Objective To investigate the effects of coronary artery bypass grafting in different bypass grafts on survival rate,angina recurrence rate and cardiac function in patients with diffuse right coronary artery disease.Methods Sixty-four patients with diffuse right coronary artery stenosis admitted to the hospital were enrolled.All patients underwent coronary artery bypass grafting and were divided into large saphenous vein group(40 cases) and internal mammary artery group(24 cases) according to the difference of graft vessels.The follow-up survival rate,bypass graft vascular/cardiac venous patency rate,angina recurrence rate,NYHA classification before and after surgery,left ventricular ejection fraction(LVEF),and left ventricular diastolic end diameter(LVEDD) level of both groups were compared.Results Comparison in the same group,NYHA cardiac function grading,LVEF and LVEDD levels were better than those before surgery(P ＜ 0.05).Compared with the great saphenous vein group,the difference of the venous patency/intracardiac venous patency rate and angina pectoris was better in the internal mammary artery group (P ＜ 0.05).At 1 year after operation,there was no significant difference in NYHA cardiac function grading,LVEF,LVEDD level and follow-up survival rate(P ＞0.05).Conclusion There is no significant difference in follow-up survival rate and long-term improvement of cardiac function between patients with diffuse right coronary artery stenosis undergoing coronary venous artery bypass grafting with saphenous vein and internal mammary artery bypass graft.However,the internal mammary artery is more helpful to improve the patency of the bypass graft vessel/cardiac vein and avoid the recurrence of angina pectoris.

Objective To evaluate the long-term therapeutic results and the safety of nephronsparing surgery(NSS) for the treatment of renal cell carcinoma. Methods Clinical data of 243 NSSfor renal cell carcinoma were retrospectively analysed. Of them, 159 were males and 84 were femaleswith average age of 58 years (range from 24 ?77 years). The average tumor size was 3. 4 cm (rangefrom 1.1 to 6. 7 cm). Three cases were solitary renal cell carcinoma, 11 were bilateral renal cell carcinoma; 237 cases were in stage T_(1a). and 6 cases were in stage T_(1b). No lymph node and distant metastasis, no renal vein cancer tumor embolus and inferior vena cava tumor embolus was found. Postoperative follow-up was carried out by ultrasound, CT and renal function. Cancer specific survival was estimated using Kaplan-Meier method and log-rank test. Results After a mean 31 months (1-147months) follow-up, long-term follow-up data were obtained in 232 cases because the other 11 did notlive in Dalian, 52 were treated with interferon. Four of the 232 patients treated with NSS had died:1died from lung cancer 16 months after lung cancer treatment, the other 3 died from cardiovascular diseases. The total survival rate and cancer specific survival rate were 98. 3% and 100. 0%, respectively.Local tumor recurrences were detected in 5 patients and tumor metastasis was detected in 1 patient.The recurrence rate was 2. 2%, and the metastasis rate was 0. 4%. The complications included temporary renal failure and urine leakage. The complication rate was 5. 6%. Conclusions NSS for renalcell carcinoma is a safe and feasible treatment option. It has the advantages of low local recurrence,good long-term survival rate and low complication rate. NSS can maximally reserve functional nephron, reduce the risk of chronic renal failure, preserve patient's quality of life and increase patient'ssatisfaction.

Objective To study the relationship between X-linked inhibitor of apoptosis protein (XIAP) expression and transitional cell carcinoma(TCC) development. Methods Forty-three TCC tissues and 12 normal transitional epithelial tissues were applied to detect XIAP expression by semi-quantitative RT-PCR, immunohistochemistry and western blot. The data were statistically analyzed by using SPSS11.5 according to the 2 groups (TCC and normal transitional epithelial) as well as the dif-ferent subgroups (tumor stage, grade, single or multiple tumor, primary or recurrence tumor). Results XIAP expression in TCC tissues was higher than in normal transitional epithelial tissues(im-munohistochemistry: 22±5 and 16±2, Western blot:1.21±0. 15 and 0. 61±0.24, mRNA: 1.17± 0. 30 and 0. 75±0. 17, P<0. 05). In the bladder tumors group, XIAP expression in recurrence tumors was higher than in primary tumors(immunohistochemistry: 24±3 and 20±3, Western blot: 1.66±0.28 and 1.10±0. 23, mRNA: 1.44±0. 27 and 1.05±0. 23, P<0. 05). However, there were no significant differences according to the tumor stage and tumor grade as well as tumor multi-plicity or not. Conclusion XIAP expression might serve as a biomarker in TCC diagnosis and recur-rence prediction.