Background: Skin wound healing, elasticity, and protective functions are closely associated with cellular regeneration and the remodeling of the extracellular matrix (ECM). MXRA7 (Matrix Remodeling Associated Protein 7) is a protein involved in ECM regulation, tissue regeneration, and inflammatory processes, and recent studies suggest that it may play a supportive role in skin wound healing. However, systematic investigations on natural small molecules capable of modulating MXRA7 activity remain limited. Flavonoids, on the other hand, have been reported to promote wound healing and ECM regulation through their antioxidant and anti-inflammatory properties. Therefore, it is hypothesized that flavonoid compounds may act as potential modulators of MXRA7 protein activity. Aim: The aim of this study was to evaluate the binding affinity, binding energy, and interaction characteristics of 14 naturally occurring flavonoid compounds with the active site of the MXRA7 protein using a molecular docking approach. Materials and Methods: The molecular structures of the flavonoids were obtained from the PubChem database, and their interactions with the MXRA7 protein were investigated using molecular docking with CB-Dock2 and SwissDock software. Docking results were visualized using PyMOL and evaluated based on root mean square deviation (RMSD), binding free energy (∆G), inhibition constant (Ki), pose ranking, and cluster analysis. An RMSD value of ≤ 2.0 Å was considered indicative of a stable binding pose. Result: The RMSD values of the MXRA7–flavonoid complexes ranged from 0.081 to 0.622 Å, indicating that all compounds stably occupied the binding cavity of the protein. Fisetin (0.081 Å), naringenin (0.107 Å), and hesperetin (0.107 Å) exhibited the lowest RMSD values, suggesting highly stable binding poses. The binding free energy (∆G) values ranged from −6.0 to −7.1 kcal/mol, with protopine showing the strongest binding affinity (∆G=−7.1 kcal/mol). Most flavonoids formed hydrogen bonds, hydrophobic interactions, and π–π interactions with key amino acid residues of MXRA7. Cluster analysis revealed that the majority of flavonoids shared a common binding mode, while fisetin, naringenin, and hesperetin formed a distinct subcluster with more stable binding poses. Ligand efficiency (LE) analysis indicated that chrysin, apigenin, and naringenin exhibited higher LE values, reflecting greater binding efficiency of smaller molecules. Conclusion This study demonstrates, through molecular docking analysis, that flavonoid compounds can stably interact with the active site of the MXRA7 protein. Protopine showed the strongest binding energy, whereas fisetin, naringenin, and hesperetin exhibited superior binding pose stability. These compounds may serve as potential bioactive molecules targeting MXRA7; however, further validation through molecular dynamics simulations and experimental studies is required.

Background: Specifically, stomach cancer ranks as the fifth leading cause of cancer morbidity and mortality worldwide. Early-stage detection significantly improves survival rates, with over 90% of patients diagnosed at stages I and II living beyond five years. To improve the early detection of gastric cancer, it is necessary to complement the conventional method of endoscopic examination with biomarker analysis. We aimed to compare biomarkers such as pepsinogen C (PGC), matrix metalloproteinase 2 (MMP2), matrix metalloproteinase 9 (MMP9), and the cell proliferation marker Ki-67 with immunohistochemical analysis. Purpose: A comparative study and evaluation of biomarkers for the early detection of gastric cancer. Materials and Methods: The study was conducted using a retrospective cohort design. Research ethics issues were discussed at the meeting of the Medical Ethics Control Committee of the Ministry of Health on October 13, 2023, and permission to start the research was obtained (Resolution No. 23/051). The information was gathered based on the criteria for K29.3, K29.4, K31, and C1 diagnoses according to the international ICD 10 classification, and participants were selected accordingly. Proteins such as PGC, MMP2, MMP9, and Ki-67 were examined using a tissue microarray kit and evaluated through immunohistochemical analysis. Results: Negative gastric tumor markers PGC, Ki-67, MMP2 and MMP9 were evaluated by immunohistochemical analysis. The mean PGC protein staining values were 6.20±2.61 for chronic superficial gastritis, 5.45±2.47 for atrophic gastritis, 3.61±2.0 for metaplasia, and 3.31±1.75 for gastric cancer, with statistically significant differences between the groups (P<0.001). The mean Ki-67 protein staining values were 0.1 ± 0.4 for chronic superficial gastritis, 0.33 ± 0.55 for atrophic gastritis, 0.09 ± 0.39 for metaplasia, and 2.62 ± 0.78 for gastric cancer, also showing statistically significant differences (P<0.001). The mean MMP2 and MMP9 protein staining values were 0.2±0.76 and 1.2±2.04, respectively, for chronic superficial gastritis; 0.28±0.52 and 3.28±2.82 for atrophic gastritis; 0.35±1.04 and 1.12±1.45 for metaplasia; and 1.38±2.11 and 5.29±2.51 for gastric cancer, with all differences being statistically significant (P<0.001). Conclusion PGC protein, a negative tumor marker, decreases during the transition from a gastric cancer precursor to cancer. MMP2 protein, a marker of cell migration and metastasis, has little diagnostic value, while the expression of MMP9 and the Ki 67 are highly effective in gastric cancer. Immunohistochemical analysis of endoscopic biopsy tissue to detect the negative tumor marker PGC, the positive marker Ki-67, and MMP9 can be used for early detection of gastric cancer.

Introduction: In Mongolia, data on the etiology and risk factors of cardioembolic stroke (CES) is scarce and few clinical studies have been performed to date. Timely identification and control of cardiovascular risk factors are priority objectives for adequate primary and secondary prevention of CES. Goal: The goal of this study was to describe risk factors for CES in our setting. Results: The case-control study enrolled a total of 525 subjects. CES was detected in 63 (35.7%) out of 176 (33.5%) ischemic stroke patients with a predominance in age group of 60-69 and men (33%). The main risk factor of CES was non-valvular atrial fibrillation (AF). AF especially paroxysmal AF increased the risk of CES by 4.6 times (p=<0.0001, OR 4.6, 95% CI 1.4-44.6). The second main cerebrovascular risk factors were hypertension and dyslipidemia. Conclusion CES accounted for 1/3 of ischemic stroke. The commonest underlying medical conditions were non-valvular atrial fibrillation, hypertension, dyslipidemia, alcohol consumption and obesity. Hence, all patients with hypertension and non-valvular AF should be meticulously screened for prevention of CES.

Introduction: We classify peritonitis as end-stage if it lasts for more than 72 hours or more than three days. At this point, the pleural effusion of the posterior abdominal wall, the pleural layer of the gastrointestinal tract, and the dimples of the esophagus are all scattered with pus. During the first operation, it is very difficult to completely cleanse these abscesses. After the operation, pus will collect in the abdomen and abscesses will form, which will require another operation. If this postoperative complication is not diagnosed in time and operated again (relaparotomy), many other complications can occur and the risk of death is high. 48-hour relaparotomy mortality is higher than early surgery (21.8% -76.8%). Necrotic pancreatitis is chronic peritonitis (an abscess of the lower extremities) in which only non-pancreatic adipose tissue, sebum glands, pericardial effusions, pericardial effusions, and kidney adipose tissue become necrotic. Purpose: Endoscopic surveillance for chronic pleurisy with pancreatic necrosis Objectives:
1. Endoscopic monitoring of the postoperative course of pancreatic necrosis.
2. Calculate the results of washing and cleaning using binoculars. Method: Patients with advanced peritoneal inflammation and necrotizing pancreatitis should be selected for reoperation. After removing the dead pancreatic tissue (necrosectomy), all layers of the abdomen are temporarily closed. A 6 mm short tube with surgical rubber is cut into the small pancreas, inserted 2 cm deep into the standard abdomen and sutured to the skin. Or use a silicone tube 4 - 5 cm long. Result: The study was carried out on 56 patients in 2016-2020. The mean age was 50 (89%) for men, 6 (11%) for women, and 47.5 ± 8.6. Conclusion
1. Endoscopic follow-up showed 19 (76%) persistent postoperative peritonitis and re-clearance, and 6 (24%) patients were not diagnosed with persistent peritonitis.
2. 25 (50%) cases of persistent peritonitis after surgery were washed 1-3 times. This method has proven to be a safe and easy procedure and can be used in any urban or rural hospital.

Background: Stroke is one of the leading causes of mortality and disability worldwide. Understanding sex differences in risk factors, clinical characteristics and death after stroke might provide valuable evidence for prevention and management of stroke. Aim: We aimed to describe sex differences in risk factors, clinical characteristics and death after intracerebral hemorrhage (ICH) and ischemic stroke (IS) using hospital-based registry in 6 districts of Ulaanbaatar, Mongolia. Materials and methods: We used hospital-based stroke registry in Ulaanbaatar Mongolia. From 2019 to 2020, total of 974 patients with acute ICH and 1612 patients with acute IS were enrolled in this study. The severity of stroke was measured by National Institutes of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS). Risk factors for stroke were defined as patient’s history and their medical record. Death after stroke was registered at 28 days and 90 days by follow-up study. A comparison of categorical and continuous variables was analyzed using chi-squared test, Student’s t-test and Mann Whitney U test. Univariable and multivariable logistic regression analyses were also performed. Results: The mean age of ICH patients was 58.41±11.56. There was significant difference in age (59 vs 57, p=0.009) between women and men. Men with ICH were more likely to drink alcohol (35.4% vs 5.2%, p=0.000) and to smoke (37.0% vs 8.4%, p=0.000) and to have arterial hypertension (72.7% vs 58.6%, p=0.000). However, there were no significant differences in other risk factors including atrial fibrillation, diabetes mellitus, prior stroke and other cardiac diseases. There were no sex differences in clinical characteristics including systole and diastole blood pressure, NIHSS scores and GCS. In our study, case fatality rate was 23.8% at 28 days and 1.9% at 90 days after ICH. By multivariable regression analyses, there were no significant association between sex and death at 28 days and at 90 days (OR:0.74; 95% CI:0.52-1.06, OR: 0.80; 95% CI:0.29-2.21).
The mean age of IS patients was 61.07±12.88. The women were older (63 vs 59, p=0.000) than men. Men with IS also were more likely to be current smokers (37.6% vs 9.0%, p=0.000), current drinkers (33.2% vs 3.4%, p=0.000) and to have arterial hypertension (74.7% vs 65.9%, p=0.000). There were no significant differences in other risk factors. For IS patients, there also was no sex difference in clinical characteristics. Case fatality rate was 13.3% at 28 days and 1.1% at 90 days after IS. By multivariable regression analyses, there were no significant association between sex and death at 28 days and at 90 days (OR:0.90; 95%CI: 0.64-1.26, OR:5.16; 95%CI: 0.99-23.9). Conclusion Our study showed sex differences in some vascular factors of both stroke subtypes which emphasized that we need to implement stroke prevention targeting sex-specific risk factors. While clinical characteristics and early mortality of intracerebral hemorrhage and ischemic stroke were not differed by gender.

Background: Globally the incidence of stroke is not decreasing, and the deaths and disabilities caused by stroke is increasing every year, especially in low and low-middle income countries.
Long-term trends in stroke incidence in different populations have not been well characterized, largely as a result of the complexities associated with population-based stroke surveillance.
Having reliable data on stroke morbidity and mortality, as well as periodic identification of long-term trends will be important information for proper prevention planning in the population, monitoring the disease and further improving the quality of health care. Material and Method: A prospective cohort study has been conducted in adult citizens (972409 in 2019, 925367 in 2020) of 6 districts of Ulaanbaatar from the 1st of January, 2019 to 31st of December, 2020. All first-ever and recurrent stroke cases were included using special software, developed for stroke registry, based on the WHO STEPS approach from participating radiology departments of state hospitals, district hospitals, and some private hospitals. Information of stroke death was obtained from forensic institute and state registration office of the capital city.
The trends of stroke incidence and mortality was compared to data between 1998-1999 and 2019- 2020 in UB. Results: The age-standardized crude incidence rate per 100.000 person-years of stroke were 209.0/100.000 (n=1934) in 2019 and 194.0/100.000 (n=1821) in 2020 among adults of UB city. The above results were compared to 1998-1999 studies and the incidence rate declined by 94.0/100.000 in 2019-2020, whereas mortality rate increased by 10.0/100.000 in women aged 16-34. Stroke mortality was 11.6% in 1998 and 26.5% in 1999, while in our study it was 33.87% in 2019 and 29.71% in 2020. Although the incidence of stroke rates has decreased in 1998-1999, the mortality rate has not decreased significantly. Conclusion Morbidity and mortality rates among the population of Ulaanbaatar citizen remain highest in the world, compared to 20 years ago with overall morbidity declining but mortality has not decreased.
In recent years, the Government of Mongolia has been focused on reducing non-communicable diseases, but the primary and secondary prevention and control of stroke in the general population, as well as the acquisition of knowledge attitudes, practices and access to health care still need to be improved.

Introduction: About 20-30% of patients with acute pancreatitis have a severe disease and mortality rate among inpatients were 15%. There are many causes of acute pancreatitis (AP), but most common cause of AP is an alcohol. According to some studies in our country, alcohol is the number one cause of acute pancreatitis and the mortality rate is 15.3%. Very important for prognosis of disease optimal choice of treatment tactics, detection of infectious evidence of necrotizing pancreatitis. Therefore, based on the above, there is an urgent need to conduct research to address important issues and to improve the diagnosis and treatment of acute alcohol-induced pancreatic necrosis. Goal: Determine the importance of early diagnostic assessment of alcohol induced severe acute necrotizing pancreatitis. Materials and Methods: Research model and research method. We conducted our research using an observational research model and a factual research method.Sampling of research materials will be carried out by targeted sampling. From November 1, 2008 to January 1, 2020, 122 patients who were hospitalized with alcohol-inducedAP were selected and archival documents or medical histories were selected. Statistical analysis was performed using averages and regression analysis methods to calculate the laboratory parameters in the analysis related to the new evaluation system. Results: The minimum age of patients with ANP was 25 and the maximum was 71, with the majority (87.4%) aged 26 to 60 years. When the Person Correlation method calculates the relationship between alcohol consumption and mortality, it is assumed that the weaker the correlation, the higher the amount of alcohol consumed, the lower the cure and the higher the mortality. Of the 31 deaths reported in the study, 24 (77.4%) were hospitalized more than 72 hours after the onset of the disease. Late hospitalization and late treatment of patients with acute necrotizing pancreatitis (ANP) disease have been shown to adversely affect the prognosis of the disease. In our study, all parameters were significant, but procalcitonin, serum amylase, serum lipase, serum LDG8 C-reactive protein, serum glucose was found to be higher than the value specified in the evaluation system for the variable (in determining pancreatic necrosis). АNOVA analysis test showed that white blood cells, procalcitonin, serum amilza, serum lipaza, serumglucose, serum LDG, C-reactive protein were higher than those specified in the evaluation system, and that the level of significance for the variable (indicating a severe pancreatitis or poor prognosis) was higher than other test results (P <0.01). According to the new evaluation system, 12 out of 122 patients were classified as A class or 0-3, 69 (56.5%) patients were class B or 4-6, and 41 (33.6%) patients were class C or >7 points. Of the total cases, 90.1% were rated as severe form of ANP and pancreatic necrosis by the classification system we developed. When we assessed the prognosis with the new assessment system, we found that 100 percent of patients in category A were cured, 89.8 percent of patients in category B were cured, and 41.5 percent of patients in category C were cured and 58.5 percent died. Statistical calculations using the correlation analysis method for the correlation between the score and the cure of the evaluation system shows negative correlation (P <0.01) other words, the higher the score of the evaluation system, the lower the cure rate and the higher the mortality rate. Conclusion In Mongolia, relatively young men suffer from alcohol-induced pancreatitis.Factors contributing to the development of necrosis in acute pancreatitis include alcohol abuse, prolonged alcohol use, delayed hospitalization, and delayed treatment.In our study, following clinical signs and laboratory findings are effective in distinguishing severe forms of acute necrotizing pancreatitis, early diagnosis, assessment of prognosis. Laboratorytests include: increase in white blood cells, procalcitonin, serum amylase, serum LDH, serum lipase, C-reactive protein and a decrease in hematocrit, serum calcium.

Background: Stroke is still one of the leading causes of morbidity and mortality worldwide. Registry-based data of stroke are scarce in low and middle-income countries such as Mongolia. We aimed to investigate the incidence and mortality of stroke in adult population of UB Mongolia by stroke registration method. Material and Method: Covering 611265 (≥15 years old) adult citizens of three districts of Ulaanbaatar, a population-based prospective study was done from the first, January of 2019 to 31st, December of 2019. All first-ever and recurrent stroke cases were included using special software, developed for stroke registry, based on the WHO STEPS approach from participating radiology departments of state hospitals, district hospitals, and family clinics. Information of stroke death was obtained from forensic institute and state registration office of the capital city. Results : In a 1-year study period, 1068 (women 39.1%) stroke cases were registered in people with 60.16±13.66 years old. Stroke incidence rate was 169.81/100000 including first-ever and recurrent events. Stroke incidence rate was higher in men and people with 80 and above years old. The ratio between IS and ICH was 1.14:1.0. Stroke mortality was 27.1% and mortality rate was 45.94/100000. The highest rate mortality was in ICH subtype, male population and older people. Conclusion We identified relatively high incidence and mortality rate of stroke in ICH indicating an urgent need for improvement of arterial hypertension control, health education and primary prevention mainly among men.

In the 13th century, a wound caused by an arrowhead was healed by scorching the surface of the injury. For instance, in the early 13th century during a battle, Ugudei Khaan was shot in the neck. One of his knights, Borokhul, sucked a blood clot from the wound and carried him on his horse. When Chinggis Khaan saw them, he grieved, wept, and ordered a fire to be made. After scorching Ugudei’s wound, he gave him something to drink and waited to fight their enemies. We came across instances of curing injuries with dairy products in the Secret History of Mongolia. In one case, when he was wounded in the neck, Chinggis Khaan traveled with difficulty and camped in a battle field at sunset.
One of Chinggis’ knights, Zelme, nursed him by sucking blood until midnight. He cared for the unconscious Khaan by himself, not trusting others. When midnight passed, Chinggis Khaan woke up and said “blood has dried and I am thirsty.” Zelme took off his hat, boots and deel (dressing-gown), leaving only underwear and entered their enemy’s camp. He searched for eseg (mare’s milk) on carriages of commoners who camped behind the military camp. However, he couldn’t find any eseg because the refugees hadn’t milked their mares. Therefore, he stole a leather sack of tarag (a drink made by fermenting the milk of sheep, goat, or cow) and carried it back to his camp.
Nobody saw Zelme, God might have blessed him. Zelme gave Chinggis Khaan the tarag mixing it with water to drink. Chinggis Khaan had the drink and said he felt relieved. At that time it was dawn. One of the achievements of Traditional Mongolian Medicine of that time was curing wounds with the help of surgical means. In the beginning, the Mongolians got much knowledge of animal anatomy by dismembering joints and internal organs of different animals while slaughtering. Afterwards, based on their knowledge of animal anatomy, they set bones and cured wounds. Additionally, they broadened their knowledge by performing autopsies on dead bodies, etc. In 1263, during one of the battles between the Mongolian and South Sun nation troops, which the Sun lost, Zuukhar was hit by 3 arrows. The arrowhead in his left shoulder could not be removed. Hyavtsag opened the wound with the help of two men who were sentenced to death (these people were Sun nation) and examined if the arrow could possibly be removed. Finally, he was able to remove the arrow from Zuukhar’s body. Thence, the Mongolians of that time performed autopsies as well as surgical treatment along with medical treatment.
In the mid-13th century, Traditional Mongolian curing methods were rapidly developing. The Mongolian army had special doctors to cure injured soldiers. According to some sources, in the early 13th century, there was a position of “military doctor,” among Chinggis Khaan’s army. When generals or troops got injured, the military doctor was ordered to cure them by a fixed deadline.

Introduction: One of the quality assurance measurements for medical schools is the achievement of students who have graduated in the assessment of the knowledge, skills and attitudes they are trained in. Goal: To analyze assignment of theoretical and practical exam and to identify the level of кknowledge students who have graduate at “Ach” Medical University during 2015-2016 academic year. Materials and Methods: The study was conducted on a cross sectional and descriptive study through the based on the task of analyzing the 261 graduate students theoretical and practical exam performance of the bachelor degree in Medicine, Dentistry, Traditional Medicine and Nursing of Ach Medical University of Mongolia /AMU/ and was assessed and to identify a reliability coefficient, difficulty factor, discrimination index, Hoffsten’s score. Results: The reliabiliy coefficient of graduate exam meets requirement when it’s 0.94-0.96. According to the analysis of the 300 test of the each classroom of graduates was 70 percent (n=202) with weak dicrimination index, difficallty factor was more than 50 percent too easy, The Hoffsten’s score to which exam was passed of Medical graduates is 70 percent, traditional medicine is 87 percent, dentistry is 79 percent, the nursing is a Hoffsten’s score was 80 percent. Conclusions The reliability coefficient the theoretical exam of the graduates’ knowledge is convenient for all occupations, and whole field examines the weak difficulty index (DI≤0) for all field examinations. The Hoffsten’s score is 70% above the medical field. Graduate assignments can not discriminate graduates’ knowledge and skills levels and the difficulty factor graduate examination was very easy.