ABSTRACT
Ionic hydrogels used as ideal and flexible strain sensor materials should have excellent mechanical, adhesive and antimicrobial properties. However, it is challenging to achieve these multifunctional requirements simultaneously. Herein, we designed and prepared a multifunctional ionic hydrogel with a multi-length tentacle bentonite backbone to initiate the free radical polymerization of acrylic acid bentonite (AABT) and acrylamide (AAm). The interactions of covalent cross-linking, hydrogen bonding cross-linking, charge interactions and physical entanglement between hybrid polyacrylamide-AABT (PAAm-AABT), sodium carboxymethyl starch (SCMS) and PAAm form an multi-in-one hybrid supramolecular network hydrogel (CABZ). This CABZ ion-conductive hydrogel is capable of detecting weak deformation with a detection limit of 1 % strain, high tensile properties of 995 %, excellent strength of 254.5 kPa, fast response (≈0.21 s), high sensitivity of 0.86 and high conductivity of 0.37 S/m. In addition, this CABZ ion-conductive hydrogel has impressive adhesion properties with shear adhesion strength up to 50.78 kPa and broad-spectrum antibacterial properties achieved by AABT-loaded ZnO nanoparticles. Through special AABT hybrid cross-linking, the CABZ ion-conductive hydrogel achieves stable mechanical properties, highly sensitive signal response and antimicrobial properties, which will make it a good choice for flexible wearable sensor materials.
Subject(s)
Anti-Infective Agents , Bentonite , Anti-Infective Agents/pharmacology , Electric Conductivity , HydrogelsABSTRACT
OBJECTIVE: To evaluate the efficacy and clinical outcomes of endovascular treatment for superior mesenteric artery dissection (SMAD) and its effect on superior mesenteric artery (SMA) remodeling compared with medical management alone after successful initial medical management. METHODS: In this retrospective analysis, all patients with spontaneous SMAD at a single institution were identified from March 2007 to August 2019. The primary outcomes were freedom from major adverse events (MAEs, a composite of dissection-related death, the recurrence of mesenteric ischemia symptoms, and a requirement for intervention). The secondary outcomes were morphologic remodeling of the dissections and stenosis or occlusion of the SMA. RESULTS: A total of 94 patients with SMAD who underwent successful initial medical management (91 males; mean age, 50.4 ± 6.3 years) were enrolled in the study. Fifty-seven (60.6%) received medical management alone, and 37 (39.4%) underwent endovascular repair after initial medical management. In the endovascular group, the technical success rate was 86.5% (32 of 37). During a mean follow-up period of 33.6 ± 26.2 months (range, 1-120 months), nine (9.6%) patients experienced a recurrence of abdominal pain, and six had additional interventions for SMAD. The patients in the endovascular group showed more complete or partial remodeling (22 [81.1%] vs 24 [44.4%]; P < .0001) or unchanged dissections (5 [13.5%] vs 23 [42.6%]; P = .0001) than those in the conservative group. Survival analysis showed that the estimated MAE-free survival rates were 95.6%, 88.9%, and 85.4% at 1, 3, and 5 years, respectively. There was a higher freedom from SMA stenosis or occlusion in the endovascular group (log rank P = .046). CONCLUSIONS: Endovascular treatment and medical management alone result in similar MAE-free survival for patients with SMAD after successful initial medical management. Moreover, endovascular therapy is associated with a higher complete remodeling rate and greater freedom from SMA stenosis or occlusion.
