Background: Multiple sclerosis (MS) is an autoimmune inflammatory neurodegenerative disease of the central nervous system and a major cause of disability in young adults. MRI is essential for diagnosis and monitoring, while early evaluation of structural brain changes is important. Aim: To evaluate brain volumetric changes using automated MRI analysis in patients with MS. Materials and Methods: This case–control study included 50 MS case patients and 50 controls patients examined between 2020–2023 at the Third State Hospital. T1-MPRAGE images were analyzed using volBrain automated segmentation software. Result: The mean age of MS patients was 45.5±11.8 years. Compared with healthy controls, the MS group showed significantly lower total grey matter volume (p=0.002), cortical grey matter volume (p<0.001), subcortical grey matter volume (p=0.006), and cerebral volume (p=0.02). Significant volume reductions were also observed in the temporal (p=0.006) and occipital (p<0.001) lobes. Deep grey matter structures, including the thalamus (p=0.001), caudate nucleus (p=0.009), putamen (p=0.008), and nucleus accumbens (p<0.001), also showed significantly reduced volumes. Disease duration was negatively correlated with total grey matter volume (r=−0.30, p=0.02), thalamic volume (r=−0.28, p=0.04), and occipital lobe volume (r=−0.43, p=0.002). Disease duration was also significantly associated with spinal cord involvement (p=0.01) and grey matter volume (p=0.04). The number of relapses was negatively correlated with total brain volume (r=−0.28, p=0.046). Conclusion Patients with MS demonstrated decreased grey matter volume, particularly within deep grey matter structures, along with increased abnormal white matter volume, suggesting the coexistence of neurodegeneration and demyelination in MS. Brain volume loss in MS appeared to occur independently of aging. Automated quantitative MRI analysis may provide important diagnostic value in detecting structural brain changes associated with MS.

Background: Globally, research on identifying bioactive compounds from medicinal plants and characterizing their in vitro and in vivo pharmacological activities is progressing rapidly. Plants native to Mongolia have adapted to unique, extreme continental climatic conditions, accumulating distinct phytochemicals, and have historically been utilized in traditional medicine and dietary practices. Establishing the non-cytotoxic safety threshold of these wild and cultivated plant extracts in RBL-2H3 mast cells a universally accepted model for type I hypersensitivity and inflammation is a vital prerequisite. Determining these baseline non-toxic dose ranges provides the essential scientific foundation for subsequent cellular allergy models, animal studies, and the elucidation of molecular mechanisms underlying their therapeutic efficacy. Aim: To determine the cytotoxicity profile and establish the non-cytotoxic dose ranges of extracts from four selected Mongolian plant species (wild and cultivated) in RBL-2H3 cells. Materials and Methods: Plant samples including lingonberry (Vaccinium vitis-idaea), strawberry (Fragaria orientalis), black radish (Raphanus sativus), and blue-berried honeysuckle (Lonicera caerulea L.) were standardly collected, authenticated, and cataloged as herbarium specimens at the Botanic Garden and Research Institute, Mongolian Academy of Sciences. A total of 12 distinct extracts were prepared from plant leaves, stems, and fruits using water and ethanol extraction, followed by concentration via rotary evaporation and freeze-drying. Rat basophilic leukemia (RBL-2H3) cells were maintained in EMEM growth medium and utilized during the exponential growth phase. Cell viability and non-cytotoxic concentration thresholds were evaluated using the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay. Result: Ethanolic extracts of strawberry leaves, black radish, and honeysuckle leaves (≥6.25 µg/mL), as well as aqueous extracts of honeysuckle fruits (≥6.25 µg/mL) and stems (≥25 µg/mL), exhibited dose-dependent cytotoxicity. Conversely, aqueous extracts of lingonberry leaves (≤200 µg/mL), strawberry leaves (≥100 µg/mL), and black radish (≤200 µg/mL), alongside ethanolic extracts of lingonberry leaves (≥50 µg/mL), demonstrated non-cytotoxic profiles. Furthermore, ethanolic extracts of honeysuckle stems (≤300 µg/mL) and fruits (≥12.5 µg/mL), as well as the aqueous extract of honeysuckle leaves (≤50 µg/mL), significantly enhanced RBL-2H3 cell viability. Conclusion The tested plant extracts influenced RBL-2H3 cell viability in a solvent polarity and plant organ dependent manner. Ethanolic extracts of strawberry leaves, black radish, and honeysuckle leaves, along with aqueous extracts of honeysuckle fruits and stems, demonstrated relatively high cytotoxicity, reducing cell viability by >40% starting at concentrations of 12.5, 25, and 50 µg/mL. In contrast, aqueous extracts of strawberry leaves and black radish, as well as both aqueous and ethanolic extracts of lingonberry leaves, maintained low cytotoxicity at concentrations below 200 µg/mL. Notably, ethanolic extracts of honeysuckle stems and fruits (>12.5 µg/mL) and its aqueous leaf extract (<100 µg/mL) enhanced cell viability, exhibiting significant cell proliferation promoting activity.

Background: Herbal teas are rich in bioactive compounds with antioxidant, anti-inflammatory, and hepatobiliary supportive properties. Despite their long-standing use in Mongolian traditional medicine for liver and gallbladder health, comprehensive scientific data regarding the specific chemical composition and antioxidant activities of these polyherbal formulations remain limited. Aim: To evaluate the bioactive compound content and antioxidant activity of a polyherbal tea formulation for supporting liver and gallbladder function, with a focus on the influence of solvent concentration. Materials and Methods: The study utilized a polyherbal tea consisting of five plant species: Achillea asiatica Serg., Thalictrum foetidum L., Zygophyllum potaninii Maxim., Tanacetum vulgare L., and Rheum undulatum L. Samples were extracted using 30% and 70% ethanol. Preliminary phytochemical screening was performed using thin-layer chromatography (TLC). Total phenolic content (TPC) was determined using the Folin-Ciocalteu method, and total flavonoid content (TFC) was measured via the AlCl3 colorimetric assay. Antioxidant capacity was assessed through DPPH, ABTS+ and FRAP assays. Results: Phytochemical screening identified flavonoid derivatives, glycosides, and terpenoids in both extracts, while alkaloids were not detected. Quantitative analysis showed that the 70% ethanolic extract contained significantly higher levels of total phenolics (5.518±0.24%) and total flavonoids (1.513±0.023) compared to the 30% extract (p < 0.05). The 70% extract also demonstrated superior antioxidant potency, with lower (IC50) values for DPPH (55.37 µg/mL) and ABTS (86.08 µg/mL). Additionally, the FRAP assay confirmed the 70% extract had substantially higher reducing power (1440.84 µM Fe²⁺/L). Conclusions 1. Phytochemical analysis confirmed that the polyherbal tea is primarily composed of flavonoid derivatives, glycosides, and terpenoids. The total phenolic and flavonoid contents in the 70% ethanolic extract were significantly higher (p < 0.05) than those in the 30% extract. 2. The free radical scavenging activity evaluated by DPPH (IC50) 55.37 µg/mL) and ABTS (IC50) 86.08 µg/mL) assays indicated that the 70% ethanolic extract possesses markedly stronger antioxidant activity compared to the 30% extract. 3. The iron ion reducing power (FRAP: 1440.84 µM/L) showed a concentration-dependent linear relationship. The positive correlation between polyphenol content and antioxidant activity confirms that this herbal formulation has a scientific basis for its traditional use in supporting liver and gallbladder function.

Background: Membranous nephropathy (MN) is among the most common causes of nephrotic syndrome in adults. MN is diagnosed in one third of cases of nephrotic syndrome on kidney biopsy. Kidney biopsy is the gold standard for diagnosing MN and plays an important role in determining the severity of the disease and in determining treatment decisions and regimens. Therefore, the lack of research on kidney biopsy in Mongolia is the reason for this study. Aim: The aim of this study was to investigate the pathological features in the kidney tissues of patients with primary membranous nephropathy diagnosed by kidney biopsy. Materials and Methods: A retrospective study was conducted on 51 cases of MN diagnosed in kidney biopsies performed at the First Central Hospital of Mongolia (FCHM) over a period of 12 years. Renal function was calculated using the CKD-EPI (2021) formula and classified into the stage of CKD by eGFR. Histopathological findings were examined using 4 light microscopy (LM) stains (Hematoxylin-Eosin, Masson-Trichrome, PAS, and Methenamine silver staining) and 8 immunofluorescence (IF) microscopy stains (IgG, A, M, complement C3, C4, C1q, and kappa, lambda). The study excluded secondary MN based on viral markers, tumor markers, and serological tests. Statistical analysis was performed using SPSS and STATA 15.0 software, using t-tests, Pearson’s chi-square tests, and multiple group comparisons were performed using ANOVA and Kruskal-Wallis methods. The study design was approved by the Ethics Committee of the MNUMS, Mongolia. (№ 2023/3-07) Results: A total of 305 kidney biopsies performed at the Kidney Center of the FCHM between 2011 and 2023 resulted in the diagnosis of 51 cases of primary MN. The mean age of patients with membranous nephropathy was 40.6±9.3 years, with the oldest age of 65 and the youngest of 22 years, and 36 (70.59%) were male and 15 (29.41%) were female. In the kidney biopsy, the average number of glomeruli was 16.51±7.82 (min-max, 3-54), and by LM, 33.3% showed global sclerosis of glomeruli by hematoxylin-eosin staining, 94.12% showed thickening of the glomerular basement membrane (GBM), 31.2% showed double counter staining of subepithelial immune complexes by methenamine-silver staining, 88.24% showed holes in the GBM, and 54.9% showed spike-like changes by Masson-Trichrome staining. IF showed IgG 3+ in 37.3%, 2+ in 39.2%, 1+ in 13.7%, and trace staining in 9.8%, while 74.5% of the cases were positive for C3, 93.1% for kappa, and 79.5% for lambda. LM showed thickening of the GBM (OR 23.5, 95% CI 0.093-0.53, p value= 0.007) and interstitial fibrosis (95% CI 6.98-31.07, p value= 0.003) contributing to the decrease in eGFR. The mean time from the onset of the first symptoms of kidney disease to the time of kidney biopsy was 35.35±61.54 months. Patients who underwent biopsy later (in months) after the diagnosis of the disease had a higher incidence of interstitial fibrosis (74.6 ± 98.43, 95% CI -90.52-20.68, p value = 0.002). Conclusion The histopathological features of MN confirmed by kidney biopsy showed thickening of the GBM in 94.12%, global sclerosis in 33.3%, and holes in 88.2%. Immunofluorescence microscopy showed 100% IgG staining, while C3, kappa, and lambda were positive in 74.5%, 93.1%, and 79.5%, respectively.

Background: Vancomycin was first approved by the US Food and Drug Administration (FDA) in 1958. Vancomycin has an active effect on gram-positive microorganisms, such as methicillin- resistant Staphylococcus aureus (MRSA), coagulase-negative staphylococcus, Streptococcus (Enterococcus faecalis), and Clostridia (Clostridium difficile). It is used in the treatment of severe infections such as endocarditis, osteomyelitis, pneumonia, blood and soft tissue infections, other staphylococcal infections, and S. epidermidis with a β-lactam ring structure that is ineffective or allergic to antibiotics and resistant to many drugs. Materials and Methods: To carry out the study, we obtained permission to conduct the study from the National Institute of Health and Welfare, and randomly sampled a total of 274 inpatients who used vancomycin in the hospital in 2023 in order to be representative in terms of age and gender (n=120). Results The one dose of vancomycin was 0.9 mg, the daily dose was 2.4 mg, the total dose was 20.5 mg, and the total daily average was 11.3 days. The daily dose and total dose of vancomycin were inversely proportional to age (r=-0.008), and the total dose is very weakly correlated with BMI and gender (r=0.052). Cefazolin used in combination with vancomycin had statistically significant differences in monocyte counts (p=0.003), cefotaxime in lymphocyte counts (p=0.027), and ceftriaxone in total white blood cell counts (p=0.048). Conclusion: Vancomycin daily dose is inversely related to age, total dose is inversely related to age, and total dose is very weakly correlated with BMI and gender. There is a statistically significant difference in the use of vancomycin with cephalosporin antibiotics

Background: Vancomycin is a glycopeptide antibiotic widely used to treat infections caused by gram-positive bacteria, especially methicillin-resistant Staphylococcus aureus (MRSA). Despite its effectiveness, vancomycin is known to be nephrotoxic, particularly when administered in high doses, for prolonged durations, or in combination with other nephrotoxic agents. This study aims to investigate the incidence and influencing factors of vancomycin associated renal impairment among hospitalized patients in Mongolia. Methods: A retrospective document review was conducted among 120 hospitalized patients who received vancomycin at the First State Central Hospital in 2023. Data on vancomycin dosage, treatment duration, clinical diagnoses, and biochemical parameters were analyzed. Renal function was assessed using the Cockcroft-Gault equation and categorized into five stages. Statistical analysis was performed using chi-square tests and logistic regression with a significance level set at p<0.05. Results: The mean age was 52.3 years, and the average BMI was 26.7. Among participants, 41.5% showed varying degrees of renal impairment. Vancomycin daily dose was significantly associated with the stage of renal impairment (p=0.040), while total dose and treatment duration were not. Co-administration with cefotaxime and metronidazole showed statistically significant changes in creatinine and urea levels, suggesting potential additive nephrotoxicity. Conclusion The findings indicate a substantial rate of renal function decline among vancomycin-treated patients. Higher daily doses and concurrent use of nephrotoxic antibiotics may increase the risk. Regular renal monitoring and dose adjustments are essential to minimize adverse renal outcomes.

: A study by Marsot and other investigators (2012) determined that the dose of vancomycin in adults is directly dependent on parameters such as creatinine clearance and body weight, as well as the need for dose correction. We used the MDRD equation to determine renal dysfunction in 113 inpatients and found grade I in 50.5%, grade II in 14.4%, grade III in 10.8%, grade IV in 6.3%, and grade V in 18%. There is a statistically significant difference (p=0.045) in renal dysfunction depending on the diagnosis. The average daily dose of vancomycin was 2.5 g, the total daily dose was 8.5 g, the total dose was 20.5 g. The daily dose and total dose of vancomycin were inversely proportional to age (g = -0.256), the daily dose was directly related to excess weight body (g=0.226), and days of vancomycin use are statistically significant (p=0.001) depending on the diagnosis. Conclusion Comprehensive programs are required to improve the vancomycin use in the hospitals. Vancomycin use should be monitored due to its large-scale empiric use. The rate of improper use of vancomycin in the infection and intensive care unit services may be high, and pharmacists must take appropriate action to optimize the use of the drug.

Background and Aims: Hepatocellular carcinoma (HCC) is a common cause of cancer related death in Mongolia. Early diagnosis is the very important management to increase successful treatment and survival rate. Glypican-3 (GPC3) protein is highly expressed in hepatocellular carcinoma (HCC) tissue and in serum of HCC patients. Recent studies have been conducted and suggested as a diagnostic biomarker for detecting HCC in the early stage. Therefore, we investigated the diagnostic value of the serum GPC3 level and compared it to the alpha-fetoprotein (AFP) level as a diagnostic biomarker of HCC. Methods: We enrolled a total of 90 participants and divided into 3 groups with HCC (30), with liver cirrhosis (LC/30) and healthy (30) as the control group (30). GPC3 and AFP serum (sGPC-3, sAFP) levels were measured using commercially available enzyme-linked immunosorbent assay kits. The diagnostic accuracy was analyzed using the receiver operating characteristics (ROC) curve and estimated sensitivity and specificity of each biomarker. Results: sGPC3 was significantly elevated in the HCC group as compared to liver cirrhosis and healthy subjects (658±138.2 pg/ml, 378±25.5 pg/ml, 356.3±29 pg/ml) respectively. sGPC-3 sensitivity was 96.6% and specificity was 100%. The area under the ROC curve (AUC) for GPC3 was 0.999 (0.996- 1.0).
In comparison, the mean of AFP was significantly higher in HCC (16.9±11.7 ng/ml) than in LC (6.7±7.6 ng/ml) and in healthy subject (3.3±2.1 ng/ml) and AFP sensitivity was 43,3 %, specificity was 95 % with an AUC of 0.808 (0.696- 0.921).
The combination of GPC-3 with AFP achieved the highest sensitivity (97.1%) and specificity (97%). Conclusion Serum GPC3 has a higher sensitivity than AFP for the early diagnosis of HCC. Combination of two markers showed greatest diagnostic accuracy.

Introduction: Air pollution has become one of the major problems in socio-economic and health issues in Mongolia. Among the various hazards of particulate matter (PM) pollutants, microorganisms in PM2.5 and PM10 are thought to be responsible for various allergies and for the spread of respiratory diseases. Recent studies have shown that PM2.5 particles can cause chronic heart failure, heart arrhythmias, and strokes, as well as lung damage, cirrhosis, inflammation, cancer, cardiovascular disease, and metabolic disorders. Furthermore, some studies have concluded that PM2.5 particles in the environment are a risk factor for gastrointestinal, liver, colon, and lung cancer as well as it affects the growth and metastasis of various cancer cells caused by other factors. In our country, the health effects of air pollution and the relationship between the pathogenesis of cancer research are scarce. Therefore, the study of the effects of PM2.5 particles on cancer cell proliferation, migration (metastasis) can provide a significant role for cancer treatment, diagnosis, and prevention. Purpose: Determining the effects of PM2.5 particles on cancer cell proliferation, migration (metastasis) in in-vitro Material and Methods: A human liver cancer cell line (HepG2), human gastric cancer cell line (AGS) were obtained from the central scientific research laboratory in the Institute of medical sciences. HepG2, AGS cells were seeded at a concentration of 1*105 cells/mL in a culture flask and cultured in RPMI-1640 medium supplemented with 10% FBS, 1% antibiotic mix (penicillin, streptomycin) in a humidified atmosphere of 5% CO2 at 37 °C. The cytotoxic effect of PM 2.5 in AGS, HepG2 cells were evaluated by MTT, CCK8 assays. AGS, HepG2 cells were incubated in 96 well plates for 24h then treated with different concentrations (0, 5, 10, 25, 50 and 100 μg ) of Bayankhoshuu, Buhiin urguu, and Zaisan samples for 24h, respectively. Results: Concentrations of 10, 25, and 50 μg/ml of samples collected from the Bukhiin urguu and Zaisan in March increased HepG2 cell growth, while doses of 25, 50 μg/ml of samples collected from Bayankhoshuu in March and December increased HepG2 cell growth. Therefore, concentrations of 25 and 50 μg/ml of samples collected from Bayankhoshuu in March increased AGS cell growth, while concentrations of 25, 100 and μg/ml of samples collected in December increased AGS cell growth. However, no cytotoxic effect was observed in the sample collected from Zaisan in March, whereas the PM2.5 sample enhanced AGS cell growth in dose dependent manner in December.(p <0.05) Conclusion High levels of heavy metals were detected in samples collected in December from Bayankhoshuu, Bukhiin urguu and Zaisan of Ulaanbaatar. Concentration of 25 μg/ml of samples collected from the Bukhiin urguu and Zaisan in March increased HepG2 cell growth. Concentrations of 25 μg/ml of PM2.5 collected from three regions around Ulaanbaatar increased HepG2 and AGS cell migration.

Research of function of vitamin D on immune system has been studying since the study revealed that vitamin D receptor is expressed on the surface of the immune cells. 1,2-dihydroxyvitamin D3 [1,25(OH)2D], physiologically active form, can be generated through hydroxylation of 25-hydroxyvitamin D3 [25(OH)D], inactive form of vitamin D, in a liver, connecting with specific VDR make biological action. Vitamin D make different biological actions depends on connecting with different immunological cells. Some studies indicated that Vitamin D plays pivotal role in antibacterial innate immune responses through regulating reaction of the main cells as macrophages and dendritic cells. Moreover, calcitriol, the active form of vitamin D, is connected with VDRE, modulates the innate immune response through directly inducing expression of catelicithin and β-defensin as antimicrobial peptides, reducing secretion of IL-1b, IL-6, TNF-a, RANKL, COX-2 as proinflammatory cytokines and increasing production of IL-10, an anti-inflammatory cytokine. Vitamin D plays in proliferation and differentiation of T and B cells and regulates the activities of over 500 genes. Vitamin D differently impacts on per se stages of T cells’ proliferation. Vitamin D indirectly mitigates the differentiation from immature B cells to plasma B cells while it directly impacts on regulation of overloaded production of antibodies in plasma B cells. In conclusion, vitamin D modulates the innate- and adaptive immune response through regulation on activation of APCells, proliferation and differentiation of immune cells, secretion of some antibacterial peptides.