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.The mathematical model for the differential diagnosis of endoscopic gastric ulcerative lesions
Haiyan TAO ; Peng LI ; Ping ZHOU ; Shutian ZHANG ; Derong YE
Chinese Journal of Digestive Endoscopy 2015;(3):180-186
Objective To establish mathematical model for the differential diagnosis of endoscopic gastric ulcerative lesions with the help of image processing software and statistical analysis method. Methods The microscopic images of 25 gastric ulcers and 25 gastric peptic cancers were collected from January 2013 to December 2013.Then the Photoshop CS4 software was used for image processing and representative measurements gathering(area,perimeter,roundness,height,width,gray scale,involving the density,color,lightness,pixels).Then the principal component analysis,the scatter plot and cluster analysis were performed by SPSS 16.0.Results According to the results of principal component analysis, Z1 showed a strong positive correlation with area,perimeter,height,width,cumulative density,pixel,which represented the shape statistics of ulcer.And Z2 showed a strong positive correlation with gray scale,color, lightness,which represented the color statistics of ulcer.On the Scatter plot,gastric peptic cancer images showed a stronger positive correlation with the principal component Z1 and Z2 .Clustering analysis results showed that for the majority of patients,there was a pattern in its incidence.In the gastric ulcer diagnostic models,the effective information should include area≤10 000;perimeter≤250;height≤90;width≤60;gray scale≥90;cumulative density≤190 000;color≥110;and lightness≥110(unit:pixel).In the gastric ulcera-tive cancers,the effective information should include area≥38 000,perimeter≥690,height≥300,width ≥ 426,gray scale ≤ 100,cumulative density ≥ 14 000 000,color ≤ 125,and lightness ≤ 130 (unit:pixel). Conclusion Among the endoscopic image data,area,perimeter,roundness,height,width,gray scale, cumulative density,color,brightness,pixels are important indices,which can contribute to the differential diagnosis of gastric ulcerative lesions.The established mathematical model based on the ten indices can be applied to predict and diagnose gastric ulcerative lesions.
5.Observation of curative effect of concurrent intensity-modulated radiation therapy and chemotherapy for advanced esophageal carcinoma
Derong LIN ; Shangyue YE ; Shengyu ZHU
China Oncology 2014;(2):157-160
Background and purpose:Intensity-modulated radiation therapy (IMRT) enables the delivery of higher radiation dose to the primary tumor target, while sparing the organs and tissues at risk (OARs). Chemotherapy is an effective means to prevent distant metastasis. The purpose of this study was to observe clinical effect of concurrent intensity-modulated radiation therapy and chemotherapy for advanced esophageal carcinoma. Methods: A total number of 62 cases of advanced esophageal carcinoma were divided into two groups. There were 32 cases in concurrent chemoradiotherapy group, and 30 cases were in radiotherapy alone group. The patients in two groups were both used IMRT radiotherapy, while the patients of concurrent chemoradiotherapy group were plused adjuvant chemotherapy. The chemotherapy regimen was TP. Twenty-eight days was a treatment cycle, 2 treatment cycles were lasted during chemoradiotherapy.After that, recent curative effect and toxicside reaction were compared between two groups. Results: The total relief rate (CR+PR) in concurrent chemoradiotherapy group was 93.8%. The total relief rate in radiotherapy alone group was 76.7%. There were signiifcant differences between the two groups (P<0.05). One-year local response rate(84.4%) and 2-year local response rate (59.4%) in concurrent chemoradiotherapy group were both higher than those (70.0%, 36.7%) in radiotherapy alone group (P<0.05), while the survival rate was similar between the two groups (P>0.05). Toxicside reaction in concurrent chemoradiotherapy group, including leucocytes decrease, radioactive esophagitis andⅢ,Ⅳtoxicity, were higher than those in radiotherapy alone group (P<0.05). Conclusion:After treating advanced esophageal carcinoma with concurrent intensity-modulated radiation therapy and chemotherapy, the recent curative effect and the local response were ifne, while toxicity was more serious.
6.Drift correction in fMRI signal based on mathematical morphology
Yun KANG ; Derong YE ; Pengxu WEI ; Yonghong JIAO
Chinese Journal of Medical Imaging Technology 2010;26(2):343-346
Objective To establish a new approach based on mathematical morphology that can effectively reduce the drifts in functional magnetic resonance imaging (fMRI) signals. Methods Based on investigation of the characteristic of drifted fMRI signals, a mathematical morphology method for baseline drift correction was presented. Results With both simulated data and real fMRI data, the results of the experiment showed that the mathematical morphology method can effectively correct the baseline drifts. Conclusion Both linear and nonlinear drifts can be removed with the proposed method without any statistical model assumption.
7.Local contrast enhancement of the medical image based on multiscale morphology
Derong YE ; Yuanyuan ZHAO ; Yanhong CHEN
Chinese Journal of Tissue Engineering Research 2006;10(45):200-202,封3
AIM: To find a more efficient and accurate method for medical image enhancement to resolve the problem of low local contrast, which often appears in magnetic resonance (MR) images.METHODS: Based on the investigation into the previous methods, a new algorithm was presented. The main features were as follows: Non-dual was used in the morphological operations and addition instead of multiplication was used in the contrast stretching operations. To avoid some gray-level bias, the method of normalized gray-level under condition was proposed.RESULTS: The new algorithm was tested by real MR images and simulated experiments. Compared with the previous method, the new method is more accurate, faster and less sensitive to noise.CONCLUSION: Non-dual morphological operations can achieve local contrast enhancement in a more accurate way, and the gray level bias can be eliminated by normalization.

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