Background: Pediatric diarrhea is one of the most common diseases among children and is the second leading cause of death and the third most prevalent disease among children worldwide. In Traditional Medicine, pediatric diarrhea is considered to result from an imbalance of the three bodily principles. In the treatment of this condition, Indra-4 decoction, which is traditionally used for its antipyretic and antidiarrheal effects, is commonly administered. Aim: To evaluate the clinical efficacy of Indra-4 in the treatment of pediatric diarrhea. Materials and Methods: A quantitative, randomized, controlled (active-control), open-label, single-center clinical trial was conducted. A total of 150 children were enrolled based on a confidence level of P>0.90 and a margin of error of D=10%, and were randomly assigned to two groups in a 1:1 ratio. The treatment group received Indra-4 decoction at a dose of 1.5 g twice daily for children aged 2–5 years and 2 g twice daily for children aged 6–9 years. The comparison group received montmorillonite powder at a dose of 2 g three times daily. Treatment was administered for 7 days in both groups. Clinical symptoms were scored and assessed before treatment, on days 3 and 5 of treatment, and after completion of treatment, and the results were compared between the two groups. The study was conducted with the approval of the Research Ethics Review Committee of the Mongolian National University of Medical Sciences, Mongolia (Approval No. 2026/1-01, January 23, 2026). Result: No statistically significant differences were observed between the two groups in terms of age, sex distribution, or total symptom scores at baseline (p>0.05), indicating that the groups were comparable. On days 3 and 5 of treatment and after treatment, the total symptom scores in the Indra-4 group were significantly lower than those in the comparison group (p<0.001). The overall treatment efficacy was 92.0% in the Indra-4 group and 78.7% in the comparison group, with a statistically significant difference (χ²=4.315, p=0.038). The percentage reduction in symptom scores was 90.97±4.14% in the Indra-4 group compared with 61.32±5.24% in the comparison group (t=28.072, p<0.001). These findings suggest that Indra-4 decoction may be more effective in reducing symptoms and improving treatment outcomes in children with diarrhea. Conclusion The results demonstrated that the Indra-4 group had significantly greater improvement in the major and accompanying symptoms of pediatric diarrhea, as well as higher overall treatment efficacy and recovery rates, compared with the comparison group. Indra-4 appears to be effective in the treatment of pediatric diarrhea and may be suitable for clinical use.

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: Pulmonary alveolar proteinosis (PAP) is a rare lung disorder characterized by the accumulation of surfactant within the alveoli, leading to impaired gas exchange and respiratory insufficiency. Although the disease is uncommon, it significantly affects patients’ quality of life and requires specific diagnostic and therapeutic approaches. Whole lung lavage (WLL) is considered the standard treatment; however, it has not been widely implemented in Mongolia. We report the first successful case of WLL performed for PAP in Mongolia. Case Presentation: A 56-year-old male presented with dyspnea. Chest computed tomography demonstrated a bilateral “crazy paving” pattern. Bronchoalveolar lavage fluid was positive for periodic acid–Schiff (PAS) staining, and anti–GM-CSF antibodies were detected, confirming the diagnosis of PAP. WLL was performed under general anesthesia using a double-lumen endotracheal tube with bronchoscopic guidance. One lung was ventilated with 100% oxygen while the contralateral lung was sequentially lavaged with 800–1000 mL of warm (37°C) saline per cycle until the effluent became clear. A total of approximately 20 liters of saline was used. Result: The procedure was completed successfully without complications. Following treatment, the patient showed marked clinical improvement with reduced dyspnea and increased exercise tolerance. Oxygen saturation improved from 88% to 93%, and spirometric parameters (FVC, FEV₁) demonstrated improvement. Chest imaging revealed a reduction in pulmonary opacities. Conclusion This case demonstrates the successful implementation of whole lung lavage (WLL) in Mongolia and highlights its importance in improving the diagnostic and therapeutic capacity for rare pulmonary diseases such as pulmonary alveolar proteinosis. The procedure resulted in significant improvement in clinical, functional, and radiological parameters, consistent with findings from international studies. Early diagnosis of PAP and the adoption of standardized protocols in accordance with international guidelines are essential to optimize treatment outcomes and enhance patients’ quality of life.

Background: HepG2 cells are widely used as an in vitro model for investigating alterations in hepatic cellular metabolism. Studies evaluating the biological activities of plant-derived compounds using HepG2 cells have also increased. Strawberry (Fragaria orientalis), lingonberry (Vaccinium vitis-idaea), radish (Raphanus sativus), and blue honeysuckle (Lonicera caerulea L.) contain polyphenols, flavonoids, anthocyanins, and other secondary metabolites. The biological activities of these plants may vary depending on species, plant tissue, growing conditions, and extraction methods. Prior to evaluating the biological activities of plant extracts, it is essential to assess their cytotoxic effects on cells and determine appropriate concentrations for subsequent experiments. Therefore, evaluating the effects of plant extracts on the viability of HepG2 cells, a human hepatocellular carcinoma cell line, is of considerable importance. Aim: To evaluate the effects of aqueous and ethanolic extracts of strawberry, lingonberry, radish, and cultivated and wild blue honeysuckle on HepG2 cell viability and to determine concentrations exhibiting cytotoxic effects. Materials and Methods: A total of 18 plant extracts were prepared using water and ethanol as extraction solvents. The extracts were obtained from strawberry leaves, lingonberry leaves, radish, and the fruits, stems, and leaves of cultivated and wild blue honeysuckle. The extracts were subsequently dried. HepG2 cells maintained in the Cell Biology Laboratory of the Institute of Biomedical Sciences were revived, stabilized, and used for the experiments. The plant extracts were prepared at concentrations of 6.25, 12.5, 25, 50, 100, 200, and 300 μg/mL and used to treat HepG2 cells. Cell viability was assessed using the Cell Counting Kit-8 (CCK-8) assay. Cytotoxicity was defined as a reduction in cell viability of more than 30% compared with the control group. Results: The aqueous extract of cultivated blue honeysuckle and the ethanolic extracts of its fruits and stems maintained HepG2 cell viability above 70% across the concentration range of 6.25–300 μg/mL, indicating relatively low cytotoxicity. In contrast, the ethanolic extract of cultivated blue honeysuckle leaves reduced cell viability at higher concentrations. The aqueous and ethanolic extracts of fruits and stems of wild blue honeysuckle showed no apparent cytotoxic effects, whereas both aqueous and ethanolic extracts of its leaves reduced cell viability to approximately 65% at 300 μg/mL, indicating relatively higher cytotoxicity. Most aqueous and ethanolic extracts of strawberry, radish, and lingonberry maintained cell viability above 70% and showed no cytotoxic effects. The ethanolic extract of strawberry leaves reduced cell viability to approximately 63% even at the lowest concentration of 6.25 μg/mL; however, cell viability tended to increase with increasing extract concentration. Conclusion The effects of plant extracts on HepG2 cell viability varied depending on plant species, tissue type, extraction solvent, and concentration. Most extracts of strawberry, lingonberry, radish, and the fruits and stems of cultivated and wild blue honeysuckle exhibited relatively low cytotoxicity at concentrations ranging from 6.25 to 300 μg/mL. However, the ethanolic extract of cultivated blue honeysuckle leaves at 200 μg/mL and the aqueous and ethanolic extracts of wild blue honeysuckle leaves at 300 μg/mL reduced cell viability by more than 30%, indicating relatively higher cytotoxicity.

Background: Childhood overweight and obesity are important public health concerns. Assessing weight status among children presenting with fractures may provide preliminary data for further investigation of a possible association between body weight and injury. Aim: To estimate the proportion of overweight and obesity among children aged under 18 years diagnosed with fractures and compare weight-status categories by sex. Materials and Methods: This descriptive study included 30 children presenting with a fracture to the outpatient clinic of Mongolia–Japan Hospital between June and September 2026. Weight status was classified using age- and sex-adjusted BMI-for-age. We summarized continuous variables as mean±standard deviation, median, quartiles, and minimum–maximum values; we reported categorical variables as counts and percentages. The Mann–Whitney U test and Fisher’s exact test were used, with p<0.05 considered statistically significant. Results: Of the 30 children, 20 (66.7%) were boys and 10 (33.3%) were girls. Eighteen children (60.0%) were classified as overweight/obese. Mean BMI was 20.58±3.44 kg/m² and median BMI was 19.82 kg/m². Mean BMI was higher in the overweight/obesity group than in the normal-weight group (22.00±3.55 vs 18.46±1.90 kg/m²; p=0.0092). Sex was not statistically associated with weight-status category (p=1.000). Conclusion The prevalence of overweight and obesity among children under 18 years of age diagnosed with bone fractures was 60.0%. The body mass index (BMI) was statistically significantly higher in children with overweight and obesity than in those with normal weight. Sex was not statistically associated with excess body weight. Further studies with larger sample sizes, a control group, and bone mineral density measurements are needed to determine the relationship between excess body weight, bone health, and fracture risk in children with bone fractures.

Climate change and child malnutrition Introductions: Globally, one billion children are living in areas at high risk of climate change exposure. Among them, over 200 million children under the age of five suffer from severe malnutrition, and 148 million experience growth and developmental stunting. Climate change affects key determinants of child health such as the nutritional value of food, environmental conditions, and living standards. Mongolia is classified among countries with a high climate vulnerability index. Therefore, it is essential to study the impact of climate change on children's health in the Mongolian context. We aimed at determining the prevalence and trends of nutritional deficiencies among children under five years of age and to assess the impact of climate change on these deficiencies. Materials and methods: This study was conducted using international databases. Climate change was evaluated using indicators such as the Climate Change Index, average annual land surface temperature, air quality, soil contamination, and precipitation levels. Data on child nutrition were collected from the Institute for Health Metrics and Evaluation (IHME) database and the Mongolian National Statistical Information Service for the period 2000–2019. Nutritional deficiencies were measured using indicators including wasting and overweight among children under five. Trends in the prevalence of nutritional deficiencies were analyzed using the AR(I)MA model to forecast changes between 2020 and 2030. Regional variations were assessed using panel regression models, and the impact of regional climate variables on child nutrition was estimated. Results: The climate vulnerability index in Mongolia has been increasing, with trends indicating further rises in temperature variability. From 2000 to 2019, the prevalence of wasting and stunting among children under five showed a decreasing trend, with annual reductions projected at 0.5% and 1.8%, respectively. In contrast, overweight and obesity among children under five are projected to increase until 2030, with Ulaanbaatar showing statistically significant high values. A correlation was found between climate change indicators and childhood overweight. Conclusions: There is a rising trend in overweight and obesity among young children. Climate change has both direct and indirect impacts on child nutrition, food safety, and nutritional deficiencies. These associations must be taken into serious consideration in public health planning and policy.

Introduction: Researchers have found that people living in polluted areas have a lower ability to resist skin bacteria and increase the number of skin microflora. Decreased immune function increases the risk of sore throat, influenza, respiratory infections, pneumonia and gastrointestinal diseases. One of the main indicators of the human immune system is the normal microflora. Goal: To study the relationship between normal human microflora and specific immunity. Material and Methods: This study was conducted within the framework of the project “Effects of non-specific immune factors on injectable infectious disease immune system”. The survey sampled 10 households from Dornod aimag, 8th khoroo of Chingeltei district, Ulaanbaatar city, and 3rd khoroo of Baganuur district. A total of 176 people aged 6 months to 50 years were involved. A total of 528 swab samples and 31 blood samples were collected from the throat, tonsils, skin and mucous membranes to study the relationship between normal human microflora and specific immunity.
The research methodology was discussed at the meeting of the Academic Council of the Ministry of Social Welfare and the Medical Ethics Review Committee under the Ministry of Health (January 5, 2018, Resolution 646) and the research was approved. Results: The total number of normal microorganisms in the skin and mucous membranes of the study participants changed, and the number of hemolytic strains and fungi increased. 58%-67% of the participants had normal and long-term immunity against diphtheria and tetanus, while 5% -14% were not. This result was as high as in urban and rural areas. Conclusion This result was as high as in urban and rural areas. As the age group increases, the level of the body’s specific immunity decreases, the structure of the normal microflora changes, and the number of fungi and hemolytic bacteria increases. Furthermore, it is necessary to study specific and nonspecific immunity in detail in relation to environmental pollution indicators.

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.