Background and ObjectiveVia direct sequencing, we have recently identified six common polymorphisms in angiotensin receptor-like 1 (AGTRL1) gene, and found only two polymorphisms were significantly associated with hypertension in a family-based analysis on 1,015 southern Han Chinese. Extending our previous work and considering the ubiquity of epistasis in determining disease susceptibility, we, in this study, sought to explore the potential interaction of AGTRL1 gene six polymorphisms with hypertension in a large northeastern Han Chinese population.Methods and ResultsThis was a case-control study involving 1,009 sporadic hypertensive patients and 756 normotensive controls. Data were analyzed by Haplo.Stats and multifactor dimensionality reduction (MDR) softwares. There were no deviations from Hardy-Weinberg equilibrium for all polymorphisms. The genotypes and alleles of rs7119675 and rs11544374 differed significantly between the two groups (P<0.0005), even after the Bonferroni correction. Under three genetic models, significant association was consistently observed for rs7119675 and rs11544374, and this association was independent of confounding factors. Taking rs7119375 as an example, the odds of having hypertension was 2.46 (95% confidence interval (95% CI): 2.06–2.94), 2.82 (95% CI: 2.29–3.46) and 3.97 (95% CI: 2.37–6.64) under additive, dominant and recessive models (P<0.001), respectively, whereas the adjusted risk estimates were slightly attenuated but still significant. The frequencies of most derived haplotypes differed significantly between patients and controls. Haplotype-phenotype analyses indicated marginal association for triglyceride (PSim = 0.011) and total cholesterol (PSim = 0.025) in patients and for triglyceride in controls (PSim = 0.023). The overall best MDR model included rs11544374, rs7119375 and rs948847 with the maximal testing accuracy of 0.737 and cross-validation consistency of 10 out of 10 (P<0.0001). Further interaction entropy graph suggested that the interaction of rs7119375 with rs11544374 and rs948847 was strongly antagonized.ConclusionsOur findings demonstrate that AGTRL1 genetic polymorphisms might contribute to the development of hypertension independently and/or through complex interaction.

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Background: Single-injection erector spinae plane block (ESPB) has been reported to be successfully used for analgesia after open thoracotomy. However, the duration of analgesia is not long enough. Adding dexmedetomidine to local anesthetics is frequently used to prolong the duration of single-injection regional nerve block. This randomized study was designed to assess whether adding dexmedetomidine to ropivacaine for ESPB could effectively prolong the duration of analgesia and reduce opioid consumption after open thoracotomy.Methods: Sixty patients with esophageal cancer were randomized to receive ESPB using 28 mL of 0.5% ropivacaine, with 2 mL of normal saline (group R) or 0.5 µg/kg dexmedetomidine in 2 mL (group RD) administered perineurally. ESPB was performed at the 5th thoracic level under ultrasound guidance. The primary outcome was the duration of analgesia. The secondary outcomes were total postoperative sufentanil consumption, numerical rating scale pain scores, Ramsay sedation scale scores and adverse effects.Results: The duration of analgesia in group RD (505.1±113.9) was longer than that in group R (323.2±75.4) (p<0.001). The total postoperative sufentanil consumption was lower in group RD (23.3±10.0) than in group R (33.8±13.8) (p=0.001). There was no significant difference in the incidence of adverse effects between the two groups.Conclusion: Adding perineural dexmedetomidine to ropivacaine for ESPB seems to be an attractive method for prolonging analgesia with almost no adverse effects in patients with esophageal cancer undergoing curative-intent thoracotomy. Trial registration: ChiCTR1800016583. Registered 10 June 2018, http://www.chictr.org.cn.