showed that glucose- dependent insulin secretion was still active after 28 days of the experiment. Alloxan-induced necrosis and apoptosis reduced the percentage of insulin- and glucagon-positive cells in the islets of Langerhans.

Background: Renal impairment (RI) is a frequent complication of liver cirrhosis and is associated with increased mortality and morbidity. Liver transplantation (LT) serves as an effective treatment method for patients with cirrhosis who have impaired renal function. However, renal function often declines after LT, influenced by various factors. This study aimed to investigate the factors contributing to RI following LT in our cases. Methods: We analyzed the demographic data, preoperative and perioperative parameters, and postoperative outcomes of patients who underwent LT at the First Central Hospital of Mongolia from September 2011 to December 2022. Renal function was assessed by measuring the glomerular filtration rate using the Cockcroft-Gault creatinine clearance formula pretransplantation and at 24 hours, 72 hours, 7 days, 14 days, and 28 days post-LT. Results: Several factors increased the risk of RI among recipients. These included female sex (odds ratio [OR], 3.06; 95% confidence interval [CI], 1.58–5.91), Child-TurcottePugh (CTP) scores of B and C (OR, 4.23; 95% CI, 0.92–19.41 and OR, 7.68; 95% CI, 1.67– 35.30, respectively), preoperative continuous renal replacement therapy (CRRT; OR, 5.86;95% CI, 1.1–31.21), and a high graft-to-recipient weight ratio (GRWR; OR, 3.45; 95% CI, 1.23–9.63). Additionally, the survival rates for recipients with RI post-LT were 93.4% at 1 year and 78.1% at 3 years. Conclusions Female sex, a high CTP score, preoperative CRRT, and high GRWR were identified as risk factors for RI after LT in Mongolia.

Background: It is stated in the Government Programme of 2016-2020 that public servants, including health care workers, shall be given a gradually increased salary based on their skill, dexterity, workload, and productivity, and such increase started from 2018 as planned. In the health sector of our country, regarding demand and regulation of the programme, the change shall be made that the system for median salary of physicians and overall staff employed at hospitals gets even constructive, and the required human resource for the sector shall be prepared. Thus, inferring from these claims, median salary, real wage, and socioeconomic condition are in critical need for further evaluation. Objective: To examine the current socio-economic condition of health care workers, and to study the influencing factors at play. Methods: In this study, we used quantitative and qualitative methods. In the survey, we involved 655 health care workers from 6 family health centers, 2 district hospitals, 3 health centers (district-based) in Songinokhairkhan, Sukhbaatar, and Baganuur districts; and Provincial hospital, regional diagnosis and health center, 16 soum health centers from Khovd, Uvs, Arkhangai, Bulgan, Khentii, Dornod, Umnugovi, and Dornogovi provinces, along with 3 National specialized health centers and 1 National central hospital. As for data gathering for the qualitative analysis, 30 focus group interviews and 47 key informant interviews were conducted for the purpose of examining socioeconomic condition, real wage sufficiency of health care workers. Results: Average household income of study participants was 1,880,269 tugrik, the real wage was 1,073,065 tugrik, and the overall household is seen to be composed of 2 different sources on average, namely, self-wage and the income coming from family members or supplement of Child Money Programme. It has come to notice that 19.5% of the participants have lower than average living standard, 89.2% have 2 different loans (mortgage, auto loan or mobile application based loans). Material deprivation index is seen to be 2.73, hence deemed as insufficient. In order to increase the real wage of those workers, it shall be taken into consideration that the basic salary is low, and some financial supplements need to be given. Furthermore, the performance based funding system of health sector is seen to be in need of improvement. Conclusion Real wage of the health care workers is, thus, insufficient. The fact that one in every five workers in this sector have lower than average living standard, and the material deprivation index is 2.73 implying that the financial lives of health care workers are immensely fragile.

Introduction : The HER2 (Human epidermal receptor 2) proto-oncogene encodes a transmembrane receptor protein involved in the development and progression of the majority of cancers. Prior studies have shown that HER2 oncogene is overexpressed in approximately 15–30% of ovarian carcinomas. However findings regarding the overexpression and prognosis are still conflicting. Goal: To determine the histomorphological structure of ovarian tumor and perform immunohistochemical analysis of HER2 in tumor tissues Materials and Methods: A total of epithelial ovarian cancer paraffin-embedded tissue blocks 11collected. The hematoxylin and eosin stained histopathology slides of each of the cases were reviewed to confirm the original diagnosis, and to assess the histological grade of the neoplasm. Our study was performed on 11 ovarian epithelial cancer tissues obtained at the time of first surgery. The staining procedure for HER2 overexpression was performed using a monoclonal antibody. Results: The positive expression rate of HER2 in this study was 81.8%. Significant association was not found between HER2 expression International Federation of Gynecologists and Obstetrics (FIGO) stage p-values of 0.196, grading 0.642 and histological subtypes. However, there were more cases of advanced-stage disease (III/IV) with HER-2 expression than early-stage EOC (I/II). HER2 positive tumor were grades 1, 2 and 3 respectively. A higher proportion of serous ovarian neoplasm and adenocarcinoma NOS was also observed to be HER2 positive. Conclusion HER2 expression was observed to increase with advanced stages of cancer and was more commonly seen in serous rather than in adenocarcinoma NOS.

Introduction : The occurrence of ovarian cancer had a trend of younger in recent years. Due to no obvious clinical symptoms in the early period, most ovarian cancer was found at later period. The main screening methods are transvaginal ultrasonography, serum CA-125 and so on. About 60-70% of ovarian cancer patients are already in phase III-IV or with abdominal metastasis when diagnosed. Therefore, the early diagnosis of ovarian cancer is still in the research, and there is no definite markers, which can be used in clinical. Goal: To determine the immunohistology of ovarian tumor and perform immunohistochemical analysis Materials and Methods: A total of epithelial ovarian cancer paraffin-embedded tissue blocks 30collected. The hematoxylin and eosin stained histopathology slides of each of the cases were reviewed to confirm the original diagnosis, and to assess the histological grade of the neoplasm. Our study was performed on 30 ovarian epithelial cancer tissues obtained at the time of first surgery. The staining procedure for HER2 overexpression was performed using a monoclonal antibody. Results: Analysis histological subtypes of ovarian malignant cancer, 90% of ovarian epithelial ovarian cancer, 6.7% of sex cord-stromal and 3.3% of germ cell tumor. (G1) well differentiated, (G2) moderately differentiated, (G3) poorly differentiated were 23.3%, 40.0% and 36.7% respectively. There is statistically significant direct, medium correlation immunohistochemical examination, the HER2 protein over expression (r=0.38, р=0.022), and HER2 protein 3+ was higher in 66.7 percent were in poorly differentiated. Conclusion In our study ovarian cancer based on the morphological architecture of tissue stained by H&E histological subtypes of epithelial ovarian cancer (90%). By immunohistochemical 93.3% positive and 6.7% negative ovarian cancer in determine HER2 expression.

BACKGROUND. Prostaglandin E2 (PGE2) is the most abundant prostanoid and a very potent lipid mediator, and is produced predominantly from arachidonic acid by it’s tightly regulated cyclooxygenases (COXs) and prostaglandin E synthases. PGE2 is involved in regulating many different fundamental biological functions, including immune responses. Recently, we have demonstrated that bacterial LPS induces NO production in auditory cells via an inducible NO synthase expression. The LPS-induced production of an excessive NO amount is suggested to cause injury of auditory cells, followed by ototoxicity. Auditory cells injured by such an inflammatory response must be accompanied by tissue repair and remodeling. In order to clarify the production of PGE2 in auditory cells for regulation of inflammatory response or tissue repair AIM: We aimed to examine an effect of LPS on the production of prostaglandin E2 in auditory cells. MATERIALS AND METHODS: The murine auditory cell line HEI-OC1 was established from long-term cultures of immortomouse cochlea and used as conditionally-immortalized auditory cells. HEI-OC1 cells were stimulated with or without LPS. The concentration of PGE2, TNF-α, IL-1β in the culture supernatant was determined with ELISA. COX-2 protein expression and mRNA were measured by immunoblotting and reverse transcription PCR, respectively. The bands were quantified by densitometric analysis using ImageJ software. Statistical analysis was performed using Student’s t-test and P values < 0.05 were considered significant. All experiments were performed independently at least three times. Data represent the mean value of triplicates SD. RESULT: HEI-OC1 auditory cells constitutively produce a small amount of PGE2. LPS augmented the PGE2 production via enhanced cyclooxygenase 2 (COX2) expression. LPS-induced augmentation of COX2 expression was dependent on up-regulation of COX2 mRNA expression. LPS induced the production of TNF-a, but not IL-1b An anti-TNF-α neutralizing Ab significantly inhibited PGE2 production and COX2 mRNA expression in response to LPS. LPS-induced PGE2 production was prevented by a series of pharmacological signaling inhibitors to NF- κB and MAPKs. Pam3CSK4 as a TLR2 ligand, as well as LPS as a TLR4 ligand, augmented the PGE2 production. However, poly I:C as a TLR3 ligand, imiquimod as a TLR7 ligand and CpG DNA as a TLR9 ligand did not augment it. HEI-OC1 cells expressed TLR2, TLR4 and TLR9, but not TLR3 or TLR7. CONCLUSION: The auditory cells produce PGE2 in response to LPS via COX2 expression. The PGE2 production may be involved in tissue repair and remodeling in the organ of Corti. Auditory cells might be important effector cells in host response to infection and inflammation in the organ of Corti and cochleae.

Introduction: Base excision repair (BER) is mainly responsible for the correction of small base changes of DNA damage. BER pathway involved many enzymes including OGG1 and XRCC1. The defective DNA repair is associated with an increased risk of various cancers including hematologic malignancies-leukemia and myelodysplastic syndrome (MDS). However, it is deniably these polymorphisms alter the susceptibility and clinical outcome of MDS patients. The aim: This study was to evaluate the impact of polymorphisms in gene encoding one protein of BER system: XRCC1 Arg399Gln in MDS and healthy population. Methods: In this study, we recruited 60 health control group [median 47.9 years, 9 MDS subjects [median 56.6 years] were included in this study. Genotyping was carried out by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Allele and genotype frequencies were calculated by direct counting. Result: The frequencies of genotypes of XRCC1 Arg399Gln were as follows: Arg /Arg 1 (11%), Arg/Gln 6 (66%), Gln/Gln 2 (22%) in MDS and Arg /Arg 18.4%, Arg/Gln40%, Gln/Gln41.6% in health control for XRCC1 Arg399Gln. The result revealed that genotypes Arg399Gln increased the risk of MDS In conclusion this study is the first to analyze XRCC1 SNPs and their associated risk of MDS in Mongolian samples. To fully understand the role of DNA damage and DNA repair in the MDS, prospective studies are needed and other genes (OGG1 Ser326Cys, MUTYH Gln324His, APE Asp148Glu) of base excision repair pathway should be analyzed.

Introduction: Pulmonary sequestration(PS) is a cystic or solid mass composed ofnonfunctioning primitive tissue that doesnot communicate with the trachea-bronchialtree and has anomalous systemic bloodsupply. Pulmonary sequestration is a raredisease, of unknown etiology, representing0.1-6% of all structural lung diseases anddevelopmental malformations. We describea case of girl with pulmonary sequestration.Result: She has been admitted in ourhospital with left lower lobe mass. Fordifferential diagnosis we did X-ray, CTscanning, MRI of chest and angiography.In the X-ray had been detected retrocardiactriangular mass. CT scanning shown us massin the left lower lobe. Due to angiography wecan’t seen arterial supply. MRI demonstratedas like as X-ray, retrocardiac triangular mass.She had been gone under the electivesurgery: Left thoracotomy, resection ofpulmonary sequestration, drainage of pleuralcavity.During and after the surgery had notcomplication and she had been dischargedafter few days of post-operative treatment.She had been fully recovered.Conclusions: Pulmonary sequestrationis rare anormaly with multiple theoreticaletiologies. Due to high technological imaginginvestigations can take right diagnosis.The patient can be fully recovered afterthe surgical treatment. Intralobular typeis more difficult to resect the pulmonarysequestration.

Introduction: Hysterectomy is second mostfrequent gynecological operation. Historicallythe uterus has been removed by either theabdominal or vaginal route. The vaginaloperation is preferable when there are nocontraindications because of lower morbidityand quicker recovery. Since it was first reportedby Reich et al in 1989 laparoscopically assistedvaginal hysterectomy (LAVH) has gainedwidespread acceptance. To compare totallaparoscopic hysterectomy (TLH), laparoscopicassistedvaginal hysterectomy(LAVH), vaginalhysterectomy (VH) and total abdominalhysterectomy(TAH).Materials and methods: A prospective,randomized study was performed atGynecologic Surgery Department of NationalCancer Center of Mongolia between March2013 and January 2014. A total of 120 womenindicated to undergo hysterectomy for cervixcancer stage 0-1, uterine myoma, uterinecancer were randomly assigned to fourdifferent groups (30 VH, 30 LAVH,30 TLH and30 TAH). Operating time, blood loss, rate ofcomplications, consumption of analgesics andlength of hospital stay were measured in eachgroup.Results: In our research the groups weresignificantly different for mean intraoperativeblood loss were TLH:119+/-54.7mL, LAVH:127.5+/-52.7 mL, VH; 145+/-57.8 mL andTAH: 210+/-77.4mL (P=.007) and operativetime were TLH 115+/-16.6 minutes LAVH:112.5 +/-18.5 minutes; VH: 51.6 +/-16.9minutes;TAH:69+/-18.2 (P = .001). Theaverage weight of uterine were from 95.1+/-27.6mg (range 58-140) in the VH group ,to 181.2+/-97 (range 76-400g) in the LAVHgroup through to 122.3+/-64 for the TAHgroup. Postoperative pain on day 0 and thetotal abdominal group were 5.5+/-0.7 days ofanalgesic request it was higher than other threegroups (TLH: 3.0+/-0.8days, LAVH: 3.08+/-0.7days, VH: 3.0+/-0.86 days P<.001). LAVHwas associated with a reduced hospital stay(TLH: 3.3+/- 0.7, LAVH: 3.3 +/- 0.6 days;VH: 3.7 +/- 0.6 days;TAH:6.5+/-0.7 P <.001). Total Laparoscopic hysterectomy hadlongest operating time (115+/- 16.6min), a lowcomplication rate, lack of severe post-operativecomplications. Vaginal hysterectomy had theshortest operating time (51.6+/-16.9min).However, there were technical problems withsalpingo-oophorectomy from the vaginalapproach and this group had a significantlyhigher rate of febrile complications (20%)compared to LAVH (2.3%) and TAH (16%).Conclusion: Even though operative timefor VH is less than TLH, there is a technical problem known as salpingo-oophorectomy.TLH and LAVH have number of advantagesincluding less interaoperative blood lose, lesspostoperative analgesic requirement, andshorter duration of postoperative hospitalstays.