Objective To investigate the predictive value of D-dimer for in-hospital mortality and heart failure with reduced ejection fraction (HFrEF) in patients with acute myocardial infarction (AMI). Methods A total of 688 patients with AMI who were hospitalized at Zhongshan Hospital, Fudan University, from January 2020 to December 2023 were retrospectively enrolled. Demographic and clinical characteristics, laboratory findings, echocardiographic parameters, and in-hospital outcomes were collected. Patients were divided into four groups according to D-dimer quartiles, and trend tests were used to compare changes in each indicator with increasing D-dimer levels. The primary endpoints were in-hospital mortality and HFrEF. Multivariable logistic regression analysis was performed to assess the independent associations of D-dimer with in-hospital mortality and HFrEF. Receiver operating characteristic (ROC) curve analysis was used to evaluate its predictive performance. Results Differences and trend tests among four groups for age, creatinine, peak cardiac troponin T, N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction, HFrEF incidence, and in-hospital mortality were statistically significant (P＜0.05). Multivariable logistic regression analysis showed that elevated D-dimer was associated with an increased risk of in-hospital mortality in patients with AMI (OR＝1.251, 95%CI 1.093–1.432, P＝0.001), and HFrEF (OR＝1.075, 95%CI 1.028–1.124, P＝0.002). ROC curve analysis showed that the area under the curve (AUC) of D-dimer for predicting in-hospital mortality and HFrEF were 0.871 and 0.716, respectively. At a cutoff value of 0.47 mg/L, the sensitivity and specificity of D-dimer in predicting HFrEF were 81.9% and 52.1%, respectively; at a cutoff value of 2.18 mg/L, the sensitivity and specificity of D-dimer in predicting in-hospital mortality were 63.6% and 93.8%, respectively. Restricted cubic spline analysis demonstrated significant non-linear associations between D-dimer and the risks of in-hospital mortality and HFrEF (P＜0.001). Conclusions Elevated D-dimer level is significantly associated with increased risks of in-hospital mortality and HFrEF in patients with AMI and shows acceptable predictive performance. As a simple and readily available laboratory biomarker, D-dimer may provide useful information for early risk stratification and clinical management in patients with AMI.

Checkpoint blockade immunotherapy has emerged as a transformative approach in cancer treatment by activating tumor-infiltrating T cells. However, the efficacy of PD-L1 blockade is restricted in "cold" tumors, which are characterized by low immunogenicity, presenting a challenge to immunotherapy. This study introduces an innovative strategy, utilizing cathepsin-cleavable N-(2-hydroxypropyl) methacrylamide (HPMA) polymer-assisted combined photodynamic therapy (PDT) and PD-L1 degradation for the first time, effectively treating T cell-deficient tumors. The degradable main-chain polymer, conjugated with photosensitizer porphyrin, facilitates the accumulation of reactive oxygen species (ROS), triggering immunogenic cell death (ICD) and promoting cytotoxic T lymphocytes (CTLs) infiltration into tumors. Multivalent peptide antagonists of PD-L1 promote PD-L1 degradation in lysosomes through receptor crosslinking, overcoming the adaptive cycling of PD-L1 to the tumor cell surface. These findings demonstrate that polymer-assisted PDT and PD-L1 crosslinking degradation represent a potential novel strategy for anti-tumor immunotherapy, providing valuable tools for expanding immunotherapy applications in immunosuppressive cancers.

OBJECTIVETo assess the association of interferon gamma gene (IFNγ ) tag single nucleotide polymorphisms (Tag SNPs) with hepatitis B virus (HBV) infection in ethnic Dai and Hani minorities from Xishuangbanna, Yunnan.

METHODSPeripheral blood samples were collected from 300 Dai minorities and 300 Hani minorities, each included 100 healthy controls and 200 HBV infected individuals (including 100 spontaneous recovery subjects and 100 chronic HBV infected patients). Matrix-Assisted Laser Desorption/Ionization Time of Flight Mass Spectrometry (MALDITOF-MS) was used to determine the Tag SNPs of IFNγ gene. Haplotypes were constructed.

RESULTSIn Hani and Dai minorities, the frequencies of rs1861494 CC genotype in HBV infected group was significantly higher than the healthy group (Dai: χ2=10.017, P=0.001; Hani: χ2=6.515, P=0.039), and there was a significant difference between the HBV infected group and the control group under the C allele recessive mode (CC/TC+TT) (Dai: P=0.035, OR=9.567, 95%CI: 1.166-78.499; Hani: P=0.027, OR=5.484, 95%CI: 1.216-24.726). In Dai minorities, the frequencies of rs2069705 CC genotype and C allele in chronic HBV infected group was significantly higher than the spontaneous recovery group (genotype: χ2=8.112, P=0.017; allele: χ2=4.066, P=0.044), and there was a significant difference between chronic HBV infected group and spontaneous recovery group under the C allele recessive mode (CC/CT+TT) (P=0.013, OR=0.341, 95%CI: 0.146-0.796).

CONCLUSIONAbove results suggested that the rs1861494 CC genotype of the IFNγ gene has conferred an increased risk for HBV susceptibility in both Dai and Hani minorities. In addition, the rs2069705 CC genotype may be a risky factor for Dai minorities to develop chronic HBV infection.

Adult ; Alleles ; Asian Continental Ancestry Group ; ethnology ; genetics ; China ; ethnology ; Female ; Genetic Predisposition to Disease ; ethnology ; Genotype ; Hepatitis B ; ethnology ; genetics ; virology ; Hepatitis B virus ; physiology ; Humans ; Interferon-gamma ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Risk Factors ; Young Adult