Peptide-AIE Nanofibers Functionalized Sutures with Antimicrobial Activity and Subcutaneous Traceability.

As one of the most widely used medical devices, sutures face challenges related to surgical site infections (SSIs) and lack of subcutaneous traceability. In the present study, a facile and effective approach using peptide-AIE nanofibers (NFs-K18) to create fluorescent-traceable antimicrobial sutures, which have been applied to four commercially available sutures is developed. The functionalized sutures of PGAS-NFs-K18 and PGLAS-NFs-K18 exhibit fluorescence with excellent penetration from 4 mm chicken breasts. They also demonstrate remarkable stability after 24 h of white light illumination and threading through chicken breasts 10 times. These sutures efficiently generate ROS, resulting in significant suppression of four clinical bacteria, with the highest antimicrobial rate of ≈100%. Moreover, the sutures exhibit favorable hemocompatibility and biocompatibility. In vivo experiments demonstrate that the optimized PGLAS-NFs-K18 suture displays potent antimicrobial activity against MRSA, effectively inhibiting inflammation and promoting tissue healing in both skin wound and abdominal wall wound models, outperforming the commercially available Coated VICRYL Plus Antibacterial suture. Importantly, PGLAS-NFs-K18 exhibits sensitive subcutaneous traceability, allowing for accurate in situ monitoring of its degradation. It is believed that this straightforward strategy offers a new pathway for inhibiting SSIs and monitoring the status of sutures.

Differential clinical outcomes after 3 versus 5 years in a comparison of preoperative chemotherapy with and without radiotherapy in locally advanced rectal cancer: A national cohort propensity score-matched study.

Background: Preoperative chemotherapy alone might be a good alternative to preoperative chemoradiotherapy for patients with locally advanced rectal cancer, yet long-term real-world data from the same cohort are lacking. Methods: Patients diagnosed with stage II-III rectal adenocarcinoma from 2011 to 2015 were randomly sampled from the SEER-Plus database to evaluate the superiority of preoperative chemoradiotherapy versus preoperative chemotherapy alone. Findings: A total of 1314 eligible patients were enrolled, with a median follow-up of 74.0 months. At 3-year follow-up, neither overall survival (OS) nor cancer-specific survival (CSS) was significantly different between the two treatment groups. At 5-year follow-up, CSS was similar across groups (HR 0.768, 95% CI 0.532-1.108; P = 0.156), but the 5-year OS was significantly better in the preoperative chemoradiotherapy group than in the preoperative chemotherapy group (HR 0.682, 95% CI 0.538-0.866; P = 0.002). Besides, the landmark analysis indicated a direct contrast in the CSS within 3 years (HR 1.101, 95% CI 0.598-2.029; P = 0.756) versus that at 3-5 years (HR 0.597, 95% CI 0.377-0.948; P = 0.027). The landmark analysis also showed directly contrasting OS outcomes within 3 years (HR 0.761, 95% CI 0.533-1.086; P = 0.130) versus those at 3-5 years (HR 0.621, 95% CI 0.451-0.857; P = 0.003). Interpretation: In patients with locally advanced rectal cancer under real-world treatment practices, the addition of preoperative radiotherapy to chemotherapy improves survival outcomes at 3-5 years' follow-up but not at 3-year follow-up.

Nanoengineered Supramolecular Adhesive Sponge for Rapid Hemostasis and Abdominal Wall Wound Healing.

Multifunctional dressing biomaterials that can promote tissue adhesion, hemostasis, and soft-tissue wound healing are of great clinical significance. Here, we report a nanocomposite supramolecular sponge constructed by an air-in-water emulsion template composed of methacrylated gelatin (GelMA), Laponite nanoclay, and branched supramolecular polymer (PAMU). The sponge has an interconnected macroporous structure and exhibits tunable mechanical properties with varying Laponite concentration. The nanoengineered sponge is endowed with tissue adhesion by intermolecular hydrogen bonds and ionic interactions contributed by the supramolecular polymer and the Laponite nanoclay. The biocompatible sponge facilitates cell proliferation and blood coagulation in both in vitro and in vivo experiments. In addition, the results of the rat external abdominal wall defect model show that the sponge can promote angiogenesis, collagen deposition, and granulation tissue formation to accelerate wound repair. These findings suggest that the unique air-in-water templated sponge is a promising candidate for applications in hemostasis and wound healing.