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.