Objective To investigate the reasons and nursing countermeasures of the discomfort of peripher-ally inserted central catheter(PICC)intubation patients in the process of placing tube.Methods 290 patients with PICC who were treated with PICC for the first time were summarized.Results 290 patients with PICC in catheter had not comfortable experience.The main reason of causing discomfort was psychological factors,accounted for 90.0%, catheter when the cold experience leads to the discomfort of 82.8%,catheter environmental factors accounted for 6 3 .8 % ,pain caused by discomfort accounted for 15.5% ,puncture posture factors leading to 13.1% .Conclusion The causes of discomfort in the process of PICC is more,strengthen preoperative health education and the operation of effective communication,to create a relaxed comfortable environment to help patients take comfortable posture,improve a catheter success rate,preventing catheter during cold and other measures can improve the patients'comfort.

Background and purpose:Adenocarcinoma of the esophagogastric junction (AEG) has a high incidence of early recurrence and metastasis after operation. The prognosis of AEG is poor. However, few studies have investigated the recurrence of AEG. The purpose of this study was to clarify the important clinical pathological factors affecting the early recurrence ofⅠ,Ⅱ type of AEG after operation. Thus more active treatment for patients at high risk of recurrence may improve the prognosis.Methods:This study retrospectively reviewed the clinical data from 145 AEG patients who underwent R0 resection during the period from Dec. 2008 to Dec. 2012. Risk factors associated with the early recurrence were analyzed.Results:The mean time to tumor recurrence was 25.4 months after R0 resection, and the 1-year recurrence rate was 38.6%. Univariate analysis showed that the histological grade (degree of tumor differentiation), number of positive lymph nodes, TNM stage and vascular invasion were signiifcantly related with the early recurrence (P<0.05). Logistic multivariate regression analysis showed that only histological grade and vascular invasion were independently related with early tumor recurrence (P<0.05).Conclusion:Histological grade and vascular invasion are independent risk factors for predicting the early tumor recurrence after R0 resection for AEG.

Objective To observe the effect of hot compress with medicinal salt pack in preventing PICC-associated mechanical phlebitis.Method Totally 200 inpatients undergone PICC intubation were randomized into a treatment group and a control group, 100 cases in each group. After PICC intubation, the treatment group was intervened by hot compress with medicinal salt pack, while the control group was by hot compress with warm wet towel. The occurrence of mechanical phlebitis was observed at different time points and compared between the two groups. Result The occurrence rate of mechanical phlebitis was 9.0% in the treatment group versus 26.0% in the control group, and the difference was statistically significant (P<0.05). In the treatment group, the occurrence rate of mechanical phlebitis was respectively 6.0% and 3.0% when treatment≤72 h and>72 h, versus 16.0% and 10.0% in the control group, and the differences were statistically significant (P<0.05). Conclusion Hot compress with medicinal salt pack can effectively reduce the occurrence of PICC-associated mechanical phlebitis.

Objective To explore the basic biological characteristics of lncRNA -uc.1 67,and its spatial dis-tribution,temporal expression pattern during the mouse embryonic development.Methods The UCSC genome browser of ENCODE was used to analyze preliminary bioinformatics of lncRNAs.Real -time (RT)-PCR was applied to detect the expression of uc.1 67 and neighboring genes in the embryonic mouse heart in different stages (P7.5,P1 1 .5,P1 4.5, P1 8.5).Dimethyl sulphoxide was used to induce P1 9 cell differentiation into the cardiomyocytes.RT -PCR was applied to detect the expression changes in uc.1 67 and neighboring genes on differential day 0,4,6,8 and 1 0.Results Full -length of human uc.167 was 201 bp,and human uc.167 was located in the genome 5q14.3 (chr5:88179623 -881 79824,GRCh37 /hg1 9).uc.1 67 mainly expressed in the ventricular muscle tissue.The expression of uc.1 67 was gradually decreased in the mouse embryonic heart development process(P7.5:1 .000 ±0.1 00,P1 1 .5:0.71 4 ±0.1 07, P1 4.5:0.393 ±0.043,P1 8.5:0.1 25 ±0.01 3),while the expression of its neighboring Mef2c gene was gradually in-creased(P7.5:1 .081 ±0.1 1 8,P1 1 .5:2.340 ±0.351 ,P1 4.5:3.958 ±0.542,P1 8.5:9.361 ±0.722),which showed an opposite trend.The expression of uc.1 67 during P1 9 cell differentiation into cardiomyocytes showed a an increase at first and then a decreasepattern,and the highest level expression of uc.1 67 was on differential day 4(d0:1 .071 ± 0.1 1 7,d4:4.71 4 ±0.501 ,d6:3.572 ±0.41 4,d8:2.550 ±0.31 4,d1 0:0.786 ±0.085).The expression of neigh-boring gene Mef2c was in an opposite trend(d0:1 .01 2 ±0.041 ,d4:0.353 ±0.037,d6:2.470 ±0.329,d8:6.706 ± 0.682,d1 0:7.765 ±0.705).Conclusions It is suggested that uc.1 67 may take part in the process of embryonic heart development and may play a role through negatively regulating its neighboring gene Mef2c.

Objective To investigate the expression of P-glycoprotein(P-gp), multidrug resistance-associated protein (MRP), lung resistance-related protein (LRP) and predicts treatment outcome in the elderly acute myeloid leukemia. Methods Multi-parameter flow eytometric assay was used to quantify expression of P-go, muhidrug-associated resistance protein (MRP) and lung resistance-related protein (LRP) in bone marrow viable blasts from 12 eldely acute myeloid leukemia patients at diagnosis (M2a:4, one is come from MDS, M3a:2, M5a:5, M6a:1). Correlation of the MDR protein expression with treatment outcome were analysed. Results The frequency of expression of P-gp, MRP and LRP was 58.33 %, 8.33 %, 50 %, respectively and P-gp(+)/MRP(+) 0, P-gp(+)/LRP(+) 33.33 %, MRP(+)/LRP(+) 0, P-gp(+)/MRP(+)/LRP(+)8.33 %, P-go(-)/MRP (-)/LRP(-) 33.33 %;respectively. The frequency of overexpression of P-gp or LRP alone and both of them were relatively higher. The rate of complete remission (CR) and overall survival (OS) at one year of P-gp(+) group were significantly lower than those of P-go(-) group, and LRP(+) group also were lower than LRP(-) group. Conclusion The Frequency of expression of P-gp or LRP and coexpression of both of them were higher in elderly patients with AML. The overexpression of P-gp and/or LRP was a poor prognotic factor for eldely myeloid leukemia in elderly patients.

Objective To explore the effect of 1a,25(OH)2 D3 on circadian clock gene expressions in cardiac myocytes.Methods Cultured cardiac myocytes isolated from 7 -day -old Sprague -Dawley(SD)rats were identified by immunofluorescence.The medium including 1a,25 (OH)2 D3 (final concentrations were 0 nmol/L,1 nmol/L, 10 nmol/L,50 nmol/L and 100 nmol/L)were added to primary myocardial cells to culture for 2 h and then total RNA was extracted.Real -time polymerase chain reaction (RT -PCR)was applied to analyze myocardial cells circadian clock gene (Bmal1,Per2,Rev -erba)transcript levels to determine optimum concentration of 1a,25(OH)2 D3 .Then, the primary myocardial cells cultured for 72 h were divided into 3 groups:the control group was of serum -free culture medium;serum shock group was of DMEMcontaining 50%volume fraction of horse serum cultured 2 h;1a,25(OH)2 D3 treatment group receiving 1a,25 (OH)2 D3 at optimal concentration cultured 2 h.The cells were collected at 7 time points (0 h,4 h,8 h,12 h,16 h,20 h,24 h)and then total RNA was extracted.RT -PCR was applied to analyze circa-dian clock gene (Bmal1,Per2,Rev -erba)transcript levels in the myocardial cells.Results In the presence of 50 nmol/L 1 a,25(OH)2 D3 ,the Bmal1 mRNA expression showed the highest level,but the Per2 and Rev -erba mRNA expression levels were minimum.Compared with the control group,both 1a,25 (OH)2 D3 treatment group and serum shock group caused day -cycle rhythmic oscillation in circadian clock genes(Bmal1,Per2,Rev -erba)in the cardiac myocytes.And the expressions pattern of Bmal1 and Per2 genes were in the opposite phase.While Bmal1 gene expres-sion appeared at peak at 12 h,Per2 gene expression appeared in a trough.Expression of Rev -erba gene trend began to rise at 8 h,and the highest expression level appeared at 12 -16 h.Conclusions 1a,25(OH)2 D3 can affect Bmal1, Per2 and Rev -erba mRNA expressions of circadian clock genes in the cardiac myocytes.

Objective To understand the current status of health literacy among caregivers of patients with liver cancer and its influencing factors so as to provide a basis for improving the level of health literacy among caregivers of patients with liver cancer.Methods Using convenience sampling method,the caregivers of the liver cancer patients,who were admitted to the Department of Interventional Radiology of a certain grade ⅢA hospital in Changsha City,Hunan Province of China between April and October of 2022 and who met the inclusion and exclusion criteria,were selected as the research objects.The general information questionnaire,Health Literacy of Caregivers Scale-Cancer(HLCS-C),and Simplified Coping Style Questionnaire(SCSQ)were used to conduct the survey.Multiple linear regression analysis was used to analyze the factors influencing the health literacy among caregivers of patients with liver cancer.Results A total of 204 valid questionnaires were collected.The score of health literacy of caregivers was(123.08±16.66)points.The results of multiple linear regression analysis showed that the residence location,the monthly income per capita of the family,the number of hospitalization times,the length of care,work/study status,and coping style were the main factors influencing the health literacy(P<0.001),which explained 81.9％of the total variance.Conclusion The health literacy among the caregivers of patients with liver cancer is at a moderate level.Clinical medical staff can implement individualized health education by evaluating caregivers with different characteristics,encourage caregivers to seek and grasp disease-related information,and help the caregivers to adopt positive coping styles,so as to improve their health literacy.