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Patients with open abdominal (OA) wounds have a mortality risk of up to 30%, and the resulting disabilities would have profound effects on patients. Here, we present a novel double-sided adhesive tape developed for the management of OA wounds. The tape features an asymmetrical structure and employs an acellular dermal matrix (ADM) with asymmetric wettability as a scaffold. It is constructed by integrating a tissue-adhesive hydrogel composed of polydopamine (pDA), quaternary ammonium chitosan (QCS), and acrylic acid cross-linking onto the bottom side of the ADM. Following surface modification with pDA, the ADM would exhibit characteristics resistant to bacterial adhesion. Furthermore, the presence of a developed hydrogel ensures that the tape not only possesses tissue adhesiveness and noninvasive peelability but also effectively mitigates damage caused by oxidative stress. Besides, the ADM inherits the strength of the skin, imparting high burst pressure tolerance to the tape. Based on these remarkable attributes, we demonstrate that this double-sided (D-S) tape facilitates the repair of OA wounds, mitigates damage to exposed intestinal tubes, and reduces the risk of intestinal fistulae and complications. Additionally, the D-S tape is equally applicable to treating other abdominal injuries, such as gastric perforations. It effectively seals the perforation, promotes injury repair, and prevents the formation of postoperative adhesions. These notable features indicate that the presented double-sided tape holds significant potential value in the biomedical field.

Inflammatory bowel disease (IBD) is a chronic disorder that affects millions of individuals worldwide. However, current drug therapies for IBD are plagued by significant side effects, low efficacy, and poor patient compliance. Consequently, there is an urgent need for novel therapeutic approaches to alleviate IBD. Hydrogels, three-dimensional networks of hydrophilic polymers with the ability to swell and retain water, have emerged as promising materials for drug delivery in the treatment of IBD due to their biocompatibility, tunability, and responsiveness to various stimuli. In this review, we summarize recent advancements in hydrogel-based drug delivery systems for the treatment of IBD. We first identify three pathophysiological alterations that need to be addressed in the current treatment of IBD: damage to the intestinal mucosal barrier, dysbiosis of intestinal flora, and activation of inflammatory signaling pathways leading to disequilibrium within the intestines. Subsequently, we discuss in depth the processes required to prepare hydrogel drug delivery systems, from the selection of hydrogel materials, types of drugs to be loaded, methods of drug loading and drug release mechanisms to key points in the preparation of hydrogel drug delivery systems. Additionally, we highlight the progress and impact of the hydrogel-based drug delivery system in IBD treatment through regulation of physical barrier immune responses, promotion of mucosal repair, and improvement of gut microbiota. In conclusion, we analyze the challenges of hydrogel-based drug delivery systems in clinical applications for IBD treatment, and propose potential solutions from our perspective.

ABSTRACTIntroductionIntestinal fibrosis is a common complication of Inflammatory Bowel Disease (IBD) with no available drugs. The current therapeutic principle is surgical intervention as the core. Intestinal macrophages contribute to both the progression of inflammation and fibrosis. Understanding the role of macrophages in the intestinal microenvironment could bring new hope for fibrosis prevention or even reversal.Areas coveredThis article reviewed the most relevant reports on macrophage in the field of intestinal fibrosis. The authors discussed current opinions about how intestinal macrophages function and interact with surrounding mediators during inflammation resolution and fibrostenotic IBD. Based on biological mechanisms findings, authors summarized related clinical trial outcomes.Expert opinionThe plasticity of intestinal macrophages allows them to undergo dramatic alterations in their phenotypes or functions when exposed to gastrointestinal environmental stimuli. They exhibit distinct metabolic characteristics, secrete various cytokines, express unique surface markers, and transmit different signals. Nevertheless, the specific mechanism through which the intestinal macrophages contribute to intestinal fibrosis remains unclear. It should further elucidate a novel therapeutic approach by targeting macrophages, especially distinct mechanisms in specific subgroups of macrophages involved in the progression of fibrogenesis in IBD.

• 4D printing shape-morphing materials include shape-memory polymers, shape-memory alloys, liquid crystal elastomers, and hydrogels. • A whole picture of 4D printing technology is painted from an application perspective. • General obstacles of 4D printing technology in large-scale applications are summarized. Four-dimensional (4D) printing technology is an extension of three-dimensional (3D) printing technology that enables a 3D-printed static structure to dynamically change its shape with time. Therefore, the resulting structure can undergo self-folding/unfolding assisted by some stimuli. This technology has made much initial progress in many industrial fields. Aiming to investigate the in-depth application value of 4D printing, this study reviews the recent research and application breakthroughs of 4D printing in several emerging directions, including the simulation of plant and animal behaviors, smart tissue scaffolds and biomedical devices, food printing, digitalization of industrial art design, renewable energy, intelligent communication, soft electronics and robots, vehicle optimization, textile customization, and flexible machinery and mechanical structure. Based on the analyses of specific cases and processes, we present the current obstacles to large-scale applications and the future prospects. [Display omitted] [ABSTRACT FROM AUTHOR]

The mechanical forces of hydrogel dressing on skin can rebuild wound shapes, but the underlying mechanobiological functions were elusive. Recent studies conducted by Aragona et al. and Hu et al. revealed that hydrogel-induced skin stretch was beneficial to wound healing because it initiated the remodeling of cytoskeleton, promoted the epidermal stem cell renewal, and regulated the damage-associated inflammation. To fabricate such a wound-contractible hydrogel dressing, the shape-deformation and tissue-adhesion strategies should be highlighted.

Herein, we report the synthesis of a biomimic hydrogel adhesive that addresses the poor healing of surgical anastomosis. Dopamine-conjugated xanthan gum (Da-g-Xan) is fabricated using deep insights into the molecular similarity between mussels' adhesive and dopamine as well as the structural similarity between barnacle cement proteins and xanthan gum. The hydrogel mimics marine animals’ adherence to wet tissue surfaces. Upon applying this adhesive to colonic anastomosis in a rat model, protective effects were shown by significantly improving the bursting pressure. Mechanistically, the architecture of Da-g-Xan hydrogel is maintained by dynamic intermolecular hydrogen bonds that allow the quick release of Da-g-Xan. The free Da-g-Xan can regulate the inflammatory status and induce type 2 macrophage polarization (M2) by specifically interacting with mannose receptors (CD206) revealed by RNA-sequencing and molecular binding assays. Consequently, an appropriate microenvironment for tissue healing is created by the secretion of chemokines and growth factors from M2 macrophages, strengthening the fibroblast migration and proliferation, collagen synthesis and epithelial vascularization. Overall, this study demonstrates an unprecedented strategy for generating an adhesive by synergistic mimicry inspired by two marine animals, and the results show that the Da-g-Xan adhesive augments native tissue regenerative responses, thus enabling enhanced recovery following surgical anastomosis.

Enterocutaneous fistulas (ECFs) requiring admission to ICU is a serious surgical complication. A growing number of patients survive ECFs but remain chronically critically ill. The aim of our study was to investigate the risk factors of hospital death in patients with chronic critical illness attributed to ECFs. A retrospective single-center study was conducted in 163 ECF patients between 2013 and 2017. Patient-specific baseline characteristics, outcomes, and process of care variables were collected. Risk factors for hospital mortality were determined using univariate and multi-variate analyses. Patients were divided into the following two groups according to the hospital discharge outcome: group survivors (n = 106) and group nonsurvivors (n = 57). Patients who received active irrigation-suction drainage (AISD) within 24 hours after the diagnosis of ECFs had a significantly lower hospital mortality rate than those who received AISD after more than 24 hours (17.9% vs46.9%, P< 0.001). Multivariate logistic regression analysis demonstrated that delayed AISD (adjusted odds ratio [AOR], 10.24; 95% confidence interval [CI], 3.03234.59; P< 0.001) and no rehabilitation therapy (AOR, 4.77; 95% CI, 1.43215.98; P= 0.011) were independently associated with a greater risk of hospital mortality. The hospital mortality rate in patients with more than or equal to four risk factors was 92.6 per cent (n = 57), compared with a mortality rate of 9.4 per cent (n = 106) in patients who did not have these risk factors (P< 0.001). The risk of hospital death is exceptionally high among patients with chronic critical illness attributed to ECFs. Efforts aimed at early AISD and rehabilitation therapy are likely to be associated with improved clinical outcomes.

Hypomagnesemia is a significant risk factor for critically ill patients to develop sepsis, a life-threatening disease with a mortality rate over 25%. Our clinic data analysis showed that hypomagnesemia is associated with a decreased monocyte count in septic patients. At the cellular level, we found that Mg2+inhibits pyroptosis. Specifically, Mg2+limits the oligomerization and membrane localization of gasdermin D N-terminal (GSDMD-NT) upon the activation of either the canonical or noncanonical pyroptotic pathway. Mechanistically, we demonstrated that Ca2+influx is a prerequisite for the function of GSDMD-NT. Mg2+blocks Ca2+influx by inhibiting the ATP-gated Ca2+channel P2X7, thereby impeding the function of GSDMD-NT and inhibiting lipopolysaccharide (LPS)-induced noncanonical pyroptosis. Furthermore, Mg2+administration protects mice from LPS-induced lethal septic shock. Together, our data reveal the underlying mechanism of how Mg2+inhibits pyroptosis and suggest potential clinic applications of magnesium supplementation for sepsis prevention and treatment.

The problems of step effects, supporting material waste, and conflict between flexibility and toughness for 3D printed intestinal fistula stents are not yet resolved. Herein, the fabrication of a support‐free segmental stent with two types of thermoplastic polyurethane (TPU) using a homemade multi‐axis and multi‐material conformal printer guided with advanced whole model path planning is demonstrated. One type of TPU segment is soft to increase elasticity, and the other is used to achieve toughness. Owing to advancements in stent design and printing, the obtained stents present three unprecedented properties compared to previous three‐axis printed stents: i) Overcoming step effects; ii) Presenting comparable axial flexibility to a stent made of a single soft TPU 87A material, thus increasing the feasibility of implantation; and iii) Showing equivalent radial toughness to a stent made of a single hard TPU 95A material. Hence, the stent can resist the intestinal contractive force and maintain intestinal continuity and patency. Through implanting such stents to the rabbit intestinal fistula models, therapeutic mechanisms of reducing fistula output and improving nutritional states and intestinal flora abundance are revealed. Overall, this study develops a creative and versatile method to improve the poor quality and mechanical properties of medical stents. In this study, segmental intestinal stents, featuring on improved step effects, and optimized mechanical strength, are developed based on the whole model path planning‐guided multi‐axis and multi‐material printing for the treatment of enteroatmospheric fistula by simultaneously targeting diverse therapeutic mechanisms.

Stent Therapy The work in article 2301313by Jinjian Huang, Xiuwen Wu, Jianan Ren, Zongan Li, and co‐workers, develops a whole model path planning‐guided multi‐axis and multi‐material printing to produce segmental intestinal stents. The stents exhibit improved step effects and optimized mechanical strength, and can be used for the treatment of enteroatmospheric fistula by reducing fistula output and maintaining gut microbiota diversity.

Wound healing is one of the most important and basic issues faced by the medical community. In this paper, we present biomass-composited inverse opal particles with a series of advanced features for drug delivery and wound healing. The particles were derived by using chitosan biomass to negatively replicate spherical colloid crystal templates. Because of the interconnected porous structures, various forms of active drugs, including fibroblast growth factor could be loaded into the void spaces of the inverse opal particles and encapsulated by temperature-responsive hydrogel. This endowed the composited particles with the capability of intelligent drug release through the relatively high temperature caused by the inflammation reaction at wound sites. Because the structural colors and characteristic reflection peaks of the composited inverse opal particles are blue-shifted during the release process, the drug delivery can be monitored in real time. It was demonstrated that the biomass-composited microcarriers were able to promote angiogenesis, collagen deposition, and granulation–tissue formation as well as reduce inflammation and thus significantly contributed to wound healing. These features point to the potential value of multifunctional biomass inverse opal particles in biomedicine.

Crohn's disease (CD) involves intensive immunologic responses to food antigens. Exclusive enteral nutrition (EEN) showed efficacy in inducing disease remission. However, relapse commonly occurred when normal diet was reintroduced. We aimed to investigate the food-specific IgG antibodies of CD, and clarify the effects of exclusion diet guided by food-specific antibodies on remission maintenance after EEN.

Vitamin MOF-laden microfibers with alginate shells and copper- or zinc-vitamin framework cores are controllably generated by using a coaxial capillary microfluidic spinning approach. The practical value of these MOF-laden hydrogel microfibers in improving tissue wound healing has also been explored based on the antibiosis and antioxidation of the controllably released vitamins, copper ions and zinc ions of the compound materials.

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The Krebs cycle-derived metabolite itaconate, whose production is catalyzed by immune response gene 1 (IRG1), has potential to link immunity and metabolism in activated macrophages through alkylation or competitive inhibition of target proteins. In support of this, our previous study demonstrated that the stimulator of interferon genes (STING) signaling platform functions as a hub in macrophage immunity and has a profound impact on the prognosis of sepsis. Interestingly, we find that itaconate, an endogenous immunomodulator, can significantly inhibit the activation of STING signaling. Moreover, 4-octyl itaconate (4-OI), which is a permeable itaconate derivative, can alkylate cysteine sites 65, 71, 88, and 147 of STING, thereby inhibiting its phosphorylation. Furthermore, itaconate and 4-OI inhibit the production of inflammatory factors in sepsis models. Our results broaden the knowledge on the role of the IRG1-itaconate axis in immunomodulation and highlight itaconate and its derivatives as potential therapeutic agents in sepsis.

AbstractBackground: Monocyte subsets and monocyte–platelet aggregates (MPAs) play important roles in inflammation. Aim: To evaluate the association between the three human monocyte subsets and their contributions to MPAs and mortality among septic patients. Methods: Consecutive septic patients were enrolled in. Age- and gender-matched nonseptic patients were recruited as control patients. Monocyte subsets and monocyte–platelet aggregates were determined by flow cytometric analysis. Results: Elevated percentage of MPAs (MPAs%) was associated with an increased risk of mortality. Conclusions: This study demonstrated increased MPAs% enables the identification of a group of septic patients at high risk of death.

Increasing evidence demonstrates that mammals have different reactions to hypoxia with varied oxygen dynamic patterns. It takes ∼24 h for tri-gas incubator to achieve steady cell hypoxia, which fails to recapitulate ultrafast oxygen dynamics of intestinal ischemia/reperfusion (IR) injury. Inspired from the structure of native intestinal villi, we engineered an intestinal organoid chip embedded with engineered artificial microvessels based on co-axial microfluidic technology by using pH-responsive ZIF-8/sodium alginate scaffold. The chip was featured on: (i) eight times the oxygen exchange efficiency compared with the conventional device, tri-gas incubator, (ii) implantation of intestinal organoid reproducing all types of intestinal epithelial cells, and (iii) bio-responsiveness to hypoxia and reoxygenation (HR) by presenting metabolism disorder, inflammatory reaction, and cell apoptosis. Strikingly, it was found for the first time that Olfactomedin 4 (Olfm4) was the most significantly down-regulated gene under a rapid HR condition by sequencing the RNA from the organoids. Mechanistically, OLFM4 played protective functions on HR-induced cell inflammation and tissue damage by inhibiting the NF-kappa B signaling activation, thus it could be used as a therapeutic target. Altogether, this study overcomes the issue of mismatched oxygen dynamics between in vitroand in vivo, and sets an example of next-generation multisystem-interactive organoid chip for finding precise therapeutic targets of IR injury.

Wound healing is a significant problem in clinical management. Various functional dressings are studied to promote wound healing through biochemical factors. They are generally expensive, complex to fabricate, and may adversely affect the wound. Mechanical forces are the critical regulators of tissue repair. Although contraction is shown to promote wound healing, the underlying mechanisms are not fully understood. In this study, a novel adhesive temperature‐sensitive mechanically active hydrogel with a simple and inexpensive preparation process is developed. The dressing is able to adhere to the wound surface and actively contract the wound in response to body temperature. This mechanical contraction enhances the proliferative activity of basal cells, reduces the inflammatory response of the wound, and promotes wound healing. Furthermore, RNA‐seq clarifies how the gene regulatory network is regulated by contraction. Finally, using pharmacological inhibitors, YAP and MEK are identified as the key signaling molecules for contraction‐mediated tissue healing in vivo. A novel viscous temperature‐sensitive mechanoactive hydrogel is designed, optimized, and characterized. Mechanical contraction is capable of promoting wound healing by enhancing the proliferative activity of basal cells. The typical mechanically stimulated transducers (YAP and MEK) are indispensable in the mechanical contraction‐mediated wound healing process.

Microcirculatory changes and coagulation disturbances are thought to play a key role in sepsis. Some evidence suggests that the percentage of reticulated platelets (RP) may be a valuable and cost-effective sepsis screening parameter. This was a prospective study in surgical patients to investigate the potential value of RP as a predictor of mortality in septic shock patients.

Acute lower gastrointestinal bleeding (ALGIB) is a rare but potentially life-threatening complication of Crohn disease (CD). Thus far, few studies of ALGIB in the context of CD have been published, most of which were case reports with limited value. We aimed to explore the prevalence of ALGIB in CD patients, evaluate risk factors for hemorrhagic CD and its recurrence, and analyze clinical data of the death cases.

This study was designed to investigate the risk factors affecting glue-assisted closure (GAC) in the enterocutaneous fistula (ECF) patients receiving glue application.

To examine the efficiency of exclusive enteral nutrition (EEN) in relieving inflammatory bowel stricture in patients with Crohn’s disease (CD).

Regional epidemiological data and resistance profiles are essential for selecting appropriate antibiotic therapy for intra-abdominal infections (IAIs). However, such information may not be readily available in many areas of Asia and current international guidelines on antibiotic therapy for IAIs are for Western countries, with the most recent guidance for the Asian region dating from 2007. Therefore, the Asian Consensus Taskforce on Complicated Intra-Abdominal Infections (ACT-cIAI) was convened to develop updated recommendations for antibiotic management of complicated IAIs (cIAIs) in Asia. This review article is based on a thorough literature review of Asian and international publications related to clinical management, epidemiology, microbiology, and bacterial resistance patterns in cIAIs, combined with the expert consensus of the Taskforce members. The microbiological profiles of IAIs in the Asian region are outlined and compared with Western data, and the latest available data on antimicrobial resistance in key pathogens causing IAIs in Asia is presented. From this information, antimicrobial therapies suitable for treating cIAIs in patients in Asian settings are proposed in the hope that guidance relevant to Asian practices will prove beneficial to local physicians managing IAIs.

The use of open abdomen in the management of gastrointestinal fistula complicated with severe intra-abdominal infection is uncommon. This study was designed to evaluate outcomes of our staged approach for the infected open abdomen. Patients who had gastrointestinal fistula and underwent open abdomen treatment were retrospectively reviewed. Various materials such as polypropylene mesh and a modified sandwich package were used to achieve temporary abdominal closure followed by skin grafting when the granulation bed matured. A delayed definitive operation was performed for final abdominal closure without implant of prosthetic mesh. Between 1999 and 2009, 56 (68.3%) of 82 patients survived through this treatment. Among them, 42 patients achieved final abdominal closure. Spontaneous fistula closure occurred in 16 patients with secondary fistula recorded in six patients. Besides, wound complications occurred in 13 patients with two cases for pulmonary infection. Within a 12-month follow-up period after definitive closure, no additional fistula was recorded excluding planned ventral hernia repair. Open abdomen treatment was effective for gastrointestinal fistula complicated by severe intra-abdominal infection. A delayed and deliberate operative strategy aiming at fistula excision and fascial closure, with simultaneous abdominal wall reconstruction, was required for the infected open abdomen.

Persistent inflammation-immunosuppression catabolism syndrome (PICS) is a newly proposed concept that has replaced late multiple-organ failure and prolongs surgical intensive care unit (ICU) duration. Enterocutaneous fistula (ECF) is one of the most challenging complications in the practice of surgery. However, no studies have been performed connecting PICS with ECF.

Numerous temporary abdominal closure (TAC) techniques have been described in treatment of the open abdomen. However, data confirming their role in the management of gastrointestinal fistula complicated with abdominal sepsis are limited. This retrospective study evaluated whether a modified sandwich-vacuum package (MSVP) improved fascial closure rate compared with the polypropylene mesh (PPM)–mediated method.

This study was designed to investigate the clinical features of nonthyroidal illness syndrome (NTIS) compared with euthyroid patients in Crohn’s disease (CD), to explore the etiology of NTIS in CD, to evaluate the clinical outcomes of NTIS patients, and to inspect the correlation of clinical variables and NTIS, and their ability of differentiating NTIS from euthyroid patients.

Objectives To explore effectiveness and safety of polyglycosides of Tripterygium wilfordii(GTW) and mesalazine (5-aminosalicylic acid [5-ASA]) in preventing postoperative clinical and endoscopic recurrence of Crohn’s disease.Methods In this prospective, single-centre, single-blind study, postoperative Crohn’s disease patients in remission were randomized to receive 1 mg/kg GTW daily, orally, or 4 g 5-ASA daily, orally, for 52 weeks. Patients underwent physical examinations, ileocolonoscopies and biochemical analyses at baseline and weeks 13, 26 and 52, or when clinical recurrence was suspected. Outcome measures were proportion of patients showing clinical or endoscopic recurrence at week 52, and changes in Rutgeerts’ and Crohn’s Disease Activity Index (CDAI) scores.Results Twenty-one patients were assigned to receive GTW and 18 to 5-ASA; two patients on GTW and one on 5-ASA were withdrawn. Clinical and endoscopic recurrences were less common in the GTW group (n= 4) versus the 5-ASA group (n= 9). There were improvements in Rutgeerts’ scores for those taking GTW. Mean between-group CDAI scores were similar. No serious adverse events were reported.Conclusion These findings indicate that GTW appears to be an effective, well-tolerated prophylactic regimen, superior to oral 5-ASA, for preventing clinical and endoscopic recurrence in postsurgical Crohn’s disease.

The optimal composition of fibrin sealant preparations is not known. We, therefore, sought to construct a series of sealants from autologous components and compare their functioning to Bioseal a commonly used sealant. Characteristics of the platelet-rich plasma, cryoprecipitate, and thrombin were determined and compared to commercial glue from composition, function, and microscopy aspects. The concentrations of platelets as well as fibronectin in autologous fibrin glues were significantly higher than those in commercial ones (P<0.001). Mechanical values (maximum amplitude and clot strength) obtained from thrombelastograph assays in two groups were not significantly different (P>0.05). A dense platelet surface and fibrin net structures could be observed in the autologous samples, whereas there were only sparse fibrin nets without cellular components in Bioseal. Characterization of autologous and Bioseal fibrin sealants and their performance do not have significant difference in biochemical and mechanical properties. The entirely autologous platelet-rich gel in the present study may get wide application in future practice after confirmation of its safety, efficiency, and economic benefits.

Despite recent advances in understanding the mechanisms of sepsis and abdominal compartment syndrome (ACS) and of improvements in their management, the mortality rates from these conditions remain high. Few studies have compared liver injuries in patients undergoing open and closed abdomen treatment. The aim of this study was to compare the effects of open versus conservative abdominal closure approaches upon liver function using a controlled and randomized model of intra-abdominal hypertension and sepsis in a rat model.

Temporary abdominal closure (TAC) is often performed after an open abdomen to prevent postoperative complications. Reducing the time of TAC and performing a skin grafting as early as possible would improve the outcome of open abdomen. This study was designed to evaluate the effects of different TAC materials and topically applied exogenous growth factors on the growth of granulation tissue covered on the wound areas after the open abdomen.

We investigated the therapeutic effects of parenteral fish oil (FO) on survival and fatty acid profile in plasma and erythrocyte membranes, T-lymphocyte subsets, and plasma cytokines in a rat model of sepsis. Adult male Sprague-Dawley rats were subjected to cecal ligation and puncture-induced sepsis. For recovery, central venous catheterization was performed 2 days before sepsis was induced. Rats were randomly assigned to receive normal saline (n = 20) or total parenteral nutrition (PN) containing a standard soybean oil emulsion (n = 20) or FO-supplemented TPN (n = 20) at the onset of sepsis for 5 days. In the control group, rats were challenged by sham operation and underwent appropriate control treatment (n = 10). Sepsis led to a high mortality and body weight loss compared with sham operation. Total PN supplemented with FO, but not without FO, improved the survival compared with normal saline. Furthermore, parenteral infusion of FO increased the concentrations of eicosapentaenoic acid and docosahexaenoic acid, as well as the ratio of (eicosapentaenoic acid + docosahexaenoic acid) to arachidonic acid both in plasma and erythrocyte membrane. In addition, FO-supplemented TPN improved the percentages of CD3+and CD3+CD4+T cells, as well as the CD4+/CD8+ratio in spleen. Meanwhile, the percentage of regulatory T cells (CD4+CD25+Foxp3+) among CD4+T cells was reduced by FO-supplemented TPN. Fish oil-supplemented TPN attenuated the production of high-mobility group box 1 and IL-10 in plasma. Moreover, parenteral FO decreased the bacterial loads in peritoneal lavage, blood, lung, and spleen. The present study suggests that FO-supplemented TPN initiated at the onset of sepsis improves survival, beneficially alters the lipids profile in plasma and erythrocyte membrane, modulates immune function, and regulates inflammatory response in a rat model.

It remains an extreme challenge in clinical practice to manage the enteroatmospheric fistula (EAF), which is a severer complication after abdominal opening. In current literature, several methods have been established, generally focusing on controlling fistula effluent and keeping the wound bed clean. However, the loss of enteric fistula effluent would potentially lead to a risk of the disturbance of internal environment and malnutrition.

Therapeutic vascularization appears to be an effective way of repairing abdominal wall defects. Attempts to implement this treatment tend to focus on the generation of featured drug carriers with the ability effectively to encapsulate the angiogenesis‐stimulating agents and control their release to maintain an appropriate concentration at the injured area. Here, a new type of composite microparticle (CM) composed of silk fibroin (SF) and hollow mesoporous silica nanocarriers (HMSNs) is presented for therapeutic agent delivery. The CMs are generated by drying microfluidic emulsion templates of HMSN‐dispersed SF solution. The resultant CMs have a distinctive micro‐nanostructure, in which two barriers control the drug release. The encapsulated HMSNs increase the drug‐carrying capacity of the CMs, and also form the first barrier via physical absorption. The microfluidic SF microparticles not only provide a shell with excellent monodispersity and biocompatibility but also form the second barrier via efficient encapsulation. Because of these superior properties of the CMs, the loaded drugs can be delivered with a satisfactory activity at the required rate, making them ideal for implementing therapeutic vascularization and repairing abdominal wall defects. Silk fibroin microparticles with hollow mesoporous silica nanocarrier encapsulationare generated by drying microfluidic emulsions. The composite microparticles have a distinctive micro‐nanostructure, and provide two barriers for controlling the drug release. After being sprayed onto a scaffold and implanted into a rat, the particles exhibit their potential value in abdominal wall repairing.

Endoscopic therapy is a valuable option for glue sealing in fistula patients with low-output volume to enable more complete filling of internal openings. However, no special endoscopes were designed and made for fistula tracts. This brief report concerns about the application of an autologous platelet-rich fibrin sealant through a refined fistula fiberscope. Symptoms achieved resolutions and the follow-up computed tomography scans revealed no intestinal fluid leakage. To our knowledge, this is the first report on this percutaneous endoscope-assisted glue procedure.

We investigated and compared the capacity of mean platelet volume (MPV) and other inflammatory markers in detecting Crohn’s disease (CD) activity and differentiating CD patients from healthy controls.