OBJECTIVE: To summarize the development of researches on sildenafil for treating cardiovascular patients with erectile dysfunction, so as to explore the safety of applying sildenafil and efficacy of treating related cardiovascular diseases.DATA SOURCES: The relevant articles to sildenafil between October 1999 and February 2006 were computer-searched in PubMed databasewith the key words of "sildenafil, erectile dysfunction, sexuality, cardiovascular disease" in English. Meanwhile, Medscape database was scanned with computer to identify relevant articles with key words of "sildenafil, cardiovascular disease". STUDY SELECTION: After the primary searching, literatures on relationship between sildenafil and cardiovascular disease were searched in full-text, while articles about erectile dysfunction but had nothing to do with cardiovascular disease were excluded. The repetitive experimental studies were also deleted. DATA EXTRACTION: A total of 55 articles were collected, and 22 of them were in accordance with the inclusion criteria and their full-texts were carefully looked through. DATA SYNTHESIS: The selected data were classified according to the relationship between erectile dysfunction and cardiovascular disease, effect of sildenafil on erectile dysfunction of patients with heart disease and rec ommendation of the Princeton conference. CONCLUSION: It is demonstrated in many literatures that the potential risk of sildenafil triggering cardiovascular disease is relatively small. Cardiac patients need not promote huge concerns when resorting to sildenafil for erectile dysfunction treatment. However, the protective cardiac effects of sildenafil should be further investigated.

Objective To determine risk factors and treatments of capillary leak syndrome (CLS) in infants with congenital heart disease(CHD)after extracorporeal bypass (GBP) . Method A retrospective study of 38 infants with CIS and another 150 cases without CLS of a random choice who underwent extracoiporeal bypass from June 2003 to July 2007 was carried out.Several risk factors with statistical significance were screened out with uni-varite logistic regression analysis, and the independent rask factors of CLS were determined with inultivariate step-wise logistic regression analysis. The outcome of CIS infants was compared with infants of control group. Results Logistic analysis showed the risk factors of CLS were the duration of GBP ( OR = 10. 353) , type of CHD ( OR = 6. 912), age ( OR = 6. 254) and temperature of CBP ( OR = 4. 151) . Of the CLS infants cohort, 10 cases underwent peritoneal dialysis and 4 cases died. Conclusions The risk factors of CLS in infants after CBP are the length of time consumed during CBP, type of CHD, age and temperature of CBP.

[Objective]To research the efficient way of isolating and proliferating of induced endothelial cells(ECs) ,measure the number of the ECs and observe the main biological characteristic of ECs m vitro during the passage cultivation.[Method]The marrow mononuclear cells(MNCs) in rabbit marrow were isolated by the gradiem centrifugation and cultivated to isolate and induce ECs. The efficiency of isolating and harvesting ECs was measured by the number of the first passage ECs from every 10~6 of the MNCs. The changes of ECs morphology, growth and proliferation were observed during the passage cultivation. The immunohistochemical staining of CD31 and vWF and function of ECs were checked.[Result]After cultivated at 1?10~6/cm~2 MNCs for 7～8 d, the first passage ECs were harvested. The number of the first and the second passage ECs had a remarkable statistical positive correlation with the number of the MNCs from one rabbit. After cultivated for 7～8 d, the first passage ECs of 7.086?0.75?10~4 in number and the second passage ECs of 53.20?6.47?10~4 in number were harvested from every 10~6 MNCs on average;ECs, which were monolayer arrayed to form cobblelike shape,The cells of 2nd passage showed positive staining of CD31 and vWF, and positive labeling of DiI-LDL and UEA.[Conclusion]The period from cultivating to harvesting ECs is shortened at the density of 1?10~6/cm~2 MNCs. It is feasible that the efficiency of isolating and harvesting ECs could be measured by the number of the first or the second passage ECs from every 10~6 MNCs. The induced ECs can act as seeding cells in bone tissue engineering in future.

The low survival rate of stem cells in the ischemic myocardium microenvironment is the bottle neck in treating ischemic diseases with stem cell transplantation.It is able to increase anti-apoptotic ability of the stem cells and promote their effective differentiation towards myocardial cells directly and indirectly by pretreating the stem cells with cytokines,drugs or chemical compounds,or modifying gene expression to promote cell adhesion,survival or angiogenesis for repairing ischemic myocardium and improving heart function after transplantation of the stem cells.

Objective To assess the usefulness of the MSCTA with 3D reconstruction to epigastric tumors in interventional treatment.Methods MSCTA were performed in 27 cases of epigastric tumors before and after interventional treatment.3D reconstruction were taken for blood vessels with technique of MIP(maximum intensity projection)and VRT(volume rendering technique).Results 42 times MSCTA and 3D reconstruction were performed in 27 cases of epigastric tumors.We discovered 5 feeding arteries with mutation in abdominal cavity,7 collateral branches formed after embolization and 2 abnormal courser of celiac artery.The display of vasculative with MSCTA was better than that of DSA.Conclusion 3D-MSCTA for epigastric tumors not only can show directly and clearly the stereo-anotomic images of the tumor feeding vessels but also provide guidance for planning the treatment.

Objective To evaluate the effects of time selection and immediate percutneous transluminal coronary angioplasty (PTCA) in refractory unstable angina pectoris.Methods PTCA was performed in 27 RUAP patients,among which 16 underwent emergency PTCA and 11 patients experienced PTCA after controlling with medicine.ECG and recurrence of symptoms were observed immediately and 6 months after PTCA.Results The procedural success rate was 100%.The immediate relieving rate was 96.3%.The recurrence rate of 11 cases within 6 months (18.2%)was significantly lower than that of 16 cases(37.5%).Conclustion The PTCA for RUAP is relatively safe and effective,but PTCA should be performed after situation is unchanged by use of medicine and PTCA shoulde be carried out immediately if the symptoms can not be controlled by medicine.

OBJECTIVE:To evaluate the effectiveness and security of Yishen huashi granules in the adjuvant treatment of chronic nephritis systematically,and to provide evidenced-based reference. METHODS:Retrieved from CBM,CJFD,Wanfang database,VIP,Medline,PubMed,EMBase and Cochrane library,randomized controlled trials(RCTs)about Yishen huashi gran-ules in the treatment of chronic nephritis were collected and related magazines were retrieved by hand. After selection and data ex-traction by 2 researchers independently,the quality of included literature was evaluated according to Jadad rating scale,and Me-ta-analysis was conducted by using Rev Man 5.3.5 software. RESULTS:A total of 8 RCTs were included,involving 1028 patients. Total response rate of trial group [RR=1.33,95%CI(1.24,1.42),P<0.001] was significantly higher than that of control group. 24 h urine protein quantity [MD=-0.32,95%CI(-0.40,-0.24),P<0.001],serum creatinine [MD=-22.38,95%CI(-23.37,-21.39),P<0.001],blood urea nitrogen [MD=-1.45,95%CI(-2.05,-0.84),P<0.001] were significantly lower than control group,with statistical significance. CONCLUSIONS:Based on routine treatment,Yishen huashi granules have good therapeutic ef-ficacy for chronic nephritis,can reduce 24 h urine protein and improve renal function.

Objective To evaluate the safety and efficacy of low-molecular weight heparin on the prevention of acute closure after percutaneous intracavitary coronary angioplasty.Methods 73 patients were randomly assigned to LMWH and SH groups.All patients underwent SPECT or CAG.Myocardial ischemia and hemorrhage complication were analyzed.Results In Group LMWH,no case of hemorrhage complication occurred,and in 3 cases angina occurred within 24h after the operation,which was proved by CAG to be acute closure of target vessel (the incidence rate 8.6%) .In Group SH,gum and subcutaneous hemorrhage occurred to 2 cases within 7h after the operation,hematuria occurred to 2 cases within 12h and one case died from cerebral hemorrhage,which was confirmed by CT (the total hemorrhage incidence 13.2%).Another 4 cases in Group SH suffered from re-occurrence of angina,which was confirmed by CAG to be acute closure of target vessel (10.5%).There was significant difference in hemorrhage complication between the two groups (P0.05)。Conclusion The results suggest that LMWH is safe and effective in the prevention of acute closure after native vessel coronary angioplasty.

Objective To evaluate the role of using non-invasive ventilation with bi-level positive airway pressure (BiPAP) in order to reduce the need of re-intubation in pediatric patients with respiratory failure after cardiac surgery. Method From January 2007 to December 2007, 25 patients aged from three months to 11 years with median 2.3 years operated on for cardiac surgery with respiratory insufficiency after extubation and re-intubation indicated were enrolled in this study. They were put on non-invasive nasal (mask) BiPAP ventilation before re-intubation. The arterial blood gas, A-aDO2 and PaO2/FiO2 were measured. In addition, clinical data including heart rate, respiratory rate, and the product of heart rate and systolic pressure were recorded before and after BiPAP. The software SPSSD 13.0 was used to process by ANOVA test for statistical analysis. Meanwhile, the outcome of these patients was analyzed. Results Twenty-five patients with 30 episodes of respiratory insufficiency were treated with BiPAP ventilation with median duration of 1.96 days ranged from 0.03 to 12 days. Of these respiratory failure episodes, 25 ones (83.3%) could be controlled by BiPAP and the needs of re-intubation were avoided. Five episodes of respiratory failure in 4 patients could not be quelled and the endo-tracheal tubes were inserted in these patients. All patients were saved with a median of mechanical ventilation duration of 3.4 days and ICU stay of 10.6 days. No major complications were observed. The heart rate, respiratory rate and the rate-pressure product were decreased significantly one hour after BiPAP (P < 0.05 all). Meanwhile, patients showed rapid improvement of oxygenation. The pH, SpO>2 and PaO2/FiO2 were increased significantly and A-aDO2 was decreased significantly (P < 0.05 all). The PaCO2, was decreased significantly four hours after BiPAP (P < 0.05). Conclusions Non-invasive nasal mask BiPAP can be used safely and effectively in children after cardiac surgery to improve oxygenation/ventilation, decreasing the work of breathing. It may be particularly useful in patients with high risk of re-intubation.

Objective To investigate the effect of comprehensive intervention on asymptomatic hyperuricemia.Methods in this random controlled study,all patients diagnosed with asymptomatic hyperuricemia on health examination according to the diagnostic standards were randomly divided into intervention group and control group.Comprehensive intervention included healthy lifestyle guidance and administration of sodium bicarbonate in the intervention group.Low purine diet was used in the control group.The follow-up period for all the patients was one year.The changes of various indexes in both groups before and after intervention were observcd and compared.Results Compared with the control group,the patients in the intervention group presented significantly lower levels of BMI,serum uric acid,blood sugar,SBP,DBP,triglyceride and less frequent occurrence of obesity,hyperglycemi,hypertension,hipertrigliceridemia (P ＜ 0.05).After intervention,the patients in the intervention group also exhibited significantly lower the levels of BMI,serum uric acid,blood sugar,SBP,DBP,triglyceride and significantly lower incidences of obesity,hyperglycemia,hypertension,hypercholesteremia and hipertrigliceridemia.Conclusion Comprehensive intervention into asymptomatic hyperuricemia can reduce the incidence of complications such as central obesity,hyperglycemia,hyperlipidemia and hypertension.