Objective: To simulate the tumor microenvironment though the 3D microtumor model which was constructed using droplet microfluidics.To explore its feasibility as a model for in vitro breast cancer research through3D microtumour fabrication,characterisation and sensitivity testing to chemotherapeutic drugs. Methods: Breast cancer cells were encapsulated with hydrogel shells in collagen-rich microencapsulated cores to obtain breast cancer microtumours in vitro;breast cancer microtumours were co-cultured with 3D microencapsulated endothelial cells by Transwell system.The structure and growth characteristics of the microtumours were directly observed by microscopy;the CCK-8 assay was used to detect the proliferation of the cells under different culture models and the drug sensitivity to doxorubicin;flow cytometry was used to compare the differences in apoptosis during the proliferation process;and the differences in the migratory and invasive abilities of the cells were assessed by scratch assay and Transwell assay;the expression of epithelial-mesenchymal transition-related proteins was detected by Western blot. Results: Breast cancer cells grew well in hydrogel nucleus-shell microcapsules;cell proliferation assays showed that 3D culture and 3D co-culture cells proliferated at a significantly lower rate than 2D culture;3D culture and 3D co-culture cells had enhanced migration and invasion ability and showed higher expression of EMT-related proteins compared to 2D culture;3D culture and 3D co-culture cells were significantly less sensitive to chemotherapeutic drugs compared to 2D culture.The sensitivity of 3D and 3D co-cultured cells to chemotherapeutic drugs was significantly reduced compared to 2D culture. Conclusion 3D cultures show similar morphology and biology to in vivo tumours and are more resistant to chemotherapeutic agents.

Purpose To explore the expression of autoph-agy-related 7(ATG7)in breast cancer and its effect on the breast cancer development.Methods Immunohistochemistry(IHC)was used to detect ATG7 protein expression in breast cancer tissues and the relationship between ATG7 and clinico-pathological features was analyzed.ShRNA was used to interfere with the expression of ATG7 in breast cancer cell line MCF-7.Puromycin was used to screen for stably transfected cells and Western blot was used to detect transfection efficiency.The effect of ATG7 knockdown cells on proliferation ability was de-tected by CCK8 and clone formation experiments.The effect of ATG7 knockdown cells on tumorigenicity in vivo was detected by subcutaneous tumor formation experiment in nude mice.Results IHC showed that ATG7 expression in breast cancer tissues was mainly localized in cytoplasm,and its expression was significant-ly correlated with tumor size and Ki67 expression(P＜0.05).ATG7-shRNA significantly interfered with ATG7 expression in breast cancer cells MCF-7.CCK8 and clone formation experi-ments showed that ATG7 knockdown promoted the cell prolifera-tion compared with the control group.The experiment of subcu-taneous tumor formation in nude mice showed that the tumor for-mation ability of mice was significantly increased after ATG7 knockdown compared with the control group.Conclusion ATG7 may inhibit the proliferation capacity of breast cancer and could be a potential target for breast cancer therapy.

Objective To investigate the clinical efficacy of CT-guided drilling,hematoma aspiration and drainage for senile cerebellar hemorrhage.Methods A retrospective analysis was performed on 89 very old patients(75-89 years old)with cerebellar hemorrhage admitted to our hospital from January 2016 to December 2022.According to their wishes,different surgical treatments were adopted,and thus they were divided into puncture group(42 cases,CT-guided drilling,aspi-ration and drainage for hematoma)and craniotomy group(47 cases,craniotomy).GCS,preopera-tive hematoma volume,length of ICU stay,postoperative complications,mortality rate and the mRS score in 3 months postoperatively in the survival were compared between the 2 groups.Re-sults There were no significant differences in age,male ratio,GCS score,preoperative hematoma volume,recurrence rate at 24 h postoperatively and mortality rate at 3 months postoperatively be-tween 2 groups(P＞0.05).The puncture group had significantly shorter length of ICU stay(7.10±1.43 dvs 8.87±1.39 d,P=0.000)and lower intracranial infection rate(4.76％vs 19.15％,P=0.040)than the craniotomy group.In 3 months of follow-up after surgery,the rate of good mRS score was higher in the puncture group than the craniotomy group,and the mRS score was lower in the former group than the latter one(P＜0.05).Conclusion CT-guided drilling,aspiration and drainage for hematoma can reduce the infection rate and improve the prognosis,and is an effective approach in the treatment of patients over 75 years old with cerebellar hemorrhage.

Objective To explore the efficacy of the retrosigmoid sinus approach through the cerebellopontine angle in the treatment of pontine hemorrhage.Methods A retrospective analysis was performed on 108 patients with pontine hemorrhage in Kaifeng Central Hospital from January 2016 to June 2022.They were divided into two groups according to the treatment methods,the conservative treatment group and the craniotomy treatment group(transcerebellopontine angle sigmoid sinus posterior approach).There were 94 cases in the conservative treatment group and 14 cases in the surgical treatment group.First analysis was conducted to examined whether there are differences in gender,age,Glasgow Coma Score(GCS)on admission,bleeding volume,comorbidities and complications between the two groups.Additional analysis was performed to analyze modified Rankin(modified Rankin scale,mRS)score and mortality rate after three month follow-up in case there was no significant difference at first analysis.Results There were no statistical differences in gender,age,Glasgow Coma Score(GCS)on admission,bleeding volume,comorbidities and complications between the two groups.After 3 months of follow-up,49 patients died in the conservative treatment group and 3 patients in the craniotomy treatment group.The mortality rates of the two groups were 52.1％and 21.4％respectively(χ2=4.600,P<0.05)).There was a statistical difference in the mortality rate between the two groups,and the mortality rate of the craniotomy treatment group was significantly lower than that of the conservative group.The modified Rankin score was 4(3,5)in the conservative treatment group and 3(2,3)in the craniotomy group(Z=-2.994,P<0.01).The modified Rankin score in the craniotomy group was lower than that in conservative treatment group after 3 months.Conclusion Microsurgery through the cerebellopontine angle retrosigmoid sinus approach to treat pontine hemorrhage can significantly reduce patient mortality and improve prognosis and is an effective surgical treatment method.

Objective To explore the effects of psychological counseling coupled with health education on the alleviation of pain during dressing change after surgery in the patients with high and complex anal fistula incision .Methods Seventy-seven patients with high and complex anorectal surgery were divided into two groups in accordance with different nursing methods after surgery : the control group (n=38) and the observation group (n=39).The control group received routine nursing care , while the observation group was given psychological counseling coupled with health education in addition to routine nursing care .Then, comparisons were made in visual analogue scores ( VAS) at the time of dressing change and 10 min after dressing change , the rate of reaching the set health education standards/the rate of satisfaction with nursing care , the SF-36 scores at the time of dressing change and 10 min after dressing change , as well as the ability of self-care after dressing change .Results ( 1 ) Ten minutes after dressing change , the VAS scores of the 2 groups were all significantly lower than those at the time of dressing change (P<0.01).Furthermore, from the second day after surgery , the VAS scores of the observation group 10 min after dressing change were significantly lower than those of the control group at the same time point of dressing change (P<0.01).Statistical significance could be noted , when comparisons were made be-tween them(P<0.05).(2) The rate of reaching the set health education standards /the rate of satisfaction with nursing care for the ob-
servation group were as high as 94.84%and 100%, which were obviously higher than those of the control group (86.84%, 89.47%), with statistical significance(P<0.05).(3)The excellent rate of self-care after dressing change for the observation group was as high as 89.74%, which was significantly higher than that of the control group (81.58%), also with statistical significance (P <0.05). Conclusion Psychological counseling coupled with health education could effectively alleviate pain during dressing change after surgery in the patients with high and complex anal fistula incision , improve their life quality and increase the rate of satisfaction with nursing care and the ability of self-care.