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Introduction@#Determining stages of liver fibrosis in chronic liver disease is essential for clinical practice such as decision making on medical treatment, setting the interval of follow-up examination for its complication, screening intervals for hepatocellular carcinoma. @*Goal@#We compared non-invasive fibrosis markers among the patients with chronic hepatitis Delta. @*Materials and Methods@#Totally 70 patients with chronic hepatitis D enrolled into this study. The blood samples were examined for complete blood count, liver function test and serum M2BPGi level. Non-invasive markers such as AAR, APRI, Fib-4 scores were calculated. Those with AAR >1, APRI >0.7, FIB-4 >1.45 were considered with advanced fibrosis. All patients underwent liver stiffness measurement using FibroScan M2 probe. The cutoff values of FibroScan for advanced fibrosis were 9 kPa for patient with normal transaminase level and 11 kPa for patients with elevated transaminase. @*Results@#Advanced fibrosis was observed in 25.7%, 38.6% and 38.6% by AAR, APRI and Fib-4 score, respectively. When cut-off levels of serum M2BPGi for advanced fibrosis was 2.2 COI, 35.7% had advanced fibrosis. FibroScan tests showed 34.4% had advanced fibrosis. The AUROC of M2BPGi were 0.894 and 0.827 for predicting advanced fibrosis and liver cirrhosis. @*Conclusion@#Serum M2BPGi and FibroScan would be reliable diagnostic tool for identifying liver fibrosis in Mongolian patients with chronic hepatitis D.
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Background@#The intestinal microbiota of Mongolians and its composition is of great interest of researchers, a few studies have did in this fields. Maybe Mongolian encompass a uniquely wide range of environmental conditions, ethno geographical cohorts and traditional nomadic lifestyles.@*Goal@#We aimed to determine the amount of gut microbiota, including Lactobacillus and Bifidobacterium in the fecal samples of relative healthy Mongolian adults residing in various regions of Mongolia by conventional culture method and PCR. @*Material and Methods@#The study was performed population based cross sectional study in healthy volunteers. In this study, 256 relative healthy Mongolian adults with no history of gastrointestinal associated diseases were enrolled between July 2018 and April 2019. Each participants was asked to complete a questionnaire containing 164 questions about demographics, physical activity, dietary habits. Fecal samples were collected for Lactobacillus and Bifidobacterium analysis using culture method and determination of genus of Bifidobacterium sрp and Lactobacillus spp by PCR. ResultsParticipants had a mean age of 38.9±12.8 years. The mean values of Lactobacillus by culture method were 5.9±1.28 and 6.24±0.94 log10 CFU/ml (4.67х106 , 4.66х106 CFU/ml), respectively. The abundance of Lactobacillus had a positive correlation with grams for fiber and amount of bifidobacterium ((r= 0.495, р<0.001, r=0.288, p<0.05), respectively). Significant difference were observed between groups of milk frequency per day for amounts of lactobacillus. In adult intestinal tracts, B.Bifidum was the most common taxon 31 (29%) followed by B. angulatum 14 (13.1%), B. adolescentis 10 (9.3%), B. catenulatum group 10 (9.3%), B. longum 9 (8.4%). B. lactis, B. breve, B. dentium and B. gallicum were subdominant species. @*Conclusion: @#The mean amount of Bifidobacterium and Lactobacillus of all participants were 6.24±0.94 and 5.9±1.28 log10 CFU/ml (4.66*106 , 4.67*106 CFU/ml) respectively. The Lactobacillus abundance of healthy adults was higher in region of Khangai, East and West of Mongolian than other regions. The composition of lactobacillus altered with ageing. Significant correlations were found between fiber, fats, potato and amount of Lactobacillus. Keywords: Bifidobacterium, Colony forming unit, Gut microbiota, Lactobacillus
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@#BACKGROUND Helicobacter pylori (H.pylori), the main cause of gastric and duodenal ulcer, is considered as a type 1 carcinogen. The primary prevention of gastric cancer is eradicating chronic H.pylori infection. However, the antimicrobial eradication rates are decreasing as low as 80% in some countries, less than 70% in Europe and are inversely correlated with antibiotic resistance rates reported worldwide. The current international guidelines recommended several regimens with higher success rate including sequential, combined, bismuth-containing and resistance-guided treatment and states that the local susceptibility testing in H.pylori should be studied. The research data that is covering correlation between H.pylori associated gastric changes and precancerous diseases, evaluation of H.pylori eradication rate are sparse in Mongolia. METHODS Totally, 495 eligible candidates were enrolled into this study. 225 patients who visited to endoscopy unit, received gastroscopy with multiple biopsies for rapid urease test, histology and H.pylori culturing. Out of these, 131 (52.2%) patients were positive for H.pylori infection. These were further tested for antibiotic resistance. 76 patients were treated with targeted therapy based on antibiotic resistance testing. Another 270 eligible patients with confirmed H.pylori associated gastritis were randomized into the following 1st line therapy regimen groups clarithromycin-based triple therapy (CBTT, n=90); bismuth-based quadruple therapy (BBQT, n=90) and sequential therapy (ST, n=90). In 43 patients that were not responded to 1st line therapy, levofloxacin-based triple therapy (LBTT) was prescribed as a second line treatment. Eradication rates were assessed using H.pylori stool antigen test 28 days of therapy just subsequent to termination of treatment. RESULTS During the gastroscopy, presence of active gastritis, nodular change and atrophy were 32.9%, 12% and 52.9% respectively. Epigastric pain was reported in 73.3%, 62.2%, 60-80% and 41.3% of patients with normal mucosa, nodular change, stomach and duodenal ulcer and antral atrophy (p<0.05). Abdominal fullness was more common among patients with extensive gastric atrophy (69.2%, p<0.05). In <40 age group gastritis was predominantly in the prepylori, while in the >50 age group it was predominantly the corpus region. H.pylori resistance rates to amoxicillin, clarithromycin, metronidazole and more than 2 antibiotics were 8.4%, 37.4%, 74% and 30.5%. On ITT analysis, eradication rates of 1st line H.pylori targeted treatment, CBTT, BBQT and ST were 92.1%, 71.1%, 87.8% and 67.8% (p<0.0001); on PP analysis, that were 94.6%, 72.7%, 89.8% and 68.5% (p<0.0001) respectively. Eradication rates of 2nd line treatment LBTT were 55.8% and 60% by ITT and PP analysis. Higher side-effects were reported during the second line treatment. CONCLUSION H.pylori infection rate was high among the dyspeptic patients resulting chronic gastritis and atrophic change. H.pylori resistance rate to metronidazole and clarithromycin was high. Among 1st line therapies; the eradication rates of CBTT and ST were poor, while BBQT and Targeted therapy had a higher success rate. 2nd line therapy showed higher failure rate.
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@#BACKGROUND. The 84.4 percent of newly diagnosed patients with diabetes have obesity in Mongolia. Nowadays, prevalence of obesity has increased steadily in Mongolia. Diabetic patients with viral hepatitis has high risk of having liver cirrhosis. Therefore, screening of fatty liver and liver fibrosis in diabetic patients is more important. The main diagnosing method of fatty liver and liver fibrosis is liver biopsy and histology but so far, we are able to detect viral infection using viral marker and determine fibrosis stage of NAFLD in patients who has diabetes mellitus type 2. Using noninvasive method determining liver fibrosis involve many researches to reveal new biomarkers and technics to find out liver fibrosis. Japanese researchers has found The Wisteria floribunda agglutinin- positive human Mac-2-binding protein (WFA+-M2BP) was recently shown to be a liver fibrosis glycobiomarker with a unique fibrosis-related glycoalteration.This biomarker helps to determine liver fibrosis stage in fatty liver disease and viral hepatitis. There is no research to reveal viral infection, fatty liver and liver fibrosis in diabetic patients in Mongolia, so far. So it is necessary to study revealing viral infection, fatty liver disease and to determine stages of fibrosis using WFA+-M2BP to screen liver fibrosis in diabetic patients. OBJECTIVE. To identify viral infection, HCV/HBV in patients with diabetes and to compare liver function and diabetes control for diabetic patients with liver disease. METHODS. We collect data from 25thNovember, 2015 to October of 2016. We got permission of research from the patients by handwriting signature who diagnosed Diabetes mellitus in National University Hospital. Haemotology, biochemistry test, coagulogramm, immunology test are evaluated in 415 patients in clinical laboratory of National university hospital. By the objective, the diabetes patients with viral hepatitis will attend to second step of research. We used HISCL 5000 apparatus of Sysmex Japan to do immunology tests. Also we use SPSS 19.0 and EXCEL program. RESULT. There were 294 patients and by WHO classification of ages 20-29 aged patient (n=4), 30-39 aged(n=19), 40-49 aged(n=65), 50-59 aged(n=126), 60-70 aged(n=48), over 70 aged(n=14)or 53.24±9.43. 146 patients are male,148 patients are female.By BMI 29.9±1.14.By blood test, thrombocytes counted 256.6±11.7;in coagulogramm the prothrombin time was 111.7±31.4; in biochemistry test total bilirubin 16.46±10.6; AP 364.7±192.3;AST 35.7±45.7; ALT 42.8±45.5; GGT 86.53±123.4;albumin 42.06±23.95;total cholesterol 6.04±2.47;triglyceride 5.72±34.5;HbA1c 8.83±5.92; in immunology testsanti-HCV 29.37±18.87 (n=58); HBsAg 590.134±1013.7 (n=23); M2BP (COI) counted 2.24±2.19. CONCLUSION. There were 58 diabetic patients with C viral infection and 23 diabetic patients with B viral infection. By WFA+-M2BP glycobiomarker, we found that diabetic patients with viral hepatitis has more liver fibrosis.
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Background:The evidence that some strains of Lactobacillus and Bifidobacteriumare able to inhibit H.pylori growth through the release of bacteriocinsor organic acids. Therefore, it is important to in vitro study develop low-cost, large-scale, alternative probiotic to the at-risk population to prevent or decrease H. pyloricolonization.Methods:18 samples of gastric biopsies were cultured according to standard microbiological proceduresand were grown under microaerophilic conditions on selective Pylori agar. An in vitro disk diffusion assay was employed to assess the lactic acid bacteria LBO1, 2, 3, 4, 6, 7 cells and cell free supernatants (CFS) and bifidobacteria BFO1, BFO4 anti-H.pylori activity.Results: Ability of LBO1 strain to inhibit growth of H.pylori is 55,5% [95% CI 32.5-78.4], LBO-2 88,8% [95% CI 74.2-103.3], LBO-3 50%[95% CI 26.9-73.0]and LBO-4 38,8% [95% CI 32.5-78.4]. Then LBO 6 and LBO7 strains had no inhibitory activity against H.pylori. Average inhibition zone is 8-14mm (11,6 mm) for LBO1 strain, 10-16mm (11.3mm) for LBO2 strain , 8-12mm (10,2mm) for LBO3 strain and 10-12mm (10,5mm) for LBO4 strain.Inhibitioryactivity of Lactobacillus LBO1 supernatant against H.pylori accounts for 61.1% (n=11), LBO2 supernatant for 72,2% (n=13), and LBO3 supernatant for 33,3% (n=6) , while LBO4 supernatant inhibits only HP78 strain. LBO6 and LBO7 supernatants were both Lactobacillus LBO cultures. Average inhibition zone is 8-12mm (10 mm) for LBO1 supernatant, 10-16mm (11.3mm) for LBO2 supernatant , and 10-12mm (10,3 mm) for LBO3 supernatant.Bifidobacterium BFO1 strain was 83.3% inhibition activity. But BFO4 was not inhibit against all H.pylori strains.Conclusion:Lactobacillus LBO2 and Bifidobacterium BFO1 strains were isolatedfrom Mongoliantraditional fermented milk product were obtained more inhibition against H.pylori strains other LactobacillusLBO and Bifidobacterium BFO strains.
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BACKGROUND The aim of the study is to detect and define the role of H. pylori virulence factors and host IL-1 polymorphisms to prevent from further gastric cancer. mwom 5ml of blood samples were collected from each of 42 patients who had abdominal complaint, after informed consent was obtained. All patients were Mongolian nationality. The biopsy specimens were stored in liquid nitrogen and homogenized before DNA isolation. After tissue lysation with proteinase K. DNA isolation was performed with "Promege" tissue kit. according to the manufacturer's instructions. PCR amplification of H. pylori gene loci was performed for the cagA gene and the vacAs mosaics vac As 1 and vacAs2. RESULTS Result of histological findings shows 84.7% from all patients were diagnosed with II. pylori infection 83% (35/42). Histologically LI'G 50% (42/21). Gastric atrophy 30% (42/13). Intestinal metaplasia 9% (42/4). Gastroduodcnal ulcer 4% (42/2), Dys¬plasia 11% (42/5), Adinocarcinoma 2% (42/1), 3 patients (42/3, 7%) were none patho¬logic change. 62% (26/42) patients infected with H. pylori, as determined by Urease test. H. pylori were investigated in all 42 patients and 83% (35/42) were infected with II. pylori, as determined by histology (haematoxylin- eosin and (iiemsa-stained). Strain characteristics of H. pylori were investigated in all 42 patients and 83% (35/42) were infected with //. pylori, as determined by UreC PCR. Result of histological findings revealed Bacilla form 48,5% (17/35), Coccoid form 28,5% (12/35), mixed form 14% (5/35) from all patients were found //. pylori. 76% (13/17) of all patients were revealed coccoid form of H. pylori were taken anti-//. pylori treatment. The vacAs 1 genotype was found in 38% (16/42) of all UreC+ patients, and cagA was found in 23% (10/42) of UreC+ patients. 16.9% of all patients were IL-RN*2 positive (7/42), (IL-1B 31C/51 IT).