[Show abstract][Hide abstract] ABSTRACT: Background:
Emergence agitation (EA) is one of the most common postoperative complications in children. The purpose of this meta-analysis is to assess the effect of dexmedetomidine for preventing postoperative agitation in children.
We searched the Cochrane Central Register of Controlled Trails, MEDLINE, and EMBASE. Randomized controlled trials were included. The following outcome measures were evaluated: incidence of EA, number of patients requiring rescue, time to eye-open, time to extubation, time to discharge from the postanesthesia care unit (PACU).
We analyzed 19 trials (1608 patients) that met the inclusion criteria. Compared with placebo, intravenous dexmedetomidine significantly reduced the incidence of EA [risk ratio (RR) 0.34, 95% confidence interval (CI) 0.25-0.44, P<0.00001). Dexmedetomidine also decreased the incidence of severe pain (RR 0.41, 95% CI 0.27-0.62, P<0.0001) and requirement of a rescue drug (RR 0.31, 95% CI 0.18-0.53, P<0.0001). However, compared with placebo, dexmedetomidine increased the time to eye-open by 0.98 min (P = 0.01) and the time to PACU discharge by 4.63 min (P = 0.02). Dexmedetomidine was also compared with midazolam, propofol, ketamine, and fentanyl, among others. No significant difference was found in the incidence of EA for most of these comparisons, with the exception of fentanyl and propofol, where dexmedetomidine was more beneficial.
Dexmedetomidine was proved effective for preventing EA and for reducing severe pain and the requirement of rescue drugs. It slightly increased the time to eye-open and the time to PACU discharge. Dexmedetomidine was also more beneficial than propofol or fentanyl in preventing EA.
PLoS ONE 05/2015; 10(5):e0128450. DOI:10.1371/journal.pone.0128450 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To observe the effect of nuclear factor erythroid 2-related factor 2 (Nrf2) agonist on the apoptosis of alveolar cell induced by hyperoxia and to explore whether Nrf2 activation could protect neonatal rats from hyperoxia induced lung injury.
90 neonatal Sprague-Dawley rats were randomized into room air group (FiO2 =21%, N group), hyperoxia group (0 group) and Nrf2 group (n=30 each). Neonatal rats in the 0 group and Nrf2 group received saline 0. 2 mL and Nrf2 agonist 30 mg/kg respectively at the first and second day after birth, and were exposed in high concentration oxygen (95%) for 4 d. N group rats were fed in room air. The apoptotic index (AI) and Nrf2 expression of lung tissue were detected by TUNEL and immunohistochemistry staining respectively.
Compared with 0 group (28. 8% ± 3. 0%), the AI of alveolar. cell was lower in N group (0. 7%±0. 6%) and Nrf2 group (7. 2% ± 0. 8%) (P<0. 01). The expression of Nrf2 was significantly higher in 0 group (926. 80 ± 130. 51) and Nrf2 group (1038. 40±151. 12) than that in N group (30. 03±9. 99) (P<0. 01).
Nrf2 activation could reduce the alveolar cellular apoptosis and protect neonatal rats from hyperoxia induced lung injury.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 05/2015; 46(3):399-402.
[Show abstract][Hide abstract] ABSTRACT: Anesthetic management of patients with preexisting diseases is challenging and individualized approaches need to be determined based on patients' complications. We report here a case of ultrasound-guided epidural anesthesia in combination with low-dose ketamine during cesarean delivery on a parturient with severe malformations of the skeletal system and airway problems. The ultrasound-guided epidural anesthesia was performed in the L1-L2 space, followed by an intravenous administration of ketamine (0.5 mg/kg) for sedation and analgesia. Satisfactory anesthesia was provided to the patient and spontaneous ventilation was maintained during the surgery. The mother and the baby were discharged 5 days after surgery, no complications were reported for either of them. Our work demonstrated that an ultrasound-guided epidural anesthesia combined with low-dose ketamine can be used to successfully maintain spontaneous ventilation and provide effective analgesia during surgery and reduce the risk of postoperative anesthesia-related pulmonary infection.
Local and Regional Anesthesia 05/2015; 8:7-10. DOI:10.2147/LRA.S81696
[Show abstract][Hide abstract] ABSTRACT: 5-HT3 receptor antagonists are effective antiemetics for perioperative use. However, their effects on myometrial contractility remain unknown. We examined whether three different 5-HT3 receptor antagonists could affect the contraction of human myometrium.Methods
Samples of human myometrium were taken from parturients undergoing elective cesarean delivery. Effects of ondansetron, granisetron and tropisetron (over a range of 1–104 ng/mL) on spontaneous contraction (ratios of amplitude, interval, and duration of the contraction) were examined and compared to saline controls (n=6 for each agent).ResultsNone of the three 5-HT3 receptor antagonists significantly affected myometrial contraction.Conclusion5-HT3 receptor antagonists do not affect the contraction of myometrial strips isolated from term pregnant women.
International Journal of Obstetric Anesthesia 11/2014; 24(1). DOI:10.1016/j.ijoa.2014.11.003 · 1.60 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To investigate the changes of lung cell apoptosis and the expression of notch signaling in the lung of neonatal rats exposed to hyperoxia and to explore the internal relationship between notch1 and hyperoxia-induced lung injury.
120 neonatal Sprague-Dawley rats of 22-day gestational age were randomized continually exposed to hyperoxia (FiO2 = 95%, hyperoxia group) or room air (FiO2 21%, air group) 30 minutes after birth. The notch signaling expression in the lung were detected by immunohistochemical methods respectively at 4, 7, 14 days after inhale hyperoxia or air. At the same time, pathological changes in the different groups were also observed with light microscope and lung cell apoptosis was determined quantitatively by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) methods.
The biopsy test showed lung injury in hyperoxia group. The amount of apoptosis cell in hyperoxia was higer than that in the control group, and increased with the prolongation of hyperoxia supply. Positive staining for North1 in hyperoxia group was much lower than that in control group at every time point (P<0. 01, P<0. 05).
Continually hyperoxic exposure might resulted in the lung injury and development of arrest. The abnormal expression of notch signaling might contributed to the pathogenesis of hyperoxia-induced lung injury in newborn rats.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 11/2014; 45(6):937-40.
[Show abstract][Hide abstract] ABSTRACT: Objective:
To investigate the effect of continuous exposure to hyperoxia on livers and changes in nuclear factor erythroid 2-related factor 2 (Nrf2) expression in hepatic tissues in neonatal rats.
100 neonatal Sprague-Dawley rats were randomized divided into hyperoxia group (FiO = 95%, O group) and normal control group (FiOG2 = 21%, N group) immediately after birth. Hepatic apoptotic index and Nrf2 expression were detected by immunohistochemical methods on 4 d, 7 d, and 14 d.
Rats with hyperoxia had higher levels of hepatic apoptotic index and Nrf2 expression compared with the controls (P < 0.01). The levels of hepatic apoptotic index and Nrf2 expression in rats with hyperoxia were higher on 7 d and 14 d than those on 4 d (P < 0.01).
Continuous exposure to hyperoxia could result in hepatic damage to neonatal rats, with increased expression of Nrf2 as a mechanism of anti-oxidant.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 09/2014; 45(5):777-9.
[Show abstract][Hide abstract] ABSTRACT: To determine the lowest effective cuff pressure of the esophageal obstruction tube to prevent reflux of gastric contents in rabbits.
Twenty-two New Zealand white rabbits (2.0-2.5 kg) were anesthetized. An esophageal obstruction tube, an esophageal observation tube, and a gastric tube were inserted into the esophagus and stomach, respectively. Normal saline containing methylene blue was injected into the stomach for an animal model of gastric contents reflux. Possible saline reflux was observed through the esophageal observation tube. It was considered "regurgitation" when the saline flowed out, and "no regurgitation" when the saline did not. When a "regurgitation" result was obtained in a particular rabbit, the intracuff pressure was increased by 10 cm H2O in the following rabbit and vice versa. The trial was not terminated until six crossover points were observed from "no regurgitation" to "regurgitation." A probit regression model was used to analyze the effective intracuff pressure of the esophagus obstruction tube after 50 % and 95 % of the rabbits showed no reflux.
The lowest effective intracuff pressure to prevent reflux of gastric contents in 50 % of rabbits from the Dixon up-down method was 61.67 ± 8.16 cm H2O. The intracuff pressures at which there was 50 % and 95 % probability of lack of gastric contents reflux from a probit regression model were 61.95 and 74.39 cm H2O, respectively.
The insertion of an esophageal obstruction tube before endotracheal intubation can be an acceptable method for preventing the reflux of gastric contents in most rabbits under light anesthesia.
Journal of Anesthesia 12/2013; 28(4). DOI:10.1007/s00540-013-1757-7 · 1.18 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To investigate the safety and efficay of low-dose furosemide in the correction of oliguria in the patients undergoing gynecologic surgery.
A total of 120 patients, aged between 20 to 50 years old, who were scheduled to receive elective gynecological open surgery under general anesthesia, were randomly divided into 3 groups: the control group, furosemide 0. 05 mg/kg (F0.5) group and furosemide 0. 1 mg/kg (F1) group (n=40). During surgery, blood volume and blood pressure was maintained in the normal range. The urine volume was recorded every 30 minutes. Oliguria was defined as the urine volume less than 0. 5 mL/(kg . h), When oliguria was observed, flurosemide or saline was given to the patients based on the enrollment status. If the patients were still oliguric 30 min later, the treatment was repeated. The total time of surgery, net fluid infusion volume, urine volume per unit time per body weight at the completion of surgery, the incidence of intraoperative oliguria, the total amount of furosemide and the average specific gravity of urine were recorded.
There was no statistically significant difference in sex, age, fasting time, the total time of surgery and intraoperative net fluid infusion volume among the three groups (P>0. 05). The urine volume per unit time per body weight in control group was significantly lower than that of the other two groups (P<0. 01). The incidence of intraoperative oliguria in the three groups (control, low dose, high dose groups) were 52. 5%, 12. 5% and 0%, respectively (P<0. 01).
Low-dose of furosemide could maintain normal urine volume and specific gravity of urine during gynecological surgery.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 09/2013; 44(5):783-6.
[Show abstract][Hide abstract] ABSTRACT: To investigate the effects of surfentanyl and fentanyl on spontaneous contractions of isolated uterine smooth muscles of rabbits.
Thirty isolated uterine smooth muscles strips of rabbits with rhythmic spontaneous contraction were randomly divided into three groups: control group (n = 10) fentanyl group (n = 10) and surfentanyl group (n = 10). The effects of fentanyl and surfentanyl on spontaneous contractions intensity, frequency and duration of isolated uterine smooth muscles of rabbits in different concentrationswere monitored.
There were no effect on the spontaneous contraction of isolated uterine muscles of rabbits at the concentration of 1 x 10(-8) mol/L in fentanyl group. The spontaneous contraction intensity was decreased significantly when the concentration of fentanyl more than 3 x 10(-8) mol/L (P < 0.05). The spontaneous contraction intensity, frequency and duration was inhibited more than 50% when the concentration of fentanyl more than 3 x 10(-7) mol/L (P < 0.05). And the spontaneous contraction duration was inhibited more than 50% when the concentration of surfentanyl more than 1 x 10(-7) mol/L (P < 0.05). Compared with surfentanyl group, there were significant difference on spontaneous contraction intensity when the concentration of fentanyl more than 3 x 10(-8) mol/L (P < 0.05). Difference on frequency, more than 3 x 10(-8) mol/L (P < 0.05) and difference on duration, at the concentration of 1 x 10(-7) and 1 x 10(-7) mol/L (P < 0.05).
Fentanyl restrained the spontaneous contractions of isolated uterine smooth muscles of rabbits in concentration-dependent manner. Surfentanyl could reduce the spontaneous contractions duration on isolated uterine smooth muscles of rabbits. But there were no effect on frequency and duration.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 03/2013; 44(2):213-7.
[Show abstract][Hide abstract] ABSTRACT: Background
Metoclopramide and magnesium sulfate (MgSO4) are extensively used agents in obstetrics. In this study, the relaxant properties of metoclopramide and MgSO4 on pregnant myometrium, together with the possible reversing influences of oxytocin and cabergoline (a dopamine D2 receptor agonist), were investigated.
Myometrial strips from 24 parturients were randomly allocated to four groups: control (Group CON), MgSO4 and oxytocin (Group MSO), metoclopramide and oxytocin (Group MEO), and metoclopramide and cabergoline (Group MEC). Myometrial strips were mounted on a myograph bathed in Krebs buffer. Saline (Group CON) and five incremental doses of MgSO4 (Group MSO) or metoclopramide (Groups MEO and MEC) were sequentially microinjected into the bath. Subsequently, oxytocin (Groups CON, MSO and MEO) or cabergoline (Group MEC) was microinjected into the bath. The myometrial contractile characteristics after each drug injection, including contractile force, interval and duration, were analyzed.
MgSO4 was more potent for prolonging myometrial contractile interval than reducing contractile force. Metoclopramide relaxed myometrial contractions by inhibiting contractile force and prolonging contractile interval in a concentration-dependent manner. Oxytocin reversed both the inhibited contractile force and the prolonged contractile interval caused by a high concentration of MgSO4 but accelerated the contractile interval and had no significant effect on the contractile force suppressed by metoclopramide. The relaxant effects of metoclopramide were completely reversed by cabergoline.
Both MgSO4 and metoclopramide relaxed myometrial contractions, and exhibited different responses to subsequent oxytocin treatment. The relaxant mechanism of metoclopramide may be via blockade of dopamine D2 receptor, which requires further investigation.
International journal of obstetric anesthesia 01/2013; 23(2). DOI:10.1016/j.ijoa.2013.11.004 · 1.60 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To investigate the protective effects of morphine postconditioning on the renal hypoxic/ reoxygenation injury in rabbit and the mechanisms involved.
Hypoxic/reoxygenation injury was induced with inhalation 8% O2 3 hours followed by breathing in air 48 hours. Thirty male white New Zealand rabbits were randomly divided into 3 groups: normal control group, hypoxic/reoxgenation group (H/R group) and morphine hypoxic postconditioning group (MO+H/R group). Animals in H/R and MO+H/R group received 5 mL of saline or morphine 3 mg/kg respectively before induction reoxygenation. The levels of serum creatinine (SCr) and blood urea nitrogen (BUN) were detected respectively at 48 hour after bypoxic and reoxgenation happened. Pathological changes in the different groups were also evaluated by light microscope. Renal apoptosis was determined quantitatively by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL)methods. Result The SCr and BUN in H/R group and MO+ H/R group were much higher respectively when compared with those in the N group. The SCr and BUN in MO+H/R group were much higher compared with those in the H/R group. The renal pathological changes were more severe in the H/R group than that of MO+H/R group. Apoptosis phenomenon was lower in MO+H/R group than H/R group (P < 0.05).
Morphine postconditioning can protect rabbit against acute renal hypoxic/reoxygenation injury by reducing renal apoptosis.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 01/2012; 43(1):38-40.
[Show abstract][Hide abstract] ABSTRACT: The maintenance of the balance between oxygen supply and oxygen consumption is a key measure in preventing acute kidney hypoxic/reoxygenation injury. Morphine can inhibit metabolism and reduce the oxygen consumption. We tried to investigate the protective effects of morphine hypoxic preconditioning on acute kidney hypoxic/reoxygenation injury in rabbit and its influence on expression of caspase-3 protein. Kidney hypoxic and reoxygenation were induced by making the tested rabbits inhale 8% oxygen for three hours firstly, and then putting them in the air to breathe in normal oxygen for another three hours. Morphine hypoxic preconditioning was induced by administering morphine 3 mg/kg, and then hypoxic of 8% oxygen was induced. Caspase-3 protein expression in renal tissue was assessed by immunohistochemical method. In the present study, the expressions of caspase-3 protein were significantly higher in saline-control hypoxic group than in morphine hypoxic preconditioning group ((29.3+/-5.7)% vs. (12.16+1.23)%, P<0.05). These observations suggested that morphine hypoxic preconditioning can protect rabbit against acute kidney hypoxic/reoxygenation injury by decreasing expression of caspase-3 protein.
Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi 06/2011; 28(3):531-3.
[Show abstract][Hide abstract] ABSTRACT: To assess the effect (harms and benefits) of nitrates for stable angina.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Randomized controlled trials with both parallel and crossover design were included. The following outcome measures were evaluated: number of angina attacks weekly and nitroglycerin consumption, quality of life, total exercise duration, time to onset of angina and time to 1 mm ST depression.
Fifty-one trials with 3595 patients meeting inclusion criteria were analyzed. Both intermittent and continuous regimens of nitrates lengthened exercise duration significantly by 31 and 53 s respectively. The number of angina attacks was significantly reduced by 2.89 episodes weekly for continuous administration and 1.5 episodes weekly for intermittent administration. With intermittent administration, increased dose provided with 21 s more length of exercise duration. With continuous administration, exercise duration was pronged more in low-dose group. Quality of life was not improved by continuous application of GTN patches and was similar between continuous and intermittent groups. In addition, 51.6% patients receiving nitrates complained with headache.
Long-term administration of nitrates was beneficial for angina prophylaxis and improved exercise performance but might be ineffective for improving quality of life. With continuous regimen, low-dose nitrates were more effective than high-dose ones for improving exercise performance. By contrast, with intermittent regimen, high-dose nitrates were more effective. In addition, intermittent administration could bring zero-hour effect.
International journal of cardiology 01/2011; 146(1):4-12. DOI:10.1016/j.ijcard.2010.05.019 · 4.04 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Sudden cardiac death (SCD) from cardiac arrest, one of the most common types of cardiac-related death, is most often triggered by ventricular arrhythmia (VA). It has been reported that aldosterone antagonists (AAs) have the benefit of reducing SCD in patients with heart failure (HF). It also has been indicated in animal experiments and clinical trials that AAs may have an antiarrhythmic effect.
AAs have an effect on VA in patients with HF or coronary artery disease.
We searched the Cochrane Central Register of Controlled Trials, PubMed, Current Controlled Trials, and the National Research Register, and identified randomized controlled trials on the effect of AAs on VA.
All together, 7 trials with a total of 8635 patients were identified and extracted. AAs reduced the risk of SCD in patients with HF by 21% (relative risk [RR]: 0.79, 95% confidence interval [CI]: 0.67-0.93). AAs significantly reduced the episodes of ventricular premature complexes (mean difference 705 ± 646 episodes per 24 hours). Risk of ventricular tachycardia was reduced by 72% (RR: 0.28, 95% CI: 0.10-0.77).
The additional administration of AAs in patients with HF or coronary artery disease shows a benefit in reducing the risk of SCD and may also be effective for reducing episodes of ventricular premature complexes and ventricular tachycardia.
[Show abstract][Hide abstract] ABSTRACT: To investigate the protective effect of morphine hypoxic preconditioning on hepatic hypoxic/reoxygenation injury in rabbits and the mechanisms involved.
Hypoxic/reoxygenation injury was induced with inhalation of 8% O2 for 3 hours followed by air for 3 hours. Thirty male white New Zealand rabbits were randomly divided into 3 groups: normal control group (N group), hypoxic/reoxgenation group (H/R group) and morphine hypoxic preconditioning group (MO + H/R group). Animals in the H/R and MO + H/R groups received 5 mL of saline or 3 mg/kg of morphine respectively before the induction of hypoxic injury. Hepatic apoptosis was determined quantitatively by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) methods. The activity of superoxide dismulase (SOD) in liver tissues was measured at the end of reoxgygenation.
A large number of TUNEL positive cells [(9.50 +/- 1.00)%] were observed in hepatic tissues of rabbits in the H/R group. The administration of morphine exerted a significant anti-apoptotic effect, as evidenced by reduced TUNEL-positive staining [(2.20 +/- 0.40)%, P < 0.05 vs. H/R group]. Compared with the H/R group, treatment with morphine increased SOD activity significantly [(85.57 +/- 19.37) vs. (48.35 +/- 15.84), P < 0.05)].
Morphine hypoxic preconditioning can protect rabbits against acute hepatic hypoxic/ reoxygenation injury by increasing SOD activity and reducing hepatic apoptosis.
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition 05/2010; 41(3):412-4.
[Show abstract][Hide abstract] ABSTRACT: This review assessed the therapeutic effect of traditional Chinese medicinal herbs commonly used in China. There is no evidence from randomised controlled trials to demonstrate that Chinese medicinal herbs are efficacious in treating acute bronchitis. We identified biases such as selection bias, conflict of interest and study design limitations. In addition, the safety of Chinese medicinal herbs is unknown due to the lack of toxicological evidence, though adverse events were reported in some case reports.
[Show abstract][Hide abstract] ABSTRACT: Acute myocardial infarction (AMI) is the most important cause of morbidity from ischaemic heart disease, and is among the leading causes of death in the western world. Danshen, a Chinese herbal medicine, is widely used in China for treatment of several diseases, including AMI.
To assess the effects (both benefits and harms) of danshen preparations for AMI.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (issue 4, 2006), MEDLINE (1966-2006), EMBASE (1980-2006), and the Chinese Biomedical Database (CBM) (1982-2006). We also handsearched 75 Chinese medical journals.
Randomised controlled trials (RCTs) lasting at least 7 days were sought. Since it seemed evident that few RCTs were available, we also considered other controlled studies.
Eligibility and trial quality were assessed by three reviewers.
Six studies comprised of 2368 participants were included. Only one trial was judged to be a genuine RCT and showed no statistically significant difference in reduction of total mortality (Peto OR 0.55, 95% CI 0.23 to 1.32), but a quasi-RCT reported a reduced total mortality (Peto OR 0.42, 95% CI 0.23 to 0.77). Pooling these trials yielded an approximate halving of mortality in those patients treated with danshen preparations plus usual care compared with usual care alone (Peto OR 0.46, 95% CI 0.28 to 0.75).
The evidence to support use of danshen preparations is too weak to make any judgement about its effects. Evidence from RCTs is insufficient and of low quality. The safety of danshen preparations is unproven, although some adverse events have been reported. More evidence from high quality trials is needed to support the clinical use of danshen preparations.
[Show abstract][Hide abstract] ABSTRACT: Suxiao jiuxin wan is widely used in China for angina pectoris.
The objective of this review is to determine the effects (benefits and harms) of suxiao jiuxin wan in the treatment of angina pectoris.
We searched the Cochrane Central Register of Controlled Trials on The Cochrane Library (issue 4 2005), Medline (1995 to 2005), EMBASE (1995 to 2005), the Register of Chinese trials developed by the Chinese Cochrane Centre (to 2006), and the Chinese Biomedical Database (1995 to 2005), and handsearched 83 Chinese journals. We also searched reference lists, databases of ongoing trials and the Internet. Date of last search: November 2005.
Randomised controlled trials of suxiao jiuxin wan compared to standard treatment in people with angina. Studies with a treatment duration > 4 weeks were included.
Two reviewers independently applied the inclusion criteria, assessed trial quality and extracted the data.
Fifteen trials involving 1776 people were included. There was weak evidence that suxiao jiuxin wan compared with nitroglycerin (xiaoxintong) improved ECG measurements (RR 1.16, 95% CI 1.05 to 1.27), reduced symptoms (RR 1.09, 95% CI 1.04 to 1.13), reduced the frequency of acute attacks of angina (difference in means -0.70, 95% CI -0.90 to -0.50), reduced diastolic pressure (difference in means -3mmHg, 95% CI -5.73 to -0.27) and reduced the need for supplementary nitroglycerin (difference in means of -0.60, 95% CI -0.94 to -0.26). There was also weak evidence that suxiao jiuxin wan compared with Salvia miltiorrhiza (danshen) reduced symptoms (RR 1.21, 95% CI 1.11 to 1.31) and improved ECG measurements (RR 1.55, 95% CI 1.30 to 1.84). There was no significant difference when comparing suxiao jiuxin wan with isosorbide dinitrate (xiaosuanyishanlizhi) both for ECG improvement (RR 1.34, 95% CI 0.91 to 1.98) and for symptom improvement (RR 1.11, 95% CI 0.86 to 1.43).
Suxiao jiuxin wan appears to be effective in the treatment of angina pectoris and no serious side effects were identified. However, the evidence remains weak due to poor methodological quality of including studies.