1.Correlation between liver fibrosis degree and carotid plaque in patients with lean metabolic dysfunction-associated fatty liver disease
Shuai ZHANG ; Shoulu JIN ; Wanqing LI ; Xijing SHI ; Hao LIANG ; Hao DONG ; Dailong LU ; Ying ZHU ; Xiaoxing XIANG ; Jun LIU
Journal of Clinical Hepatology 2026;42(2):319-325
ObjectiveTo investigate the association between noninvasive liver fibrosis markers and carotid plaque (CP) in patients with lean metabolic dysfunction-associated fatty liver disease (MAFLD), and to provide a basis for screening high-risk populations. MethodsA total of 957 patients with lean MAFLD who underwent physical examination in Subei People’s Hospital from January 2021 to June 2023 was enrolled as the observation cohort, with the presence or absence of CP as the outcome, and fibrosis-4 (FIB-4) index and nonalcoholic fatty liver disease fibrosis score (NFS) were used to assess liver fibrosis degree. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The multivariate logistic regression analysis, the restricted cubic spline analysis, the receiver operating characteristic curve, and the mediation effect analysis were used to investigate the association between liver fibrosis degree and CP. ResultsThe prevalence rate of CP was 36.6% in the lean MAFLD population. Compared with the non-CP group(n=607), the CP group (n=350) had a significantly higher proportion of male patients, a significantly higher proportion of patients with smoking/diabetes/hypertension, and significantly higher levels of age, creatinine, blood urea nitrogen, triglycerides, fasting blood glucose, aspartate aminotransferase, aspartate aminotransferase/alanine aminotransferase ratio, NFS, and FIB-4 index, as well as significantly lower levels of platelet count and albumin (all P<0.05). The multivariate logistic regression analysis showed that after adjustment for confounding factors, FIB-4 index (odds ratio[OR]=2.979, 95% confidence interval[CI]:2.141 — 4.219, P<0.001) and NFS (OR=1.747, 95%CI: 1.499 — 2.046, P<0.001) were positively correlated with CP. Both FIB-4 index and NFS had a good value in predicting CP. Hypertension had a significant indirect effect on the prevalence rate of CP through its impact on liver fibrosis markers, and its mediating effect accounted for 39.5% — 40.8% of the total effect (P<0.001). ConclusionIn patients with lean MAFLD, NFS and FIB-4 index are significantly positively correlated with the prevalence rate of CP, and they can be used as potential epidemiological predictive indicators. Liver fibrosis markers may play a mediating role in the association between hypertension and CP. Interventions targeting hypertension and liver fibrosis markers may help to prevent and delay the progression of CP.
2.Analysis of Disease Burden and Attributable Risk Factors of Early-onset Female Breast Cancer in China and Globally from 1990 to 2021
Danqi HUANG ; Min YANG ; Wei XIONG ; Jingyi LIU ; Wanqing CHEN ; Jingbo ZHAI ; Jiang LI
Medical Journal of Peking Union Medical College Hospital 2025;16(3):777-784
To analyze the disease burden, temporal trends, and attributable risk factors of early-onset female breast cancer (EOBC) in China and globally from 1990 to 2021. Data on the absolute numbers and crude rates of incidence, mortality, and disability-adjusted life years (DALYs) for EOBC (diagnosis age < 50 years) in China and globally were extracted from the Global Burden of Disease (GBD) 2021 database. Attributable DALY proportions for five risk factors (smoking, alcohol use, physical inactivity, high red meat consumption, elevated fasting plasma glucose) and all combined risk factors were obtained. Joinpoint regression analysis was performed to assess temporal trends in age-standardized rates, quantified by annual percentage change (APC) and average annual percentage change (AAPC). From 1990 to 2021, age-standardized incidence rates of EOBC increased significantly in both China (AAPC=2.25%) and globally (AAPC=0.64%; pairwise comparison, China's age-standardized EOBC incidence is rising rapidly and approaching global levels, while mortality and DALY rates have increased over the past decade, underscoring persistent challenges in disease control. Future efforts should prioritize expanding the coverage of breast cancer screening programs, optimizing screening protocols, and enhancing public awareness of cancer prevention to mitigate the growing burden of EOBC in China.
3.Summary of best available evidence on pharmacological prophylaxis for pregnancy-associated venous thromboembolism
Chenshi LI ; Wanqing LI ; Zhaofeng XUE ; Yicheng LI ; Yucheng WANG ; Wei ZHOU
Journal of Clinical Medicine in Practice 2025;29(15):63-71
Objective To search,analyze,and summarize the best available evidence on phar-macological prophylaxis for pregnancy-associated venous thromboembolism(PA-VTE).Methods Uti-lizing evidence-based medicine methodologies,a computerized search was conducted for all evidence pertaining to pharmacological prophylaxis of PA-VTE,including guidelines,expert consensus,sys-tematic reviews,clinical decisions,evidence summaries,and recommended practices.The time for the search ranged from the establishment of relevant databases up to December 13,2024.Two re-searchers independently assessed the quality of the included literature.In cases of disagreement,a third researcher was consulted to reach a consensus on the final evaluation.Results A total of 20 arti-cles were included,comprising 6 guidelines,7 systematic reviews,2 clinical decisions,3 expert consensus documents,and 2 evidence summaries.From seven aspects including drug types,drug selection,drug contraindications,timing of prophylactic medication,prophylactic strategies and implementation plans,medication precautions,and health education,28 pieces of evidence were summarized.Con-clusion This study has compiled the best available evidence on pharmacological prophylaxis for PA-VTE,which can guide healthcare professionals inproviding individualized pharmacological prophylaxis strategies for pregnant women,thereby reducing the incidence of venous thromboembo-lism and improving pregnancy outcomes.
4.Disability-adjusted life years for colorectal cancer in China, 2017-2030: A prevalence-based analysis focusing on the impact of screening coverage and the application of local weights.
Yujie WU ; Yanjie LI ; Xin WANG ; Xinyi ZHOU ; Xinxin YAN ; Hong WANG ; Juan ZHU ; Wanqing CHEN ; Jufang SHI
Chinese Medical Journal 2025;138(8):962-972
BACKGROUND:
Most studies have evaluated disability-adjusted life years (DALYs) of colorectal cancer (CRC) patients based on a set of generic disability weights (DWs). This study aimed to apply local CRC-stage-specific DWs to estimate the burden of DALYs for CRC (CRC-DALYs) in populations in China and consider the influence of local screening coverage of CRC.
METHODS:
A prevalence-based model was constructed using data from various sources. Years lived with disability (YLDs) were estimated mainly via cumulative prevalence data (based on CRC incidence rates, population numbers, and survival rates), stage-specific proportions of CRC, and DWs of the local population. Years of life lost (YLLs) were calculated based on the CRC mortality rates and standard life expectancies. CRC incidence and mortality rates for the years 2020, 2025, and 2030 were estimated by joinpoint regression, and the corresponding DALYs were predicted. The main assumption was made for CRC screening coverage. Sensitivity analyses were used to assess the impact of population, DWs, and coverage.
RESULTS:
In 2017, among the Chinese population, the estimated number of CRC-DALYs was 4,303,314 (11.9% for YLDs). If CRC screening coverage rate in China (2.3%) remains unchanged, the overall DALYs in 2030 are predicted to increase by 37.2% (45.1% of those aged ≥65 years). More optimistically, the DALYs would then decrease by 0.7% in 2030 (from 5,902,454 to 5,860,200) if the coverage could be increased to 25.0%. A sensitivity analysis revealed that using local DWs would change the base-case values by 5.7%.
CONCLUSIONS
The estimated CRC-DALYs in China using population-specific DWs were considerably lower (with a higher percentage of YLDs) than the global burden of disease (GBD) estimates (5,865,004, of 4.6% for YLDs), suggesting the impact extent of applying local parameters. Sustainable scale-up CRC screening needs to be in place to moderate the growth trend of CRC-DALYs in China.
Humans
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Colorectal Neoplasms/diagnosis*
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China/epidemiology*
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Disability-Adjusted Life Years
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Male
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Prevalence
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Female
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Middle Aged
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Aged
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Early Detection of Cancer
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Quality-Adjusted Life Years
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Adult
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Incidence
5.Corrigendum: Comparative analysis of cancer statistics in China and the United States in 2024.
Yujie WU ; Siyi HE ; Mengdi CAO ; Yi TENG ; Qianru LI ; Nuopei TAN ; Jiachen WANG ; Tingting ZUO ; Tianyi LI ; Yuanjie ZHENG ; Changfa XIA ; Wanqing CHEN
Chinese Medical Journal 2025;138(10):1260-1260
6.Current Status and Prospects of Gene Therapy for Primary Ciliary Dyskinesia
Wanqing LU ; Yixuan LI ; Miao HE ; Xinlun TIAN ; Yaping LIU
JOURNAL OF RARE DISEASES 2025;4(3):377-383
Primary ciliary dyskinesia (PCD) is a genetically heterogeneous disease characterized by structural or functional abnormalities of motile cilia. It often presents clinically with recurrent respiratory infections, situs inversus, hydrocephalus, and infertility. Currently, there is no clinical treatment to directly restore ciliary motility in PCD patients.In recent years, researchers have explored gene therapy methods such as gene replacement, gene editing, and RNA replacement
7.Predictive modeling of efficacy of neoadjuvant chemotherapy for breast cancer using ultrasound and immunohistochemistry
Zhaoyun LI ; Yue PANG ; Cuijing CHEN ; Jingning MAO ; Rui DU ; Wanqing HAN ; Hongli TIAN ; Yuejuan GAO ; Ling BAI
Military Medical Sciences 2025;49(9):687-693
Objective To establish a model that integrates ultrasound features and immunological characteristics for predicting the efficacy of neoadjuvant chemotherapy(NAC)in breast cancer patients.Methods A total of 203 breast cancer patients undergoing preoperative NAC at the Fifth Medical Center of the PLA General Hospital between July 2021 and July 2024 were screened.In line with the inclusion/exclusion criteria,177 patients were included.Data on ultrasound and immunohistochemistry was collected.These patients were divided into pathological complete response(pCR)and non-pathological complete response(non-pCR)groups based on postoperative pathology.Factors with P<0.0 1 in univariate analysis were evaluated using multivariate Logistic regression.Independent predictive factors were used to construct and validate the ultrasound-immunohistochemical model via Bootstrap.Results The reduction rateof the maximum diameter of lesions,posterior echo attenuation,PR status and HER-2 status were identified as independent predictors of pCR(all P<0.05).The model proved to be highly accurate and stable.Conclusion The model that combines ultrasound and immunohistochemical features can effectively evaluatep CR after NAC in breast cancer patients.
8.Effects of Electroacupuncture on Skeletal Muscle Mitochondrial Dynamics in SAMP8 Mice
Ruolan WEN ; Wanqing GUO ; Weiguo DONG ; Limin CHEN ; Jinquan LI ; Chenguang WEN ; Lan LIN ; Feng WANG
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(2):104-109
Objective To observe the effects of electroacupuncture on the motor function and mitochondrial dynamics of skeletal muscle of SAMP8 mice;To explore the mechanism of electroacupuncture in improving the motor dysfunction of Alzheimer disease(AD)from the perspective of mitochondrial dynamics.Methods Totally 18 SAMP8 mice were divided into model group and electroacupuncture group,with 9 mice in each group,and the SAMR1 mice with the same age were set as control group."Baihui","Dazhui"and"Shenshu"were selected in the electroacupuncture group,and electroacupuncture was performed daily for 20 min,8 d as a course of treatment.Each course of treatment was separated by 2 d,for a total of 3 courses of treatment.The model group and the control group were not intervened.The motor function of mice was tested by grip strength test,suspension test,hind limb extension test and Morris water maze experiment.The morphology and structure of gastrocnemius were observed by HE staining,ATP content in gastrocnemius was determined by colorimetry,the mRNA expression of optic atrophy 1(OPA1),mitofusin 2(MFN2)and dynamin-related protein 1(DRP1)in gastrocnemius were detected by real-time quantitative PCR,the expressions of OPA1,MFN2 and DRP1 in gastrocnemius were detected by Western blot.Results Compared with the control group,the grip strength,the score in suspension test,and the average speed and maximum speed of Morris water maze experiment of mice in model group significantly decreased(P<0.01);the arrangement of fibers in the gastrocnemius muscle tissue was disordered,the gaps become wider,and the distribution of nuclei was uneven;the ATP content in the gastrocnemius muscle tissue was significantly decreased(P<0.01),the mRNA and protein expressions of OPA1 and MFN2 were significantly decreased(P<0.01),and the expression of DRP1 mRNA and protein significantly increased(P<0.01).Compared with the model group,the grip strength,the score in suspension test,and the average speed and maximum speed of Morris water maze experiment in electroacupuncture group significantly increased(P<0.01);the arrangement of gastrocnemius muscle tissue was relatively neat,the gaps become narrower,and the distribution of nuclei was more uniform;the ATP content in gastrocnemius muscle tissue significantly increased(P<0.01),while the mRNA and protein expressions of OPA1 and MFN2 significantly increased(P<0.05,P<0.01),the expression of DRP1 mRNA and protein significantly decreased(P<0.01).Conclusion Electroacupuncture can improve the skeletal muscle morphological structure and motor dysfunction of SAMP8 mice,and the mechanism may be related to the correction of skeletal muscle mitochondrial dynamic imbalance and the increase of skeletal muscle ATP content.
9.Socioeconomic inequalities in cancer incidence and mortality: An analysis of GLOBOCAN 2022
Wei CAO ; Kang QIN ; Feng LI ; Wanqing CHEN
Chinese Medical Journal 2024;137(12):1407-1413
Background::Given the recent updates in cancer burden estimates by GLOBOCAN 2022, this study was undertaken to provide pertinent perspectives within the context of the Human Development Index (HDI) and major world economies.Methods::Datasets sourced from GLOBOCAN encompassed cancer cases and deaths across all cancer types in 2022, alongside projections up to 2050. Cancer incidences and deaths of the top 10 cancers within China and four distinct HDI-classified regions were compared using descriptive analyses. Age-standardized incidence rates (ASIRs) and mortality rates (ASMRs) worldwide for the most prevalent cancers in 2022 across ten largest economies and four-tier HDIs were examined. The top five cancer types concerning both incidence and mortality in China were delineated by sex and age group.Results::In males, prostate cancer predominated in countries with low, high (except China), and very high HDI. Prostate and liver cancers were prominent causes of death in countries with low HDI. In females, breast and cervical cancers predominated in countries with low-to-medium HDI. Lung and colorectal cancer incidence and deaths increased with high HDI for both sexes. ASIRs and ASMRs for breast, prostate, lung, and colorectal cancers in the top 10 economies were higher than the global average. However, liver, stomach, and cervical cancers in most Western countries exhibited lower rates. In China, hematologic malignancies (43%) were prevalent among children aged 0–14 years, whereas thyroid cancer led among adolescents and young adults aged 15–39 years. Regarding incidence and mortality, lung cancer predominated for individuals over 40 years, except for females aged 40–59 years, in whom breast cancer predominated. Projected trends indicated substantial increases in new cancer cases (76.6%) and deaths (89.7%) over the next three decades.Conclusions::Infection- and poverty-related cancer burdens are offset by increased prostate, breast, colorectal, and lung cancer incidence associated with rapid societal and economic transitions. Cancer incidence and mortality patterns in China feature characteristics of developed and developing countries, necessitating tailored, evidence-based, and comprehensive strategies for effective cancer prevention and control.
10.Survey of hepatitis B virus infection for liver cancer screening in China: A population-based, cross-sectional study
Yongjie XU ; Changfa XIA ; He LI ; Maomao CAO ; Fan YANG ; Qianru LI ; Mengdi CAO ; Wanqing CHEN
Chinese Medical Journal 2024;137(12):1414-1420
Background::Hepatitis B virus (HBV) infection is the primary cause of hepatocellular carcinoma (HCC) in China. The target population for HCC screening comprises individuals who test positive for hepatitis B surface antigen (HBsAg). However, current data on the prevalence of HBV infection among individuals who are eligible for HCC screening in China are lacking. We aimed to assess the seroepidemiology of HBV infection among Chinese individuals eligible for HCC screening to provide the latest evidence for appropriate HCC screening strategies in China.Methods::Questionnaires including information of sex, age, ethnicity, marital status, educational level, source of drinking water, as well as smoking and alcohol consumption history and serum samples were collected from females aged 45–64 years and males aged 35–64 years in 21 counties from 4 provinces in eastern and central China between 2015 and 2023. Enzyme-linked immunosorbent assay methods were used to detect the serum HBV marker HBsAg.Results::A total of 603,082 individuals were enrolled, and serum samples were collected for analysis from January 1, 2015 to December 31, 2023. The prevalence of HBsAg positive in the study population was 5.23% (31,528/603,082). The prevalence of HBsAg positive was greater in males than in females (5.60% [17,660/315,183] vs 4.82% [13,868/287,899], χ 2 = 187.52, P <0.0001). The elderly participants exhibited a greater prevalence of HBV infection than younger participants (χ 2 = 41.73, P <0.0001). Birth cohort analysis revealed an overall downward trend in HBV prevalence for both males and females. Individuals born in more recent cohorts exhibited a lower prevalence of HBV infection as compared to those born earlier. Conclusions::The current prevalence of HBV infection remains above 5% in populations eligible for HCC screening in China.

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