Background: Reconstruction of mandibular and maxillary defects resulting from malignant tumors has remained a complex challenge in recent years. Defects caused by tumors—as well as trauma, inflammatory diseases, and congenital anomalies—lead to impaired essential functions such as mastication, swallowing, and speech. Prior to the 1950s, reconstruction of maxillofacial hard tissue was not commonly performed. Instead, metal plates were used to reestablish bony continuity, and surrounding tissues were utilized to close soft tissue defects, without effectively restoring function. With modern advances in three-dimensional (3D) virtual planning, it is now possible to accurately plan free bone flaps for reconstructing jaw defects. During surgery, manually bending reconstruction plates to fit donor bone precisely is often not feasible. Preoperative 3D planning allows for precise fabrication of surgical guides and fixation plates, improving accuracy and significantly reducing operative time. Additionally, incorporating dental implant planning into the reconstruction process facilitates restoration of both structural and functional outcomes. Aim: To evaluate the outcomes of mandibular defect reconstruction using scapular free flaps in Mongolia and explore potential approaches to optimize the technique. Materials and Methods: This was a case study series. Data from reconstructive surgeries performed at the National Cancer Center of Mongolia, Central Dental Hospital, and the Mongolia-Japan Hospital were collected. Variables included patient age and sex, etiology of the mandibular defect, size of the scapular bone segment, operative time, ischemia time of the free flap, number of vascular anastomoses performed, and pedicle length. For 3D planning, CT scans of the patient's head and lower limb (slice thickness <1 cm) were used to generate 3D models via the 3D Slicer software. Cutting guides for the mandible and scapula (ASIGA), as well as the reconstruction models (AMS), were printed using a 3D printer. Results: A total of 400 free flap reconstructions were performed during the study period. Of these, 29 cases involved reconstruction of mandibular defects using scapular free flaps. The mean age of patients was 40.0 ± 18.3 years, with 52% (15 patients) being female. The etiologies of the defects included malignant tumors (13 cases, 45%), benign tumors (6 cases, 21%), and pre-existing defects (10 cases, 34%). In one case, tumor resection and mandibular reconstruction were performed using 3D planning. The total operative time was 9 hours and 30 minutes, and the ischemia time was 2 hours and 40 minutes. Conclusion Between 2012 and 2025, a total of 29 mandibular reconstructions using scapular free flaps were performed in Mongolia. Traditional reconstruction methods were associated with prolonged ischemia time. The use of 3D surgical planning has shown potential in significantly reducing ischemia time and improving surgical outcomes.

Background: The craniofacial region is one of the most frequently injured parts of the human body, with mandibular fractures being the most common type of facial skeletal injury. The leading causes of mandibular fractures include traffic accidents, falls, interpersonal violence, and sports-related injuries. In Mongolia, mandibular fractures are prevalent, with a higher incidence among males. However, to date, no national-level analysis of mandibular fractures has been conducted. This study aims to comprehensively examine mandibular fractures in Mongolia by identifying demographic factors and causes of injury. Aim: To determine the incidence and causes of mandibular fractures recorded in Mongolia over the past ten years. Materials and Methods: This study collected data on mandibular fractures recorded in the Health Development Center of Mongolia between 2014 and 2023. Cases were identified using the International Classification of Diseases (ICD-10) code S02.6. Information on patient age, gender, and hospital diagnosis was collected, along with the cause of injury, classified according to ICD-10 codes. Patient age was categorized based on the classification system of the National Statistics Office. Statistical analysis was performed using SPSS 26.00 software, employing the chi-square test for data analysis. Results: During the study period, a total of 2,872 patients were diagnosed with mandibular fractures, with the highest incidence occurring in the 20-40 age group. The average patient age was 31.1±12 years. Males were 5.6 times more likely to sustain mandibular fractures compared to females. The primary causes of injury were interpersonal violence (42%), mechanical trauma (17%), falls (16%), and traffic accidents (15%). Conclusion Between 2014 and 2023, 2,872 cases of mandibular fractures were recorded in Mongolia, with the majority occurring in individuals aged 20-40 years. The leading causes of mandibular fractures were interpersonal violence, mechanical trauma, falls, and traffic accidents. Specialized trauma care services were accessed differently in urban and rural areas.

Background: Down syndrome (DS) is a chromosomal disorder and a leading cause of intellectual and physical developmental delay in children. In Mongolia, there is no current national guideline recommending the use of the quadruple biomarker test for prenatal screening of DS. Instead, triple marker testing during the second trimester remains standard practice. However, the quadruple test offers higher specificity and sensitivity. Therefore, this study was conducted to determine gestational age specific normative values for the quadruple markers, adjusted for ethnic characteristics. Currently, multiple of the median (MoM) values for Mongolian women are calculated using reference medians derived from Caucasian populations. This study aims to establish population-specific reference values for Mongolian women. Objective: To determine the normative serum levels of second-trimester quadruple biomarkers — alpha-fetoprotein (AFP), free beta-subunit of human chorionic gonadotropin (β-hCG), unconjugated estriol (uE3), and inhibin A (Inh-A) — in Mongolian pregnant women. Methods: A retrospective study was conducted involving pregnant women between 14 and 21 weeks of gestation. The concentrations of each biomarker were analyzed using multivariable quantile regression models, adjusting for gestational age and maternal weight. Results: MoM values calculated using the Mongolian model differed significantly from those based on the Caucasian model (Wilcoxon signed-rank test; p < 0.001). Specifically, the concentrations and MoM values for AFP and uE3 were significantly lower, while those for β-hCG and Inh-A were notably higher in the Mongolian cohort. Conclusion The serum levels of β-hCG and Inh-A were significantly elevated in Mongolian pregnant women compared to the ethnicity-adjusted Caucasian reference model, highlighting the importance of using population-specific normative data for accurate prenatal screening.

Background: Generation Z students, born after 1995, are characterized by their ability to multitask, low tolerance for traditional learning methods, impatience, short attention span, and preference for working independently rather than collaboratively. They are also considered more vulnerable to mental health challenges compared to previous generations. Aim: To assess the level of academic engagement among Generation Z students studying in the School of Nursing. Materials and Methods: This descriptive, cross-sectional quantitative study was conducted from February 1 to April 1, 2025. A total of 420 students majoring in nursing, midwifery, physical therapy, occupational therapy, and traditional medicine nursing at the School of Nursing, Mongolian National University of Medical Sciences, participated in the study. The Student Course Engagement Questionnaire (Handelsman, 2005) was used to evaluate students’ engagement levels. The reliability of the questionnaire was confirmed with a Cronbach’s α of 0.955. Statistical analysis was performed using SPSS version 25, and results were considered statistically significant at p<0.05. Results: Among the 420 participants, 91.9% were female and 8.1% were male. By major, 57.1% studied nursing, 22.6% midwifery, 8.8% physical therapy, and the remainder were from other disciplines. Student engagement was analyzed across three domains: academic involvement, personal responsibility and effort, and learning attitude and motivation. Pearson correlation analysis revealed strong positive correlations between academic involvement and personal responsibility/ effort (r=0.828), learning attitude and motivation (r=0.825), and between responsibility/effort and learning attitude/ motivation (r=0.903) (p<0.01). Age showed a weak positive correlation with year of study (r=0.381), while major and year of study had a weak negative correlation (r= -0.146) (p<0.01). Year of study and learning motivation also showed a weak negative correlation (r=-0.107, p<0.05). Conclusion The learning motivation and class engagement of Generation Z nursing students were found to be strongly correlated with their sense of responsibility, effort, and learning attitude (r=0.82–0.90, p<0.01). Most students demonstrated consistent participation and motivation to learn, showed less interest in traditional teaching approaches, and preferred practical training.

Introduction: Mostly fever change influences for heart and vital vessel and it is important for future treatment to compare difference of diagnosis and treatment feature of heart-disease in fever change. Goal: To compare difference of pain, feature, treatment and diagnosis when reduced fever change in heart Materials and Methods: The study was conducted using methods of ‘Comparing manuscript sources studies’, ’Analyses and syntheses’ for determining numbers and described with ‘Hermeneutics’ methodology. The study was based on approved methodology and ethical review in December 2018 Result: Fever could be directly matter of death because it should be needed to pay attention for method of treatment, to make research for general medicine of fever, to make research other organs & heart, to take medicine within ice sweet, to reduce fever and to treat through cautery, oily cream and ointment. Conclusion
1. Most diagnostic and pain of fever influence for heart and it depends on process of fever accordance with our research collection.
2. It is possible to consider similarly pain, diagnosis and treatment of heart pneumonia and heart fever based on classification of general heart disease of science of medicine.

Introduction: In 2018, the overall colorectal cancer (CRC) incidence rate was 3.6%, according to the National Cancer Center of Mongolia (NCCM), and the incidence of colorectal cancer has increased slightly in recent years. According to cancer stages, late stage cancer has a 5-year survival rate of 51%, while early stage cancer has a 5-year survival rate of 79%. The overall survival rate of colorectal cancer in Mongolia has not been studied in precisely. In Asia, the 5-year survival rate for colorectal cancer was 60%. Therefore, this study investigated the colorectal cancer survival rate and prognostic factors at NCCM. Methods: A total of 108 patients diagnosed with CRC at NCCM’s General Surgery Department from 2013 to 2015 were used in this retrospective cohort study. The Kaplan-Meier method was used to develop the survival graphs, which were then compared using the Log-rank test. Results: The median survival time was 42 months, with a 95% CI (38.55-45.66). A 5-year period, the overall survival rate for CRC was 61.2%. Survival rates at the I, II, III, and IV stages were 100%, 75%, 65.4%, and 13.5%, respectively. There was a significant difference in CRC survival rates across all stages (p=0.0001). There was a statistically significant difference in determining the relationship between adjuvant chemotherapy and survival rate (p=0.0003). Conclusion The outcome of the surgery is determined by the CRC stage. The postoperative survival rate (61.2%) is directly related to tumor stage, peripheral glandular metastasis, distant metastasis, and chemotherapy effects.

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.

Introduction: It is necessary and right to study and analyze all aspects of drug materials now when number of mineral based drugs are reducing. Especially it is very important for further researches to properly establish names and number of raw materials for traditional drugs based on ancient scripts. Goal: To carry out comparative study on mineral based drugs numbers and their differences mentioned in Mongolian and Tibetan manuscripts about drug identification methods using ‘Four basics of medicine’ book and its interpretations as a source. Materials and Methods: The study was conducted using methods of ‘Comparing manuscript sources studies’, ‘Analyses and syntheses’ for determining numbers and described with ‘Hermeneutics’ methodology. The study was based on approved methodology and ethical review in December 2018. Results: As it was compiled from manuscripts number of drugs mentioned in Four basic roots of medicine was 57, Ancestors’ important teachings – 68, Blue binderya – 77, Golden descript – 87, Clear crystal beads about medicine – 134, White crystal mirror – 121, Beauty eyes décor – 96. It is seen that books written about mineral based drugs became more comprehensive compared with previous manuscripts and authors were trying to reflect their on drug identification methods and ideas. Conclusion
1. The same time it evidences that traditional medicine was enriched year by year with innovation and searches of every generation scientists.
2. In “The four basics of medicine” manuscript theoretical book they described 57 mineral based traditional drugs but in other studies that number increased to 121 which means in manuscripts like “Basics of magic” and “Basics of future” drugs used that time were described more comprehensive.

Introduction: Endothelial progenitor cells (EPC) have a role in the maintenance and promotion of vascular repair and are negatively correlated with coronary atherosclerosis. Goal: To culture of EPC-CFUs during coronary atherosclerosis, evaluate endothelial nitric oxide synthetase (eNOS) enzyme levels in the culture. Materials and Methods: The 10 ml blood was drawn from the peripheral vein of 12 man patients that stable angina 4, acute myocardial infarction (AMI) 4 and healthy people 4. Peripheral blood mononuclear cells were isolated by Ficoll density-gradient centrifugation and EPC-CFUs was assayed after two platings and a 6 day culture on fibronectin coated, 72 well plates, as described. eNOS enzyme titers were determined by ELISA according to the protocol in the cells culture. Results: The people were 52±2.12 years. The number of EPC-CFUs increases with accordance of patients with stable angina, AMI, healthy people with the statistical significance (F=17.3, p<0.001): stable angina (2.6±0.47 colony/well), AMI (6.7±0.81 colony/well), healthy people (10.5±1.34 colony/well). Furthermore, ANOVA test of eNOS enzyme levels in patients with stable angina (5.2±0.61 pg/ml), AMI (8.7±1.49 pg/ml) and healthy people (13.7±2.48 pg/ml). The significant difference (F=6.2, p=0.003) was observed among the three groups. The number of EPC-CFUs had direct significantly correlation (r=0.621, p<0.001) with the eNOS enzyme levels of this culture. Conclusion: Number of EPC-CFUs and eNOS enzyme levels decrease at patient with stable angina, indicate more than endothelial dysfunction. Ethical approval The ethics committee of Mongolian National University of Medical Sciences (ID: 6/3/201506, approved on Jan 01, 2015)

Objective: To compare the nature of pregnancy and deliveryin women with leiomyoma who were treated with uterine artery embolization to the outcomes in women who were treated with abdominal myomectomy. Material and Methods: A prospective, clinical study was conducted in 2010-2013 at “Urguu” Maternity Hospital, Ulaanbaatar. 94 women meeting the criteria were selected for the study. Post-treatment, the patients were reviewed for a period of two years. Uterine artery embolization was performed using polyvinyl alcohol particles (300-500 µm in diameter). Results: The percentage of conception in UAE group was 25.5% and 31.9% in myomectomy group (p=0.494); complication of pregnancy was 50.0% and 57.1% respectively (p=0.729); complication of delivery was 33.3% and 0.0% respectively (p=0.047). 88.9% and 90.0% (p=0.596) had Caesarean delivery. 16 (84.2%) women had uncomplicated and 3 (15.8%) women had complicated delivery due to placenta praevia, placenta acreta and uterine hypotonia. These cases all belonged to UAE group. Conclusion Pregnancy rates in women with leiomyoma who were treated by uterine artery embolization, compared with pregnancies after abdominal myomectomy, were similar.(p=0.494) In this study, there was the rate of Cesarean delivery above 80 percent in both group. There were no differences in newborn weights and Apgar scores.