Alcohol consumption is an important environmental factor in the development of essential hypertension (EH) and cardiovascular disease. Several epidemiological studies have investigated the association between hypertension and acetaldehyde dehydrogenase 2 (ALDH2) genotype, although the results are inconsistent. The aim of the present study was to evaluate the possible effect of drinking behavior on the ALDH2-EH relationship in a Chinese Han population. A total of 1098 unrelated individuals with EH and 1021 controls of Chinese Han ethnicity were included. We evaluated the effect of three tag single-nucleotide polymorphisms on blood pressure (BP) and serum lipid level by blood chemical assays. The major findings were that rs671 guanine/adenine genotype (odds ratio (OR)=0.45, 95% confidence interval (CI): 0.28-0.74) and A allele (OR=0.55, 95% CI: 0.36-0.85) were associated with a decreased risk of EH in drinkers. In addition, the rs671 genotype influenced BP, triglyceride (TG) level and high-density lipoprotein cholesterol (HDL-C) level in the same drinking-dependent pattern. Drinkers who carried the A allele displayed lower systolic BP (β=-0.16, P=0.001) and TG level (β=-0.14, P=0.004) and higher HDL-C level (β=0.11, P=0.019), but this association was not observed in nondrinkers. In summary, we present evidence for the association of rs671 in the ALDH2 gene with susceptibility to EH, increase in BP and disturbance of serum lipid profiles in drinkers, but not in nondrinkers. Further functional research is warranted to elucidate the role of rs671 in the variation of BP and lipid levels in EH.
This study aims to report the technical details and preliminary outcomes of robot-assisted Ivor-Lewis esophagectomy (RAILE) using two different types of intrathoracic anastomosis from a single institution in China. From May 2015 to October 2017, 61 patients diagnosed with mid-lower esophageal cancer were treated with RAILE. The RAILE procedure was performed in two stages. The first 35 patients underwent circular end-to-end stapled intrathoracic anastomosis (stapled group), and the remaining 26 patients had a double-layered, completely hand-sewn intrathoracic anastomosis (hand-sewn group). Patient characteristics, surgical techniques, postoperative complications, and pathology outcomes were analyzed. The mean operating time and mean blood loss were 315.6 ± 59.4 minutes and 189.3 ± 95.8 mL, respectively. There was one patient who underwent conversion to thoracotomy. The 30-day and in-hospital mortality rates were 0%. Overall complications were observed in 22 patients (36.1%) according to the Clavien-Dindo (CD) and the Esophagectomy Complications Consensus Group (ECCG) classifications, of whom 6 patients (9.8%) had anastomotic leakage (ECCG, Type II). The median length of hospitalization (LOH) was 10 days (IQR, 5 days). Complete (R0) resection was achieved in all cases. The mean tumor size was 3.2 ± 1.5 cm, and the mean number of totally dissected lymph nodes was 19.3 ± 9.2. Regarding the operative outcomes between stapled and hand-sewn groups, there were no significant differences in the operative time (325.4 ± 66.6 vs. 302.3 ± 45.9 min, P = 0.114), blood loss (172.9 ± 74.1 vs. 211.5 ± 117.0 mL, P = 0.147), conversion rate (2.9 vs. 0%, P = 1.000), overall complication rate (37.1 vs. 34.6%, P = 0.839) or LOH (10 vs. 9.5 days, P = 0.415). RAILE using both stapled and hand-sewn intrathoracic anastomosis is safe and technically feasible with satisfactory perioperative outcomes for the treatment of mid-lower thoracic esophageal cancer.
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