Objective To evaluate the effectiveness and safety of Dan hong injection for treating diabetic nephropathy (DN). Methods We electronically searched CENTRAL (the second issue 2009), MEDLINE (1980-2009.6), EMBASE (1980-2009.6), CNKI (1994-2009.6), CBM (1990-2009.6), WANG FANG (1984-2009.6) and VIP (1989-2009.6) to June 2009, and reference lists of all papers identified also were checked. Randomized controlled trials (RCTs), quasi- RCTs and cross-over studies were identified and assessed according to the Cochrane Handbook for Systematic Reviews of Interventions, and then Revman 5.0 was used to undertake meta analysis. Results Ten RCTs of 736 patients of diabetic nephropathy were included. Meta analyses showed that Dan hong injection was superior to routine treatment in decreasing UAER [MD= – 27.08, 95%CI (– 30.40, – 24.02)], Hb1AC [MD= – 1.12, 95%CI (– 1.67, – 0.56)] and FDP [MD= – 2.28, 95%CI (– 2.70, – 1.86)]; and Dan hong had similar effects in reducing the 24 hours proteinuria [MD= – 0.03, 95%CI (– 0.10, 0.04)], serum creatinine [MD= – 1.00, 95%CI (– 7.86, 5.86)], endogenous creatinine clearance rate [MD= – 2.30, 95%CI (– 15.51, 10.91)], blood cholesterol [MD= – 0.10, 95%CI (– 0.68, 0.48)], blood triglyceride [MD= – 0.15, 95%CI (– 0.36, 0.05)] and fasting blood sugar [MD= – 0.10, 95%CI (– 0.68, 0.48)]; However, Dan hong had more effective action on decreasing the UAER [MD= – 13.14, 95%CI (– 18.00, – 8.27)], blood cholesterol (Plt;0.05) and triglyceride (Plt;0.05) comparing with Dan shen, and on reducing 24 hour albuminuria (Plt;0.05) and FDP (Plt;0.05) with Mai luoning; no significant adverse effects or allergic reactions were reported. Conclusion Dan hong can improve UAER of DN; conclusive results cannot be made about the effectiveness and safety of dan hong for diabetic nephropathy according to limited existing trials. Larger and higher quality randomized controlled trials are needed to assess the available evidence.
Objective To evaluate the effectiveness and safety of AAI pacing mode versus DDD pacing mode for treating sick sinus syndrome (SSS). Methods We electronically searched CENTRAL (Issue 2, 2009), MEDLINE (1980 to June 2009), EMbase (1980 to June 2009) and CBM (1990 to June 2009). Randomized controlled trials (RCTs), quasi- RCTs and cross-over studies were identified and assessed, and then RevMan 5.0 software was used to perform metaanalysis. Results A total of 509 patients of six parallel and two crossover RCTs were identified, and the quality of reporting was found poor. Studies showed a statistically significant preference to AAI pacing mode for the reduction of left atrial diameter (MD=2.09, 95%CI 0.22 to 3.97), left ventricular end-diastolic diameter (MD=3.00, 95%CI –1.58 to 7.58), the prevention atrial fibrillation (P=0.026) and the improvement of life quality (Plt;0.05), but with more replacement or remodulation. Non-significant preference was shown to the prevention of all-cause mortality (P=0.51), cardiovascular mortality (P=0.43), stroke (P=0.32) and heart failure (P=0.17), the reduction of left ventricular end-systolic diameter (MD=1.21, 95%CI –0.85 to 3.28) and left ventricular ejection fraction (MD= –2.91, 95%CI –6.53 to 0.70). No significant adverse effects were reported. Conclusion The review shows a trend towards AAI pacing mode compared with DDD pacing mode in terms of effectiveness. However, because of the high bias risk of the included trials, the evidence is insufficient, so more large-sample and high-quality RCTs are needed.