Ischemic preconditioning (IPC), as a powerful endogenous cardioprotective adaptation, has brought a new research field for prevention and inhibition of myocardial ischemic reperfusion injury. This article is to evaluate the current information regarding the process of IPC and the possible mechanisms involved, with special attention paid to the protein kinase C and mitochondrial ATP sensitive potassium channels. The article also pointed out that the future role of IPC in clinical practice would strongly depend on the exact cellular and molecular mechanism underlying the IPC phenomenon. Pharmacological preconditioning seems to represent a perspective role of IPC in clinical practice.

BACKGROUND:When leucocytes were activated in the process of lung ischemia-reperfusion,various cell factors will be released,including tumor necrosis factor ?(TNF-?) and interleukin 1?(IL-1?),which lead to ischemia-reperfusion injury.Recent research demonstrates that transforming growth factor-?1 plays a protective role in ischemia-reperfusion injury after lung transplantation OBJECTIVE:To investigate the level changes of TNF-? and IL-1?after interfered with transforming growth factor-?1 after lung ischemic-reperfusion injury DESIGN,TIME AND SETTING:The randomized controlled experiment of animal was performed in the Cardiothoracic Surgery Laboratory of Changhai Hospital,Second Military Medical University of Chinese PLA from August to October 2007.MATERIALS:Thirty Sprague-Dawley rats with clean grade,were randomly divided into the sham operation,ischemia-reperfusion and transforming growth factor?1 groups,with 10 animal in each group.The transforming growth factor?1 was phuchased from Peprotech INC.METHODS:The left lung of rat in the ischemia-reperfusion and transforming growth factor?1 groups was prepared for to ischemia-reperfusion model by blocking pulmonary circulation with hilar vessels ligation for 60 minutes,followed by reperfusion for 2 hours.Animals in the sham operation group were crossed hilar with 10# silk thread.Heparin was administered intravenously through vena cervicalis at 15 minutes before ischemia in each group.Concurrently,10 ?g/kg transforming growth factor?1 was administered in transforming growth factor?1 group.MAIN OUTCOME MEASURES:After 2 hours of ischemia-reperfusion,the tissues of left lung were removed,histomorphological changes,wet-dry weight ratio,the index of histological lung injury and the content of TNF-?and IL-1?were determined by light microscope,enzyme-linked immunosorbent assay(ELISA),respectively.RESULTS:A total of 30 animals were enrolled in the result analysis.There was no obvious pathological change of lung in the sham operation group.Visible tissue edema and neutrophil infiltration could be found in the ischemia-reperfusion group,while,there was mild tissue edema and little neutrophil infiltration in the transforming growth factor?1 group.The wet-dry weight ratio and index of histological lung injury in the ischemia-reperfusion group was obvious greater than that of the sham operation group(P

Influenced by a variety of pathologic factors, cardiac fibroblasts can transdifferentiate into myofibroblasts and pro-liferate excessively, followed by an overdue secretion of extracellular matrix ( ECM) .This process involves complicated signaling path-ways and electrophysiological mechanisms and may result in atrial fibrosis and contribute to atrial remodeling in structure, function and electrophysiological signaling, which is considered as a most important phase of atrial fibrillation.This review focuses on the role of fi-broblasts in atrial fibrosis, atrial remodeling, and the development of atrial fibrillation.

There are very close associations between spinal surgery teaching and medical imaging.Medical Imaging used in clinical medical teaching includes noumenal photograph,conceptual diagram,radiological imaging,operation photographic recording and computer-aided instruction courseware,etc.It is very important to collect the medical imaging through various means,set up medical imaging resources library for spinal surgery and use these resources in spinal surgery teaching.

Problem-based learning is a student-centered teaching mode,which is based on creating question circumstances.In our clinical teaching,we put up questions based on real cases and inspire students'enthusiasm,activity and creativity.The results show the PBL can elevate students' clinical ability and also can promote teachers'capability.

Physician-patient communication skill is the core clinical capability,and its im-portance is more and more recognized by educationists.Introducing the communication skill education into the standardized resident training can improve the residents'clinical and communicative ability and train them to be the comprehensive quality talents.

To improve the quality of clinical teaching of plastic surgery for foreign students at different levels,we think that good teaching result will be got by applying English teaching for whole range,attaching importance to the selection and cultivation of the teaching staff,establishing individualized teaching program and compiling suitable material,and sticking to trial teaching before class,collective discussion and flexible teaching methods.

0.05). The postoperative incidence of AFL was significantly lower than preoperative ( P

Objective To elucidate the effect of ischemic preconditioning(IPC)on regional fluidity of myocardial cell membrane during cardiopulmonary bypass (CPB). Methods Seventy-five felines were randomized into three groups: Group A (CPB group,n =25),in which CPB was conducted without aortic cross-clamping (ACC);Group B (IR group,n =25),with 60min ACC followed by 60min reperfusion,and cardioplegia used during period of ACC;Group C (IPC group,n =25),with protocol similar to that of group B except for three-cycle IPC applied before ACC. Electron spin resonance (ESR) technique was employed to monitor membrane regional fluidity of cardiomyocyte during CPB in all groups. Results Regional fluidity of myocardial cell membrane kept unchanged in CPB group and markedly decreased during ACC and reperfusion periods in IR group. Though the regional fluidity of myocardial cell membrane during ACC and reperfusion periods in IPC group was slightly decreased compared to CPB group,it was significantly higher than that in IR group. Conlusion IPC can protect myocardial cells from ischemia and reperfusion injury by maintaining the fluidity of myocardial membrane during CPB.

"3+2" educational model was performed in our clinical medical college as a reformation based on traditional "4+1" model.After 5 years teaching practice,it obtained some good results as we prospected,however,there still exists some problems.This article analyzes the problems around the aspect of the teachers,the students,the teaching administration and arrangements,and proposes the corresponded measure to improve it.