China's foreign minister warned Antony Blinken on Friday that US pressure could trigger a "downward spiral", as the visiting secretary of state raised concerns on issues including support for Russia.
In a sign of the importance of the relationship between the world's top two economies, officials said Chinese President Xi Jinping would receive Blinken, who is visiting for the second time in less than a year.
Blinken said he had "extensive and constructive" conversations in more than five and a half hours of meetings with Foreign Minister Wang Yi.
A US official said he directly raised areas of difference including Russia, Taiwan and trade.
China in turn has been infuriated by President Joe Biden's pressure on the economic front -- which is unlikely to ease during an election year -- including a sweeping ban on semiconductor exports and efforts to wrest blockbuster video app TikTok away from its Chinese owners.
Wang received Blinken at the Diaoyutai state guesthouse in the capital's ancient gardens before tables from the late Qing dynasty and an imposing painting of a Chinese mountain scene.
Wang told Blinken that relations between the world's two largest economies were "beginning to stabilise", especially after Biden and Xi met in November near San Francisco.
"But at the same time, the negative factors in the relationship are still increasing and building," Wang said.
"China's legitimate development rights have been unreasonably suppressed and our core interests are facing challenges," he said, urging "respect for each other's core interests"
"Should China and the United States keep in the right direction of moving forward with stability, or return to a downward spiral?
"This is a major question before our two countries and tests our sincerity and ability."
Despite the tough talk from Wang, US officials and experts believe that Xi's foremost priority is to manage headwinds in the Chinese economy and that, at least in the short term, he is looking to avoid flare-ups with the West.
Blinken raised concern with Wang about China's support for Russia, which has rapidly rebuilt its military base two years into its invasion of Ukraine, State Department spokesman Matthew Miller said.
As he opened the meeting with Wang, Blinken said the two countries should manage the relationship "responsibly" and added: "I hope we make some progress on the issues our presidents agreed" on at the California summit.
The two countries should be as "clear as possible about the areas where we have differences -- at the very least to avoid misunderstandings, to avoid miscalculations", Blinken said.
"That really is a shared responsibility that we have not only for our own people, but for people around the world, given the impact that our relationship has," he said.
Biden, who recently spoke by telephone with Xi, faces a tough re-election fight in November against his predecessor Donald Trump, who has cast China as an enemy and vowed a hard line.
The Biden administration has highlighted wins achieved by its diplomacy with China including what officials say is the first crackdown in years by Beijing on producers of precursor chemicals to fentanyl, the painkiller behind an addiction epidemic in the United States.
But while open to cooperation, Biden has increased pressure on China beyond Trump in some areas.
In the latest move, the US Congress, with Biden's support, voted to force the divestment of TikTok from Chinese company ByteDance or risk a ban in the United States.
US officials allege security and privacy concerns over the app, which has taken off among US teenagers.
ByteDance denies the allegations and has insisted it has no intention of selling.
US officials said Blinken also sought calm from China ahead of next month's inauguration of a new president in Taiwan -- the self-governing democracy claimed by Beijing -- and asked Beijing to use its leverage with Iran to encourage restraint in its increasingly open conflict with Israel.
