Smart Polycationic Hydrogel Dressing for Dynamic Wound Healing.

It is challenging for traditional wound dressings to adapt to the complex and changeable environment, due to the lack of stable, efficient, and continuous bactericidal activity. They also cannot be satisfied in a multifunctional sensing platform to reconstruct skin sensory functions for human health monitoring. A multifunctional hydrogel dressing is developed here for the treatment of infected wounds and human health monitoring, which is based on alginate and polycation. The in situ polymerization and solvent displacement method are used to functionalize the hydrogel for the improvement of antifreezing, water retention, and environmental adaptability, as well as the adhesion and photothermal property. As a wound dressing, the as-prepared hydrogel exhibits an excellent antibacterial property against both Escherichia coli and Staphylococcus aureus. In a rat model of full-thickness wound infection, it significantly accelerates the healing of infected wounds with a high healing rate of 96.49%. In the further multifunctional sensory tests, the hydrogel shows multiple response modes of strain, pressure and temperature, and sensing stability. An idea is provided here to develop a smart hydrogel dressing that can accelerate wound healing and achieve human health monitoring.

The correlation between albumin-corrected anion gap and prognosis in patients with acute myocardial infarction.

AIMS: Acute myocardial infarction (AMI) is a cardiovascular disease with high morbidity and mortality. We collected patients with AMI from the Medical Information Mart for Intensive Care IV (v2.0) database and explored the association between serum albumin-corrected anion gap (ACAG) level and mortality in patients with AMI. METHODS AND RESULTS: Data of adult patients with AMI were collected. According to the 360 day prognosis, patients were divided into survival and non-survival groups. Based on the ACAG level, patients were then divided into normal and high ACAG groups. Cox hazard proportional models and restricted cubic splines (RCSs) were used to investigate the correlation between ACAG and mortality. Kaplan-Meier curves were created to compare the cumulative survival rates between the high and normal ACAG groups. The receiver operating characteristic (ROC) curve was used to analyse the predictive value of ACAG for the prognosis of patients with AMI. Sensitivity and subgroup analyses were conducted to revalidate the results. Finally, 1783 patients were included. Elevated ACAG (>20 mmol/L) was significantly associated with 30 and 360 day mortality (P < 0.001). Adjusted for multiple confounding factors, the Cox proportional hazard analysis showed that elevated ACAG (>20 mmol/L) was an independent risk factor of increased all-cause mortality in patients with AMI (hazard ratio 1.423, 95% confidence interval 1.206-1.678, P < 0.001). RCS analysis further showed that there was a non-linear trend relationship between ACAG and the risk of all-cause mortality at 30 and 360 days (χ2 = 10.750, P = 0.013; χ2 = 13.960, P = 0.003). Kaplan-Meier survival curves showed that the 30 and 360 day cumulative survival rates of patients with AMI were significantly lower (log-rank test, χ2 = 98.880, P < 0.001; χ2 = 105.440, P < 0.001) in the high ACAG group. ROC curve analysis showed that the area under the curve (AUC) of ACAG was 0.651, while the AUC of anion gap (AG) was 0.609, indicating that ACAG had a higher predictive value for 360 day mortality than AG. When combined with Sequential Organ Failure Assessment score, the predictive performance of ACAG for 360 day mortality was better, with an AUC of 0.699. Sensitivity and subgroup analyses were conducted suggesting the stability of our results. CONCLUSIONS: Elevated serum ACAG (≥20 mmol/L) is an independent risk factor for short-term and long-term mortality in critically ill patients with AMI, and it may assist clinicians and nurses identifying high-risk patients.

Freeze-resistant, rapidly polymerizable, ionic conductive hydrogel induced by Deep Eutectic Solvent (DES) after lignocellulose pretreatment for flexible sensors.

In this paper, ternary DES (choline chloride, glycerol, Lewis acid) was used to pretreat lignocellulose, and the DES solution with dissolved lignin was utilized as the medium of hydrogel to prepare DES-based polyacrylic acid/polyvinyl alcohol (PAA/PVA) double network hydrogels with great mechanical properties, self-adhesion, and high electrochemical sensitivity. The entanglement of PAA with PVA chains, the covalent linkage between Al3+ and PAA chains and the metal phenol network (MPN) formed by Al3+ and lignin improved the mechanical properties of the hydrogels, enabling the prepared hydrogels to achieve a tensile strain of 400 % and an elongation at break of 150 kPa. Secondly, the introduction of DES solution endowed the hydrogel with excellent electrical sensing ability and anti-freezing property, so that the hydrogel still maintains good flexibility and ionic conductivity at -20 °C. It was also found that the above hydrogel can achieve a high gauge factor of 4.19 as a flexible sensor, which provides scientific ideas for the application of the pretreated DES solution in the field of flexible wearable.

Injectable In Situ Photocrosslinked Hydrogel Dressing for Infected Wound Healing.

A traditional injectable photocrosslinked hydrogel had disadvantages of the residual photoinitiator and toxic crosslinker, slow in situ curing, and a complex preparation process. At the same time, hydrogels cannot act as artificial skin to restore skin sensory function during the wound healing cycle. In this work, an injectable photocrosslinked hydrogel was prepared which can be quickly in situ cured without photoinitiator. Oxidized sodium alginate was used as a natural macromolecular crosslinking agent to form an injectable hydrogel framework with the photosensitive polymer polyvinyl alcohol bearing styrylpyridinium group (PVA-SBQ). In addition, the hydrogel was endowed with photothermal therapy property after the introduction of biomass-like polydopamine particles. When used as a wound dressing, the hydrogel exhibited an excellent antibacterial property, with an antibacterial rate of 99.56% Escherichia coli and 97.96% Staphylococcus aureus. As a result, the hydrogel could significantly accelerate the repair of infected wounds, with a wound healing rate of 96.45% after 14 days. Moreover, the hydrogel exhibited a sensitive and stable sensing property, making it promising to reconstitute the sensory function of damaged skin during treatment. This work provides an idea for the development of injectable photocrosslinked hydrogel dressing.

Targeting polysaccharides such as chitosan, cellulose, alginate and starch for designing hemostatic dressings.

Unfortunately hemorrhage and its complications (e.g. anemia, organ failure, and hypothermia) induced by traumatic injury, surgery, and disorders of bleeding play an all too familiar role in human morbidity and mortality. Therefore, it is difficult to overstate the importance of better understanding the role of polysaccharides in advanced hemostatic dressings (HDs). This review includes consideration of polysaccharide hemostatic dressing mechanism of action, relative efficacy, cost and safety. Polysaccharide-based HDs are widely used in management not only of external and internal bleeding but also of massive hemorrhage. These polysaccharide-based HDs have been shown to be effective in both compressible and non-compressible hemorrhage. Hemostatic dressings are designed with different principles depending on location and extent of injury. This review focuses on polysaccharide HD design and associated hemostatic mechanisms. It addresses current issues, challenges, and future perspectives.

Baicalin inhibits the TGF-ß1/p-Smad3 pathway to suppress epithelial-mesenchymal transition-induced metastasis in breast cancer.

TGF-ß1 is an epithelial-mesenchymal transition (EMT)-inducing factor that is critical in tumor progression. However, whether the effect of TGF-ß1 on breast cancer is through the EMT pathway remains to be determined, and drug development based on this mechanism needs to be improved. Results of this study showed that TGF-ß1 dysregulation significantly correlated with the expression levels of EMT-associated markers and transcriptional factors. Exogenous expression of TGF-ß1 promoted breast cancer cell metastasis and EMT progression. In addition, direct binding of baicalin to TGF-ß1 caused its inactivation, which subsequently blocked signal transduction and inhibited breast cancer cell metastasis. In vivo experiment results further invalidated the inhibitory effect of baicalin on TGF-ß1-induced tumor metastasis. These results suggest that baicalin, an active ingredient used in traditional Chinese medicine, exhibits a potential therapeutic effect on breast cancer metastasis by regulating TGF-ß1-dependent EMT progression.

Development of adult worms and granulomatous pathology are collectively regulated by T- and B-cells in mice infected with Schistosoma japonicum.

Schistosoma blood flukes, which cause schistosomiasis affecting 200 million people in the world, are dependent on signals from host CD4(+) T cells to facilitate parasite growth and development in the mammalian host and to induce Th2-biased inflammatory granulomas. B cells, however, are reported to down-regulate granulomatous pathology in schistosomiasis, but not to affect the development of blood flukes together with CD4(+) T lymphocytes. Thus it is not clear whether B cells mediate parasite development, reproduction and egg granuloma formation of schistosomes without the help of CD4(+) T lymphocytes. Using mice that have severe combined immunodeficiency (scid) and mice lacking T cells (nude), we found that the absence of B cells can more seriously hamper the development and paring of adult worms, but granuloma formation of Schistosoma japonicum in scid mice was not down-regulated comparing with that in nude mice. The level of IL-10 in the sera of nude mice was significantly higher than of scid mice at 43 days post infection (p.i.). Thus multiple mechanisms of immune modulation seem to be involved in parasite development and reproduction by helminth-induced regulatory B cells. Our findings have significance for understanding the molecular connections between schistosomes and T- and B-cells, indicating that more research is needed to develop efficient vaccine-based therapies for schistosomiasis.