BACKGROUND:Steroid-induced femoral head necrosis is mostly caused by long-term and extensive use of hormones,but its specific pathogenesis is not yet clear and needs further study. OBJECTIVE:To screen out the differential miRNAs in osteoclast exosomes after the intervention of Panax notoginseng saponins,and on this basis,to further construct an osteogenic-related ferroptosis regulatory network to explore the potential mechanism and research direction of steroid-induced osteonecrosis of the femoral head. METHODS:MTT assay was used to detect the toxic effects of different concentrations of dexamethasone and different mass concentrations of Panax notoginseng saponins on Raw264.7 cell line.Tartrate resistant acid phosphatase staining and TUNEL assay were used to detect the effects of Panax notoginseng saponins on osteoclast inhibition and apoptosis.Exosomes were extracted from cultured osteoclasts with Panax notoginseng saponins intervention.Exosomes from different groups were sequenced to identify differentially expressed miRNAs.CytoScape 3.9.1 was used to construct and visualize the regulatory network between differentially expressed miRNAs and mRNAs.Candidate mRNAs were screened by GO analysis and KEGG analysis.Finally,the differential genes related to ferroptosis were screened out,and the regulatory network of ferroptosis-related genes was constructed. RESULTS AND CONCLUSION:(1)The concentration of dexamethasone(0.1 μmol/L)and Panax notoginseng saponins(1 736.85 μg/mL)suitable for intervention of Raw264.7 cells was determined by MTT assay.(2)Panax notoginseng saponins had an inhibitory effect on osteoclasts and could promote their apoptosis.(3)Totally 20 differentially expressed miRNAs were identified from osteoclast-derived exosome samples,and 11 differentially expressed miRNAs related to osteogenesis were predicted by target mRNAs.The regulatory networks of 4 up-regulated differentially expressed miRNAs corresponding to 155 down-regulated candidate mRNAs and 7 down-regulated differentially expressed miRNAs corresponding to 238 up-regulated candidate mRNAs were constructed.(4)Twenty-four genes related to ferroptosis were screened out from the differential genes.Finally,12 networks were constructed(miR-98-5p/PTGS2,miR-23b-3p/PTGS2,miR-425-5p/TFRC,miR-133a-3p/TFRC,miR-185-5p/TFRC,miR-23b-3p/NFE2L2,miR-23b-3p/LAMP2,miR-98-5p/LAMP2,miR-182-5p/LAMP2,miR-182-5p/TLR4,miR-23b-3p/ZFP36,and miR-182-5p/ZFP36).These results indicate that Panax notoginseng saponins may regulate osteoblast ferroptosis by regulating the expression of miRNAs derived from osteoclast exosomes,thus providing a new idea for the study of the mechanism of steroid-induced femoral head necrosis.

Objective To investigate the clinical and imaging characteristics of myelin oligodendrocyte glycoprotein antibody-associated disease(MOGAD).Methods The clinical symptoms,MRI features,results of laboratory tests and clinical prognosis of 14 MOGAD patients who were hospitalized in our hospital from June 2016 to June 2022 were collected and retrospectively analyzed.Their clinical and imaging characteristics were summarized and discussed.Results Among the 14 enrolled patients,there were 10 males and 4 females,with a male to female ratio of 2.5∶1.Their age of first onset was＜18 years in 3 cases,18～45 years in 8 cases,and＞45 years in 3 cases.Optic neuritis(10/14,71.43％)was the most common clinical type,followed by encephalitis or meningoencephalitis(9/14,64.29％),brainstem encephalitis(5/14,35.71％)and myelitis(5/14,35.71％).Visual impairment(10/14,71.43％)was the most common clinical symptom,followed by headache in 8 cases(8/14,57.14％),fever in 6 cases(6/14,42.86％),dizziness in 6 cases(6/14,42.86％),parethesia in 5 cases(5/14,35.71％),and seizures,limb paralysis,sphincter dysfunction,ataxia,and vomit were all in 4 cases(4/14,28.57％).Four patients(4/14,28.57％)had a history of upper respiratory tract infection before MOGAD onset.There were 10 patients undergoing cerebrospinal fluid(CSF)test,and 8 of them had abnormal results,including 2 patients(2/10,20％)of increased pressure,8 patients(8/10,80％)of larger WBC count in CSF,and 5 patients(5/10,50％)of elevated total protein in CSF.MRI displayed multiple lesion involvement,and there were 7 cases(7/14,50.00％)in cortical/subcortical white matter,6 cases in brainstem(6/14,42.86％),5 cases in optic nerve(5/14,35.71％),4 cases in spinal cord(4/14,28.57％).The hippocampus,thalamus,basal ganglia,and paraventricular white matter were involved in 3 cases(3/14,21.43％),respectively,and the cerebellum and corpus callosum were in 2 cases(2/14,14.29％),respectively.MRI lesions demonstrated patchy hyperintensity on T2 WI and T2 FLAIR,with patchy,nodular and linear enhancement.Among the 10 patients undergoing visual evoked potential(VEP)test,abnormalities were detected in 9 cases(9/10,90％),and 8(8/10,80％)had bilateral visual pathway abnormalities.Eight patients(8/14,57.14％)experienced relapse and remission course.Both methylprednisolone pulse therapy and immunoglobulin modulation therapy were effective in the acute phase.Five patients with relapsed remission presented a significant reduction in recurrence after immunosuppressants.Conclusion MOGAD is manifested with various clinical features,with vision loss,headache,fever and dizziness more common.MRI lesions of MOGAD involve cerebral cortex,subcortical white matter,brainstem,and optic nerve,etc.Patchy hyperintesive signals are observed on T2WI and T2 FLAIR,and some lesions can be enhanced.Corticosteroid pulse therapy and immunoglobulin therapy show effective treatment in the acute phase,and immunosuppressants in the remission phase can reduce relapse.

To investigate the clinical characteristics of primary Sj-gren's Syndrome （pSS） patients with central nervous system（CNS） damage as the initial manifestation.Methods Fifteen pSS patients with CNS damage as the initial manifestation were recruited.Clinical manifestations，laboratory results and imaging findings were retrospectively analyzed.Descriptive statistics was used for statistical analysis.Results Among the 15 patients，the ratio of male to female was 1∶4，and the first onset age was （45.53±16.19） years old.The diagnosis was confirmed after an average of 32.37 months.The initial symptoms included headache （6.67%），dizziness （20%），vomiting （20%），slurred speech （6.67%），facial paralysis （6.67%），hemilateral limb weakness （26.67%），numbness and weakness of both lower limbs （13.33 %） or the limbs （46.67%），chest and back pain（26.67%），blurred vision （6.67%）.The lesions involved the cerebral hemisphere （33.33%），brain stem （53.33%），cerebellum （6.67%），spinal cord （53.33%），and optic nerve （6.67%），presenting as cerebral infarction（33.33%），SAH（6.67%），transverse myelitis（6.67%），bulbar lesion（6.67%），neuromyelitis optica spectrum disorder （NMOSD）（53.33%） and NMOSD complicated with cerebral infarction in 1 case （6.67%）.CNS symptoms recurred in 3 cases （20%） before pSS was diagnosed.At the time of diagnosis，the positive rate of autoimmune antibodies was anti-SSA antibody 100%，anti-nuclear antibody 100%，anti-SSB antibody 73.33%，anti-R0-52 antibody 80%，anti-ds-DNA antibody 6.67%，respectively.The positive rate of RF was 20%.The increase rate of IgG and IgA were 20%，and the decrease rate of complement C3 was 20%.The cerebrospinal fluid study showed：CSF pressure （80-240） mmH-2O，white blood cells cout （4-130）×106/L，protein （0.27-1.46） g/L；CSF IgG increased in 5 cases，and IgM increased in 2 cases，and IgA increased in 4 cases.Conclusion CNS damage can be the initial manifestation of pSS.The lack of timely screening and monitoring of autoimmune antibody is an important reason for the delayed diagnosis of pSS.For unexplained CNS lesions，especially those presenting as recurrent demyelinating events or cerebral infarction，autoimmune antibodies such as anti-SSA and SSB should be examed actively，while the symptoms such as dry eyes and dry mouth should be questioned.It is important for early diagnosis.

Objective:To study the correlation between the acute-phase characteristics of motor evoked potential (MEP) and severities of spinal cord injury in patients with acute cervical hyperextension injury and central cord syndrome (CCS).Methods:Retrospectively analyzed were the data of 45 patients with acute cervical hyperextension injury and CCS (observation group) who had been admitted to Department of Orthopedics, Tongji Hospital Affiliated to Tongji University from December 2018 to July 2021 and 20 healthy controls. Examination of transcranial magnetic stimulation-induced MEP was performed in patients with CCS and healthy controls using a magpro x100 magnetic stimulator, and recording was conducted in bilateral abductor pollicis brevis (APB). The characteristics of MEP waveform latency, amplitude and motor threshold were described and compared between the healthy control and observation groups; the correlations were analyzed between the MEP latency and the severity of spinal cord injury [American Spinal Injury Association (ASIA) total score and motor function of Upper Extremity Motor Subscores (UEMS)] in the observation group. According to different MEP-induced states, the patients in the observation group were divided into a resting group ( n=19), a facilitation group ( n=18), and a no-waveform group ( n=8). The severity of spinal cord injury (ASIA total score) and the functional independence of the spinal cord (SCIM-Ⅲ score) were compared among the 3 groups to analyze the correlation between the MEP-induced state and the severity of spinal cord injury (ASIA total score). Results:The observation group had a significantly longer MEP latency [(30.16±6.32) ms], a significantly smaller amplitude [(0.54±0.30) mV] and a significantly higher motor threshold [(65%±11%)] than the healthy control group (all P<0.05). The MEP latency in the observation group was significantly correlated with ASIA total score ( r=-0.730, P<0.001) and UEMS ( r=-0.740, P<0.001). The ASIA total score and SCIM-Ⅲ score were significantly different among the 3 groups ( P<0.05), and the MEP-induced state was significantly correlated with the severity of spinal cord injury (ASIA total score) ( r=0.668, P<0.001). Conclusions:In patients with acute cervical hyperextension injury and CCS, the MEP latency is prolonged, the amplitude lowered, and the motor threshold enhanced. The MEP latency is strongly correlated with the severity of spinal cord injury and upper limb motor function. The MEP-induced state is also closely related to the severity of spinal cord injury.

Based on the requirements of military professional education reform and in view of the problems existing in the operation and maintenance of first-aid medical equipment in grass-roots forces. We put forward a construction scheme of online course which named operation and maintenance of first-aid medical equipment in grass-roots forces, and then expound the scheme from teaching content construction and teaching mode construction. The teaching content construction consists of two parts: the management theory of conventional medical equipments and the operation and maintenance teaching of specific first-aid medical equipments. In the construction of teaching mode, we elaborate on the organization forms of teaching, answering questions, training and examination units in detail. The design scheme of the online course is in line with the learning characteristics and meets the demand of learning the knowledge of the operation and maintenance of first-aid medical equipment systematically, so as to improve the post competency of the grass-roots forces.

Objective:To summarize the experience of surgical treatment of primary liver cancer.Methods:The clinical data of 10 966 surgically managed cases with primary liver cancer, from January 1986 to December 2019 at Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University, were retrospectively analyzed. The life table method was used to calculate the survival rate and postoperative recurrence rate. Log‐rank test was used to compare the survival process of different groups, and the Cox regression model was used for multivariate analysis. In addition, 2 884 cases of hepatocellular carcinoma(HCC) with more detailed follow‐up data from 2009 to 2019 were selected for survival analysis. Among 2 549 patients treated with hepatectomy, there were 2 107 males and 442 females, with an age of (56.6±11.1) years (range: 20 to 86 years). Among 335 patients treated with liver transplantation, there were 292 males and 43 females, with an age of (51.0±9.7) years (range: 21 to 73 years). The outcomes of hepatectomy versus liver transplantation, anatomic versus non-anatomic hepatectomy were compared, respectively.Results:Of the 10 966 patients with primary liver cancer, 10 331 patients underwent hepatectomy and 635 patients underwent liver transplantation. Patients with liver resection were categorized into three groups: 1986－1995(712 cases), 1996－2008(3 988 cases), 2009?2019(5 631 cases). The 5‐year overall survival rate was 32.9% in the first group(1986－1995). The 5‐year overall survival rate of resected primary liver cancer was 51.7% in the third group(2009‐2019), among which the 5‐year overal survival rates of hepatocellular carcinoma, intrahepatic cholangiocarcinoma and mixed liver cancer were 57.4%, 26.6% and 50.6%, respectively. Further analysis was performed on 2 549 HCC patients with primary hepatectomy. The 1‐, 3‐, 5‐, and 10‐year overall survival rates were 88.1%, 71.9%, 60.0%, and 41.0%, respectively, and the perioperative mortality rate was 1.0%. Two hundred and forty‐seven HCC patients underwent primary liver transplantation, with 1‐, 3‐, 5‐, and 10‐year overall survival rates of 84.0%, 64.8%, 61.9%, and 57.6%, respectively. Eighty‐eight HCC patients underwent salvage liver transplantation, with the 1‐, 3‐, 5‐, and 10‐year overall survival rates of 86.8%, 65.2%, 52.5%, and 52.5%, respectively. There was no significant difference in survival rates between the two groups with liver transplantation ( P>0.05). Comparing the overall survival rates and recurrence rates of primary hepatectomy (2 549 cases) with primary liver transplantation (247 cases), the 1‐, 3‐, 5‐, and 10‐year overall survival rates in patients within Milan criteria treated with hepatectomy and transplantation were 96.3%, 87.1%, 76.9%, 54.7%, and 95.4%, 79.4%, 77.4%, 71.7%, respectively ( P=0.754). The 1‐, 3‐, 5‐year recurrence rates were 16.3%, 35.9%, 47.6% and 8.1%, 11.7%, 13.9%, respectively( P<0.01). The 1‐, 3‐, 5‐, 10‐year overall survival rates in patients with no large vessels invasion beyond the Milan criteria treated with liver resection and transplantation were 87.2%, 65.9%, 53.0%, 33.0% and 87.6%, 71.8%, 71.8%, 69.3%, respectively( P=0.003); the 1‐, 3‐, 5‐year recurrence rate were 39.2%, 57.8%, 69.7% and 29.7%, 36.7%, 36.7%, respectively ( P<0.01). The 1‐, 3‐, 5‐, and 10‐year overall survival rates in patients with large vessels invasion treated with liver resection and transplantation were 62.1%, 36.1%, 22.2%, 15.0% and 62.9%, 31.8%,19.9%, 0, respectively ( P=0.387); the 1‐, 3‐, 5‐year recurrence rates were 61.5%, 74.7%, 80.8% and 59.7%, 82.9%, 87.2%, respectively( P=0.909). Independent prognostic factors for both overall survival and recurrence‐free survival rates of HCC patients treated with liver resection included gender, neoadjuvant therapy, symptoms, AST, intraoperative or postoperative blood transfusion, tumor number, tumor size, cirrhosis, macrovascular invasion, microvascular invasion, and pathological differentiation. Propensity score matching analysis of 443 pairs further showed that there was no significant difference in overall survival rate between anatomical liver resection and non‐anatomical liver resection( P=0.895), but the recurrence rate of non‐anatomical liver resection was higher than that of anatomical liver resection( P=0.035). Conclusions:In the past decade, the overall survival rate of HCC undergoing surgical treatment is significantly higher than before. For HCC patients with good liver function reservation, surgical resection can be performed first, and salvage liver transplantation can be performed after recurrence. The effect of salvage liver transplantation is comparable to that of primary liver transplantation. As for the choice of liver resection approaches, non‐anatomical resection can reserve more liver tissue and can be selected as long as the negative margin is guaranteed.

Objective:To summarize the experience of surgical treatment of primary liver cancer.Methods:The clinical data of 10 966 surgically managed cases with primary liver cancer, from January 1986 to December 2019 at Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University, were retrospectively analyzed. The life table method was used to calculate the survival rate and postoperative recurrence rate. Log‐rank test was used to compare the survival process of different groups, and the Cox regression model was used for multivariate analysis. In addition, 2 884 cases of hepatocellular carcinoma(HCC) with more detailed follow‐up data from 2009 to 2019 were selected for survival analysis. Among 2 549 patients treated with hepatectomy, there were 2 107 males and 442 females, with an age of (56.6±11.1) years (range: 20 to 86 years). Among 335 patients treated with liver transplantation, there were 292 males and 43 females, with an age of (51.0±9.7) years (range: 21 to 73 years). The outcomes of hepatectomy versus liver transplantation, anatomic versus non-anatomic hepatectomy were compared, respectively.Results:Of the 10 966 patients with primary liver cancer, 10 331 patients underwent hepatectomy and 635 patients underwent liver transplantation. Patients with liver resection were categorized into three groups: 1986－1995(712 cases), 1996－2008(3 988 cases), 2009?2019(5 631 cases). The 5‐year overall survival rate was 32.9% in the first group(1986－1995). The 5‐year overall survival rate of resected primary liver cancer was 51.7% in the third group(2009‐2019), among which the 5‐year overal survival rates of hepatocellular carcinoma, intrahepatic cholangiocarcinoma and mixed liver cancer were 57.4%, 26.6% and 50.6%, respectively. Further analysis was performed on 2 549 HCC patients with primary hepatectomy. The 1‐, 3‐, 5‐, and 10‐year overall survival rates were 88.1%, 71.9%, 60.0%, and 41.0%, respectively, and the perioperative mortality rate was 1.0%. Two hundred and forty‐seven HCC patients underwent primary liver transplantation, with 1‐, 3‐, 5‐, and 10‐year overall survival rates of 84.0%, 64.8%, 61.9%, and 57.6%, respectively. Eighty‐eight HCC patients underwent salvage liver transplantation, with the 1‐, 3‐, 5‐, and 10‐year overall survival rates of 86.8%, 65.2%, 52.5%, and 52.5%, respectively. There was no significant difference in survival rates between the two groups with liver transplantation ( P>0.05). Comparing the overall survival rates and recurrence rates of primary hepatectomy (2 549 cases) with primary liver transplantation (247 cases), the 1‐, 3‐, 5‐, and 10‐year overall survival rates in patients within Milan criteria treated with hepatectomy and transplantation were 96.3%, 87.1%, 76.9%, 54.7%, and 95.4%, 79.4%, 77.4%, 71.7%, respectively ( P=0.754). The 1‐, 3‐, 5‐year recurrence rates were 16.3%, 35.9%, 47.6% and 8.1%, 11.7%, 13.9%, respectively( P<0.01). The 1‐, 3‐, 5‐, 10‐year overall survival rates in patients with no large vessels invasion beyond the Milan criteria treated with liver resection and transplantation were 87.2%, 65.9%, 53.0%, 33.0% and 87.6%, 71.8%, 71.8%, 69.3%, respectively( P=0.003); the 1‐, 3‐, 5‐year recurrence rate were 39.2%, 57.8%, 69.7% and 29.7%, 36.7%, 36.7%, respectively ( P<0.01). The 1‐, 3‐, 5‐, and 10‐year overall survival rates in patients with large vessels invasion treated with liver resection and transplantation were 62.1%, 36.1%, 22.2%, 15.0% and 62.9%, 31.8%,19.9%, 0, respectively ( P=0.387); the 1‐, 3‐, 5‐year recurrence rates were 61.5%, 74.7%, 80.8% and 59.7%, 82.9%, 87.2%, respectively( P=0.909). Independent prognostic factors for both overall survival and recurrence‐free survival rates of HCC patients treated with liver resection included gender, neoadjuvant therapy, symptoms, AST, intraoperative or postoperative blood transfusion, tumor number, tumor size, cirrhosis, macrovascular invasion, microvascular invasion, and pathological differentiation. Propensity score matching analysis of 443 pairs further showed that there was no significant difference in overall survival rate between anatomical liver resection and non‐anatomical liver resection( P=0.895), but the recurrence rate of non‐anatomical liver resection was higher than that of anatomical liver resection( P=0.035). Conclusions:In the past decade, the overall survival rate of HCC undergoing surgical treatment is significantly higher than before. For HCC patients with good liver function reservation, surgical resection can be performed first, and salvage liver transplantation can be performed after recurrence. The effect of salvage liver transplantation is comparable to that of primary liver transplantation. As for the choice of liver resection approaches, non‐anatomical resection can reserve more liver tissue and can be selected as long as the negative margin is guaranteed.

Objective:To evaluate the clinical value of 18F-fluorodexoyglucose (FDG) PET/CT in distinguishing benign from malignant tumors in patients with cardiac tumors. Methods:Between January 2015 and September 2018, 18F-FDG PET/CT was performed in 3 678 patents in Beijing Anzhen Hospital, and 51 of them (51/3 678, 1.39%) were diagnosed as cardiac tumors. Finally, 28 patients (10 males, 18 females; mean age (52±14) years, age range: 18-84 years) with pathological results were included. According to pathological results, patients were divided into 4 groups: group 1 with primary benign cardiac tumor ( n=9), group 2 with primary malignant cardiac tumor ( n=9), group 3 with lymphoma ( n=6) and group 4 with secondary malignant cardiac tumor ( n=4). All patients underwent early (60 min) 18F-FDG PET/CT imaging and 22 patients (6, 7, 6, 3 patients in group 1, group 2, group 3, group 4 respectively) underwent delayed (120 min) imaging. The maximum standardized uptake value (SUV max) and target/backgroud ratio (TBR) of 4 groups in early imaging and delayed imaging were calculated and compared with one-way analysis of viariace and Scheffe Post-hoc test. TBR were calcualted as SUV max/mean standardized uptake value (SUV mean) in the liver. Receiver operating characteristic (ROC) curve analysis was also performed. Results:SUV max during early imaging, defined SUV max(early), was 2.6±1.5, 9.9±4.0, 20.5±6.1, 9.2±5.8 in group 1-4 respectively ( F=21.39, P<0.01), the value of group 1 was lower than that of group 2 and 3, and the value of group 3 was the highest (all P<0.005). TBR early was 1.1±0.6, 4.1±1.6, 9.4±2.6, 3.7±2.0 in the 4 groups ( F=29.15, P<0.01), the value of group 1 was lower than that of group 2 and 3, and the value of group 3 was the highest (all P<0.005). SUV max in delayed imaging (SUV max(delay)) was 2.4±1.2, 11.0±5.9, 25.8±7.7, 13.7±7.7 respectively in the 4 groups ( F=16.01, P<0.01). TBR delay was also significantly different among the 4 groups (1.3±0.7, 5.5±2.9, 14.4±4.9, 7.9±5.0; F=14.78, P<0.01), the value of group 3 was higher than that of group 1 and 2 (all P<0.05). ROC curve analysis showed optimal cut-off values for indicating malignancy were: SUV max(early)=4.2, TBR early=1.6, SUV max(delay)=4.6, TBR delay=1.9. The corresponding sensitivities, specificities, accuracies were 19/19, 8/9, 96.4%(27/28); 19/19, 7/9, 92.9%(26/28); 16/16, 6/6, 100%(22/22); 16/16, 5/6, 95.5%(21/22), respectively. Conclusions:18F-FDG PET/CT imaging can accurately diagnose malignant cardiac tumors. Delayed imaging can further improve the accuracy for diagnosis of malignant cardiac tumors.

Objective:To investigate the use of proton pump inhibitors (PPIs)in gynecological patients in a hospital and analyze the use rationality of PPIs for the prevention of stress ulcer so as to provide reference for the clinical application of PPIs. Methods:To-tally 1000 patients' medical records admitted to the gynecological department for the first time from January 1st to December 31st in 2016 were randomly selected to conduct a retrospective analysis,and the rationality of PPIs was evaluated. Results:The preventive use rate of PPIs was 90.72%(880/970). Among the 880 patients, 28.18%(248/880) of the patients were without indications for the preventive medication,95.68%(842/880) of the patients were with wrong administration time, and 91.46%(578/632) of the pa-tients were with wrong usage and dosage. Conclusion:When PPIs are used for the prevention of SU in gynecological surgery,irrational use such as without indications, unsuitable variety selection and wrong usage and dosage still exists. It is suggested that regulators should strengthen technical and administrative interventions and establish standard for the rational use of PPIs in hospitals so as to avoid the excessive use of PPIs and improve the situation of inappropriate application.

Objective: To investigate the mechanism of emodin ( EM) in the expression of related protein for the fibrosis of the transforming growth factor-β1(TGF-β1)-stimulated human renal tubular epithelial (HK-2) cells. Methods: HK-2 cells were randomly divided into the normal control group, TGF-β1-stimulated model control group and emodin ( TGF-β1 +EM) group. The contents of Collage Ⅰ and fibronectin in the culture supernatant were determined by ELISA. After HK-2 cells were stimulated with TGF-β1 for 24 h, the cells were collected for immunofluorescence, Western blot and RT-PCR analysis. RT-PCR was used to detect PI3K, p-Akt and mTOR. The protein expressions of PI3K, p-Akt and mTOR were detected by Western blot. Immunofluorescence was used to detect PI3K. Results: Compared with those in the model control group, the contents of CollageⅠand fibronectin in the supernatant of emod-in group significantly decreased (P<0. 05), the expression of PI3K protein was inhibited, the expression of downstream p-Akt protein decreased, and the downstream mTOR decreased (P<0. 05), the expression levels of PI3K, p-Akt and mTOR mRNA decreased, the differences were statistically significant (P<0. 05), and the expression of PI3K decreased. Conclusion: Emodin can alleviate fibrosis of HK-2 cells stimulated by TGF-β1 through the classical Akt/mTOR pathway of autophagy.