Background: Choriocarcinomas after full-term pregnancies are a rare entity. Case presentation: A 34-year-old woman was admitted to the hospital with a seizure in a comatose state. A computed tomography scan revealed an intracerebral haemorrhage in the right parietal region. A chest CT scan showed a single metastatic lesion in the right upper lung field. The patient delivered a viable infant at 39 weeks of gestation, 4 months before the hospitalisation. Her pregnancy course was uncomplicated. Despite receiving intensive treatment, the patient died 1 day later. Choriocarcinoma was diagnosed at the autopsy. Conclusion Metastatic choriocarcinoma should always be in the differential diagnosis for women of childbearing age presenting with unexplained stroke-like symptoms.

Background: Carotid artery stenting is increasingly being selected as the treatment for severe (≥70%) carotid artery stenosis, creating a growing need to prevent potential secondary complications associated with the procedure. In-stent restenosis (ISR) remains an important complication during long-term follow-up after carotid artery stenting. In this clinical case, we have addressed risk factors, pathogenesis, diagnosis, treatment, and monitoring of in-stent restenosis. Case Presentation: We describe the case of a 70-year-old man with severe, symptomatic IRS detected 1.8 years after carotid artery stenting (CAS). Conclusion IRS following carotid artery stenting is a clinically significant complication that may adversely affect cerebral perfusion and increase the risk of recurrent ischemic stroke. Early detection and follow-up with carotid duplex ultrasonography, regular follow-up, and lifestyle modifications, particularly smoking cessation, are essential for prevention of adverse cerebrovascular events.

Background: Cancer is not only a physiological disease but also a complex condition that profoundly affects an individual’s psychological well-being and social relationships. Misconceptions about cancer within the public, including its association with death and the tendency to attribute blame to patients as being “personally responsible,” contribute to the development of social stigma among cancer survivors. This stigma negatively impacts patients’ engagement in treatment and their quality of life, highlighting the need to assess societal attitudes based on survivors’ lived experiences. Aim: To examine the everyday lived experiences of cancer survivors, measure perceived social stigma, and identify psychological challenges as well as sources of support. Materials and Methods: A mixed-methods design was employed. In the quantitative component, the Cancer Stigma Scale (CASS) and the Attitudes Toward Cancer Questionnaire (ATCQ) were translated and their content validity was evaluated by an expert panel using the Content Validity Index (CVI), followed by pilot testing to confirm feasibility (FVI). In the qualitative component, focus group discussions were conducted with cancer survivors, and coping ability was assessed using psychological assessment tools. Result: A total of 207 participants (68% female; mean age 33.82±13.7 years) were included in the quantitative study. Participants experienced a moderate level of cancer-related stigma, with negative attitudes most strongly associated with perceptions of disease severity and individual responsibility. Qualitative findings revealed that physician communication and family support played a decisive role in psychological responses at the time of diagnosis disclosure. Excessive sympathy or social distancing increased psychological distress, whereas normal interpersonal interaction and realistic encouragement were identified as the most effective forms of support. Conclusion To improve psychosocial support for cancer survivors, it is essential to enhance healthcare professionals’ communication skills, promote accurate public understanding of cancer, and strengthen the sustainability of survivor support group activities.

Background: According to a study by US scientists, 1/3 percent of the world’s population uses tobacco, and the use of tobacco has steadily decreased over the years, while the use of tobacco-like products, including electronic cigarettes, has increased rapidly. In order to combat this problem, it is necessary to assess the knowledge about e-cigarettes among young people, who are considered to be the main users of e-cigarettes. The lack of research on e-cigarettes is the basis for this study. Aim: To evaluate the knowledge of electronic cigarettes among Nursing students of the School of Nursing. Materials and Methods: The study was conducted by randomly selecting 128 first-year Bachelor of Nursing students from the School of Nursing and taking a questionnaire. The results of the research were statistically processed using the IBM statistics SPSS-25.0 program. Results: Considering the age of the students in the study, 18 years old (41.4%), 19 years old (46.9%), and 20 years old (11.7%) were included. Regarding gender, 113 (88.3%) were female and 15 (11.7%) were male. 65 (50.8%) of the students are enrolled from Ulaanbaatar city, 63 (49.2%) from the local area. When assessing knowledge about electronic cigarettes, 100 (78.1%) had knowledge and 28 (21.9%) had no knowledge. Among students who smoke, 34 (87.2%) smoke e-cigarettes and 5 (12.8%) smoke cigarettes. Sex, where you started, and who you live with are irrelevant to e-cigarette use. But the smoking status is that 32 (36.0%) smoke by themselves with someone in the family who smokes, 7 (17.9%) smoke by themselves without a smoker in the family, friends smoke e-cigarettes 37 (34.3%) smoke by themselves, friends 2 (10%) are related to self-attractors who do not attract friends. (p=0.022) who the participants live with is the motivation for smoking. 36% of students who live with their parents smoke, while 64% of students who live apart from their parents smoke. 84.4% of respondents do not know that e-cigarettes contain propylene glycol, 15.6% do, 63.3% do not know that electronic cigarettes contain benzene, and 36.7% do. Conclusion The level of knowledge about electronic cigarettes among nursing students was insufficient. In addition, having family members or friends who smoke was found to influence students smoking behavior.

Field Epidemiology Training Programmes (FETPs), which are modelled after the Centers for Disease Control and Prevention’s Epidemic Intelligence Service programme, began in 1980 and have produced graduates in more than 70 countries, including 12 in the Western Pacific Region.1,2 These programmes aim to “build sustainable capacity for detecting and responding to public health threats” and “develop expertise so that disease outbreaks can be detected locally and prevented from spreading”.3 FETPs thus include training in applied epidemiology and public health services. FETP trainees and graduates, however, often have additional responsibilities: mentoring newer trainees, supervising in the field, leading short training courses, facilitating meetings, etc. Programmes therefore must provide trainees with the knowledge and skills to fulfil these responsibilities.

Introduction: Toll like receptors (TLRs) are a class of proteins that key role in the innate immune system. The SOCS1 and SHP2 proteins are negative-feed loop inhibitors of signaling of JAK/STAT and TLRs pathways. Purpose: To determine negative regulator protein activation which is activated through TLR7 ligand/IFN-γ signal transduction in endothelial cells. Methods: We used mouse aortic linear endothelial cell (END-D); protein expressio was detected by western blotting Results: We analyzed a time dependent stimulation effects of negative regulator proteins stimulated by TLR7 ligand/IFN-γ in endothelial cell cultures. Imiquimod of 10 μg/ml treatment of 1 hr was followed by 100 ng/ml IFN-γ stimulation for 1-8hr to analysis of negative regulator SOCS1 and SHP2 protein expression.
In untreated cells, there was low activations of negative regulator SOCS1 and SHP2 proteins. IFN-γ stimulation alone had increased SOCS1 and SHP2 protein expressions, also imiquimod treatment highly elevated SOCS1 and SHP2 expressions. However imiquimod and IFN-γ doubled treatment have decreased activation of negative regulator SOCS1 and SHP2 proteins. These findings suggest SOCS1 and SHP2 proteins are inhibitors in the TLR7 ligand/IFN-γ signaling. Conclusion Negative regulators, SOCS1 and SHP2 strongly suppressed activations of TLR7 ligand/IFN-γ signaling

Introduction: When human body encounters external pathogens primary/innate immunity cells are activated by recognizing them and secondary/adaptive immunity is activated consecutively. In our previous study, we revealed that there is a synergistic action between TLR9 and IFN-γ signaling in the endothelial cells. Purpose: To determine the role of negative and positive regulator proteins on the IFN-γ/TLR9 signaling pathway. Methods: In this study, murine endothelial cell (END-D) culture was used. END-D cells pre-treated with TLR9 ligand CpG DNA and then stimulated with IFN-γ. The negative (SHP-2, SOCS1, PIAS1) and positive (p38) regulator protein expression was detected by Western blotting. Results and Conclusion Treatment by TLR9 ligand CpG DNA and IFN-γ increased positive regulator p38 phosphorylation in 0.5 hour. CpG DNA inhibited IFN-γ negative regulator PIAS1 protein expression in 6 hour and SOCS1 and SHP-2 expression could not affect in 4 hour.

Introduction: Now days in case of two countries’ cooperation has been developing day by day, diversified activities such as collaboration and exchanging experience has been performing in health sector, medical science, besides pharmacology. Methods: This study aimed to compare two countries’ pharmacist’s acquirements and roles and provide information to Mongolian Pharmaceutical Universities and pharmacist students. Pharmaceutical: Statistics :
Population:
  - 3 million in Mongolia
  - 5 million in Korea
Number of pharmacists:
  - 1726 (by 2016) in Mongolia
  - 33182 (by 2016) in Korea
Number of Pharmaceutical Universities
  - 7 universities, including 1 public and 6 private in Mongolia
  - 34 universities, including 10 public and 25 private in Korea Results As a result of this study, pharmacist’s acquirements, role and working sectors of pharmacists in two countries are ordinarily same. There are some different sides below:
  • Period of pharmacist’s preparatory training is 5 years at university in Mongolia and 2+4 years in Korea.
  • Pharmaceutical Universities of Mongolia trains 2 specialists: pharmacist (bachelor`s degree) and pharmacist (diplom`s degree); College of Pharmacy of Korea trains pharmacist, pharmacist of traditional medicine and pharmaceutical engineering.
  • For a role of business, in Mongolia pharmacist (diplom`s degree) is a separate specialist trained with diploma, whereas in Korea, if pharmacist gets a license, they have a right to compound a medicine legally, but commonly in pharmaceutical industry.
  • As for sector, pharmacists are trained in many specializes, such as general pharmacist, clinical pharmacist, military pharmacist, nuclear pharmacist, cancer pharmacist and vet pharmacist.
  • Special legal professional pharmacists work in Korea, such as governmental organization’s pharmacist, civil service pharmacist and public organization’s pharmacist.
  • No person, other than pharmacists or oriental pharmacists may dispense drugs, and pharmacists or oriental pharmacists shall dispense drugs within the limit of the license, respectively: However, students who major in pharmacy at college may dispense drugs within the limits prescribed by Ordinance of the Ministry of Health and Welfare.

BACKGROUND: Toll like receptors (TLRs) are a class of proteins that key role in the innate immune system. TLR7 is expressed on monocytes, macrophages and dendritic cells, T cell, B cell and eosinophiles. TLR7, originally identified as recognizing imidaquinoline, loxibrine, broprimine and ssRNA, ssRNA viruses such as vesicular stomatitis virus, influenza A virus and human immunodefiency virus. It is known that virus ssRNA affects signaling molecule of IFN-y. Objective: To determine gene and protein activation of IFN-y signal transduction by TLR7 ligand in the endothelial cells. MATERIAL: In study we used mouse aortic linear endothelial cell which is cultured (END-D) in 5% heat- inactivated fetal calf serum (FCS), medium (DMEM) containing antibiotic mix(penicillin G, streptomycin, amphotericin B) at 37°C (5% CO2). Endothelial cells treated with synthetic IFN-γ and imiquimodligands, then the NO (nitric oxide) concentration in the supernatant is determined by Griess reagent. Endothelial cells are cultured in 6 well cell culture plate and in each well 2*104cells are expected to be grown for 24 hours of culture. Then, the cells are treated with synthetic IFN-γ and имиквимод ligand for 6 hours and the NO signaling gene activation iNOS mRNA expression which is induced by IFN-γ is determined by RT-qPCR. Endothelial cells are cultured in 12 well cell culture plate and in each well 2*104 cells are expected to be grown for 18 hours of culture. Then, the cells are treated with synthetic IFN-γ and imiquimodligands for 24 hours and the NO signaling protein iNOS expression which is induced by IFN-γ is determined by western blotting. The experiment was conducted as representation mean of at least three test results. The difference between statistical probabilities is determined by the “Students” t test. The p<0.01 value is assumed to be statistically different. RESULTS: TLR7 ligand imiquimodaugmented interferon gamma induced nitric oxide production TLR7 ligand imiquimodincreased interferon gamma induced iNOS mRNA gene expression. TLR7 ilgand imiquimodup-regulated interferon gamma induced iNOS protein expression. CONCLUSIONS: TLR7 ligand imiquimod augments IFN-γ signaling in the endothelial cells. This synergistic effect has revealed in the levels of gene and protein expression.

Introduction: The aim of this research project is to elucidate the crosstalk of innate and adaptive immune reactions against the DNA containing bacteria. : This study held in the Core laboratory, Science Technology Center, Mongolian National University of Medical Sciences (MNUMS). Murine aortal endothelial cells, END-D cultured and the cell viability checked by MTT assay. In addition, the NO production, protein and gene expression studied by Griess Reagent assay, R.T-PCR and immunoblotting, respectively. Results: 0.1µM, 1µM and 10µM of TLR9 ligand exhibited no cytotoxic action against the cells by MTT assay. IFN-ү alone induced NO production in END-D cells. In the other hand, TLR9 ligand at 0.1µM, 1µM and 10µM up-regulated IFN-ү induced NO production in dose dependent manner. RTPCR results exhibit that TLR9 ligand up regulates iNOS mRNA. Immunoblotting analysis showed the enhanced iNOS protein expression and phosphorylation of STAT1 in cells pre-treated with TLR9 ligand. Discussion: We have demonstrated CpG DNA, TLR9 ligand, up-regulates IFN-ү induced NO via enhanced IFN-ү signaling. The result of Western Blotting and RT-PCR support the up-regulation of NO. CpG DNA can be used as agent against virus and bacteria. Further research need to be conducted. Conclusion TLR9 ligand, CpG DNA up-regulates IFN-ү induced NO production in time and dose dependent manner. TLR9 ligand augments the expression of iNOS mRNA and STAT1 phosphorylation in response to IFN-ү.