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.

To analyze long-term trends in the burden of major depressive disorder(MDD) in China and globally from 1990 to 2023 based on the Global Burden of Disease 2023(GBD 2023), characterize pre-and post-pandemic patterns and demographic drivers, and project future burden trends.

Data were extracted from the GBD 2023 database covering 204 countries/territories. Age-standardized incidence rate(ASIR), age-standardized prevalence rate(ASPR), age-standardized disability-adjusted life year rate(ASDR), and their 95% uncertainty intervals(UI) were calculated. Joinpoint regression analysis was used to estimate average annual percent change(AAPC) with 95% confidence intervals(CI), along with correlations with sociodemographic index(SDI), inequality, and frontier gaps. Das Gupta decomposition was applied to assess demographic contributions. Autoregressive integrated moving average(ARIMA) models were developed based on 1990 to 2018 time-series to forecast trends from 2024 to 2040. Attributable burdens of major modifiable social risk factors were also analyzed.

In 2023, China's ASIR, ASPR, and ASDR were 3002.50/100000, 2107.50/100000, and 429.44/100000, respectively, all lower than the global estimates of 3464.17/100000, 2815.75/100000, and 567.77/100000, correspondingly. From 1990 to 2023, all 3 age-standardized rates showed upward trends. In China, AAPC was 1.214%(P<0.05) for ASIR, 0.920%(P<0.05) for ASPR, and 0.947%(P<0.05) for ASDR; globally, corresponding AAPCs were 1.222%(P<0.05), 1.385%(P<0.05), and 1.380%(P<0.05), respectively. Post-pandemic ASPR and ASDR maintained high plateau levels: in 2023, China's rate increased by 7.5% and 7.4% relative to 2019, while global rates increased by 24.5% and 24.1%, respectively. Age distribution patterns showed that in 2023, China's crude incidence rate peaked at 3909.88/100000(95%UI: 3009.15 to 4874.13) in the 15 to 19 years age group, and crude DALY rate also peaked at 584.29/100000(95%UI: 361.23 to 887.27) in the same age group. Whereas the crude prevalence rate increased with age and peaked at age of ≥95 years at 3084.41/100000(2410.08 to 4107.62). In 2023, correlations between ASIR/ASPR/ASDR and SDI were weak and not statistically significant(P>0.05). ARIMA projections suggested that by 2040, China's ASIR, ASPR, and ASDR would reach 3648.92/100000, 2576.16/100000, and 536.31/100000, respectively. In 2023, attributable proportions of DALYs(China/global) were 8.70%/8.32% for intimate partner violence, 8.24%/6.82% for bullying victimization, and 7.48%/8.20% for childhood sexual abuse. Sex-stratified analyses consistently showed higher burdens in females than in males.

From 1990 to 2023, the burden of MDD in China and globally continued to rise. The COVID-19 pandemic produced an additional surge, with accumulated burden maintaining high levels post-pandemic. Age patterns indicate coexistence of “high incidence and high health loss in adolescence” and “accumulation of absolute burden in middle-aged and older adults.” Projections based on pre-pandemic trends suggest that China's future burden may continue to increase.

While improving service accessibility, we recommend advancing screening and stratified interventions to priority populations, especially adolescents and females, and integrating social risk governance measures, such as anti-domestic violence, anti-bullying, and child protection, into a comprehensive MDD prevention and control system.

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, P < 0.001) and globally(AAPC=-0.001, 95% CI: -0.001 to -0.001, P < 0.001). The age-standardized prevalence rate(ASPR) in China showed an increasing trend(AAPC=0.006, 95% CI: 0.006 to 0.007, P < 0.001), while the global trend was not significant(AAPC=0, 95% CI: -0.001 to 0, P= 0.082). The age-standardized DALY rate(ASDR) in China showed a declining trend(AAPC=-0.022, 95% CI: -0.033 to -0.011, P < 0.001), whereas globally it showed an increasing trend(AAPC=0.033, 95% CI: 0.028 to 0.039, P < 0.001). Additionally, the MND disease burden was higher in males than in females across most age groups in China, with the burden being particularly heavy in the 45-74 age group.

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.