Background: Respiratory and gastrointestinal infectious diseases are the leading causes of morbidity in children. Numerous international studies have demonstrated that handwashing with soap is one of the most effective and cost-efficient methods for preventing these diseases in children. A previous study conducted in Ulaanbaatar found that only 50.1% of general education school students practiced proper handwashing, which is considered insufficient even in areas with relatively adequate facilities. In Mongolia, 56.1% of the 865 schools lack handwashing facilities and soap, and 25% do not meet the WASH standards. Although knowledge about handwashing increased during the COVID-19 pandemic, sustained behavioral change remained limited, highlighting a gap between knowledge and practice and indicating the need for targeted educational interventions. Furthermore, there is limited research comparing the effectiveness of such interventions across different school environments and urban–rural settings, which provides the rationale for this study. Aim: To evaluate the effectiveness of a handwashing educational intervention among primary school students and determine differences in knowledge change across four schools in urban and rural areas. Materials and Methods: A quasi-experimental study design was used from December 2024 to June 2025. A total of 1,353 students from grades 3–5 in four general education schools (two in Ulaanbaatar and two in rural areas) were included in the study. Preand post-intervention handwashing knowledge scores were analyzed using paired t-tests and one-way ANOVA (α=0.05) with STATA 14.0. Ethical approval was obtained from the Ethics Committee of the Mongolian National University of Medical Sciences. Result: The mean handwashing knowledge score increased significantly from 9.68 (±2.64) before the intervention to 10.30 (±2.74) after the intervention, with a mean difference of +0.63 (p<0.001). The differences in improvement between schools were also statistically significant (ANOVA: F(3,1335)=5.90, p=0.0005). The highest improvement was observed in urban School A (+1.49), while the lowest was observed in School B (+0.16). Rural schools C and D showed moderate and relatively consistent improvements (+0.51 and +0.70, respectively). Conclusion School-based handwashing educational interventions effectively improve knowledge among primary school students. However, environmental factors, such as infrastructure and geographic location, significantly influence the effectiveness of the intervention. Therefore, educational interventions should be implemented alongside infrastructure improvements.

Background: School health services play a critical role in protecting and promoting students’ health, thereby contributing to improved academic performance. School nurses provide a wide range of services, including preventive care, health education, and management of chronic conditions among students. Aim: This review aimed to synthesize existing evidence on the effectiveness of school-based nursing interventions based on published research. Materials and Methods: A literature review was conducted using international databases, including PubMed, Scopus, and Web of Science. Relevant studies on school-based nursing interventions were systematically analyzed. The findings indicate that school nursing interventions positively impact the management of chronic diseases, promotion of mental health, and development of healthy behaviors among students. Additionally, reductions in school absenteeism and emergency incidents were consistently reported. Results: The reviewed studies demonstrated that school-based nursing interventions significantly improve students’ health outcomes. These include better chronic disease control, enhanced mental well-being, and increased adoption of healthy lifestyles. Furthermore, students receiving such interventions showed decreased absenteeism and fewer emergency health events at school. Conclusion School-based nursing interventions have a positive impact on students’ health and well-being. Strengthening school nursing services and enhancing collaboration between the education and health sectors are essential to promote the health of children and adolescents and to ensure a healthier future generation.

Background: Health literacy is a multidimensional concept encompassing the knowledge, attitudes, and skills required for individuals to obtain, understand, appraise, and apply health-related information. It is essential for accessing quality healthcare services and making informed health decisions in daily life. Aim: This study aimed to evaluate the level of health literacy among the adult population of Mongolia. Materials and Methods: A cross-sectional quantitative study was conducted involving 1,500 Mongolian adults. Data was collected using the Health Literacy Survey European Questionnaire (HLS-EU-Q47), which evaluates four core competencies: accessing, understanding, appraising, and applying health information. Responses were measured on a 4-point Likert scale ranging from 1 (very difficult) to 4 (very easy). Health literacy levels were categorized based on standardized scores: inadequate (0–25), limited (25–33), sufficient (33–42), and excellent (42–50). Results: The mean age of the participants was 34.79±15.04 years, with 42.1% being male and 57.9% female. Socioeconomic data showed that 52.1% were married, 37.7% were single, 43.2% had completed secondary education, and 40.5% held a university degree. Lifestyle assessments revealed that 16.4% were daily smokers, 7.0% consumed alcohol daily, and only 12.5% engaged in regular physical exercise. Regarding education, 50.7% of participants with higher education demonstrated “sufficient or excellent” health literacy, whereas only 27.1% of those with secondary education reached this level. The 18–30 age group exhibited the highest capacity to receive health information (44.0%), with a significant decline in health literacy levels observed as age increased (p=0.014). Conclusion Although the overall health literacy level among the adult population of Mongolia is generally sufficient, the capacity to access health information remains limited.

OBJECTIVE To evaluate the quality of Zhachong-13 pills.METHODS The contents of agarotetrol， costunolide， hypaconitine， dehydrocostus lactone， mesaconitine， aconitine， liquiritigenin， glycyrrhizic acid， ellagic acid， liquiritin， corilagin， and gallic acid in 18 batches of samples were determined by high-performance liquid chromatography-tandem triple quadrupole mass spectrometry （HPLC-MS/MS） method. Cluster analysis （CA） was performed using the Microbioinformatics online analysis platform. Principal component analysis （PCA） and orthogonal partial least squares discriminant analysis （OPLS-DA） were performed using SIMCA 14.1 software. Random forest， extremely randomized trees， and extreme gradient boosting machine learning models were constructed using the SPSSAU online analysis platform. The comprehensive quality of the samples was evaluated by the entropy weight-technique for order preference by similarity to ideal solution （TOPSIS） method.RESULTS The contents of the above 12 components were 104.331-694.382， 652.217-1 085.075， 6.051-130.980， 612.174-1 417.179， 1.018-32.239， 0.953-24.967， 65.552-652.239， 2 019.412-5 385.807， 52.867-4 990.450， 156.307-883.180， 10.142-475.722， and 1 102.863-4 826.396 μg/g， respectively. The results of CA and PCA showed that the 18 batches of samples were divided into two categories： S1-S6， S10-S15 were grouped into one category， while S7-S9 and S16-S18 were grouped into another category. The OPLS-DA results showed that the variable importance in projection values of mesaconitine， glycyrrhizic acid， liquiritin， ellagic acid， hypaconitine， liquiritigenin， agarotetrol， gallic acid， and dehydrocostus lactone were greater than 1. The results of the three machine learning models showed that ellagic acid and hypaconitine had relatively large differential contributions. The entropy weight-TOPSIS results showed that the overall quality of samples from manufacturer B was superior to that of the other four manufacturers.CONCLUSIONS The established method is stable and feasible， and can be used to evaluate the quality of Zhachong-13 pills， in combination with multivariate statistical analysis. Ellagic acid and hypaconitine are differential markers that affect its quality.

OBJECTIVE To establish a content determination method for multiple components in Sophora flavescens from different origins and to evaluate its quality by combining with chemometrics. METHODS Thirteen batches （No. K1-K13） of S. flavescens from different origins were selected as test samples. A high-performance liquid chromatography-tandem triple quadrupole mass spectrometry （HPLC-MS/MS） method was established to determine the contents of 12 components， including matrine， oxymatrine， betaine， cytisine， N-methylcytisine， sophoridine， genistein， sophoricoside， sophorone， formononetin， sophorolone Ⅰ and norkurarinone in S. flavescens. Chromatographic separation was performed on a Shim-pack GIST-HP C18 column with a mobile phase consisting of methanol （A） and water containing 0.1% formic acid （B）， using gradient elution at a flow rate of 0.25 mL/min， column temperature of 35 ℃， and an injection volume of 3 μL. Mass spectrometry was conducted using an electrospray ionization source with positive and negative ion scanning. Data were collected in segments using the multiple reaction monitoring mode. Technique for order preference by similarity to ideal solution （TOPSIS） and grey relational analysis （GRA）methods were employed to compare and comprehensively evaluate the 13 batches of S. flavescens from different origins. RESULTS The methodological validation for the content determination met the relevant regulatory requirements. The contents of the 12 components were 490.66-1 231.00， 11 088.10- 18 021.50， 7.91-25.38， 903.97-1 713.64， 336.08-1 485.54，1 065.33-2 075.50， 27.52-71.80， 109.36-517.83， 6 034.55-10 632.73， 21.26-145.35， 814.84-1 911.32， 1 040.87-3 446.37 μg/g）， respectively. TOPSIS results showed that the top 7 samples in Euclidean distance ranking were K6， K12， K11， K3， K5， K10， K13. The GRA results showed that the top 7 samples in the relative correlation ranking were K12， K11， K10， K6， K13， K5， K3. CONCLUSIONS The established HPLC-MS/MS method is rapid， accurate， highly sensitive， stable and reliable. Combined with chemometrics methods， it can be used for the quality control and evaluation of S. flavescens. The comprehensive quality of samples K3， K5， K6（ from Hebei）， K10（ from Sichuan）， K11-K13（ from Shanxi）， etc. is relatively superior.

Aim To explore the potential mechanism of metformin on ATP-binding cassette transport A1(ABCA1)expression.Methods J774A.1 macrophages were treated with metformin and cycloheximide,and ABCA1 expression was determined by Western blot.His-tagged ABCA1 and HA-tagged Ub plasmids were co-transferred into HEK293 cells and stimulated with metformin.Co-immunoprecipitation(Co-IP)was used to test the binding ability of ABCA1 and ubiquitin.Candidate E3 ubiquitin-protein ligases(CE3)of ABCA1 were identified through Co-IP-based pro-teomics.The MIB1 plasmid was constructed and transferred into HEK293 cells,and Western blot was used to determine the effect of metformin and MIB1 on ABCA1 expression.Results Metformin increased the expression of ABCA1 in J774A.1 cells(P<0.01),and inhibited ABCA1 degradation(P<0.05).Metformin disrupted the binding of ABCA1 to ubiquitin(P<0.05).The proteins regulated by metformin in ABCA1 expression were primarily enriched in pathways re-lated to cell development,inflammation and immune defense.Metformin may upregulate ABCA1 protein expression via MIB1(P<0.05).Conclusion Metformin inhibits the degradation of ABCA1 by blocking the ubiquitin-proteasome system(UPS),and MIB1 might act as a candidate E3 ubiquitin-protein ligase(CE3)for ABCA1.

Objective To explore the effect and potential mechanism of total lignans of syringae ramuls(TLS)against liver cancer u-sing in vitro cellular assays,network pharmacological and molecular docking.Methods Flow cytometry was performed to detect the effect of TLS on apoptosis and cycle of HepG2 cells.TL components were collected by literature search;drug-like properties and synthetic scores of components were assessed by ADMETlab;toxicological parameters of components were predicted by ProTox-Ⅱ;TLS component targets were predicted by Swiss Target Prediction website;GeneCards,OMIM,DisGeNET,and PharmGKB databases were used to screen the related targets of liver cancer;The"component-disease-target"network diagram was constructed by Cytoscape software and the"protein-protein interaction"(PPI)network diagram was constructed by STRING platform;and DAVID database was used to analyse GO,KEGG and WIKI metabolic pathways.Results TLS at 50-200μg/ml could significantly inhibit the proliferation of HepG2 cells,induce apoptosis and block the cell cycle.The main components of TLS in anti-liver cancer were 31 active components,such as(-)matairesinol,(-)-secoisolariciresinol,and pinnatifolin A,which mainly acted on 82 key targets such as Akt1,Bel-2 and EGFR,which were mainly enriched in the cancer pathway,EGFR tyrosine kinase inhibitor resistance,cycle and apoptosis signaling pathways.Conclusion TLS may play an anti-liver cancer effect through multi-components,multi-targets,and multi-pathway.

Aim To explore the potential mechanism of metformin on ATP-binding cassette transport A1(ABCA1)expression.Methods J774A.1 macrophages were treated with metformin and cycloheximide,and ABCA1 expression was determined by Western blot.His-tagged ABCA1 and HA-tagged Ub plasmids were co-transferred into HEK293 cells and stimulated with metformin.Co-immunoprecipitation(Co-IP)was used to test the binding ability of ABCA1 and ubiquitin.Candidate E3 ubiquitin-protein ligases(CE3)of ABCA1 were identified through Co-IP-based pro-teomics.The MIB1 plasmid was constructed and transferred into HEK293 cells,and Western blot was used to determine the effect of metformin and MIB1 on ABCA1 expression.Results Metformin increased the expression of ABCA1 in J774A.1 cells(P<0.01),and inhibited ABCA1 degradation(P<0.05).Metformin disrupted the binding of ABCA1 to ubiquitin(P<0.05).The proteins regulated by metformin in ABCA1 expression were primarily enriched in pathways re-lated to cell development,inflammation and immune defense.Metformin may upregulate ABCA1 protein expression via MIB1(P<0.05).Conclusion Metformin inhibits the degradation of ABCA1 by blocking the ubiquitin-proteasome system(UPS),and MIB1 might act as a candidate E3 ubiquitin-protein ligase(CE3)for ABCA1.

Objective To explore the effect and potential mechanism of total lignans of syringae ramuls(TLS)against liver cancer u-sing in vitro cellular assays,network pharmacological and molecular docking.Methods Flow cytometry was performed to detect the effect of TLS on apoptosis and cycle of HepG2 cells.TL components were collected by literature search;drug-like properties and synthetic scores of components were assessed by ADMETlab;toxicological parameters of components were predicted by ProTox-Ⅱ;TLS component targets were predicted by Swiss Target Prediction website;GeneCards,OMIM,DisGeNET,and PharmGKB databases were used to screen the related targets of liver cancer;The"component-disease-target"network diagram was constructed by Cytoscape software and the"protein-protein interaction"(PPI)network diagram was constructed by STRING platform;and DAVID database was used to analyse GO,KEGG and WIKI metabolic pathways.Results TLS at 50-200μg/ml could significantly inhibit the proliferation of HepG2 cells,induce apoptosis and block the cell cycle.The main components of TLS in anti-liver cancer were 31 active components,such as(-)matairesinol,(-)-secoisolariciresinol,and pinnatifolin A,which mainly acted on 82 key targets such as Akt1,Bel-2 and EGFR,which were mainly enriched in the cancer pathway,EGFR tyrosine kinase inhibitor resistance,cycle and apoptosis signaling pathways.Conclusion TLS may play an anti-liver cancer effect through multi-components,multi-targets,and multi-pathway.