Biomaterials for Hemostasis

Smart design in biopolymer-based hemostatic sponges: From hemostasis to multiple functions

Uncontrolled hemorrhage remains the leading cause of death in clinical and emergency care, posing a major threat to human life. To achieve effective bleeding control, many hemostatic materials have emerged. Among them, nature-derived biopolymers occupy an important position due to the excellent inherent biocompatibility, biodegradability and bioactivity. Additionally, sponges have been widely used in clinical and daily life because of their rapid blood absorption. Therefore, we provide the overview focusing on the latest advances and smart designs of biopolymer-based hemostatic sponge. Starting from the component, the applications of polysaccharide and polypeptide in hemostasis are systematically introduced, and the unique bioactivities such as antibacterial, antioxidant and immunomodulation are also concerned. From the perspective of sponge structure, different preparation processes can obtain unique physical properties and structures, which will affect the material properties such as hemostasis, antibacterial and tissue repair. Notably, as development frontier, the multi-functions of hemostatic materials is summarized, mainly including enhanced coagulation, antibacterial, avoiding tumor recurrence, promoting tissue repair, and hemorrhage monitoring. Finally, the challenges facing the development of biopolymer-based hemostatic sponges are emphasized, and future directions for in vivo biosafety, emerging materials, multiple application scenarios and translational research are proposed.

Fructose-Modified Chitosan/Gelatin 3D Composite Sponge for Enhanced Rapid Hemostasis

Managing uncontrolled and noncompressible bleeding presents a major challenge in emergency trauma care. Methods to halt bleeding quickly and efficiently, without applying direct pressure on the wound, have become a key focus of research. Herein, a novel fructose-modified chitosan/gelatin composite sponge has been developed, exhibiting high elasticity, low rebound pressure, and excellent cell compatibility. This material can rapidly return to its original form in around 1.5 s after being compressed by 80% upon contact with water. Additionally, experimental results from a rat liver wound model demonstrated that it exhibited a clear hemostatic effect. The hemostatic time was shortened from 204 ± 15.35 s to 53.3 ± 6.54 s, and the blood loss was reduced from 867 ± 153.15 mg to 187 ± 61.06 mg. Moreover, it can promote tissue healing by inhibiting the production of inflammatory factors including TNF-α, MCP-1, and IL-6. This material offers an effective solution for noncompressible tissue injuries.

Recent progress in polysaccharide microsphere-based hemostatic material for intravascular and extravascular hemostasis: A review

Hemorrhage, a common consequence of diseases, surgical procedures, and traffic accidents, poses a significant threat to public health. Effective hemostasis is crucial for patient survival and prognosis, particular in case of internal bleeding. While polysaccharide microsphere-based hemostatic materials have gained clinical acceptance due to their effectiveness, good biocompatibility, and versatility in both intravascular and extravascular hemostasis, they are limited by their single function and insufficient hemostatic properties. Recently, booming developments have been witnessed in microsphere-based biomaterials to achieve a combination therapy for hemostasis. This review first examines the fundamentals of coagulation process, hemostatic mechanisms, and microsphere fabrication techniques. We then discuss the latest investigations in functionalized microsphere-based hemostatic materials for controlling intravascular and extravascular hemorrhage, focusing on design strategies, hemostatic properties, and clinical implementation. Finally, we also propose some limitations and challenges of these hemostatic materials, aiming to provide valuable insights for future research in novel polysaccharide microsphere-based biomaterial.

Hemostasis Strategies and Recent Advances in Hydrogels for Managing Uncontrolled Hemorrhage

Hemorrhage continues to pose a significant challenge in various medical contexts, underscoring the need for advanced hemostatic materials. Hemostatic hydrogels have gained recognition as innovative tools for addressing uncontrollable bleeding, attributed to their distinctive features including biological compatibility, tunable mechanical properties, and exceptional hemostatic performance. This review provides a comprehensive overview of hemostatic hydrogels that offer rapid and effective bleeding control. Particularly, this review focuses on hemostatic hydrogel design and associated hemostatic mechanisms. Additionally, recent advancements in the application of these materials are discussed in detail, especially in clinical trials. Finally, the challenges and potential advancements of hemostatic hydrogels are analyzed and assessed. This review seeks to emphasize the role of hydrogels in biomedical applications for hemorrhage control and provide perspectives on the innovation of clinically applicable hemostatic materials.

Hemostatic Antimicrobial Hydrogels Based on Silicon, Iron, Zinc, and Boron Glycerolates for Wound Healing Applications

The use of glycerolates of biogenic elements as biocompatible precursors in sol-gel synthesis is an innovative direction and opens up new scientific and practical prospects in chemistry and technology of producing practically important biomedical materials, including hemostatic, antimicrobial, and wound healing materials. Using biocompatible precursors, silicon, zinc, boron, and iron glycerolates, new bioactive nanocomposite hydrogels were obtained by the sol-gel method. The composition and structural features of the hydrogels were studied using a complex of modern analytical techniques, including TEM, XRD, AES, and ESI MS. Hemostatic activity of the hydrogels was studied in the in vivo experiments; using the example of silicon-iron-zinc-boron glycerolates hydrogel, primary toxicological studies were carried out. Antimicrobial properties of hydrogels were studied using the agar diffusion method. The structural features of hydrogels and their relationship to medical and biological properties were revealed. It was shown that glycerolates hydrogels are non-toxic, and exhibit pronounced hemostatic activity, generally comparable to the commercial hemostatic drug Capramine. Antimicrobial activity is more pronounced for silicon-iron-zinc-boron and silicon-iron-boron glycerolates gel. The results obtained indicate that these glycerolates hydrogels are potential hemostatic and antibiotic-independent antimicrobial agents for topical wound healing applications in medical and veterinary practice.

Multifunctional injectable oxidized sodium alginate/carboxymethyl chitosan hydrogel for rapid hemostasis

Uncontrolled bleeding from incompressible or irregularly shaped wounds is a major factor in the death of people in the battlefield or surgery process. Ideal rapid hemostatic materials should have the performance of rapid hemostasis and at the same time can be applied to a variety of complex wound trauma types, in addition, excellent antimicrobial properties, adhesion, biocompatibility, degradation, and the non-toxicity of degradation products are also necessary, but there are fewer hemostatic materials that meet these requirements. Herein, we prepared an injectable hemostatic hydrogel based on the natural products sodium alginate (SA) and carboxymethyl chitosan (CMC). Oxidized sodium alginate (OSA) was prepared by the oxidation reaction of NaIO4 with SA, and OSA with aldehyde group was mixed with CMC with amino group to rapidly form an in situ injectable hemostatic hydrogel (OSA/CMC) by the Schiff base reaction. OSA/CMC hydrogel exhibited excellent antimicrobial and adhesion properties by the Schiff base reaction. In addition, OSA/CMC hydrogel directly activate the endogenous coagulation pathway through the synergistic effect of OSA, CMC to enhance the hemostatic effect. The results of in vivo hemostasis study showed that OSA/CMC hydrogel significantly accelerated hemostasis and reduced blood loss in liver hemorrhage model and tail amputation model. Therefore, OSA/CMC hydrogel is expected to be a potential material in the direction of rapid clinical hemostasis due to its good adhesion properties, antimicrobial properties, biocompatibility, blood compatibility, and efficient rapid hemostasis.

Rapid hemostatic covered stent with drug-loaded gelatin-alginate/PVDF Janus composite membrane for coronary artery perforation

The implantation of covered stents has significantly contributed much to the rescue treatment of coronary artery perforation (CAP). The ability to achieve rapid hemostasis in cases of severe coronary artery perforation using covered stents alone has so far been elusive. Here, we investigate a Janus composite covered stent for rapid hemostasis in CAP. The covered stent has the dual functions of sealing perforation and rapid hemostasis, which is suitable for the rescue of CAP. This achievement is realized by assembling the tough polyvinylidene fluoride (PVDF) membrane and the drug-loaded hemostatic coating, thereby amalgamating their distinct functionalities. The PVDF membrane served as a physical shield that prevented blood leakage and blocked procoagulant drugs from forming the thrombus in the vessel. Meanwhile, the drug-loaded hemostatic coating, when it came into contact with the perforation area, swiftly promoted coagulation. The in vitro cytocompatibility and coagulation property tests demonstrated excellent biocompatibility and hemostatic performance of the Janus composite covered stent. The approach is applicable across almost all sizes of common bare stents in clinical, which has great potential for the rescue of CAP.

Preparation strategies of mussel-inspired chitosan-based biomaterials for hemostasis

Chitosan (CS) has been extensively studied in wound care for its intrinsic hemostatic and antibacterial properties. However, CS has limiting hemostasis applications on account of its drawbacks such as poor adhesion in humid environments and water solubility at neutral pH. CS-based biomaterials, inspired by mussel-adhesive proteins, serve as a suggested platform by biomedical science. The reports show that the mussel-inspired CS-based hemostatic structure has negligible toxicity and excellent adhesiveness. Biomedicine has witnessed significant progress in the development of these hemostatic materials. This review summarizes the methods for the modification of CS by mussel-inspired chemistry. Moreover, the general method for preparation of mussel-inspired CS-based biomaterials is briefly discussed in this review. This work is expected to give a better understanding of opportunities and challenges of the mussel-inspired strategy for the functionalization of CS-based biomaterials in hemostasis and wound healing. This review is hoped to provide an important perspective on the preparation of mussel-inspired CS-based hemostatic materials.

Multifunctional Hydrogels Based on γ-Polyglutamic Acid/Polyethyleneimine for Hemostasis and Wound Healing

Current hemostatic materials have many shortcomings, such as biotoxicity or poor degradability, and do not effectively promote wound healing after hemostasis. To address these limitations, a hemostasis-promoting wound-healing hydrogel, polyglutamic acid/polyethyleneimine/montmorillonite (PPM), comprising polyglutamic acid, 3,4-dihydroxybenzaldehyde-modified polyethyleneimine, and amino-modified montmorillonite (montmorillonite-NH2) was constructed in this study. Due to the excellent water absorption abilities of γ-polyglutamic acid, the PPM and polyglutamic acid/polyethyleneimine hydrogels could rapidly absorb the blood and tissue fluid exuded from the wound to keep the wound clean and accelerate the blood coagulation. The homogeneous distribution of montmorillonite-NH2 enhanced not only the mechanical properties of the hydrogel but also its hemostatic properties. In addition, the modification of polyethylenimine with 3,4-dihydroxybenzaldehyde provided anti-inflammatory effects and endorsed the wound healing. Cellular and blood safety experiments demonstrated the biocompatibility of the PPM hydrogel, and animal studies demonstrated that the PPM hydrogel effectively stopped bleeding and promoted wound healing. The concept design of clay-based hydrogel may create diverse opportunities for constructing hemostasis and wound-healing dressings.

Chitosan-based injectable hydrogel with multifunction for wound healing: A critical review

Different types of clinical wounds are difficult to treat while infected by bacteria. Wound repair involves multiple cellular and molecular interactions, which is a complicated process. However, wound repair often suffers from abnormal cellular functions or pathways that result in unavoidable side effects, so there is an urgent need for a material that can heal wounds quickly and with few side effects. Based on these needs, hydrogels with injectable properties have been confirmed to be able to undergo self-healing, which provides favorable conditions for wound healing. Notably, as a biopolymer with excellent easy-to-modify properties from a wide range of natural sources, chitosan can be used to prepare injectable hydrogel with multifunction for wound healing because of its outstanding flowability and injectability. Especially, chitosan-based hydrogels with marked biocompatibility, non-toxicity, and bio-adhesion properties are ideal for facilitating wound healing. In this review, the characteristics and healing mechanisms of different wounds are briefly summarized. In addition, the preparation and characterization of injectable chitosan hydrogels in recent years are classified. Additionally, the bioactive properties of this type of hydrogel in vitro and in vivo are demonstrated, and future trend in wound healing is prospected.

Preparation and Application of Hemostatic Hydrogels

Hemorrhage remains a critical challenge in various medical settings, necessitating the development of advanced hemostatic materials. Hemostatic hydrogels have emerged as promising solutions to address uncontrolled bleeding due to their unique properties, including biocompatibility, tunable physical characteristics, and exceptional hemostatic capabilities. In this review, a comprehensive overview of the preparation and biomedical applications of hemostatic hydrogels is provided. Particularly, hemostatic hydrogels with various materials and forms are introduced. Additionally, the applications of hemostatic hydrogels in trauma management, surgical procedures, wound care, etc. are summarized. Finally, the limitations and future prospects of hemostatic hydrogels are discussed and evaluated. This review aims to highlight the biomedical applications of hydrogels in hemorrhage management and offer insights into the development of clinically relevant hemostatic materials.

Wound microenvironment-responsive dually cross-linked nanofibrillar peptide hydrogels for efficient hemostatic control and multi-faceted wound management

The wound microenvironment-responsive hydrogel, featuring a dually cross-linked architecture, offers distinct advantages in the realm of drug delivery due to its exceptional mechanical properties and responsiveness to stimuli. In this investigation, a versatile dually cross-linked hydrogel was synthesized. The initial framework was established through non-covalent interactions employing a self-assembling peptide indomethacin-Gly-Phe-Phe-Tyr-Gly-Arg-Gly-Asp (abbreviated as IDM-1), while the second framework underwent chemical cross-linking of chitosan (CS) mediated by genipin. This dually-network arrangement significantly bolstered the structure, proving effective for hemostatic control. In addition, hydrogels can be triggered for degradation by proteases highly expressed in the wound microenvironment, releasing drugs like indomethacin (IDM) and CS. This characteristic introduced efficient multi-faceted wound management in vitro and in vivo, such as anti-inflammatory and antibacterial activities, ultimately augmenting the wound healing process. Thus, the development of a dually cross-linked hydrogel that enables smart drug release triggered by specific wound microenvironment presents considerable potential within the realm of wound management.

Novel microneedle platforms for the treatment of wounds by drug delivery: A review

The management and treatment of wounds are complex and pose a substantial financial burden to the patient. However, the complex environment of wounds leads to inadequate drug absorption to achieve the desired therapeutic effect. As a novel technological platform, microneedles are widely used in drug delivery because of their multiple drug loading, multistage drug release, and multiple designs of topology. This study systematically summarizes and analyzes the manufacturing methods and limitations of different microneedles, as well as the latest research advances in pain management, drug delivery, and healing promotion, and presents the challenges and opportunities for clinical applications. On this basis, the development of microneedles in external wound repair and management is envisioned, and it is hoped that this study can provide guidelines for the design of microneedle systems in different application contexts, including the selection of materials, preparation methods, and structural design, to achieve better healing and regeneration results.

State of the art, trends, hotspots, and prospects of injection materials for controlling bleeding

Traumatic haemorrhage is a prevalent clinical condition, and effective and timely haemostasis is crucial for the preservation of patients' lives. In recent years, injectable hemostatic materials have gained significant attention due to their excellent hemostatic efficacy, biocompatibility, and biodegradability, making them widely applied in the treatment of incompressible traumatic haemorrhage. Systematic analysis of injectable hemostatic materials is crucial for research in this area. This article provides a comprehensive review of the development and research trends of injectable hemostatic materials over the past 20 years using visualization techniques. Analysis of collaboration and co-citation networks revealed localized research collaboration networks, highlighting the need for enhanced international collaboration in the field of injectable hemostatic materials. Current research focuses primarily on hemostatic materials, hemostatic processes, and hemostatic mechanisms. Injectable hemostatic materials with excellent performance offer promising strategies for wound healing. This review provides a comprehensive and systematic summary of injectable hemostatic materials, offering valuable guidance for the development and clinical application of novel injectable hemostatic materials. Additionally, visualized methodology and mapping analysis are effective data mining methods that provide approaches and strategies for clear knowledge network analysis. These methods facilitate better understanding and interpretation of research dynamics in the field of injectable hemostatic materials, thereby guiding and inspiring future research.

Chemical modification of chitosan for developing of new hemostatic materials: A review

Uncontrolled bleeding that occurs during surgery, trauma, and in combat conditions is critical and require immediate action. Chitosan is a polysaccharide, obtained from natural sources with unique biological properties. It is often used as basis for local hemostatic agents (LHA). We summarized the data on hemostatic properties of chitosan, commercially available chitosan-based products with focus in the field of chemical modification of chitosan. Various approaches are used to enhance hemostatic activity of chitosan-based materials. The approach with chemical modification of chitosan allows changing the properties of the polymer in order to obtain an active macromolecule that contributes to hemostasis. Ongoing research on the mechanism of interaction with blood components in the case of different chitosan derivatives will make it possible to identify promising directions for chemical modification to obtain an effective LHA.

Progress and future prospects of hemostatic materials based on nanostructured clay minerals

The occurrence of uncontrolled hemorrhage is a significant threat to human life and health. Although hemostatic materials have made remarkable advances in the biomaterials field, it remains a challenge to develop safe and effective hemostatic materials for global medical use. Natural clay minerals (CMs) have long been used as traditional inorganic hemostatic agents due to their good hemostatic capability, biocompatibility and easy availability. With the advancement of science, technology and ideology, CM-based hemostatic materials have undergone continuous innovations by integrating new inspirations with conventional concepts. This review systematically summarizes the hemostatic mechanisms of different natural CMs based on their nanostructures. Moreover, it also comprehensively reviews the latest research progress for CM-based hemostatic hybrid and nanocomposite materials, and discusses the challenges and developments in this field.

Influence of Lavender Essential Oil on the Physical and Antibacterial Properties of Chitosan Sponge for Hemostatic Applications

Uncontrollable bleeding continues to stand as the primary cause of fatalities globally following surgical procedures, traumatic incidents, disasters, and combat scenarios. The swift and efficient management of bleeding through the application of hemostatic agents has the potential to significantly reduce associated mortality rates. One significant drawback of currently available hemostatic products is their susceptibility to bacterial infections at the bleeding site. As this is a prevalent issue that can potentially delay or compromise the healing process, there is an urgent demand for hemostatic agents with antibacterial properties to enhance survival rates. To mitigate the risk of infection at the site of a lesion, we propose an alternative solution in the form of a chitosan-based sponge and antimicrobial agents such as silver nanoparticles (AgNPs) and lavender essential oil (LEO). The aim of this work is to provide a new type of hemostatic sponge with an antibacterial barrier against a wide range of Gram-positive and Gram-negative microorganisms: Staphylococcus epidermidis 2018 and Enterococcus faecalis VRE 2566 (Gram-positive strains) and Klebsiella pneumoniae ATCC 10031 and Escherichia coli ATCC 35218 (Gram-negative strains).

Gelatin Sponges with a Uniform Interoperable Pore Structure and Biodegradability for Liver Injury Hemostasis and Tissue Regeneration

Developing a hemostatic sponge that can effectively control bleeding from visceral injuries while guiding in situ tissue regeneration in incompressible wounds remains a challenge. Most of the existing hemostatic sponges degrade slowly, are relatively single-functioning, and cannot cope with complex environments. Herein, a biodegradable rapidly hemostatic sponge (GPZ) was created by dual-dynamic-bond cross-linking among Zn2+, protocatechualdehyde (PA)-containing catechol and aldehyde groups, and gelatin. GPZ had a uniformly distributed interconnected pore structure with excellent fluid absorption. It could effectively absorb the oozing blood and increase the blood concentration while stimulating platelet activation and accelerating blood coagulation. Compared to commercial hemostats, GPZ treatment significantly accelerated hemostasis in the rat liver defect model (∼0.33 min, ≥50% reduction in the hemostatic time) and in the rabbit liver defect model (∼1.02 min, ≥60% reduction in the hemostatic time). Additionally, GPZ had excellent antibacterial and antioxidant properties that effectively protected the wound from infection and excessive inflammation. In the liver regeneration model, GPZ significantly increased the rate of hepatic tissue repair and promoted rapid functional recovery without complications and adverse reactions. Overall, we designed a simple and effective biodegradable rapid hemostatic sponge with good clinical translational potential for treating lethal incompressible bleeding and promoting wound healing.

Bacteriosynthetic Degradable Tranexamic Acid-Functionalized Short Fibers for Inhibiting Invisible Hemorrhage

Current research on hemostatic materials have focused on the inhibition of visible hemorrhage, however, invisible hemorrhage is the unavoidable internal bleeding that occurs after trauma or surgery, leading directly to a dramatic drop in hemoglobin and then to anemia and even death. In this study, bacterial nanocellulose (BNC) was synthesized and oxidized from the primary alcohols to carboxyl groups, and then grafted with tranexamic acid through amide bonds to construct degradable nanoscale short fibers (OBNC-TXA), which rapidly activated the coagulation response. The hemostatic material is made up of nanoscale short fibers that can be constructed into different forms such as emulsions, gels, powders, and sponges to meet different clinical applications. In the hemostatic experiments in vitro, the composites had significantly superior pro-coagulant properties due to the rapid aggregation of blood cells. In the coagulation experiments with rat tail amputation and liver trauma hemorrhage models, the group treated with OBNC-TXA1 sponge showed low hemorrhage and inhibited invisible hemorrhage in rectus abdominis muscle defect hemorrhage models, with a rapid recovery of hemoglobin values from 128±5.5 to 165±2.6 g L-1 within 4 days. In conclusion, the degradable short fibers constructed from bacterial nano-cellulose achieved inhibition of invisible hemorrhage in vivo.

Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics

Short designer self-assembling peptide (dSAP) biomaterials are a new addition to the hemostat group. It may provide a diverse and robust toolbox for surgeons to integrate wound microenvironment with much safer and stronger hemostatic capacity than conventional materials and hemostatic agents. Especially in noncompressible torso hemorrhage (NCTH), diffuse mucosal surface bleeding, and internal medical bleeding (IMB), with respect to the optimal hemostatic formulation, dSAP biomaterials are the ingenious nanofiber alternatives to make bioactive neural scaffold, nasal packing, large mucosal surface coverage in gastrointestinal surgery (esophagus, gastric lesion, duodenum, and lower digestive tract), epicardiac cell-delivery carrier, transparent matrix barrier, and so on. Herein, in multiple surgical specialties, dSAP-biomaterial-based nano-hemostats achieve safe, effective, and immediate hemostasis, facile wound healing, and potentially reduce the risks in delayed bleeding, rebleeding, post-operative bleeding, or related complications. The biosafety in vivo, bleeding indications, tissue-sealing quality, surgical feasibility, and local usability are addressed comprehensively and sequentially and pursued to develop useful surgical techniques with better hemostatic performance. Here, the state of the art and all-round advancements of nano-hemostatic approaches in surgery are provided. Relevant critical insights will inspire exciting investigations on peptide nanotechnology, next-generation biomaterials, and better promising prospects in clinics.

Applications of injectable hemostatic materials in wound healing: principles, strategies, performance requirements, and future perspectives

Uncontrolled traumatic bleeding can lead to death due to excessive blood loss within minutes. Early intervention is crucial to save lives, making timely and effective hemostasis is a major global challenge. Injectable hemostatic materials (IHMs) have been proposed to improve the effectiveness of hemostasis, facilitate wound healing, and enhance survival rates in emergency situations. The superior hemostatic performance of IHMs has garnered significant attention. However, there are relatively few comprehensive reviews on IHMs. This paper aims to provide a comprehensive review of the latest research progress on IHMs in recent years. Firstly, the physiological hemostatic process and the underlying principles of hemostasis are analyzed. Subsequently, the synthesis strategies for different IHMs are discussed. The performance requirements of IHMs are then summarized, including high efficiency, biocompatibility, degradability, manipulability, stability and antibacterial ability. Finally, the development prospects and challenges of IHMs are presented. This review serves as a necessary and systematic summary of IHMs, providing a valuable reference for the development of new high-performance hemostatic materials and their practical clinical applications.

Hydrophobic aerogel-modified hemostatic gauze with thermal management performance

Current hemostatic agents or dressings are not efficient under extremely hot and cold environments due to deterioration of active ingredients, water evaporation and ice crystal growth. To address these challenges, we engineered a biocompatible hemostatic system with thermoregulatory properties for harsh conditions by combining the asymmetric wetting nano-silica aerogel coated-gauze (AWNSA@G) with a layer-by-layer (LBL) structure. Our AWNSA@G was a dressing with a tunable wettability prepared by spraying the hydrophobic nano-silica aerogel onto the gauze from different distances. The hemostatic time and blood loss of the AWNSA@G were 5.1 and 6.9 times lower than normal gauze in rat's injured femoral artery model. Moreover, the modified gauze was torn off after hemostasis without rebleeding, approximately 23.8 times of peak peeling force lower than normal gauze. For the LBL structure, consisting of the nano-silica aerogel layer and a n-octadecane phase change material layer, in both hot (70 °C) and cold (-27 °C) environments, exhibited dual-functional thermal management and maintained a stable internal temperature. We further verified our composite presented superior blood coagulation effect in extreme environments due to the LBL structure, the pro-coagulant properties of nano-silica aerogel and unidirectional fluid pumping of AWNSA@G. Our work, therefore, shows great hemostasis potential under normal and extreme temperature environments.

4D Light-sheet imaging and interactive analysis of cardiac contractility in zebrafish larvae

Despite ongoing efforts in cardiovascular research, the acquisition of high-resolution and high-speed images for the purpose of assessing cardiac contraction remains challenging. Light-sheet fluorescence microscopy (LSFM) offers superior spatiotemporal resolution and minimal photodamage, providing an indispensable opportunity for the in vivo study of cardiac micro-structure and contractile function in zebrafish larvae. To track the myocardial architecture and contractility, we have developed an imaging strategy ranging from LSFM system construction, retrospective synchronization, single cell tracking, to user-directed virtual reality (VR) analysis. Our system enables the four-dimensional (4D) investigation of individual cardiomyocytes across the entire atrium and ventricle during multiple cardiac cycles in a zebrafish larva at the cellular resolution. To enhance the throughput of our model reconstruction and assessment, we have developed a parallel computing-assisted algorithm for 4D synchronization, resulting in a nearly tenfold enhancement of reconstruction efficiency. The machine learning-based nuclei segmentation and VR-based interaction further allow us to quantify cellular dynamics in the myocardium from end-systole to end-diastole. Collectively, our strategy facilitates noninvasive cardiac imaging and user-directed data interpretation with improved efficiency and accuracy, holding great promise to characterize functional changes and regional mechanics at the single cell level during cardiac development and regeneration.

Chitosan-Based Hemostatic Hydrogels: The Concept, Mechanism, Application, and Prospects

The design of new hemostatic materials to mitigate uncontrolled bleeding in emergencies is challenging. Chitosan-based hemostatic hydrogels have frequently been used for hemostasis due to their unique biocompatibility, tunable mechanical properties, injectability, and ease of handling. Moreover, chitosan (CS) absorbs red blood cells and activates platelets to promote hemostasis. Benefiting from these desired properties, the hemostatic application of CS hydrogels is attracting ever-increasing research attention. This paper reviews the recent research progress of CS-based hemostatic hydrogels and their advantageous characteristics compared to traditional hemostatic materials. The effects of the hemostatic mechanism, effects of deacetylation degree, relative molecular mass, and chemical modification on the hemostatic performance of CS hydrogels are summarized. Meanwhile, some typical applications of CS hydrogels are introduced to provide references for the preparation of efficient hemostatic hydrogels. Finally, the future perspectives of CS-based hemostatic hydrogels are presented.

Advances in Hemostatic Hydrogels That Can Adhere to Wet Surfaces

Currently, uncontrolled bleeding remains a serious problem in emergency, surgical and battlefield environments. Despite the specific properties of available hemostatic agents, sealants, and adhesives, effective hemostasis under wet and dynamic conditions remains a challenge. In recent years, polymeric hydrogels with excellent hemostatic properties have received much attention because of their adjustable mechanical properties, high porosity, and biocompatibility. In this review, to investigate the role of hydrogels in hemostasis, the mechanisms of hydrogel hemostasis and adhesion are firstly elucidated, the adhesion design strategies of hemostatic hydrogels in wet environments are briefly introduced, and then, based on a comprehensive literature review, the studies and in vivo applications of wet-adhesive hemostatic hydrogels in different environments are summarized, and the improvement directions of such hydrogels in future studies are proposed.

Biodegradable Polymer Nanosheets Incorporated with Zn-Containing Nanoparticles for Biomedical Applications

So far, poly(L-lactic acid), PLLA nanosheets proved to be promising for wound healing. Such biodegradable materials are easy to prepare, bio-friendly, cost-effective, simple to apply and were shown to protect burn wounds and facilitate their healing. At the same time, certain metal ions are known to be essential for wound healing, which is why this study was motivated by the idea of incorporating PLLA nanosheets with Zn²⁺ ion containing nanoparticles. Upon being applied on wound, such polymer nanosheets should release Zn²⁺ ions, which is expected to improve wound healing. The work thus focused on preparing PLLA nanosheets embedded with several kinds of Zn-containing nanoparticles, their characterization and ion-release behavior. ZnCl₂ and ZnO nanoparticles were chosen because of their different solubility in water, with the intention to see the dynamics of their Zn²⁺ ion release in liquid medium with pH around 7.4. Interestingly, the prepared PLLA nanosheets demonstrated quit similar ion release rates, reaching the maximum concentration after about 10 h. This finding implies that such polymer materials can be promising as they are expected to release ions within several hours after their application on skin.