1.Efficacy Connotation and Mechanisms of Shudi Qiangjin Pills Against Steroid-induced Osteonecrosis of Femoral Head Based on "Disease-Syndrome-Formula" Association Network
Zhijian CHEN ; Suya ZHANG ; Longlong DING ; Guixin ZHANG ; Bo LIU ; Baohong MI ; Yanqiong ZHANG ; Na LIN ; Weiheng CHEN ; Chunzhu GONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):88-99
ObjectiveTo elucidate the efficacy connotation of Shudi Qiangjin pills (SQP) against liver and kidney deficiency in steroid-induced osteonecrosis of femoral head (SONFH) from the perspective of the "disease-syndrome-formula" association and to clarify the underlying mechanisms based on in vivo and in vitro experiment validation. MethodsThe chemical components and the corresponding putative targets of SQP were collected from the Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine (TCMIP) v2.0, the Encyclopedia of Traditional Chinese Medicine (ETCM) v2.0, and HERB databases. The SONFH-related genes were identified based on the differential expression profiles of peripheral blood of patients with SONFH compared to the healthy volunteers, and the disease phenotype-related targets were collected from the TCMIP v2.0 database. Then, the interaction network of "SONFH-related genes and candidate targets of SQP" was constructed based on "gene-gene interaction information", and the major network targets were screened by calculating the topological characteristic values of the network followed by the functional mining according to the Kyoto Encyclopedia of Genes and Genomes (KEGG) database and the SoFDA database. After that, the SONFH rat model was prepared by lipopolysaccharide combined with methylprednisolone injection, and 2.5, 5, 7.5 g·kg-1 SQP (once per day, equivalent to 1, 2, and 3 times the clinical equivalent dose, respectively) or 7.3×10-3 g·kg-1 of alendronate sodium (ALS, once per week, equivalent to the clinical equivalent dose) was given for 8 weeks. The effect characteristics of SQP and ALS in the treatment of SONFH were evaluated by micro-computed tomography scanning, hematoxylin and eosin staining, alkaline phosphatase (ALP) staining, immunohistochemical staining, enzyme-linked immunosorbent assay, and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling(TUNEL)staining, and a comparative efficacy analysis was conducted with ALS. In addition, SONFH cell models were prepared by dexamethasone stimulation of osteoblasts, and the intervention was carried out with the medicated serum of SQP at the aforementioned three doses. Cell counting kit-8, ALP staining, ALP activity assay, alizarin red staining, and flow cytometry were employed to investigate the regulatory effect of SQP on osteoblasts. The expression levels of osteogenesis-related proteins and key factors of the target signaling axis were detected by quantitative real-time polymerase chain reaction and Western blot. ResultsThe network analysis results demonstrated that the candidate targets of SQP primarily exerted their therapeutic effects through key signaling pathways, including phosphoinositide 3-kinase(PI3K)/protein kinase B(Akt), lipid metabolism and atherosclerosis, prolactin, chemokines, and neurotrophic factors pathways. These pathways were significantly involved in critical biological processes such as muscle and bone metabolism and the regulation of the "neuro-endocrine-immune" network, thereby addressing both modern medical symptoms (e.g., delayed skeletal maturation and recurrent fractures) and traditional Chinese medicine (TCM) symptoms (e.g., fatigue, aversion to cold, cold limbs, and pain in the limbs and joints in patients with SONFH characterized by liver and kidney deficiency syndrome. Among these pathways, the PI3K/Akt signaling pathway exhibited the highest degree of enrichment. The in vivo experimental results demonstrated that starting from the 4th week after modeling, the modeling group exhibited a significant reduction in body weight compared to the control group (P<0.05). After six weeks of treatment, all dosage groups of SQP showed significantly higher body weights compared to the model group (P<0.01). Compared with the normal group, the model group exhibited significant decreases in bone mineral density (BMD), bone volume fraction (BV/TV), trabecular number (Tb.N), osteocalcin (OCN), alkaline phosphatase (ALP) levels in femoral head tissue, and serum bone-specific alkaline phosphatase (BALP) (P<0.01), along with significant increases in trabecular separation (Tb.Sp), empty lacunae rate in tissue, and apoptosis rate (P<0.01). In comparison to the model group, the SQP intervention groups showed significant improvements in BMD, BV/TV and Tb.N (P<0.01), significant reductions in Tb.Sp, empty lacunae rate and apoptosis rate (P<0.05), and significant increases in protein levels of OCN and ALP as well as BALP content (P<0.05). The in vitro experimental results revealed that all dosage groups of SQP medicated serum showed no toxic effects on osteoblast. Compared with the normal group, the model group displayed significant suppression of osteoblast proliferation activity, ALP activity, and calcified nodule formation rate (P<0.01), significant decreases in mRNA transcription levels of OCN and Runt-related transcription factor 2 (RUNX2) (P<0.01), significant reductions in protein content of osteopontin (OPN), typeⅠ collagen (ColⅠ)A1, B-cell lymphoma-2 (Bcl-2), PI3K, and phosphorylated (p)-Akt (P<0.01), and a significant increase in apoptosis rate (P<0.01). Compared with the model group, the SQP medicated serum intervention groups exhibited significant increases in proliferation activity, ALP activity, calcified nodule formation rate, mRNA transcription levels of OCN and RUNX2, and protein content of OPN, ColⅠA1, Bcl-2, PI3K, and p-Akt (P<0.05), along with a significant decrease in apoptosis rate (P<0.01). ConclusionSQP can effectively reduce the disease severity of SONFH with liver and kidney deficiency syndrome and improve bone microstructure, with the therapeutic effects exhibiting a dose-dependent manner. The mechanism may be related to its regulation of key processes such as muscle and bone metabolism and the correction of imbalances in the "neuro-endocrine-immune" network, thereby promoting osteoblast differentiation and inhibiting osteoblast apoptosis. The PI3K/Akt signaling axis is likely one of the key pathways through which this formula exerts its effects.
2.Exploration in Pathological Mechanisms of Myocardial Infarction and Osteoporosis Based on "Heart-bone" Axis Theory
Yuzhuo ZHANG ; Qi SHANG ; Hui REN ; Bin LIU ; Jingzhi ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):251-257
Myocardial infarction (MI) and osteoporosis (OP), as two prevalent metabolic diseases with high morbidity and mortality rates, are respectively characterized by cardiovascular system dysfunction and bone homeostasis imbalance, collectively posing significant global public health challenges. While clinically often considered as independent diseases, recent studies have revealed shared pathological mechanisms between the two. This study initiated its exploration from the traditional Chinese medicine concept of the "heart-bone" axis, systematically analyzing the correlation between MI and OP from perspectives including hemodynamics, neuroendocrinology, calcium homeostasis, inflammation and vascular injury, as well as hormone levels. By discussing the pathological mechanisms of "heart disease affecting the bones and bone disease affecting the heart", the study also elucidated advancements in both Western and traditional Chinese medicine treatments. The goal is to provide novel insights and methodologies for the prevention and treatment of "heart-bone comorbidities", thereby facilitating comprehensive management of cardiovascular and skeletal diseases.
3.Exploration in Pathological Mechanisms of Myocardial Infarction and Osteoporosis Based on "Heart-bone" Axis Theory
Yuzhuo ZHANG ; Qi SHANG ; Hui REN ; Bin LIU ; Jingzhi ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):251-257
Myocardial infarction (MI) and osteoporosis (OP), as two prevalent metabolic diseases with high morbidity and mortality rates, are respectively characterized by cardiovascular system dysfunction and bone homeostasis imbalance, collectively posing significant global public health challenges. While clinically often considered as independent diseases, recent studies have revealed shared pathological mechanisms between the two. This study initiated its exploration from the traditional Chinese medicine concept of the "heart-bone" axis, systematically analyzing the correlation between MI and OP from perspectives including hemodynamics, neuroendocrinology, calcium homeostasis, inflammation and vascular injury, as well as hormone levels. By discussing the pathological mechanisms of "heart disease affecting the bones and bone disease affecting the heart", the study also elucidated advancements in both Western and traditional Chinese medicine treatments. The goal is to provide novel insights and methodologies for the prevention and treatment of "heart-bone comorbidities", thereby facilitating comprehensive management of cardiovascular and skeletal diseases.
4.Inheritance and Current Research Status of Major Spleen-Stomach Theories in Traditional Chinese Medicine
Ling HU ; Fengyun WANG ; Xudong TANG ; Beihua ZHANG ; Yunkai DAI ; Xu CHEN ; Shiqi LI
Journal of Traditional Chinese Medicine 2026;67(1):87-94
This paper systematically reviews the core concepts and lines of theoretical inheritance of major spleen-stomach theories in traditional Chinese medicine (TCM), including spleen deficiency theory, spleen-stomach damp-heat theory, and liver-spleen disharmony theory. It is found that these theories have all undergone a developmental trajectory characterized by classical foundation, refinement of therapeutic methods, systematization of pathogenesis, and modern innovation. The evolution of spleen-stomach theory has achieved a shift from a singular focus on tonifying the spleen to regulating dynamic middle-jiao (焦) balance, and from localized spleen-stomach regulation to the circular movement of qi involving all five zang organs. In terms of modern disease-syndrome integrative research, spleen deficiency syndrome is shown to be closely associated with impairment of the gastrointestinal mucosal barrier, metabolic disorders, and gene polymorphisms related to Helicobacter pylori-associated gastric diseases. Spleen-stomach damp-heat syndrome is closely linked to hyperactive energy metabolism, inflammatory cytokines, and abnormal expression of aquaporins. Liver-spleen disharmony syndrome is mainly associated with dysregulation of the brain-gut axis and microbiota-related metabolic disorders. It is proposed that future research on spleen-stomach diseases and syndromes should further elucidate their potential multidimensional differential biological characteristics, thereby promoting the modernization of the TCM discipline of spleen-stomach studies.
5.Empirical study of input, output, outcome and impact of community-based rehabilitation stations
Xiayao CHEN ; Ying DONG ; Xue DONG ; Zhongxiang MI ; Jun CHENG ; Aimin ZHANG ; Didi LU ; Jun WANG ; Jude LIU ; Qianmo AN ; Hui GUO ; Xiaochen LIU ; Zefeng YU
Chinese Journal of Rehabilitation Theory and Practice 2026;32(1):83-89
ObjectiveTo investigate the present situation of input, output, outcome and impact of all registered community-based rehabilitation stations in Inner Mongolia in China, and analyze how the input predict the output, outcome and impact. MethodsFrom March 1st to April 30th, 2025, a questionnaire survey was conducted on all registered community-based rehabilitation stations in Inner Mongolia, covering four dimensions: input, output, outcome and impact. A total of 1 365 questionnaires were distributed. The input included four items: laws and policies, human resources, equipment and facilities, and rehabilitation information management. The output included two items: technical paths and benefits/effectiveness. The outcome included three items: coverage rates, rehabilitation interventions and functional results. The impact included two items: health and sustainability. Each item contained several questions, all of which were described in a positive way. Each question was scored from one to five. A lower score indicated that the situation of the community-based rehabilitation station was more in line with the content described in the question. Regression analysis was performed using the total score of each item of input dimension as independent variables, and the total scores of the output, outcome and impact dimensions as dependent variables. ResultsA total of 1 262 valid questionnaires were collected. The mean values of input, output, outcome and impact of community-based rehabilitation stations were 1.827 to 1.904, with coefficient of variation of 45.892% to 49.239%. The regression analysis showed that, rehabilitation information management, human resources, and laws and policies significantly predicted the output dimension (R² = 0.910, P < 0.001). Meanwhile, all four items in the input dimension predicted both the outcome (R² = 0.850, P < 0.001) and impact dimensions (R² = 0.833, P < 0.001). ConclusionInput, output, outcome and impact of the community-based rehabilitation stations in Inner Mongolia were generally in line with the content of the questions, although some imbalances were observed. Additionally, the input of community-based rehabilitation stations could significantly predict their output, outcome and impact.
6.Effect and Mechanisms of Ermiao Formula Analogs and Their Active Components in Treating Dampness-heat Type Gouty Arthritis: A Review
Xueping ZHAO ; Xinya ZHANG ; Le YANG ; Ye SUN ; Xin SUN ; Hui SUN ; Qimeng ZHANG ; Guangli YAN ; Xijun WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(6):276-285
Gouty arthritis (GA) is caused by monosodium urate(MSU) deposition due to purine metabolism disorders. In traditional Chinese medicine (TCM), it falls under the category of "dampness-heat Bi syndrome", with core pathogenesis involving dampness-heat accumulation and dysfunction of the spleen and kidney. The dampness-heat syndrome is the most common and the primary syndrome type during acute attacks. In Western medicine, GA is associated with purine metabolism imbalance and inflammation triggered by MSU crystals, involving pathways such as NOD-like receptor protein 3 (NLRP3) inflammasome activation and Toll-like receptor 2/4 (TLR2/4) signaling. Clinically, colchicine and similar drugs are commonly used to treat GA, although long-term use carries potential side effects. Ermiao Formula analogs originate from ancient prescriptions, including Ermiao, Sanmiao, and Simiao compound formulas. All contain Atractylodis Rhizoma and Phellodendri Chinensis Cortex. Ermiaowan follow a 1∶1 formulation ratio. Sanmiaowan add Cyathulae Radix. Simiaowan further incorporate Coicis Semen. These formulas are rich in active ingredients, including alkaloids, terpenoids, flavonoids, and sterols, and treat GA through multi-component, multi-pathway, and multi-target mechanisms. Ermiaosan primarily exerts anti-inflammatory effects by inhibiting pathways such as TLR4/nuclear factor kappa-B (NF-κB) or regulating immune responses to reduce the release of inflammatory mediators, while also suppressing xanthine dehydrogenase (XDH) and xanthine oxidase (XO) activity to decrease uric acid production. Sanmiaowan enhance uric acid-lowering and anti-inflammatory effects through the guiding herb Cyathulae Radix, while also protecting cartilage from damage. Simiaowan utilizes Coicis Semen to regulate intestinal flora, alleviate dampness-heat symptoms, and exert multi-pathway anti-inflammatory and uric acid-lowering effects. The active ingredients contribute differently to uric acid metabolism regulation, anti-inflammation, antioxidant activity, and bone repair, resulting in varying therapeutic effects due to differences in formula composition. In summary, formulas derived from Ermiaosan demonstrate significant efficacy in treating dampness-heat type GA. This review summarizes their research progress and mechanisms, providing a reference for clinical application, new drug development, and further studies.
7.Epidemiological characteristics and disease burden of liver cancer in Guangdong Province
Ying ZHANG ; Yixuan CHEN ; Rong CAO ; Yue GAO ; Yutong HAN ; Ye WANG ; Ruilin MENG ; Xueyan ZHENG ; Yu LIAO ; Zhuanping ZENG
Journal of Public Health and Preventive Medicine 2026;37(1):68-72
Objective To analyze the epidemiological characteristics and disease burden of liver cancer in Guangdong Province in 2020, and to provide a scientific foundation for the development of regionalized prevention and control strategies for liver cancer. Methods According to the cancer registry data of Guangdong Province, the incidence, mortality and age-standardized rate by Chinese standard population in 2020 were calculated to analyze the epidemiological characteristics of liver cancer. The disability adjusted life years (DALYs), year of life loss (YLL), year of lived with disability (YLD), and cause-eliminated life expectancy were used to assess the disease burden of liver cancer. Results In 2020, the crude incidence rate and the age-standardized incidence rate of liver cancer in Guangdong Province were 27.79/100 000 and 20.84/100 000,respectively, and the crude mortality rate and the age-standardized mortality rate of liver cancer were 25.49/100,000 and 17.64/100 000, respectively. The total DALY and DALY rate of liver cancer in Guangdong Province were 515 311 person-years and 513.83/100 000, respectively. After eliminating the causes of death from liver cancer, the life expectancy in Guangdong Province increased from 84.60 years to 84.99 years. All indicators consistently demonstrated that the burden of liver cancer was higher in males than that in females, and the burden of liver cancer was higher in rural areas than that in urban areas. Conclusion Liver cancer in Guangdong Province exhibits a high incidence, mortality and disease burden level in 2020. There are obvious differences of gender, age and region in cancer burden. It is necessary to strengthen liver cancer screening and diagnosis and treatment in men, the elderly and those in rural areas to reduce the burden of liver cancer gradually in Guangdong Province.
8.Signal mining of adverse reactions associated with macrolide antibiotics in pediatric patients based on the FAERS database
Zhenpo ZHANG ; Jiaxin HE ; Jingping ZHENG ; Yuting WANG ; Lin MA ; Ling SU
Journal of Pharmaceutical Practice and Service 2026;44(3):160-166
Objective To explore the adverse event signals of children using macrolide drugs (azithromycin, clarithromycin, and erythromycin), and provide reference for rational medicine use in clinical practice. Methods Data from children under 12 years old were extracted from the US FAERS database spanning from the first quarter of 2004 to the second quarter of 2023. The adverse drug reaction (ADR) signal mining for three macrolide antibiotics was conducted using the Reporting Odds Ratio (ROR) and Bayesian Confidence Propagation Neural Network (BCPNN) methods. Special emphasis was placed on analyzing and contrasting the differences in adverse events among the three drugs. Results A total of 1 615 reports for children under 12 years old were retrieved from the FAERS database, including 1 024 reports of azithromycin, 460 reports of clarithromycin, and 131 reports of erythromycin. Among azithromycin and erythromycin, there were more reports from boys than girls, while for clarithromycin, there were more reports from girls than boys. Oral administration was the most common route of administration for all three drugs. Regarding the outcome of adverse events reported, azithromycin and clarithromycin were primarily associated with other serious adverse events, whereas erythromycin was mainly associated with hospitalization and other serious adverse events. The number of adverse events reported decreased with increasing age, with a higher number of reports in the 0-3 age group. Using the ROR and BCPNN methods for signal detection, 86 signals were identified for azithromycin, 91 for clarithromycin, and 34 for erythromycin. These signals involved 22 System Organ Classes (SOCs), with azithromycin mainly concentrated in skin and subcutaneous tissue disorders (n=21), clarithromycin in gastrointestinal disorders (n=15), and erythromycin in gastrointestinal disorders (n=8). Twenty-four signals of moderate to high risk were detected, with 13 for azithromycin, 9 for clarithromycin, and 2 for erythromycin. Conclusion The adverse events induced by the three drugs with different risks in different systems. When clinically treating Mycoplasma pneumoniae pneumonia in children, the risk profiles of drugs in different systems should be considered, and personalized dosing should be implemented.
9.Analysis of hepatitis B infection characteristics in HBsAg-/HBV DNA+ blood donors in Taiyuan
Zhiye LI ; Baifeng SHAN ; Liuming ZHANG ; Yixuan LI ; Aichun CHU ; Weiyu YUAN ; Lixia DOU ; Qiang ZHANG ; Yuan BAI ; Yuan ZHOU
Chinese Journal of Blood Transfusion 2026;39(3):373-378
Objective: To analyze characteristics of hepatitis B infection in HBsAg-/HBV DNA+ blood donors in Taiyuan, so as to provide evidence for adjusting blood screening strategies. Methods: Blood samples of HBsAg-/HBV DNA+ donors were tested using enzyme-linked immunosorbent assay (ELISA), chemiluminescence assay, nucleic acid qualitative test, and nucleic acid quantitative test. Data on HBsAg-/HBV DNA+ donors in Taiyuan region from January 1, 2016 to December 31, 2024 were statistically analyzed to evaluate the detection rate, demographic characteristics, influencing factors of detection rate, nucleic acid quantitative results, and serological patterns of HBsAg-/HBV DNA+ donors. Results: From January 1, 2016 to December 31, 2024, 991 565 donor samples underwent nucleic acid testing in Taiyuan. A total of 309 HBsAg-/HBV DNA+ samples were detected, resulting in an HBsAg-/HBV DNA+ detection rate of 3.12 per 10 000. The detection rate varied significantly across different years (P<0.05). Males had a significantly higher HBsAg-/HBV DNA+ detection rate than females, first-time donors had a higher rate than repeat donors, and whole blood donors had a higher rate than apheresis donors (P<0.05). The detection rate also differed significantly among age groups (P<0.05). Logistic regression analysis showed that gender, age, donation frequency, and donation type were all influencing factors for HBsAg-/HBV DNA+ detection (all P<0.05). The predominant serological patterns among HBsAg-/HBV DNA+ donors were HBsAb+/HBcAb+ (43.69%, 135/309) or HBcAb+ alone (24.27%, 75/309). Viral load was detectable in 53.40% (165/309) of the HBsAg-/HBV DNA+ donors. Among these, 61.21% (101/165) donors had a viral load<20 IU/mL, and 94.55% (156/165) had a viral load<200 IU/mL. Donors with viral load<200 IU/mL primarily exhibited HBsAb+/HBcAb+ (41.67%, 65/156) or HBcAb+alone (36.54%, 57/156) serological patterns. Conclusion: The prevalence of HBsAg-/HBV DNA+ is low among blood donors in Taiyuan. Higher detection rates were observed in the 46-55 years age group, males, first-time donors, and whole blood donors. HBsAg-/HBV DNA+ donors exhibit specific serological patterns and generally have low viral loads, indicating a potential residual transfusion risk. It is recommended to add HBcAb testing, together with high-sensitivity nucleic acid testing technologies and donor follow-up, to ensure blood safety and guide donor reentry.
10.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.


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