1.Analysis of the Burden of Acute Lymphoid Leukemia in China and Globally from 1990 to 2021
Derong LIN ; Jingya FANG ; Yue LI ; Xiaohua XIE ; Xiaolin YE ; Xiaowen ZHANG ; Jiexuan LI ; Aiguo XUE
Medical Journal of Peking Union Medical College Hospital 2026;17(2):463-475
To analyze the disease burden of acute lymphoid leukemia(ALL) and its changing trends in China and globally from 1990 to 2021, aiming to provide a theoretical basis for disease prevention, treatment, and policy formulation. Data on the incidence, prevalence, mortality, and disability adjusted life years(DALYs) of ALL in China and globally from 1990 to 2021 were extracted from the Global Burden of Disease(GBD) 2021 database. The Joinpoint regression model was used to calculate the average annual percentage change(AAPC) to assess the trends in disease burden. Decomposition analysis was employed to identify and quantify the contributions of different factors to the changes in ALL disease burden. The population attributable fraction(PAF) was used to compare the risk factors for ALL in China and globally in 1990 and 2021. Stratified by the sociodemographic index(SDI), the locally estimated scatterplot smoothing(LOESS) method was used to assess the association between age-standardized incidence rate(ASIR), age-standardized mortality rate(ASMR), and SDI. The incidence-mortality ratio(IMR) was calculated to evaluate the diagnostic level and current treatment status of ALL. From 1990 to 2021, ASIR of ALL in the Chinese population increased from 3.385/100 000 to 3.637/100 000(AAPC: 0.005), the age-standardized prevalence rate(ASPR) increased from 6.596/100 000 to 22.022/100 000(AAPC: 0.478), the ASMR decreased from 3.051/100 000 to 1.357/100 000(AAPC: -0.056), and the age-standardized DALYs rate(ASDR) decreased from 195.792/100 000 to 74.063/100 000(AAPC: -3.996). Globally, the corresponding figures were: ASIR decreased from 1.789/100 000 to 1.371/100 000(AAPC: -0.014), ASPR increased from 4.122/100 000 to 5.425/100 000(AAPC: 0.039), ASMR decreased from 1.551/100 000 to 0.898/100 000(AAPC: -0.021), and ASDR decreased from 94.894/100 000 to 48.858/100 000(AAPC: -1.494). During this period, the aforementioned disease burden indicators were generally higher in males than in females, both in China and globally.In 2021, the peak incidence of ALL in China and globally was primarily concentrated in the 0-19 years age group, with the highest rate observed in those under 5 years of age. The burden of prevalence and DALYs was also mainly concentrated in this age group. Regarding mortality, the death burden in China was predominantly observed in the older adult age group, particularly among those aged ≥60 years. Globally, the mortality burden was highest in the under-5 age group, while remaining at a relatively high level in the older adult population. SDI correlation analysis based on data from 204 countries/regions globally from 1990 to 2021 showed that ASIR gradually increased with increasing SDI, whereas ASMR showed an initial increase followed by a decreasing trend. The ASIR and ASMR for the overall Chinese population and by sex were higher than expected. PAF results indicated that smoking and high body mass index were the main attributable risk factors for ALL mortality and DALYs burden, with their contribution consistently increasing. Decomposition analysis revealed that population growth and epidemiological changes were the primary drivers behind the changes in ALL incidence and mortality burden. Compared with 1990, the IMR for ALL in both China and globally increased in 2021. Over the past three decades, the ASMR and ASDR for ALL in China and globally have generally declined. During the same period, the ASIR and ASPR for ALL increased in China, while globally, the ASIR decreased and the ASPR increased. However, the disease burden of ALL remains high in males, children, and the older adult population. Differentiated prevention and control measures should be implemented in accordance with changes in SDI. The findings highlight the importance of strengthening prevention and early diagnosis, and suggest the need for targeted screening and treatment strategies for different age and sex groups. Concurrently, attention should be paid to the role of weight management and tobacco control in comprehensive prevention and control efforts to further reduce the disease burden of ALL.
2.Ubiquitin-specific peptidase 21 promotes M2 polarization of endometriotic macrophages by increasing FOXM1 stability.
Min DONG ; Min XU ; Derong FANG ; Yiyuan CHEN ; Mingzhe ZHANG
Chinese Journal of Cellular and Molecular Immunology 2025;41(7):603-610
Objective To explore the mechanism of ubiquitin specific peptidase 21 (USP21) increasing the stability of forkhead box protein M1 (FOXM1) and promoting M2 polarization of macrophages in endometriosis (EM). Methods Eutopic endometrial stromal cells (EESC) collected from patients and normal endometrial stromal cells (NESC) from routine health examiners were cultured in vitro, and the expression levels of USP21 and FOXM1 were detected using RT-qPCR and Western blot. EESCs were co-cultured with macrophages. M1 polarization markers of interleukin 6 (IL-6) and CXC chemokine ligand 10 (CXCL10) and M2 polarization markers of CD206 and fibronectin 1 (FN1) were tested using RT-qPCR. M2 marker CD206 was further detected by flow cytometry. IL-6, tumor necrosis factor-alpha (TNF-α), IL-10, and transforming growth factor-beta (TGF-β) levels in cell supernatant were detected by ELISA. Co-immunoprecipitation was used to assess the interaction between USP21 and FOXM1, and the ubiquitination level of FOXM1. FOXM1 protein stability was detected through cycloheximide (CHX) assay. Results USP21 and FOXM1 expression levels in the EESC group were significantly increased compared with those in the NESC group; compared with the NESC + M0 group, the EESC + M0 group showed no significant difference in the expression of M1 polarization markers (IL-6 and CXCL10), but increased expression of M2 polarization markers (CD206 and FN1), along with notably increased number of M2 macrophages; there was no significant difference in IL-6 and TNF-α levels, but increased levels of IL-10 and TGF-β in the cell supernatant. The above findings indicated that the deubiquitinase USP21 was highly expressed in EM, promoting M2 polarization of macrophages. Knocking down USP21 or FOXM1 can inhibit M2 polarization of EM macrophages. USP21 interacted with FOXM1 in EESC, leading to a decrease in FOXM1 ubiquitination level and an increase in FOXM1 protein stability. Overexpression of FOXM1 reversed the inhibitory effect of knocking down USP21 on M2 polarization of EM macrophages. Conclusion The deubiquitinase USP21 interacts with FOXM1 to increase the stability of FOXM1 and promote M2 polarization of EM macrophages.
Humans
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Forkhead Box Protein M1/genetics*
;
Female
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Macrophages/cytology*
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Endometriosis/genetics*
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Ubiquitin Thiolesterase/genetics*
;
Cells, Cultured
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Endometrium/metabolism*
;
Ubiquitination
;
Adult
;
Interleukin-10/metabolism*
;
Interleukin-6/metabolism*
;
Protein Stability
;
Stromal Cells/metabolism*
3.Burden and Trends of Motor Neuron Disease in China and Globally from 1990 to 2021
Derong LIN ; Jingya FANG ; Yue LI ; Xiaohua XIE ; Xiaolin YE ; Xiaowen ZHANG ; Jiexuan LI ; Aiguo XUE
Medical Journal of Peking Union Medical College Hospital 2025;17(1):188-196
To analyze the disease burden and trends of motor neuron disease(MND) in China and globally from 1990 to 2021, providing evidence for the formulation of relevant health strategies inChina. Data on the incidence, prevalence, and disability-adjusted life years(DALYs) of MND in China and globally from 1990 to 2021 were extracted from the 2021 global burden of disease(GBD) database. The Joinpoint model was used to analyze trends through the average annual percentage change(AAPC). The disease burden differences were further analyzed by age and gender. From 1990 to 2021, the number of MND incident cases in China increased by 6.87%, while globally it increased by 74.54%.The number of prevalent cases in China rose by 29.78%, compared to a 68.43% increase globally. DALYs due to MND in China increased by 40.08%, while globally they increased by 105.59%. The age-standardized incidence rate(ASIR) of MND showed a declining trend both in China(AAPC=-0.006, 95% CI: -0.006 to -0.006, The overall disease burden of MND in China is lower than the global level, with ASIR and ASDR showing a declining trend. However, the annual number of incident cases, prevalent cases, and DALYs continues to increase. Furthermore, there are gender and age differences in the MND disease burden in China, with middle-aged and elderly males being the key targets for prevention and control.
4.Regulatory effect of transcription factor E4BP4 on pathological myocardial fibrosis through the AMPK-TGF-β1/SMAD3 signaling pathway
Derong HUANG ; Qing WEN ; Yuchen SU
Journal of Chongqing Medical University 2025;50(5):640-648
Objective:To explore the effects of transcription factor adenovirus E4 promoter-binding protein(E4BP4)in regulating pathological myocardial fibrosis through the adenosine monophosphate-activated protein kinase(AMPK)-transforming growth factor(TGF)-β1/Smad homolog 3(SMAD3)pathway.Methods:A mouse model of myocardial fibrosis was established,and the expression of E4BP4 was determined in the model group and the sham-operation group.Primary cardiac fibroblasts were isolated,cultured,activated by angiotensin Ⅱ(Ang Ⅱ),and divided into the following groups:Ang Ⅱ+E4BP4 group(transfected with E4BP4 overexpression plasmids),Ang Ⅱ+siE4BP4 group(transfected with E4BP4 interfering plasmids),Ang Ⅱ group,and control group(without Ang Ⅱtreatment).The fluorescence intensity of ɑ-smooth muscle actin(α-SMA)was determined by the immunofluorescence assay,the cell viability by the cell counting kit,the expression of E4BP4,α-SMA,collagen type Ⅰ(collagen Ⅰ),and collagen type Ⅲ(collagen Ⅲ)by polymerase chain reaction,and the protein expression of TGF-β1,AMPK,and SMAD3 by Western blot.Results:Compared with the sham-operation group,the model group showed significantly in-creased myocardial fibrosis degree(38.46±1.21 vs.3.39±0.39,t=-78.564,P=0.000)and E4BP4 protein expression(0.96±0.03 vs.0.75±0.03,t=-11.480,P=0.000).In vitro experiments found that the mean fluorescence intensity(0.05±0.01 vs.0.42±0.03,F=677.591,P=0.000),cell viability(91.30±2.39 vs.123.74±2.60,F=132.696,P=0.000),and the levels of α-SMA(1.26±0.09 vs.3.59±0.86,F=52.274,P=0.000),collagen Ⅰ(1.16±0.11 vs.3.79±0.89,F=55.336,P=0.000),collagen Ⅲ(1.23±0.13 vs.2.92±0.36,F=119.929,P=0.000),TGF-β1(0.66±0.04 vs.0.96±0.02,F=142.954,P=0.000),and p-SMAD3/SMAD3(0.81±0.03 vs.1.37±0.02,F=739.609,P=0.000)in the Ang Ⅱ+siE4BP4 group were significantly lower than those in the Ang Ⅱ+E4BP4 group.The expression of p-AMPK/AMPK in the Ang Ⅱ+siE4BP4 group was significantly higher than that in the Ang Ⅱ+E4BP4 group(0.89±0.01 vs.0.58±0.02,F=284.541,P=0.000).Conclusion:E4BP4 plays a crucial role in the regulation of fibrosis.Inhibition of E4BP4 expression exerts an anti-fibrotic effect by activating AMPK and inhibiting TGF-β1/SMAD3 pathway.
5.Growing burden of atherosclerotic cardiovascular disease in China:An analysis on lifestyle and metabolic factors based on the Global Burden of Disease Study 2021
Qiuyue TU ; Xinyu PENG ; Ziyi HE ; Derong LIN ; Jianhua LIU ; Jingrong LIANG
Journal of Army Medical University 2025;47(22):2824-2836
Objective To analyze the burden of atherosclerotic cardiovascular disease(ASCVD)attributable to lifestyle and metabolic factors in China from 1990 to 2021 and predict its future trends,providing evidence for public health prevention and control.Methods Based on the Global Burden of Disease(GBD)2021 database,we extracted disability-adjusted life years(DALYs)of ASCVD attributable to 7 key risk factors:dietary,low physical activity,smoking,high body mass index(BMI),high fasting blood glucose,high low-density lipid cholesterol(LDL-C),and hypertension.Age-standardized DALY rates(ASDR)were also calculated to account for variations in age structure,and an ARIMA model was applied to predict future trends.Results ① Overall trend analysis showed the leading risk factor for ischemic heart disease(IHD)shifted from dietary risks in 1990 to hypertension in 2021,while hypertension and smoking remained the primary risk factors for ischemic stroke(IS)and peripheral artery disease(PAD),respectively.② In BRICS nations,hypertension was the dominant risk factor for both IHD and IS,whereas in China,smoking and high fasting blood glucose continued to be the major drivers of PAD burden.③ Sex-specific analysis revealed that hypertension was the leading risk factor for IHD and IS in both males and females.For PAD,smoking was the main risk factor in males,while high fasting blood glucose was for females.Age-stratified analysis revealed that in the 15-49 age group,dietary,high LDL-C and smoking were the primary factor for IHD,IS and PAD,respectively;in the 50-69 group,dietary predominated IHD risk,hypertension IS,and smoking PAD;and among those aged≥70 years,hypertension was the leading risk factor for both IHD and IS,and high fasting blood glucose was for PAD.④ ARIMA model forecasted that by 2035,DALYs for IHD,IS,and PAD will increase to 82.816 million,46.808 million,and 0.192 million person-years,respectively.Conclusion The ASCVD burden attributable to lifestyle and metabolic factors continues to rise in China from 1990 to 2021,and is projected to further increase by 2035.Countermeasures We suggest that current prevention and control priorities are enhanced management of metabolic factors,tailored interventions by sex and age,promotion of healthy lifestyles and tobacco control,and establishment of an integrated system of prevention-treatment-rehabilitation-research.
6.Expert consensus:Prevention and treatment of dental implant biological complications
Xing WANG ; Liping WANG ; Qintao WANG ; Rong SHU ; Dongying XUAN ; Yiqun WU ; Lixin QIU ; Derong ZOU ; Yingliang SONG ; Jiang CHEN ; Yan XU ; Jincai ZHANG ; Yucheng SU ; Linhu GE ; Yufeng XIE
STOMATOLOGY 2025;45(11):801-807
Dental implantology has developed rapidly for over half a century,since pure titanium(99.7%)dental cylindrical threaded implants were exploited and osseointegration was introduced in 1960s by Prof.Br?nemark.The long term retention rates of 10 years or more are over 95%.However,the biological complications jeopardize the long term effects of dental implant treatment seriously.The prevalence of dental implant biological complications varies greatly among different reports resulting from the disparities on the defini-tions of dental implant biological complications.After analyzing and summarizing the major opinions proposed internationally in recent years,the consensus for the definition of dental implant biological complications has been reached.Generally the dental implant biologi-cal implications can be classified into early stage(before restoration)biological complications and late stage(after restoration)biological complications.The early stage biological complications include acute and chronic infections,pain,soft tissue deficiency,and osseointegration failure,etc.The late stage complications include peri-implant diseases(peri-implant mucositis and peri-implantitis),soft tissue deficiency around implant,implant loosening and dropping off,etc.The various risk factors related to different dental implant biological complications,the strategies of the prevention and treatment for the dental implant biological complications have been discussed comprehensively,and the consensus has been reached.It is aimed to advocate the dentist to pay more attention to the early prevention of the biological implant complications,to promote more researches on the implant biological complications,and to help elevate the level of dental implantology in our country.
7.Single narrow-diameter implant-supported dual-unit cantilever restorations for consecutive missing teeth in the anterior mandible:a 3D finite element analysis
Renqiang BAO ; Chengqi LÜ ; Lüfeng YU ; Jiayu LU ; Derong ZOU
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(3):301-309
Objective·To evaluate the applicability of dual-unit cantilever restorations supported by a single narrow-diameter implant for consecutive missing teeth in the anterior mandibular region.Methods·A simplified mandibular anterior jaw model and a dual-unit cantilever model supported by a single narrow-diameter implant were constructed.The dimensions of the mandibular anterior bone block were set to 20 mm(length),5 mm(width),and 15 mm(height).The narrow-diameter implant used was the Axiom 2.8 two-stage implant,2.8 mm× 10 mm,paired with a 2.5 mm straight abutment.Based on calculations,the edentulous gap ranged from 5.8 mm to 11.6 mm,leading to the creation of seven crown models with mesiodistal widths of 5.8,6.8,7.8,8.8,9.8,10.8,and 11.8 mm.The implant,crowns,and jaw model were assembled using Siemens Nx 12.0 software,and the data were imported into Ansys Workbench 18.0 for finite element analysis.A vertical load of 100 N and a 30° oblique load were applied to simulate occlusal forces.The Von-Mises stress on the implants,as well as the maximum compressive and tensile stresses in the cortical bone and the maximum tensile stress in the cancellous bone,was analyzed to investigate stress distribution under varying cantilever lengths.Results·The implant neck region exhibited the highest stress concentration.As the cantilever length increased,the peak Von-Mises stress on the implants,the maximum tensile stress in the cortical and cancellous bones,and the maximum compressive stress in the cortical bones all increased progressively.However,all stress values remained within physiological limits.The peak Von-Mises stress ranged from 141.52 MPa to 707.17 MPa,below the implant's ultimate tensile strength of 930 MPa.The maximum tensile stress in the cortical bones(with a peak of 60.82 MPa in the 11.8 mm group)was below the cortical bone's tensile strength limit of 100-130 MPa.The maximum compressive stress in the cortical bone(with an absolute maximum value of 129.39 MPa in the 11.8 mm group)was below the cortical bone's compressive strength limit of 170 to 190 MPa(absolute values).The maximum tensile stress in the cancellous bone ranged from 0.84 MPa to 4.70 MPa,which was below or close to its ultimate tensile strength of 2-5 MPa.Conclusion·Dual-unit cantilever restorations supported by a single narrow-diameter implant may represent a viable treatment option for consecutive missing teeth in the anterior mandibular region.
8.Expert consensus:Prevention and treatment of dental implant biological complications
Xing WANG ; Liping WANG ; Qintao WANG ; Rong SHU ; Dongying XUAN ; Yiqun WU ; Lixin QIU ; Derong ZOU ; Yingliang SONG ; Jiang CHEN ; Yan XU ; Jincai ZHANG ; Yucheng SU ; Linhu GE ; Yufeng XIE
STOMATOLOGY 2025;45(11):801-807
Dental implantology has developed rapidly for over half a century,since pure titanium(99.7%)dental cylindrical threaded implants were exploited and osseointegration was introduced in 1960s by Prof.Br?nemark.The long term retention rates of 10 years or more are over 95%.However,the biological complications jeopardize the long term effects of dental implant treatment seriously.The prevalence of dental implant biological complications varies greatly among different reports resulting from the disparities on the defini-tions of dental implant biological complications.After analyzing and summarizing the major opinions proposed internationally in recent years,the consensus for the definition of dental implant biological complications has been reached.Generally the dental implant biologi-cal implications can be classified into early stage(before restoration)biological complications and late stage(after restoration)biological complications.The early stage biological complications include acute and chronic infections,pain,soft tissue deficiency,and osseointegration failure,etc.The late stage complications include peri-implant diseases(peri-implant mucositis and peri-implantitis),soft tissue deficiency around implant,implant loosening and dropping off,etc.The various risk factors related to different dental implant biological complications,the strategies of the prevention and treatment for the dental implant biological complications have been discussed comprehensively,and the consensus has been reached.It is aimed to advocate the dentist to pay more attention to the early prevention of the biological implant complications,to promote more researches on the implant biological complications,and to help elevate the level of dental implantology in our country.
9.Single narrow-diameter implant-supported dual-unit cantilever restorations for consecutive missing teeth in the anterior mandible:a 3D finite element analysis
Renqiang BAO ; Chengqi LÜ ; Lüfeng YU ; Jiayu LU ; Derong ZOU
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(3):301-309
Objective·To evaluate the applicability of dual-unit cantilever restorations supported by a single narrow-diameter implant for consecutive missing teeth in the anterior mandibular region.Methods·A simplified mandibular anterior jaw model and a dual-unit cantilever model supported by a single narrow-diameter implant were constructed.The dimensions of the mandibular anterior bone block were set to 20 mm(length),5 mm(width),and 15 mm(height).The narrow-diameter implant used was the Axiom 2.8 two-stage implant,2.8 mm× 10 mm,paired with a 2.5 mm straight abutment.Based on calculations,the edentulous gap ranged from 5.8 mm to 11.6 mm,leading to the creation of seven crown models with mesiodistal widths of 5.8,6.8,7.8,8.8,9.8,10.8,and 11.8 mm.The implant,crowns,and jaw model were assembled using Siemens Nx 12.0 software,and the data were imported into Ansys Workbench 18.0 for finite element analysis.A vertical load of 100 N and a 30° oblique load were applied to simulate occlusal forces.The Von-Mises stress on the implants,as well as the maximum compressive and tensile stresses in the cortical bone and the maximum tensile stress in the cancellous bone,was analyzed to investigate stress distribution under varying cantilever lengths.Results·The implant neck region exhibited the highest stress concentration.As the cantilever length increased,the peak Von-Mises stress on the implants,the maximum tensile stress in the cortical and cancellous bones,and the maximum compressive stress in the cortical bones all increased progressively.However,all stress values remained within physiological limits.The peak Von-Mises stress ranged from 141.52 MPa to 707.17 MPa,below the implant's ultimate tensile strength of 930 MPa.The maximum tensile stress in the cortical bones(with a peak of 60.82 MPa in the 11.8 mm group)was below the cortical bone's tensile strength limit of 100-130 MPa.The maximum compressive stress in the cortical bone(with an absolute maximum value of 129.39 MPa in the 11.8 mm group)was below the cortical bone's compressive strength limit of 170 to 190 MPa(absolute values).The maximum tensile stress in the cancellous bone ranged from 0.84 MPa to 4.70 MPa,which was below or close to its ultimate tensile strength of 2-5 MPa.Conclusion·Dual-unit cantilever restorations supported by a single narrow-diameter implant may represent a viable treatment option for consecutive missing teeth in the anterior mandibular region.
10.Exploration on the Relationship Between Emotion and Liver from Different Perspectives of Chinese and Western Medicine
Ying ZHANG ; Yanyu DONG ; Derong KONG ; Zhiying DOU ; Zhen YANG ; Hui WANG
World Science and Technology-Modernization of Traditional Chinese Medicine 2024;26(4):879-885
In recent years,with the development of the bio-psycho-social medical model,more and more attention has been paid to the relationship between psycho-emotional factors and liver.According to traditional Chinese medicine theory,the liver is mainly responsible for catharsis and regulating emotion,which is closely related to emotion.Epidemiological studies have shown that all kinds of liver diseases are accompanied by different degrees of mental disorders,and mental and emotional abnormalities may promote the occurrence of liver diseases and affect the prognosis.Liver and emotion have a common pathogenesis in pathology,involving the dysfunction of nervous,endocrine and immune systems.Based on the basic theory of traditional Chinese medicine and modern medical research,this review analyzes the correlation between emotions and liver.At the same time,neurotransmitters,inflammatory cytokines,brain-derived neurotrophic factor(BDNF),soluble epoxide hydrolase(sEH),intestinal microecology,hypothalamic-pituitary-adrenal(HPA)axis and hypothalamic-pituitary-thyroid(HPT)axis,which summarizes the potential mechanisms of liver disease complicated with emotional disorders,and provides certain reference value for future theoretical research and clinical treatment.

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