Gastrointestinal bleeding (GIB) is a critical condition that requires rapid and effective intervention. Although thrombin is a widely used hemostatic agent, its efficacy is limited in the harsh environment of the digestive tract, especially in patients with chronic liver disease or coagulation disorders. Current treatment techniques often fall short, particularly when faced with severe blood loss and coagulation challenges. Here, a novel solution: waxberry-inspired smart nanogels that offer a cost-effective, highly efficient, and mechanically stable approach for local hemostasis is presented. Drawing inspiration from the microfibrous structures of waxberry, a waxberry-like nano-silica with a radially fibrous structure is synthesized for effective thrombin loading and release upon emergency. This nano-silica, coated with GelMA, forms a stable nanogel network activated by blue laser during endoscopy. Within just 5 s, the nanogel effectively triggers coagulation, even in patients with coagulation disorders. The formed blood clots are stable enough to withstand the challenging conditions of the digestive tract, preventing secondary bleeding. Upon injection, thrombin rapidly converts fibrinogen to fibrin, creating a secondary network that reinforces clot stability. This dual-network system demonstrates strong adhesive properties and effective hemostasis in the blood of cirrhotic patients, as well as in gastrointestinal bleeding scenarios involving the esophagus, stomach, and duodenum of mini-pigs.

中文翻译：

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Bioinspired 智能纳米凝胶用于胃肠道出血中的快速蓝色激光激活止血

消化道出血 （GIB） 是一种需要快速有效干预的危急疾病。凝血酶虽然是一种广泛使用的止血剂，但其疗效在消化道的恶劣环境中是有限的，特别是对慢性肝病或凝血障碍患者。目前的治疗技术往往不足，尤其是在面临严重的失血和凝血挑战时。在这里，提出了一种新颖的解决方案：受杨梅启发的智能纳米凝胶，为局部止血提供了一种经济高效、高效且机械稳定的方法。从杨梅的微纤维结构中汲取灵感，合成了一种具有径向纤维结构的杨梅状纳米二氧化硅，用于在紧急情况下有效加载和释放凝血酶。这种涂有 GelMA 的纳米二氧化硅在内窥镜检查过程中形成由蓝色激光激活的稳定纳米凝胶网络。在短短 5 秒内，纳米凝胶可有效触发凝血，即使在凝血障碍患者中也是如此。形成的血凝块足够稳定，可以承受消化道的挑战性条件，防止继发性出血。注射后，凝血酶迅速将纤维蛋白原转化为纤维蛋白，形成一个增强凝块稳定性的二级网络。这种双网络系统在肝硬化患者的血液中以及涉及迷你猪食道、胃和十二指肠的胃肠道出血情况下表现出强大的粘附性能和有效的止血作用。