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Liver fibrosis is a pathological process of various liver diseases, and a large number of studies have shown that liver fibrosis is reversible. Natural products are important sources of drugs for treating liver fibrosis. The present study evaluated the protective effect of cycloastragenol (CAG) on liver fibrosis and the underlying mechanisms. The mouse model of liver fibrosis was established by intraperitoneal injection of carbon tetrachloride (CCl4) and olive oil. Subsequently, CAG was administered orally at different doses (2.5 mg/kg/d, 5 mg/kg/d, 10 mg/kg/d), and the degree of liver fibrosis was assessed using hematoxylin-eosin, Van Gieson, and Sirius Red staining. Alanine aminotransferase, aspartate aminotransferase, hyaluronic acid, and hydroxyproline levels were detected using biochemical analyses. The mRNA and protein expression levels of α-SMA, LC3, P62, PI3K, Akt, and mTOR in the liver tissue were assessed by reverse-transcription polymerase chain reaction and western blot, respectively. The expression of fibrogenesis-related marker α-SMA in the liver tissue was assessed using immunofluorescence. As expected, CAG alleviated liver fibrosis and suppressed hepatic stellate cell activation. And then, CAG inhibited autophagy and activated the PI3K/Akt/mTOR signaling pathway. Thus, CAG attenuated CCI4-induced liver fibrosis in mice by inhibiting autophagy and activating the PI3K/Akt/mTOR signaling pathway. [ABSTRACT FROM AUTHOR]

Background Reduced cardiorespiratory fitness levels are associated with increased short-term complications after surgery, and potentially exert long-lasting effects on the postoperative lives, work and educational pursuits of patients. Currently, research suggests that lifestyle interventions, such as preoperative physical exercise undertaken by patients themselves, may improve patients’ cardiopulmonary fitness and reduce post-operative complications. This study aims to investigate the effectiveness and feasibility of a remote medical supervision model for prehabilitation exercise in patients undergoing thoracoscopic lung tumour resection surgery. Methods/Design All enrolled patients will participate in a 4-week pre-operative exercise intervention to improve their cardiorespiratory fitness. During this period, patients will wear wearable devices and exercise at home based on exercise prescriptions. The exercise prescription comprises aerobic exercise (three times a week or more), muscle strengthening exercise (twice a week or more), and respiratory muscle exercise (once a day). The primary aim is to investigate whether baseline VO 2 max could be improved following a 4-week preoperative exercise program. Secondary objectives include changes in forced expiratory volume in 1 s and forced vital capacity, degree of acceptance of the technology, quality of life, handgrip strength, postoperative complication rate and length of hospital stay. Discussion This study aims to evaluate the influence of preoperative prehabilitation exercises in a telemedicine active supervision mode in patients undergoing thoracoscopic lung tumour resection. As such, results of this trial might have some impact on future implementations of group- and home-based prehabilitation exercises in lung cancers. Trial registration This study was approved by the Medical Ethics Committee of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology (approval number: TJ-IRB20220564) with registration at ClinicalTrials.gov (identifier: NCT05608759).