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.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.
3.Dose-Dense Rituximab-CHOP versus Standard Rituximab-CHOP in Newly Diagnosed Chinese Patients with Diffuse Large B-Cell Lymphoma: A Randomized, Multicenter, Open-Label Phase 3 Trial
Xueying LI ; He HUANG ; Bing XU ; Hongqiang GUO ; Yingcheng LIN ; Sheng YE ; Jiqun YI ; Wenyu LI ; Xiangyuan WU ; Wei WANG ; Hongyu ZHAN ; Derong XIE ; Jiewen PENG ; Yabing CAO ; Xingxiang PU ; Chengcheng GUO ; Huangming HONG ; Zhao WANG ; Xiaojie FANG ; Yong ZHOU ; Suxia LIN ; Qing LIU ; Tongyu LIN
Cancer Research and Treatment 2019;51(3):919-932
PURPOSE: Rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone administered every 3 weeks (R-CHOP-21) is the standard care for diffuse large B-cell lymphoma (DLBCL). It is unknown whether the dose-dense R-CHOP (R-CHOP-14) could improve the outcome of the disease in Asian population. MATERIALS AND METHODS: Newly diagnosed DLBCL patients were centrally, randomly assigned (1:1) to receive R-CHOP-14 or R-CHOP-21. R-CHOP-14 was administered every 2 weeks, and R-CHOP-21 was administered every 3 weeks. Primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS), progression-free survival (PFS), response rate and toxicities. RESULTS: Seven hundred and two patients were randomly assigned to receive R-CHOP-14 (n=349) or R-CHOP-21 (n=353). With a median follow-up of 45.6 months, the two groups did not differ significantly in 3-year DFS (79.6% for R-CHOP-14 vs. 83.2% for R-CHOP-21, p=0.311), 3-year OS (77.5% for R-CHOP-14 vs. 77.6% for R-CHOP-21, p=0.903), or 3-year PFS (63.2% for R-CHOP-14 vs. 66.1% for R-CHOP-21, p=0.447). Patients with an International Prognostic Index (IPI) score ≥ 2 had a poorer prognosis compared to those with an IPI score < 2. Grade 3/4 hematologic and non-hematologic toxicities were manageable and similar between R-CHOP-14 and R-CHOP-21. CONCLUSION: R-CHOP-14 did not improve the outcome of DLBCL compared to R-CHOP-21 in Asian population. With manageable and similar toxicities, both of the two regimens were suitable for Asian DLBCL patients. For high-risk patients with IPI ≥ 2, new combination regimens based on R-CHOP deserve further investigation to improve efficacy.
Asian Continental Ancestry Group
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B-Lymphocytes
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Cyclophosphamide
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Disease-Free Survival
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Doxorubicin
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Follow-Up Studies
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Humans
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Lymphoma, B-Cell
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Prednisone
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Prognosis
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Rituximab
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Vincristine
4.Incidence of pancreatic cancer related depression in Guangzhou,China
Shuman JIANG ; Lin JIA ; Yuanyuan SHANG ; Yijun LI ; Derong XIE ; Kaihong HUANG ; Fachao ZHI
Chinese Journal of Pancreatology 2010;10(1):18-20
Objective To investigate the incidence of pancreatic cancer-related depression in Guangzhou,China.Methods A multicenter,prospective survey was conducted,50 patients with pancreatic cancer,60 with liver cancer,50 with esophageal cancer,50 with gastric cancer,52 with colorectal cancer were enrolled from 4 hospitals in Guangzhou between June 2007 and June 2009.Hamilton Rating Scale for Depression-24 (HAMD-24) questionnaire was used to assess the degree of depression.Results The incidence of depression in pancreatic cancer patients was 78% (39/50),which was significantly higher than that among liver cancer patients (60% ,36/60),gastric cancer patients (36%,18/50),esophageal cancer patients(24%,12/50),and colorectal cancer patients(19.2%,10/52,P<0.05 ).Twelve of 50 patients in pancreatic cancer were reported to have severe depression (24%),which was significantly more than that in liver cancer (10%,6/60),gastric cancer (4%,2/50),esophageal and colorectal cancer (0,P <0.05).In pancreatic cancer patients,the incidence of depression was significantly higher in patients with advanced stage (94.3%) than that in early stage (46.7%,P<0.05).Patients who underwent chemotherapy had high incidence of depression(92.3%)than that of patients who underwent operation (62.5%,P<0.05 ).Conclusions Compared with other cancers of digestive tract,the incidence of pancreatic cancer-related depression was higher,and its degree was more severe than that of other cancers.
5.Association between Hepatitis B Virus Infection and Pancreatic Cancer
Wen MA ; Derong XIE ; Wanping CAO ; Qiong YANG ; Zhimin JIANG ; Denglin CHEN ; Zhuofei BI ; Yuandong ZHANG
Chinese Journal of Clinical Oncology 2009;36(24):1388-1390
Objective: To analyze the association between hepatitis B virus (HBV) infection and pancreatic cancer. Methods: Retrospective analysis was performed to explore the positive rate of serum hepatitis B virus surface antigen (HBsAg) in patients with pancreatic cancer, lung cancer, diabetes mellitus and general population. Z test was used to compare the rate of HBV infection between the samples and general population. The rates among the samples were compared by Chi-square test. Results: A total of 3,701 registered patients seen in our hospital between January 1st 2003 and March 31st 2009 were collected. There were 230 pancreatic cancer patients with a positive rate of serum HBsAg of 16.1%, 1,188 lung cancer patients with a positive rate of serum HBsAg of 10.7%, and 2,283 patients with diabetes mellitus with a positive rate of serum HBsAg of 11.6%. There was no statistical significance in Z-test results between lung cancer patients and general population (Z=1.104, P=0.163), but the Z-test results between patients with diabetes mellitus and general population showed a statistical significance (Z=2.98, P=0.002). The positive rate of HBsAg was higher in pancreatic cancer patients than that in lung cancer patients (OR=1.60, 95% Cl: 1.077-2.382, r=5.487, P=0.019). Similar results were found between pancreatic cancer patients and diabetic patients (OR=1.46, 95% CI: 1.004-2.123, r=3.965, P=0.046). Conclusion: The positive rate of HBsAg is high in pancreatic cancer patients. There might be an association between HBV infection and pancreatic cancer.
6.Prevalence and clinical features of pain in patients with pancreatic cancer
Lin JIA ; Jianjun ZHENG ; Yuanyuan SHANG ; Shineng ZHANG ; Kaihong HUANG ; Derong XIE
Chinese Journal of Pancreatology 2009;9(5):294-296
Objective To investigate the prevalence and the clinical features of pancreatic cancer pain in a Chinese patient population.Methods The study was carried out in 415 cages of pancreatic cancer which were admitted to the First Municipal people's Hospital of Guangzhou Medical college and the Second Affiliated Hospital of Sun Yat-sen University from 1999 to 2007.The prevalence,clinical features of pancreatic cancer pain and its correlations with the cancer site and the clinical staging were analyzed.Results Of the 415 patients.the prevalence of pain wag 65.1%and 60.5%of all the patients presented pain as the initial symptom;the incidence of pain in pancreatic body/tail cancer patients was 80.7%.while it was 71.4%in total pancreatic cancer patients.and the incidence was 58.2%in pancreatic head cancer patients;the incidence between pancreatic body/tail cancer and pancreatic head cancer patients was statistically different (P<0.05).The incidence of pain in patients with stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ was 28.6%,58.1%,66.2%and 78.6%.and the difference was statistically significant(P<0.01).The incidence of moderate to severe degree of pain in patients with stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ was 18.8%,44.4%,53.1%and 68.2%,and the differenee was statistically significant(P<0.01).Conclusions Pain was very common in patients with advanced pancreatic cancer.The incidence and severity of pain increased with the progression of pancreatic cancer.
7.Effect of erythropoietin on chemo-sensitivity of pancreatic cancer cell line SW1990 to gemcitabine
Qiong YANG ; Derong XIE ; Zhimin JIANG ; Denglin CHEN ; Zhuofei BI ; Wen MA
Chinese Journal of Pancreatology 2009;9(3):178-180
.036;r=-0.968,P=0.032).Conclusions Epo might decrease the chemo-sensitivity of SW1990 to gemcitabine possibly by up-regulating the expressions of MDR-1 and RRM1.
8.Gemcitabine arterial infusion chemotherapy versus intravenous chemotherapy for patients with advanced pancreatic cancer: a comparative study
Lin JIA ; Jianjun ZHENG ; Shineng ZHANG ; Derong XIE
Chinese Journal of Pancreatology 2009;9(1):15-17
Objective To compare the clinical efficacy of gemcitabine arterial infusion chemotherapy with intravenous chemotherapy in the management of patients with advanced pancreatic cancer and to evaluate the efficacy and safety of gemcitabine arterial infusion chemotherapy. Methods 43 patients with advanced pancreatic cancer were included in this study, of whom 21 patients received arterial infusion chemotherapy (Group A) and the other 22 were treated by intravenous chemotherapy (Group B), gemcitabine combined with 5-FU chemotherapy was administrated in both groups. The main outcomes were clinical benefit response (CBR), tumor response rate and toxicity. Results Compared with Group B, there was a significant improvement of CBR in group A (81% vs 50%, P =0.033) ; there was also significant improvement of pain control in group A (76.2% vs 45.5%, P =0.039). There was no significant difference in the tumor response rate between two groups (33.3% vs 22.7%, P =0.498). No significant increase of side effects was observed in both groups. Conclusions In the management of advanced pancreatic cancer, the arterial infusion method may be more favorable than intravenous approach in improving clinical benefits with mild toxicity and well tolerability.
9.Influence of distribution of nursing human resource in maternal-infant wards on patients'satisfaction degree
Wei YANG ; Huiqiong XIE ; Derong YANG
Chinese Journal of Practical Nursing 2008;24(35):5-8
Objective To discuss the influence of distribution of nursing human resource in maternalinfant wards on patients'satisfaction degree.Methods To analyze the satisfaction degree with nursing quality of all patients and distribution of nursing human resource in maternal-infant wards in our hospital in 2007.Results There was a positive correlation between inpatients'satisfaction of nursing service and distribution of nurses.Theinsufficiency of distribution of nursing human resource in maternal-infant wards caused nurses' sensation of work tiredness,degradation of service quality,bad service attitude,indifference to patients,lack of detail service,insufficiency of basic nursing care,simplistic health education,and unwarranted quality of technique operation.Conclusions The distribution of nursing human resource in maternal-infant wards should be hisher than that in common wards and We should pay attention to the distribution of naming safety in maternal-in-fant wards,increase nurse staffing,rationally utilize human resource,enhance training of comprehensive quality of nurses,strengthen quality awareness,service awareness and safety awareness,ensure the nursing quality and mother-infant safety,and improve patients'satisfaction.
10.Efficacy of Xiangsha Yangwei Wan in Inhibiting Side Effects due to Chemotherapy in Upper Digestive Tract
Weikua ZHENG ; Lizhu LIN ; Shude CHEN ; Feng ZHAN ; Jiaqi RAO ; Derong XIE ; Mingzhi HAO
Journal of Guangzhou University of Traditional Chinese Medicine 2004;0(06):-
[Objective] To investigate the efficacy of Xiangsha Yangwei Wan (XYW) on the inhibition of chemotherapy-induced chemical gastritis and upper gastrointestinal symptoms. [Methods] A randomized controlled trial (RCT) was carried out in 87 cases of maligant tumor confirmed by histopathological and cytological examination. All the cases were treated with chemotherapy regimen of adriamycin ( ADM) , adcarbazine ( DTIC) , platinum-based agents, irinotecan (CPT-11) and fluorouraeil (5-FU). Meanwhile, 41 cases in group A were also treated with dexamethason and 5-HT3 receptor antagonist as an essential anti-emesis and with XYW to regulate gastrointestinal function; other 46 cases in group B were given dexamethason and 5-HT3 receptor antagonist only. Seven days after treatment, incidences of chemical gastritis and upper gastrointestinal symptoms were observed and compared between the two groups. [Results] Seven days after chemotherapy, upper gastrointestinal symptoms and signs were relieved in 95.1% (39/41) of the patients of group A and in 76.1 % (35/46) of group B; the occurring rate of chemical gastritis with symptoms was 2.4% (1/41) in group A and 19.6% (9/46) in group B, the differences being significant statistically between the two groups( P - 0.0122) . [ Conclusion ] XYW has an inhibitory effect on chemotherapy-induced chemical gastritis and upper gastrointestinal symptoms.

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