Phosphodiesterase-5 inhibitors (PDE5i) have been used as the first-line treatment for erectile dysfunction (ED) in recent years. However, with the increased clinical application of PDE5i, the incidence rate of PDE5i-induced adverse reactions is on the rise, which may involve the cardiovascular, digestive, nervous, respiratory, and reproductive systems. Most of the adverse reactions are mild to moderate, occasionally with serious or rare complications. The probability and severity of the adverse reactions are associated with the dosage and frequency of medication as well as with individual differences. Therefore individualized medication is necessitated and, for the patients with cardiovascular disease, epilepsy, psychosis, or anaphylactic conditions, PDE5i should be cautiously given or avoided. This review provides an overview of PDE5i-induced adverse reactions and countermeasures in the treatment of ED.
Erectile Dysfunction ; drug therapy ; Humans ; Male ; Phosphodiesterase 5 Inhibitors ; administration & dosage ; adverse effects

Objective To evaluate arterial reconstruction of traumatic iliac-femoral artery pseudoaneurysm in parenteral drug abusers.Methods Data of 21 consecutive patients who presented with iliac-femoral artery pseudoaneurysm with the diameter ranging from 3.0 cm～7.5 cm secondary to parenteral drug abuse from 2004 to 2007 were analyzed.Fifteen patients were male and the median age was 3 1.3 years.the aneurysm involved the common femoral artery and distal external iliac artery.Autologous greater saphenous vein was used as a graft for arterial reconstruction after iliac-femoral artery pseudoaneurysm excision through a single curved inguinal incision.Results The surgical procedure was successful in all 21 eases without intraoperative mortality and severe complications.All the 21 patients were free of postoperative claudication symptoms except 1 case with preoperative popliteal artery stenosis.Wound infection and tissue fistula developed in one ease.Ingunal incisional hematoma and cutaneous abnormal sensation developed in one each eases.Conclusions The use of autologous greater saphenous venous grafts for aaefial reconstruction after false aneurysm excision in drug abusers is safe and effective.The harvest of the greater saphenous vein is precondition of this precedure.These preliminary results indicate that the implementation of this technique offers advantages compared with the artery ligation alone without revascularization,that is frequently associated with later intermittent claudication.

Objective To observe the influence of electroacupuncure(EA) at different therapeutic time windows on the effects of inosine on neuronal apoptosis and expression of heat-shock-proteins-70 (HSP70)after focal cerebral ischemic reperfusion injury (CIRI) in rats.Methods The model was established by ligation of the artery for 2 hour.EA was delivered to “baihui” and “dazhui” through acupuncture needles 0.5 hr,2 hr,6 hr and 12 hr respectively following MCAO.The expression level of HSP70 and the number of apoptotic cells were examined by immunohistochemical technique and TUNEL,comparing the average optical density of HSP70 and the number of apoptotic positive cells of cortex penumbra and hippocampus CA1 area in rat brain.Results Compared with the model group,the average optical density of HSP70 in every EA group was increased in apoptotic positive cells of cortex penumbra and hippocampus CA1 area 0.5 h (89.98± 6.55),(128.73 ± 8.03),2 h (90.96±6.38),(132.25±8.78),6 h (93.71±6.12),(132.58±7.04),12 (96.19±7.30),(133.57±6.19)and the number of apoptotic positive cells of cortex penumbra in every EA group was decreased 0.5 h (1.80±0.84),2 h (3.40± 1.14),6 h (5.00± 1.00),12 h (5.00±2.45).The number of apoptotic cells of hippocampus CA1 area was decreased just in the EA group of 0.5 h (1.60± 1.89).Conclusion EA could increase the expression level of HSP70 and at the same time decrease the number of apoptotic cells,EA plays an important part in protecting the neuronal cells of brain after focal cerebral ischemic reperfusion injury.The acupuncture treatment should be taken as far as early.

AIM:To investigate retinal vascular endothelial growth factor(VEGF)level and retinal cells apoptosis in the early stage of diabetic NOD mouse retina.METHODS:Animals were divided into the control group(non-diabetes mice)(2,4,6,8,12 weeks group,n=30)and diabetes group(2,4,6,8,12 weeks group,n=30).EUSA(Enzyme-Linked Immunosorbent Assay)was performed to detect VEGF level in both serum and retina.Transmission electron microscope method was used to examine retinal cell apoptosis.RESULTS:Compared with the control group,VEGF levels in serum and retina were increased significantly in the NOD group(12 weeks:4.9±0.4μg/g versus 0.19±0.1μg/g in serum sample,P ＜ 0.01;165.0±9.0μg/g versus 18.0±4.0μg/g in retinal sample,P＜0.01).There exists a positive correlation between serum VEGF and retinal VEGF levels in the early diabetic NOD mice(γ=0.9902,P=0.001).The number of the cells apoptosis in the ganglion significantly in the NOD group(P＜0.01).CONCLUSION:The high VEGF expression may be contributed to increase retinal cells apoptosis.Many factors associated with retinal VEGF expression might involve in the early diabetes stage.

Diabetes is a complex and heterogeneous disorder presently affecting more than 100 million people worldwide and causing serious socio-economic problems. Spontaneous rodent models of diabetes mellitus have proved invaluable in understanding the pathogenesis, complications, and genetic or environmental influences that increase the risks of diabetes. We have reviewed here in the development and characterization of spontaneous rodent models that displayed most features commonly associated with diabetic retinopathy.

Gastrointestinal Tract ; physiopathology ; Humans ; Infection ; physiopathology ; Sepsis ; physiopathology ; Shock, Septic ; physiopathology

[ ABSTRACT] AIM:In this study, we aim to obtain the induced pluripotent stem cells ( iPSCs) from the patients with sporadic Alzheimer disease ( AD) .METHODS:Three typical Alzheimer’ s patients were chosen, and the epithelial cells were isolated from their urine.We reprogrammed these cells into induced pluripotent stem cells by transfection of 4 factors (Oct4, Sox2, Klf4 and SV40LT) with the technique of electro-transfection.After getting these iPSCs, we continue to differentiate them into neural cells by a specific method—dual inhibition of Smad signaling.RESULTS: The primary cells from 3 AD patients were successfully reprogrammed to iPSCs, and these patients-derived iPSCs were differentiated into neural cells.There was no significant difference, during iPSCs reprogramming and neural differentiation, between cells from AD patients and normal people.CONCLUSION: The urine cells from AD patients were able to transfer to iPSCs, functional neurons and neurogliocytes.

Objective: To explore the role of human hematopoietic growth factors (HGFs) in proliferation and differentiation of cord blood CD34+ cells. Methods: Human cord blood mononuclear cells (MNC) were cultured with different combinations of HGFs (including rhIL-1,rhIL-3, rhIL-6, rhG-CSF, rhGM-CSF and rhSCF). The expansion folds of MNC, the changes of cellular surface markers by FACS, and CFU-GM of hematopoietic cells were observed. Results: The total nucleated cells expanded by 44 folds after cultured with 6 cytokines for 20 days. The number of CFU-GM increased by 14 .74 folds after cultured in liquid for 8 days, but decreased heavily after 18 days. The total number of CD34+ cells increased by 127. 79 ~ 196 .40 folds at 6 to 8 day, but decreased to 101.51 folds at 18 day. Conclusion: Human hematopoietic growth factors can increase the expansion of cord blood CD34+ cells and CFU-GM significantly.

Objective To analyze the therapeutic effects of different meth ods in operative treatment of intertrochanteric fractures of femur. Methods 106 cases were treated with operation and their average age was 72 year old. 39 case s of them were treated with external fixation, 3 cases with steeliness, 13 cases with Metanghin nail, 45 cases with DHS, and 6 cases with proximal femoral nail( PFN). Results The therapeutic effects of the dynamic hip screw(DHS) and PFN trea tment were the best among these methods. The excellent and good rates of DHS, PF N, external fixation, steeliness, and Metanghin were 100%, 87.2%, 33.3%, 69. 2%, respectively. Conclusion For the intertrochanteric fracture of lemur,DHS or PFN is recommendable to the patients who can tolerate an operation, whereas uni lateral external fixation is preferable to those who cannot or will not receive an operation.

Objective To isolate new conotoxins of Conus textile from the South China Sea,provide new conopeptides for drug discovery and design, and investigate the effects of living environment on toxin secretion by comparing the compositions of the conotoxins of this species from different areas. Methods Crude conotoxins were purified by Sephadex G-25 and RP-HPLC, the amino acid sequences of the purified peptides were determined. Results More than 10 conotoxins were isolated from Conus textile, 4 conotoxins were firstly isolated and 6 conotoxins had the similar sequence as the reported peptides. Conclusion Many M-family conotoxins were isolated from Conus textile, the main compositions of the venom of Conus textile from the South China Sea were similar to those from Cebu and Marinduquc island in Philippines.