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Aims and Objectives: (i) To estimate the national incidence of unplanned removal of peripherally inserted central catheters (PICCs) in China. (ii) To explore the associated risk factors to provide evidence for the prevention. Design: A multi‐centre prospective cohort study. Methods: A representative sample of 3222 Chinese adult patients with successful PICC insertion was recruited for the PICC Safety Management Research (PATH) using a two‐stage cluster sampling method from December 2020 to June 2022. Sixty hospitals from seven Chinese provinces representing all geographical regions were selected. Demographic information and PICC characteristics were collected using a standard online case report form. Risk factors for the unplanned removal of PICCs were assessed using a cause‐specific hazard model and verified using a sub‐distribution hazard model. STROBE guidelines were followed in reporting this study. Results: Three thousand one hundred and sixty‐six patients were included in the final analysis with a mean age of 59 years and a total of 344,247 catheter days. The incidence of unplanned removal was 10.04%. Female, with thrombosis history, PICC insertion due to infusion failure, valved catheter and double‐lumen catheter were risk factors, whereas longer insertion and exposure length were protective factors in the cause‐specific hazard model. Higher BMI became an independent risk factor in the sub‐distribution hazard model. Conclusions: Unplanned removal of PICCs is a serious clinical challenge in China. Our findings call for prevention strategies targeting the identified risk factors. Relevance to Clinical Practice: Our study characterised the epidemiology of unplanned removal of PICCs among Chinese adult inpatients, highlighting the need for prevention among this population and providing a basis for the formulation of relevant prevention strategies. Patient or Public Contribution: Patients contributed through sharing their information required for the case report form. Healthcare professionals who provide direct care to the patient at each medical centre contributed by completing the online case report form. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) initiated by hepatitis B virus (HBV) infection is a complicated process. MiR‐155 can alter the immune microenvironment to affect the host's anti‐infective ability. This study investigated the mechanism by which miR‐155 affects tumour‐associated macrophage (TAM) polarization at a molecular level, thus affecting the malignant progression of HBV+HCC. MiR‐155 and TAM‐related cytokine expression were analysed by qRT‐PCR. The distribution of TAMs was detected by immunohistochemistry. The effect of the aberrant miR‐155 expression on macrophage polarization was examined by flow cytometry. The targeted relationship was verified by dual‐luciferase assay, and the protein level of src homology 2 domain‐containing inositol polyphosphate 5‐phosphatase 1 (SHIP1) was detected by western blot. The proliferation of HCC cells was examined by CCK‐8 and colony formation assays. Invasion and migration of HCC cells were detected by transwell assay. In HBV+HCC tissues, miR‐155 was significantly highly expressed and the number of CD206‐positive TAM (CD206+ TAM) and CD68‐positive TAM (CD68+ TAM) were higher than those in HBV−HCC tissues. In addition, miR‐155 overexpression significantly promoted M2‐type macrophage polarization, whilst miR‐155 silencing expression significantly promoted M1‐type macrophage polarization. Besides, the miR‐155/SHIP1 axis accelerated HCC cell invasion, proliferation and migration by inducing M2‐type macrophage polarization. MiR‐155 accelerates HCC cell proliferation, migration and invasion by targeting SHIP1 expression and inducing macrophage M2 polarization. This finding provides new insights into the development of novel therapeutic strategies for combatting HBV+HCC and a new reference for exploring anti‐tumour immunotherapy. [ABSTRACT FROM AUTHOR]