Spatial multi-omic map of human myocardial infarction.

Myocardial infarction is a leading cause of death worldwide1. Although advances have been made in acute treatment, an incomplete understanding of remodelling processes has limited the effectiveness of therapies to reduce late-stage mortality2. Here we generate an integrative high-resolution map of human cardiac remodelling after myocardial infarction using single-cell gene expression, chromatin accessibility and spatial transcriptomic profiling of multiple physiological zones at distinct time points in myocardium from patients with myocardial infarction and controls. Multi-modal data integration enabled us to evaluate cardiac cell-type compositions at increased resolution, yielding insights into changes of the cardiac transcriptome and epigenome through the identification of distinct tissue structures of injury, repair and remodelling. We identified and validated disease-specific cardiac cell states of major cell types and analysed them in their spatial context, evaluating their dependency on other cell types. Our data elucidate the molecular principles of human myocardial tissue organization, recapitulating a gradual cardiomyocyte and myeloid continuum following ischaemic injury. In sum, our study provides an integrative molecular map of human myocardial infarction, represents an essential reference for the field and paves the way for advanced mechanistic and therapeutic studies of cardiac disease.

New tools to study renal fibrogenesis.

PURPOSE OF REVIEW: Kidney fibrosis is a key pathological aspect and outcome of chronic kidney disease (CKD). The advent of multiomic analyses using human kidney tissue, enabled by technological advances, marks a new chapter of discovery in fibrosis research of the kidney. This review highlights the rapid advancements of single-cell and spatial multiomic techniques that offer new avenues for exploring research questions related to human kidney fibrosis development. RECENT FINDINGS: We recently focused on understanding the origin and transition of myofibroblasts in kidney fibrosis using single-cell RNA sequencing (scRNA-seq) [1] . We analysed cells from healthy human kidneys and compared them to patient samples with CKD. We identified PDGFRα+/PDGFRß+ mesenchymal cells as the primary cellular source of extracellular matrix (ECM) in human kidney fibrosis. We found several commonly shared cell states of fibroblasts and myofibroblasts and provided insights into molecular regulators. Novel single-cell and spatial multiomics tools are now available to shed light on cell lineages, the plasticity of kidney cells and cell-cell communication in fibrosis. SUMMARY: As further single-cell and spatial multiomic approaches are being developed, opportunities to apply these methods to human kidney tissues expand similarly. Careful design and optimisation of the multiomic experiments are needed to answer questions related to cell lineages, plasticity and cell-cell communication in kidney fibrosis.

The relationship between vocabulary depth knowledge, word reading, and reading comprehension in Chinese.

Although vocabulary depth (VD) is recognized as a crucial factor in reading comprehension, the investigation of its role in reading comprehension remains insufficient. This study aimed to address two significant research gaps in this domain. First, empirical evidence is needed to explore the construct of VD knowledge, particularly within the Chinese language. Second, the underlying mechanism that connects VD and reading comprehension requires further clarification. In this study, a sample of 326 native Chinese students from Grade 4 participated in a comprehensive battery of tests assessing VD knowledge, word reading, and reading comprehension. Based on theoretical frameworks of VD knowledge, we measured six subtypes of VD knowledge: polysemy, collocation, word register, part-of-speech, semanticassociations, and homonyms. The results of factor analysis revealed that Chinese VD knowledge can be conceptualized as a two-factor construct, encompassing in-depth semantic knowledge (VD-meaning) and knowledge of word usage (VD-usage). Both VD-meaning and VD-usage demonstrated significant direct effects on reading comprehension, highlighting the critical role of VD in determining reading comprehension outcomes in Chinese. Furthermore, our findings indicated an indirect contribution of VD to reading comprehension, specifically through the mediating effect of word reading on the relationship between VD-meaning and reading comprehension. This study represents a pioneering empirical investigation that delved into the construct of VD in Chinese. In addition, we discuss the role of VD knowledge and its interaction with word reading in the context of Chinese reading comprehension, which could significantly enhance our understanding of the underlying mechanism that links vocabulary knowledge to reading comprehension.

Electromagnetic Detection System with Magnetic Dipole Source for Near-Surface Detection.

This paper proposes a nondestructive, separate transmitter-receiver (TX-RX) electromagnetic measurement system for near-surface detection. Different from the traditional dual-coil integrated design, the proposed transient electromagnetic (TEM) system performs shallow subsurface detection using independent TX coil and movable RX coils. This configuration requires a large primary field so that the far-away secondary field is able to generate reliably induced voltages. To achieve this goal, a bipolar current-pulsed power supply (BCPPS) with a late resonant charging strategy is designed to produce a sufficiently large magnetic moment for the exciting coil with low source interference. The magnetic dipole source (MDS) with a large proportion of weight is separated from the field observation device and does not need to be dragged or transported during the detection process. This setup lowers the weight of the scanning device to 3 kg and greatly improves the measurement efficiency. The results of the laboratory test verify the effectiveness of the separate MDS and RX module system. Field experimental detection further demonstrates that the proposed system can realize highly efficient and shallow surface detection within a 200 m range of the MDS device.

An Approach to Vinylidenequinazolines from Isoxazoles and Dioxazolones.

An effective strategy for the synthesis of vinylidenequinazolines has been efficaciously developed, which involves Rh(III)-assisted C-H amidation followed by ring-opening and intramolecular annulation. This protocol shows a straightforward way to construct diverse quinazoline units with a wide functional group compatibility from readily available isoxazoles and dioxazolones.

Comprehensive analysis of M2 macrophage-derived exosomes facilitating osteogenic differentiation of human periodontal ligament stem cells.

BACKGROUND: The role of periodontal ligament stem cells (PDLSCs) and macrophage polarization in periodontal tissue regeneration and bone remodeling during orthodontic tooth movement (OTM) has been well documented. Nevertheless, the interactions between macrophages and PDLSCs in OTM remain to be investigated. Consequently, the present study was proposed to explore the effect of different polarization states of macrophages on the osteogenic differentiation of PDLSCs. METHODS: After M0, M1 and M2 macrophage-derived exosomes (M0-exo, M1-exo and M2-exo) treatment of primary cultured human PDLSCs, respectively, mineralized nodules were observed by Alizarin red S staining, and the expression of ALP and OCN mRNA and protein were detected by RT-qPCR and Western blotting, correspondingly. Identification of differentially expressed microRNAs (DE-miRNA) in M0-exo and M2-exo by miRNA microarray, and GO and KEGG enrichment analysis of DE-miRNA targets, and construction of protein-protein interaction networks. RESULTS: M2-exo augmented mineralized nodule formation and upregulated ALP and OCN expression in PDLSCs, while M0-exo had no significant effect. Compared to M0-exo, a total of 52 DE-miRNAs were identified in M2-exo. The expression of hsa-miR-6507-3p, hsa-miR-4731-3p, hsa-miR-4728-3p, hsa-miR-3614-5p and hsa-miR-6785-3p was significantly down-regulated, and the expression of hsa-miR-6085, hsa-miR-4800-5p, hsa-miR-4778-5p, hsa-miR-6780b-5p and hsa-miR-1227-5p was significantly up-regulated in M2-exo compared to M0-exo. GO and KEGG enrichment analysis revealed that the downstream targets of DE-miRNAs were mainly involved in the differentiation and migration of multiple cells. CONCLUSIONS: In summary, we have indicated for the first time that M2-exo can promote osteogenic differentiation of human PDLSCs, and have revealed the functions and pathways involved in the DE-miRNAs of M0-exo and M2-exo and their downstream targets.

Identification of C-glycosyl flavones and quality assessment in Dendrobium nobile.

RATIONALE: Flavones are significant indicators of quality in traditional Chinese medicines (TCMs) and thus play a significant role in the quality control of TCMs in the pharmaceutical industry. Most flavones in Dendrobium nobile Lindl, a TCM with a long cultivation history and rich sources, have not been identified. This study was aimed at identifying the flavones in D. nobile from various habitats. METHODS: High-performance liquid chromatography (HPLC) coupled with diode-array detection and HPLC multiple-stage tandem mass spectrometry was used to identify the chemical constituents of D. nobile from various habitats, and a method was established to determine the content of vicenin II, violanthin and isoviolanthin. Hierarchical cluster analysis, principal component analysis and orthogonal partial least-squares discriminant analysis were used to analyze the variations among 26 batches from different habitats. RESULTS: A total of 33 flavones were tentatively identified. Twenty-five flavones, previously undescribed in D. nobile, were acylated by p-coumaroyl, feruloyl, sinapoyl or 3-hydroxy-3-methylglutaryl. The D. nobile habitats were distinguished by significant differences in their flavone content. The C-glycosyl flavones were demonstrated to be characteristic compounds for evaluating D. nobile from various habitats. In particular, flavones acylated with 3-hydroxy-3-methylglutaryl were specific compounds that were only detected in samples from Yunnan. CONCLUSIONS: The results of this study could be used to improve the quality control of D. nobile and could provide references for the identification of acylated C-glycosyl flavones in other natural products.

Rh(III)-Catalyzed three-component cascade annulation to produce the N-oxopropyl chain of isoquinolone derivatives.

Developing powerful methods to introduce versatile functional groups at the N-substituents of isoquinolone scaffolds is still a great challenge. Herein, we report a novel three-component cascade annulation reaction to efficiently construct the N-oxopropyl chain of isoquinolone derivatives via rhodium(iii)-catalyzed C-H activation/cyclization/nucleophilic attack, with oxazoles used both as the directing group and potential functionalized reagents.

Medical expenditure for lung cancer in China: a multicenter, hospital-based retrospective survey.

BACKGROUND: Lung cancer is the most prevalent cancer, and the leading cause of cancer-related deaths in China. The aim of this study was to estimate the direct medical expenditure incurred for lung cancer care and analyze the trend therein for the period 2002-2011 using nationally representative data in China METHODS: This study was based on 10-year, multicenter retrospective expenditure data collected from hospital records, covering 15,437 lung cancer patients from 13 provinces diagnosed during the period 2002-2011. All expenditure data were adjusted to 2011 to eliminate the effects of inflation using China's annual consumer price index. RESULTS: The direct medical expenditure for lung cancer care (in 2011) was 39,015 CNY (US$6,041) per case, with an annual growth rate of 7.55% from 2002 to 2011. Drug costs were the highest proportionally in the total medical expenditure (54.27%), followed by treatment expenditure (14.32%) and surgical expenditure (8.10%). Medical expenditures for the disease varied based on region, hospital level, type, and stage. CONCLUSION: The medical expenditure for lung cancer care is substantial in China. Drug costs and laboratory test are the main factors increasing medical costs.

Health-related quality of life of patients with colorectal neoplasms in China: A multicenter cross-sectional survey.

BACKGROUND AND AIM: This study aimed to clarify health-related quality of life (HRQoL) of patients with colorectal precancer and colorectal cancer (CRC) in China and to better understand related utility scores. METHODS: A hospital-based cross-sectional survey was conducted in precancer and CRC patients from 2012 to 2014, covering 12 provinces in China. HRQoL was assessed with EuroQol 5-Dimensions 3-Levels. Utility scores were derived using Chinese value set. A multivariate regression model was established to explore potential predictors of utility scores. RESULTS: A total of 376 precancer (mean age 58.7 years, 61.2% men) and 2470 CRC patients (mean age 58.6 years, 57.6% men) were included. In five dimensions, there was a certain percentage of problem reported among precancer (range: 12.0% to 36.7%) and CRC (range: 32.4% to 50.3%) patients, with pain/discomfort being the most serious dimension. Utility scores of precancer and CRC patients were 0.870 (95% confidence interval [CI], 0.855-0.886) and 0.751 (95% CI, 0.742-0.759), both of which were lower than those of general Chinese population (0.960 [95% CI, 0.960-0.960]). Utilities for patients at stage I to stage IV were 0.742 (95% CI, 0.715-0.769), 0.722 (95% CI, 0.705-0.740), 0.756 (95% CI, 0.741-0.772), and 0.745 (95% CI, 0.742-0.767), respectively. Multivariate analysis showed that therapeutic regimen, time point of the interview, education, occupation, annual household income, and geographic region were associated with utilities of CRC patients. CONCLUSION: Health-related quality of life of both precancer and CRC patients in China declined considerably. Utility scores differed by sociodemographic and clinical characteristics, and findings of these utilities may facilitate implementation of further cost-utility evaluations.

Comparing EQ-5D-3L and EQ-5D-5L performance in common cancers: suggestions for instrument choosing.

PURPOSE: To compare the performance of three-level EuroQol five-dimensions (EQ-5D-3L) and five-level EuroQol five-dimensions (EQ-5D-5L) among common cancer patients in urban China. METHODS: A hospital-based cross-sectional survey was conducted in three provinces from 2016 to 2018 in urban China. Patients with breast cancer, colorectal cancer, or lung cancer were recruited to complete the EQ-5D-3L and EQ-5D-5L questionnaires. Response distribution, discriminatory power (indicator: Shannon index [H'] and Shannon evenness index [J']), ceiling effect (the proportion of full health state), convergent validity, and health-related quality of life (HRQoL) were compared between the two instruments. RESULTS: A total of 1802 cancer patients (breast cancer: 601, colorectal cancer: 601, lung cancer: 600) were included, with the mean age of 55.6 years. The average inconsistency rate was 4.4%. Compared with EQ-5D-3L (average: H' = 1.100, J' = 0.696), an improved discriminatory power was observed in EQ-5D-5L (H' = 1.473, J' = 0.932), especially contributing to anxiety/depression dimensions. The ceiling effect was diminished in EQ-5D-5L (26.5%) in comparison with EQ-5D-3L (34.5%) (p < 0.001), mainly reflected in the pain/discomfort and anxiety/depression dimensions. The overall utility score was 0.790 (95% CI 0.778-0.801) for EQ-5D-3L and 0.803 (0.790-0.816) for EQ-5D-5L (p < 0.001). A similar pattern was also observed in the detailed cancer-specific analysis. CONCLUSIONS: With greater discriminatory power, convergent validity and lower ceiling, EQ-5D-5L may be preferable to EQ-5D-3L for the assessment of HRQoL among cancer patients. However, higher utility scores derived form EQ-5D-5L may also lead to lower QALY gains than those of 3L potentially in cost-utility studies and underestimation in the burden of disease.

Effect of Powder Particle Size and Spray Parameters on the Ni/Al Reaction During Plasma Spraying of Ni-Al Composite Powders.

It was known for long that Ni-Al composite powders can be used to deposit self-bonding coating as a bond coat for common ceramic coatings due to the exothermic reaction between Ni and Al. However, it was found that with commercial Ni-Al composite powders with a large particle size, it is difficult to ignite the self-propagating reaction between Ni and Al to form Ni-Al intermetallics by plasma spraying. In this study, Ni-Al composite powder particles of different sizes were used to prepare Ni-Al intermetallics-based coatings by plasma spraying. The dependencies of the exothermic reaction between Ni and Al and the coating microstructure on powder particle size and spray parameters were investigated. The phase composition, microstructure, porosity and oxide content of the coatings were characterized by x-ray diffraction, scanning electron microscope and image analyzing. The results show that particle size of Ni-Al composite powders is the dominant factor controlling the exothermic reaction for the formation of Ni-Al intermetallics during plasma spraying. When the powders larger than about 50 µm are used, the reaction forming aluminide cannot complete even by heating of plasma flame generated at high plasma arc power. However, when smaller powders less than 50 µm are used, the exothermic reaction can completely occur rapidly in plasma spraying, contributing to heating of Ni-Al droplets to the highest temperature for development of the self-bonding effect. The positive relationship between molten droplet temperature and tensile adhesive strength of the resultant coatings is recognized to confirm the contribution of high droplet temperature to the adhesive or cohesive strength.

[A Thyroid Ultrasound Image-based Artificial Intelligence Model for Diagnosis of Central Compartment Lymph Node Metastasis in Papillary Thyroid Carcinoma].

Objective To establish an artificial intelligence model based on B-mode thyroid ultrasound images to predict central compartment lymph node metastasis(CLNM)in patients with papillary thyroid carcinoma(PTC). Methods We retrieved the clinical manifestations and ultrasound images of the tumors in 309 patients with surgical histologically confirmed PTC and treated in the First Medical Center of PLA General Hospital from January to December in 2018.The datasets were split into the training set and the test set.We established a deep learning-based computer-aided model for the diagnosis of CLNM in patients with PTC and then evaluated the diagnosis performance of this model with the test set. Result The accuracy,sensitivity,specificity,and area under receiver operating characteristic curve of our model for predicting CLNM were 80%,76%,83%,and 0.794,respectively. Conclusion Deep learning-based radiomics can be applied in predicting CLNM in patients with PTC and provide a basis for therapeutic regimen selection in clinical practice.

Effect of all-trans retinoic acid on casein and fatty acid synthesis in MAC-T cells.

OBJECTIVE: Caseins and fatty acids of milk are synthesized and secreted by the epithelial cells of the mammary gland. All-trans retinoic acid (ATRA), an active metabolite of vitamin A, has been shown to promote mammary development. This study was conducted to determine the effect of ATRA on casein synthesis and fatty acid composition in MAC-T cells. METHODS: MAC-T cells were allowed to differentiate for 4 d, treated with ATRA (0, 1.0, 1.5, and 2.0 µM), and incubated for 3 d. We analyzed the fatty acid composition, the mRNA expression of casein and fatty acid synthesis-related genes, and the phosphorylation of casein synthesis-related proteins of MAC-T cells by gas chromatography, quantitative polymerase chain reaction, and western blotting, respectively. RESULTS: In MAC-T cells, ATRA increased the mRNA levels of αS1-casein and ß-casein, janus kinase 2 (JAK2) and E74-like factor 5 of the signal transducer and activator of transcription 5 ß (STAT5-ß) pathway, ribosomal protein S6 kinase beta-1 (S6K1) and eukaryotic translation initiation factor 4E binding protein 1 of the mammalian target of rapamycin (mTOR) pathway, inhibited the mRNA expression of phosphoinositide 3-kinase and eukaryotic initiation factor 4E of the mTOR pathway, and promoted the phosphorylation of STAT5-ß and S6K1 proteins. Additionally, ATRA increased the de novo synthesis of fatty acids, reduced the content of long-chain fatty acids, the ratio of monounsaturated fatty acids to saturated fatty acids (SFA), the ratio of polyunsaturated fatty acids (PUFA) to SFA, and the ratio of ω-6 to ω-3 PUFA. The mRNA levels of acetyl-CoA carboxylase 1, fatty acid synthase, lipoprotein lipase, stearoyl-CoA desaturase, peroxisome proliferator-activated receptor gamma, and sterol regulatory element-binding protein 1 (SREBP1) were enhanced by ATRA. CONCLUSION: ATRA promotes the synthesis of casein by regulating JAK2/STAT5 pathway and downstream mTOR signaling pathway, and it improves the fatty acid composition of MAC-T cells by regulating SREBP1-related genes.

One-way quantum state transfer in a lossy coupled-cavity array.

Quantum state transfer plays an important role in quantum information processing, and it has been obtained many of the theoretical and experimental triumphs. But designing a dissipation-assisted scheme to transfer a quantum state is still by no means trivial. Here we put forward an easier scheme to dissipatively transfer an arbitrary quantum state from a sender to a receiver with two four-level atoms and three lasers in a lossy coupled-cavity array, and make the quantum state stable at the receiver via the photon loss of optical cavities. Owing to the assistance of the dissipation, the target state becomes the steady state of the whole process. Thus there is no requirement on external time-dependent controls. Furthermore, the atomic spontaneous emission can be significantly suppressed as the adiabatic elimination of the excited states. We also discuss the experimental feasibility of this scheme with the current experimental technologies and a high fidelity of the transferred state in the receiver can be above 98%.

Short-term impact of breast cancer screening intervention on health-related quality of life in China: A multicentre cross-sectional survey.

OBJECTIVE: The impact of participating in breast cancer screening programmes on health-related quality of life (HRQoL)is poorly understood. METHODS: Based on a national breast cancer screening programme in China, a multicentre cross-sectional survey was conducted covering 12 provinces from September 2013 to December 2014. HRQoL of participants in the screening population and general population was evaluated by the three-levelEuroQol-five-Dimensions (EQ-5D-3L) instrument, and utility scores were generated through the Chinese value set. Univariate and multivariate regression analyses were performed to explore determinants of utility scores and anxiety/depression problems. RESULTS: For screening group and general population (n = 4756, mean age = 51.6 year old), the corresponding utility scores were 0.937 (95% CI, 0.933-0.941) and 0.953 (0.949-0.957) (P < .001). Pain/discomfort and anxiety/depression were the most common reported in both groups (51.4% and 34.3%, P < .001). Utility scores at prescreening, in-screening, and postscreening interview timings were 0.928 (0.921-0.935), 0.958 (0.948-0.969), and 0.938 (0.933-0.943), respectively (P < .001); the corresponding proportions of anxiety/depression reporting were 25.9%, 16.3%, and 21.1%, respectively (P = .004). Interview timing, geographical region, and insurance status were associated with HRQoL and anxiety/depression in women at high-risk of breast cancer. CONCLUSIONS: Utility scores of screening participants were significantly lower than that of general population in China, but the difference may be clinically insignificant. Further cohort studies using HRQoL measurements are needed.

Molecular Tweezers-like Calix[4]arene Based Alkaline Earth Metal Cation (Ca2+, Sr2+, and Ba2+) Chemosensor and Its Imaging in Living Cells and Zebrafish.

Although alkaline earth metal cations play an important role in our daily life, little attention has been paid to the field of fast quantitative analysis of their content due to a lack of satisfactory precision and a fast and convenient means of detection. In this study, we have designed a set of molecular tweezers based on the calix[4]arene chemosensor L, which was found to exhibit high selectivity and sensitivity toward Ca2+, Sr2+, and Ba2+ (by UV-vis and fluorescence methods) with low detection limits of the order of 10-7 to 10-8 M and high association constants (of the order of 106). More significantly, sensor L not only can recognize Ca2+, Sr2+, and Ba2+ but also can further discriminate between these three cations via the differing red shifts in their UV-vis spectra (560 nm for L·Ca2+, 570 nm for L·Sr2+, and 580 nm for L·Ba2+ complex) which is attributed to their different atomic radii. A rare synergistic effect for the recognition mechanism has been demonstrated by 1H NMR spectroscopic titration. Sensor L constructed a high shielding field by the cooperation of Tris with alkaline earth metal ion after complex. Additionally, the presence of acetoxymethyl group in sensor L results in enhancement of cell permeability, and as a consequence, sensor L exhibited excellent sensing and imaging (in vivo) in living cells and in zebrafish.

A Semi-Automatic Coupling Geophone for Tunnel Seismic Detection.

The tunnel seismic method allows for the detection of the geology in front of a tunnel face for the safety of tunnel construction. Conventional geophones have problems such as a narrow spectral width, low sensitivity, and poor coupling with the tunnel wall. To tackle issues above, we propose a semi-automatic coupling geophone equipped with a piezoelectric sensor with a spectral range of 10-5000 Hz and a sensitivity of 2.8 V/g. After the geophone was manually pushed into the borehole, it automatically coupled with the tunnel wall under the pressure of the springs within the device. A comparative experiment showed that the data spectrum acquired by the semi-automatic coupling geophone was much higher than that of the conventional geophone equipped with the same piezoelectric sensor. The seismic data were processed in combination with forward modeling. The imaging results also show that the data acquired by the semi-automatic coupling geophone were more in line with the actual geological conditions. In addition, the semi-automatic coupling geophone's installation requires a lower amount of time and cost. In summary, the semi-automatic coupling geophone is able to efficiently acquire seismic data with high fidelity, which can provide a reference for tunnel construction safety.

Strategy Use in Oral Communication with Competent Synthesis and Complex Interaction.

Strategy use is a critical competence for academic achievement and problem solving in globalised and information-based knowledge economies. It involves skills such as synthesising information from task source materials and elaborating on interlocutors' viewpoints during integrated group discussions. However, evidence from empirical studies on this topic is scarce. We recruited 171 local Hong Kong undergraduate students to participate in an integrated group discussion task in Putonghua as an L2 (i.e., second language) and to complete a strategy use inventory of the task. The students' performances and responses were analysed with multiple statistical methods. The strategy use inventory of the integrated group discussion was validated. Five categories of strategy were identified: active engagement, non-verbal, synthesis, clarification and affective strategies. These strategies significantly predicted task performance (with 19.9% variation), leading to significant improvement in oral production quality. Both the synthesis (the integrative use of information) and active engagement (including elaborating viewpoints) strategies were significantly associated with task performance, which are rarely found in existing oral communication strategy inventories. The participants with high levels of task performance demonstrated significantly more use of the active engagement, clarification and synthesis strategies (with the first two merged in the complex interaction strategy) than those with medium or low task performance levels. The implications of the results are discussed.

Medical expenses of urban Chinese patients with stomach cancer during 2002-2011: a hospital-based multicenter retrospective study.

BACKGROUND: In China, stomach cancer is the third most common cancer and the third leading cause of cancer death. Few studies have examined Chinese stomach cancer patients' medical expenses and their associated trends. The Cancer Screening Program in Urban China (CanSPUC) is a Major Public Health Project funded by the central government. Through this project, we have extracted patients' medical expenses from hospital billing data to examine the costs of the first course treatments (which refers to 2 months before and 10 months after the date of cancer diagnosis) in Chinese patients with stomach cancer and the associated trends. METHODS: The expense data of 14,692 urban Chinese patients with stomach cancer were collected from 40 hospitals in 13 provinces. We estimated the inflation-adjusted medical expenses per patient during 2002-2011. We described the time trends of medical expenses at the country-level, and those trends by subgroup, and analyzed the compositions of medical expenses. We constructed the Generalized Linear Mixed (GLM) regression model with Poisson distribution to examine the factors that were associated with medical expenses per patient. RESULTS: The average medical expenses of the first course treatments were about 43,249 CNY (6851 USD) in 2011, more than twice of that in 2002. The expenses increased by an average annual rate of 7.4%. Longer stay during hospitalization and an increased number of episodes of care are the two main contributors to the expense increase. The upward trend of medical expenses was observed in almost all patient subgroups. Drug expenses accounted for over half of the medical expenses. CONCLUSIONS: The average medical expenses of the first course (2 months before and 10 months after the date of cancer diagnosis) treatments per stomach cancer patient in urban China in 2011 were doubled during the previous 10 years, and about twice as high as the per capita disposable income of urban households in the same year. Such high expenses indicate that it makes economic sense to invest in cancer prevention and control in China.