1.Aquaporin 1 promotes proliferation and migration of tumor by up-regulating claudin-1 expression in colon cancer
Wei Wei XIE ; Lin XU ; Qian LI ; Dao Quan ZHANG ; Yu Bao ZHOU
Journal of Pathology and Translational Medicine 2026;60(3):307-318
With the rising incidence of colon cancer, several studies have indicated that aquaporin 1 (AQP1) expression is associated with the development of colon cancer. This study aims to elucidate the potential molecular mechanisms between them. Methods: We screened data from The Cancer Genome Atlas (TCGA) database and retrospectively examined AQP1 protein expression in 127 colon cancer patients to analyze the relationship between AQP1 expression and pathological stages, prognosis. We created stable colon cancer cell lines with differential AQP1 expression, the effect of AQP1 expression on the proliferation and migration of colon cancer cells was assessed by in vitro and in vivo studies, and explored potential molecular mechanisms through Western blotting. Results: High AQP1 expression was associated with poorer survival (overall survival [OS], p = .028) in colon cancer patients from the TCGA database. Similarly, retrospective clinical data indicated that high AQP1 expression was associated with reduced disease-free survival and OS (p = .036 and p = .017, respectively). The low-expressing AQP1 colon cancer cells exhibited a decrease in proliferation and migration ability of colon cancer cells compared to the overexpressing AQP1 group (p < .05) in vitro and in vivo. Immunohistochemistry and western blotting experiments validated heightened expression of N-cadherin, vimentin, and claudin- 1 in the tumor tissues of the overexpressing AQP1 group. Conversely, reduced AQP1 expression resulted in decreased expression of claudin- 1. Conclusions: AQP1 correlates with unfavorable prognosis in colon cancer and potentially enhances the proliferation and migration of colon cancer by up-regulating claudin-1 expression.
2.Screening of the Monkeypox Virus Key Proteins Regulating Inflammation Based on NOD-like Receptor Family Pyrin Domain Containing 3 Inflammasome Signaling
Mingxing LUO ; Chenchen PEI ; Liyun GONG ; Xinlei ZHENG ; Jun QIAN ; Quan LIU ; Jun ZHENG
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(2):259-268
ObjectiveTo screen and identify the key proteins of Monkeypox Virus (MPXV) that regulate the NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome. MethodsUsing the genomic sequence of the domestic epidemic strain of MPXV as a template to construct an expression plasmid library containing 82 viral genes. To screen for viral genes that significantly inhibit the production of interleukin-1β (IL-1β), the expression plasmids encoding NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), cysteine protease-1(Caspase-1), and pro-IL-1β-Luc reporter gene were co-transfected into HEK293T cells, along with the viral gene plasmids. The signal of the NLRP3 inflammasome was monitored by measuring luciferase activity in the cell supernatant. The inhibition effects were further confirmed by Western Blot (WB), and the interactions between the viral proteins and the components of the NLRP3 inflammasome were determined by Co-immunoprecipitation (Co-IP). Additionally, site-directed mutagenesis was performed to identify the specific interaction motifs. ResultsAn NLRP3 inflammasome signal screening system were successfully established and optimized. Screening the MPXV plasmids using this system revealed that B10R most significantly inhibits IL-1β maturation in a dose-dependent manner (P<0.000 1). Further characterization demonstrated that B10R interacts directly with pro-IL-1β. Notably, the C-terminal motif mutant of B10R (B10Rmut-C, T96A, Y97A, I98A) lost its ability to interact with pro-IL-1β. ConclusionsThe MPXV B10R protein interacts with pro-IL-1β, thereby inhibiting the IL-1β maturation. The C-terminal motif (T96, Y97, I98) of the B10R protein is crucial for function. This study provides important clues and a foundation for further elucidating the molecular mechanisms by which MPXV regulates the NLRP3 inflammasome.
3.Relationship between serum PAI-1 and ANXA2 levels and carotid plaque stability in patients with transient ischemic attack
Quan ZHAO ; Shide QIAN ; Ziqi HU ; Dongsheng JIAO
International Journal of Laboratory Medicine 2025;46(5):543-547
Objective To investigate the relationship between serum levels of plasminogen activator inhibi-tor-1(PAI-1)and annexin A2(ANXA2)and the carotid atherosclerosis stability(CAS)plaque in patients with transient ischemic attack(TIA).Methods A total of 131 patients with TIA admitted to the hospital from January 2021 to January 2023 were selected as the TIA group,and 46 healthy people in the same period were selected as the control group.According to the CAS plaque stability of TIA patients,they were divided into unstable plaque group(64 cases)and stable plaque/no plaque group(67 cases).The serum levels of PAI-1 and ANXA2 were detected by enzyme-linked immunosorbent assay and chemiluminescence immunoassay,respectively.Multivariate Logistic regression analysis was used to analyze the factors of CAS plaque stability in TIA patients.Receiver operating characteristic curve was used to analyze the predictive value of serum PAI-1 and ANXA2 levels for CAS instability in TIA patients.Results Compared with the control group,the levels of PAI-1 and ANXA2 in TIA group were significantly increased(P<0.05).Compared with the stable plaque/no plaque group,the unstable plaque group was significant increaseed in the serum levels of PAI-1 and ANXA2(P<0.05).Smoking,high risk of TIA,elevated PAI-1 and ANXA2 were independent risk factors for CAS plaque stability in patients with TIA(P<0.05).The area under the curve predicted by serum PAI-1 and ANXA2 levels combined was 0.879,which was larger than 0.788 and 0.783 predicted by serum PAI-1 and ANXA2 levels alone(P<0.05).Conclusion The increased levels of serum PAI-1 and ANXA2 are closely re-lated to CAS plaque instability in patients with TIA.The combination of serum PAI-1 and ANXA2 levels has a higher value in predicting CAS plaque instability in patients with TIA.
4.Correlation between serum levels of HAMP, SPP1, RGS2 and clinical pathological characteristics of gastric cancer patients and their predictive value for postoperative recurrence or metastasis
Guangxin LI ; Huijuan QUAN ; Zhijuan GAO ; Xiaojun WANG ; Liang LI ; Qian DONG ; Yongtao MIAO ; Dongsheng LIU
Journal of International Oncology 2025;52(8):502-507
Objective:To explore the correlation between serum hepcidin antimicrobial peptide (HAMP), secreted phosphoprotein 1 (SPP1), and regulator of G protein signaling 2 (RGS2) levels and the clinical pathological characteristics of gastric cancer patients, and their predictive value for postoperative recurrence or metastasis.Methods:A total of 92 gastric cancer patients treated at Handan First Hospital from March 2021 to March 2023 were selected as the gastric cancer group, and 92 healthy individuals who underwent physical examinations during the same period were selected as the control group. The serum levels of HAMP, SPP1 and RGS2 were compared between the two groups. According to the mean levels of HAMP, SPP1, and RGS2 in the serum of gastric cancer patients, they were divided into HAMP high level group and HAMP low level group, SPP1 high level group and SPP1 low level group, RGS2 high level group and RGS2 low level group. The clinicopathological characteristics of gastric cancer patients with different levels of HAMP, SPP1 and RGS2 were compared respectively. After a median follow-up of 18 months, gastric cancer patients were divided into a non-recurrence or metastasis group ( n=59) and a recurrence and metastasis group ( n=33) based on whether the tumor recurred or metastasized. The serum levels of HAMP, SPP1, and RGS2 were compared between the two groups of patients. The predictive value of HAMP, SPP1 and RGS2 for postoperative recurrence or metastasis in patients with gastric cancer was analyzed by using the receiver operator characteristic (ROC) curve. Results:Compared with the control group, the gastric cancer group had higher levels of serum HAMP [ (52.28±5.44) ng/ml vs. (31.22±4.18) ng/ml] and SPP1 [ (55.96±6.43) ng/ml vs. (36.99±5.25) ng/ml] ( t=29.44, P<0.001; t=21.92, P<0.001), and lower level of RGS2 [ (3.72±0.66) mg/L vs. (5.11±0.87) mg/L) ] ( t=12.21, P<0.001). There were statistically significant differences in maximum tumor diameter ( χ2=13.07, P<0.001; χ2=6.71, P=0.010; χ2=10.56, P=0.001), TNM staging ( χ2=7.42, P=0.006; χ2=6.36, P=0.012; χ2=5.39, P=0.020), lymph node metastasis ( χ2=23.41, P<0.001; χ2=6.52, P=0.011; χ2=13.11, P<0.001), and differentiation degree ( χ2=9.01, P=0.003; χ2=7.97, P=0.005; χ2=15.29, P<0.001) between the gastric cancer patients in the HAMP high level group ( n=44) and the HAMP low level group ( n=48), the SPP1 high level group ( n=43) and the SPP1 low level group ( n=49), and the RGS2 high level group ( n=50) and the RGS2 low level group ( n=42). Compared with the non-recurrence or metastatic group, the recurrence and metastatic group had higher levels of serum HAMP [ (59.26±5.66) ng/ml vs. (48.37±4.28) ng/ml] and SPP1 [ (62.85±6.36) ng/ml vs. (52.11±5.38) ng/ml] level ( t=10.40, P<0.001; t=8.60, P<0.001), and lower level of RGS2 [ (3.01±0.48) mg/L vs. (4.12±0.69) mg/L] ( t=8.19, P<0.001). ROC curve analysis showed that the area under the curve (AUC) values of serum HAMP, SPP1, and RGS2 levels alone for predicting postoperative recurrence or metastasis in gastric cancer patients were 0.777, 0.813, and 0.778, respectively. The AUC value of the combination of the three indicators for predicting postoperative recurrence or metastasis in gastric cancer patients was 0.871. The predictive efficacy of the combination of the three indicators for predicting postoperative recurrence or metastasis in gastric cancer patients was better than that alone ( Z=2.51, P=0.035; Z=2.61, P=0.032; Z=2.71, P=0.029) . Conclusions:The levels of HAMP and SPP1 in the serum of gastric cancer patients increase, while the level of RGS2 decreases, and the levels of the three are related to the maximum tumor diameter, TNM staging, lymph node metastasis and differentiation degree, and their combined detection has higher predictive value for postoperative recurrence or metastasis in gastric cancer patients.
5.Design and application of home pulmonary rehabilitation checklist for postoperative lung cancer patients
Qian DING ; Shuang QUAN ; Shuang HE ; Yanyan NING ; Fengjuan YANG ; Hui YANG
Chinese Journal of Practical Nursing 2025;41(28):2192-2198
Objective:To explore the design and application effect of a home-based pulmonary rehabilitation checklist for postoperative lung cancer patients and to analyze the feasibility of this innovative rehabilitation approach.Methods:A prospective non-concurrent controlled study was conducted. Eighty postoperative lung cancer patients from the Department of Thoracic Surgery, Henan Provincial People's Hospital, were conveniently selected. According to the time of admission, postoperative lung cancer patients from April to June 2024 ( n=40) were assigned to the control group, while those postoperative lung cancer patients from August to October 2024 ( n=40) were assigned to the experimental group. The control group was given routine home-based pulmonary rehabilitation knowledge education upon discharge, while the experimental group was provided with the application of a home-based pulmonary rehabilitation checklist in addition to the routine home-based pulmonary rehabilitation knowledge education. Assessments were performed on the day of discharge and 1-month post-discharge using the Chinese version-Strategies Used by People to Promote Health (C-SUPPH), the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC-QLQ-C30), the six-minute walk test (6MWT) and the Brog score. Results:A total of 40 patients in each group completed this study. Among them, there were 26 males and 14 females in the control group, aged (51.25 ± 11.39) years, and 23 males and 17 females in the experimental group, aged (53.07 ± 12.21) years. One month after discharge, the scores of positive attitude, self-decision making and self-stress reduction on the C-SUPPH in the experimental group were (44.25 ± 10.29), (30.76 ± 8.31) and (9.51 ± 2.17) points, respectively. They were higher than those in the control group (37.02 ± 7.14), (26.61 ± 6.71) and (7.58 ± 1.09) points, and the differences were statistically significant ( t=-3.65, -2.46, -5.03, all P<0.05). The scores of somatic function, role function, cognitive function and emotional function on the EORTC-QLQ-C30 in the experimental group were (65.77 ± 6.41), (71.46 ± 7.21), (70.11 ± 5.61) and (69.59 ± 5.71) points, respectively. They were higher than those in the control group (57.71 ± 7.01), (64.27 ± 5.25), (62.79 ± 7.18), (61.11 ± 6.25) points, and the differences were statistically significant ( t values were -6.34 to -5.08, all P<0.05). The 6MWT distance in the experimental group was (411.31 ± 35.02) m, which was higher than (376.58 ± 30.26) m in the control group, and the difference was statistically significant ( t=-4.75, P<0.05). The Brog score in the experimental group was (2.12 ± 0.68) points, which was lower than (2.50 ± 0.65) points in the control group, and the difference was statistically significant ( t=2.56, P<0.05). Conclusions:The implementation of home pulmonary rehabilitation list can improve the self-management ability of patients after lung cancer surgery, improve the quality of life, and then enhance the exercise ability, which is worthy of clinical promotion.
6.The application analysis of antitoxin therapy in severe infant botulism
Lijuan WANG ; Quan WANG ; Chaonan FAN ; Kechun LI ; Jun LIU ; Zheng LI ; Xinlei JIA ; Jie WU ; Yibing CHENG ; Xinhui LUO ; Fawudan ABUDU ; Suyun QIAN
Chinese Journal of Pediatrics 2025;63(3):254-258
Objective:To analyze the application of antitoxin therapy in severe infant botulism.Methods:A retrospective analysis was conducted on 14 cases of severe infant botulism treated at 3 pediatric medical centers from July 2020 to August 2024. This study investigated antitoxin dosage, treatment duration, discontinuation criteria and adverse reactions.Results:A total of 14 cases (12 males and 2 females) were included, with an age of 5.0 (3.8, 7.0) months. Botulinum toxin typing revealed 10 cases of Type B, 2 cases of Type A and 2 untyped cases. The interval from symptom onset to antitoxin administration was 9.0 (6.0, 11.5) d. The initial dosage of type A antitoxin was 12 500 (10 000, 22 500) U, while type B was 5 000 (5 000, 5 000) U. The dosage was tapered in some cases after symptom improvement, the duration of treatment was 16.5 (9.8, 25.3) d. In total, 11 infants discontinued medications after improvement in muscle strength, while 3 infants discontinued treatment after obtaining negative results from fecal mouse bioassays. Adverse events were reported in 2 cases, both of which resulted in rash, and 1 case was complicated with anaphylactic shock. All the patients survived upon discharge with a follow-up period of 11 d to 3 years and 8 months. Totally 12 infants had fully recovered, while 2 infants were still recovering after discharge.Conclusion:Antitoxin therapy is a feasible and safe approach which showed favorable prognosis in severe infant botulism.
7.Management and prognosis of pediatric acute liver failure in pediatric intensive care unit
Boliang FANG ; Gang LIU ; Quan WANG ; Zheng LI ; Xinlei JIA ; Jiansheng ZENG ; Rubo LI ; Suyun QIAN
Chinese Journal of Pediatrics 2025;63(8):879-884
Objective:To understand the management of children with pediatric acute liver failure (PALF) in pediatric intensive care unit (PICU).Methods:A retrospective case-control study was conducted. A total of 101 children with PALF hospitalized in PICU of Beijing Children′s Hospital from July 2017 to October 2022 were included. Demographic, clinical management and prognosis data were collected. According to whether PALF was the main diagnosis, the patients were divided into primary diagnosis group and complication group. The primary diagnosis group was subdivided into effective group and ineffective group with routine treatment (except liver transplantation). The intergroup comparisons were performed using independent samples t-test, Mann-Whitney U test, χ2 test or Fisher exact test. Multivariate Logistic regression analysis was employed to identify risk factors associated with prognosis. Results:Among the 101 children with PALF, 58 were male and 43 were female, with an age of 30 (10, 103) months, 60 cases in primary diagnosis group and 41 cases in complication group. There were no significant differences in prothrombin time (PT) and international normalized ratio (INR) between the two groups (both P>0.05), while the total bilirubin, direct bilirubin and blood ammonia were all significantly higher in the primary diagnosis group (all P<0.05). Unoriginal liver failure (25 cases (42%)) and poisoning (13 cases (22%)) were the most common causes of PALF in the primary diagnosis group, while shock (17 cases, 43%) and hemophagocytic syndrome (14 cases (34%)) in the complication group. The mortality rate of the main diagnosis group was significantly lower than that of the complication group (25% (15/60) vs. 61% (25/41), χ2=13.18, P<0.001), as well as the incidence of combined organ function injury, while the amount of plasma used and the ratio of plasma exchange times to PICU hospitalization days were significantly higher (all P<0.05). In the primary diagnosis group, there were 32 cases (53%) in the effective group and 28 cases (47%) in the ineffective group. In the ineffective group, 15 cases (54%) died and 13 cases (46%) were transferred to another site for liver transplantation assessment. The hospitalization time of PICU in the effective group was significantly longer than that in the ineffective group, while the ratio of plasma exchange times to PICU hospitalization days, the average daily hours of continuous renal replacement therapy (CRRT), the rate of CRRT and the average daily plasma dosage in the effective group were all significantly lower than those in the ineffective group (all P<0.05). The worst PT, INR and blood ammonia, and the stage 4 hepatic encephalopathy morbidity and significant bleeding rate in the effective group were all significantly lower than those in the ineffective group (all P<0.05). Multivariate Logistic regression analysis showed that after adjusting for age, sex, total bilirubin, INR and blood ammonia, stage 4 hepatic encephalopathy was the independent risk factor for the failure of routine treatment of PALF ( OR=84.16,95% CI 4.04-1752.37, P=0.004). Conclusions:PT and INR could not specifically represent liver synthetic function in some PICU patients, so current PALF diagnostic criteria for PICU children has limitations. Complicated with stage 4 hepatic encephalopathy was an independent risk factor of the failure of conventional treatment in patients with PALF.
8.Epidemiologic and clinical characterization of nontuberculous mycobacterial lung disease in a certain infectious disease hospital in Xinjiang
Qian PANG ; Quan WANG ; Yu PANG ; Ruiying MA ; Ting YANG ; Gulibike MULATI ; Ertai A
Chinese Journal of Zoonoses 2025;41(10):1048-1054
To understand the epidemiological and clinical features of patients with non-tuberculous mycobacteria(NTM)lung disease in a hospital for infectious diseases in Xinjiang,and to provide basis for prevention and control of NTM in Xinjiang.The strain distribution,epidemiological features and clinical features of 78 patients with NTM lung disease in the Sixth People′s Hospital of Xinji-ang Uygur Autonomous Region were analysed from June 2021 to June 2024,and a comparative analysis of the clinical features of 156 patients with pulmonary tuberculosis in this hospital during the same period was performed.Among 78 patients with NTM lung disease,the bacteria identified by molecular biology accounted for the top three cases:24 cases of Mycobacterium avium intracellulare complex,16 cases of Mycobacterium Kansaii and 11 cases of Mycobacterium Gordonae.There was no statistically significant difference in gender(χ2=0.009),age(χ2=2.670),smoking history(χ2=0.064),and BMI(χ2=0.896)between the NTM lung disease group and the pulmonary tuberculosis group(P>0.05).However,there were statistically significant differences in the combined bronchiectasis(χ2=19.068),immune-related indicators CD4(Z=-3.498)and CD3(Z=-3.187),and chest CT cavities on imaging(χ2=9.308)be-tween the two groups(P<0.05).There was no statistically significant difference in clinical symptoms such as cough(χ2=0.188)and expectoration(χ2=0.044)between the two groups(P>0.05).The common underlying diseases of NTM lung disease were diabetes mellitus(23.08%),hypertension(21.79%),bronchiectasis(20.51%)and others.The common clinical symptoms of NTM lung disease include cough,sputum,fatigue,poor appetite and others.The common manifestations of chest CT in NTM lung disease were Patchy cord shadows(62.82%),nodule(51.28%),pleural thickening(46.15%),calcification(41.03%)and others.Multivariate Logistic regression analysis showed that bronchiectasis(OR=8.019)is risk factor for NTM lung disease.The dominant strains of NTM in this study were My-cobacterium avium intracellulare complex,Mycobacterium kansasii and Mycobacterium Gordonae.NTM lung disease and pulmonarytuber-culosis have similar clinical manifestations and are difficult to distinguish,especially for patients with bronchiectasis,it is necessary to actively investigate NTM lung disease,provide basis for early diagnosis and treatment of NTM lung disease,and gradually form a system-atic and standardized NTM lung disease diagnosis and treatment system according to local conditions.
9.Toxic effects of subacute exposure to pyrethrin on the nervous system of mice
Chan ZHANG ; Luolin BAO ; Fenglian ZENG ; Hongbo YANG ; Qian ZHANG ; Xuelin QUAN
Chinese Journal of Neuroanatomy 2025;41(5):556-564
Objective:To investigate the effects and mechanisms of subchronic exposure to pyrethrin on the mice nervous system.Methods:Twenty-four male mice were randomly divided into a control group,low-,medium-,and high-dose groups,and were exposed continuously for 28 days.The control group received corn oil.The general condi-tion of the mice was observed,and the body weight and brain organ coefficient were measured.Neurobehavioral tests were conducted after the exposure period.The histopathological changes of the hippocampus in mice were observed by HE and nissl staining.The activities of lactate dehydrogenase(LDH),superoxide dismutase(SOD),catalase(CAT)and the contents of malondialdehyde(MDA),glutathione(GSH),acetylcholine(ACh)and glutamate(Glu)in brain tissue of mice were detected by biochemical kit.The Western blot was employed to measure the expression levels of kelch-like ech-associated protein 1(Keap1),nuclearfactorerythroid2-relatedfactor2(Nrf2),and heme oxygenase 1(HO-1)in brain tissue of mice.Results:Compared with the control group,the body weight of the mice in the high-dose group decreased,the brain organ coefficient increased,and the neurological function test showed that the mice had reduced autonomic activity,delayed nerve reflex,and impaired sensory and motor function.Histopathology showed that the hippocampal neurons in the middle-and high-dose groups presented with pyknosis,vacuolization,and disordered arrangement of the CA3 area.Biochemical analysis indicated that in the brain tissue of mice,the activity of LDH and the content of MDA were increased in the medium-and high-dose groups,while the activity of CAT and the content of GSH were decreased.The content of Glu was increased and the content of ACh was decreased.The activity of SOD was reduced in the low-,medium-,and high-dose groups.Western blot analysis showed that the expression of HO-1 and Nrf2 protein in the brain tissue of mice in the middle-and high-dose groups was down-regulated,while the expression of Keap1 protein in the high-dose group was up-regulated.Conclusion:Pyrethrin may cause damage to the nervous system by affecting the Keap1/Nrf2/HO-1 signaling pathway and neurotransmitter levels.
10.Multicenter survey on the current status of pediatric life support training
Xin QIAN ; Xiaodi CAI ; Quan WANG ; Meifang LIN ; Qian WANG ; Tingting XUE ; Biru LI ; Quelan HUANG ; Yi WANG ; Yunxia HONG ; Zhixu CHEN ; Guoping LU ; Ye CHENG ; Hongyang HU
Chinese Pediatric Emergency Medicine 2025;32(11):827-831
Objective:To investigate the current status and challenges of pediatric life support training in China and provide references for improving training quality.Methods:A cross-sectional study was conducted to collect data from pediatric life support training centers across the country,covering basic institutional information,training capacity and training faculty,training program funding,as well as existing challenges and issues.The domestic registry of training centers in 2023 was obtained through the American Heart Association's online platform.After contacting and verifying each center,an online questionnaire was distributed,and the aggregated data were statistically analyzed.Results:A total of 42 institutions participated in the survey,including 19 children's hospitals,14 general hospitals,6 maternal and child health hospitals,2 women and children’s hospitals,and 1 training institution.The distribution of training centers showed a concentration in coastal areas,with the top three provinces/municipalities being Guangdong(7/42,16.7%),Zhejiang(6/42,14.3%),and Shanghai(4/42,9.5%).As of December 31 2023,the 42 institutions had an annual basic life support(BLS)training volume of 8 587 individuals,the median was 120 (100,200),and an annual pediatric advanced life support(PALS)training volume of 2 448 individuals,the median was 30 (20,50).Among the 42 institutions,there were 598 BLS instructors and 306 PALS instructors.Among the surveyed institutions,24(24/42,57.1%)reported BLS instructor teams comprising fewer than 10 members,and 33(33/42,78.6%)reported PALS instructor teams comprising fewer than 10.Only 7 centers(7/42,16.7%)reported having dedicated funding support.The top three challenges were:training sessions occupying instructors’personal time(27/42,64.3%),low instructor compensation(16/42,38.1%),and issues with the data submission system(16/42,38.1%).Conclusion:Pediatric life support training centers in China are primarily children’s hospitals,with a geographical concentration in coastal areas,which is also reflected in the distribution of training scale and instructor resources.Most centers have relatively small training scales and limited instructor capacity,with many instructors conducting training during their personal time.These issues may hinder the implementation and effectiveness of training programs.

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