Background: Helicobacter pylori is a highly prevalent pathogen infecting more than half of the global population, with considerable geographic variation in its genetic characteristics and antibiotic resistance patterns. The EPIYA motifs of the CagA protein play a critical role in bacterial virulence; however, data on the association between CagA genotypes and antibiotic resistance remain limited in Mongolia. Aim: To determine the antibiotic resistance, CagA EPIYA patterns, and clarithromycin resistance-associated mutations of H. pylori strains in Mongolia, and to evaluate the agreement between phenotypic and molecular diagnostic methods. Materials and Methods: Gastric biopsy specimens were collected from 210 patients undergoing endoscopy and cultured for H. pylori. Antibiotic susceptibility to metronidazole, clarithromycin, amoxicillin, levofloxacin, and tetracycline was determined using the E-Test method according to EUCAST guidelines. CagA EPIYA patterns were analyzed, and clarithromycin resistance-associated mutations (A2142C, A2142G, A2143G) were detected using real-time PCR. Result: H. pylori was successfully cultured in 86 of 210 samples (41%), and 61 isolates were included in the final analysis. CagA-positive strains accounted for 86.9%, with a predominance of Western-type CagA (52/53), while only one East Asian-type strain was identified. Among Western-type strains, the ABC (58.5%) and ABCC (37.7%) patterns were most common. The highest resistance rate was observed for metronidazole (70.5%), followed by levofloxacin (50.9%). Clarithromycin and amoxicillin resistance were both 19.7%, whereas no resistance to tetracycline was detected. Multidrug resistance (≥2 antibiotics) was observed in 45.9% of isolates, and 14.8% showed resistance to ≥3 antibiotics. Clarithromycin resistance-associated mutations were detected in 21.3% of isolates, predominantly A2143G. The agreement between E-test and real-time PCR methods was excellent (κ=0.95, p<0.001). Conclusion H. pylori strains in Mongolia are characterized by a predominance of Western-type CagA, with ABC and ABCC as the most common subtypes. Notably, the AAABC and AAAAB subtypes were identified for the first time. High levels of antibiotic resistance, particularly to metronidazole and levofloxacin, as well as a substantial prevalence of multidrug resistance, highlight the need for region-specific treatment strategies. In Mongolia, H. pylori demonstrated the highest resistance to metronidazole, accompanied by a high proportion of multidrug-resistant isolates.

Introduction: Health care workers of First Central Hospital of Mongolia have vaccinated with three different vaccines against SARS-CoV-2. We detected SARS-CoV-2 N and S-RBD antibodies after 30-90 days of second dose of vaccination. Method: Quantitation of antibodies to the spike protein of SARS-CoV-2 was performed for the detection of adaptive immune response in 291 HCWs vaccinated with Covishield, Sinopharm and Pfizer Biontech. Detection and quantitation of SARS-CoV-2 N and S antibodies were performed by the electrochemiluminesce assay Cobas e411, Roche. Result: SARS-CoV-2-S-RBD IgG titer were negative 0%, weak positive 0.4%, positive 17.5%, strong positive 82.1% of 246 HCWs vaccinated with Covishield and were negative 2.8%, weak positive 8.5%, positive 57.1%, strong positive 31.4% of 35 HCWs vaccinated with Sinopharm.
In all HCWs vaccinated with Pfizer Biontech SARS-CoV-2-S-RBD IgG titers were strong positive. Conclusion Humoral immunity was produced in HCWs after two doses of Covishield vaccine 100%, Sinopharm 97.0%, Pfizer Biontech 100% respectively. Antibody titer was higher among younger age workers.

Introduction: Base excision repair (BER) is mainly responsible for the correction of small base changes of DNA damage. BER pathway involved many enzymes including OGG1 and XRCC1. The defective DNA repair is associated with an increased risk of various cancers including hematologic malignancies-leukemia and myelodysplastic syndrome (MDS). However, it is deniably these polymorphisms alter the susceptibility and clinical outcome of MDS patients. The aim: This study was to evaluate the impact of polymorphisms in gene encoding one protein of BER system: XRCC1 Arg399Gln in MDS and healthy population. Methods: In this study, we recruited 60 health control group [median 47.9 years, 9 MDS subjects [median 56.6 years] were included in this study. Genotyping was carried out by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Allele and genotype frequencies were calculated by direct counting. Result: The frequencies of genotypes of XRCC1 Arg399Gln were as follows: Arg /Arg 1 (11%), Arg/Gln 6 (66%), Gln/Gln 2 (22%) in MDS and Arg /Arg 18.4%, Arg/Gln40%, Gln/Gln41.6% in health control for XRCC1 Arg399Gln. The result revealed that genotypes Arg399Gln increased the risk of MDS In conclusion this study is the first to analyze XRCC1 SNPs and their associated risk of MDS in Mongolian samples. To fully understand the role of DNA damage and DNA repair in the MDS, prospective studies are needed and other genes (OGG1 Ser326Cys, MUTYH Gln324His, APE Asp148Glu) of base excision repair pathway should be analyzed.

Introduction: Hepatocellular carcinoma(HCC) is the 6th most common cancer inthe world, but the first most commoncause of cancer death in Mongolia. Thereis no universally accepted consensuspractice guidelines for HCC owing to rapiddevelopments in new treatment modalities,the heterogeneous epidemiology and clinicalpresentation of HCC worldwide.Methods and Materials: This study wasconducted in the department of generalsurgery of Second Central Hospital ofMongolia between 2015 and 2016 on a totalof 36 patients with hepatocellular carcinoma.Results: The average of operationtime is a 132.2 min, the hospital stay 18.2days. Postoperative bleeding was 2.7% (1),encephalopathy 5.4% (2), wound infection5.4% (2), and incisional hernia 8.1% (3).There were not bile leak during 30 dayspostoperative day.Conclusion: Postoperative complicationis a comparable to different researcher.There were no death within first month.

Background:However kidney transplantation has being performed in Mongolia since 2006, because of pre-transplant ensitization, ABO incompatibility, hepatitis B and C virus activation many patients are taken kidney transplantation in abroad. The transplantation centers use own immunosuppressive regimens.Objective:Our aim was to assess the immunosuppressive regimens efficacy and toxicity in kidney transplant Mongolian recipients.Material and Methods:We analyzed data from 96 adult kidney transplant recipients who had taken kidney transplantation in different transplant centers from August 2006 through January 2014. There were 3 kinds of regimens Group I Simulect induction with standard triple /FK506/CyA+MMF/AZA+steroid/, Group II Campath-1H induction with CNI monotherapy and Group III Campath-1H induction with standard triple /FK506/CyA+MMF/AZA+steroid/. We retrospectively collected the post-transplant first two year serum creatinine. The study was performed in 2014. The questionnaire was taken and blood samples collected for determination of tacrolimus through level and for other laboratory tests. The primary end point was the first two years serum creatinine, the secondary end points included rejection episodes, blood through level of tacrolimus and some laboratory findings.Results:The post-transplant first two years serum creatinine levels were significantly different in 3 groups. Group III showed similar results compared to Group I. There was not enough data of biopsy proven acute rejection episodes however group II said more rejections occurred. However participants said that rejection occurred in 15 (15.6%) biopsy was done only 3 (3.1%) cases. Blood through level of tacrolimus was significantly different in three groups. Some laboratory findings showed different between three groups.Conclusion:A regimen of Campath-1H induction with CNI monotherapy (Group II) may be advantageous for short-term renal function and cost effective but there were more rejection complications and increased creatinine. The regimen of Campath-1H induction with standard triple (Group III) may be advantageous for long-term renal function, allograft survival, but there should consider about infection complications and polycythemia. Simulect induction with standard triple could be best choice but transplantations were performed in experienced centers. The study enrolled few cases and cases which were performed at the beginning of transplant program so many things could influence on the result. The study was compared beginner transplant center with experienced centers. Longitudinal cohort study needed in the future.