Background: Functional constipation is a common condition in early childhood, with an estimated global prevalence of approximately 3%. In Mongolia, functional constipation has been increasingly diagnosed among young children, particularly those aged 2–6 years. The condition is associated with abdominal pain, bloating, painful defecation, stool retention behaviors, and long-term physical and psychological complications. Although pediatric Tuina massage is widely used in Traditional Chinese Medicine as a non-pharmacological intervention, evidence regarding its effectiveness remains limited in the local context. Aim: To evaluate the effectiveness of therapeutic massage on stool frequency and stool consistency in children with functional constipation. Materials and Methods: A randomized controlled study was conducted between May and December 2025 at the “Bomborduk” Pediatric Traditional Medicine Center. Sixty children diagnosed with functional constipation (ICD-10 K59.04) were randomly assigned to a therapeutic massage group (n=30) or an exercise therapy group (n=30). Outcomes were assessed at baseline and after one month using the Constipation Assessment Scale (CAS) and the Bristol Stool Form Scale. Result: The mean age of participants was 3.75±0.94 years, with no significant difference between groups. In the massage therapy group, CAS scores decreased from 8.23±2.39 to 3.17±2.36, while Bristol Stool scores improved from 1.33±0.48 to 3.00±0.87. Improvements were significantly greater in the massage group compared with the exercise therapy group (p < 0.05). Conclusion Therapeutic massage is a safe and effective non-pharmacological intervention that significantly improves stool consistency and reduces constipation severity in children with functional constipation.

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: Tuberculosis (TB) remains a major public health concern worldwide and continues to be a leading cause of morbidity and mortality. Delays in diagnosis and care seeking exacerbate disease severity and increase financial burdens on healthcare systems and patients. In Mongolia, comprehensive evidence on diagnostic delays and direct hospitalization costs for TB patients remains limited. Aim: To evaluate the duration of diagnostic delay and estimate direct medical costs incurred during hospitalization among TB patients, as well as to identify associated factors. Materials and Methods: A retrospective cross-sectional study was conducted using medical records of 285 newly diagnosed TB patients hospitalized at the National Center for Communicable Diseases (NCCD) in 2024. Statistical analyses were performed using SPSS version 26 and MS Excel. A p-value of <0.05 was considered statistically significant. Result: The mean age of participants was 42.6±16.0 years, and 56.5% (n=161) were male. Median patient delay was 14 days (IQR: 5–31), median diagnostic delay was 4 days (IQR: 0–14), and mean hospital stay was 21.0±16.0 days. Median direct costs per patient were: diagnostic cost 262.0 thousand MNT (IQR: 187.0–363.0), treatment cost 490.9 thousand MNT (IQR: 234.4–884.1), and total cost 761.7 thousand MNT (IQR: 460.4–1247.6). Multivariate linear regression revealed that patient delay >14 days was significantly associated with higher total costs (=659.333, p=0.004). Conclusion 1. The median patient delay among patients with tuberculosis was 14 days (IQR, 5–31), while the median diagnostic delay was 4 days (IQR, 0–14). Overall, 61.6% of patients experienced patient delay, and 63.5% experienced diagnostic delay. 2. The median total direct medical cost among hospitalized patients was 761.7 thousand Mongolian Tugriks (MNT). A patient delay of more than 14 days was significantly associated with increased total direct medical costs (β=659.333, P=.004).

Background: Panzerina lanata (L.) is widely distributed across various ecosystems in the mountain, steppe, and Gobi regions of Mongolia and has traditionally been used in folk medicine to alleviate joint and muscle inflammation, reduce liver heat, lower blood pressure, promote diuresis, and treat edema and tumors. Its similar applications in Mongolian and Chinese traditional medicine suggest considerable therapeutic potential and biological activity. Studies conducted since 2019 have reported that P.lanata (L.) is rich in phenolic compounds, flavonoids, and antioxidant-active constituents; however, studies on the microscopic and histochemical characteristics of the species growing under Mongolian conditions remain limited, providing the rationale for this study. Aim: To characterize the microscopic features of Panzerina lanata (L.), determine the distribution of starch, polysaccharides, and phenolic compounds using histochemical methods, and evaluate the total polyphenol and flavonoid contents and antioxidant activity. Materials and Methods: For microscopic analysis, plant materials were softened by soaking for 24 h in a 1:1:1 water–ethanol–glycerin mixture (Strich–Fleming solution), followed by preparation of manual transverse and longitudinal sections of the stems, roots, and petals. A 10% chloral hydrate solution was used for clearing. Histochemical analyses were performed using potassium dichromate (K₂Cr₂O₇), ferric chloride (FeCl₃), Lugol’s solution (I₂/KI), thymol (C₁₀H₁₄O) with concentrated sulfuric acid (H₂SO₄), methylene blue (C₁₆H₁₈ClN₃S), and Dragendorff’s reagent. The prepared sections were cleared with glycerin and examined under an Olympus light microscope at ×40 and ×100 magnifications, with images documented using a 12-MP camera. Result: Microscopic examination of the roots, stems, and petals revealed that the root stele exhibited a polyarchy arrangement, with clearly differentiated xylem, phloem, and cambial tissues in both transverse and longitudinal sections. Scalariform tracheary elements in the xylem contributed to water and mineral transport and mechanical support. The stem xylem contained both spiral and scalariform tracheary elements. The petals consisted of cells with double walls and single nuclei, while the floral seed tissue was composed of meristematic tissue associated with continuous cell division, growth, and tissue differentiation. Histochemical analysis of transverse and longitudinal sections of the stems and roots, as well as petal sections, revealed the presence of essential oils, polyphenolic compounds (tannins and flavonoids), and starch. Conclusion Microscopic, histochemical, and phytochemical analyses of Panzerina lanata (L.) revealed the presence of biologically active compounds, indicating its potential for use in the quality evaluation of medicinal plant raw materials.

Background: Numerous experimental and clinical studies have investigated the therapeutic potential of Silybum marianum (L.) Gaertn., mainly attributing its biological activities to antioxidant, anti-inflammatory, antifibrotic, and hepatoprotective effects. In particular, silymarin has been reported to exert hepatoprotective effects by reducing oxidative stress, protecting cell membranes from certain toxic insults, and modulating protein synthesis. Therefore, cultivation of S. marianum and utilization of its seeds for industrial and research purposes are important for establishing a sustainable source of pharmacologically valuable bioactive compounds and increasing the availability of high-quality medicinal plant material. Aim: To evaluate the feasibility of cultivating S. marianum from seeds and to determine seed germination, seedling growth and development, survival after transplantation to open-field conditions, phenological stages, and seed yield characteristics. Materials and Methods: Seeds of S. marianum were germinated under indoor conditions, and normally developed seedlings were subsequently raised in a greenhouse and transplanted to a cultivation site near Tamgan Öndör, Erdene sum, Töv Province, Mongolia. Germination percentage (GP), mean germination time (MGT), seedling growth based on morphometric parameters, and survival rate after transplantation were evaluated. At harvest, the number and diameter of capitula, seed weight per plant, 1000-seed weight, and seed yield per unit area were determined. Data were expressed as mean±SD, and statistical significance was evaluated at p < 0.05. Result: Of the 1,000 seeds sown, 852 germinated, resulting in a germination percentage of 85.2% and a mean germination time of 11 days. Under greenhouse conditions, plant height increased from 1.0 to 3.0 cm, while rosette diameter increased from 1.2 to 7.0 cm. Of the 452 seedlings transplanted to the open field, 353 survived, corresponding to a survival rate of 78.1%. The first flowering was observed on June 12, full flowering on July 9, and full seed maturation on August 30, with 175 days from sowing to seed maturity. On average, each plant produced 18 branches and 20 capitula, with a capitulum diameter of 4.4 cm, seed weight per plant of 15.5 g, 1000-seed weight of 11.5 g, and seed yield of 195.325 kg/ha. Conclusion S. marianum was able to germinate, establish, complete its major growth, flowering, and seed maturation stages, and produce seeds under the cultivation conditions of the Tamgan Öndör area, Erdene sum, Töv Province. These findings indicate that S. marianum can potentially be cultivated in this specific area as a source of medicinal plant material.

Background: Bioactive compounds derived from plants have been extensively studied and widely applied in cosmetic and dermatological fields. In particular, plant-derived polyphenols and anthraquinones are known for their antioxidant properties as well as their ability to inhibit elastase enzyme activity. Elastase is a key proteolytic enzyme responsible for degrading elastin, a structural protein essential for maintaining skin elasticity. Excessive elastase activity contributes to skin aging and wrinkle formation. Therefore, the identification of plant-derived compounds capable of interacting with elastase is of significant importance for improving the composition and efficacy of cosmetic products. Aim: To identify bioactive compounds in the extract of Rheum undulatum L. and to investigate their interaction with elastase enzyme activity. Materials and Methods: The root of Rheum undulatum L. was used as the study material. Sample preparation was performed by grinding the plant root followed by extraction using 50% ethanol assisted by an ultrasonic water bath. The obtained extract was evaporated to dryness using a vacuum centrifugation system to remove the solvent completely. A total of 10 mg of the dried extract was dissolved in 100 µL methanol and 900 µL water, then filtered through a 0.1 µm membrane filter. Subsequently, two sample sets were prepared: a control sample and an elastase-incubated sample at a 1:1 ratio. Both were analyzed using liquid chromatography–mass spectrometry (LC-MS). Data processing was performed using Agilent MassHunter Qualitative Analysis software (version 10.0). Results: LC-MS analysis revealed a total of 16 bioactive compounds in the root extract of Rheum undulatum L. Comparative analysis between the control and elastase-treated samples demonstrated a decrease in the peak areas of gluconic acid and citric acid, while an increase in the peak area of emodin was observed. These changes indicate compositional differences between the two sample conditions. Conclusion The LC-MS analysis of Rheum undulatum L. root extract identified multiple bioactive compounds belonging to anthraquinone, phenolic, and flavonoid classes. Variations in peak intensities between control and elastase-treated samples suggest potential interactions between certain compounds and the enzyme. These findings indicate that the root extract contains biologically active constituents capable of modulating elastase activity, supporting its potential application in anti-aging and cosmetic formulations.

Background: Bone mineral density (BMD) is a key indicator reflecting bone strength and resistance to fracture. It is influenced by multiple factors, including age, sex, genetic background, body composition, nutrition, and physical activity. During young adulthood, peak bone mass is actively formed; therefore, identifying early variations in this period is essential for predicting future skeletal health risks. Accordingly, assessing BMD and evaluating its relationship with physical characteristics among first-year nursing students provides a scientific rationale for this study. Aim: To examine the relationship between bone mineral density and selected physical parameters among students. Materials and Methods: A total of 297 first-year students aged 17-35 years from the School of Nursing, Mongolian National University of Medical Sciences were included. Bone mineral density was assessed by measuring the speed of sound through the radius using an ultrasound bone densitometry device. Handgrip strength was measured using an electronic dynamometer. Physical parameters including age, sex, height, and body weight were measured using standardized procedures, and statistical analysis was performed. The study was approved by the Research Ethics Committee of MNUMS on November 21, 2025 (No. 26/1) and March 28, 2026 (No. 26/03-B02), with no ethical violations identified. Results: According to T-scores, 37.1% (n=110) of participants had normal bone status and 62.9% (n=187) showed reduced bone density. Based on Z-scores, 52.5% (n=159) were normal, while 45.6% (n=138) had decreased values. T-score values were 1.87±0.69 (<20 years), 1.44±0.55 (20–30 years), and 1.10±0.31 (>30 years), while Z-score values were −0.73±1.38, −0.43±1.23, and −0.02±1.27, respectively. ANOVA analysis revealed statistically significant differences among age groups (p<0.01). A positive correlation was observed between T-score and age, whereas no significant correlations were found with other physical parameters. Z-score showed a positive correlation with handgrip strength. Conclusions 1. A high prevalence of reduced bone mineral density was observed among the students, which may be associated with incomplete attainment of peak bone mass in adolescents and young adults. 2. A significant difference in bone mineral density was found between age groups (p<0.01), indicating that age is an important factor influencing bone mineral density.

Background: Saponins are secondary metabolites in plants that play an important role in defense mechanisms and physiological processes. Since stomatal cells are crucial for gas exchange and water balance in plant tissues, studying the anatomical and biochemical features of stomatal cells in saponin-rich plant species provides insight into the interactions between these compounds and cellular mechanisms. This serves as the basis of our study. Aim: To determine the structure, types, and functions of stomatal cells in saponin-containing medicinal plants Materials and Methods: During June–September 2024, nine species of saponin-containing medicinal plants were collected from Bulgan, Tuv provinces, and “Gorkhi-Terelj National Park” in Mongolia. Prepared microscopic specimens were examined using macroscopic and microscopic techniques to study the structure, position, number, and epidermal features of stomatal cells. Results: The study revealed that Anemone crinita Juz. exhibited the highest stomatal density (107 stomata/mm²) and epidermal cell density (229 cells/mm²), indicating strong adaptation and protective capacity in arid conditions. Vicia baicalensis (Turcz.) B. Fedtsch. showed the highest stomatal index (39.6), highlighting its significant role in regulating transpiration. Stomatal types varied among species: • Anomocytic stomata were observed in Potentilla multifida and Vicia baicalensis. • Anisocytic stomata were found in Delphinium grandiflorum and Ranunculus borealis. • Paracytic stomata were present in Gentiana algida, Adenophora remotiflora, Helianthemum nummularium, Anemone crinita, and Ranunculus acris. Conclution In the study of the structure, form, and number of stomatal cells in saponin-containing plants growing in Mongolia, Anemone crinita Juz. was found to have the highest number of stomatal and epidermal cells, indicating its high efficiency in gas exchange, water regulation, and protection against external stress. Furthermore, Vicia baicalensis (Turcz.) B.Fedtsch. showed the highest stomatal index, confirming its strong capacity for active regulation of gas exchange. The variation in stomatal cell types among plant species was identified as playing an important role in ecological and biological adaptation as well as protective mechanisms.

Background: Plants of the family Gentianaceae in Mongolia are rich in bitter iridoid glycosides, flavonoids, and polyphenolic compounds, and have been traditionally used in Mongolian medicine to promote digestion, protect the liver, and reduce fever. However, standardized information on the micro-morphology and histochemical characteristics of the widely distributed species Gentiana decumbens L.f. is scarce, limiting the assessment of its quality as a medicinal raw material. Aim: To identify the morphological and anatomical characteristics of the aerial and underground parts of Gentiana decumbens and to localize the distribution of starch, polysaccharides, and phenolic compounds using histochemical methods. Materials and Methods: Plant materials were collected in July 2024 from Tsagaan-Uul soum, Khuvsgul province, andshade-dried. Samples were softened in a water–ethanol–glycerol solution (1:1:1) for 24 hours, and transverse and longitudinal sections of stem, leaf, root, and floral parts (anther, petal, receptacle/bract) were prepared using a hand microtome. Sections were cleared with 10% chloral hydrate. Histochemical reagents included potassium dichromate (K2Cr2O7), ferric chloride (FeCl3), Lugol’s iodine (I₂+KI), thymol + concentrated H₂SO₄, and methylene blue. Slides were mounted in glycerin and examined under an Olympus light microscope at 40× and 100× magnifications, and images were recorded using a 12 MP digital camera. Results: Leaf: The leaf exhibits a dorsiventral structure with a dense palisade parenchyma on the adaxial side and a loosely arranged spongy mesophyll on the abaxial side. Stomata are hypostomatic, and collenchyma is well developed around the vascular bundles. Histochemical reactions were negative for starch and phenolic compounds. Stem: The stem consists of an epidermis, a wide cortex, a continuous ring of sclerenchyma, 12–15 collateral vascular bundles, and a broad central parenchyma. Histochemical tests showed a brownish-yellow coloration with potassium dichromate (K2Cr2O7), indicating the presence of polyphenols and lignin, and a brown coloration with Lugol’s iodine, confirming the presence of starch. Reactions with ferric chloride (FeCl₃), methylene blue, and thymol + H2SO4 were mostly negative in cross sections. However, in longitudinal sections, Lugol’s and thymol + H2SO4 showed positive reactions, suggesting the presence of starch and polysaccharides, respectively. Root: The root displays a primary structure with radial xylem and phloem, a distinct endodermis with Casparian strips, and a pericycle layer. Positive reactions were observed with K2Cr2O7 and FeCl₃, indicating phenolic compounds and lignin. Lugol’s iodine showed abundant starch granules in parenchyma cells. Receptacle / Bract: The receptacle is covered by a thick cuticular epidermis with trichomes, and composed of outer and central parenchyma layers containing numerous small closed (amphivasal-type) vascular bundles. Positive reactions were detected with K2Cr2O7 and FeCl₃, indicating polyphenols, flavonoids, and tannins; Lugol’s iodine confirmed the presence of starch; thymol + H2SO4 showed partial positivity for polysaccharides. Stamen (longitudinal section): The stamen structure includes epidermis, endothecium, pollen sacs, and a distinct vascular bundle. Positive staining was observed with K2Cr2O7, Lugol’s iodine, and FeCl3, confirming the presence of polyphenolic compounds, lignified elements, and starch. Conclusion The anatomical features of G. decumbens indicate adaptations to dry, high-light environments through well-developed mechanical strengthening (sclerenchymatous ring), efficient photosynthetic structure (compact palisade mesophyll), and nutrient storage (starch-rich pith and cortex). Histochemical analysis revealed the localization of polyphenolic compounds and starch/polysaccharides mainly in the root, stem, and floral organs, while absent in the leaves, demonstrating organ-specific accumulation patterns. These findings scientifically support the plant’s traditional medicinal uses for digestive stimulation and hepatoprotection.

Background: Serum natriuretic peptide (NT-proBNP) is a critical biomarker for diagnosing left ventricular dysfunction. Heart failure is the leading cause of mortality in chronic kidney disease (CKD), emphasizing the need for its early detection and prognosis. Objective: This study aimed to determine the serum NT-proBNP levels in participants with CKD and establish a cut-off value for predicting heart failure. Methods: A descriptive cross-sectional study was conducted from April 1 to July 1,2024. This study received approval from the Ethics Committee of the Institute of Medical Sciences (Approval No.24/01). A total of 117 CKD patients hospitalized in the Nephrology and Endocrinology Department of the third state hospital were enrolled based on predefined inclusion and exclusion criteria. Data were collected using questionnaires, laboratory and heart ultrasound test results. Serum NT-proBNP levels were measured using a rapid immunofluorescence quantitative analyzer. Data were analyzed with SPSS 26.0. Results: The mean age of the 117 participants was 57.9 ± 14.7 years, with 51.3% being male. The mean serum NT-proBNP level was 7686 ± 12149 pg/mL. Statistically significant differences were observed in serum creatinine, sodium, calcium, CKD stage, and arterial hypertension between genders (p<0.05). NT-proBNP levels in hemodialysis patients differed significantly between heart failure and non-heart failure groups (p<0.05). Significant differences were also found in hemoglobin, serum albumin, NT-proBNP levels, and CKD stages (p<0.05). NT-proBNP correlated significantly with risk factors such as hemodialysis, diabetes, and decreased systolic blood pressure (p<0.0001). A weak inverse relationship was noted between systolic blood pressure and NT-proBNP (R² = 0.16). The NT-proBNP cut-off value for predicting heart failure was 3027 pg/mL, with an AUC of 61.7% (sensitivity: 74.5%, specificity: 55%). Conclusion Serum NT-proBNP levels are elevated in CKD patients regardless of heart failure. The established cut-off value for NT-proBNP in CKD patients to detect heart failure was 3027 pg/mL, with moderate diagnostic utility (AUC = 61.7%).