Background: Leptopyrum fumarioides (L.) Reichenb a relatively widely distributed annual herbaceous plant belonging to the Ranunculaceae family, grows predominantly in the dry steppe regions of Mongolia. In recent years, the global use of traditional medicine and natural products has increased substantially. In this context, elemental studies of medicinal plants including macroelements, microelements, and heavy metals provide a fundamental scientific basis for evaluating their nutritional value, therapeutic efficacy, safety, and standardization. Therefore, the investigation of the elemental composition of Leptopyrum fumarioides (L.) Reichenb is of significant importance as a foundational study supporting its medicinal application. Aim: To investigate the chemical elements, present in Leptopyrum fumarioides (L.) Reichenb. Objectives: 1. To prepare plant samples and determine the contents of aluminum oxide, silicon dioxide, iron oxides, and calcium oxide in the plant material. 2. To identify and quantify the mineral elements present in the plant material. 3. To investigate the heavy metals in the plant material. Materials and Methods: Leptopyrum fumarioides (L.) Reichenb were collected from Altanbulag soum, Töv Province, Mongolia, during the flowering stage in June 2023. The collected plant materials were air dried in accordance with standard procedures and used for analysis. The quantitative contents of macroelements, microelements, and ultra-trace elements in the plant were determined using high precision X ray fluorescence (XRF) analysis. Result: In the raw plant material of Leptopyrum fumarioides (L.) Reichenb, the silicon dioxide (SiO₂) content was 15.99%, which increased to 33.69% in the extracted residue. Titanium dioxide (TiO₂) was present at 0.16% in the raw material and 0.379% in the plant residue. Aluminum oxide (Al₂O₃) was 3.54% in the raw material and 7.52% in the extracted residue. Iron oxide (Fe₂O₃) was 1.14% in the raw material and 2.51% in the residue. Other oxides, including calcium oxide (CaO), potassium oxide (K₂O), and phosphorus pentoxide (P₂O₅), remained in the extracts. The concentrations of trace elements in the plant were determined as follows: copper (Cu) 40.5 mg/kg, zinc (Zn) 211 mg/kg, chromium (Cr) 8.5 mg/kg, and nickel (Ni) 8 mg/kg. The levels of Zn (211 mg/kg) and Cu (40.5 mg/kg) were found to be relatively higher compared to those reported in other plant species. Conclusion 1. In the raw plant material of Leptopyrum fumarioides (L.) Reichenb, silicon dioxide (SiO₂) content was 15.99%, increasing to 33.69% in the extracted residue. Titanium dioxide (TiO₂) was 0.16% in the raw material and 0.379% in the residue. Aluminum oxide (Al₂O₃) was 3.54% in the raw material and 7.52% in the extracted residue. Iron oxide (Fe₂O₃) was 1.14% in the raw material and 2.51% in the residue. Other oxides, including calcium oxide (CaO), potassium oxide (K₂O), and phosphorus pentoxide (P₂O₅), were retained in the extracts. 2. The trace element analysis revealed the following concentrations: copper (Cu) 40.5 mg/kg, zinc (Zn) 211 mg/kg, chromium (Cr) 8.5 mg/kg, and nickel (Ni) 8 mg/kg. The levels of Zn (211 mg/kg) and Cu (40.5 mg/kg) were higher than those typically found in most plants; however, these concentrations are below the threshold considered toxic to plant physiology. Rubidium (Rb) at 49 mg/kg and zirconium (Zr) at 69 mg/kg were also relatively high compared to other elements. This may be related to the ability of Leptopyrum fumarioides (L.) Reichenb to accumulate certain elements when growing in moderately contaminated soils near cultivated fields. 3. Rare earth elements, such as cerium (Ce) and ytterbium (Yb), were found to be below the general concentration range and can be considered within normal limits. Furthermore, the plant contains numerous trace elements that participate in various enzymatic activities and contribute to the components of the blood coagulation system.

Background: Megaloblastic anemia is a hyperchromic macrocytic anemia caused by impaired DNA synthesis and delayed cell division, most commonly resulting from deficiencies of cobalamin and folic acid. Vitamin B12 is obtained from animal-derived foods such as meat, fish, eggs, and dairy products. In the stomach, it is released from dietary proteins by gastric acid and subsequently binds to an intrinsic factor, after which it is absorbed in the distal ileum. Therefore, vitamin B12 deficiency may occur following gastric or intestinal resection surgery. Another common cause of vitamin B12 deficiency is pernicious anemia, which results from autoimmune atrophic gastritis leading to decreased secretion of intrinsic factor. Vitamin B12 deficiency is most frequently observed in individuals over 60 years of age, and its clinical manifestations vary depending on the severity of deficiency. Patients with mild to moderate deficiency commonly present with fatigue, general symptoms of anemia, glossitis, and neurological disturbances. In cases of severe deficiency, profound hematological abnormalities, severe neurological manifestations, and cardiac involvement such as cardiomyopathy may be observed. In this report, we present a clinical case of a 46-year-old male who developed severe vitamin B12 deficiency anemia following total gastrectomy, complicated by anemia-induced mild hypokinesia of the anterior and inferior walls of the heart. Conclusion If vitamin B12 deficiency–related anemia is accurately diagnosed, appropriately treated, prevented, and monitored starting from the primary health care level, it can have a positive impact on patients’ quality of life. Given that this condition may present with diverse clinical manifestations, a multidisciplinary team approach involving specialists in hematology, neurology, psychiatry, gastroenterology, cardiology, and nutrition enables early identification and prevention of potential complications, thereby improving overall clinical outcomes.

Background: Sjögren’s syndrome is a chronic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, particularly the lacrimal and salivary glands, as a result of genetic and environmental factors, and it is mainly manifested by mucosal dryness. Sjögren’s syndrome is a rare disorder with a prevalence of approximately 6 cases per 1,000 population and shows a marked female predominance. It is most commonly diagnosed between the ages of 40 and 60 years. Anemia is observed in about 70% of patients diagnosed with Sjögren’s syndrome; however, autoimmune hemolytic anemia occurs in only approximately 3% of cases. In this report, we present a rare case of Sjögren’s syndrome that manifested with warm autoimmune hemolytic anemia. Conclusion In cases of autoimmune hemolytic anemia of unknown etiology, it is crucial to investigate the underlying causes leading to hemolysis in order to establish the differential diagnosis and to confirm or exclude the condition. Sjögren’s syndrome typically presents initially with sicca symptoms, with chronic anemia developing during the course of the disease and its treatment. In contrast, in our case, persistent manifestations of autoimmune hemolytic anemia over a prolonged period represented the initial clinical presentation that led to the diagnosis of Sjögren’s syndrome. Immunological markers play a key role in the diagnosis of this syndrome, as they are essential for early detection of Sjögren’s syndrome, timely diagnostic confirmation, monitoring of disease progression, and adjustment of therapeutic dosing.

Background: Branch atheromatous disease (BAD) is believed to be one subtype of ischemic stroke brought on by plaque accumulation that obstructs or stenoses the entrance of penetrating branches. Based on clinical status, risk factors, laboratory results, and radiographic features of infarct and blood vessel morphologies, BAD has been differentiated from large-vessel occlusion and small-vessel disease. BAD-induced stroke has been strongly associated with worse outcomes than lacunar strokes, including high rates of early neurological deterioration (END), recurrent transient ischemic attacks and strokes, and disability. Determining treatment options and each patient’s prognosis depends on early identification of BAD. Case Presentation: A 34-year-old male with a history of recurrent acute ischemic stroke within 7 months, caused by stenosis of the M1 segment of the right middle cerebral artery, was hospitalized twice at the Third Central Hospital of Mongolia. Intravenous Thrombolytic therapy (tPA) was administered during each admission. Conclusion Precise diagnosis of BAD is crucial for planning subsequent treatment and secondary prevention.

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.

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: The frequency of cerebral infarction and stenosis of intra- and extracranial arteries may be vary with age-group and gender. Objective: This study was conducted to clarify the risk factors and characteristics of cerebral infarction and stenosis of vessels in Mongolian young adults. Methods: This was a prospective study, from October 2015 to July 2020, of 100 patients below 50 years diagnosed with acute cerebral infarction. Patient characteristics were compared according to sex (61 males and 39 females) and age group (29 patients were below 34 years and 71 patients were 35–49 years). Characteristics of acute cerebral infarction were studied by DWI-diffusion weighted MRI imaging. Stenosis of intra- and extracranial arteries was diagnosed by duplex sonography, head and cervical magnetic resonance angiography (MRA). Results: Leading causes for cerebral infarction in the young patients were hypertension (71%), smoking (57%), dyslipidemia (45%), diabetes (33%), and migraine with aura (25%). Lacunar Infarction was most common in our patients (33%). Partial anterior circulation infarction was predominant in males (45.9% vs 38.5%; P<0.05) and posterior circulation infarction in females (23.1% vs 11.5 %; P<0.05). Small artery atherosclerosis was found in 33% cases, with higher prevalence in patients of the 35–49 years age-group. Intracranial stenosis was more common than extracranial stenosis, and middle cerebral artery stenosis was most prevalent (38.9%). Stenosis in the anterior circulation was more frequent than in the posterior circulation (P<0.001). Conclusions In these young patients, hypertension, smoking, dyslipidemia, diabetes, and migraine with aura were common risk factors. Intracranial stenosis was most common, particularly in the middle cerebral artery.

Introduction: Valproic acid (VPA) has been used in the treatment of seizures and bipolar disorders. In the present study, we examined how VPA affected PI3K-Akt pathway in response to LPS by using mouse RAW 264.7 macrophage cells. Material and methods: Mouse RAW 264.7 macrophage-like cells cultured and the cell viability checked by MTT and TUNEL assay. In addition, protein expression and protein interaction were detected by immune blotting and immune precipitation, respectively. TLR4 expression on cell surface studied by FACS analysis. Results: The MTT and TUNEL assays demonstrated no significant difference between VPA at 2 mM treated and untreated control cells. VPA attenuated LPS-induced phosphorylation of phosphatidylinositol 3-kinase (PI3K) and Akt, but not nuclear factor (NF)-κB and mitogen activated protein kinases (MAPKs). There was no significant difference in the TLR4 expression on the cell surface between cells treated with or without VPA. VPA inhibited LPS-induced PI3K/Akt signal transduction in a dose dependent manner. Conclusion VPA at 2mM exhibits nontoxic effect in the RAW 264.7 cells. VPA down regulates LPS-induced phosphorylation of Akt via inhibition of PI3K activation.

Introduction: When human body encounters external pathogens primary/innate immunity cells are activated by recognizing them and secondary/adaptive immunity is activated consecutively. Immune cell surface receptors, called Toll-like receptors (TLRs) recognize and bind pathogens. 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 regulatory proteins on the IFN-γ/TLR9 synergistic signaling pathway Materials and Methods: This study was held in the Core Laboratory, Science Technology Center, Mongolian National University of Medical Sciences (MNUMS). In this study, murine endothelial cell (END-D) culture was used. The negative and positive regulator protein expression was detected by Western blotting. Result: Result of immunoblotting assay indicated that CpG DNA enhanced IFN-γ positive regulator protein p38 phosphorylation in the endothelial cells. Treatment by TLR9 ligand CpG DNA and IFN-γ increased p38 activation in 0.5 hour and 1 hour. CpG DNA inhibited IFN-γ negative regulator SOCS1 protein expression in 4 hr and 8 hr. Therefore, TLR9 ligand CpG DNA increased IFN-γ signal transduction in the endothelial cell line. Conclusion TLR9 ligand CpG DNA has decreased IFN-γ negative regulator protein SOCS1 expression. CpG DNA has increased IFN-γ positive regulator protein p38 phosphorylation.

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