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Objective To evaluate the causal relationship between gastroesophageal reflux disease(GERD)and obstructive sleep apnea(OSA)using two-sample Mendelian randomization(2SMR)and to identify potentially beneficial drugs and pathways for OSA from GERD treatment options.Methods The 2SMR was used as the primary analysis method,and multivariable Mendelian randomization(MVMR)was used to adjust for the potential impact of obesity on both diseases.Secondly,the DrugBank database was used to search for target genes of anti-reflux drugs used to treat GERD,and the dbSNP database was used to determine the target gene loci to identify the genetic tools of anti-reflux drugs.Significant target genes related to OSA risk were obtained through 2SMR analysis.Finally,the target genes were subjected to Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis and Gene Ontology(GO)analysis using the DAVID database.Results The genetically predicted risk of GERD was significantly associated with an increased risk of OSA[OR=1.43,95%CI=(1.33,1.54),P=5.29×10-22],and MVMR analysis showed that this result remained robust after adjusting for obesity.Four significant genes,including BCHE,DRD2,GRM5,and PTGER3,were identified,which are related to drugs such as nizatidine,bromperidol,ADX10059,and misoprostol.KEGG analysis identified three pathways.Conclusion GERD increases the risk of developing OSA,and anti-reflux drug targets can provide useful genetic clues for drug development in OSA treatment.
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Objective To elevate diagnosis level and improve treatment for retroperitoneal chemodectoma. Methods Clinical data of 21 cases with retroperitoneal chemodectoma in four hospitals of Songhua river drainage area were analyzed retrospectively. Results CT, Ultrasonography and arteriography delineated retroperitoneal tumor in all 21 cases including 2 cases diagnosed as having retroperitoneal chemodectoma by MRI and arteriography, 19 cases were misdiagnosed (90.5%). All cases underwent surgical resection, with tumors removed completely in 16 cases (76. 2% ) , and 5 were irresetable. Four cases who were not resected died within 11 months postoperatively and 1 died intraoperatively in an resection attempt. In tumor resected cases, 11 have survived more than 12 years, 3 died 8 years later, 2 were still alive at the follow-up of 2 years. Conclusion Surgical treatment is the only effective method to treat the retroperitoneal chemodectoma.