Beyond PIK3/Akt signaling, Li et al. found that betulinic acid inhibits MAKP and activates the NRF signaling pathway [1,35], and Zhou et al. demonstrated that betulinic acid ameliorates the severity of acute pancreatitis via inhibition of the NF-κB signaling pathway in mice [36]. This evidence concerns the gene NKRF and acute pancreatitis.