Journal of the Chinese Medical Association : JCMA最新文献

{"title":"Empirical comparison of iodine excretion estimated from spot urine samples with measured 24-hour urinary iodine excretion in healthy adults.","authors":"Chun-Jui Huang, Yi-Wen Chen, Shun-Jie Yang, Jia-Zhen Li, Chii-Min Hwu, Harn-Shen Chen, Fan-Fen Wang, Chen-Chang Yang","doi":"10.1097/JCMA.0000000000001363","DOIUrl":"10.1097/JCMA.0000000000001363","url":null,"abstract":"<p><strong>Background: </strong>Ideally, 24-hour urine collections are the reference standard for assessing iodine status. While median urinary iodine concentration (UIC) from spot samples has commonly replaced 24-hour collections for assessments of iodine status within populations, the validity of spot samples remains unclear. This study aimed to validate the estimated 24-hour urinary iodine excretion (e24-h UIE) derived from spot urine samples as an alternative to actual 24-hour urinary iodine excretion (24-h UIE).</p><p><strong>Methods: </strong>Healthy volunteers aged ≥18 years without thyroid or kidney diseases were recruited from National Yang Ming Chiao Tung University and Taipei Veterans General Hospital, Taiwan. Participants were recruited from a pool of university students, hospital staff, local vendors, and their social networks. Each participant provided one 24-hour urine sample, and two-spot urine samples collected immediately before and after the 24-hour period. UIC was measured using inductively coupled plasma mass spectrometry. The e24-h UIE was calculated from spot urine UIC and creatinine (Cr) concentrations, adjusted by anthropometry-based predicted 24-hour Cr excretion.</p><p><strong>Results: </strong>Twenty-three healthy adults (mean age: 36.4 ± 10.1 years, 60.8% men) were enrolled between September 2022 and May 2024. Median e24-h UIE (154.3 μg/d, interquartile range [IQR] 114.2-201.2) did not differ significantly from measured 24-h UIE (158.3 μg/d, IQR 106.7-213.7; Pearson's r = 0.44, indicating a moderate correlation, p = 0.003). Passing-Bablok regression and Bland-Altman analysis indicated good agreement between methods, with a mean difference of 6.8 μg/d (regression line: Y = 0.92 × X + 9.53).</p><p><strong>Conclusion: </strong>These findings suggest that e24-h UIE from spot samples reasonably estimates actual 24-h UIE, offering a practical alternative to avoid the inconvenience of complete 24-hour urine collections.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"271-278"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zolpidem use and the risk of arrhythmia: A nationwide population-based cohort study in Taiwan.","authors":"Hong-Jhe Chen, Hsun Ou, Jia-Ying Shen, Chi-Hsiang Chung, Yuan Hung, Chieh-Wen Chen, Brendon Stubbs, Wu-Chien Chien, Tien-Yu Chen","doi":"10.1097/JCMA.0000000000001360","DOIUrl":"10.1097/JCMA.0000000000001360","url":null,"abstract":"<p><strong>Background: </strong>Zolpidem is a widely prescribed hypnotic agent; however, its potential cardiovascular safety remains clinically uncertain. This study aimed to investigate the association between zolpidem use and the risk of various cardiac arrhythmias, specifically identifying which subtypes are most prevalent, using a nationwide population-based cohort in Taiwan.</p><p><strong>Methods: </strong>This population-based, matched-cohort study utilized the Longitudinal Generation Tracking Database (2000-2015) in Taiwan, comprising two million randomly sampled individuals. To establish a robust new-user design and minimize confounding, we included only those with zolpidem use for at least 7 days and strictly excluded individuals with any history of arrhythmia or heart failure. Users were matched 1:2 with controls by age, sex, and index year. The primary outcome was the incidence of cardiac arrhythmia, defined using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes. Data were analyzed using Cox regression and Kaplan-Meier methods, adjusting for multiple comorbidities including hypertension and diabetes.</p><p><strong>Results: </strong>A total of 457 956 participants (152 652 zolpidem users and 305 304 matched controls) were analyzed. The groups were well-balanced with a mean age of 55.4 years and 49.2% being male. Zolpidem use was associated with a significantly increased risk of cardiac arrhythmia (adjusted hazard ratio [aHR], 1.983; 95% CI, 1.149-2.760; p < 0.001). Subgroup analyses revealed that zolpidem use notably increased the risk of paroxysmal tachycardia (aHR, 2.574; 95% CI, 1.514-3.998; p < 0.001) and atrial flutter (aHR, 2.491; 95% CI, 1.457-4.212, p < 0.001).</p><p><strong>Conclusion: </strong>Zolpidem use is independently associated with an increased risk of incident arrhythmia, particularly tachyarrhythmias such as paroxysmal tachycardia and atrial flutter. Clinicians should incorporate cardiac risk assessment into their prescribing decisions and consider periodic monitoring for high-risk patients. Study limitations include the observational design and the unavailability of granular dosage data.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"284-292"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Target-controlled infusion achieves smoother autonomic modulation than manual bolus during propofol induction: Evidence from wavelet-based spectral analysis.","authors":"Jing-Yang Liou, Kun-Hui Chen, Chen Lin, Hsin-Yi Huang, Chien-Kun Ting, Men-Tzung Lo, Wen-Kuei Chang, Hsin-Yi Wang","doi":"10.1097/JCMA.0000000000001364","DOIUrl":"10.1097/JCMA.0000000000001364","url":null,"abstract":"<p><strong>Background: </strong>Anesthesia induction involves rapid autonomic shifts that may compromise hemodynamic stability. Propofol administered via target-controlled infusion (TCI) produces a more gradual onset, whereas rapid manual bolus (MB) administration often triggers abrupt autonomic disturbances. Thus, the propofol delivery method is critical to autonomic stability; however, conventional monitoring lacks sufficient temporal resolution to capture transient fluctuations during early induction. To address this gap, we compared TCI and MB using high-temporal-resolution wavelet-based spectral analysis (WBSA) of heart rate variability (HRV) and pulse photoplethysmography amplitude (PPGA) to characterize real-time autonomic dynamics.</p><p><strong>Methods: </strong>This prospective, single-center observational study included adult patients undergoing elective surgery who received propofol induction via TCI or MB administered over 10 seconds. HRV and PPGA were continuously recorded and analyzed using WBSA. High-frequency power and low-to-high frequency ratio assessed parasympathetic tone and sympathovagal balance, while PPGA served as a surrogate for peripheral sympathetic tone. Simulated effect-site concentrations (CeP) were calculated to examine relationships between concentration dynamics and autonomic responses.</p><p><strong>Results: </strong>Forty-four patients were analyzed. Compared with MB, TCI produced significantly more gradual and attenuated changes in high-frequency, low-frequency, and low-to-high frequency ratio (all p < 0.05), along with slower and smaller increases in PPGA, indicating better preservation of autonomic balance and milder peripheral sympatholysis. Simulated CeP reached 5.5 μg·mL - 1 at 117 seconds with TCI vs 36 seconds with MB. Greater transient autonomic disturbance was associated with a faster rise in CeP, rather than absolute CeP values, indicating that delivery mode and rate were primary determinants of autonomic modulation.</p><p><strong>Conclusion: </strong>TCI provided smoother autonomic modulation than did MB during the physiologically unstable induction phase. By enabling real-time detection of short-lived fluctuations, WBSA revealed mechanistic differences not captured by conventional analyses, supporting TCI as a potentially more stable and physiologically balanced induction strategy, particularly for patients at risk of peri-induction instability.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"312-318"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NOA masquerading as OA: Rethinking the role of testis biopsy from an East Asian perspective.","authors":"Cheng Chu, William J Huang","doi":"10.1097/JCMA.0000000000001366","DOIUrl":"10.1097/JCMA.0000000000001366","url":null,"abstract":"<p><strong>Background: </strong>In this study, we aimed to evaluate the proportion of nonobstructive azoospermia (NOA) cases exhibiting features resembling the obstructive azoospermia (OA) phenotype and assess the applicability of the Schoor criteria in an East Asian cohort.</p><p><strong>Methods: </strong>We retrospectively reviewed azoospermic patients who presented with low follicle-stimulating hormone level (≤9.2 IU/L) and large testicular volume (≥15 mL), consistent with the \"phenotypical OA (phOA)\" criteria proposed by Huang et al. All patients underwent a testicular biopsy to confirm the pathological diagnosis. Complete spermatogenesis was considered the key feature of \"pathological OA (pOA).\"</p><p><strong>Results: </strong>A total of 271 patients with azoospermia were included in the analysis. Among them, 222 (81.9%) exhibited complete spermatogenesis consistent with pOA, whereas 49 (18.1%) were diagnosed with pathological NOA (pNOA). According to the Schoor criteria, 17 patients were classified as phOA; however, two (11.8%) were subsequently confirmed to have pNOA. Conversely, 31 patients were classified as having phNOA, of whom 23 (74.2%) demonstrated pOA on testicular biopsy. Under the Schoor criteria, the positive predictive value (PPV) for pOA was 88.2%, and the negative predictive value (NPV) for pOA was 25.8%. Using the Huang criteria, 49 of 271 patients (18.1%) met the definition of phOA but were diagnosed as pNOA on biopsy (ie, false positives), yielding a PPV of 81.9% for pOA.</p><p><strong>Conclusion: </strong>The Schoor criteria, derived from a Caucasian cohort, may be unsuitable for East Asian patients, given the much lower NPVs for pOA in our cohort (25.8%) than that in the Schoor study (92.3%). These findings highlight the limitations of relying solely on clinical criteria, either Schoor or Huang, to guide sperm retrieval strategies, including the choice of retrieval method and microsurgical approach. Therefore, a testicular biopsy is essential to confirm complete spermatogenesis in patients with clinically phOA.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"279-283"},"PeriodicalIF":2.4,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal depression and psychotropics in offspring asthma and atopic dermatitis.","authors":"Li-Chi Chen, Wei-Sheng Huang, Tzeng-Ji Chen, Mu-Hong Chen","doi":"10.1097/JCMA.0000000000001369","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001369","url":null,"abstract":"<p><strong>Background: </strong>The associations of prenatal maternal depression and exposure to antidepressants and benzodiazepines/Z-drugs with the risks of offspring asthma and atopic dermatitis are unclear.</p><p><strong>Methods: </strong>The data of 1,369 child-mother dyads with maternal depression and 13,690 birth year- and sex-matched child-mother dyads without maternal depression for the period from 2002 and 2009 were selected. Prenatal exposure to antidepressants and benzodiazepines/Z-drugs was also considered. All children were followed from their birth date to the end of 2011 to identify the development of asthma and atopic dermatitis.</p><p><strong>Results: </strong>The offspring of mothers with depression were more likely to develop atopic dermatitis (hazard ratio [HR], 1.16) and asthma (HR, 1.12) during the follow-up period relative to the control group. Prenatal exposure to benzodiazepines/Z-drugs was strongly associated with an increased risk (HR, 1.27) of offspring asthma. However, prenatal exposure to antidepressants was not associated with the risks of offspring asthma and atopic dermatitis.</p><p><strong>Conclusion: </strong>The mechanisms underlying the complex relationship between maternal depression, exposure to benzodiazepines/Z-drugs, and the risk of offspring atopy warrant further investigation.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular complications from glucagon-like peptide-1 receptor agonists: Clinical evidence, potential mechanisms, and clinical recommendations.","authors":"Tzu-En Wu, Harn-Shen Chen","doi":"10.1097/JCMA.0000000000001370","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001370","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs)-central to type 2 diabetes mellitus (T2DM) management owing to their comprehensive benefits (glycemic control, weight reduction, cardiovascular benefits, and renal protection)-exhibit a concerning ocular safety profile. Clinical trial data, notably from SUSTAIN-6, revealed a higher incidence of diabetic retinopathy (DR) complications with semaglutide, particularly in patients with pre-existing DR and rapid HbA1c reduction, reflecting early worsening. Conversely, the REWIND and LEADER trials reported no significant DR, suggesting variability among agents and the potential influence of glycemic trajectory. Observational studies and meta-analyses provide mixed findings: some suggest increased DR progression risk in vulnerable populations, while others indicate a lower risk than insulin therapy. Beyond DR, recent pharmacoepidemiologic studies and pharmacovigilance reports have implicated GLP-1 RAs-especially semaglutide-in nonarteritic anterior ischemic optic neuropathy (NAION), leading the European Medicines Agency to classify NAION as a very rare adverse effect and prompting regulatory scrutiny. Conversely, real-world data suggest possible protective associations with other retinal disorders, including reduced incidence of neovascular age-related macular degeneration and diabetic macular edema, although findings remain inconsistent. The mechanistic pathways involve rapid metabolic shifts, vascular dysregulation, and potentially direct effects on retinal or optic nerve tissue. While GLP-1 RAs confer substantial systemic benefits, their ocular risks appear concentrated in high-risk subgroups. Individualized prescribing, baseline ophthalmic assessment, and interdisciplinary monitoring are essential until ongoing prospective trials clarify their long-term ocular impact.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluorescein tear breakup time predicts pre-lens tear film stability and contact lens comfort.","authors":"Chen-Hua Lin, Yu-Ru Chen, Hsiu-Hui Hsieh, Elizabeth P Shen, Kai-Feng Hung, Yi-Chen Sun","doi":"10.1097/JCMA.0000000000001354","DOIUrl":"10.1097/JCMA.0000000000001354","url":null,"abstract":"<p><strong>Background: </strong>Soft contact lenses divide the tear film into pre-lens and post-lens layers. This study evaluated whether pre-lens tear film stability, assessed by fluorescein tear breakup time (TBUT) and noninvasive keratograph breakup time (NIKBUT), predicts subjective comfort.</p><p><strong>Methods: </strong>This single-center prospective study recruited participants aged 20 to 40 years without ocular diseases. Narafilcon A and verofilcon A contact lenses were used in a crossover design, with participants assigned to wear narafilcon A lenses for 1 week, followed by verofilcon A lenses for another week (Group NV), or the reverse sequence (Group VN). Pre-lens tear film stability was assessed by NIKBUT and fluorescein TBUT on day 1 and day 7. These ocular measurements were correlated with subjective comfort evaluated with the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) after wearing each lens type.</p><p><strong>Results: </strong>A total of 82 participants (mean age 29.3 ± 3.3 years; 84% female) completed the study. CLDEQ-8 scores were lower with verofilcon A than with narafilcon A (7.09 ± 5.92 vs 10.21 ± 7.23; p < 0.05). Fluorescein TBUT was consistently longer with verofilcon A than with narafilcon A, both at 15 minutes on day 1 (Group NV: 6.04 vs 3.80 seconds; Group VN: 7.24 vs 3.25 seconds) and at 6 hours on day 7 (Group NV: 4.87 vs 3.03 seconds; Group VN: 5.67 vs 3.15 seconds). NIKBUT did not differ significantly between the two lenses at either time point. CLDEQ-8 scores negatively correlated with fluorescein TBUT for both lens types ( ρ = -0.29 for narafilcon A, p = 0.002; ρ = -0.20 for verofilcon A, p = 0.008).</p><p><strong>Conclusion: </strong>Verofilcon A provided better subjective comfort compared with Narafilcon A. Fluorescein TBUT, but not NIKBUT, may serve as a complementary assessment for pre-lens tear film stability and subjective comfort, suggesting that fluorescein TBUT offers distinct clinical value in contact lens practice.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"235-242"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146127587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential therapeutic role of calcitonin gene-related peptide medications for tinnitus.","authors":"Abigail Dichter, Khushi Bhatt, Martha Lucía Gutiérrez Pérez, Ella J Lee, Karen Tawk, Hamid R Djalilian","doi":"10.1097/JCMA.0000000000001351","DOIUrl":"10.1097/JCMA.0000000000001351","url":null,"abstract":"<p><p>Tinnitus is defined as the perception of sound without an external stimulus. It is classified as a subjective phenomenon described as ringing, buzzing, or hissing in the ears. Tinnitus often co-occurs with migraine, as both conditions originate from disturbances of the central nervous system, specifically the auditory and trigeminal nerve pathways. The overlap in populations and pathophysiological similarities between tinnitus and migraine provide strong evidence for overlap between the conditions and a shared potential for therapy. Calcitonin gene-related peptide (CGRP) medications are a recent development in migraine treatment that have proven to be effective prophylactic agents. CGRP medications work by blocking CGRP's inflammatory role in migraine formation, a physiological process that may also be involved in the loudness of tinnitus. This narrative review aims to provide an overview of the role of CGRP in migraine and tinnitus and discuss managing CGRP and central sensitization as a potential therapeutic role in tinnitus.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"198-203"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage radiotherapy for recurrent prostate cancer diagnosed by prostate-specific membrane antigen positron emission tomography imaging.","authors":"Wen-Hsun Chang, Szu-Ting Yang","doi":"10.1097/JCMA.0000000000001348","DOIUrl":"10.1097/JCMA.0000000000001348","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"255-256"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146055607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and application of a genetically engineered mouse model of gastric adenocarcinoma.","authors":"Yelizhati Madeti, Xiaoyi Chong, Xiaotian Zhang","doi":"10.1097/JCMA.0000000000001350","DOIUrl":"10.1097/JCMA.0000000000001350","url":null,"abstract":"<p><strong>Background: </strong>The lack of specific and immunocompetent gastric cancer models has hindered the exploration of gastric adenocarcinoma (GAC). We constructed a spontaneous and transplantable GAC model using a genetically engineered mouse.</p><p><strong>Methods: </strong>We generated a tamoxifen-inducible CRISPR-based Anxa10-CreERT2 mouse line and crossed it with the KrasG12D/+ and Tp53R172H/+ strains to develop Anxa10-CreERT2; KrasG12D/+; Tp53R172H/+ mice on a C57BL/6J background. Tamoxifen and N-methyl-N-nitrosourea were administered to induce in situ tumor development. An orthotopic gastric tumor was confirmed by histological analysis and positron emission tomography/computed tomography. A transplantable mouse-derived allograft (MDA) model and stable GAC cell line (ST-YC19) were subsequently established using MDA. The malignant characteristics and drug responses were evaluated.</p><p><strong>Results: </strong>Spontaneous GAC had a 100% incidence within 2.5 months, was predominantly of the intestinal type, and presented essential molecular features of the CIN subtype. The ST-YC19 GAC cell line derived from MDAs exhibited an aggressive phenotype, robust tumorigenic potential, peritoneal dissemination, and distant metastasis. This model showed limited sensitivity to anti-programmed death-1 immunotherapy.</p><p><strong>Conclusion: </strong>We successfully established a spontaneous GAC model and its corresponding cell line in C57BL/6J mice, enabling a comprehensive investigation of tumor progression, metastasis, therapeutic response, and resistance mechanisms in vivo. This model represents a valuable platform for advancing precision medicine in gastric cancer.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"243-254"},"PeriodicalIF":2.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}