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Background All-trans-retinoic acid (ATRA) has been shown to posses the function of preventing cell death in various tissues undergone ischemia/reperfusion (I/R) injury.ATRA expression could be cut down in the presence of Aldose reductase (AR) which has been recognized as a key role in increasing cardiac I/R injury,especially in diabetes.Our objectives were to investigate the contribution of ATRA down regulation conducted by AR in cardiac I/R injury and that of ATRA supplement in cardiac I/R injury.