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: Type I hypersensitivity, commonly known as an allergic reaction, is characterised by an IgE-mediated immune response triggered when foreign proteins enter the body. During allergic reactions, cytokines such as IL-4, IL-5, IL-9, and IL-13, secreted by T-helper 2 (Th2) cells, play a crucial role in activating immune effector cells like eosinophils and mast cells, which contribute significantly to airway inflammation and obstruction. Conversely, interferon-gamma (IFN-γ), produced by Th1 cells, suppresses Th2-mediated responses and plays an essential role in regulating allergic inflammation. Therefore, determining the balance of cytokines produced by Th1 and Th2 cells is crucial for understanding the mechanisms underlying allergic responses. Aim: We aimed to induce an allergic response in experimental animals using ovalbumin and to determine the levels of IL-4 and IFN-γ cytokines using an in-house enzyme-linked immunosorbent assay (ELISA). Materials and Methods: A total of 20 female C57BL/6 mice aged 6–8 weeks were selected for the experiment and randomly divided into two groups: control and experimental groups. The concentrations of IL-4 and IFN-γ cytokines in mouse serum were determined using an in-house enzyme-linked immunosorbent assay (ELISA). Result: Compared to the control group, the levels of IL-4 and IFN-γ cytokines in the serum of allergic model-induced C57BL/6 mice were determined to be 513.7 pg/mL and 193.2 pg/mL, respectively. A statistically significant difference was observed in IL-4 cytokine levels between the two groups (p < 0.001). Conclusion In the allergic model group, serum levels of IL-4 cytokine were elevated, while IFN-γ cytokine levels were decreased, suggesting a predominant Th2-type immune response.

Background: Globally, approximately 322,000 new cases of brain and central nervous system (CNS) tumors were reported in 2022, accounting for 1.6% of all newly diagnosed cancers. Primary brain tumors represent 85–90% of all CNS tumors, and survival varies substantially by tumor type and stage. Malignant brain tumors have a 5-year survival rate of approximately 35.7%, while meningioma, the most common benign brain tumor, has a 5-year survival rate of 88.2%. Furthermore, survival outcomes are substantially poorer in low- and middle-income countries (LMICs). For example, the median survival of patients with glioblastoma (GBM) is 12–15 months in high-income countries but only 6–9 months in LMICs. In Mongolia, 93 new cases of brain and CNS tumors were reported in 2024. Although the incidence is lower than that of other common cancers, the mortality rate remains high (80.4%). Because brain tissue biopsy is invasive and repeated sampling is often impractical, in Mongolia, brain and CNS tumors continue to be associated with high mortality, underscoring the need for minimally invasive biomarkers for early diagnosis and disease monitoring MicroRNAs (miRNAs) are small non-coding RNAs (18–22 nucleotides) that regulate gene expression at the post-transcriptional level and remain stable in body fluids, making them promising biomarkers. Among them, miR-21 is a well-characterized oncogenic miRNA that is overexpressed in glioma and glioblastoma. However, evidence regarding its clinical utility in LMICs, particularly in Mongolia, remains limited. Aim: To evaluate plasma miRNA-21 expression in patients with primary brain tumors and evaluate its diagnostic performance. Materials and Methods: This study enrolled 120 participants, including patients with primary brain tumors, patients with other neurological disorders (non-tumor), and healthy controls. Peripheral blood samples were collected, and plasma miRNA-21 expression was quantified using quantitative real-time polymerase chain reaction. Relative expression was calculated using the 2^-ΔΔCt method. Descriptive statistics and one-way analysis of variance (ANOVA) were performed to evaluate differences among groups. Receiver operating characteristic curve analysis was performed to assess diagnostic performance, with statistical significance set at p < 0.05. Result: Plasma miRNA-21 expression was significantly higher in patients with primary brain tumors than in healthy individuals, showing a 3.81-fold increase (p<0.001), and was 1.53-fold higher than in patients with neurological disorders (p<0.001). miRNA-21 expression was significantly elevated in patients with glioma, meningioma, and adenoma compared with both healthy individuals and patients with neurological disorders (p<0.001). Similarly, miRNA-21 expression was significantly higher in both glial and non-glial tumors than in the healthy and neurological disorder groups (p<0.001) and showed an increasing trend according to tumor stage/grade (p<0.001). ROC curve analysis demonstrated that miRNA-21 had a sensitivity of 92.3% and a specificity of 80.5% for distinguishing patients with primary brain tumors from the comparison groups. Conclusion Plasma miRNA-21 has the potential to distinguish patients with primary brain tumors from healthy individuals and patients with neurological disorders and may serve as a minimally invasive diagnostic biomarker for primary brain tumors.

Background: Medical education has shifted toward integrated, student-centered curricula. Mongolia’s School of Medicine adopted a vertically integrated block model, yet systematic evaluation through student feedback remains limited. Aim: To evaluate the quality of the block curriculum for the “General Medicine” program based on student satisfaction, and to identify factors influencing satisfaction with course content. Materials and Methods: This analytical cross-sectional study was conducted using a questionnaire survey between January 2023 and January 2026. A total of 1,130 students (66.8% of the source population) were selected through stratified random sampling from 1,692 third- to sixth-year medical students enrolled in the Doctor of Medicine program at the School of Medicine, Mongolian National University of Medical Sciences (MNUMS). The mean age of participants was 22.18±1.43 years, of whom 79.7% were female and 20.3% were male. Educational quality was evaluated across three domains: educational content (59 items), learning environment (59 items), and course organization (59 items), using a 5-point Likert scale (5=strongly agree, 4=agree, 3=neutral, 2=disagree, 1=strongly disagree). Internal consistency reliability was assessed using Cronbach’s alpha. Differences between blocks were analyzed using one-way ANOVA and Tukey’s HSD post hoc test. Pearson correlation analysis was used to examine associations among domains, while factors influencing educational content were identified using multivariable linear regression analysis. Statistical significance was established at the 95% confidence level (p<0.05). Results: The questionnaire demonstrated high internal consistency across all seven blocks (Cronbach’s α=0.888–0.937). The overall mean scores were 4.00±0.78 for educational content, 3.91±0.85 for learning environment, and 3.92±0.82 for course organization. Block 6 received the highest ratings across all domains, including educational content (4.15±0.74), learning environment (4.04±0.81), and course organization (4.03±0.81), whereas Block 1A had the lowest mean scores (3.82–3.92). One-way ANOVA revealed statistically significant differences among blocks across all three domains (p≤0.005); however, the effect sizes were very small (Partial η²=0.003–0.006). Tukey’s HSD test showed that Block 6 was rated significantly higher than Block 1A in educational content by 0.226 points (95% CI: 0.103–0.349, p<0.001) and in course organization by 0.206 points (95% CI: 0.078–0.334, p<0.001). Strong positive correlations were observed among educational content, learning environment, and course organization (r=0.747–0.820, p<0.001). Academic year demonstrated weak negative correlations with all three evaluation domains (r=−0.033 to −0.045, p<0.05). Multivariable linear regression analysis indicated that learning environment (β=0.348, p<0.001) and course organization (β=0.487, p<0.001) explained 63.6% of the variance in educational content ratings (R²=0.636, F(2,5894)=5143.82, p<0.001). Conclusion The study findings demonstrated that students generally evaluated the content, learning environment, and organization of the integrated block curriculum positively, with higher ratings observed in senior-level blocks. The strong positive correlations among these dimensions suggest that they are interrelated factors influencing student satisfaction. Furthermore, multivariable linear regression analysis revealed that course organization and the learning environment had the greatest influence on the evaluation of educational content. These findings indicate that improving course scheduling, instructional organization, and the learning environment is essential for enhancing educational quality and students’ perceived value of the curriculum.

Background: Globally, medical education has been shifting from traditional discipline-based models toward student-centered, outcome-based, and integrated curricula. The Mongolian National University of Medical Sciences (MNUMS) has implemented a six-block integrated curriculum; however, evidence on how teaching methodology and assessment practices influence student learning outcomes within this framework remains limited. Aim: To determine the effect of teaching methodology and assessment practices on student learning outcomes in a block-based undergraduate medical curriculum. Materials and Methods: A retrospective study was conducted from January 2023 to January 2026 among 1,130 undergraduate medical students (years 3–6) at the School of Medicine, MNUMS. A stratified random sampling method was applied, representing 66.8% of the target population. Data were collected using a structured 185-item questionnaire based on a 5-point Likert scale. Statistical analyses included descriptive statistics, independent t-tests, one-way ANOVA with Tukey post-hoc tests, and multiple linear regression using SPSS version 26.0. Internal consistency was high (Cronbach’s α=0.90–0.98). Results: The overall mean evaluation score was 4.00±0.73. A decreasing trend in scores was observed with advancing academic years, with final-year students reporting the lowest scores (M≈3.92). Significant inter-year differences were found in Blocks 3 and 4 (p<0.05), suggesting a potential gap during the theory-to-clinical transition. Blocks 5 and 6 showed consistently high and stable scores (M≈4.10–4.15). Teaching methodology and assessment practices were strong predictors of learning outcomes (β=0.289–0.610), with regression models explaining 67–77% of the variance (R²=0.668–0.774). Elevated VIF values indicated multicollinearity among predictors. Conclusion Teaching methodology and assessment practices were found to be decisive determinants of learning outcomes within the integrated block curriculum (R²=0.668–0.774). Although overall student evaluations exceeded the mean threshold, a systematic decline observed across advancing academic years reflects the phenomenon of retrospective critical evaluation, while inter-year discrepancies in Blocks 3 and 4 indicate insufficient curricular coherence during the theory-to-clinical transition. Therefore, it is imperative to further develop the curriculum in a competency-based framework, and to reform both teaching methodology and assessment practices in alignment with clinical competence requirements.

Background: Between 2017 and 2021, the prevalence of obesity among children aged 2-19 years reached 19.7%, affecting approximately 14.7 million children, with rates of 12.7% among those aged 2-5 years and 22.2% among those aged 6-11 years. Globally, dental caries is among the most common non-communicable diseases, often leading to pain, infection, tooth loss, and reduced quality of life. In Mongolia, the prevalence of overweight and obesity among children and adolescents has increased markedly since 2010, beginning at an early age. In 2018, one in six children under five years and one in eight adolescents were overweight. Aim: This study aimed to assess selected non-communicable disease risk factors among children and adolescents. Materials and Methods: A cross-sectional study was conducted in Ulaanbaatar, Mongolia, using Family Health Centers across all nine districts. A total of 622 children aged 6–17 years were included. Anthropometric measurements (weight, height, and waist circumference) were obtained, and body mass index (BMI) was calculated. Oral health examinations were performed to determine the Decayed, Missing, and Filled Teeth (DMFT) index. Nutritional status was classified based on age and sex-specific growth charts into normal weight, overweight, and obesity categories. Results: Among the participants, 10.29% (n=64) were overweight and 9.97% (n=62) were obese. Overweight was more prevalent among girls, whereas obesity was relatively higher among boys (p<0.001). Regarding dental caries, 37.6% (n=234) of participants had no caries (DMFT=0), 48.1% (n=299) had mild caries (DMFT=1-2), and 14.3% had moderate to severe caries (DMFT≥3). The overall prevalence of dental caries was 62.38%, with significant variation by age group: highest in children aged 6-9 years (69.9%) and lowest in those aged 15-17 years (46.1%) (p<0.001). No statistically significant association was found between BMI categories and dental caries status. Although normal weight predominated in the DMFT=0 and DMFT=1-2 groups, logistic regression adjusted for age and sex showed no significant relationship between BMI and dental caries. However, children aged 6-9 years had a significantly higher likelihood of having dental caries compared to those aged 15-17 years (OR=0.39, 95% CI: 0.24-0.63, p<0.001). Conclusions 1. Among the risk factors for non-communicable diseases (NCDs), overweight and obesity were highly prevalent among children, with one in every five children classified as overweight or obese. The prevalence among male children was approximately two times higher than that among female children (p<0.001). 2. The prevalence of dental caries among the study participants was 90.7%, with a mean caries intensity of 6.4, indicating high level of severity. Age-group analysis demonstrated that children aged 6–10 years exhibited the highest prevalence and severity of dental caries, with a prevalence of 93.5% and a mean caries intensity of 7.3.

Background: Globally, adolescent sexual and reproductive health (SRH) remains a public health priority within the Sustainable Development Goals. In Mongolia, individuals aged 15-24 account for over 40% of all sexually transmitted infections (STIs), representing a significant national challenge. Current health education for adolescents focuses predominantly on biological knowledge while neglecting life skills, consent, and communication. This focus has led to a deepening “knowledge-practice gap,” increasing vulnerability to risky behaviors. Therefore, it is essential to identify the actual SRH needs of youth and evaluate the national curriculum against international Comprehensive Sexuality Education (CSE) standards. Aim: To compare and evaluate the SRH knowledge, attitudes, and practices (KAP) of university students and to identify content gaps by comparing the national curriculum with international CSE standards. Materials and Methods: An analytical case-control study was conducted among 585 students (freshmen, n=289; senior students, n=296) using random sampling. Data were collected via a structured questionnaire based on UNESCO CSE standards and the national curriculum. Statistical analysis was performed using SPSS 26.0, employing X2 and t-tests for significance (p<0.05). Content analysis was executed using a triangulation matrix. Results: Statistically significant differences were observed between the study groups in terms of age (p<0.001), marital status (p<0.001), and living environment (p<0.001), while groups were homogeneous regarding gender (p=0.183) and socio-economic status. Senior students demonstrated significantly higher levels of SRH knowledge, attitudes, and practices across all variables compared to freshmen (p<0.001). However, a profound knowledge-practice gap persists; for instance, while 70% of freshmen were aware of STI transmission routes, regular condom use was reported at only 45%. Content analysis revealed that while the national curriculum covers biological aspects well, key CSE concepts such as “Consent,” “Psychology of Relationships,” and “Digital Safety” are notably absent. Furthermore, a curriculum based on negative attitudes and “prohibitions” contributes to fear among youth regarding seeking medical assistance. Conclusion The significant knowledge-practice gap (p<0.001) among students highlights the urgent need to revise the national curriculum in alignment with international CSE standards. To mitigate risky behaviors, it is recommended to transition from information-based teaching to a competency-based “Integrated Learning Model” supported by school-hospital-family partnerships.

Background: Ephedra przewalskii Stapf. is a perennial shrubby plant of the family Ephedraceae, naturally distributed in the dry and cold desert regions of Mongolia. In traditional medicine, the stems and roots of this plant have been used as decoctions for the treatment of gastrointestinal spasms, abdominal distension, urinary retention, and general fatigue. Members of the Ephedraceae family are known to contain sympathomimetic alkaloids such as ephedrine and pseudoephedrine, which exert strong physiological effects on the central nervous system, respiratory tract, and cardiovascular system. However, detailed information on the tissue- and cell-level localization of biologically active compounds and the microstructural characteristics of E. przewalskii remains limited. Aim: This study aimed to investigate the microanatomical structure and histochemical characteristics of the stem and root of Ephedra przewalskii Stapf., with particular emphasis on the localization of biologically active compounds. Materials and Methods: Plant samples were collected in July from Chandmani soum, Govi-Altai province, Mongolia. The collected material was air-dried in the shade and softened using Ostrich and Fleming solution prior to sectioning. Transverse sections of the stem and root were prepared using a hand microtome and examined under an Olympus light microscope. Histochemical analyses were performed using standard reagents to detect alkaloids, phenolic compounds, tannins, essential oils, polysaccharides, and starch. Results: The stem epidermis consisted of thin-walled, quadrangular cells with a surface covered by spherical protuberances. The stomatal apparatus exhibited a tetracytic structure, and photosynthetic activity was primarily localized in the stem chlorenchyma. The vascular bundles were collateral, with phloem located externally and xylem internally. Idioblasts containing reddish-brown crystalline inclusions were observed in the central pith of the stem. The root showed a polyarch central cylinder, with uniformly distributed, rounded parenchymal cells, and idioblasts similar to those observed in the stem. Histochemical analysis revealed the presence of flavonoids, alkaloids, polysaccharides, and tannins in the stem, predominantly localized in parenchymal and chlorenchymal tissues. In the root, polysaccharides, tannins, and starch were detected, whereas alkaloid accumulation was more prominent in the stem parenchyma. Conclusion The microscopic examination of Ephedra przewalskii Stapf. revealed the characteristic structures of the stem epidermis, stomata, chlorenchyma, vascular tissues, and crystal-containing idioblasts, as well as a polyarch central cylinder in the root. Histochemical reactions detected flavonoids, alkaloids, tannins, starch, and polysaccharides in the stem, whereas tannins, starch, and polysaccharides were identified in the root. These findings provide a comprehensive characterization of the anatomical and chemical features of the different plant organs.

Background: Cardiovascular disease is the leading cause of death in Mongolia, and atherosclerosis is its main pathogenic factor. The cardio-ankle vascular index (CAVI) is a marker of arterial stiffness, and measuring it allows atherosclerosis to be detected before clinical symptoms appear. This study was based on the need to assess CVD risk in older adults and to plan prevention accordingly. Aim: To determine whether CAVI independently predicts CVD mortality in older adults. Materials and Methods: This prospective cohort study included 1,403 adults aged 55–95 years from five regions of Mongolia who had participated in the study “Factors Influencing Population Longevity,” (2011–2015). CAVI was measured with a VaSera VS-1000 device (Fukuda Denshi, Japan). Mortality data as of December 20, 2025 were obtained from the Center for Health Development by linking participants’ national registration numbers to the death registry. Deaths coded I00–I99 under the International Classification of Diseases, 10th revision, were classified as CVD deaths. Participants were divided into four equal groups by CAVI value (quartiles: Q1 <8.0, Q2 8.0–8.8, Q3 8.9–9.7, Q4 ≥9.8), and the cumulative incidence of CVD mortality was estimated with the Aalen–Johansen method. Cox regression analysis was adjusted for age, sex, hypertension, smoking, LDL cholesterol, HDL cholesterol and estimated glomerular filtration rate. A Fine–Gray sensitivity analysis was also performed. Results: The mean age of participants was 66.8±7.9 years. During follow-up (median 13.2 years), 121 CVD deaths (8.6%) and 127 deaths from other causes (9.1%) were recorded. The cumulative incidence of CVD mortality rose stepwise from 3.3% in Q1 to 6.0% in Q2, 9.3% in Q3 and 14.1% in Q4 (Gray’s test p<0.001). Compared with Q1, the hazard of CVD death was higher in Q3 (HR 2.03 [95% CI 1.04–3.98]) and Q4 (HR 2.42 [95% CI 1.23–4.76]) (p-trend=0.012). Per 1-unit increase in CAVI, the HRs were: crude: 1.42 [95% CI 1.24–1.63], age- and sex-adjusted: 1.19 [95% CI 1.03–1.38] and fully adjusted: 1.17 [95% CI 1.00–1.36], p=0.045. Hypertension was an independent risk factor for CVD mortality (HR 1.53 [95% CI 1.06–2.21]). Conclusion In older adults, higher CAVI predicts CVD mortality independently of age, sex and traditional risk factors, and the risk of CVD death rises stepwise with higher CAVI quartiles.

Background: Nuclear factor erythroid 2-related factor 2 (NRF2) is a transcription factor that plays a crucial role in regulating cellular responses to oxidative stress and xenobiotic exposure. However, excessive NRF2 activation can enhance cancer cell survival and contribute to chemoresistance. Therefore, increasing attention has been directed toward naturally occurring flavonoids that may modulate NRF2 activity. Molecular docking provides a computational approach for predicting potential interactions between flavonoids and NRF2 and may help identify candidate compounds for further investigation in cancer therapy. Objective: To evaluate the potential interactions of five naturally occurring flavonoids—daidzin, rutin, luteolin, apigenin, and quercetin—with the Neh1 domain of NRF2 using molecular docking and to identify promising candidates for further investigation based on docking scores and ligand efficiency. Materials and Methods: The potential interactions of five natural flavonoids, namely daidzin, rutin, luteolin, apigenin, and quercetin, with the target region of NRF2 were investigated using molecular docking. Three-dimensional structures of the flavonoids were retrieved from the PubChem database, while the NRF2 protein structure was obtained from the Protein Data Bank (PDB). Molecular docking calculations were performed using the CB-Dock2 web platform, which incorporates the AutoDock Vina algorithm. Results: The docking scores of the selected flavonoids ranged from −64.9 to −77.2. Daidzin exhibited the most favorable docking score (−77.2), followed by apigenin (−72.0) and luteolin (−71.4), whereas rutin showed the least favorable score (−64.9). The calculated RMSD values ranged from 14.766 to 15.344 Å, with relatively small differences among the ligands. Daidzin and apigenin exhibited comparatively lower RMSD values. The reported pose-clustering analysis indicated that all ligands occupied similar binding regions. In terms of ligand efficiency, apigenin (−2.40), luteolin (−2.30), and quercetin (−2.20) showed comparatively favorable values. Although daidzin had the most favorable docking score, its ligand efficiency relative to molecular size was comparatively lower. Conclusion The results suggest that daidzin and apigenin may be candidate compounds for further investigation of potential interactions with the Neh1 domain of NRF2. However, these findings are based solely on computational analysis. Further molecular dynamics simulations and experimental studies are required to validate the predicted interactions and determine their actual effects on NRF2 activity.