1.Research and Outlook on The Application of Radar-based Non-contact Health Monitoring Technology
Jia-Bin ZHONG ; Qing ZHANG ; Shuai-Wei QIAN
Progress in Biochemistry and Biophysics 2026;53(4):982-999
Radar-based non-contact health monitoring technology (RBNHMT) has emerged as a transformative paradigm in continuous health sensing, enabling non-invasive and continuous monitoring of physiological parameters and behavioral patterns by transmitting electromagnetic waves, analyzing the reflected signals, and detecting subtle bodily movements—ranging from millimeter-scale chest wall displacements due to respiration to micro-scale vibrations associated with cardiac activity—ultimately transforming them into quantifiable health data. Distinguished by its non-contact operation, inherent privacy preservation, and adaptability to diverse scenarios, RBNHMT exhibits stronger resistance to environmental interference than conventional contact-based monitoring, and has solidified its position as a prominent and dynamic research focus in the field of non-contact health monitoring. Currently, significant and multifaceted progress has been made across several key areas. In human activity recognition (HAR), systems leveraging micro-Doppler signatures or point cloud sequences achieve high-precision detection of gait, gestures, and fall events, with state-of-the-art deep learning-based models achieving accuracy rates exceeding 99% in controlled experimental settings. For vital sign and sleep monitoring, it not only tracks respiratory and heart rates continuously but also extracts clinically relevant metrics such as heart rate variability (HRV) for autonomic nervous system assessment and estimates blood pressure through indirect methods like pulse transit time analysis, while maintaining robustness in dynamic settings through advanced motion compensation algorithms. In sleep monitoring, it further enables sleep posture classification and apnea event detection. In emotion and stress recognition, it provides a non-intrusive approach for psychological assessment by analyzing autonomic-response physiological signal patterns or behavioral features. Furthermore, its applications in auxiliary medical diagnosis have expanded to promising interdisciplinary areas such as non-contact heart sound auscultation, radar-based screening for obstructive sleep apnea (OSA), and emerging research into breast cancer detection using microwave and millimeter-wave imaging techniques. However, several challenges impede its practical deployment. Signal quality is significantly compromised by multipath interference in complex indoor environments and clutter from static objects, and by motion artifacts in dynamic scenarios where gross body movements obscure the subtle physiological signals. Algorithmically, separating signals from multiple targets in close proximity and calibrating for substantial individual physiological differences, such as body habitus, baseline vital signs, remain difficult and limit generalizability. Hardware design also faces the challenge of balancing power consumption, cost, integration, and performance, often requiring trade-offs that constrain miniaturization, battery life, or measurement sensitivity. Future advancement, therefore, requires collaborative and targeted innovation across multiple dimensions. Algorithmically, developing adaptive signal processing models based on emerging paradigms such as few-shot learning (for user-specific calibration with minimal data) and reinforcement learning (for dynamic noise suppression) is essential. At the hardware level, highly integrated radar SoCs with embedded processing capabilities and advanced packaging technologies are crucial for achieving the dual goals of device miniaturization and cost reduction without sacrificing performance. At the system level, fusing radar data with complementary modalities such as infrared and acoustic sensing can create a synergistic, multi-modal framework that significantly enhances perceptual robustness and reliability in complex, real-world environments. This review provides a comprehensive synthesis that systematically summarizes the relevant theoretical foundations and application progress, and offers an in-depth analysis of the current technical bottlenecks. It aims to provide a clear development path and a foundational academic reference for the in-depth integration and practical application of RBNHMT in critical scenarios including rehabilitation engineering, smart elderly care, in-vehicle health monitoring, and beyond, thereby offering innovative technical support for the vision of universal, proactive, and personalized health management.
2.Standardization of outpatient medical record in rehabilitation setting
Ye LIU ; Qing QIN ; Haiyan YE ; Yifan TIAN ; Yingxin ZHANG ; Yaru YANG ; Zhongyan WANG ; Meng ZHANG ; Xiaoxie LIU ; Yanyan YANG ; Bin ZENG ; Mouwang ZHOU ; Yuxiao XIE ; Guangxu XU ; Jiejiao ZHENG ; Mingsheng ZHANG ; Xiangming YE ; Fubiao HUANG ; Qiuchen HUANG ; Yiji WANG ; Di CHEN ; Zhuoying QIU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(1):45-54
ObjectiveTo analyze the data structure and standards of rehabilitation outpatient medical records, to provide data support for improving the quality of rehabilitation outpatient care and developing medical insurance payment policies. MethodsBased on the normative documents issued by the National Health Commission, Basic Standards for Medical Record Writing and Standards for Electronic Medical Record Sharing Documents, in accordance with the Quality Management Regulations for Outpatient (Emergency) Diagnosis and Treatment Information Pages (Trial), reference to the framework of the World Health Organization Family of International Classifications (WHO-FICs), the data framework and content of rehabilitation outpatient medical records were determined, and the data standards were discussed. ResultsThis study constructed a data framework for rehabilitation outpatient medical records, including four main components: patient basic information, visit process information, diagnosis and treatment information, and cost information. Three major reference classifications of WHO-FICs, International Classification of Diseases, International Classification of Functioning, Disability and Health, and International Classification of Health Interventions,were used to establish diagnostic standards and standardized terminology, as well as coding disease diagnosis, functional description, functional assessment, and rehabilitation interventions, to improve the quality of data reporting, and level of quality control in rehabilitation. ConclusionThe structuring and standardization of rehabilitation outpatient medical records are the foundation for sharing of rehabilitation data. The using of the three major classifications of WHO-FICs is valuable for the terminology and coding of disease diagnosis, functional description and assessment, and intervention in rehabilitation outpatient medical records, which is significant for sharing and interconnectivity of rehabilitation outpatient data, as well as for optimizing the quality and safety of rehabilitation medical services.
3.Structure, content and data standardization of inpatient rehabilitation medical record summary sheet
Haiyan YE ; Qing QIN ; Ye LIU ; Yifan TIAN ; Yingxin ZHANG ; Yaru YANG ; Zhongyan WANG ; Meng ZHANG ; Xiaoxie LIU ; Yanyan YANG ; Bin ZENG ; Mouwang ZHOU ; Yuxiao XIE ; Guangxu XU ; Jiejiao ZHENG ; Mingsheng ZHANG ; Xiangming YE ; Fubiao HUANG ; Qiuchen HUANG ; Yiji WANG ; Di CHEN ; Zhuoying QIU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(1):55-66
ObjectiveTo explore the standardization of inpatient rehabilitation medical record summary sheet, encompassing its structure, content and data standards, to enhance the standardization level of inpatient rehabilitation medical record summary sheet, improve data reporting quality, and provide accurate data support for medical insurance payment, hospital performance evaluation, and rehabilitation discipline evaluation. MethodsBased on the relevant specifications of the National Health Commission's Basic Norms for Medical Record Writing, Specifications for Sharing Documents of Electronic Medical Records, and Quality Management and Control Indicators for Inpatient Medical Record Summary Sheet (2016 Edition), this study analyzed the structure and content of the inpatient rehabilitation medical record summary sheet. The study systematically applied the three major reference classifications of the World Health Organization Family of International Classifications, International Classification of Diseases (ICD-10/ICD-11, ICD-9-CM-3), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Interventions (ICHI Beta-3), for disease diagnosis, functional description and assessment, and rehabilitation intervention, forming a standardized terminology system and coding methods. ResultsThe inpatient rehabilitation medical record summary sheet covered four major sections: inpatient information, hospitalization information, diagnosis and treatment information, and cost information. ICD-10/ICD-11 were the standards and coding tools for admission and discharge diagnoses in the inpatient rehabilitation medical record summary sheet. The three functional assessment tools recommended by ICD-11, the 36-item version of World Health Organization Disability Assessment Schedule 2.0, Brief Model Disability Survey and Generic Functioning domains, as well as ICF, were used for rehabilitation functioning assessment and the coding of outcomes. ICHI Beta-3 and ICD-9-CM-3 were used for coding surgical procedures and operations in the medical record summary sheet, and also for coding rehabilitation intervention items. ConclusionThe inpatient rehabilitation medical record summary sheet is a summary of the relevant content of the rehabilitation medical record and a tool for reporting inpatient rehabilitation data. It needs to be refined and optimized according to the characteristics of rehabilitation, with necessary data supplemented. The application of ICD-11/ICD-10, ICF and ICHI Beta-3/ICD-9-CM-3 classification standards would comprehensively promote the accuracy of inpatient diagnosis of diseases and functions. Based on ICD-11 and ICF, relevant functional assessment result data would be added, and ICHI Beta-3/ICD-9-CM-3 should be used to code rehabilitation interventions. Improving the quality of rehabilitation medical records and inpatient rehabilitation medical record summary sheet is an important part of rehabilitation quality control, and also lays an evidence-based data foundation for the analysis and application of inpatient rehabilitation medical record summary sheet.
4.PD-1-mediated CD4+T cell exhaustion exacerbates gut microbiota translocation in mouse model of sepsis
Bin QING ; Xinxin KONG ; Dongfan YE ; Chuangye WANG ; Jian ZHANG ; Bin WANG ; Xiaoou HUANG ; Nanbo WANG ; Hang QIAN ; Zhi XU
Journal of Army Medical University 2025;47(19):2302-2314
Objective To investigate the characteristics of immune exhaustion in sepsis and analyze its association with gut microbiota translocation.Methods A total of 130 mice were randomly divided into a cecal ligation and puncture(CLP)group(n=100)and a Sham group(n=30)Mouse model of sepsis was established with CLP procedure.Flow cytometry was used to analyze the proportions of peripheral blood CD4+T and CD8+T cells and programmed cell death protein 1(PD-1)positive T cell subsets in mice.Bacterial colonization in organs such as the heart,liver and kidneys was quantified by plating homogenates of the organs.Pathological changes in immune organs were observed with HE staining.The expression and localization of CD4?,CD8?,and PD-1?cells in immune organs were detected with immunohistochemical staining,and Image J software was employed for subsequent quantification of the number of the positive cells.Results HE staining demonstrated that immune organs exhibited varying degrees of pathological damages with disease progression.Compared with the Sham mice,the CLP mice exhibited significantly increased bacterial colonization in parenchymal organs and peripheral blood(P<0.05),notably in the liver,which showed the most severe infection.In the CLP group,the proportion of CD4+T lymphocytes in peripheral blood at days 1,3,and 5 postoperatively was decreased by 56%,70.57%,and 87.42%,respectively,when compared with the Sham group(P<0.001).The proportion of CD8+T lymphocytes was decreased by 48.33%relative to the Sham group only at day 5(P<0.001).In contrast,the proportion of CD4+T cell subsets expressing PD-1 was increased to 673.08,423.08,and 600 times that of the Sham group,respectively,at the same postoperative time points(P<0.001).Immunohistochemical results showed that,in the CLP group,the proportion of CD4+T cells in the thymus,spleen,and mesenteric lymph nodes was increased to 7.65,2.66,and 3.7 times that of the Sham group,respectively,at the early-stage peak(P<0.001),and then these proportions were decreased by 82.8%(P<0.001),41.9%(P<0.01),and 60.15%(P<0.001),respectively,at the late-stage trough when compared with the early-stage peak in the corresponding organs.The proportion of CD8+positive cells was increased in the early stage and then decreased insignificantly,while the proportion of PD-1+positive cells was increased continuously,and reached 6.24,13.9,and 20.96 times that of the Sham group at the peak in the thymus,spleen,and mesenteric lymph nodes respectively(P<0.001),with their expression regions showing a rough overlap with those of CD4+cells.Conclusion During sepsis,the inflammatory response can cause severe damage to immune organs and persistent exhaustion of CD4?T lymphocytes,leading to declined defenses against infection,which may be the main causes for exacerbated gut microbiota translocation and then systemic infection.
5.Establishment and evaluation of a lipopolysaccharide-induced acute respiratory distress syndrome model in minipigs
Chuang-Ye WANG ; Ran WANG ; Jian ZHANG ; Ling-Xiao QIU ; Bin QING ; Heng YOU ; Jin-Cheng LIU ; Bin WANG ; Nan-Bo WANG ; Jia-Yu LI ; Xing LIU ; Shuang WANG ; Jin HU ; Jian WEN ; Quan LI ; Xiao-Ou HUANG ; Kun ZHAO ; Shuang-Lin LIU ; Gang LIU ; Mei-Ju WANG ; Qing XIANG ; Hong-Mei WU ; Xiao-Rong SUN ; Tao GU ; Dong ZHANG ; Qi LI ; Zhi XU
Medical Journal of Chinese People's Liberation Army 2025;50(9):1154-1161
Objective To establish a stable,reliable,and clinically relevant porcine model of endotoxin-induced acute respiratory distress syndrome(ARDS).Methods Ten 8-month-old male Bama minipigs were deeply sedated,followed by invasive mechanical ventilation and electrocardiographic monitoring.Lipopolysaccharide(LPS)was intravenously pumped at 600 μg/(kg·h)for 3 hours,then maintained at 15 μg/(kg·h)thereafter.Dynamic monitoring was performed at five time points after LPS injection(LPS 0,1,3,5,and 8 h),including arterial blood gas analysis and chest computed tomography(CT)scans.Pathological examination of lung tissues obtained via bronchoscopic biopsy(HE staining and transmission electron microscopy)was conducted.These indicators were comprehensively used to evaluate the success of the animal model.Results At 5 hours after LPS administration,8 minipigs developed symptoms such as skin cyanosis,elevated body temperature,and respiratory distress.The oxygenation index decreased to<300 mmHg.Chest CT scans showed diffuse pulmonary infiltrates.Histopathology revealed alveolar edema and hyaline membrane formation.Transmission electron microscopy demonstrated disruption of pulmonary blood-air barrier,depletion of lamellar bodies in type Ⅱ pneumocytes,inflammatory cell infiltration,and exudation of plasma proteins and fibrin.Compared with LPS 0 h,at LPS 8 h,the oxygenation index and arterial blood pH were significantly decreased(P<0.001),while blood lactic acid and serum potassium were significantly increased(P<0.05);serum calcium and base excess were significantly decreased(P<0.05),and the lung injury score based on HE-stained lung sections was significantly increased(P<0.01).Conclusion The porcine ARDS model established by continuous LPS injection can dynamically simulate the pathophysiological characteristics and typical pathological manifestations of clinical septic ARDS,making it an effective tool to study the pathogenesis,prevention,and treatment strategies of septic ARDS.
6.Risk factors and predictive value of postoperative pulmonary infection after thoracoscopic lobectomy for NSCLC
Jia YAN ; Jiayuan JIN ; Qing ZHANG ; Bin LI ; Jingtao LI
Clinical Medicine of China 2025;41(2):111-116
Objective:To explore the risk factors of pulmonary infection in patients with non-small cell lung cancer (NSCLC) after thoracoscopic lobectomy and evaluate their predictive value.Methods:A retrospective analysis was conducted on the clinical data of 152 NSCLC patients who underwent thoracoscopic lobectomy at the Central Hospital of Tongchuan Mining Bureau in Shaanxi Province from May 2021 to May 2024. Among them, 45 cases were diagnosed with pulmonary infection by postoperative lung CT examination (postoperative infection group), while the remaining 107 cases did not develop pulmonary infection (non infection group). The levels of serum procalcitonin, serum amyloid A (SAA), and soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) between two groups of patients before and after surgery were compared, and conduct a multivariate logistic regression analysis on the risk factors of pulmonary infection in NSCLC patients undergoing thoracoscopic lobectomy was conducted to evaluate the predictive value of each indicator for pulmonary infection in NSCLC patients after thoracoscopic lobectomy. The normally distributed quantitative data was represented by xˉ± s. Independent sample t-test was used for comparison between two groups, and paired t-test was used for comparison before and after treatment; The count data was presented as an example (%), and the comparison between groups was conducted using the chi square test. The risk factors for postoperative pulmonary infection in NSCLC patients were analyzed using multiple logistic regression analysis. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of each indicator for pulmonary infection after thoracoscopic lobectomy. Results:No difference were found in the levels of serum procalcitonin, SAA, and sTREM-1 between two groups of patients before surgery(all P>0.05); 24 hours after surgery, the levels of serum procalcitonin, SAA, and sTREM-1 in both groups of patients were higher than before surgery [Postoperative infection group: (1.16±0.29) μg/L compared to (0.34±0.09) μg/L, (10.2±1.8) mg/L compared to (7.3±0.9) mg/L, (20.3±4.8) ng/L compared to (8.0±1.2) ng/L, t-values were 20.70, 9.70, and 16.89, respectively, all P<0.001; The uninfected group (0.84±0.14) μg/L compared to (0.32±0.08) μg/L, (8.2±1.1) mg/L compared to (7.4±0.9) mg/L, and (13.5±6.3) ng/L compared to (8.1±1.2) ng/L, with t-values of 33.36, 6.13, and 8.73, respectively, all P<0.001, and the infected group was higher than the uninfected group ( t-values of 9.18, 8.32, and 6.52, respectively, all P<0.001). The results of multivariate logistic regression analysis showed that serum procalcitonin, SAA, and sTREM-1 levels at 24 hours after surgery were all risk factors for pulmonary infection in NSCLC patients undergoing thoracoscopic lobectomy (odds ratios of 2.40, 1.61, 1.60, 95% confidence intervals: 1.14~5.04, 1.09~2.38, 1.13~2.26, P values of 0.021, 0.017, 0.009, respectively). The area under curve(AUC) of serum procalcitonin, SAA, and sTREM-1 predicting pulmonary infection after thoracoscopic lobectomy in NSCLC patients 24 hours after surgery were 0.84, 0.74, and 0.79, respectively, with cutoff values of 1.03 μg/L, 9.74 mg/L, and 16.85 ng/L, respectively. Conclusions:The levels of serum procalcitonin, SAA, and sTREM-1 24 hours after surgery are all risk factors for pulmonary infection in NSCLC patients undergoing thoracoscopic lobectomy, and all three had a high predictive value for postoperative pulmonary infection.
7.The Valvular Heart Disease-specific Age-adjusted Comorbidity Index (VHD-ACI) score in patients with moderate or severe valvular heart disease.
Mu-Rong XIE ; Bin ZHANG ; Yun-Qing YE ; Zhe LI ; Qing-Rong LIU ; Zhen-Yan ZHAO ; Jun-Xing LV ; De-Jing FENG ; Qing-Hao ZHAO ; Hai-Tong ZHANG ; Zhen-Ya DUAN ; Bin-Cheng WANG ; Shuai GUO ; Yan-Yan ZHAO ; Run-Lin GAO ; Hai-Yan XU ; Yong-Jian WU
Journal of Geriatric Cardiology 2025;22(9):759-774
BACKGROUND:
Based on the China-VHD database, this study sought to develop and validate a Valvular Heart Disease- specific Age-adjusted Comorbidity Index (VHD-ACI) for predicting mortality risk in patients with VHD.
METHODS & RESULTS:
The China-VHD study was a nationwide, multi-centre multi-centre cohort study enrolling 13,917 patients with moderate or severe VHD across 46 medical centres in China between April-June 2018. After excluding cases with missing key variables, 11,459 patients were retained for final analysis. The primary endpoint was 2-year all-cause mortality, with 941 deaths (10.0%) observed during follow-up. The VHD-ACI was derived after identifying 13 independent mortality predictors: cardiomyopathy, myocardial infarction, chronic obstructive pulmonary disease, pulmonary artery hypertension, low body weight, anaemia, hypoalbuminaemia, renal insufficiency, moderate/severe hepatic dysfunction, heart failure, cancer, NYHA functional class and age. The index exhibited good discrimination (AUC, 0.79) and calibration (Brier score, 0.062) in the total cohort, outperforming both EuroSCORE II and ACCI (P < 0.001 for comparison). Internal validation through 100 bootstrap iterations yielded a C statistic of 0.694 (95% CI: 0.665-0.723) for 2-year mortality prediction. VHD-ACI scores, as a continuous variable (VHD-ACI score: adjusted HR (95% CI): 1.263 (1.245-1.282), P < 0.001) or categorized using thresholds determined by the Yoden index (VHD-ACI ≥ 9 vs. < 9, adjusted HR (95% CI): 6.216 (5.378-7.184), P < 0.001), were independently associated with mortality. The prognostic performance remained consistent across all VHD subtypes (aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation, tricuspid valve disease, mixed aortic/mitral valve disease and multiple VHD), and clinical subgroups stratified by therapeutic strategy, LVEF status (preserved vs. reduced), disease severity and etiology.
CONCLUSION
The VHD-ACI is a simple 13-comorbidity algorithm for the prediction of mortality in VHD patients and providing a simple and rapid tool for risk stratification.
8.Efficacy and Safety of Yangxue Qingnao Pills Combined with Amlodipine in Treatment of Hypertensive Patients with Blood Deficiency and Gan-Yang Hyperactivity: A Multicenter, Randomized Controlled Trial.
Fan WANG ; Hai-Qing GAO ; Zhe LYU ; Xiao-Ming WANG ; Hui HAN ; Yong-Xia WANG ; Feng LU ; Bo DONG ; Jun PU ; Feng LIU ; Xiu-Guang ZU ; Hong-Bin LIU ; Li YANG ; Shao-Ying ZHANG ; Yong-Mei YAN ; Xiao-Li WANG ; Jin-Han CHEN ; Min LIU ; Yun-Mei YANG ; Xiao-Ying LI
Chinese journal of integrative medicine 2025;31(3):195-205
OBJECTIVE:
To evaluate the clinical efficacy and safety of Yangxue Qingnao Pills (YXQNP) combined with amlodipine in treating patients with grade 1 hypertension.
METHODS:
This is a multicenter, randomized, double-blind, and placebo-controlled study. Adult patients with grade 1 hypertension of blood deficiency and Gan (Liver)-yang hyperactivity syndrome were randomly divided into the treatment or the control groups at a 1:1 ratio. The treatment group received YXQNP and amlodipine besylate, while the control group received YXQNP's placebo and amlodipine besylate. The treatment duration lasted for 180 days. Outcomes assessed included changes in blood pressure, Chinese medicine (CM) syndrome scores, symptoms and target organ functions before and after treatment in both groups. Additionally, adverse events, such as nausea, vomiting, rash, itching, and diarrhea, were recorded in both groups.
RESULTS:
A total of 662 subjects were enrolled, of whom 608 (91.8%) completed the trial (306 in the treatment and 302 in the control groups). After 180 days of treatment, the standard deviations and coefficients of variation of systolic and diastolic blood pressure levels were lower in the treatment group compared with the control group. The improvement rates of dizziness, headache, insomnia, and waist soreness were significantly higher in the treatment group compared with the control group (P<0.05). After 30 days of treatment, the overall therapeutic effects on CM clinical syndromes were significantly increased in the treatment group as compared with the control group (P<0.05). After 180 days of treatment, brachial-ankle pulse wave velocity, ankle brachial index and albumin-to-creatinine ratio were improved in both groups, with no statistically significant differences (P>0.05). No serious treatment-related adverse events occurred during the study period.
CONCLUSIONS
Combination therapy of YXQNP with amlodipine significantly improved symptoms such as dizziness and headache, reduced blood pressure variability, and showed a trend toward lowering urinary microalbumin in hypertensive patients. These findings suggest that this regimen has good clinical efficacy and safety. (Registration No. ChiCTR1900022470).
Humans
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Amlodipine/adverse effects*
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Drugs, Chinese Herbal/adverse effects*
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Male
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Female
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Hypertension/complications*
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Middle Aged
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Treatment Outcome
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Drug Therapy, Combination
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Adult
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Blood Pressure/drug effects*
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Double-Blind Method
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Aged
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Antihypertensive Agents/adverse effects*
9.Psychological stress-activated NR3C1/NUPR1 axis promotes ovarian tumor metastasis.
Bin LIU ; Wen-Zhe DENG ; Wen-Hua HU ; Rong-Xi LU ; Qing-Yu ZHANG ; Chen-Feng GAO ; Xiao-Jie HUANG ; Wei-Guo LIAO ; Jin GAO ; Yang LIU ; Hiroshi KURIHARA ; Yi-Fang LI ; Xu-Hui ZHANG ; Yan-Ping WU ; Lei LIANG ; Rong-Rong HE
Acta Pharmaceutica Sinica B 2025;15(6):3149-3162
Ovarian tumor (OT) is the most lethal form of gynecologic malignancy, with minimal improvements in patient outcomes over the past several decades. Metastasis is the leading cause of ovarian cancer-related deaths, yet the underlying mechanisms remain poorly understood. Psychological stress is known to activate the glucocorticoid receptor (NR3C1), a factor associated with poor prognosis in OT patients. However, the precise mechanisms linking NR3C1 signaling and metastasis have yet to be fully elucidated. In this study, we demonstrate that chronic restraint stress accelerates epithelial-mesenchymal transition (EMT) and metastasis in OT through an NR3C1-dependent mechanism involving nuclear protein 1 (NUPR1). Mechanistically, NR3C1 directly regulates the transcription of NUPR1, which in turn increases the expression of snail family transcriptional repressor 2 (SNAI2), a key driver of EMT. Clinically, elevated NR3C1 positively correlates with NUPR1 expression in OT patients, and both are positively associated with poorer prognosis. Overall, our study identified the NR3C1/NUPR1 axis as a critical regulatory pathway in psychological stress-induced OT metastasis, suggesting a potential therapeutic target for intervention in OT metastasis.
10.CRTAC1 derived from senescent FLSs induces chondrocyte mitochondrial dysfunction via modulating NRF2/SIRT3 axis in osteoarthritis progression.
Xiang CHEN ; Wang GONG ; Pan ZHANG ; Chengzhi WANG ; Bin LIU ; Xiaoyan SHAO ; Yi HE ; Na LIU ; Jiaquan LIN ; Jianghui QIN ; Qing JIANG ; Baosheng GUO
Acta Pharmaceutica Sinica B 2025;15(11):5803-5816
Osteoarthritis (OA), the most prevalent joint disease of late life, is closely linked to cellular senescence. Previously, we found that the senescence of fibroblast-like synoviocytes (FLS) played an essential role in the degradation of cartilage. In this work, single-cell sequencing data further demonstrated that cartilage acidic protein 1 (CRTAC1) is a critical secreted factor of senescent FLS, which suppresses mitophagy and induces mitochondrial dysfunction by regulating SIRT3 expression. In vivo, deletion of SIRT3 in chondrocytes accelerated cartilage degradation and aggravated the progression of OA. Oppositely, intra-articular injection of adeno-associated virus expressing SIRT3 effectively alleviated OA progression in mice. Mechanistically, we demonstrated that elevated CRTAC1 could bind with NRF2 in chondrocytes, which subsequently suppresses the transcription of SIRT3 in vitro. In addition, SIRT3 reduction could promote the acetylation of FOXO3a and result in mitochondrial dysfunction, which finally contributes to the degradation of chondrocytes. To conclude, this work revealed the critical role and underlying mechanism of senescent FLSs-derived CRTAC1 in OA progression, which provided a potential strategy for the OA therapy.

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