Background: Copper is a mineral that is involved in many functions og the human body and copper has antibacterial reaction. However many scientists have studied the antibacterial activity of nano copper, in our country, the lack of research is the basis of our research. Aim: Determination of antibacterial activity of colloidal copper (CuNP) Materials and Methods: The study protocol was reviewed and approved by the Research Ethics Review Committee of the Mongolian National University of Medical Sciences on February 18, 2022 (Protocol No. 2022/3-02). An ionized copper solution was produced by passing an electric current (19–20 V, 3–5 A, for 24 h) through sterilized distilled water using copper plates. Ascorbic acid was then added to prepare colloidal copper. The concentration was determined using a PPM meter, and the solution was filtered through a 0.22 µm bacterial filter. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against standard bacterial strains were determined by the broth dilution method. To determine the bactericidal time, bacterial cultures were exposed to the bactericidal concentration and subcultured hourly for 10 hours. Additionally, antibacterial activity was evaluated on Mueller–Hinton agar using the disk diffusion method according to CLSI standards, where 20 µL of colloidal copper was applied onto antibiotic disks. The plates were incubated at 37°C for 24 hours, and the diameter of the inhibition zones was measured. Result: The concentration of the prepared colloidal copper was 0.7 ppm. Using the broth dilution method, complete bactericidal activity was observed at 0.006 ppm against Klebsiella pneumoniae, Escherichia coli, and Salmonella enteritidis, while Pseudomonas aeruginosa was completely killed at 0.008 ppm. In terms of exposure time, complete bacterial killing occurred after 2 hours for S. enteritidis and K. pneumoniae, after 6 hours for E. coli, and after 11 hours for P. aeruginosa. In addition, antibacterial activity was evaluated on Mueller–Hinton agar using the disk diffusion method according to CLSI standards. Colloidal copper increased the inhibition zone diameter of most antibiotics by 1–5 mm, particularly against P. aeruginosa. In K. pneumoniae, the activity of aztreonam and ceftriaxone was enhanced. When evaluating the inhibition zone diameter of cefotaxime against E. coli, the susceptibility result changed from intermediate to susceptible, while no significant change was observed for the other antibiotics tested. For K. pneumoniae, the addition of colloidal copper increased the inhibition zone diameter of aztreonam and ceftriaxone by approximately 1–2 mm. In P. aeruginosa, the inhibition zone diameters of most antibiotics increased by 1–5 mm; however, the activity of imipenem decreased. For S. enteritidis, most antibiotics showed an increase in susceptibility of approximately 1–2 mm, while ceftriaxone showed no observable effect. Conclusion 1. Colloidal copper solution, at low concentrations, exhibits bactericidal activity against some Gram-negative rod-shaped bacteria. 2. Colloidal copper solution shows a synergistic effect with certain drugs, enhancing their activity; however, it exhibits an inhibitory effect on the activity of imipenem.

Background: Allergic and atrophic forms of chronic rhinitis are common among the population, characterized by a chronic progressive course with a tendency toward increasing prevalence. Worldwide, allergic rhinitis affects approximately 10–40% of adults and 2–25% of children. According to a study conducted in Mongolia, the prevalence of allergic rhinitis among adults in Ulaanbaatar was reported to be 23.6%, with an increasing trend anticipated in the future. In allergic and atrophic rhinitis, structural alterations occur in the nasal mucosa, including disruption of the normal architecture of the pseudostratified epithelium and ciliated cells, accompanied by changes in goblet cell number and dysfunction of their activity, resulting in a complex pathological process. In otorhinolaryngology practice in Mongolia, there is a relative lack of studies investigating the ultrastructural changes of the nasal mucosa in allergic and atrophic rhinitis. Aim: To compare ultrastructural and histological changes of the nasal mucosa in allergic and atrophic rhinitis. Materials and Methods: Ethical approval was obtained from the Research Ethics Review Committee of the Mongolian National University of Medical Sciences at the meeting held on April 24, 2020 (Protocol No. 2020/З-04). Appropriate ethical permission was also obtained from the EMJJ ENT Hospital. Nasal mucosal tissue samples were collected from surgically resected specimens of patients aged 20–45 years diagnosed with allergic and atrophic rhinitis. The mucosal specimens were processed at the Institute of Biomedical Sciences of the Mongolian National University of Medical Sciences. Samples were fixed and dehydrated according to the protocol, coated with 100 Å gold, and examined using a scanning electron microscope (FEI Quanta FEG 250, USA). In addition, paraffin blocks were prepared, sectioned at 4 μm thickness, stained with Hematoxylin and Eosin, and analyzed histologically. Results: In allergic rhinitis, the pseudostratified epithelium was relatively preserved; however, disorganization of ciliated cells, partial loss of cilia, and goblet cell hyperplasia were observed. In contrast, atrophic rhinitis showed epithelial thinning, near-complete loss of ciliated structures, glandular atrophy, and submucosal fibrosis. Conclusion Allergic rhinitis is associated with relatively mild and predominantly functional mucosal alterations, whereas atrophic rhinitis demonstrates severe structural damage with irreversible impairment of mucosal protective function.

Background: Double-lumen tubes (DLTs) are widely used in thoracic surgery to achieve one-lung ventilation. International recommendations suggest tube size selection based on height and sex (39 41 Fr for males ≥160 cm, 35–37 Fr for females ≥150 cm). However, in Mongolian practice, applying these standards often leads to oversized tube use and related complications. Objective: To compare international standards for DLT size selection with body height and sex in Mongolian patients. 10 Methods: A cross-sectional study was conducted among patients who underwent esophagectomy with left-sided DLT placement at the National Cancer Center of Mongolia between 2018 and 2023. Data included age, sex, height, and DLT size. Statistical analysis was performed using chi-square and t-tests, with p < 0.05 considered significant. Results: A total of 211 patients were analyzed (58.8% male, 41.2% female). Among males, 170 cm patients received 37 Fr in 90% of cases (p < 0.001). Among females, 160 cm patients either 35 Fr or 37 Fr (p < 0.001). Tube size also differed significantly by sex (p < 0.001): 68.5% of males received 37 Fr, while 83.9% of females received 35 Fr. Conclusion In Mongolian clinical practice, DLT sizes are generally chosen smaller than those recommended by international standards, based on sex and height. All patients in the study achieved successful one-lung ventilation and favorable surgical conditions, indicating that international standards may not be fully applicable to the Mongolian population. Moreover, the study highlights that while DLT size selection correlates strongly with height in males, the association is weaker in females. Therefore, reliance solely on height and sex may be insufficient, and additional biometric and anatomical parameters should be considered for optimal tube selection

Background: The skin barrier serves as the primary defense against environmental factors. Mongolia’s extreme climate conditions may contribute to skin barrier impairment, increased trans-epidermal water loss (TEWL), and decreased skin moisture. Objective: To determine and compare skin moisture, TEWL, and skin pH levels in children. Methods: A cross-sectional study was conducted in June 2023 with 104 relatively healthy children selected through random sampling. Skin physiological parameters, including skin moisture, skin pH and TEWL were measured following the EEMCO (European Group on Efficacy Measurement of Cosmetics and Other Topical Products) guidelines using the Multi Skin Test MC750 device (Courage+Khazaka Electronics, Germany) at nine different sites. Data analysis was performed using Microsoft Excel and Stata-14 software. Results: Among the participants, 51.9% (n=54) reported having dry skin (p<0.0001). Additionally, 64.5% (n=67) used moisturizers, but their usage did not show a statistically significant difference in skin moisture (p=0.929), skin pH (p=0.378), or TEWL (p=0.332). 14.42% (n=15) had extremely dry skin, while 85.58% (n=89) had dry skin, with no participants falling within the normal skin moisture range. TEWL showed a moderate inverse correlation with age (r=-0.331, p=0.0006). When analyzed by age groups, skin moisture (p=0.023) and TEWL (p=0.038) differed significantly between groups. Conclusion Skin moisture and TEWL significantly differ across age groups. Given that all participants had dry skin, moisturization is crucial. Mongolia’s extreme climate is likely a key contributing factor to childhood skin dryness.

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: The aim of this research project is to elucidate the crosstalk of innate and adaptive immune reactions against the DNA containing bacteria. : This study held in the Core laboratory, Science Technology Center, Mongolian National University of Medical Sciences (MNUMS). Murine aortal endothelial cells, END-D cultured and the cell viability checked by MTT assay. In addition, the NO production, protein and gene expression studied by Griess Reagent assay, R.T-PCR and immunoblotting, respectively. Results: 0.1µM, 1µM and 10µM of TLR9 ligand exhibited no cytotoxic action against the cells by MTT assay. IFN-ү alone induced NO production in END-D cells. In the other hand, TLR9 ligand at 0.1µM, 1µM and 10µM up-regulated IFN-ү induced NO production in dose dependent manner. RTPCR results exhibit that TLR9 ligand up regulates iNOS mRNA. Immunoblotting analysis showed the enhanced iNOS protein expression and phosphorylation of STAT1 in cells pre-treated with TLR9 ligand. Discussion: We have demonstrated CpG DNA, TLR9 ligand, up-regulates IFN-ү induced NO via enhanced IFN-ү signaling. The result of Western Blotting and RT-PCR support the up-regulation of NO. CpG DNA can be used as agent against virus and bacteria. Further research need to be conducted. Conclusion TLR9 ligand, CpG DNA up-regulates IFN-ү induced NO production in time and dose dependent manner. TLR9 ligand augments the expression of iNOS mRNA and STAT1 phosphorylation in response to IFN-ү.

There are a lot of influencing factors of facial nerve palsy; experts believe that is most likely caused by a Virus (54%) and Bacterial infections. Noninfectious causes of facial nerve palsy induce tumors (28%) and less commonly influences head trauma (18%). The retrospective analysis of WHO, in 2012. There are some cases of postoperative complication in middle ear surgery is facial nerve palsy and the total recovery outcome of function was not good. From 2013 to 2016 in EMJJ hospital, Mongolia, we enrolled 16 cases with facial nerve damaged in intratympanic canal but we could not recruit some patients with facial palsy over 6 months. Each subject was tested with pure tone test, ABR, Tympanometry. These were performed for the detection of hearing loss after Temporal bone injury. Then we also investigated location of facial nerve damages of patients by MRI and CT before reconstructive surgery. After that surgery, all patients were given corticosteroid treatment (20mg/day) and physical therapy performed such as acupuncture for a week. Study results revealed that 6 cases after 18 days, 2 cases after 30 days, 1 patient after 45 days of reconstructive surgery regained good symmetry. Therefore, we considered that, postoperative treatments like physical therapy with B12, steroid had good benefits for operation result and to shorten the recovery time. There was a patient who had damaged facial nerve in the tympanic segment during Mastoidectomy. In that case, we performed cable nerve grafting using the r.auricularismagnium but we could not recover facial nerve function. Traumatic facial nerve paralysis is the second most common type. We discussed that performing reconstruction surgery within first 3 months after intratemporal facial nerve injury is extremely desirable and more effective. In our opinion, nerve recovery might be not successfully cause of injured myelin sheet of facial nerve during middle ear surgery.