Objective To explore the clinical efficacy of reteplase(rPA) combined with reduced glutathione(GSH) for the treatment of acute ST-segment elevation myocardial infarction(STEMI).Methods 80 patients with STEMI received in our hospital from Feb 2010 to Feb 2013 were divided into observation group and control group according to the treatment type,with 40 cases in each group.The control group was treated with rPA for intravenous injection on the basis of conventional treatment,and the observation group was added reduced GSH intravenously on the basis of control group.The recanalization rate,myocardial enzymes levels,ventricular structure and function of the heart and major adverse cardiac events in the two groups of patients were compared.Results There canalization rate in observation group was 90％ after treatment,compared with the control group (82.5％) which showed no significant difference as compared with the control group(90％ vs.82％,P＞0.05).Serum creatine kinase-MB fraction(CK-MB),cardiac troponin(cTn) I and TcTnI and cTnT levels in observation group after 24h were significantly lower in observation group than in the control group after 24 h of treatment(t=10.44,6.008,29.63,respectively,all P＜0.05); left ventricular end diastolic diameter (LVEDd) and left ventricular end systolic diameter (LVESd) in observation group were significantly shorter and left ventricular ejection fraction (LVEF) was significantly higher in observation group than in the control group after 1 month of treatment (t =4.543,5.605,4.652,respectively,all P＜0.05).The incidence of cardiogenic shock,reinfarction,angina and arrhythmia in observation group were significantly lower in observation group than in the control group(x2=5.128,7.825,6.000,4.669,respectively,all P＜0.05).Conclusions rPA combined with reduced GSH for the treatment of STEMI had is significantly effective,safe and reliable,has fewer complications,and is worthy of clinical promotion.

Objective To explore the relationship of sevoflurane neurotoxicity with the expres-sion of Bid,Bim,Puma.Methods The cortical neuron from newborn SD rat (within 24 h)were see-ded in 6 or 12 well plate,and then randomly divided into 4 groups.Rat culture cortical neurons in vitro exposed in 1%,2%,4% and 0% sevoflurane for 6h were divided into A,B,C and D group. The effect of neuron viability,death and apoptosis were assessed using CCK-8,LDH and caspase-3 cleavage 1 7kDa expression assay.The expressions of Bid,Bim and Puma were assessed by western blot.Results Compared with group D, there were significant increases of neuron death and apoptosis,but a decrease of neuron viability,and upregulated expressions of Bid,Bim and Puma in group B (P <0.05);Compared with group B,Group C had increased death and apoptosis and de-creased viability of neurons,as well as upregulated expressions of Bid,Bim and Puma (P <0.05 ). Conclusion Along with the increase of the concentration,sevoflurane neurotoxicity was increased by upregulation of Bid,Bim,Puma expression.