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.CDH17-targeting CAR-NK cells synergize with CD47 blockade for potent suppression of gastrointestinal cancers.
Liuhai ZHENG ; Youbing DING ; Xiaolong XU ; Huifang WANG ; Guangwei SHI ; Yang LI ; Yuanqiao HE ; Yue GONG ; Xiaodong ZHANG ; Jinxi WEI ; Zhiyu DONG ; Jiexuan LI ; Shanchao ZHAO ; Rui HOU ; Wei ZHANG ; Jigang WANG ; Zhijie LI
Acta Pharmaceutica Sinica B 2025;15(5):2559-2574
Gastrointestinal (GI) cancers are a leading cause of cancer morbidity and mortality worldwide. Despite advances in treatment, cancer relapse remains a significant challenge, necessitating novel therapeutic strategies. In this study, we engineered nanobody-based chimeric antigen receptor (CAR) natural killer (NK) cells targeting cadherin 17 (CDH17) for the treatment of GI tumors. In addition, to enhance the efficacy of CAR-NK cells, we also incorporated CV1, a CD47-SIRPα axis inhibitor, to evaluate the anti-tumor effect of this combination. We found that CDH17-CAR-NK cells effectively eliminated GI cancers cells in a CDH17-dependent manner. CDH17-CAR-NK cells also exhibit potent in vivo anti-tumor effects in cancer cell-derived xenograft and patient-derived xenograft mouse models. Additionally, the anti-tumor activity of CDH17-CAR-NK cells is synergistically enhanced by CD47-signal regulatory protein α (SIRPα) axis inhibitor CV1, likely through augmented macrophages activation and an increase in M1-phenotype macrophages in the tumor microenvironment. Collectively, our findings suggest that CDH17-targeting CAR-NK cells are a promising strategy for GI cancers. The combination of CDH17-CAR-NK cells with CV1 emerges as a potential combinatorial approach to overcome the limitations of CAR-NK therapy. Further investigations are warranted to speed up the clinical translation of these findings.
3.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.
4.Enzyme-catalyzed synthesis of mannose ester and its enhancement of tanshinone and glycyrrhetinic acid lipid nanoparticles
Yue Li ; Jiexuan Wang ; Xiuli Wang ; Xue Guo
Journal of Traditional Chinese Medical Sciences 2025;2025(3):390-401
ObjectiveTo improve the efficiency of drug delivery, a mannose vinyl stearate mannose ligand (Man ligand) with active liver-targeting properties was synthesized.MethodsNon-aqueous enzymatic synthesis was used to modify the structure of mannose. Glycyrrhetinic acid-tanshinone lipid nanoparticles (GT-LN) and liver-targeted glycyrrhetinic acid-tanshinone mannose-modified lipid nanoparticles (GT-MLN) were prepared. The physicochemical properties and release profiles of both formulations were evaluated, and their pharmacokinetic behavior and tissue distribution were investigated.ResultsThe average particle sizes of GT-LN and GT-MLN were 190.20 ± 1.35 and 204.83 ± 3.86 nm, respectively, with corresponding surface Zeta potentials of −28.0 ± 1.68 and −30.24 ± 2.10 mV. The drug release profile of GT-LN conformed to the Higuchi equation, whereas that of GT-MLN followed both the first-order kinetic and Ritger–Peppas equations. Both formulations significantly enhanced the gastrointestinal stability of the drug. In vivo studies in mice demonstrated that hepatic GA and TSN concentrations in both groups were significantly higher than those in the original drug suspension group (P = .01). Notably, the concentrations in the GT-MLN group were significantly higher compared to the GT-LN group (P = .01).ConclusionMan ligand was formed via the linkage of vinyl stearate with the hydroxyl group at C-6 in mannose. The Man ligand endowed these lipid nanoparticles with obvious active liver-targeting properties. Our results provide an efficient and stable route of drug delivery to the liver with improved drug availability.
5.Analysis of risk factors associated with endoscopic retrograde cholangiopancreatography for patients with liver cirrhosis: a multicenter, retrospective, clinical study.
Jielin LI ; Jiexuan HU ; Peng LI ; Yongdong WU ; Yongjun WANG ; Ming JI ; Haiyang HUA ; Wenbin RAN ; Yanglin PAN ; Shutian ZHANG
Chinese Medical Journal 2022;135(19):2319-2325
BACKGROUND:
Endoscopic retrograde cholangiopancreatography (ERCP) is the endoscopic modality of choice for the treatment of biliary and pancreatic diseases. However, patients with cirrhosis, particularly those with decompensated cirrhosis, are believed to be at increased risk for complications associated with ERCP. There is a paucity of literature describing the outcomes of ERCP for patients with cirrhosis. This study aimed to investigate the outcomes of ERCP for cirrhosis patients, especially adverse events, and evaluated its safety and efficacy.
METHODS:
We performed a multicenter, retrospective study of all patients at Beijing Friendship Hospital affiliated to Capital Medical University, Xijing Hospital affiliated to Air Force Military Medical University, Beijing Youan Hospital affiliated to Capital Medical University, and the Fifth Medical Center of the People's Liberation Army General Hospital from June 2003 to August 2019. The adverse events of inpatient ERCP for patients with ( n = 182) and without liver cirrhosis (controls; n = 385) were compared.
RESULTS:
A total of 567 patients underwent ERCP between January 2003 and December 2019 were enrolled in this study. Compared to patients without cirrhosis, patients with cirrhosis were at higher risk for postoperative complications (odds ratio [OR], 4.172; 95% confidence interval [CI], 1.232-7.031; P < 0.001) such as postoperative pancreatitis (OR, 2.026; 95% CI, 1.002-4.378; P = 0.001) and cholangitis (OR, 3.903; 95% CI, 1.001-10.038; P = 0.036). The main indications for ERCP for patients with cirrhosis in this study included choledocholithiasis (101 cases; 55.5%), benign bile duct strictures (46 cases; 25.3%), and malignant bile duct strictures (28 cases; 15.4%). Among them, 23 patients (12.6%) underwent balloon dilation and 79 patients (43.4%) underwent sphincterotomy. Of the patients with cirrhosis, delayed bleeding occurred in ten patients (5.5%), postoperative pancreatitis occurred in 80 patients (44.0%), and postoperative cholangitis occurred in 25 patients (13.7%). An additional multivariate analysis showed that the total bilirubin (TBIL) level (OR, 4.58; 95% CI, 2.37-6.70) and Child-Pugh score of C (OR, 3.11; 95% CI, 1.04-5.37) were risk factors for postoperative complications in patients with cirrhosis.
CONCLUSIONS
Compared with the general population of patients undergoing ERCP, patients with cirrhosis were more prone to postoperative pancreatitis and cholangitis. TBIL levels and Child-Pugh scores were risk factors for postoperative complications in patients with cirrhosis.
Humans
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Cholangiopancreatography, Endoscopic Retrograde/adverse effects*
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Retrospective Studies
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Constriction, Pathologic
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Risk Factors
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Liver Cirrhosis/complications*
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Pancreatitis/etiology*
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Postoperative Complications/epidemiology*
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Cholangitis
6.The mediating role of family cohesion between family expressiveness and preschool children's behavior
Guoyan LIU ; Jiexuan LI ; Limei XIAO ; Xiaohui ZHU ; Yanchun CAI
Chinese Journal of Behavioral Medicine and Brain Science 2020;29(2):159-162
Objective:To explore the mediating role of family cohesion between family expressiveness and preschool children's behavior.Methods:Using the method of stratified cluster random sampling, the parents of 1 213 children in Shenzhen kindergartens were assessed by the Achenbach child behavior checklist (parent questionnaire) (CBCL, 4-16 years) and family environment scale-Chinese version (FES-CV). After the survey, SPSS 24.0 was used to conduct the data analysis and the Bootstrap method was used to test the mediation effect.Results:(1)The total score of children's behavior 147.0(135.0, 163.0) was found to be significantly negatively correlated with family expressiveness score 6.0 (5.0, 7.0) and family cohesion score 8.0 (6.0, 9.0), and the correlation coefficients were -0.145 and -0.187(both P<0.01). (2) Family expressiveness score was positively related to family cohesion score ( r=0.443, P<0.01). (3)The direct effect of family expressiveness on children's behavior was -0.072, and the 95% confidence interval was (-0.133, -0.010). Family cohesion had a mediating effect between family expressiveness and children's behavior, 95% confidence interval was (-0.129, -0.058), and the mediating effect accounted for 56.4% of the total effect. Conclusion:Family cohesion plays a partial mediating role between family expressiveness and children's behavior.


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