Biomedical dressings have been comprehensively explored for wound healing; however, the complicated manufacturing process and mono-function of the dressing remain critical challenges for further applications. Here, a versatile extrusion three-dimensional (3D) printing strategy to prepare MXene and spidroin-incorporated microneedle scaffolds with photothermal responsive and self-healing properties for promoting wound healing is proposed. Inspired by the cactus, the microneedle scaffold is composed of a top porous scaffold, and microneedles whose inverse opal (IO) photonic crystal (PC) structure and the ample space between the scaffold gaps endow the microneedle scaffold with high drug-carrying capacity. Furthermore, the excellent electrical and photothermal properties of MXene allow the microneedle scaffold to perform sensitive wound movement monitoring and controlled drug release under nearinfrared irradiation. Moreover, the extensive hydrogen bonding and Schiff base between the spidroin, polyurethane (PU), and aloe vera gel (avGel) molecules conferred high self-healing and mechanical performance to the microneedle scaffold. In vivo experiments with rat models of wounds have shown that drug-laden microneedle scaffolds under near-infrared (NIR) light can promote the recovery of full-skin wounds. These unique characteristics suggest that 3D-printed multifunctional microneedle scaffolds show great potential for applications in facilitating wound healing and will find widespread applications in wound management.
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ObjectivesPostoperative acute kidney injury (pAKI) is a serious complication of Stanford type A aortic dissection (TAAD) surgery, which is significantly associated with the inflammatory response. This study aimed to explore the relationship between blood count-derived inflammatory markers (BCDIMs) and pAKI and to construct a predictive model for pAKI.MethodsPatients who underwent TAAD surgery were obtained from our center and the Medical Information Mart for Intensive Care (MIMIC)-IV database. The differences in preoperative BCDIMs and clinical outcomes of patients with and without pAKI were analyzed. Logistic regression was used to construct predictive models based on preoperative BCDIMs or white cell counts (WCCs). The performance of the BCDIMs and WCCs models was evaluated and compared using the receiver operating characteristic (ROC) curve, area under the ROC curve (AUC), Hosmer–Lemeshow test, calibration plot, net reclassification index (NRI), integrated discrimination improvement index (IDI), and decision curve analysis (DCA). The Kaplan–Meier curves were applied to compare the survival rate between different groups.ResultsThe overall incidence of pAKI in patients who underwent TAAD surgery from our center was 48.63% (124/255). The presence of pAKI was associated with longer ventilation time, higher incidence of cerebral complications and postoperative hepatic dysfunction, and higher in-hospital mortality. The results of the logistic regression indicated that the monocyte–lymphocyte ratio (MLR) was an independent risk factor for pAKI. The BCDIMs model had good discriminating ability, predictive ability, and clinical utility. In addition, the performance of the BCDIMs model was significantly better than that of the WCCs model. Analysis of data from the MIMIC-IV database validated that MLR was an independent risk factor for pAKI and had predictive value for pAKI. Finally, data from the MIMIC-IV database demonstrated that patients with a high MLR had a significantly poor 28-day survival rate when compared to patients with a low MLR.ConclusionOur study suggested that the MLR is an independent risk factor for pAKI. A predictive model based on BCDIMs had good discriminating ability, predictive ability, and clinical utility. Moreover, the performance of the BCDIMs model was significantly better than that of the WCCs model. Finally, a high MLR was significantly associated with poor short-term survival of patients who underwent TAAD surgery.
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