Background: In our country, the high prevalence of chronic liver diseases is influenced by factors such as hepatotoxic viruses, excessive alcohol and drug consumption, and a high incidence of obesity among the population. Although the point at which liver fibrosis becomes irreversible remains unclear, some researchers have suggested, based on clinical studies, that fibrosis may still be reversible in the early stages of cirrhosis. Aim: Therefore, in this study, we aimed to evaluate the degree of liver fibrosis using key markers involved in the pathogenesis of hepatic scarring—MMP-1 (matrix metalloproteinase-1), MMP-2 (matrix metalloproteinase-2), and PIIINP (N-terminal propeptide of type III procollagen)—as well as non-invasive serum markers of hepatocyte injury (APRI and FIB-4), and to compare these findings with the results of liver biopsy. Materials and Methods: This analytical case-control study included 50 patients in the State Third Central Hospital. Peripheral blood samples were analyzed for platelet count, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) using a fully automated analyzer, while serum direct markers were measured using ELISA. Non-invasive serum markers (APRI and FIB-4) were calculated using the MD+CALC online system. Liver tissue for histological examination was obtained via biopsy, and the degree of liver fibrosis was assessed according to the METAVIR scoring system. Differences in mean values of quantitative variables between two groups were analyzed using the Mann-Whitney U test was applied. The correlation between METAVIR stages and serum markers was evaluated using Spearman’s correlation. Results: Among the study participants, according to the METAVIR classification, 15 individuals (30%) had no or minimal fibrosis (F0–F1), 26 individuals (52%) had significant fibrosis without cirrhosis (F2–F3), and 9 individuals (18%) had cirrhosis (F4). As the stage of fibrosis increased, the mean levels of AST (r=0.326, p=0.021), ALT (r=0.392, p=0.005), MMP-2 (r=0.393, p=0.005), PIIINP (r=0.472, p=0.001), as well as APRI (r=0.503, p<0.001) and FIB-4 (r=0.482, p<0.001) showed an increasing trend. In contrast, mean platelet count (r=–0.507, p<0.001) and MMP-1 (r=–0.383, p=0.006) decreased with advancing fibrosis stages. Using AUC-ROC analysis to assess the diagnostic performance of both direct and indirect serum markers, the ability to detect significant fibrosis and cirrhosis was estimated as follows: APRI 80%, FIB-4 75%, MMP-1 67.1%, MMP-2 72.2%, and PIIINP 72.3%. Conclusion In our study, the diagnostic performance of both direct and indirect serum markers for predicting liver fibrosis exceeded 65%. Mean levels of AST, ALT, MMP-2, PIIINP, APRI, and FIB-4 increased with advancing fibrosis stages, whereas mean platelet counts and MMP-1 levels decreased.

Introduction: Rhodiola rosea L. (R.rosea) is a popular plant in traditional medicine of the Nordic countries, Eastern Europe, and Asia. R.rosea plants are successfully cultivated in Mongolia. The Botanical Garden of Medicinal Plants under the “Monos” Group started to cultivate R. rosea since May 2015. Objective: The aim of this research was to study the salidroside contents of R.rosea collected from Zavkhan and Khuvsgul province, Mongolia, and cultivated in the Botanical Garden of Medicinal Plants, Drug research Institute, Monos group. Material and Methods: The underground parts of wild roseroot plants were collected from April to May 2020 from Jargalant soum, Khuvsgul province, and Nomrog soum, Zavkhan province, 3-years and 4-years-old cultivated R.rosea gathered from the Botanical Garden of Medicinal Plants in April 2020. For comparison, 4-year-old Rhodiola grenulata (R. grenulata) was ordered from Shanxi Zhendong Genuine Medicinal Materials Development Co., Ltd, China, and used for the study. The quantity of the salidroside constituents of the underground parts were compared and the sourcing of roseroot raw material was evaluated. Chemical analysis of roots and rhizome of R. Rosea namely the appearance, identification, moisture, organic impurities, mineral impurities, residue on ignition, water-soluble extractives, fresh weight of roots, and salidroside content were determined according to the National Pharmacopoeia of Mongolia (NPhM) 2011. Microbiological analysis was performed in accordance with the requirements of grade 3b specified in Annex 1 of the Order No. A / 219 of the Minister of Health dated May 30, 2017 to determine the degree of microbiological purity in medicinal products of roots and rhizome raw materials. Result: The content of salidroside, the main biologically active substance of R.rosea plant, was 1.57% in samples collected from Zavkhan province, 1.45% in samples collected from Khuvsgul province, 1.7% in samples grown in China and 0.25% for 3-years-old samples and 1.89% for 4-years-old samples grown in the Botanical Garden of Medicinal Plants, Monos group, Mongolia. In addition, these raw materials meet the general requirements for plant raw materials and microbiological parameters. Conclusion Samples of underground parts of R.rosea cultivated for 4 years in the Botanical Garden of Medicinal Plants have the highest content (1.89%) of the salidrosde. Therefore, it is suggested that the roots and rhizomes of R.rosea planted in the future can be standardized and used as a raw materials for medicines.

BACKGROUND. HCV-infected and obesity related liver diseases are leading to increases in the prevalence of advanced liver disease. So, studying liver disease, especially liver fibrosis is crucial issue of today. In Mongolia digestive system disease is second causation of non-communicable disease. Therefrom in last years hepatocellular carcinoma is most common malignancy, first of all cancers in Mongolia. In response to acute or chronic liver injury, hepatic fibrosis is the accumulation of extracellular matrix and ultimately leads to cirrhosis. Cirrhosis is the end-stage of fibrosis, resulting in nodule formation that may lead to altered hepatic function and blood flow. Defining the phase of liver fibrosis is crucial for therapeutic choice prognosis, important role in monitoring treatment. At the present time, use of direct and undirect biomarkers methods could be recommended for liver fibrosis stage. The aim of this study is to determine liver fibrosis stage and to compare undirect biomarkers in chronic viral hepatitis, cirrhosis. METHODS: 630 cases by chronic viral hepatitis and cirrhosis at third central hospital in Mongolia from retrospectively reviewed and analysed. The clinical data including AST, ALT, platelet count and INR were recorded. APRI, FIB-4, AAR and FibroQ were calculated. RESULT: From all, males 42.06% and females 57.94%, with mean age of 55.35±24.0, in 130 cases with chronic viral hepatitis and 500 cases with cirrhosis. In cases of cirrhosis, mean value of platelet count, ALT, AST, INR was 120.54±73.53, 104.55±500.22, 111.68±279.97, 2.19±10.45, respectively. And in cases of chronic viral hepatitis platelet count mean value was 211.18±6.42. APRI was detected <0.5 cutoff value (F0-F1) 11.7% non-fibrosis, 0.5-1.5 score (F2-F3) 27.5% fibrosis, >1.5 cutoff value (F4) 60.8% cirrhosis. FIB-4 was determined <1.45 cutoff value (F0-F1) 14.8% non-fibrosis, 1.45-3.25 score (F2-F3) 15.7% fibrosis, >3.25 cutoff value (F4) 69.5%, AAR was showed <0.4 cutoff value (F0-F1) 2.3% non-fibrosis, 0.4-1 score (F2-F3) 30.2% fibrosis, >1 cutoff value (F4) 67.5%. And FibroQ was detected <0.6 cutoff value (F0- F1) 0.5% non-fibrosis, 0.6-2.6 score (F2-F3) 6% fibrosis, cutoff value 2.6< (F4) 93.5 cirrhosis. In study liver fibrosis staging by APRI, AAR, FIB-4 and FibroQ score system, AAR was determined fibrosis in 190 cases. CONCLUSION: Recorded data ALT, AST, INR in cases of cirrhosis were detected 104.55±500.22, 111.68±279.97, 2.19±10.45, respectively. And in cases of chronic hepatitis platelet count mean value was 211.18±6.42. APRI, AAR, FIB-4, FibroQ was determined fibrosis 27.5%,30.16%,15.71% and 6.03%, respectively.