There is no effective and noninvasive solution for thrombolysis because the mechanism by which certain thrombi become tissue plasminogen activator (tPA)-resistant remains obscure. Endovascular thrombectomy is the last option for these tPA-resistant thrombi, thus a new noninvasive strategy is urgently needed. Through an examination of thrombi retrieved from stroke patients, we found that neutrophil extracellular traps (NETs), ε-(γ-glutamyl) lysine isopeptide bonds and fibrin scaffolds jointly comprise the key chain in tPA resistance. A theranostic platform is designed to combine sonodynamic and mechanical thrombolysis under the guidance of ultrasonic imaging. Breakdown of the key chain leads to a recanalization rate of more than 90% in male rat tPA-resistant occlusion model. Vascular reconstruction is observed one month after recanalization, during which there was no thrombosis recurrence. The system also demonstrates noninvasive theranostic capabilities in managing pigs’ long thrombi (>8 mm) and in revascularizing thrombosis-susceptible tissue-engineered vascular grafts, indicating its potential for clinical application. Overall, this noninvasive theranostic platform provides a new strategy for treating tPA-resistant thrombi. There is no noninvasive solution for tPAresistant thrombi as the mechanism remains obscure. Here, the authors show a constructed ultrasound-responsive theranostic platform for real-time monitoring and efficient thrombolysis by breaking the keychain in tPA-resistant thrombi.

During myocardial infarction, microcirculation disturbance in the ischemic area can cause necrosis and formation of fibrotic tissue, potentially leading to malignant arrhythmia and myocardial remodeling. Here, we report a microchanneled hydrogel suture for two-way signal communication, pumping drugs on demand, and cardiac repair. After myocardial infarction, our hydrogel suture monitors abnormal electrocardiogram through the mobile device and triggers nitric oxide on demand via the hydrogel sutures’ microchannels, thereby inhibiting inflammation, promoting microvascular remodeling, and improving the left ventricular ejection fraction in rats and minipigs by more than 60% and 50%, respectively. This work proposes a suture for bidirectional communication that acts as a cardio-patch to repair myocardial infarction, that remotely monitors the heart, and can deliver drugs on demand.

Topic: 33. Bleeding disorders (congenital and acquired) Background: When the femoral vein dialysis tube is placed in hematology patients, blood vessel injury will occur due to the thick catheter or low platelet, and even complications such as hematoma, infection and skin swelling will occur. Therefore, effective hemostasis is a crucial step in postoperative nursing. Absorbent gelatin sponge can stop bleeding locally, and at the same time, it can be given local pressure and cold compress immediately. Elastic bandage has good hemostasis effect by elastically pressing the bleeding site, which is a common hemostasis nursing method. Aims: To explore the application effect of two ways to prevent severe oozing at the puncture point of femoral vein dialysis tube in patients with hematological diseases. Methods: From January 2022 to January 2013, 10 patients with persistent severe oozing were selected from the patients who underwent femoral vein dialysis tube implantation in our hospital, and the oozing time was observed and recorded. The patients were divided into control group and observation group in turn according to the recording order, with 5 cases in each group. The control group used gauze dressing+transparent dressing+external application of ice to stop bleeding, while the observation group used absorbent gelatin sponge+transparent dressing+elastic bandage+external application of ice to stop bleeding. The blood leakage at the puncture point of femoral vein dialysis tube within one day, the times of unplanned change of application were observed, and the bleeding duration and treatment efficiency of the two groups were compared. Results: The number of dressing changes per day (1-2 times), blood leakage at puncture point (about 10ml) and bleeding duration (2-3 days) in the observation group were less than those in the control group (P<0.1), and the effective rate of hemostasis treatment in the observation group was better than that in the control group. Summary/Conclusion: The special nursing care of absorbent gelatin sponge+transparent dressing+elastic bandage+external application of ice cubes can reduce the number of dressing changes for severe bleeding at the puncture point of deep vein catheterization in hemodialysis patients in hematology department, reduce the amount of bleeding, shorten the duration of bleeding and improve the treatment efficiency. Keywords: Hematological malignancy