Hip fracture patients who experience a greater fluctuation in RDW during hospital course are at heightened risk for all-cause mortality: a prospective study with 2-year follow-up

This study aims to detect whether there remains valuable prognostic information in fluctuation of red cell distribution width (RDW) in hip fracture patients. Results show that this readily available parameter may provide a more effective strategy for assessment of mortality risk, therefore providing a reference for clinical planning and decision-making.

INTRODUCTION

Prognostic values have been found in the fluctuation of some hematologic parameters. The red cell distribution width (RDW) routinely reported with all complete blood cell counts (CBC) has proven to be associated with poor outcomes in various diseases. However, whether the fluctuation in RDW is predictive of long-term mortality in hip fracture patients treated with surgery remains unknown.

METHODS

One thousand three hundred thirty hip fracture patients who underwent surgery from January 1, 2000 to November 18, 2012 were recruited in this prospective cohort study. Fluctuation in the RDW between admission and discharge was measured, and a Kaplan-Meier (KM) analysis and multivariable Cox regression model were applied to evaluate the relationship between this fluctuation and mortality. Risk factors for a larger fluctuation were detected by using Logistic regression analyses.

RESULTS

In addition to the admission RDW, a high RDW level at the time of discharge was also associated with an increased risk of death, while no significant difference was found in the postoperative RDW. Fluctuation in the RDW between admission and discharge was an independent risk predictor for 2-year mortality (HR 1.45 95%CI 1.06-2.00, p = 0.022). Factors affecting the change in the RDW between admission and discharge included both the demographic characteristics of the patients and clinical interventions.

CONCLUSION

Hip fracture patients who experience a greater fluctuation in RDW during the hospital course are at a heightened risk for 2-year all-cause mortality.

Gastroscopy-guided placement of intranasal jejunum nutrient canal and analysis of nutrient absorption efficiency

This study investigated and analyzed using both a pair of clamping pliers to place intranasal-jejunum nutrient canal under the guidance of gastroscope and using a guide wire to place the canal under the guidance of gastroscope. Ninety critically ill patients were randomly divided into a control (n=45) and an observation (n=45) group. The observation group had the intranasal-jejunum nutrient canal placed under the guidance of gastroscope by using a pair of clamping pliers while patients in the control group had the same canal placed under the guidance of gastroscope but using the guide wire. An intergroup comparison was conducted on the success rate of intranasal-jejunum nutrient canal placement and the incidence of complications. The results showed that the comparison yielded no significant difference in the success rate between observation (95.56%) and control (97.78%) groups (P＞0.05). When compared with control group, the A/G ratio and BMI level in the observation group increased significantly (P＞0.05). The intergroup comparison also yielded no significant difference in the incidence of complications. It was concluded that the method of gastroscopy-guided placement of intranasal jejunum nutrient canal produced better clinical results. The operating steps were simple and it had very low incidence of complications, therefore this method can be widely promoted for clinical practices.

[Dynamic variation trend and prognostic value of bronchial wall thickness in severely burned patients combined with inhalation injury]

Objective: To explore the dynamic variation trend of bronchial wall thickness (BWT) in severely burned patients combined with inhalation injury, and to determine the value of BWT to prognosis of patients. Methods: Forty-three severely burned patients with inhalation injury hospitalized in Intensive Burn Department of the Affiliated Hospital of Nankai University (Tianjin No.4 Hospital) from July to November 2016, conforming to the study criteria, were divided into survival group (n=27) and death group (n=16) according to the prognosis of patients within 14 days after admission. All patients underwent fiberoptic bronchoscopy and inhalation injury rating based on abbreviated injury scale at admission. High resolution CT examination was performed in patients of two groups at admission and 24 h post admission, 3, 7, and 14 d post admission to measure the BWT of right superior lobar bronchus trunk opening. Receiver operating characteristic curves of rating of inhalation damage at admission and BWT at admission were drawn to evaluate the predictive value for death of 43 patients. Data were processed with chi-square test, independent sample t test, Wilcoxon rank sum test, analysis of variance for repeated measurement and least-significant difference-t test. Results: (1) The numbers of patients rated as 0, 1, 2, 3, and 4 grade for inhalation injury in survival group and death group were 0, 19, 6, 2, and 0, and 0, 2, 7, 7, and 0, respectively. There were statistically significant differences between the two groups (Z=-3.79, P<0.01). (2) BWT of patients in death group at admission and 24 h post admission, 3, 7, and 14 d post admission was respectively (2.72±0.26), (3.18±0.22), (2.98±0.18), (2.29±0.17), and (1.45±0.21) mm, which was significantly larger than (2.24±0.15), (2.49±0.15), (1.51±0.17), (1.04±0.16), and (1.01±0.13) mm in survival group (t=7.55, 12.14, 27.11, 19.99, 7.11, P<0.01). BWT of patients in survival group and death group at 24 h post admission, 3, 7, and 14 d post admission showed statistically significant difference when compared with that at admission within the corresponding group (t=5.97, 16.63, 28.21, 38.57, 5.34, 3.31, 4.39, 6.48, P<0.01). BWT of patients in survival group and death group on 3, 7, and 14 d post admission was significantly smaller than that at 24 h post admission within the corresponding group (t=22.27, 34.02, 45.03, 2.77, 10.53, 10.59, P<0.01). BWT of patients in survival group and death group on 7 and 14 d post admission was significantly smaller than that on 3 d post admission within the corresponding group (t=10.49, 18.26, 9.57, 11.44, P<0.01). BWT of patients in survival group and death group on 14 d post admission was significantly smaller than that on 7 d post admission within the corresponding group (t=6.97, 6.15, P<0.01). (3) The total areas under ROC curves of inhalation injury rating at admission and BWT at admission for predicting death of 43 patients were 0.880 and 0.956, respectively (with 95% confidence intervals 0.768-0.991, 0.882-1.000, P<0.05). Grade 1.5 and 2.75 mm were respectively chosen as the optimal threshold values of inhalation injury rating at admission and BWT at admission, with sensitivity of 87.50%, 83.33% and specificity of 77.78%, 96.00%, respectively. Conclusions: The BWT of survived and dead patients with severe burn and inhalation injury increases significantly post burn, while the BWT of survived patients restores to normal level faster. BWT can be used to assess the severity of inhalation injury and to predict death in severely burned patients combined with inhalation injury.

Controlled Synthesis and Photocatalytic Performance of Au@ZnO Nanospheres with Core-Shell and Yolk-Shell Structures Assisted by Carbonaceous Layers as Intermediate

Au@ZnO nanospheres with controlled core-shell and yolk-shell features were successfully fabricated through a facile template-based solvothermal method using carbonaceous layers as intermediate. The active carbonaceous layers containing numerous surface functional groups such as OH and C═O play key roles in fabrication of the Au@ZnO nanospheres. The structures of Au@ZnO can easily controlled by adjusting the concentration of Zn ions aqueous solution and/or the size of Au@C microspheres. The synthesis strategy proposed in this paper is also verified to be suitable for fabricating some other Au@metallic oxides nanospheres such as Au@SnO2 and Au@Fe2O3 with controlled structures. Furthermore, due to the synergic effect of the surface plasma resonance effect of Au cores and the large surface area of 122.67 m2 g-1, the Au@ZnO nanospheres with yolk-shell feature exhibite good photocatalytic activity and stability under visible-light irradiation.

Local structure, nucleation sites and crystallization behavior and their effects on magnetic properties of Fe81Si x B10P8-xCu1 (x = 0~8)

In this work, an attempt has been made to reveal critical factors dominating the crystallization and soft magnetic properties of Fe₈₁Si _x B₁₀P_8-xCu₁ (x = 0, 2, 4, 6 and 8) alloys. Both melt spun and annealed alloys are characterized by differential scanning calorimetry, X-ray diffractometry, Mössbauer spectroscopy, transmission electron microscopy, positron annihilation lifetime spectroscopy and magnetometry. The changes in magnetic interaction between Fe atoms and chemical homogeneity can well explain the variation of magnetic properties of Fe₈₁Si _x B₁₀P_8-xCu₁ amorphous alloys. The density of nucleation sites in the amorphous precursors decreases in the substitution of P by Si. Meanwhile, the precipitated nanograins gradually coarsen, but the inhibiting effect of P on grain growth diminishes causing the increase of the crystallinity. Moreover, various site occupancies of Si are observed in the nanocrystallites and the Si occupancy in bcc Fe decreases the average magnetic moment of nanograins. Without sacrificing amorphous forming ability, we can obtain FeSiBPCu nanocrystalline alloy with excellent soft magnetic properties by optimizing the content of Si and P in the amorphous precursors.

Group Velocity Engineering of Confined Ultrafast Magnons

Quantum confinement permits the existence of multiple terahertz magnon modes in atomically engineered ultrathin magnetic films and multilayers. By means of spin-polarized high-resolution electron energy-loss spectroscopy, we report on the direct experimental detection of all exchange-dominated terahertz confined magnon modes in a 3 ML Co film. We demonstrate that, by tuning the structural and magnetic properties of the Co film, through its epitaxial growth on different surfaces, e.g., Ir(001), Cu(001), and Pt(111), one can achieve entirely different in-plane magnon dispersions, characterized by positive and negative group velocities. Our first-principles calculations show that spin-dependent many-body correlation effects in Co films play an important role in the determination of the energies of confined magnon modes. Our results suggest a pathway towards the engineering of the group velocity of confined ultrafast magnons.

Preparation of MoS2/TiO2 based nanocomposites for photocatalysis and rechargeable batteries: progress, challenges, and perspective

The rapidly increasing severity of the energy crisis and environmental degradation are stimulating the rapid development of photocatalysts and rechargeable lithium/sodium ion batteries. In particular, MoS₂/TiO₂ based nanocomposites show great potential and have been widely studied in the areas of both photocatalysis and rechargeable lithium/sodium ion batteries due to their superior combination properties. In addition to the low-cost, abundance, and high chemical stability of both MoS₂ and TiO₂, MoS₂/TiO₂ composites also show complementary advantages. These include the strong optical absorption of TiO₂vs. the high catalytic activity of MoS₂, which is promising for photocatalysis; and excellent safety and superior structural stability of TiO₂vs. the high theoretic specific capacity and unique layered structure of MoS₂, thus, these composites are exciting as anode materials. In this review, we first summarize the recent progress in MoS₂/TiO₂-based nanomaterials for applications in photocatalysis and rechargeable batteries. We highlight the synthesis, structure and mechanism of MoS₂/TiO₂-based nanomaterials. Then, advancements and strategies for improving the performance of these composites in photocatalytic degradation, hydrogen evolution, CO₂ reduction, LIBs and SIBs are critically discussed. Finally, perspectives on existing challenges and probable opportunities for future exploration of MoS₂/TiO₂-based composites towards photocatalysis and rechargeable batteries are presented. We believe the present review would provide enriched information for a deeper understanding of MoS₂/TiO₂ composites and open avenues for the rational design of MoS₂/TiO₂ based composites for energy and environment-related applications.

High-pressure discovery of β-NiBi

Herein, we present the discovery of a new high-pressure phase in the Ni-Bi system, β-NiBi, which crystallizes in the TlI structure type. The powerful technique of in situ high-pressure and high-temperature powder X-ray diffraction enabled observation of the formation of β-NiBi and its reversible reconversion to the ambient pressure phase, α-NiBi.

[Status and analysis of oral disease burden: comparison of the domestic and overseas data]

At present, it has been regarded that oral disease was one of the most prevalent problems for people's general health around the world. Oral disease burden study focuses on the pressure and effect of oral diseases to the whole social economy and people's health. Oral disease burden, as a public health problem, needs to be attached importance in China and foreign countries. By means of retrieving the literature, this review article summarizes the progress of domestic and oversea studies on oral disease burden, analyses the epidemiological burden through the indicators such as the prevalence rate, decayed missing and filled teeth, disability adjusted life years, disability weights, and illustrates the economic burden of oral diseases by using part of the data. Results shows that the oral disease burden is obvious in most countries and regions both in China and foreign countries. The study of oral disease burden in China has not been well developed. Giving priority to dental caries, periodontal disease and tooth loss, the prevalence of oral diseases in China is high. The rate of seeking dental treatments is low and the proportion of self-supporting treatments is high. In general, the epidemiological and economic burden of oral diseases is heavier in China than that in the rest of the world.

Clinical utility of a short resting-state MRI scan in differentiating bipolar from unipolar depression

OBJECTIVE

Depression in bipolar disorder (BipD) requires a therapeutic approach that is from treating unipolar major depressive disorder (UniD), but to date, no reliable methods could separate these two disorders. The aim of this study was to establish the clinical validity and utility of a non-invasive functional MRI-based method to classify BipD from UniD.

METHOD

The degree of connectivity (degree centrality or DC) of every small unit (voxel) with every other unit of the brain was estimated in 22 patients with BipD and 22 age, gender, and depressive severity-matched patients with UniD and 22 healthy controls. Pattern classification analysis was carried out using a support-vector machine (SVM) approach.

RESULTS

Degree centrality pattern from 8-min resting fMRI discriminated BipD from UniD with an accuracy of 86% and diagnostic odds ratio of 9.6. DC was reduced in the left insula and increased in bilateral precuneus in BipD when compared to UniD. In this sample with a high degree of uncertainty (50% prior probability), positive predictive value of the DC test was 79%.

CONCLUSION

Degree centrality maps are potential candidate measures to separate bipolar depression from unipolar depression. Test performance reported here requires further pragmatic evaluation in regular clinical practice.

The association between serum uric acid level and the risk of fractures: a systematic review and meta-analysis

Controversy has arisen in regarding the association between serum uric acid (UA) and fracture risk. Therefore, we conducted a systemic review and meta-analysis by pooling estimate of five prospective studies (29,110 participants). Results showed that an increased serum UA level is associated with a lower risk of fracture. Numerous studies have demonstrated that high serum UA is a relevant risk factor for a wide variety of diseases, whereas new understanding in serum uric acid follows recent reports demonstrating a protective role of UA in health status. However, the association between serum UA and fracture remains controversial. Therefore, we conduct a systemic review and meta-analysis to determine whether elevated UA level is a protective factor for fracture among prospective studies. We searched for studies published before May 6, 2016, using PubMed, Embase, and Cochrane databases, without any language restriction. The inclusion criteria were published studies investigating the association between UA and fractures. Two authors independently screened the retrieved articles in accordance to the predefined inclusion criteria. We pooled the study-specific relative risk estimates using a random-effect model for comparison of persons whose UA levels were in the top tertile with those in the bottom tertile. Factors that may predict these associations were evaluated in subgroup analysis and meta-regression. The five included prospective studies included 29,110 participants. In random-effect models that included all five included studies, the summary hazard ratios (HRs) (top vs bottom tertiles) were 079 (95% CI, 0.69 to 0.89), without evidence of heterogeneity (P for heterogeneity = 0.458; I ² = 0%). Similar results were shown when pooling estimate of three higher-quality studies (HR 0.80 95% CI, 0.69 to 0.93). The association between UA and fracture remained in sensitivity and subgroup analyses. An increased serum UA level is shown to be associated with a lower risk of fracture, albeit additional large, high-quality prospective studies or a meta-analysis of individual data are still needed to verify the association.

Comparative transcriptomic analysis of porcine peripheral blood reveals differentially expressed genes from the cytokine-cytokine receptor interaction pathway related to health status

While some research has looked into the host genetic response in pigs challenged with specific viruses or bacteria, few studies have explored the expression changes of transcripts in the peripheral blood of sick pigs that may be infected with multiple pathogens on farms. In this study, the architecture of the peripheral blood transcriptome of 64 Duroc sired commercial pigs, including 18 healthy animals at entry to a growing facility (set as a control) and 23 pairs of samples from healthy and sick pen mates, was generated using RNA-Seq technology. In total, 246 differentially expressed genes were identified to be specific to the sick animals. Functional enrichment analysis for those genes revealed that the over-represented gene ontology terms for the biological processes category were exclusively immune activity related. The cytokine-cytokine receptor interaction pathway was significantly enriched. Nine functional genes from this pathway encoding members (as well as their receptors) of the interleukins, chemokines, tumor necrosis factors, colony stimulating factors, activins, and interferons exhibited significant transcriptional alteration in sick animals. Our results suggest a subset of novel marker genes that may be useful candidate genes in the evaluation and prediction of health status in pigs under commercial production conditions.

Association between bone mineral density, muscle strength, and vitamin D status in patients with myasthenia gravis: a cross-sectional study

Myasthenia gravis (MG) patients had low proximal hip BMD, which could be explained by reduced muscle strength, elevated bone resorption markers, vitamin D deficiency, and increased PTH levels in those with MG compared to controls.

INTRODUCTION

Muscle strength is closely correlated with bone mineral density (BMD) and vitamin D status. Here, we evaluated muscle strength, BMD, and vitamin D status in a large sample of Chinese patients with MG.

METHODS

In this cross-sectional survey, 86 patients with MG without glucocorticoid treatment and 86 healthy controls were included. Serum levels of 25-hydroxyvitamin D [25OHD], parathyroid hormone (PTH), bone turnover markers (BTMs), and BMD were measured and compared between the two groups. Grip strength and one-leg standing time (OLST) were also assessed in MG patients.

RESULTS

Low grip strength and short OLST were found in 11 (12.8%) and 12 (14.0%) MG patients, respectively. There were 3 (3.5%) MG patients with low bone mass for chronological age. Serum beta C-terminal telopeptide and PTH levels were higher (p < 0.001 and p = 0.001, respectively), and BMD at the femoral neck and trochanter were lower in MG patients (p < 0.001 and p < 0.001, respectively) compared to healthy controls. In patients with MG, grip strength was positively correlated with BMD. Serum 25OHD levels were lower in MG patients than in healthy controls (17.36 ± 6.64 vs. 22.11 ± 7.28 ng/ml, p < 0.001).

CONCLUSION

Grip strength was positively correlated with BMD in Chinese patients with MG. MG patients tended to have low proximal hip BMD, which may partially be explained by reduced muscle strength, vitamin D deficiency, increased PTH levels, and elevated bone resorption markers compared to controls.

PDE3A is hypermethylated in cisplatin resistant non-small cell lung cancer cells and is a modulator of chemotherapy response

OBJECTIVE

In this study, we aimed to investigate the mechanism of PDE3A downregulation in chemoresistant non-small cell lung cancer (NSCLC) cells, its functional role in chemotherapy response and association with survival outcomes.

MATERIALS AND METHODS

The raw data of GDS5247 was downloaded from GEO datasets and reanalyzed. The expression of PDE3A in patients with NSCLC and its DNA methylation status were analyzed in NSCLC cohort in TCGA database. Cisplatin resistant A549/Cis cells and the parental A549 cells were used as the in vitro cell model. The association between PDE3A expression and overall survival (OS) and progression-free survival (PFS) in NSCLC patients with adenocarcinoma or squamous cell carcinoma, as well as the median OS and PFS, were assessed by Kaplan-Meier curves using Kaplan-Meier plotter.

RESULTS

PDE3A was significantly downregulated in chemoresistant NSCLC cells. Heat map of PDE3A expression and methylation in NSCLC patient cohort in TCGA database indicated a negative association between PDE3A expression and DNA methylation in lung adenocarcinoma. A549/Cis cells treated with 5-AZA-dC, a demethylation reagent, had significantly restored PDE3A expression. High PDE3A expression was associated with favorable OS (HR: 0.53, 95% CI: 0.41-0.68, p<0.0001) and PFS (HR: 0.54, 95% CI: 0.39-0.75, p<0.001) in patients with adenocarcinoma. However, in patients with squamous cell carcinoma, high PDE3A expression was associated with unfavorable OS (HR: 1.56, 95% CI: 1.08-2.24, p=0.017) and PFS (HR: 1.83, 95% CI: 1.02-3.29, p=0.04).

CONCLUSIONS

PDE3A is downregulated in chemoresistant NSCLC cells due to DNA hypermethylation. Enforced PDE3A expression can sensitize A549/Cis cells to cisplatin. High PDE3A expression is associated with better OS and PFS in patients with adenocarcinoma, but not in patients with squamous cell carcinoma.

Ancestry, Plasmodium cynomolgi prevalence and rhesus macaque admixture in cynomolgus macaques (Macaca fascicularis) bred for export in Chinese breeding farms

BACKGROUND

Most cynomolgus macaques (Macaca fascicularis) used in the United States as animal models are imported from Chinese breeding farms without documented ancestry. Cynomolgus macaques with varying rhesus macaque ancestry proportions may exhibit differences, such as susceptibility to malaria, that affect their suitability as a research model.

METHODS

DNA of 400 cynomolgus macaques from 10 Chinese breeding farms was genotyped to characterize their regional origin and rhesus ancestry proportion. A nested PCR assay was used to detect Plasmodium cynomolgi infection in sampled individuals.

RESULTS

All populations exhibited high levels of genetic heterogeneity and low levels of inbreeding and genetic subdivision. Almost all individuals exhibited an Indochinese origin and a rhesus ancestry proportion of 5%-48%. The incidence of P. cynomolgi infection in cynomolgus macaques is strongly associated with proportion of rhesus ancestry.

CONCLUSIONS

The varying amount of rhesus ancestry in cynomolgus macaques underscores the importance of monitoring their genetic similarity in malaria research.

Dynamics of Polarons in Organic Conjugated Polymers with Side Radicals

Based on the one-dimensional tight-binding Su-Schrieffer-Heeger (SSH) model, and using the molecular dynamics method, we discuss the dynamics of electron and hole polarons propagating along a polymer chain, as a function of the distance between side radicals and the magnitude of the transfer integrals between the main chain and the side radicals. We first discuss the average velocities of electron and hole polarons as a function of the distance between side radicals. It is found that the average velocities of the electron polarons remain almost unchanged, while the average velocities of hole polarons decrease significantly when the radical distance is comparable to the polaron width. Second, we have found that the average velocities of electron polarons decrease with increasing transfer integral, but the average velocities of hole polarons increase. These results may provide a theoretical basis for understanding carriers transport properties in polymers chain with side radicals.

[Mechanism of angiotensin-converting enzyme 2 overexpression improving collagen synthesis in lung]

Objective: To explore the mechanism of angiotensin-converting enzyme 2 (ACE2) overexpression improving collagen synthesis in lung. Methods: Lung fibroblasts of mice over-expressing ACE2 and the wild type (WT) were cultured in vitro and divided into 5 groups: WT-control, WT-AngiotensinⅡ (AngⅡ), ACE2(+ /+) -control, ACE2(+ /+) -AngⅡ and ACE2(+ /+) -AngⅡ+ A779. The protein relative expression levels of ACE2, collagen Ⅰ, nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4), nucleotide binding and oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3), autophagy-related protein (Beclin1), ubiquitin-binding protein p62 (P62), microtubule-associated proteins light chain 3-Ⅱ (LC3-Ⅱ) were measured by Western blot and triphosadenine (ATP) level was measured by ATP Assay Kit. Fibroblasts over-expressing ACE2 were pretreated with or without the autophagy inhibitor and were separated into 4 groups: ACE2(+ /+) -control, ACE2(+ /+) -AngⅡ, ACE2(+ /+) -AngⅡ+ 3-MA and ACE2(+ /+) -3-MA. In vivo, random allocation was used to averagely divide mice into four groups: WT-control, WT-Bleomycin (BLM), ACE2(+ /+) - control, ACE2(+ /+) -BLM. Wild type and ACE2 over-expressing mice were instilled with bleomycin endotracheally (3.5 mg/kg) or the same volume saline. All mice were sacrificed after 28 days and the lung tissue were used for HE and Masson staining as well as immunohistochemical staining for NOX4, P62 and LC3. Results: The vimentin in lung fibroblasts isolated from mice was proved to be positive by both immunohistochemical and immunofluorescence. The ACE2 protein level of lung fibroblasts over-expressing ACE2 was higher than the wild type (0.202±0.062 and 0.067±0.040, P<0.05). The protein levels of collagenⅠ, NOX4 and NLRP3 in WT-AngⅡ group were obviously higher than the WT-control group (0.861±0.129 and 0.417±0.076, 0.432±0.036 and 0.318±0.058, 0.367±0.125 and 0.045±0.012, all P<0.05). The difference of collagenⅠand NLRP3 between ACE2(+ /+) -AngⅡ group and ACE2(+ /+) -control group had no statistical significance (all P>0.05). CollagenⅠand NOX4 protein level in ACE2(+ /+) -AngⅡ+ A779 group were observably higher than ACE2(+ /+) - AngⅡ group (0.707±0.155 and 0.458±0.108, 0.299±0.038 and 0.149±0.090, all P<0.05). The autophagy related protein levels of Beclin1, P62 and LC3-Ⅱ in ACE2(+ /+) -control group were distinctly higher than WT-control group (0.834±0.051 and 0.274±0.018, 0.467±0.078 and 0.093±0.025, 0.494±0.065 and 0.150±0.054, all P<0.05). However, these protein levels in ACE2(+ /+) -AngⅡ+ A779 group were lower than ACE2(+ /+) -AngⅡ group (1.331±0.203 and 1.565±0.069, 0.298±0.096 and 0.438±0.077, 0.464±0.093 and 0.768±0.071, all P<0.05). ACE2(+ /+) -AngⅡ+ 3-MA group had higher collagenⅠ (0.383±0.125 and 0.032±0.013, P<0.05) and lower LC3-Ⅱ protein level (1.177±0.140 and 1.387±0.183, P<0.05) than AngⅡ group. In bleomycin induced lung fibrosis in mice, ACE2(+ /+) -BLM mice exhibited milder lung fibrosis and lower NOX4 protein level but higher LC3-Ⅱprotein level compared with WT-BLM mice. Conclusion: ACE2 over-expression ameliorated collagen synthesis through enhancing autophagy in lung.