Objective To study the interventional effects of Candesartan Cilexetil on vascular endothelial function and expres-sions of ERK/CREB signaling pathway in rats with acute myocardial infarction.Methods 30 rats were randomized into CAN group,AMI group and Sham group.Two weeks after the treatment rats were sacrificed and blood pressure,levels of blood AngⅡ, NO and NOS,endothelial vasomotor effects of isolated thoracic aorta strips,myocardial infarctual area and the expressions of ERK mRNA and CREB mRNA in infarctual myocardium were explored.Results Blood AngⅡ levels were distinctly higher in AMI group when compared with the Sham group,while the NO and NOS level were much lower.accompanied with EDDs decreased seri-ously,and higher mRNA expressions of ERK1 and CREB in infarctual myocardium.All of the above differences were significant. After the treatment of Candesartan Cilexetil,levels of serum NO and activities of NOS were obviously higher and almost reached the similar levels to those in Sham group,additionally endothelium-dependent diastole in isolated aortic strips improved greatly.Mean-while Candesartan Cilexetil can not only increase the plasma AngⅡ,but also decrease the size of myocardial infarction and the mR-NA expressions of ERK1 and CREB in infarctual myocardium significantly.However,blood pressure in all groups was not affected. Conclusion Candesartan Cilexetil can greatly improve the disordered endothelial function developing post-AMI,decrease the size of myocardial infarction and down-regulate the mRNA expressions of ERK and CREB in myocardium of infarctual zone.And all of the above protective effects of Candesartan Cilexetil were independent on blood pressure lowering.

Examination reform was explored in Introduction to clinical medicine, and a new evaluation system was constructed which included the combination of formative assessment and sum-mative assessment as well as content system, operation system and monitoring system. The feedback mechanism of formative assessment was put into a full use to improve the teaching effect in this new evaluation system. At the same time, the method of summative assessment was substituted from the traditional closed-book exam to literature translation and presentation carried out by groups. The com-bination of summative assessment and formative assessment could evaluate the teaching efficiency of introduction to clinical medicine more comprehensively and objectively. In addition, it played an ac-tive role in improving students' comprehensive ability and their learning enthusiasm.

Among the current curricula of medical teaching in China, most courses focus on the integrated teaching of a single organ-system combination, while there are relatively a few integrated courses that focus on the multiple dimensions between different organs and systems and between medical sciences and social sciences. In 2016, Chongqing Medical University started to cooperate with University of Leicester to establish the clinical medicine major and introduced the course of Integration for Clinical Application (ICA) that had been run well in University of Leicester for years. With reference to the education goal of our university, the curriculum group adopted a series of actions for the localization of this course from the aspects of teaching objectives, contents, teaching model, education resources, and quality of faculty. After the completion of the first round of this course, the passing rate reached 86.96%(100/115) in the quantified evaluation of accomplishment, which was higher than the passing rate of other courses introduced from University of Leicester. The quantitative expert assessment of this course also ranked among the top courses in our university, and student assessment showed that the ability indicators were improved by 25.00%- 38.00%. The above data show that good results have been achieved for the curriculum localization of ICA.