Volume 93  ·   Issue 15  ·  2013

Pedicle subtraction osteotomy (PSO) is a spinal realignment technique of correcting the sagittal spinal imbalance.Theoretically, the level and degree of resection via a PSO should impact the degree of sagittal correction.However, the quantitative effect of PSO level and focal angular change on postoperative spinopelvic parameters has not been fully elucidated.The purpose of this study was to analyze the relationship between the level/degree of PSO and changes in global sagittal balance and spinopelvic parameters.

Retrospective analysis was conducted for 34 patients undergoing PSO surgery for ankylosing spondylitis.Preoperative and postoperative free-standing sagittal radiographs were obtained and analyzed by regional curves (lumbar lordosis, thoracic kyphosis), pelvic parameters of pelvic tilt (PT), pelvic incidence (PI) and sacral slope (SS) and global balance of sagittal vertical axis (SVA).And the correlations between PSO parameters (level and degree) and spinopelvic parameters were analyzed.

There were significant changes in spinopelvic parameters including decreased thoracic kyphosis, increased lumbar lordosis, decreased SVA, decreased PT and increased SS.The decreased SVA were 3.94±3.38 and 3.97±1.91 in lumbar/thoracic osteotomy respectively (P>0.05).The decreased values of PT were 9.71±6.46 and 5.20±2.74 respectively (P<0.05).Larger degree of osteotomy (≥22°) had greater SVA and PT decreases (P<0.05).

PSOis a quite useful technique of restoring spinal alignment.Lumbar and larger degrees of osteotomy have greater effects on spinopelvic parameters.

To explore the relationship between variations of severe isthmic spondylolisthesis spinopelvic parameters and clinical symptoms.

A retrospective study of spinopelvic parameters was conducted for 45 patients with L5 severe isthmic spondylolisthesis.Their spinopelvic parameters were analyzed on preoperative full spinal radiography: grade of spondylolisthesis, pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK),SFHD,SFVD,SC7D and T9 tilting angle.According to the Oswestry score, the patients with low back pain were divided into light and severe groups.T-tests were used to compare their parameters.The analyses of multiple factor correlation, linear regression and stepwise regression were used to examine the associations between all parameters and Oswestry score.Results Grade of spondylolisthesis, PT, LL, T9 tilting angle,SFHD,SC7D,PT/SS,SFHD/SFVD, LL/TK were significantly greater and SS, SFVD were significantly smaller for patients with severe low back pain versus light low back pain (P<0.05).PI or TK had no statistically significant difference between two groups.Multiple factor correlation, linear regression and stepwise regression: Grade of spondylolisthesis, PT, SC7D, LL and SF HD had significant positive correlations with Oswestry score.Degree of positive correlation:Grade of spondylolisthesis>SC7D>PT>LL>SFHD. And PI, TK or T9 tilting angle had no significant correlation with Oswestry score.SSand SFVD had significant negative correlations with Oswestry score.Degree of negative correlation: SS>SFVD. PT/SS, SFHD/SFVD and LL/TK had significant positive correlation with Oswestry score.Degree of positive correlation: PT/SS>SFHD/SFVD>LL/TK.

Clinical symptoms of severe isthmic spondylolisthesis have significant positive correlations with grade of spondylolisthesis, PT, SC7D, LL, SF HD, PT/SS, SFHD/SFVD, LL/TK and significant negative correlations with SS and SFVD.Low back pain symptom has no significant correlation with PI, TK or T9 tilting angle.

To evaluate retrospectively the relationship between low back pain and changes of lumbar spine sagittal alignment after lumbar spine fusion.

During January-December 2008,a total of 182 consecutive patients with degenerative lumbar spine diseases underwent posterior lumbar interbody fusion (PLIF) and the follow-up period was over 24 months.Standing lumbar spine anterioposterior and lateral radiography were taken during the follow-up and the lumbar lordosis Cobb angles were measured on radiography.Pain degrees were assessed by visual analog scale (VAS) and Oswestry disability index (ODI).The relationship between the changes of Cobb angle and lumbar sagittal plane curve was analyzed by the SPSS software.Also the relationship between back pain degreeand Cobb angle wasexamined.

Among them, 42 cases with postoperative back pain were followed up for 24 months.There were 19 males and 23 females with a mean age of 59.6 years (range:40-77).Lumbar spine sagittal Cobb angles were measured from radiographic images:lumbar lordosis angle:①mean angle at 12-month follow-up:40.1°±10.6°, range:20°-60°;②mean angle at 24-month follow-up:40.8°±10°, range: 24°-60°.Back pain of 42 patients:VAS:①mean at 12-month follow-up:29.4±11.5, range:5-50;②mean at 24-month follow-up:27.6±11.7, range:25- 48.Lumbar spine function of 42 patients: ODI:①mean at 12-month follow-up:15.1±5.4, range:0-25;②mean at 24-month follow-up:13.9±5.2, range:0-24.Difference between lumbar lordosis angle and standard score:①mean angle at 12-month follow-up:19.9°±10.6°, range:0°-40°;②mean angle at 24-month follow-up:19.2°±10.0°, range:0°-36°.Angle difference versus back pain VAS:①at 12-month follow-up:P<0.001, positive correlation;②24-month follow-up:P<0.001, positive correlation; angle difference versus back pain ODI:①12-month follow-up:P<0.001, positive correlation;②24-month follow-up:P<0.001, positive correlation.

There is a close relationship between back pain after fusion and loss of lumbar sagittal lordosis.And reconstruction of lumbar lordosis should be one important goal for lumbar fusion.

To elucidate the relationship between spino-pelvic sagittal balance parameters and lumbar intervertebral disc degeneration of each segment through retrospective analysis in lumbar degeneration patients.

Retrospective analysis was conducted for the follow-up data in 126 patients with lumbar degenerative disease from July 2009 to June 2012.There were 38 cases with whole spine plates and 88 cases with lumbar plates.All of them received magnetic resonance imaging (MRI) scans.Through software Image J, the following spino-pelvic sagittal balance parameters were measured:sagittal vertical axis (SVA, distance between C7 plumb line and posterior upper corner of S1 endplate), thoracic kyphosis (TK, T5-T12 Cobb angle), thoracolumbar kyphosis (TLK, T10-L2 Cobb angle), lumbar lordosis (LL, L1-L5 Cobb angle), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), T1 spino-pelvic inclination (T1-SPI), T9 spino-pelvic inclination (T9-SPI), spino-sacral angle (SSA), spino-pelvic angle (SPA) and C7 tilt (C7T).Based on the grading system of Pfirrmann et al, the intervertebral disc degeneration grades were acquired for each lumbar segment.According to the normal range of previous studies, each spino-pelvic sagittal balance parameter was classified into 3 groups,i.e.Group A (less than normal), Group B (normal) and Group C (more than normal).All statistical analyses were performed to compare the differences of each lumbar segment/intervertebral disc degeneration among groups by one-way ANOVA test via SPSS 18.0.And P-value<0.05 was deemed significant.

PI had a significant impact on the L5/S1 disc degeneration.And L5/S1 disc degeneration had a significant impact on sagittal balance.Among 57 cases of large PI, LL,PT,SS,SVA, C7T,SPA in L5/S1 of mild-to-moderate and severe degeneration groups was 36.91±14.93 and 29.71±11.30 (P=0.045), 18.82±8.27 and 25.18±10.19 (P=0.012), 39.45±8.82 and 34.57±8.88 (P=0.042), 23.04±26.63 and 62.15±33.82 (P=0.002), 88.85±3.13 and 83.98±4.62 (P=0.003),157.88±11.20 and 147.75±13.98 (P=0.043) respectively.TLK in L1/L2 with mild-to-moderate and severe degeneration groups was 4.59±7.81 and 14.91±14.75 (P=0.026).All of L1/L2, L2/L3 and L3/L4 disc degeneration had a significant impact on SPA.SPA in L1/L2, L2/L3, and L3/L4 with mild-to-moderate and severe degeneration groups was 158.47±11.97 and 147.84±12.72 (P=0.031),159.91±10.78 and 148.75±13.17 (P=0.024),158.46±10.86 and 148.61±13.93 (P=0.047) respectively.

With an important impact on lumbar disc degeneration, PI, either too big or too small, may predispose to the occurrences of lumbar disc degeneration.L5/S1 disc degeneration has a significant impact on pelvis postural parameters (PT, SS).L5/S1 degeneration is a key causative factor of pelvic posterior rotation and compensatory process.L5/S1 disc degeneration has an important impact on pelvis overall parameters (SVA, SPA, C7T).And the degeneration of L5/S1 is a key cause of trunk imbalance.

To analyze select patients of ectopic pregnancy for expectant management.

Retrospective analyses were conducted for the relative factors of 180 cases of ectopic pregnancy with expectant management at Department of Family Planning of our hospital from August 2004 to January 2012.Their general clinical data, clinical manifestations and laboratory tests were collected.The cases requiring neither surgery nor drug therapy belonged to the cure group while the rest fell into the failure group.

A total of 140 patients were successfully managed with a cure rate of 75.27%.There was no significant difference between two groups in size of mass on ultrasonography (P>0.05).The cases with gestational sac of mass on ultrasonography had statistical difference between two groups (P<0.05).Statistical difference existed between two groups (P<0.01) in initial blood beta-human chorionic gonadotropin (β-hCG), initial blood β-hCG and D3-5/D0 (ratio of blood β-hCG at day 3-5 and initial) were the variables for predicting the likelihood of successful expectant management under the ROC curve.The Youden Index was the largest at an initial blood β-hCG of 634 IU/L or D3-5/D0 of 0.711.

At blood β-hCG≤634 IU/L or D3-5/ D0<0.711, expectant management may be offered.And mass with gestational sac on ultrasonography is a relative factor of expectant management.

To explore the clinical and laboratory characteristics of patients with lupus enteritis to provide rationales for clinical diagnosis and treatment.

A retrospective group control study was conducted for systemic lupus erythematosus (SLE) patients with complaints of acute abdominal pain from 2004 to 2011.They were divided into 2 groups:lupus enteritis (n=66) and non-lupus related abdominal pain (n=73).The associated factors included demographic, laboratory, clinical and radiographic data.

Lupus enteritis (39.3%) was the most common cause of lupus patients with acute abdominal pain.There were no differences in autoantibody profiles, complement, erythrocyte sedimentation rate, C reactive protein and SLE disease activity index (SLEDAI) score between two groups.The level of D-dimer and European consensus lupus activity measurement (ECLAM) score were significantly higher in the group of lupus enteritis than those in non-lupus related gastrointestinal injury.Lupus enteritis had significantly higher percentage of complications with multiple serous cavity effusions and ascites.But after adjusting with logistic regression multivariate analysis, only the level of D-dimer, ECLAM and volume of ascites were associated with occurrence of lupus enteritis.

Lupus enteritis is the most common cause of acute abdominal pain.D-dimer is an excellent predictor for lupus abdominal pain.As compared with SLEDAI, ECLAM may be more suitable for assessment in SLE patients with alimentary tract injury.

To analyze the clinicopathological features of patients with granulomatosis with polyangiitis (Wegener′s)(GPA) complicated by acute renal failure (ARF).

A total of 27 GPA patients with ARF at our hospital from January 1988 to December 2011 were recruited into this retrospective study.A structured interview, systemic rheumatologic examination, laboratory tests (including autoantibodies) and renal pathology were conducted.And their treatment and prognosis were also analyzed.

The incidence of GPA with ARF was 15% and the average age 50 years old.The common symptoms were fever (n=23) and weight loss (n=15) while the most common extra-renal organ damages affected lung (n=20) and nose (n=19).Renal damages manifested as mild or moderate proteinuria (n=26) and hematuria (n=25).However, oliguria and anuria were rare.Anti-neutrophil cytoplasma antibodies (ANCA) were positive in 23 patients.Among them, 22 were identified by proteinase 3.Renal biopsies revealed pauci-immune crescentic glomerulonephritis.Combined treatment of glucocorticoid and immunosuppressants was effective.Twenty-two patients became relieved and only 4 patients died.

As a common complication of GPA, ARF has a rapid onset and a fast progression.Oliguria and anuria are rare.Renal biopsy is not only vital in the diagnosis and evaluation of disease activity, but also helpful for therapeutic decision-making.

To discuss the relevant predicative factors of dural arteriovenous fistula (dAVF) in intracranial hemorrhage.

A total of 144 consecutive patients with dAVFs were recruited for a retrospective analysis from 1996 to 2006.The relevant factors of gender, age, fistula flow rate,arterial supply, lesion and venous drainage pattern were analyzed to evaluate the outcome of intracranial hemorrhage.

Univariate analysis showed that gender, lesion and venous drainage pattern were statistical significant for intracranial hemorrhage of DAVF (P<0.05).However, only venous drainage pattern was significant in the predication of intracranial hemorrhage (P<0.05).

Only venous drainage pattern is significant in the predication of dural arteriovenous fistulas in intracranial hemorrhage.Both gender and lesion may be confounding factors.

To perform the dynamic contrast-enhanced and perfusion magnetic resonance imaging (MRI) of nasopharyngeal carcinoma (NPC) and analyze the correlation with Tstaging.

A total of 46 na?ve NPC patients underwent MRI.The parameters of dynamic contrast-enhanced and perfusion MRI included time to peak (TTP), Slope_maxand area under the curve (AUC).

The increasing period of signal intensity-time curve of all cases was steep.And the perfusion image of AUC could reflect the blood perfusion of tumor tissue.Parameters (TTP/Slope_max/AUC) in different T-staging were T1-staging (60.45/10.59/20 619.56), T2-staging (58.12/12.47/23 037.23), T3-staging (70.61/15.06/26 507.23) and T4-staging (41.72/19.87/30 092.27).Their statistical results were r=-0.247, P>0.05 and r=0.859, P<0.050 and r=0.963, P<0.05 respectively.And statistical significance existed in Slope_max, AUC with T-staging.

Dynamic contrast-enhanced and perfusion MRI can reflect angiogenesis of NPC.And there is a positive correlation between the parameters of dynamic contrast-enhanced and perfusion MRI (Slope_max, AUC) and T-staging.

To compared the outcomes of autogenous brachial-basilic arteriovenous fistula (BBAVF) and AV graft (AVG) in patients undergoing long-term hemodialysis.

Approved by Zhong Da hospital ethics committiee, we analyzed 61 complex patients,30 randomized to receive AVG and 31 received BBAVF.We compared patency rates of BBAVF and AVGin 3 months,1 year, 2 years,3 years,and complication rates.

Patency rates of BBAVF in 3 months,1 year, 2 years, 3 years were 100%, 96.8%, 90.3%, 87.1%, 3 years accumulative total infection rate was 3.2%, thrombosis rate was 3.2%.Patency rates of AVG in 3 months, 1 year,2 years,3 years were 96.7%, 50.0%, 36.7%, 33.3%, 3 years accumulative total infection rate was 26.7%, thrombosis rate was 33.3%.Patency rates of BBAVF in 1 year,2 years,3 years were higher than patency rates of AVG.The complication rates of infection and thrombosis were significantly lower for BBAVF than for AVG (P<0.05, respectively).

BBAVF has the advantage of a higher patency rate, a lower complicantion rates of infection and thrombosis, should be served as a favourable choice in building the vascular access in maintenance hemodialysis patients.

To analyze the 64-slice computed tomographic (CT) perfusion parameters of hepatocellular carcinoma (HCC) nodule so as to assess the diagnostic value of hemodynamic changes of HCC nodule by this perfusion technique.

Forty volunteers without liver disease (control subjects) and 37 HCC patients (experimental group) were selected.After informed consents, all of them underwent plain, perfusion and contrast CT examinations.Perfusion CT scan was performed at 120 kV, 60 mA and a thickness of up to 40 mm.The injection rate of contrast medium was 4-5 ml/sec at a dose of 1.0 ml/kg body weight.And 50 seconds of continuous scanning time was set at 5 seconds post-injection.The indices were 1 second per 360° revolution, 5 mm slice thickness image reconstruction and a matrix size of 512×512 pixels.Perfusion parameters associated with changes in hepatic blood flow included blood flow (HBF), hepatic blood volume (HBV), hepatic arterial perfusion index (HAI), hepatic artery perfusion (HAP) and portal venous perfusion (HPP).Perfusion parameters were measured thrice at each timepoint for each different region of interest (ROI) :hepatic parenchyma surrounding HCC nodule, HCC nodule and normal liver parenchyma (control group).

For HCC nodule, the increased levels of HBF, HAP and HAI were significantly differentiated from normal liver parenchyma of control group (P<0.01).Increased HBV and decreased HPP had no difference from control group (P>0.05).Higher levels of HAP, HPP and HAI in HCC nodules were differentiated from hepatic parenchyma surrounding HCC nodules (P<0.05).HBV decreased and HBF increased in HCC nodule.But it had no differences from hepatic parenchyma surrounding HCC nodule (P>0.05).

Perfusion CT may visualize the status of liver blood flow caused by HCC nodule so as to serve as a new tool of studying the hemodynamic changes of HCC nodules.

To assess if shunting during carotid endarterectomy (CEA) can lower the risk of postoperative cerebral hyperperfusion (CH) and cerebral hyperperfusion syndrome (CHS).

This study was a prospective non-randomized controlled trial which approved by human rights committee of our hospital.From August 2009 to August 2012,180 eligible patients with carotid arterial stenosis who had indication for CEA entered our study.146 patients were males and 34 patients were females.Their age range was 38-83 years.Average age was (66±9) years.Cerebral blood flow changes were monitored through Transcranial Doppler routinely.There were 81 cases with shunting and 99 without shunting.We compared the rate of CH, CHS and other complications between two groups.

No patient died or suffered hemorrhagic stroke.There were no significant difference in average operation time between two groups ((144±25) min vs (139±34) min,P>0.05), but the clamping time of shunting group was significantly shorter than no shunting group ((4±4) min vs (26±14) min, P<0.05).The rate of CH and CHS of shunting group is lower than no shunting group (7.4% vs 18.2%, P<0.05; 3.7% vs 12.1%, P<0.05).There were no differences in other complications between two groups.

Shunting during CEA can lower the rate of CH and CHS by shortening the time of intraoperative cerebral ischemia, but didn′t increase the rate of other complications.Using shunt may be an effective method of preventing CHS after CEA, especially for the high risk patients according to preoperative evaluation.

To explore the effects of silencing hypoxia inducible factor-2a (HIF-2a) by small interference RNA on the growth of mammosphere cells in nude mice under hypoxic microenvironment.

The empty and interference vectors were transfected into MCF-7 cell.Then G418 was added to screen the positive cells to obtain stable cell line.The empty and interference vectors were inoculated subcutaneously into left and right back near hind limb of nude mice.The volume and weight of tumors were calculated respectively.The expressions of HIF-2α, CD44, OCT-4 and KLF-4 protein in xenograft tumor tissues were detected by Western blot.

The expression vector of HIF-2α-siRNA was successfully established.The formation of mammosphere was lowered by silencing HIF-2a gene expression.In contract to empty vector group cell, there were obvious decreases in the volumes and weights of tumors in interference group (P<0.05).The expression of HIF-2αprotein of interference group (0.42±0.01) was much lower than that of the empty vector group (0.89±0.03, P<0.05), the expression of CD44 protein of interference group (0.21±0.01) was much lower than the empty vector group (0.78±0.03, P<0.05), the expression of OCT-4 protein of interference group (0.42±0.01) was much lower than the empty vector group (0.68±0.03, P<0.05) and the expression of KLF-4 protein of interference group (0.34±0.01) was much lower than the empty vector group (0.72±0.03,P<0.05).

Silencing HIF-2αgene can effectively inhibit the growth of breast cancer stem cells in nude mice under hypoxic microenvironment.Its mechanism may be through inhibited capacity for self-renewal and proliferation of breast cancer stem cells in vivo through the down-regulated expressions of markers associated with stem cells.HIF-2αis expected to become a new target for gene therapy of breast cancer.

To explore the feasibility and efficacy of multiple-radiofrequency ablation (RFA) in swine liver.

One swine undergone percutaneous and intra-operative RFA for three times in succession (an interval of 5 days) guided by real-time ultrasound.Then 6 ablated lesions formed.The outcome of RFA and the change of tissues adjacent to ablated lesions (billiary, liver vascular and abdominal wall) were observed by trans-abdominal ultrasonography (US), contrast enhanced ultrasound (CEUS), intra-operative ultrasound (IOUS) and contrast enhanced computed tomography (CT).

Bile duct dilatation was found beside primary porta hepatis on US, CT, IOUS after RFA.There was no thrombus in liver vein through the ablated lesion with electrodes parallel to primary porta hepatis.Two ablated lesions were incompletely fused together.Small thermal injury was observed on abdominal wall after an injection of saline into subcapsular gap.Subcapsular hepatic tissue around ablation lesion changed into coagulative necrosis from hyperemia with elapsing time.Carbonizing granule formed during RFA on the top of intro-operative radio-frequency electrode easily caused bleeding along the withdrawing passage.Gelfoam was helpful to stop bleeding during intro-operative RFA.Occluding blood flow into liver definitely enlarged ablated area with the same amount of RFA energy.

Multiple-RFA is feasible and efficacious for patients with RFA indication.But the complications of RFA increase if the ablation areas are adjacent to such organs as bile duct, stomach, intestine and diaphragm, etc.

To investigate the effect of Resveratrol on Hydrogen peroxide-treated human umbilical vein endothelial cells (HUVEC).

Oxidative stress in HUVEC was induced by hydrogen peroxide (H₂O₂).The cells were divided in to 5 groups: A.Control group| B.H₂O₂ group|C.Res+H₂O₂group|D.Res+H₂O₂+LY294002 group|E.H₂O₂+LY294002 group.The cell viability were measured by cck-8 assay| Malondialdehyde (MDA) and Superoxide dismutase (SOD) were determined by using commercially available kits|Reactive oxygen species (ROS) were detect by flow cytometer| the expression of Nuclear factor-E2-related factor (Nrf2),Protein kinase B (Akt), Mammalian target of rapamycin (m TOR) were determined by Western blot.

Compared with control,resveratrol increased the cells viability (36.14±2.20) to (72.05±2.46)(P=0.004), decreased MDA formation (299.38±12.42) to (159.17±7.30)(P=0.006),elevated SOD activity (35.61±3.26) to (81.37±4.55) (P=0.007),inhibited ROS production (177.86±8.98) to (133.96±4.17)(P=0.003).These changes were accompany with the activation of p-Nrf2 (198.57±6.89) to (371.10±8.41) (P=0.005),p-Akt (102.93±3.29) to (221.62±6.51)(P=0.004),p-mTOR (93.26±4.12) to (172.14±5.74)(P=0.008).However these protective effect of resveratrol were abolished by L Y294002.

Resvertrol could protects HUVEC cells from H₂O₂-induced oxidative stress,in which the PI3K-AktmTOR pathway may be involved.

To explore the impact of chloride ion channel and its blockers 4,4′-diisothiocyanostilbene-2, 2′-disulfonic acid (DIDS), cyanato-stilbene-2,2′-disulfonic acid (SITS) and 5-nitro-2- (3-phenyl-propylamino) benzoic acid (NPPB) on arrhythmias caused by myocardial ischemia reperfusion.

A total of 40 rabbits were divided into control, ischemia reperfusion, DIDS low-dose, DIDS high-dose, SITS low-dose, SITS high-dose, NPPB low-dose and NPPB high-dose groups.Myocardial ischemia reperfusion model was established by ligation of anterior descending coronary artery.And standard limb leadⅡof electrocardiogram (ECG) was continuously monitored during the experimental process.Then comparisons of heart rate, ECG P wave, R wave, T wave,ST segment changes and arrhythmias score were made between the above groups.

During 30-minute ischemia, compared with the control group, all other groups showed significantly decreased heart rate ( (199.8±4.0) - (253.6±2.1) vs (267.0±3.4),all P<0.01),elevated ECG P wave ( (0.216±0.019) - (0.356±0.024) vs (0.186±0.019), all P<0.01), R wave ( (0.564±0.017) - (1.138±0.048) vs (0.506±0.018), all P<0.01), T wave ( (0.542±0.013) - (0.856±0.045) vs (0.278±0.015), all P<0.01) and ST segment ( (0.326±0.027) - (0.668±0.054) vs (0.024±0.023), all P<0.01) and increased arrhythmia score ( (1.4±0.5) - (4.6±0.5) vs (0.4±0.5), all P<0.01).Compared with the ischemia reperfusion group, the above indices significantly improved in the intervention groups (heart rate: (214.8±3.4) - (246.8±4.0) vs (199.8±4.0), all P<0.01| P wave: (0.216±0.019) - (0.316±0.011) vs (0.356±0.024), all P<0.01| R wave: (0.564±0.017) - (0.980±0.035) vs (1.138±0.048), all P<0.01| T wave: (0.542±0.013) - (0.792±0.026) vs (0.856±0.045),all P<0.01| ST segment: (0.326±0.027) - (0.596±0.018) vs (0.668±0.054), all P<0.01| arrhythmia score: (1.4±0.5) - (3.8±0.4) vs (4.6±0.5), all P<0.01).Among which, the DIDS group was the best, followed by the SITS group and then the NPPB group.And the high-dose subgroups were better than those of the low-dose subgroups.During 60-minute reperfusion, the decreased heart rate upswung significantly in each group and the elevated P wave, R wave, T wave and ST segment fell back gradually.The DIDS group showed the most obvious amplitude change, followed by the SITS group and then the NPPB group.And the high-dose subgroups were better than those of the low-dose subgroups.The arrhythmia score during reperfusion showed the same trend.

Chloride ion channel is involved in the generation of myocardial ischemia reperfusion arrhythmia.Early application of chloride ion channel blockers DIDS, SITS and NPPB may improve the ECG manifestations and reduce the degree of reperfusion arrhythmia.