28 research outputs found

    Fibrinogen deposition on silicone oil-infused silver-releasing urinary catheters compromises antibiofilm and anti-encrustation properties

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    [Image: see text] Slippery silicone-oil-infused (SOI) surfaces have recently emerged as a promising alternative to conventional anti-infection coatings for urinary catheters to combat biofilm and encrustation formation. Benefiting from the ultralow low hysteresis and slippery behavior, the liquid-like SOI coatings have been found to effectively reduce bacterial adhesion under both static and flow conditions. However, in real clinical settings, the use of catheters may also trigger local inflammation, leading to release of host-secreted proteins, such as fibrinogen (Fgn) that deposits on the catheter surfaces, creating a niche that can be exploited by uropathogens to cause infections. In this work, we report on the fabrication of a silicone oil-infused silver-releasing catheter which exhibited superior durability and robust antibacterial activity in aqueous conditions, reducing biofilm formation of two key uropathogens Escherichia coli and Proteus mirabilis by ∼99%, when compared with commercial all-silicone catheters after 7 days while remaining noncytotoxic toward L929 mouse fibroblasts. After exposure to Fgn, the oil-infused surfaces induced conformational changes in the protein which accelerated adsorption onto the surfaces. The deposited Fgn blocked the interaction of silver with the bacteria and served as a scaffold, which promoted bacterial colonization, resulting in a compromised antibiofilm activity. Fgn binding also facilitated the migration of Proteus mirabilis over the catheter surfaces and accelerated the deposition and spread of crystalline biofilm. Our findings suggest that the use of silicone oil-infused silver-releasing urinary catheters may not be a feasible strategy to combat infections and associated complications arising from severe inflammation

    A New Aortic Arch Dissection Classification: The Fuwai Classification

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    Aims: We describe a new aortic arch dissection (AcD) classification, which we have called the Fuwai classification. We then compare the clinical characteristics and long-term prognoses of different classifications. Methods: All AcD patients who underwent surgical procedures at Fuwai Hospital from 2010 to 2015 were included in the study. AcD procedures are divided into three types: Fuwai type Cp, Ct, and Cd. Type Cp is defined as the innominate artery or combined with the left carotid artery involved. Type Cd is defined as the left subclavian artery or combined with the left carotid artery involved. All other AcD surgeries are defined as type Ct. The Chi-square test was adopted for the pairwise comparison among the three types. Kaplan-Meier was used for the analysis of long-term survival and survival free of reoperation. Results: In total, 1,063 AcD patients were enrolled from 2010 to 2015: 54 patients were type Cp, 832 were type Ct, and 177 were type Cd. The highest operation proportion of Cp, Ct and Cd were partial arch replacement, total arch replacement, and TEVAR. The surgical mortality in type Ct was higher compared to type Cd (Ct vs. Cd = 9.38 vs. 1.69%, p \u3c 0.01) and type Cp (Ct vs. Cp = 9.38 vs. 1.85%, p = 0.06). There was no difference in surgical mortality of type Cp and Cd (p = 0.93). There were no significant differences in the long-term survival rates (p = 0.38) and free of aorta-related re-operations (p = 0.19). Conclusion: The Fuwai classification is used to distinguish different AcDs. Different AcDs have different surgical mortality and use different operation methods, but they have similar long-term results

    Enhanced antibacterial and anti-adhesive activities of silver–PTFE nanocomposite coating for urinary catheters

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    Catheter-associated urinary tract infection (CAUTI) presents a significant health problem worldwide and is associated with increased morbidity and mortality. Herein, a silver-polytetrafluoroethylene (Ag-PTFE) nanocomposite coating for catheters was developed via a facile wet chemistry method. Benefiting from the synergistic effect of Ag and PTFE, the as-prepared Ag-PTFE-coated catheter exhibited enhanced antibacterial and antiadhesive activities against two CAUTI-associated strains: E. coli WT F1693 and S. aureus F1557. Compared to the uncoated commercial silicone catheters and the Ag-coated catheters, the Ag-PTFE-coated catheters were able to reduce bacterial adhesion by up to 60.3% and 55.2%, respectively. The Ag-PTFE-coated catheters also exhibited strong antibiofilm activity, reducing biofilm coverage by up to 97.4% compared with the commercial silicone catheters. In an in vitro bladder model, the Ag-PTFE-coated catheter displayed excellent anti-infection efficacy against bacteriuria, extending the lifetime of silicone catheters from a mean of 6 days to over 40 days. The Ag-PTFE coating also showed good biocompatibility with fibroblast cells in culture, making it a prospective strategy to overcome current challenges in CAUTI
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