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.

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.

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.

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

AIM:To compare the mutant prevention concentration(MPC)of linezolid and vancomycin against methicillin resistant staphylococcus aureus(MRSA)and study the correlation between minimal inhibitory concentration(MIC)and MPC.METHODS:MICs and MPCs of two drugs against 35 MRSA clinical stains were determined by agar plates dilution method.The correlations between MIC and MPC were determined by linear regression.The ability to restrict the resistance was evaluated according the pharmacokinetics of two drugs.RESULTS:The MPCs of two drugs against MRSA were 16 and 8 ?g/mL and the MPC/MIC was 8.MPCs and MICs correlated poorly(R2 were 0.32 and 0.008,respectively).According to pharmacokinetics of two drugs,the concentration of linezolid was inside the MSW(mutant selective window)for the entire dosage interval,while the concentration of vancomycin exceeded the MPC for the most dosage interval.CONCLUSION:The capacity of vancomycin for restricting the selection of MRSA resistant mutants is stronger than that of linezolid.There is low correlation between MPC and MIC.

Objective To study the allele and genotype distribution of CD14 gene promoter region-159C/T,-260C/T polymorphisms in Chinese patients with Henoch-Schonlein purpura(HSP),and to discuss the association between CD14 gene promoter region polymorphisms and HSP.Methods Under the case-control study,CD14-159C/T and CD14-260C/T site polymorphisms in 144 children with HSP and 180 healthy controls were analyzed with polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP),and the relationship between CD14-159C/T and CD14-260C/T site polymorphisms and the risk of HSP were analyzed.SPSS 13.0 software was used to analyze the data.Results The distribution of CD14 gene-159C/T polymorphism was significantly different between gastro-intestinal(GI)involvement group,renal involvement group and healthy control group(P=0.041,0.010,respectively);but the CD14 gene-260C/T polymorphism was significantly different between simple lesion group,renal involvement group and healthy control group(P=0.003,0.037,respectively)and C and T allele were significantly different between simple lesion group,joint damage group,GI involvement group,renal involvement group,healthy control group(P=0.017,0.035,0.024,0.007)and the relative risk for different types of HSP in T allele carriers was higher than that in C allele carriers(simple lesion:OR=2.097,95%CI 1.131-3.823;joint:OR=1.603,95%CI 1.031-2.493;GI:OR=1.602,95%CI 1.062-2.415;renal:OR=1.843,95%CI 1.175-2.889;respectively).Conclusions CD14 gene promoter region polymorphism is associated with HSP and T alele of CD14-260C/T may be a risk factor for HSP.

AIM: To evaluate the effect of intravitreal bevacizumab (IVB) injection 1 week before pars plana vitrectomy (PPV) in proliferative diabetic retinopathy (PDR) patients. METHODS: A retrospective research was done on 46 PDR patients who were divided into PPV group (n=28) and IVB group (n=18, PPV with preoperative IVB). Bevacizumab was injected 1 week before PPV. Main outcome measures were visual acuity, incidence of iatrogenic retinal breaks, intraoperative and postoperative bleeding. RESULTS: At 1 month after surgery, visual acuity in PPV (82.1%) and IVB group (88.9%) improved significantly (P<0.01) and the difference between the two groups was not significant. Iatrogenic retinal breaks were reported in 18 cases (64.3%) in PPV group and 4 cases (22.2%) in IVB group (P<0.05). Intraoperative bleeding was encountered in all cases in PPV group and 7 cases (39%) in IVB group (P<0.01). Postoperative bleeding was reported in 9 cases (32.1%) in PPV group and none in IVB group (P<0.01). CONCLUSION: IVB injection before PPV is helpful in reducing iatrogenic retinal breaks, intraoperative and postoperative bleeding in PDR patients.

?ln recent years, the number of patients with diabetes increase rapidly. Diabetic retinopathy ( DR ) , one of the complications of diabetes, is also the important aspect of current and future prevention of blindness in our country. Now, more and more scholar have noticed the important role of immune inflammation in the pathogenesis of diabetic retinopathy. ln this article, we reviewed the role of interleukin-6 ( lL-6 ) in diabetic retinopathy.