ObjectiveTo investigate the protective effect and mechanism of arbutin on LPS induced Acute lung injury in mice. Methods SPF BCLB/C mice were randomly divided into control group, model group,arbutin group, and arbutin+PI3K inhibitor group.arbutin group and arbutin+PI3K group were intervened with corresponding drugs respectively; Constructing an ALI model by intranasal instillation of LPS into mice; After modeling for 6 hours, the mice were killed. After staining the lung tissue slices, observe the pathological changes of the lung tissue and evaluate the lung injury score, and calculate the wet to dry weight ratio (W/D); ELISA method was used to determine the levels of TNF-a and IL-6 in serum and bronchoalveolar lavage fluid (BALF); Measure the ROS content, MDA level,and MPO activity in the lungs; Western blot method was used to detect the expression of PI3K/Akt/mTOR pathway related proteins and autophagy related proteins Beclin-1 and LC3II/I. ResultsCompared with the control group, the pathological changes in the lung tissue of model group mice worsened, and the W/D and lung injury scores increased, The levels of IL-6 and TNF-a in BALF and serum was increased, The ROS content, MDA expression and MPO activity in the lungs was increased,the expression of Beclin-1 and LC3II/I in the lungs was increased. The expression of PI3K/Akt/mTOR pathway related proteins in the lungs decreased (P<0.05). Compared with the model group, the pathological changes in the lung tissue of arbutin group mice were alleviated, with a decrease in W/D and lung injury score, The levels of IL-6 and TNF-a in BALF and serum decrease,ROS content, MDA expression and MPO activity in lung were decreased.The expression of PI3K/Akt/mTOR pathway related proteins in the lung was increased, The expression of Beclin-1 and LC3II/I decreased. However, the appeal performance was partially blocked in the arbutin+PI3K group after the administration of LY294002.ConclusionsArbutin regulates autophagy through PI3K/Akt/mTOR pathway to inhibit inflammatory response and oxidative stress in LPS-induced ALI mice, and plays a protective role in LPS-induced ALI.
Objective To analyze the current situation of the centralized treatment mode for daytime treatment (excluding daytime surgery) services in a large-scale military hospital, and provide practical support for the management and operation of the centralized treatment mode for daytime treatment. Methods Data on patients undergoing centralized daytime treatment in the Department of Ambulatory Medicine, First Medical Center of PLA General Hospital were retrospectively collected between February 7, 2021 and December 31, 2023. The patients’ condition, daytime treatment operation indicators, and quality control indicators were statistically analyzed. Results A total of 14903 patients underwent daytime treatment, including 8548 females and 6355 males. The patients’ age ranged from 18 to 74 years old. There were 9757 patients (65.47%) who had been hospitalized ≥ 2 times. The main payment method for patients was medical insurance (83.16%). Breast cancer accounted for the highest proportion (26.45%). The main treatment methods for patients were targeted therapy and immunotherapy (68.03%). The patients experienced a total of 1146 drug-related adverse reactions, mainly involving anti-tumor drugs. Among them, 15 cases were drug-related adverse reactions treated on the day of treatment, and the other 1131 cases were drug-related adverse reactions that occurred outside the hospital. After optimizing the entire process of daytime hospitalization (timed based treatment) in January 2023, compared to 2022, the average waiting time for patients after admission was reduced by 26.89%, the bed utilization rate increased by 9.09%, and patient satisfaction increased to 98.98%. In 2023, the default rate of daytime treatment was 1.15%, the cancellation rate of daytime treatment on the day of treatment was 4.39%, and the discharge follow-up rate reached 100%. Conclusions The daytime treatment under the centralized treatment mode in the the Department of Ambulatory Medicine, First Medical Center of PLA General Hospital focuses on breast cancer patients, and the main treatment methods are targeted therapy and immunotherapy. Time based treatment is beneficial for shortening the average waiting time of patients after admission, improving bed utilization and patient satisfaction.