Anasarca as the first presentation of anti-synthetase syndrome.

A woman in her 70s presented with anasarca and exertional dyspnoea. Investigation showed severe hypoalbuminaemia with no urinary or gastrointestinal protein losses. CT thorax reported lung consolidations, and transbronchial lung biopsy demonstrated organising pneumonia. Autoimmune myositis serology was positive for anti-Jo-1, anti-Ro-52, and anti-PM/Scl-100 antibodies. She was diagnosed with anti-synthetase syndrome with organising pneumonia. She was treated with oral prednisolone and oral mycophenolate mofetil with a good clinical response.

Hyperbranched Polymer Induced Antibacterial Tree-Like Nanofibrous Membrane for High Effective Air Filtration.

The air filtration materials with high efficiency, low resistance, and extra antibacterial property are crucial for personal health protection. Herein, a tree-like polyvinylidene fluoride (PVDF) nanofibrous membrane with hierarchical structure (trunk fiber of 447 nm, branched fiber of 24.7 nm) and high filtration capacity is demonstrated. Specifically, 2-hydroxypropyl trimethyl ammonium chloride terminated hyperbranched polymer (HBP-HTC) with near-spherical three-dimensional molecular structure and adjustable terminal positive groups is synthesized as an additive for PVDF electrospinning to enhance the jet splitting and promote the formation of branched ultrafine nanofibers, achieving a coverage rate of branched nanofibers over 90% that is superior than small molecular quaternary ammonium salts. The branched nanofibers network enhances mechanical properties and filtration efficiency (99.995% for 0.26 µm sodium chloride particles) of the PVDF/HBP-HTC membrane, which demonstrates reduced pressure drop (122.4 Pa) and a quality factor up to 0.083 Pa-1 on a 40 µm-thick sample. More importantly, the numerous quaternary ammonium salt groups of HBP-HTC deliver excellent antibacterial properties to the PVDF membranes. Bacterial inhibitive rate of 99.9% against both S. aureus and E. coli is demonstrated in a membrane with 3.0 wt% HBP-HTC. This work provides a new strategy for development of high-efficiency and antibacterial protection products.

Removal characteristics of high concentration glyphosate in bioretention cells.

Glyphosate, as one of the most widely used pesticides, has been found in rainwater runoff. A bioretention cell with two types of fillers was constructed to explore removal of glyphosate in runoff an transformation of glyphosate in the filler. The type of filler had a significant impact on adsorption and degradation of glyphosate in the bioretention cell. The glyphosate removal efficiencies of coal cinder modified loess (CLB) and zeolite modified loess (ZLB) were 33.13-99.7% and 55.04-99.7%, respectively. Conversion of glyphosate in the bioretention cell occurred mainly in the upper layer of the filler. When the concentration of glyphosate in the runoff was 0.25 or 0.5 mg/L, the concentration of glyphosate degradation products at the two outlets along the way was as much as 26 times higher than that at the lowest outlet. Rainfall events promoted the migration of glyphosate and its degradation products within the filler. Glyphosate and its degradation products in ZLB were mainly distributed at 15 and 25 cm deep in the filler layer, while the highest concentrations in CLB were at 5 and 35 cm. Discontinuous runoff into the bioretention cell leads to continuous leaching and adsorption of glyphosate in the bioretention cell until complete degradation occurs.

Rotary Wind-driven Triboelectric Nanogenerator for Self-Powered Airflow Temperature Monitoring of Industrial Equipment.

Heat dissipation performance is crucial for the operational reliability of industrial equipment, which can be monitored by detecting the wind or airflow temperature of the radiator. The emergence of triboelectric nanogenerators (TENGs) provides new routes for wind energy harvesting and self-powered sensing. Herein, a rotary wind-driven triboelectric nanogenerator (RW-TENG) with soft-contact working mode is newly designed to achieve tunable contact areas by utilizing the reliable thermal response of NiTi shape memory alloy (SMA) to air/wind temperature. The RW-TENG can generate different triboelectric outputs under air stimulation with different speeds or temperatures, which is demonstrated as a power source for online monitoring sensors, self-powered wind speed sensing, and airflow temperature monitoring. Specifically, a self-powered sensor of wind speed is demonstrated with a sensitivity of 0.526 µA m-1 s between 2.2 and 19.6 m s-1, and a self-powered monitoring device of high airflow temperature, which show relatively short response time (109 s), strong anti-interference ability and outstanding long-term durability. This study introduces an innovative route for real-time detection of airflow temperature in wind-cooled industrial equipment, showing broad application prospects for information perception and intelligent sensing of the industrial IoTs.

Nitrogen removal performance of bioretention cells under polyethylene (PE) microplastic stress.

The use of bioretention cells as a stormwater control measure allows stormwater runoff to be collected and filtered, effectively removing microplastics and other pollutants from stormwater. This study investigated the effect of polyethylene microplastics (PE-MPs) retention on the bioretention cell, in terms of denitrification performance and microbial community structure. Four PE-MP exposures were compared at different concentrations of 0, 250, 500 and 1000 mg/L under alternating dry and wet period conditions. Results showed that the removal efficiency reduced by 14.99%, 28.37% and 18.59% with PE-MP concentrations of 250, 500 and 1000 mg/L. The NO3--N removal efficiency increased by 36.19%, 20.19% and 35.39%. After 8 days of dry conditions, the NO3--N removal efficiencies of the bioretention cells were reduced by 36.66%, 46.86% and 31.11% compared to those after 2 days of dry conditions. Microbial sequencing results indicated that the accumulation of PE-MPs changed the microbial community structure within the bioretention cell filler material, promoting the growth of bacteria such as Actinobacteria, Bacteroidetes and Firmicutes. Furthermore, PE-MPs reduced the relative abundance of nitrifying bacteria (e.g. Nitrospira) within the bioretention cell and promoted denitrifying bacteria (e.g. Dechloromonas and Hydrogenophaga), along with numerous other genera such as Azotobacter and Nocardia.

Breathable Metal-Organic Framework Enhanced Humidity-Responsive Nanofiber Actuator with Autonomous Triboelectric Perceptivity.

Autonomous object manipulation and perception with environmental factor-triggered and self-powered actuation is one of the most attractive directions for developing next-generation soft robotics with a smart human-machine-environment interface. Humidity, as a sustainable energy source ubiquitous in the surrounding environment, can be used for triggering smart grippers. In this work, it is proposed that by contacts between the gripper and objects upon humidity-induced actuation, real-time distinguishable triboelectric signals can be generated to realize the humidity-driven object manipulation and identification. Herein, a thermo-modified electrospun polyvinylpyrrolidone/poly(acrylic acid)/MIL-88A (T-PPM) nanofibrous film with micro-to-nano cross-scale porosity is developed, and a bilayer humidity-responsive actuator (T-HRA) was designed, mimicking the tamariskoid spikemoss to enhance the humidity-driven actuation. The breathing effect of MIL-88A and hierarchical porous structure of the T-PPM facilitate moisture diffusion and offer huge actuation (2.41 cm-1) with a fast response (0.084 cm-1 s-1). For autonomous object manipulation perception, T-PPM was verified as a tribo-positive material located between paper and silk. Accordingly, the T-HRA was demonstrated as a smart soft gripper that generates a different electric signal upon contact with objects of different material. This work proposes a concept of soft robots that are interactive with the environment for both autonomous object manipulation and information acquisition.

Performance evaluation of a low-cost loess-based filler for bioretention cells.

The sand and gravel fillers used in traditional bioretention cells are expensive and becoming increasingly scarce, and their performance is unstable. It is important to find a stable, reliable, and low-cost alternative filler for bioretention facilities. Using cement as a modified loess filler for bioretention cells is a low-cost and easily obtainable alternative. The loss rate and anti-scouring index of the cement-modified loess (CM) were analyzed under different curing times, cement addition amount, and compactness control conditions. This study found that the stability and strength of the cement-modified loess in water with a density of not less than 1.3 g/cm3, a curing time, of not less than 28 d and a cement addition amount not less than 10% meets the use requirements of the bioretention cell filler. X-ray diffraction and Fourier transform infrared spectroscopy of cement-modified materials with a 10% cement addition and a curing time of 28 days (CM28) and 56 days (CM56). Cement-modified materials with 2% straw and a curing time of 56 days (CS56) showed that the three kinds of modified loess all contain calcium carbonate and that the surface contains hydroxyl and amino functional groups that can effectively remove phosphorus. The specific surface areas of the CM56, CM28, and CS56 samples were 12.53 m2/g, 24.731 m2/g, and 26.252 m2/g, respectively, which are significantly higher than that of sand (0.791 m2/g). At the same time, the adsorption capacity of the ammonia nitrogen and the phosphate that was present in the three modified materials is better than that of sand. CM56, like sand, has rich microbial communities, which can entirely remove nitrate nitrogen in water under anaerobic conditions, indicating that CM56 can be used as an alternative filler for bioretention cells. The production of cement-modified loess is simple and cost-effective, and using modified loess as a filler can reduce the use of stone resources or other on-site materials. Current methods for improving the filler of bioretention cells are mainly based on sand. This experiment used loess to improve the filler. The performance of loess is better than sand, and can completely replace sand as the filler in bioretention cells.

Effects of inorganic ions with different concentrations on the nanofiltration separation performance of perfluorobutane sulfonic acid (PFBS).

Perfluorobutane sulfonic acid (PFBS) is a kind of anthropogenic recalcitrant contaminant that has posed a threat to drinking water safety and brought widespread public health concerns. Nanofiltration (NF) is an effective way to remove PFBS from drinking water, while the removal is influenced by coexisting ions. To investigate the effects and intrinsic mechanisms of coexisting ions on the rejection of PFBS, poly(piperazineamide) NF membrane was utilized in this work. Results showed that most cations and anions in the feedwater could effectively improve PFBS rejection and simultaneously reduce NF membrane permeability. In most cases, the decrease in NF membrane permeability corresponded to an increase in the valence of cations or anions. When cations (Na+, K+, Ca2+, and Mg2+) were present, the rejection of PFBS was effectively improved from 79% to more than 91.07%. Under these conditions, electrostatic exclusion was the dominant NF rejection mechanism. This was also the leading mechanism for 0.1 mmol/L Fe3+ coexisted condition. As the concentration of Fe3+ increased to 0.5-1 mmol/L, intensified hydrolyzation would accelerate the formation of the cake layers. The differences in the cake layer characteristics led to the different rejection trends of PFBS. For anions (SO42- and PO43-), both sieving effects and electrostatic exclusion were enhanced. As anionic concentration raised, the NF rejection of PFBS increased to above 90.15%. By contrast, the effect of Cl- on PFBS rejection was also affected by coexisting cations in the solution. The dominant NF rejection mechanism was electrostatic exclusion. Accordingly, it is suggested that the usage of negatively charged NF membranes could facilitate the efficient separation of PFBS under ionic coexisting conditions, thereby ensuring the safety of drinking water.

A supramolecular gel-elastomer system for soft iontronic adhesives.

Electroadhesion provides a promising route to augment robotic functionalities with continuous, astrictive, and reversible adhesion force. However, the lack of suitable conductive/dielectric materials and processing capabilities have impeded the integration of electroadhesive modules into soft robots requiring both mechanical compliance and robustness. We present herein an iontronic adhesive based on a dynamically crosslinked gel-elastomer system, including an ionic organohydrogel as adhesive electrodes and a resilient polyurethane with high electrostatic energy density as dielectric layers. Through supramolecular design and synthesis, the dual-material system exhibits cohesive heterolayer bonding and autonomous self-healing from damages. Iontronic soft grippers that seamlessly integrate actuation, adhesive prehension, and exteroceptive sensation are devised via additive manufacturing. The grippers can capture soft and deformable items, bear high payload under reduced voltage input, and rapidly release foreign objects in contrast to electroadhesives. Our materials and iontronic mechanisms pave the way for future advancement in adhesive-enhanced multifunctional soft devices.

Influence of double-layer filling structure on nitrogen removal and internal microbial distribution in bioretention cells.

The nitrogen removal effect of traditional bioretention cells on runoff rainwater is not stable. The nitrogen removal effect of bioretention cells can be improved by setting up a layered filling structure, but the effect of changes in filling structure on the nitrogen removal process and microbial community characteristics is still unclear. Two types of porosity fillers were set up in the experiment, and a homogeneous bioretention cell and three bioretention cells with layered fillers were constructed by changing the depth range of the upper and lower layers to analyze the influence of the pore variation of different depth fillers on the nitrogen removal process and microbial community characteristics. The experimental results showed that, compared with the homogeneous filing structure, the layered filling structure can strengthen the adsorption of NH4+-N and the conversion of NO3--N, so as to increase the removal rates of NH4+-N and NO3--N by 20.71-81.56% and 9.25%-78.19%, respectively. Although the low porosity filler structure will reduce the nitrification activity and urease activity by 48.63%-66.68% and 8.00%-20.64% respectively, it can increase the denitrification activity by 19.14%-31.92%, thus significantly reducing the nitrate content in the filler. The low porosity filler structure can affect the growth and reproduction of various phylum bacteria such as Proteobacteria, Chloroflexi, Acidobacteria, and genus bacteria such as Nitrospira, Ellin6067, Rhizobacter, Pseudomonas, which can improve the diversity and richness of microorganisms.

Nitrogen transfer and transformation in bioretention cells under low temperature conditions.

The nitrogen removal effect of traditional bioretention cells is generally poor under low temperature conditions, with significant levels of fluctuation and leaching often reported. Therefore, the migration characteristics of nitrogen were explored in bioretention cells under low temperature conditions, with the aim of improving the nitrogen removal effect. Four groups of modified collapsible loess bioretention cells were constructed and operated at 1, 5, 10 and 25 °C. The nitrogen removal effect of the cells was determined at different temperatures and the nitrogen migration and transformation characteristics under low temperature conditions were discussed. Experimental results showed that during the rainfall period, the ammonia nitrogen removal efficiency remained similar at different temperatures (above 97 %), while the nitrate nitrogen removal efficiency varied significantly at 1, 5, 10 and 25 °C, from 28.15 %-65.22 %, 96.68 %-98.8 %, 96.75 %-98.88 % and 80.14 %-96.72 %, respectively. In addition, nitrate nitrogen accumulation occurred in the filler during rainfall events, with lower temperature conditions increasing the final concentration of nitrate nitrogen accumulated. Following a rainfall event, the content of nitrate nitrogen in the filler decreased significantly over a 60 h dry period. However, the nitrate nitrogen reduction rate was significantly lower under low temperature conditions, than at 25 °C. Overall, low temperature conditions had a negative effect on the accumulation of nitrate nitrogen in the filler during rainfall events, as well as the transformation and migration of nitrate nitrogen within the filler during drought periods, with the adverse effects most significant at temperatures lower than 5 °C.

Silk fibroin fibers-based shape memory membrane with Janus wettability for multitiered wearable protection.

Realizing breathable shape memory fiber-based material with antibacterial and waterproof performances is important for multitiered wearable protection to address the increasing concerns of air pollution. Herein, using an alternating electrospinning-electrospraying technology, we develop a fiber-based membrane with Janus wettability based on a silk fibroin nanofibers-substrate (SFNFs), a polyurethane nanospheres-top layer (PUNSs), and a middle layer of PU nanofibers-mat with in-situ grown silver nanoparticles (PUNFs-AgNPs), which serves separately for skin contact, a self-cleaning physical barrier to resist external aerosol/bacteria (PM2.5 filtration efficiency ~ 98.1%), and a bio-barrier that can sterilize harmful particles and inhibit bacteria proliferation (> 95%). This breathable Janus film (SFNFs/PUNFs-AgNPs/PUNSs, SPAP) with an antibacterial filter shows shape memory stretchability enabled by the thermoplastic PU component, which is mechanically adaptive to human body for wearable protection. This work presents a breathable wearable material for air-filtration and anti-bacteria, promising for applications such as wound dressings, medical masks, protection suits, and multifunctional filters. Graphical abstract: An alternating electrospinning-electrospraying technology was proposed to achieve a silk fibroin-based antibacterial membrane with Janus wettability, as well as good skin affinity and breathability, which serves well as physical and bio-barriers for water resistance, PM2.5 filtration (~98.1%) and bacteria inhibition (efficiency of 95%). This shape memory Janus membrane can adapt mechanically to human body curvatures for functional wearable protections. Supplementary Information: The online version contains supplementary material available at 10.1557/s43578-022-00805-w.

Effects of freeze-thaw cycles on nutrient removal from bioretention cells.

There have been numerous summaries of the runoff purification characteristics of bioretention cells in warm climates. However, little has been done on the effects of freeze-thaw cycles (FTCs) that frequently occur in cold regions on bioretention cell performance. Three experimental columns were constructed to simulate the operation of the bioretention cell under the FTCs. The effects of FTCs on the nutrient removal efficiency of different filling bioretention cells were analyzed. The results showed that the ammonia nitrogen (NH4+-N) concentration in the effluent of the wood chip bioretention cell under the T3 conditions (WBCF) (2.35 mg/L) was significantly higher than that of the wood chip bioretention cell operating at room temperature (WBCR) (0.62 mg/L). The effluent NH4+-N concentration of aluminum sludge bioretention cell (ABCF) (0.096 mg/L) under the FTCs was lower than that of WBCF (0.91 mg/L). Under the T3 condition, the effluent nitrate nitrogen (NO3--N) and total nitrogen (TN) concentrations of WBCF (5.33 mg/L and 8.86 mg/L) were higher than those of WBCR (5 mg/L and 6.11 mg/L) at room temperature. Under FTCs conditions, both WBCF and ABCF had high NO3--N removal efficiency (up to 85.87% and 24.75%) at the initial stage of thawing of the filler, and the efficiency gradually decreased with the thawing of the filler. With the increase of FTCs, the NO3--N removal efficiency of WBCF gradually decreased (always higher than 13.6%), while the removal efficiency of ABCF fluctuated wildly (the removal efficiency was primarily negative). The total phosphorus (TP) concentration in the effluent of WBCF (0.11 mg/L) under the T3 conditions was lower than that of WBCR (0.02 mg/L) at room temperature, and the TP concentration of ABCF (0.021 mg/L) in the effluent under the FTCs was slightly lower than that of WBCF (0.031 mg/L). The FTCs have a more significant impact on removing nitrogen pollutants in runoff, but have little effect on phosphorus. Compared with aluminum sludge, wood chips are more suitable for efficient removal of nitrogen pollutants in runoff under the FTCs. The experimental conclusions can provide a reference for the construction of bioretention cells in cold regions.

Quercetin/Anti-PD-1 Antibody Combination Therapy Regulates the Gut Microbiota, Impacts Macrophage Immunity and Reshapes the Hepatocellular Carcinoma Tumor Microenvironment.

OBJECTIVE: The use of immune checkpoint inhibitors (ICIs) provides promising strategies for hepatocellular carcinoma (HCC) treatment. This study aimed to explore impact and underlying mechanism of the combination therapy of quercetin and anti-programmed cell death 1 (anti-PD-1) antibody on HCC. METHODS: Orthotopically transplanted HCC tumors in mice were treated with quercetin, anti-PD-1 antibody, or a combination of both therapies. Histopathological changes and programmed cell death ligand 1 (PD-L1) expression were characterized by hematoxylin and eosin (H&E) and immunohistochemistry (IHC) staining. The diversity and differences of gut microbiota (GM) were evaluated through 16S rRNA sequencing. Levels of macrophage immunity-related cytokines were quantified by enzyme-linked immunosorbent assay (ELISA), quantitative real-time polymerase chain reaction (RT-qPCR), and Western blot. RESULTS: Combination therapy reduced necrosis, fibrosis, and PD-L1 expression in liver tissues. Additionally, combination therapy reduced GM imbalance and increased abundance of Firmicutes, Actinobacteria, and Verrucomicrobiota at the phylum level as well as Dubosiella and Akkermansia at the genus level. Combination therapy improved macrophage immunity, raised the expressions of CD8a, CD4, CD11b, interleukin (IL)-10, and interferon (IFN)-γ , and declined the expressions of IL-4, IL-6, toll-like receptor 4 (TLR4), an inhibitor of nuclear factor κBα (IκBα), and the NFκB subunit p65. Upon combination therapy, expressions of M2 macrophage-related genes arginase-1 (Arg-1), IL-10, transforming growth factor-ß (TGF-ß), and matrix metalloproteinase-9 (MMP-9) were upregulated. Instead, M1 macrophage-related genes IL-6, IL-12a, IL-1ß, and tumor necrosis factor-α (TNF-α) were downregulated. CONCLUSIONS: Quercetin/anti-PD-1 antibody combination therapy reshaped HCC tumor microenvironment in mice in parallel with regulating the GM and macrophage immunity.

Elastic Fibers/Fabrics for Wearables and Bioelectronics.

Wearables and bioelectronics rely on breathable interface devices with bioaffinity, biocompatibility, and smart functionality for interactions between beings and things and the surrounding environment. Elastic fibers/fabrics with mechanical adaptivity to various deformations and complex substrates, are promising to act as fillers, carriers, substrates, dressings, and scaffolds in the construction of biointerfaces for the human body, skins, organs, and plants, realizing functions such as energy exchange, sensing, perception, augmented virtuality, health monitoring, disease diagnosis, and intervention therapy. This review summarizes and highlights the latest breakthroughs of elastic fibers/fabrics for wearables and bioelectronics, aiming to offer insights into elasticity mechanisms, production methods, and electrical components integration strategies with fibers/fabrics, presenting a profile of elastic fibers/fabrics for energy management, sensors, e-skins, thermal management, personal protection, wound healing, biosensing, and drug delivery. The trans-disciplinary application of elastic fibers/fabrics from wearables to biomedicine provides important inspiration for technology transplantation and function integration to adapt different application systems. As a discussion platform, here the main challenges and possible solutions in the field are proposed, hopefully can provide guidance for promoting the development of elastic e-textiles in consideration of the trade-off between mechanical/electrical performance, industrial-scale production, diverse environmental adaptivity, and multiscenario on-spot applications.

Assessment of plants radial oxygen loss for nutrients and organic matter removal in full-scale constructed wetlands treating municipal effluents.

Bidirectional cross flow wetlands with different plant species were set to investigate seasonal variation in radial oxygen loss (ROL) and its effects on COD and NH4+-N removal. Findings demonstrated a strong seasonal effect on the rate of ROL, with Arundo donax var.versicolor showing the highest ROL of 2.99 µmol·h-1·g-1. Additionally, ROL showed strong positive correlations with plant total biomass (P < 0.01), aboveground biomass (P < 0.01), height, maximum root length (P < 0.01), root porosity (P < 0.01), and removal efficiency of COD and NH4+-N (P < 0.01). Furthermore, high-throughput sequencing analysis of substrate samples from three wetland units planted with Thalia dealbata, Canna indica and Arundo donax var. versicolor revealedProteobacteria as the predominant rhizospheric phylum. Relative abundance of Alpha- and Gamma-Proteobacteria were higher in the Arundo donax var.versicolor samples due to its higher oxygen transport capacity. These results demonstrate that root properties are important determinants for selecting appropriate plants for constructed wetland.

Entropy-Mediated Polymer-Cluster Interactions Enable Dramatic Thermal Stiffening Hydrogels for Mechanoadaptive Smart Fabrics.

Thermal stiffening materials that are naturally soft but adaptively self-strengthen upon heat are intriguing for load-bearing and self-protection applications at elevated temperatures. However, to simultaneously achieve high modulus change amplitude and high mechanical strength at the stiffened state remains challenging. Herein, entropy-mediated polymer-mineral cluster interactions are exploited to afford thermal stiffening hydrogels with a record-high storage modulus enhancement of 13 000 times covering a super wide regime from 1.3 kPa to 17 MPa. Such a dramatic thermal stiffening effect is ascribed to the transition from liquid-liquid to solid-liquid phase separations, and at the molecular level, driven by enhanced polymer-cluster interactions. The hydrogel is further processed into sheath-core fibers and smart fabrics, which demonstrate self-strengthening and self-powered sensing properties by co-weaving another liquid metal fiber as both the joule heater and triboelectric layer.

Acute Flaccid Tetraparesis after COVID-19 Infection: Think of the Thyroid.

A previously well 32-year-old Chinese male presented with acute bilateral upper and lower limb paralysis upon waking, ten days after the onset of COVID-19 infection. Examination revealed areflexia over all four limbs, associated with reduced muscle strength, but no sensory or cranial nerve deficit. Initial concern was Guillain-Barre syndrome given the acute flaccid paralysis following COVID-19 infection. However, investigations revealed severe hypokalaemia (1.7 mmol/L) and primary hyperthyroidism. He was treated for thyrotoxic periodic paralysis (TPP) with ß-blockers, antithyroid medications, and intravenous potassium chloride (KCl). Despite frequent monitoring of potassium, rebound hyperkalaemia occurred with prompt resolution of paralysis.

Silk Fabric Decorated with Thermo-Sensitive Hydrogel for Sustained Release of Paracetamol.

Paracetamol is a safe and widely used antipyretic and analgesic drug, however, with the drawbacks of gastrointestinal first-pass effect and short intervals of administration. Transdermal drug delivery system can effectively avoid the liver metabolism caused by excess oral ingestion of paracetamol. Herein, a silk fabric-based medical dressing decorated by a thermo-responsive hydrogel for sustained release of paracetamol is proposed. Genipin as a bio-safe cross-linker is applied to assist gelation of a thermo-responsive hydrogel system coupled with chitosan and glycerol-phosphate disodium salt around body temperature (37 °C), as well as densifying the microporous gel to improve mechanical strength. The in situ sol-gel transition enabled hydrogel well penetrate and coat the silk fabric, forming a hierarchical hydrogel structure capable of prolonging the sustained release of drug to 12 h, twice as long as a blank fabric. The silk fabric with a thin gel coating maintains a good water vapor transmission rate, compatible for skin contact application. The drug release properties can be tuned by regulating the genipin content and fabric braiding structure. The silk fabric dressing exhibits temperature-dependent instant release behavior within the first 2 h. The sustained release mechanism of paracetamol well matches with the Korsmeyer-Peppas model in a non-Fickian diffusion.