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Protein-based coatings are of immense interest due to their rich biological functions. Layer-by-layer (LbL) assembly, as a powerful means of transferring protein functions to the material surface, has received widespread attention. However, the assembly mechanism of protein-based LbL coatings is still far from being explained, not only because of protein structure and function diversity but also characterization limitations. Herein, we monitored in situ the LbL assembly process of tannic acid (TA) and lysozyme (Lyz), a classic pair of polyphenol and protein, by combining quartz crystal microbalance with dissipation monitoring (QCM-D) and spectroscopic ellipsometry (SE). The water content, morphology, mechanical properties, antioxidant activity, and the driving force of TA-Lyz coating engineered under different pH values were analyzed in detail by various techniques. The water content, a key factor in TA-Lyz coatings, increased with increasing assembled pH values, which resulted in a porous morphology, inhomogeneous mechanical distribution, faster assembly growth, and better antioxidant activity in both acellular and cellular levels. In addition, high water content is unfavorable to both entropy and enthalpy changes, and the thermodynamic driving force of TA and Lyz assembly mainly comes from the enthalpy change brought by the noncovalent interaction between TA and Lyz. These results provide new insights into engineering the structure, function, and assembly mechanisms of protein-based coatings.

Objective To investigate whether staged angioplasty (SAP) is a safe and effective treatment to prevent hyperperfusion syndrome after carotid artery stenting (CAS).Methods A systematic literature search was performed according to established criteria to identify eligible articles published before October 2020. Pooled dichotomous data were presented as odds ratios (OR) and corresponding 95% confidence intervals (CI) using random-effect models. The efficacy endpoints were hyperperfusion syndrome (HPS), hyperperfusion phenomenon (HPP), and intracerebral hemorrhage (ICH). The safety endpoint was post-procedural thromboembolic events. The feasibility of the procedure was assessed by device-related adverse events (vessel dissection and failed angioplasty) in SAP.Results Ten studies (1030 participants) were eligible. SAP was superior to regular CAS in preventing HPS (OR = 0.35, 95% CI 0.14–0.86, P = 0.02). There was no significant difference in the rate of thromboembolic events between the SAP group and the regular CAS group. The rates of vessel dissection and failed angioplasty with the use of a 3.0-mm-diameter balloon were 5.4% and 0.4%, respectively.Conclusion SAP may reduce the incidence of post-CAS HPS without increasing procedure-related complications. A 3.0-mm-diameter balloon used in SAP may be appropriate for Asian populations. However, the confounded study design and confused definitions of reporting items hinder the current recommendation of SAP in clinical use.

Background and Purpose Cochlear vascular micro-thrombosis has been hypothesized as one of the pathogenic mechanisms for sudden sensorineural hearing loss (SSNHL) refractory to regular management. This study aimed to evaluate the feasibility and safety of intra-arterial pulsed-injection urokinase (IAPU) as a salvage therapy for SSNHL after the failure of conventional therapy.Methods We retrospectively reviewed our patient database to identify refractory SSNHL patients between November 2017 and July 2020. Study outcomes before and after the IAPU therapy were compared between IAPU and conventional therapy groups.Results Sixty-seven moderate-profound SSNHL patients (29 in IAUP group, 38 in control group) were included in this study. Compared to the control group, patients in the IAPU group showed more significant improvement in pure tone average (PTA) (34.2 ± 23.5 vs. 10.7 ± 13.1, p < 0.001) and degree of hearing recovery (total: 20.7% vs. 5.3%, partial: 24.1% vs. 10.5%, mild: 27.6% vs. 13.2% and non: 27.6% vs. 71.1%) 2 weeks after admission. In the IAPU group, a significant improvement of PTA (86.6 ± 11.5 vs. 54.6 ± 20.1 dB, p < 0.005) was observed on the first day after IAPU treatment.Conclusion In carefully selected SSNHL cases with a highly suspected vascular origin, IAPU is a safe and effective therapy when conventional treatments have failed. Despite the encouraging findings of our work, large studies are needed to better investigate the strengths and limitations of this salvage therapy.