Background: Nitric oxide (NO) is a biological messenger molecule that plays a significant role in the pathogenesis of inflammation. It has anti-inflammatory effects under physiological conditions but can act as a pro-inflammatory mediator when produced excessively under abnormal conditions. NO is involved in the pathogenesis of inflammatory diseases affecting the joints, intestines, and lungs. Therefore, compounds that inhibit NO production are considered important for the treatment of inflammatory diseases and are used clinically. The RAW 264.7 mouse macrophage-like cell line is a widely used model for inflammation studies. Lipopolysaccharide (LPS), a component of the outer membrane of Gram-negative bacteria, is used to activate RAW 264.7 cells and create an inflammation model. Glycyrrhiza uralensis, also known as licorice, is a perennial herbaceous plant in the Fabaceae family. It has been widely used in traditional medicine due to its anti-inflammatory, antiviral, and hepatoprotective properties. Recent studies have shown that licorice contains bioactive compounds such as glycyrrhizin, liquiritigenin, and isoliquiritigenin, which play an important role in inhibiting the synthesis of pro-inflammatory cytokines in macrophages induced by LPS. Inula helenium L., also known as elecampane, is a perennial herbaceous plant used as an expectorant, anti-infective, anti-inflammatory, and anti-helminthic agent in various respiratory diseases. Licorice and Inula helenium are included in Mongolian traditional medicine prescriptions, but their anti-inflammatory effects have not been fully determined, which forms the basis for this research. Aim: To study the effect of Glycyrrhiza uralensis and Inula helenium extracts on the production of NO, the end product of inflammation, in RAW 264.7 macrophage cell lines stimulated with lipopolysaccharide. Materials and Methods: The non-toxic dose of the plant extracts was determined in RAW 264.7 mouse macrophage-like cell line cultures using the MTT assay. Nitric oxide production in RAW 264.7 cell line cultures stimulated with lipopolysaccharide was assessed using the Griess method. Statistical analysis of the results was performed using SPSS 25.0 software, with the p-value calculated by one-way ANOVA, and the differences between groups were evaluated. Results: In RAW 264.7 cell cultures, Glycyrrhiza uralensis and Inula helenium extracts were non-toxic and promoted cell growth at doses ranging from 1 to 25 μg/ml, while a dose of 50 μg/ml was toxic and inhibited cell growth (p<0.01). When the combined plant extracts were applied to cells at doses ranging from 1 to 100 μg/ml, they were also non-toxic and enhanced cell growth, while a dose of 500 μg/ml was toxic and inhibited growth (p<0.001). In terms of nitric oxide production, Glycyrrhiza uralensis extract increased NO production in a dose- and time-dependent manner compared to the control or PBS-treated group. However, Inula helenium extract did not show a dose- or time-dependent effect on NO production. In the lipopolysaccharide-induced inflammation model, licorice extract inhibited NO production at a dose of 30 μg/ml after 12 hours, and further reduced NO production in a dose- and time-dependent manner after 48 hours. Conversely, no significant changes were observed in the Inula helenium extract group at a dose of 25 μg/ml after 48 hours, but a reduction in LPS-induced NO production was observed at a dose of 25 μg/ml after 48 hours. Conclusion Glycyrrhiza uralensis extract alone increased NO production in a dose- and time-dependent manner. It also reduced LPS-induced NO production in a dose- and time-dependent manner. In contrast, Inula helenium extract inhibited LPS-induced NO production at a dose of 25 μg/ml after 48 hours.

: The increasing prevalence of noncommunicable diseases (NCDs), driven by factors such as population growth, urbanization, and economic development, presents significant individuals, families, challenges and to healthcare systems. These diseases are often linked to lifestyle choices, poor diet, and physical inactivity. As a result, there is growing interest in finding alternatives to synthetic drugs, particularly those derived from medicinal plants. Medicinal plants are known to contain bioactive compounds that offer therapeutic properties with fewer side effects compared to conventional pharmaceuticals. This study explores the cytoprotective effects of Glycyrrhiza uralensis (licorice) and Inula helenium (elecampane) extracts against oxidative stress induced by hydrogen peroxide (H₂O₂) in RAW 264.7 macrophage-like cells.
The study found that both plant extracts were non-toxic at doses ranging from 1 to 25 µg/mL and promoted cell growth (p<0.01). The results suggest that these extracts support cell survival and exhibit biological activity.
To assess the antioxidant effects, various concentrations of H₂O₂ (10–400 µM) were tested, and 200 µM was found to significantly reduce cell viability. Licorice and elecampane extracts (10 µg/mL and 25 µg/ mL, respectively) enhanced cell viability and reduced oxidative damage. Both extracts significantly reduced cell death compared to the H₂O₂-only group (p<0.01), highlighting their potent antioxidant properties. Conclusion Glycyrrhiza uralensis and Inula helenium extracts demonstrated strong cytoprotective and antioxidant effects, supporting their potential as natural therapeutics for oxidative stress-related conditions.

Background: The assessment of patients’ quality of life has emerged as a critical metric in evaluating healthcare services. Internationally, numerous studies have been conducted to assess the QoL of individuals diagnosed with pulmonary embolism through the development of standardized questionnaires and their association with various clinical parameters. Aim: To adapt a standardized questionnaire for assessing the quality of life following a pulmonary embolism and to evaluate the quality of life of affected patients. Materials and Methods: A total of 33 patients diagnosed with pulmonary embolism and hospitalized in the Department of Pulmonology at the Third State Central Hospital in Mongolia between August 2022 and December 2023 were included in the study. An observational cross-sectional study design was used. Inclusion criteria encompassed all patients diagnosed with PE during the study period, while exclusion criteria included individuals with severe comorbidities, those aged over 85 years, and those who declined participation. QoL was assessed using the Pulmonary Embolism Quality of Life (PEmb-QoL) questionnaire, which consists of 39 questions categorized into six domains. Higher scores indicate poorer QoL. Data analysis was performed using SPSS version 16. Results: The average age of the participants was 61±15 years, and 18 (54.5%) were female. The median duration of anticoagulant therapy was 170 days (range: 27–2555 days), and the average monthly expenditure on medication was 80,000 MNT (range: 63,000–400,000 MNT). The overall mean QoL score was 69.7±23.2. The median scores for the six domains were as follows: frequency of complaints 1.6 (IQR 1.5-1.9; max 5 score), activities of daily living limitations 1.5 (1.3–1.8; max 3 score), work-related problems 1.7 (1.5–2.0; max 2 score), social limitations 2.0 (2.0–3.0; max 5 score), intensity of complaints 3.0 (3.0–4.0; max 6 score), emotional complaints 2.0 (1.5–2.4; max 6 score). The internal consistency reliability of the questionnaire was assessed, with the symptom frequency category scoring well (α=0.74), while the other categories had excellent reliability (α>0.85). A weak positive correlation was observed between overall QoL scores and age, while a weak negative correlation was identified with body mass index (r=0.14 & r= -0.13, P>0.05). Conclusion The study findings indicate a low QoL among PE patients, emphasizing the necessity for enhancements in post-diagnosis medical care and long-term management strategies to improve patient outcomes.

Background: The annual incidence of pulmonary thromboembolism is reported to be 39–115 cases per 100,000 population, with rates of 60–120/100,000 in Western countries and 10–20/100,000 in Asian countries. In Mongolia, few studies revealed the prevalence of risk factors and clinical manifestations of acute pulmonary embolism. Over the past 30 years, the incidence of risk factors for non-communicable diseases, which are mainly triggered by lifestyle and social parameters, has rose. Moreover, environmental conditions such as cold climate, hypoxia, and blood hyperviscosit may contribute to higher incidences of acute pulmonary embolism in high-altitude regions. This condition is potentially fatal and can become impair quality of life. Aim: We aimed to compare risk factors and clinical characteristics based on age and sex, and to evaluate laboratory findings and diagnostic tests among Mongolian patients diagnosed with acute pulmonary embolism. Materials and Methods: This retrospective research included total 232 patients meeting inclusion criteria. The information was collected from patient histories, including general demographics, risk factors, comorbidities, symptoms, and physical examination findings. Laboratory analyses included complete blood count, coagulation profile, and immunological markers (D-dimer, NT-proBNP, troponin, protein C, homocysteine, and C-reactive protein), as well as selected imaging parameters. We used Wells and Geneva scoring systems to assess probability of acute pulmonary embolism and Pulmonary Embolism Severity Index to determine disease severity. Differences by age and sex were analyzed using independent t-tests for continuous variables and chi-square tests for categorical variables. Results: Among participants with acute pulmonary embolism, the prevalence of tobacco and alcohol use was significantly higher among males (p<0.001). Among comorbidities, arterial hypertension and other pulmonary diseases were more common in males, whereas cardiac diseases were more frequent in females (p=0.028). Participants aged 65 years and older showed higher rates of comorbid conditions and regular medication use (p<0.001). The most common symptoms were dyspnea (90.9%), chest pain (74.2%), cough (70.5%), leg pain (38.9%), hemoptysis (20.7%), and cyanosis (9.3%). According to sPESI scoring, 69.8% (n=162) were at high risk of death within 30 days, with no significant difference by sex. However, mortality risk within 30 days was significantly higher in participants aged 65 years and above (p<0.001). As increasing age, the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were elevated, indicating an acute inflammatory response (p=0.001). Contrast-enhanced CT scans revealed that 95 participants (44.2%) had main pulmonary artery involvement, with no significant sex difference, though involvement of the main pulmonary artery was more frequent in those aged 65 and older. Conclusion Dyspnea, chest pain, and cough were the most common symptoms among patients diagnosed with acute pulmonary embolism. The 30-day mortality risk associated with it was higher among males and increased with advancing age.

Background: Rheumatoid arthritis is more common in people aged 30-40 years. The cause of this disease has not yet been solved, but it is believed to be due to the weakening of the body’s resistance. It is a phenomenon that causes the body to become sick due to changes in the immune system that protects the body from the external environment. In general, genetic diseases, bacterial and viral infections are believed to be the source of arthritis. Physical and mental stress increases the risk of developing this condition. Drug treatment and surgery are often used selectively in cases of rheumatoid arthritis. Tuiplan treatment has recently been recommended as one of the traditional medical treatments, but there are few studies evaluating the results. Clinical case: Patient A, a 55-year-old woman. From 2009, the small joints of the hands began to swell and turn red. Since May 2010, both large and small joints have been swollen and painful to move. rheumatism was diagnosed after giving general blood test, urine test and immunological tests. Since June 2010, he has been using anti-inflammatory steroids and gold and silver needles, but the pain has not subsided. Pain: Stinging, hot and red pain in wrists, fingers, knees, and ankles. When you get up in the morning, you wake up stiff. Morning stiffness lasts 30 minutes. The pain is worse when moving at night.
Urine: Red, smelly and sticky.
Pulse: Fine, quick, intense, throbbing pulsation. Treatment process: The therapists used Tuiplan treatment for 21 days under the supervision of a doctor in a warm, well ventilated, closed, window-free room, taking the Tuiplan treatment together with the treatment in a heavy or closed way once a year or 3 times in 3 years. Conclusion: It is proved that the use of Tuiplan treatment in the treatment of chronic diseases is less dangerous, the recurrence of the disease is less, and complete recovery is possible if the disease is maintained. The results of the treatment were calculated and monitored by laboratory tests before and after the administration of Tuiplan. Acknowledgements I would like to thank the honorable, Dr.Mendsaikhan, consultant physician, doctor, and professor for helping, advising, and guiding me in my research work

Background: Numerous studies among the western population have been demonstrated that the intolerance of uncertainty can cause mental disorders such as OCD, anxiety disorder major depressive disorder. The lack of research in this field among the eastern population, especially the Mongolians, is the basis of our study. Material and Methods The study was designed as a cross-sectional study with a self-report questionnaire and conducted between December 5th and February 5th of 2022. The Intolerance of Uncertainty scale (IUS-12) is for measuring intolerance of uncertainty, Patient health questionnaire (PHQ-9), and Generalized anxiety disorder (GAD-7) were used to measuring mental health among study participants. The present study was undertaken following ethical approval from the MNUMS scientific research ethics committee (approval number: 2021/3-06). Statistical analysis was performed using SPSS version 24. Purpose: The current study was aimed to explore the impact of intolerance of uncertainty on students’ mental health. Results: Total of 3137 students (2440 Chinese, 697 Mongolian), 65.7% of them were female students participated in the current study. The mean score of IUS-12 was 33.53±7.72 among Chinese students, while 38.65±8.48 among Mongolians. This reveals the statistically significant (p=0.003) difference intolerance level between Chinese and Mongolian students. Moreover, Chinese students were less depressed and less anxious than Mongolian students. The anxiety and depression level was directly impacted by the influence of intolerance of uncertainty. Conclusion Chinese students are more tolerant toward uncertainties than Mongolian students. The intolerance of uncertainty causes depression and anxiety, regardless of nationality.

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.

The result of a study of prevalence, type and degrees Of hearing impairment in newborns and infants Introduction: Significant bilateral hearing loss is the most common congenital disorder of the newborn, occurring 2-3 times per 1000 live infants. In December 2012, for the first time in Mongolia, neonatal hearing screening was introduced at the National Center for Maternal and Child Health. We aimed at investigated the outcomes of neonatal hearing screening and diagnostics of type and degree of hearing loss in neonates and infants. Materials and methods: During the study period, 2019-2020, a total of 70,614 infants born in Urguu, Khuree, Amgalan maternity hospitals, Baganuur district health center, Intermed hospital, and the National Center for Maternal and Child Health were included in the prospective cohort study. The study was performed in three phases, following the clinical guidelines for neonatal hearing screening. Results from the well-baby newborn hearing screening program and diagnostic follow-up of referred children from 2019 to 2021 were included in calculating prevalence rates. Hearing loss was classified according to the degree and type. Results: A total of 94.1% of 70,614 children eligible for screening were included. A prevalence rate of bilateral hearing loss 2.23 per 1000 children was found. A prevalence rate of bilateral severe and profound hearing loss 1 per 1000 children was found. The mild sensorineural hearing loss 28 (26.0%) was most common in children, followed by moderate 19 (17,6%), severe 21 (19.4%), profound 19 (17.6%) and deaf 21 (19.4%). Conclusions: The coverage of hearing screening in maternity hospitals in Ulaanbaatar is relatively good (94.1%), but there is a repeat screening (62.1%) and follow-up and diagnostic tests (49.9%). shows that the system needs to be improved. Because of the well-by hearing screening program, reported results approximate prevalence rates of permanent hearing loss by severity.

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.

Introduction: Soum and family health care centers (primary health care centers) provide public health services to reduce the negative effects of air pollution on health. In order to decrease the risk factors due to air pollution, it is crucial for health professionals, who are providing health care services to the public, to have the knowledge, attitude and practice to give an advice for residents on how to protect their health from air pollution. The “Air pollution and child health” report from WHO recommended that responsibility of health professionals must include knowing the latest information on air pollution, doing a research, spreading the knowledge, educating families and community and learning from them as well, proposing solutions, and finding a solution for policy developers and decision makers in other sectors. Therefore, we conducted this survey with purpose to determine the long-term effects of air pollution on population psychology and lifestyle and to evaluate the level of knowledge, attitude, and practice of health professionals on how to protect a health from air pollution. Goal: Evaluate the level of knowledge, attitude, and practice of health professionals on air pollution. Material and Methods: In 2019, this study conducted a cross-sectional design and collected quantitative and qualitative data. 88.4% of (n=532) health professionals from 48 secondary health care centers (SHCC) and 64 family health care centers (FHCC), which are agents that implement UNICEF project, in Bayanzurkh, Songinokhairkhan districts and Bayankhongor aimag were participated in the survey. Results: 97.4% of the participants agreed that air pollution has negative effects on human health. 99.5% of participants did not know the Mongolian standard for the acceptable level of air pollutant particulate matter (PM) and 73.1% of all participants did not receive information about air quality index. 82.1% of participants regularly give prevention advice with the purpose of protecting maternal and child health from air. The participants who worked for more than 21 years and who are older than 51 years old were more likely to give advice (p<0.05). As for the reasons for not giving advice about air pollution for protecting the maternal and child health, 29.2% of participants answered the service time is not enough, and 22.9% mentioned the lack of knowledge and information. 30.5% (162) of participants were not satisfied with their skill to give an advice on how to protect maternal and child health from air pollution. 86.8% of participants indicated that they did not receive proper training on air pollution and prevention from air pollution. Conclusion There is a need to provide training and information on how to protect maternal and child health from air pollution for health professionals.