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.Rustic Opinion on"Reverse Spread to the Pericardium"
Jinli LUO ; Yayun WANG ; Yingying YANG ; Qingwei LI ; Ling ZHOU ; Ye MIN ; Linhua ZHAO ; Xiaolin TONG
Journal of Nanjing University of Traditional Chinese Medicine 2025;41(4):421-424
"When warm evil is received,it first attacks the lungs and then spread to the pericardium reversely"is the general rule of warm diseases.Doctors of different dynasties have different views on the phrase"reverse spread to the pericardium",especially the word"reverse".Professor Tong Xiaolin proposed that the heart governs the mind,the pericardium and the heart are connected in qi,and when the heart is affected by evil,the pericardium instead suffers from the evil.The"reverse spread to the pericardium"proposed by Ye Tianshi is actually the spread of warm evil to the brain.Taking meningococcal meningitis as the basic disease,it can be matched one by one with the typical stages of the transmission of Wei-Qi-Ying-Xue.Combined with the theory of Dingjiao,it is believed that the function of"the heart governing the mind"focuses more on the brain in the modern anatomical sense.Combining traditional Chinese medicine's ideas on diagnosis and treatment of warm diseases with modern medicine,revealing the essence of the disease,grasping the core of the pathogenesis,analyzing the word"reverse"from a new perspective,and exploring its true meaning,is of great significance for clarifying its connotation,exploring the development laws of warm diseases,and guiding the diagnosis and treatment of warm disea-ses.
3.Finite element analysis on miniscrews and hooks with different locations assisted clear aligners in maxillary molar distalization
Panpan YE ; Changxi XU ; Hui LI ; Yang ZHANG ; Xiaolin XU ; Hongning WANG
Chinese Journal of Tissue Engineering Research 2025;29(28):6012-6019
BACKGROUND:The utilization of miniscrews for assisting in molar distalization with clear aligners is a commonly adopted clinical approach.However,treatment outcomes may be influenced by the implantation position of miniscrew and the hooks in various tooth location.OBJECTIVE:To analyze the biomechanical effects of hooks at different tooth positions and the assistance of buccal and palatal miniscrews in distalizing molars with clear aligners by using the finite element method.METHODS:By integrating volunteer cone beam CT and Itero intraoral scan data,high-precision finite element models were constructed to simulate the combined use of miniscrews and hooks to assist in the distalization of the maxillary first and second molars with clear aligners,aiming for a designed distalization magnitude of 0.2 mm.Four conditions were established based on the placement of buccal or palatal miniscrews,as well as the located of hooks at the canine or first premolar.The buccal anchorage screw was used in combination with hooks on the buccal side of the canine;the buccal anchorage screw was used in combination with hooks on the buccal side of the first premolar;the palatal anchorage screw was used in combination with hooks on the lingual side of the canine,and the palatal anchorage screw was used in combination with hooks on the lingual side of the first premolar.Analysis using ANSYS software was conducted to evaluate the three-dimensional displacement trends of maxillary teeth and the maximum equivalent stress on the periodontal ligament under each condition.RESULTS AND CONCLUSION:(1)Regardless of whether hooks were placed on canines or first premolars,palatal miniscrews had been shown to enhance the distal movement of maxillary molars and reduce the mesial movement of premolars as well as the labial tipping tendency of anterior teeth,compared to buccal miniscrews.The maximum equivalent stress in the periodontal ligament of molars was increased,while that of anterior teeth was decreased.(2)Regardless of whether the miniscrews were located on the buccal or palatal side,compared with hooks at the first premolar,when hooks were done at the canine,the labial inclination trend of the anterior teeth was reduced,the distal movement of the molars was reduced,the mesial movement of the premolars was increased,and the maximum equivalent stress of the molar and the periodontal membrane of the anterior teeth was reduced.(3)Regardless of whether miniscrews were located on the buccal or palatal side,and the hooks were located on the canine or the first premolar,the molar could not achieve overall movement.(4)The results show that clear aligner combined with palatal miniscrews and hooks at the first premolar are more conducive to improving the efficiency of maxillary molar distalization,but attention should be paid to protecting the anterior tooth miniscrews and molar torque control;clear aligner combined with palatal miniscrews and hooks at the canine is more conducive to reducing the labial tipping tendency of anterior teeth,but the efficiency of molar distalization will be relatively reduced.
4.Health state trends of the children aged 3-6 in Changping District,Beijing,2021 to 2023
Tianzhuo ZHANG ; Xiumei LI ; Yan KONG ; Jie WU ; Xiaolin YE
Chinese Pediatric Emergency Medicine 2025;32(3):186-190
Objective:To analyze the nutritional development status and trends of preschool children aged 3-6 in Changping District,Beijing.Methods:The physical examination informations of preschool children aged 3-6 from over 180 kindergartens who participated in physical examinations in Maternal and Child Health Care Hospital of Changping District from 2021 to 2023 were collected retrospectively.The malnutrition,vision examination and dental caries of children with different ages across these years were compared.Results:A total of 135 215 children underwent physical examinations from 2021 to 2023,with 43 098 cases in 2021,45 985 cases in 2022,and 46 132 cases in 2023.Among them,there were 601 cases (0.44%) of malnutrition (including underweight,stunted growth,and wasting),and 13 512 cases (9.99%) of excessive nutrition (including overweight and obesity).The prevalence rates of overweight were 7.19%,5.56%,and 5.28% for the years 2021,2022,and 2023,respectively,with the highest rate in 2021; the obesity rates were 4.41%,3.79%,and 3.85% for the same years,also with the highest rate in 2021.The differences were statistically significant ( P<0.05).The analysis of overweight and obese children of different ages in 2021 showed that the highest rate of overweight was in 3-year-olds (8.33%, P<0.05),and the highest rate of obesity was in 6-year-olds (6.19%, P<0.05).The detection rates of dental caries were 51.97%,39.14%,and 49.68%; the total caries treatment rates were 39.39%,43.09%,and 47.34%,showing an increasing trend,with statistically significant differences ( P<0.05).From 2021 to 2023,the detection rates of vision abnormalities among children aged 4 to 6 were 4.93%,3.74%,and 3.71%,respectively; the vision correction rates were 68.71%,76.51%,and 86.27%,showing an increasing trend over the years,with statistically significant differences ( P<0.05). Conclusion:The issues of overweight/obesity,dental caries,and vision abnormalities remain significant among children aged 3-6 in Changping District,Beijing.There is a need for continued attention to the physical examinations of preschool children and to further strengthen the prevention and control of common diseases in preschoolers to ensure their healthy growth.
5.Research progress of immune metabolic regulation in inflammatory bowel disease
Tianzhuo ZHANG ; Xiaolin YE ; Dongdan LI ; Xiaoshuang CUI ; Jie WU
Chinese Journal of Inflammatory Bowel Diseases 2025;09(4):358-362
Immune dysregulation is a critical factor in the pathogenesis of inflammatory bowel disease (IBD), and numerous studies have focused on the impact of immune cell metabolic pathways. Immune system cells dynamically adapt to the microenvironment, regulating the body's response to external stimuli through intricate metabolic pathways. This review summarizes the mechanisms by which glycolysis, fatty acid and amino acid metabolisms influence immune metabolism and thereby modulate IBD progression, offering new perspectives for the diagnosis and treatment of IBD.
6.The value of Hawk spectral CT in predicting lymph node metastasis in papillary thyroid carcinoma
Lili YE ; Renli ZANG ; Xiangfa HE ; Ming LIANG ; Xiaolin ZHENG
Journal of Practical Radiology 2025;41(6):928-932
Objective To investigate the value of multiple quantitative parameters derived from Hawk spectral CT in predicting lymph node metastasis in papillary thyroid carcinoma(PTC).Methods Preoperative Hawk spectral CT images of 57 cancerous foci from 44 PTC patients confirmed by surgery and pathology were retrospectively collected.All patients underwent lymph node dissection.Based on pathological results,the patients were categorized into metastatic group(26 patients with 35 cancerous foci)and non-metastatic group(18 patients with 22 cancerous foci).The CT morphological features of the primary PTC lesions included location,diameter,bite-cookie sign,and calcification,respectively.Quantitative parameters of Hawk spectral CT plain scan,arterial phase(AP)and venous phase(VP),including conventional CT values,virtual monoenergetic imaging(MonoE)CT values(40 keV,100 keV),effective atomic number(Zeff)and electron density(Rho),respectively.The rank sum test or chi-square test was used to compare the differences in CT morphological features and Hawk spectral CT quantitative parameters between the two groups.For parameters with significant differences,logistic regression was used to construct a combined model.Area under the curve(AUC),accuracy,sensitivity,and specificity were used to evaluate the effectiveness of the combined model.Results There was statistically significant difference in the diameter of the primary lesion between the metastatic group and the non-metastatic group(P<0.05),and the diameter of the primary lesion in the metastatic group was larger than that in the non-metastatic group.The conventional CT value,MonoE CT values(40 keV,100 keV),Rho and Zeff in plain scan,AP-Rho,and VP-MonoE CT value(100 keV)of the primary lesion in the metastatic group were all significantly lower than those in the non-metastatic group(P<0.05).The AUC,accuracy,sensitivity and specificity of the Hawk spectral CT plain scan parameter combination model were 0.765,0.754,0.800,and 0.682,respectively.The AUC,accuracy,sensitivity,and specificity of the Hawk spectral CT enhancement parameter combination model were 0.726,0.667,0.600,and 0.786,respectively.Conclusion Through the analysis of multiple quantitative parameters from Hawk spectral CT of PTC primary lesion,the primary lesion in the metastatic group exhibited significant differences from those in the non-metastatic group in multiple quantitative parameters,which can further improve the predictive efficacy for lymph node metastasis.
7.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.
8.Knowledge, attitudes and practice regarding three major infectious diseases among freshmen in Jiangsu Province from 2019 to 2022
ZHANG Xiaolin, DU Guoping, CHEN Xiaoyan, LI Xiaoshan, WEI Yixuan, LI Yanhui, TAN Bingxin, YE Yuxiu
Chinese Journal of School Health 2025;46(2):205-209
Objective:
To understand the changing trends and related factors of knowledge, attitude and practice (KAP) regarding the three major infectious diseases (acquired immunodeficiency syndrome, tuberculosis, hepatitis B) among freshmen in Jiangsu from 2019 to 2022, so as to provide a reference basis for the health education of infectious diseases in schools.
Methods:
From 2019 to 2022, a total of 33 944 freshmen from 20 universities in Jiangsu Province were randomly selected for four consecutive years to investigate their KAP levels online through self designed questionnaires on three major infectious diseases. The multiple linear regression model was used to analyze the changing trends of students KAP levels of the three major infectious diseases, and to explore the influencing factors of KAP.
Results:
From 2019 to 2022, the knowledge scores(18.0±3.1,18.4±3.2,18.7±3.2,18.8±3.2), related to the three major infectious diseases showed an upward trend ( F=436.50, P <0.01), and the positive attitude reporting rates were 81.77%, 81.46%, 82.68% and 81.74%, respectively. The reporting rates of positive practice were 80.11%, 79.25%, 79.08 % and 79.04%, respectively. Multiple linear regression showed that school type, parental education level, mother s occupation, average income per person in family and living arrangements during high school all had an impact on the knowledge ( β = -1.510 -0.559), attitudes ( β =-0.043-0.065) and practice ( β =-0.028-0.027) of the three major infectious diseases ( P < 0.05 ). The family residence areas only affected the reporting rate of positive attitude scores ( β =0.002-0.065), and whether only children or not affected the reporting rate of positive practice scores ( β =0.009)( P <0.05). The knowledge score showed an upward trend ( β= 0.297, P <0.01), the positive attitude reporting rate showed no statistically significant change ( β=0.001, P =0.22), and the positive practice reporting rate showed a downward trend ( β=-0.005, P <0.01).
Conclusions
Freshman in Jiangsu Province from 2019 to 2022 have shown a separation in KAP scores regarding the three major infectious diseases. Targeted measures should be taken to improve their health practice level.
9.Research progress of immune metabolic regulation in inflammatory bowel disease
Tianzhuo ZHANG ; Xiaolin YE ; Dongdan LI ; Xiaoshuang CUI ; Jie WU
Chinese Journal of Inflammatory Bowel Diseases 2025;09(4):358-362
Immune dysregulation is a critical factor in the pathogenesis of inflammatory bowel disease (IBD), and numerous studies have focused on the impact of immune cell metabolic pathways. Immune system cells dynamically adapt to the microenvironment, regulating the body's response to external stimuli through intricate metabolic pathways. This review summarizes the mechanisms by which glycolysis, fatty acid and amino acid metabolisms influence immune metabolism and thereby modulate IBD progression, offering new perspectives for the diagnosis and treatment of IBD.
10.Characteristics and clinical significance of neutrophil extracellular traps in children with inflammatory bowel disease
Yan KONG ; Tianzhuo ZHANG ; Xueying AN ; Jie WU ; Xiaolin YE
Chinese Journal of Pediatrics 2025;63(7):759-764
Objective:To evaluate the characteristics of neutrophil extracellular traps (NET) in children with inflammatory bowel disease (IBD) and its role in diagnosis and disease activity monitoring.Methods:A total of 66 IBD children admitted to Beijing Children′s Hospital from December 2017 to August 2024 were enrolled in this cross-sectional study, another 20 age-matched children who underwent gastrointestinal endoscopy during the same period in the same hospital and showed no abnormalities were selected as the controls. Clinical data of IBD and control group were collected. Children with IBD were divided into active group and remission group according to clinical score and endoscopic score. The peripheral blood of IBD and control group were collected, and the levels of NET markers, including neutrophil elastase (NE) and myeloperoxidase (MPO)-DNA were detected by enzyme-linked immunosorbent assay. The levels of NET markers in control group and different IBD groups were compared. Independent sample t-test or Mann-Whitney U test was used for group comparisons. Kruskal-Wallis H test was used for multiple group comparisons. Spearman correlation analysis was used to analyze the correlation between NET markers and IBD activity. The efficacy of laboratory indicators in diagnosing IBD and control group was evaluated using receiver operating characteristic (ROC) curve. Results:There were 66 children with IBD, including 36 in Crohn′s disease group with the age of (11.0±3.7) years, and 30 in ulcerative colitis (UC) group with the age of (8.3±5.0) years. The control group consisted of 20 children with the age of (10.1±3.5) years. Compared with control group, the levels of NE (958 (771, 1 328) vs. 303 (196, 501) μg/L) and MPO-DNA (0.11 (0.09, 0.18) vs. 0.09 (0.06, 0.12)) in peripheral blood of IBD group were significantly higher (both P<0.05). However, there was no significant difference in the levels of NE (1 008 (863, 1 301) vs. 807 (567, 1 535) μg/L) and MPO-DNA (0.11 (0.09, 0.21) vs. 0.12 (0.09, 0.14)) between Crohn′s disease and UC groups (both P>0.05). The NE levels in the endoscopic active group and remission group of Crohn's disease were higher than those in the control group (both P<0.05). The MPO-DNA level in the endoscopic active group of Crohn's disease was higher than that in the control group ( P<0.05), while the MPO-DNA level in the endoscopic remission group of Crohn's disease was lower than that in the control group ( P>0.05). The NE levels in the endoscopic activity group and remission group of UC were higher than those in control group (both P<0.05). NET markers were not correlated with the clinical activity and endoscopic activity of IBD (all P>0.05). ROC curve analysis showed that the area under the curve of NE combined with MPO-DNA for distinguishing IBD from controls was 0.95, with a sensitivity was 90.0% and a specificity was 89.4%. Conclusion:The combination of NE and MPO-DNA demonstrated high sensitivity and specificity for distinguishing pediatric IBD patients from healthy children, suggesting its potential as a diagnostic biomarker panel of IBD.


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