Meta-analysis on Intravascular Low Energy Laser Therapy*

Shu-Dong Zhao1, 2, Timon Cheng-Yi Liu#1, 2, Yan-Fang Wang1, Song-Hao Liu3

1. Laboratory of Laser Sports Medicine, South China Normal University, Guangzhou, GD 510006 China
2. College of Life Science, South China Normal University, Guangzhou, GD 510631, China
3. Photon TCM Laboratory, South China Normal University, Guangzhou, GD 510631, China

ABSTRACT
Intravascular low energy laser therapy (ILELT) was put forward for cardiocirculatory diseases in USA in 1982, was
popular in Russia in 1980s, and then in China in 1990s. The therapeutic effects of ILELT and drugs in comparison with
drugs only on Chinese patients and their blood parameters were analyzed with meta-analyses and reported as (OR,
95%CI) for patient improvement and (WMD, 95% CI) for blood parameter improvement, where 95%CI, OR and WMD
denoted 95% confidence intervals, odds ratio and weighted mean difference, respectively. It was found that the patients
of cerebral infarction (2.39, 2.09~2.74) and cerebrovascular diseases (2.97, 1.69~2.53) were cured, respectively, (P <
0.01), and the symptom improvement of patients of cerebral infarction, cerebrovascular diseases and diabetes were
significant (3.13, 2.79~3.51), (4.92, 3.39~7.14) , and (3.80, 2.79~5.18), and mild (3.66, 3.15~4.24), (4.95, 2.77~8.84),

and (7.11, 4.54~11.13), respectively, (P < 0.01). It was also found that the blood parameters such as cholesterol (-0.78，

-1.32~-0.24), total cholesterol (-1.08, -1.80~-0.36), low density lipoprotein cholesterol (-0.6, -1.01~-0.19), triacylglycerol

(0.63, -0.83~-0.42), high density lipoprotein (0.34，0.10~0.59), erythrocyte aggregation index (-0.24, -0.27~-0.21),

erythrocyte Sedimentation Rate (-4.57, -7.26~-1.89), fibrinogen (-0.76, -1.31~-0.21), whole blood contrast viscosity
(-0.40, -0.69~-0.12), low cut blood viscosity (-1.2, -1.93~-0.48), high cut blood viscosity (-0.62, -0.92~-0.32), whole
blood viscosity(-1.2, -1.85~-0.54) and plasma blood contrast viscosity(-0.07, -0.12~-0.03) were found improved (P <
0.05). It is concluded that the patients of cerebral infarction, cerebrovascular diseases and diabetes might be improved
with ILELT, which might be mediated by blood parameter improvement.

KEYWORDS: photobiomodulation, reactive oxygen species, meta-analysis

1 INTRODUCTION

Photobiomodulation (PBM) is a modulation of laser irradiation or monochromatic light (LI) on biosystems, which
stimulates or inhibits biological functions but does not result in irreducible damage. The LI used in PBM is always low
intensity LI (LIL), ~10 mW/cm2. However, moderate intensity LI (MIL), 102~3 mW/cm2, is of PBM if the radiation time
is not so long that it damages organelles or cells. The PBM of LIL and MIL is called LPBM and MPBM, respectively.

*
corresponding author. Email: [email protected]

Seventh International Conference on Photonics and Imaging in Biology and Medicine

edited by Qingming Luo, Lihong V. Wang, Valery V. Tuchin, Proc. of SPIE Vol. 7280,
728012 · © 2009 SPIE · CCC code: 1605-7422/09/$18 · doi: 10.1117/12.823336

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 Intravascular low energy laser therapy (ILELT) as an intravascular application of MPBM was put forward for
cardiocirculatory diseases by Lee et al (1982) in USA in 1982, was popular in Russia in 1980s, and then in China in
1990s. For ILELT, an optical needle was smoothly inserted into the vein, and the needle was connected to the laser
transducer through an optical fiber (diameter, 0.2 mm) (Tong et al. 2000). The order of the intensity at the tip of the optic
fiber used in ILELT is about 103 mW/cm2, a kind of MIL, but the blood velocity in vein is about 1~10 cm/s (Dowsett et
al. 1985) so that the order of the irradiation time of each blood cell is about 10 ms, and then the order of the dose of each
blood cell is about 100 J/m2, a kind of low energy. Therefore, the laser irradiation of ILELT is of moderate intensity but
low energy. In other words, ILELT is just a clinical application of intravascular MIL.

Chinese therapeutic applications of ILELT were the most widely in the world, and its basic studies such as blood
research in vitro(Mi et al 2004&2006), animal blood research in vivo (Tong et al 2000), human blood research in vivo
(Zhu 1999) and traditional Chinese medicine research (Yan et al 1999), was also very progressive in China. ILELT might
work in view of its previous research, but it should be verified by randomized placebo-controlled trial. However, there
was only one study on ILELT within the frame of evidence-based medicine. Zvereva et al. (1994) have made a
randomized placebo-controlled study of the clinical efficacy of four different methods of ILELT with He-Ne laser in 150
patients suffering from rheumatoid arthritis. The therapeutic effects of ILELT and drugs in comparison with drugs only
on patients and blood parameters were analyzed with meta-analyses in this paper.

2 META ANALYSIS

We searched reports in the Chinese National Knowledge Infrastructure (http://dlib3.edu.cnki.net/kns50/) (until May
2008) using the key words “intravascular” and “laser”. The second key word “laser” was searched on the base of result
of the first word “intravascular”. The language was Chinese.

We defined criteria for the inclusion and exclusion of literatures before analysis (Lichtenstein MJ 1987, Zodpey SP
2003). There were four rules to include the reports. First, the clinic trial included both treatment group and control group
or both the before trail data and after trail data for only one group. Second, the treatment group was treated with ILELT
and drugs. Third, both the treatment group and the control group used the same drugs which may be Chinese traditional
medicine or Western medicine. Fourth, both two groups have no significant difference in age and the degree of the
diseases before trial. There were six rules to exclude the reports. First, it was a reviewed report. Second, there were
neither numeric data nor continuous value. Third, the control group was treated with more drugs. Fourth, the control
group was also treated with ILELT. Fifth, the control group was treated with hyperbaric oxygen therapy. Sixth, it is the
repeated publication. Every report was assessed solely by two authors (Zhao SD and Wang YF). Consensus was reached
through discussion or arbitration by a third author (Liu TCY and Liu SH) before data entry. We have found high
agreement among most of them.

From each report, we recorded the published time, the journal, the first author, the report title, the drug, the disease,
the disease diagnosis standard, the age range (mean or median), the laser dose, the method of trail designed, curative
effect criteria, dichotomous data (cure number, remarkable number, effectual number, ineffectual number and the total),
and continuous value (mean and standard deviation). We then classified the data recorded into 3 kinds. The first kind of

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 data included the 130 reports of dichotomous data according to the fourth China cardio-cerebrovascular disease
conference’s curative effect criteria. It was analyzed solely using odds ratio (OR) for all cure number vs the total, cure
number plus remarkable number vs the total, cure number plus remarkable number plus effectual number vs the total, in
order to compare the treatment effects in trials. The second kind of data included the 43 reports of continuous data. Their
mean and standard deviation were analyzed using weighted mean difference (WMD) in the hemorheology variables of
patients in order to detect the change of the hemorheology of patients. The third kind of data included the 33 reports of
other continuous data. Their mean and standard deviation were analyzed using WMD in the reactive oxygen species
(ROS) and immune system variables of patients, for detecting how they influenced the ROS and immune system.

Paired t tests were used to test the differences between treatment and control groups before trial. Every report was
first estimated for quality scale (Crowther MA et al 2007). According to allocation concealment criterion, the four levels,
adequate, unclear, inadequate, not used, were denoted as A, B, C, and D in order, respectively. We used the cochrane
collaboration software (RevMan Analyses 4.2) to analyze the data in terms of a random-effects model or fixed-effects
model, calculated the OR or WMD with 95% confidence intervals (CIs) (DerSimonian R et al 1986, Hedges LV et al
1985, Bartolucci AA 2007). Subgroup, sensitivity and bias analyses were also performed. We also tested for
heterogeneity (homogeneity) in the results of different reports using the Q statistic and considered heterogeneity to be
significant if P < 0.05(Higgins JP et al 2002). We then choose the random-effect model (if P < 0.05) and the fixed-effect
model (if P ≥ 0.05) for farther analysis. Fail-safe number (Nfs) was used to test for publication bias. The fail-safe number
means how many negative reports could change the result. And its formula: Nfs0.05= (∑Z/1.645) 2-k, k means the number
of reports we analysed. Under the P = 0. 05 conditions, according to P received from each trial get the Z from the
standard normal school table. Comparing the Nfs0.05 with 5k+1, we would think the result we received is stead-going if
Nfs0.05>5k+1, or the result we received is biased so that the reliability of the result would be lower. Funnel plot could also
help us to judge weather the result we received is biased (Egger M et al 1997, Felson D 1992). In the funnel plot, the
chosen effect and its standard error are the abscissa (adopting hyperbolic logarithm as scale) and the ordinate,
respectively, and the swatch spots are spread round an axis which is paralleling the y-axis and the whole spots is just like
an inversion funnel. The whole spots are axis symmetry if the result is steady-going. Publication bias was evaluated by
funnel plot constructing a funnel diagram originating from the pooled OR or WMD of the literatures.

3 PATIENT IMPROVEMENT

The time range of the literature we recorded is from 1995 to 2007. The analyzed diseases in the 130 dichotomous
reports were cerebral infarction, pulmonary heart disease, coronary heart disease, diabetes, angina pectoris and heart
failure and cerebrovascular disease, but hypertension, tinnitus (deafness), and neurasthenia could not be analyzed for
lacking enough data.

There were 57 reports about cerebral infarction disease. 919 patients were cured among 2964 patients in treatment
group, but 437 were cured among 2632 patients in control group. The pooled OR was 2.39 (95% CI, 2.09~2.74). There
was a significant homogeneity (P =0.99) in the result (Figure 1) and the fix-effect model was chosen. According to table

1, Nfs0.05=701, 5K+1=286, Nfs0.05＞5K+1. This meant that the result was steady-going and the publication bias was lower

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 (Rosenthal R 1991). Therefore, we thought that ILELT with drug was better than treatment only using drug and the
former therapeutic effect was up to 1.39 than the latter. Figure 2 has implied Publication bias on the small side.

Table 1 has summarized the meta-analysis of the 6 diseases, pulmonary heart disease, coronary heart disease,
diabetes, angina pectoris and heart failure and cerebrovascular disease. It has also indicated that ILELT is better than
treatment only with the same drugs which was Chinese traditional medicine or Western medicine. Especially it works

well with cerebral infarction，diabetes, and cerebrovascular disease.

4 BLOOD PARAMETER IMPROVEMENT

43 of continuous reports recorded included 17 hemorheology variables, cholesterol, low density lipoprotein,
triglyceride, high density lipoprotein, packed cell volume of erythrocyte, erythrocyte deformation index, erythrocyte
aggregation index, hematocrit, whole blood contrast viscosity, whole blood low-shear viscosity, whole blood high-shear
viscosity, whole blood viscosity, fibrinogen, erythrocyte sedimentation rate, plasma radio viscosity, plasma viscosity, and
total cholesterol. The 17 parameters were analyzed in 6 diseases. For example, there were 6 trials on cholesterol in
analysis. There was no difference between the treatment group and control group (P = 0.25). The pooled WMD was
-0.78 (95% CI, -1.32~-0.24). This meant that ILELT with drug reduced cholesterol parameter more 0.78 mmol/L than the

drugs only using. Table 2 indicated that ILELT with drugs reduced cholesterol，low density lipoprotein, triglyceride,

whole blood contrast viscosity, whole blood high-shear viscosity, whole blood viscosity, erythrocyte sedimentation rate,
and total cholesterol. Especially it works well with decreased erythrocyte aggregation index and plasma radio viscosity
(the result more steady-going), and increased high density lipoprotein. Because of literatures’ bias, both whole blood
low-shear viscosity and fibrinogen didn’t been judged. While packed cell volume of erythrocyte, plasma viscosity and
erythrocyte deformation index didn’t reduce significantly.

5 REDOX IMPROVEMENT

The redox effects of ILELT on dogs in the only laser group have been also analyzed. In table 3, the data after trial
changed little comparing with that before trial for superoxidase dismutase (SOD) in small dose with 523 nm laser (such
as 0.5-1.5 mW, 2.0-5.0 mW). While in big dose (8.0-15.0 mW), it changed significantly. Maybe big dose resulted in cell
damnification. But in small dose with 632.8nm laser (0.5-1.5mW), ILELT enhanced the consistence of SOD. In table 4,
the data after trial changed little comparing with that before trial for malondialdehyde (MDA) in small dose (such as
0.5-1.5 mW, 2.0-5.0 mW). While in big dose (8.0-15.0 mW), it increased the consistence of MDA significantly. But in
small dose with 632.8nm laser (0.5-1.5 mW), ILELT reduced the consistence of MDA.
For lacking data about period of treatment with laser, we can’t analyse the effect of period of treatment to cure some
diseases deeply now.

6 REACTIVE OXYGEN SPECIES MEDIATED MECHANISM

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 MIL may be mainly mediated by reactive oxygen species (ROS) (Liu et al. 2005). As a kind of localized ROS signal,
MIL induced ROS production has been directly found in MPBM. Wu S et al.(2007) have studied the apoptotic effect of
moderate intensity He-Ne laser irradiation (MHNL) (200 mW/cm2) on ASTC-a-1 cells, and found immediate generation
of mitochondrial ROS following MHNL, reaching a maximum level 60 mins after irradiation. Zhang J et al.(2008) use
fluorescence resonance energy transfer (FRET) to visualize the dynamic Src activation in HeLa cells immediately after
irradiated with MHNL (64.4 mW/cm2), and found that it was ROS that mediated MHNL induced Src activation.

As an intravascular application of MIL, ILELT should be mainly mediated by ROS (Liu et al 2008). It was
supported by the redox effects of ILELT on dogs in the only laser group as in tables 3 &4. ILELT may generate ROS.
ROS generation in whole blood can be registered with luminol-dependent chemiluminescence (LDC). Acute pneumonia
and asthmatics (Farkhutdinov et al. 2001), or bronchial asthma (Farkhutdinov et al. 2007) patients with low intensity of
blood LDC exposed to ILELT activated ROS generation and raised treatment effectiveness in low intensity of blood
LDC. After intravenous blood exposure to ILELT, patients with haemorrhagic pancreatitis exhibited inhibition of the
blood proteolytic activity, enhancement of free-radical oxidation, kallikrein-kinin system activity, blood oxygen transport,
and correction of endotoxic pancreatogenic syndrome. In addition, the positive shifts were also observed in the
immunological status, morphofunctional characteristics of the red blood cells and hemoglobin, hepatic and renal
functions (Dedenko 1989).

As Lubart et al. (2005) have pointed out, PBM induced ROS can promote antioxidation. Therefore, ILELT induced
ROS may promote antioxidation. Vitreshchak et al. (2003) have studied the effect of He-Ne laser radiation on activity of
Cu/Zn-SOD, Mn-SOD, and catalase in blood cells from patients with Parkinson's disease in vivo and in vitro. The effects
of ILELT were more pronounced than those observed in similar in vitro experiments.

MPBM in ILELT may be an homeostatic regulation (Liu et al 2008). The level of ROS was so low that there were
no effects on normal blood cells in homeostasis, but there was rehabilitation on dysfunctional blood cells far from
homeostasis. Different ROS levels activate different mitogen-activated protein kinase pathways so that ILET at different
intensity might rehabilitate ROS level, immune functions and hemorheological functions, respectively. ILET might treat
many diseases, especially infective diseases such as surgical infection, suppurative septic complications, pneumonias and
tuberculosis.

7 DISCUSSION

Antioxidant supplements, hyperbaric oxygen therapy (HBOT) and ILELT are all mediated by ROS. Their
relationships will be discussed in this section.

7.1 Antioxidant supplements

ROS play an important role in the development of many diseases such as cancer, hypertension, atherosclerosis,
diabetes, cardiac hypertrophy, heart failure, ischemia-reperfusion injury, and stroke. Antioxidant supplements have been
used for prevention of several diseases. However, Bjelakovic et al. (2007) have shown that treatment with carotene,
vitamin A, and vitamin E may increase mortality. Overall results of clinical studies investigating antioxidant effects have

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 been disappointing given the consistent and promising findings from experimental investigations, clinical observations,
and epidemiological data (Paravicini et al. 2008). In these cases, antioxidant supplements might reduce ROS level to so
low that they might disrupt oxidant-antioxidant homeostasis (OAH). OAH can automatically maintain ROS level, but
antioxidant supplements can only work when their local concentration is high enough. Moreover, physiological
concentrations of ROS may function as signaling molecules to mediate various responses, including cell migration and
growth although excess ROS are toxic. At this point, ILELT is an ideal regulation of OAH because it can not disrupt
OAH except its regulation on the cells far from OAH.

7.2 Hyperbaric oxygen therapy

Kantariia et al. (2006) have found that ILELT and HBOT can be included in the therapeutic complex for the
treatment of bacterial endocarditis. At the height of disease there was marked immune deficiency, basically at the
expense of T-helpers, and also of the B- lymphocyte part. The phagocyte system efficiency indices were decreased. By
the admission of patients in the clinic the number cells with aberrations of chromosomes was increased. After the
treatment, there was absolute and relative elevation on the number of T-and B- lymphocytes, T- helpers, also the decrease
of leukocytes, T-lymphocyte index, and the increase of blast transformation lymphocytes level.

As a fact, ILELT and HBOT (Alleva et al. 2005, Daruwalla et al. 2006 ) share the similar mechanism from the
viewpoint of ROS generation so that their clinical applications might refer with each other. ILELT is a clinical
application of fPBM and the ROS generation of ILELT is homeostatic, but the ROS generation of HBOT might damage
cells (Alleva et al. 2005, Daruwalla et al. 2006 ) and lead to oxygen toxicity (Huang et al. 2006) and its complications
(Plafki et al. 2000). No side effects of ILELT have been found, but patients scheduled for HBO therapy need a careful
pre-examination and monitoring. If safety guidelines are strictly followed, HBO therapy is a modality with an acceptable
rate of complications (Plafki et al. 2000). However, analysis of patients with central nervous system oxygen toxicity
revealed its unpredictability and inevitability (Huang et al. 2006). Although it is common sense that patients who
develop a seizure in the hospital need help from the medical staff, it cannot be done in a monoplace hyperbaric chamber
because of pressure unequalization. Therefore, a multiplace chamber equipped with an antechamber for medical
contingency is possibly the better facility in consideration of safety (Huang et al. 2006).

Because of the documented cellular and biochemical benefits of HBOT, HBOT is applied now with increasing
frequency to various orthopedic conditions (Huang et al. 2006). Despite ongoing controversy, HBOT is frequently
administered in various clinical situations (Plafki et al. 2000). The clinical applications of ILELT and HBOT might refer
with each other since they have shared the similar mechanism from the viewpoint of ROS generation. Moreover, ILELT
might further be used in stead of HBOT because it is homeostatic.

ACKNOWLEDGMENTS: This work was supported by National Science Foundation of China (60878061,
60478048, 6017800 and 6027812), National 973 basic project of China (2005CB523502), National Postdoctoral
Foundation of China (20070420143).

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 Review: Cerebral infarction
Comparison: 01 Laser with drug VS only drug
Outcome: 01 Comparing cure number

Study Treatment group Control group OR (fixed) Weigle OR (fixed)

or sub-category n,N ndt 90% Cl % 95% Cl Quality

lggbLiangbiqin Ce/so 10/SO 144 500 1.05. 0.601 B

l995yuanjianjun 9/20 0/19 - 1.S1 108 0.45, O.02t B
lgg6C80008ngxin 16/40 0/40 172 zea tOS8. 725t A
lgg6Hexiaoysn 22/60 10/60 227 2_go t125. 605t A
lggitLiniangui le/126 12/12S S74 104 tO7i. S50t A
lgglLianghaiyan 12/40 S/an 075 029 t1S6. zOOS] A
lgglPanli0000ng 7/50 S/Sn - 0_as 274 to_es. 11.82] A
lgolSongnhengyu 35/56 22/04 S02 2_az t115. 022t A
lgo7Wangyerning 2/SO 0/SO 018 4O5 tozi. SeeS] B
lgolzhouyunming aS/cO 17/45 275 2_es t120. 077t A
l99000ngali 21/60 S/25 108 S18 to_as. 11.91] B
l990Jiangenba 15/40 7/40 107 205 t100. 798t A
l990Liujianhui 12/04 4/62 142 2_az t074. 709t B
l990xiafeng 18/00 6/40 225 165 toeo. a_Oat A
l99908nglantfin 14/50 9/29 175 194 t067. 064t A
l999000000g
l999Houlinjiang
22/100
S2/60
10/90
5/40 - 060 2S5 226 t100. 0O7t
1CIO tS91, 00.76]
B

-
A
l999Liyamin 14/21 8/16 109 2O0 tOO5, 760t A
l999Liuhuij000 20/57 11/60 200 2_al t105. 0_eat B
l999L0000 12/24 0/21 096 S20 t09. 11.56] A
l999lantaOtian le/co 12/62 297 179 t077. 415t A
l999Wangliping 2/20 0/20 016 OO4 t025. 12508t A
l999Wangyaohui 4/21 2/10 0_es 108 to_So. liSa] A
2000Chencaihua 12/50 4/00 109 565 t108. 12.10] A
2000Huangxin 14/54 0/52 174 210 t075. 601t A
2000Liyue le/4o 12/40 2S7 191 tO76. 479t A
2000Liuchengxiang 11/40 6/40 106 215 tO7i. 605t A
2000Wangdeling 15/60 9/00 2_ca 102 tO6O. Sa4t
2000WangOiaOpiOg 20/46 10/46 5.05 109 to_es. s,it
2000vangj0050 17/68 4/47 1.27 508 t112. 11.46] A
2000zh805jianhong 8/24 6/24 1.44 100 tO45, 026t A
200lCaol000heng 6/SO 2/20 0.69 225 to_al. 12.40] B
200lLeioiaofeng 8/50 6/SO 1.00 145 toaa. a_Oct
200lLOhOi az/cO 6/20 101 ze7 to9o. 707t B
200lW000aifeng 4/42 5/45 094 147 tOSi. 70it A
200lYanrnin 9/100 6/150 2O5 105 tOO5. 442t A
200lZengwei508ng 9/S2 S/S2 o,s s78 tosz. 15.60] A
200llhangfenxia 9/24 5/21 O72 seo to_az. 15.74] A
2002Oengbinghai 5/50 1/SO 0S5 C59 to_as. 39.82] A
2002Mingdeyu 14/56 10/55 225 109 t009. a_Sot
2002Zh805busin 44/122 20/102 0O0 2Si t125. 427t A
200SCaOhaOc8i 2/21 2/21 0_es 100 t015. 705t B
200SChenh005bing 11/40 4/S7 125 2_as t07i. a45t B
200S0009yanmin e/sl 5/51 0.00 525 t077. 15.66] B
200SHuangbintpfin 15/100 6/100 1.03 276 t105. 745t A
200SOuy000wu 10/OS 4/49 1.21 262 0.76. 0.97t A
200SSonglihong 10/50 6/29 1.46 192 0.09, e.zit B
200SZhaiyankun 35/76 10/76 1.94 0_es t202, 12.00] A
2004Chendanchan 66/100 4S/100 0.25 2O7 t145. a_Oct B
2004Chenzhongping 15/56 O/S2 12i sos toSs. 90st A
200408ijianwu 8/S2 10/28 207 0_es t020. 105t A
2004W000baOping 19/56 10/45 2_es 1.00 t075. 44Ot A
2004zhangzhiting 16/60 11/06 500 1.49 t062. 506t A
2005Liuy009i 26/64 14/64 299 2.44 t115. 050t A
2005Panzhifeng 10/40 0/40 1S5 2.33 t072. 709t A
200itDengmiaoling 8/19 2/20 0_al 605 t117. 36.61] A
200it0000yanrnin 21/100 0/100 227 5.06 t128. 728t A

Total (96% Cl) 2964 26S2 100 00 2.S9 t2 09. 2

Total events: 919 (Treatment group), 457 (Control group)
Tent for heterogeneity: Chi'= 54.76, dt = 66 (P = 0.99), l= 0%
Tent for overall effect: Z 12.06 (P00.00001)
0.1 0.2 0.5 1 2 5 10
Favours treatment Favours control

Figure 1. Meta-analysis of cure number

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 Review: Cerebral inlarction
Comparison: 01 Laser with drug VS only drug
Outcome: 01 Comparing cure number

0.0 SE(/o OR)

,. %*'..
- 0.4

S.
0. t
%. -
.
a a
a
. a
1.2

- .6

0,1 0.2 0.5 1 2 5 10

OR (fi)ed)

Odds ratio (logarithmic scale)

Figure 2.The funnel plot of 57 reviewed literatures on comparison of cure effect level

Table 1. Statistical calculation of dichotomous literatures

Disease PN DG OR 95%CI P Bias RR

CC 2.39 2.09—2.74 <0.01 high

Nfs0.05=701
2964 5K+1=286
a(57) RC 3.15 2.80—3.54 <0.01 high
2632
Nfs0.05＞5K+1
EC 3.64 3.14—4.22 <0.01 high

RC 2.59 1.48—4.52 0.13 low

108
b(4) Nfs0.05 < 0
108
EC 4.69 2.18—10.09 <0.01 low

RC 1.95 1.40—2.72 <0.01 low

336
c(6) Nfs0.05 < 0
311
EC 3.49 2.15—5.68 <0.01 low

Nfs0.05=49
RC 3.80 2.79—5.18 <0.01 high
438 5K+1=36
d(7)
359
EC 7.11 4.54—11.13 <0.01 Nfs0.05＞5K+1 high

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 RC 2.47 1.43—4.27 <0.01 low
125
e(4) Nfs0.05 < 0
116
EC 5.60 2.56—12.26 <0.01 low

CC 2.97 1.69—2.53 <0.01 middle

Nfs0.05=42
337 5K+1=46
f(9) RC 4.92 3.39—7.14 <0.01 middle
303
Nfs0.05＜5K+1
EC 4.95 2.77—8.84 <0.01 middle

In the first line of the table, PN, DG, OR, CI and RR denote patient number, disease grouping, odds ratio, confidence interval and
result’s reliability, respectively. In the first row, a, b, c, d ,e and f denote cerebral infarction, pulmonary heart disease, coronary heart
disease, diabetes, angina pectoris and heart failure, and cerebrovascular disease, respectively, with the report numbers in the bracket.
In the second row of the each line, the top and foot numbers denote the treatment group number and the control group number,
respectively. In the third row,
CC, RC and EC denote cure comparison, remarkable comparison and effectual comparison.

Table 2. Statistical calculation of continuous literatures

after funnel plot

Test variable Trials before (P) WMD 95%CI RR
(P) symmetry

Ch(mmol/L) 6 0.25 0.005 -0.78 -1.32—-0.24 nearly middle

LDL(mmol/L) 4 0.44 0.004 -0.6 -1.01—-0.19 nearly middle

Tr(mmol/L) 12 0.72 ＜0.001 -0.63 -0.83—-0.42 nearly middle

HDL(mmol/L) 6 0.90 0.005 0.34 0.10—0.59 nearly middle

PCVE (%) 3 0.42 0.05 —— —— —— ——

EDI (%) 4 0.74 0.48 —— —— —— ——

EAI (%) 5 0.94 ＜0.00001 -0.24 -0.27—-0.21 well high

He (%) 21 0.02 —— —— —— —— ——

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 WBCV(mPa.s) 5 0.33 0.006 -0.40 -0.69—-0.12 nearly middle

WBLV(mPa.s) 23 0.35 0.001 -1.2 -1.93—-0.48 not low

WBHV(mPa.s) 22 0.07 ＜0.0001 -0.62 -0.92—-0.32 nearly middle

WBV(mPa.s) 3 0.12 0.0003 -1.20 -1.85—-0.54 nearly middle

Fi(g/L) 18 0.33 0.007 -0.76 -1.31—-0.21 not low

ESR(mm/h) 12 0.11 0.0008 -4.57 -7.26—-1.89 nearly middle

PRV(mPa.s) 9 0.06 0.0007 -0.07 -0.12—-0.03 well high

PV(mPa.s) 17 0.13 0.09 —— —— —— ——

TC(mmol/L) 8 0.83 0.003 -1.08 -1.80—-0.36 nearly middle

In the first line of the table, ‘before’ and ‘after’ denote before and after trial, respectively, P is the test value between treatment
group and control group, and RR denotes result’s reliability. In the first raw, Ch, LDL, Tr, HDL, PCVE, EDI, EAI, He, WBCV, WBLV,
WBHV, WBV, Fi, ESR, PRV, PV and TC denote cholesterol, low density lipoprotein, triglyceride, high density lipoprotein, packed cell
volume of erythrocyte, erythrocyte deformation index, erythrocyte aggregation index, hematocrit, whole blood contrast viscosity,
whole blood low-shear viscosity, whole blood high-shear viscosity, whole blood viscosity, fibrinogen erythrocyte sedimentation rate,
plasma radio viscosity, plasma viscosity and total cholesterol, respectively.

Table 3. Statistical calculation of dog’s superoxidase dismutase in the only laser group

Trials Number Λ(nm) Dose(mW) WMD 95%CI P

2 3 533 0.5-1.5 -1.98 -4.48—0.52 0.12

1 3 533 2.0-5.0 1.54 -0.60—3.68 0.16

2 7 533 8.0-15.0 2.37 1.23—3.52 ＜0.0001

1 3 632.8 0.5-1.5 -1.78 -2.45—-1.11 ＜0.00001

Table 4. Statistical calculation of dog’s malondialdehyde in the only laser group

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 Trials Number Λ(nm) Dose(mW) WMD 95%CI P
2 3 533 0.5-1.5 0.41 -0.06—0.88 0.09
1 3 533 2.0-5.0 -1.47 -3.39—0.45 0.13
533
2 7 8.0-15.0 -2.93 -3.94—-1.92 ＜0.0001

1 3 632.8 0.5-1.5 0.43 0.10—0.76 0.01

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