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The Lancet. Neurology
The Lancet. Global health
Time to spatialise epidemiology in China

Although many studies on the COVID-19 epidemic in China have been published since the outbreak began, very few, if not none, have been useful to real-time epidemic control. None have proposed methods to identify areas at risk or to allocate (or reallocate) scarce health-care resources at a fine enough scale to effectively inform epidemic control on the ground. This situation is common to many infectious diseases, particularly epidemics, which have become increasingly multifactorial and dynamic as a result of rapid urbanisation, population growth and mobility, globalisation of travel and trade, and climate change.

The Lancet. Global health

West China Fourth Hospital

Stroke in China: advances and challenges in epidemiology, prevention, and management

With over 2 million new cases annually, stroke is associated with the highest disability-adjusted life-years lost of any disease in China. The burden is expected to increase further as a result of population ageing, an ongoing high prevalence of risk factors (eg, hypertension), and inadequate management. Despite improved access to overall health services, the availability of specialist stroke care is variable across the country, and especially uneven in rural areas. In-hospital outcomes have improved because of a greater availability of reperfusion therapies and supportive care, but adherence to secondary prevention strategies and long-term care are inadequate. Thrombolysis and stroke units are accepted as standards of care across the world, including in China, but bleeding-risk concerns and organisational challenges hamper widespread adoption of this care in China. Despite little supporting evidence, Chinese herbal products and neuroprotective drugs are widely used, and the increased availability of neuroimaging techniques also results in overdiagnosis and overtreatment of so-called silent stroke. Future efforts should focus on providing more balanced availability of specialised stroke services across the country, enhancing evidence-based practice, and encouraging greater translational research to improve outcome of patients with stroke.

The Lancet. Neurology

West China Hospital, Sichuan University

Novel coronavirus infection during the 2019-2020 epidemic: preparing intensive care units-the experience in Sichuan Province, China

With the rapid transmission, the epidemic has spread throughout the country, and 177 cases have been reported in Sichuan Province. As nCoV infection is a highly contagious disease with high mortality (3–15%) [1,2,3] and West China Hospital (WCH) is the largest hospital in the southwest of China and the referral medical center in Sichuan Province, it is our responsibility to prepare for admission of additional critically ill patients as a matter of emergency. We have held several expert meetings and have reviewed the related literature to develop a plan to respond to the epidemic [4, 5]. The purpose of the plan is to enable us to provide the maximum level of care to critically ill patients while ensuring the protection of medical staff.

Intensive Care Medicine

Sichuan University West China Hospital

Tissue-specific transcription reprogramming promotes liver metastasis of colorectal cancer

Metastasis, the development of secondary malignant growths at a distance from a primary tumor, is the cause of death for 90% of cancer patients, but little is known about how metastatic cancer cells adapt to and colonize new tissue environments. Here, using clinical samples, patient-derived xenograft (PDX) samples, PDX cells, and primary/metastatic cell lines, we discovered that liver metastatic colorectal cancer (CRC) cells lose their colon-specific gene transcription program yet gain a liver-specific gene transcription program. We showed that this transcription reprogramming is driven by a reshaped epigenetic landscape of both typical enhancers and super-enhancers. Further, we identified that the liver-specific transcription factors FOXA2 and HNF1A can bind to the gained enhancers and activate the liver-specific gene transcription, thereby driving CRC liver metastasis. Importantly, similar transcription reprogramming can be observed in multiple cancer types. Our data suggest that reprogrammed tissue-specific transcription promotes metastasis and should be targeted therapeutically.

Cell research

Chengdu University of Traditional Chinese Medicine

How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People's Hospital

Acute myocardial infarction (AMI) is a cardiovascular emergency and requires an emergency diagnosis and treatment process. Unfortunately, the highly contagious COVID-19 pneumonia is obviously affecting the diagnosis and treatment of acute myocardial infarction (AMI) which includes ST-elevated myocardial infarction (STEMI) and non-ST-segment elevation acute myocardial infarction (NSTEMI). There are increasing confirmed cases around multiple countries every day. The transmission dynamics is not fully understood [1]. It is necessary to adjust the routine diagnosis and treatment protocol of AMI to face the serious public health event.

Intensive Care Medicine

Sichuan Provincial People's Hospital