Objective:To explore the application research of continuity nursing based on the interactive reaching standard theory after heart transplantation.Methods:The clinical data of 104 patients after heart transplantation in Nanjing Hospital Affiliated to Nanjing Medical University (Nanjing First Hospital) from June 2012 to June 2020 were collected for retrospective study. According to the file order, they were divided into the control group and the experimental group with 52 cases in each group. The control group took regular nursing care, and the experimental group took continuation nursing based on the interactive standard theory on the basis of the control group. The intervention continued for 24 weeks. The compliance behavior, psychological state and other indexes were compared between two groups.Results:The scove of Positive and Negative Affect Scale: after 12 weeks and 24 weeks of nursing, the experimental group′s positive emotion scores (27.71 ± 4.42, 35.11 ± 4.19) were higher than those of the control group (24.45 ± 4.03, 28.87 ± 4.36). The negative emotional scores (24.52 ± 3.71, 16.66 ± 2.28) were lower than those of the control group (28.84 ± 4.14, 23.31 ± 3.46), the differences were statistically significant ( t=5.60, 11.57, P<0.05). After 12-week and 24-week nursing, the experimental group′s health knowledge level score (44.12 ± 4.43, 53.64 ± 4.55) , self-care skills score(35.35 ± 4.01, 44.78 ± 4.22) , self-responsibility score (21.15 ± 2.38, 26.11 ± 1.44) , and self-concept score (18.56 ± 6.25, 23.58 ± 2.58) were higher than the control group (37.78 ± 4.52 and 45.56 ± 5.13, 31.11 ± 3.64 and 36.65 ± 3.91, 18.82 ± 2.46 and 22.35 ± 1.29, 15.96 ± 4.10 and 18.12 ± 3.10), the differences were statistically significant ( t values were 2.51-14.03, P<0.05). Conclusions:Continuing care led by the interactive standard theory can improve the health literacy of patients after heart transplantation, relieve negative emotions, promote post-traumatic growth, enhance self-management capabilities, establish compliance behaviors, and improve heart function.

Objective:To investigate the protective effects of Elabela(ELA) on the renal injury of db/db mice and its possible mechanism.Methods:Sixteen eight-week-old male db/db mice were intraperitoneally injected with ELA(5 mg·kg -1·day -1) or equivalent normal saline( n=8) for 8 weeks. Eight age-matched male db/m mice received equivalent normal saline injection as normal control. At the end of the experiment, blood and urine samples were obtained for HbA 1C and urinary albumin/creatinine(ACR) measurements. Immunohistochemistry was used to observe the expression of ELA. Histopathological changes in kidney tissue were observed by HE staining and Masson staining. The levels of collagen type Ⅳ(Col-Ⅳ) and transforming growth factor-β1(TGF-β1) as well as Yes-associated protein(YAP) phosphorylation in kidney tissue were examined by western blot. Results:Immunohistochemistry results showed that ELA expression was decreased in the renal tissue of db/db mice as compared with that of db/m mice( P<0.05). After ELA treatment, ACR and blood pressure were markedly decreased in db/db mice( P<0.05), but without significant changes in the body weight and HbA 1C. Renal tubular epithelial cells edema, basement membrane thickening, and increased collagen fiber in db/db were improved by ELA administration. Compared with db/m mice, the levels of TGF-β1 and Col-Ⅳ expression, as well as YAP phosphorylation were significantly increased in renal tissue of db/db mice(0.98±0.08 vs 0.68±0.10, 1.10±0.14 vs 0.51±0.08, 3.38±0.72 vs 0.81±0.13, all P<0.05), which were down-regulated after ELA administration(0.80±0.06, 0.51±0.05, 2.21±0.22, all P<0.05). Conclusion:ELA may improve the renal injury of db/db mice by regulating the signaling pathway of YAP, thereby delaying the development of diabetic nephropathy.

目的 探讨早期糖尿病肾病患者血清微小RNA(miRNA)的表达水平及其与炎症因子的相关性.方法 选取2018年1月—12月于南京医科大学附属淮安第一医院内分泌科治疗的糖尿病患者作为研究对象,共68例.根据Mogensen分期法将患者分为单纯糖尿病(DM)组(尿白蛋白/肌酐<30 mg/g,n=32)和早期糖尿病肾病(DN)组(30 mg/g≤尿白蛋白/肌酐≤300 mg/g,n=36),选取同期在本院体检的健康志愿者为对照组(n=30).实时荧光定量PCR技术检测各组血清中miRNA21、miRNA155的表达水平变化,并分析其与血清高迁移率族蛋白B1(HMGB1)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)的相关性.结果 与对照组相比,单纯DM组和早期DN组miRNA21水平均明显下降,而miRNA155水平显著上升,差异有统计学意义(均P<0.05).早期糖尿病肾病患者血清miRNA21与HMGB1、TNF-α和IL-6均呈负相关(r=-0.809,P<0.05;r=-0.841,P<0.05;r=-0.851,P<0.05),而血清miRNA155与HMGB1、TNF-α和IL-6呈正相关(r=0.829,P<0.05;r=0.851,P<0.05;r=0.862,P<0.05).结论 血清miRNA21可缓解糖尿病肾病的进展,而miRNA155参与早期糖尿病肾病的发生,其机制可能与调节炎症因子的表达有关.

Objective To determine the association between serum levels of high-mobility group box-1 （HMGB1）,insulin-like growth factor-1 （IGF-1）,vascular endothelial growth factor 165 （VEGF165） and occurrence and development of diabetic nephropathy （DN）. Methods A

目的:研究细胞色素P4502C19(CYP2C19)基因多态性对中国健康受试者服用埃索美拉唑镁肠溶片后药物药代动力学的影响.方法:入组38名健康受试者,单剂量口服埃索美拉唑镁肠溶片40 mg,采集给药前后不同时间的血样,应用LC-MS/MS方法测定埃索美拉唑的血药浓度,计算药动学参数;采用聚合酶链反应限制性片段长度多态性分析技术,检测受试者基因位点CYP2C192(681G>A)和CYP2C193(636G>A),按基因型分组为快代谢组(EM)、中间代谢组(IM)和慢代谢组(PM),比较各代谢组药动学(PK)参数.结果:EM、IM和PM各组主要药代动力学参数分别为ρmax(957±324)、(1602±636)和(1835±15)ng·mL-1,tmax(2.2±0.6)、(2.3±1.0)和(3.0±0.5)h,t1/2(0.9±0.1)、(1.3±0.3)和(1.6±0.0)h,AUC0-12h(1656±548)、(4237±2339)和(5294±302)ng·h·mL-1,AUC0-∞(1657±548)、(4276±2397)和(5367±296)ng·h·mL-1;除tmax外,其余各组参数均有显著差异(P<0.05).结论:CYP2C19基因多态性对埃索美拉唑药动学参数有显著影响.

目的:研究早期下床活动对冠状动脉搭桥术后病人呼吸功能恢复的影响.方法:将符合入选标准的120例冠状动脉搭桥术后病人采用随机分组的方法分成观察组(58例)和对照组(62例),观察组为术后12～24 h下床活动,对照组为术后24～48 h下床活动.根据早期活动纳入标准对病人进行评估,按首次下床活动规范流程分别对2组病人指导进行下床活动,同时2组均按照下床活动计划表进行功能锻炼.比较2组术后1～7d呼吸功能障碍程度,术后1～7d的深吸气量,术后第2、4、7天的氧分压及二氧化碳分压,及肺部并发症的发生率.结果:呼吸功能障碍程度术后第1天2组比较差异无统计学意义(P>0.05),术后第2～7天观察组明显低于对照组(P<0.05～P<0.01);深吸气量术后第1～7天观察组高于对照组(P<0.01);氧分压术后第2、4、7天观察组高于对照组(P<0.01);二氧化碳分压术后第4天观察组低于对照组(P<0.01),术后第2、7天2组比较差异均无统计学意义(P>0.05);观察组肺部并发症的发生率低于对照组(P<0.05).结论:冠状动脉搭桥术后病人早期下床活动是安全可行的,并且下床活动时间越早,肺部并发症的发生率越低,越能促进呼吸功能的恢复.

目的 探讨1+3管理模式应用于改善血液科住院患者按时服药率的效果.方法 选取2015年7月～2016年7月我院收治行常规护理的住院患者82例作为对照组.选取2016年8月～2017年8月我院收治行1+3管理模式的住院患者82例作为观察组.比较两组护理前后按时服药率、护理质量及护理满意度.结果 观察组护理后10d按时服药率高于对照组,差异有统计学意义(P<0.05);观察组护理后病房管理、基础护理、消毒隔离、安全管理评分均高于对照组,差异有统计学意义(P<0.05);观察组护理满意度高于对照组,差异有统计学意义(P<0.05).结论 1+3管理模式应用于血液科住院患者护理,可有效提高其按时服药率及护理满意度,改善护理质量.

To determine the associations between expressions of insulin-like growth factor-Ⅰ( IGF-Ⅰ), tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor (VEGF) 165 in serum, and the occurrence and development of diabetic retinopathy ( DR). A total of 129 patients diagnosed as DM in our hospital between September 2015 and September 2017 were randomly selected in the study, including 58 cases single DM, diabetes with non-proliferative retinopathy group ( 45 cases) and diabetic proliferative retinopathy group ( 26 cases). Meanwhile, 110 healthy examinees during the same period were collected as a normal control group. The severity of retinopathy was judged by fundus photography and fundus fluorescein angiography. Blood glucose, BMI, HbA1C , TC, TG, HDL-C, LDL-C, and VLDL-C were detected in all subjects. Enzyme-linked immunosorbent assay (ELISA) was adopted to detect the serum concentrations of IGF-Ⅰ, TNF-α, and VEGF165. The expressions of serum IGF-Ⅰ, TNF-α, and VEGF in DM patients were significantly higher than those in the control group (all P<0.05). As diabetic retinopathy worsened, the expressions of serum IGF-Ⅰ, TNF-α, and VEGF increased. Pearson correlation analysis showed that serum IGF-Ⅰ was positively correlated with TNF-α, TNF-α, and VEGF165, IGF-Ⅰ, and VEGF165(P<0.05). Logistic regression analysis showed that IGF-Ⅰ and VEGF165 were risk factors for DR (OR = 1.059, 1.165, all P<0.05). The sensitivity, specificity and diagnostic accuracy of IGF-Ⅰ, TNF-α, and VEGF165 were higher than IGF-Ⅰ, TNF-α, and VEGF165 alone(AUC = 0.968, 0.928, 0.792, 0.893, all P<0.05). The expression level of IGF-Ⅰ, TNF-α, and VEGF165 in serum was related to the severity of diabetic retinopathy. The diagnosis of diabetic retinopathy with combined IGF-Ⅰ, TNF-α, and VEGF165 measurements was better than the single index of IGF-Ⅰ, TNF-α, and VEGF165.

目的 了解非糖尿病患者冠状动脉搭桥术后血糖波动特点及其与院内预后的相互关系,提高护理人员对术后血糖波动的关注度,进一步提高术后护理质量.方法 以便利抽样的原则,选取2017年3—9月于某三级甲等医院心胸外科拟行冠状动脉搭桥术的非糖尿病患者120例,收集一般临床资料及术毕即刻、术后4 h,术后3 d血糖值,采用血糖不稳定指数作为血糖波动情况的评价指标.以血糖不稳定指数总数的第P50位百分数将患者分为低水平血糖波动组(58例)和高水平血糖波动组(62例)2组,比较相关指标的组间差异.结果 术后第1天患者平均血糖值、血糖不稳定指数最高,随后逐渐降低;共有56(46.6%)例患者出现相应并发症,包括手术切口并发症22(18.3%)例、肺部并发症26(21.6%)例、发生恶性心律失常18(15%)例、出现肾功能损害13(10.8%)例;与低水平血糖波动组相比,高水平血糖波动组术后ICU滞留时间、术后住院时间更容易延长(P<0.001)且发生相关并发症的风险更高(P<0.05).结论非糖尿病患者术后血糖峰值及血糖不稳定指数峰值出现时间较早;血糖波动水平可以在一定程度上预测患者院内预后情况的好坏,血糖波动幅度较高的患者术后预后情况显示不佳,临床医护人员应重视非糖尿病患者术后血糖波动情况,维持术后血糖的稳定性.

目的 评价单次口服琥珀酸美托洛尔缓释片在中国健康受试者体内的药代动力学特征和安全性.方法 7例中国健康志愿者空腹单次口服琥珀酸美托洛尔缓释片47.5 mg,8例中国健康志愿者在高脂餐后单次口服琥珀酸美托洛尔缓释片47.5 mg,用液相色谱-串联质谱联用法测定给药后不同时间美托洛尔的血药浓度,并用WinNonlin 6.4软件计算主要药代动力学参数.结果 本研究未观察到药物相关的不良事件和严重不良事件.空腹单次口服琥珀酸美托洛尔缓释片后的药代动力学参数如下: Cmax为(14.63 ±8.93 ) ng· mL-1, tmax为(9.43 ±2.76)h,t1／2为(9.36 ±5.76)h,AUC0-t为(343.63 ±262.07)ng· mL-1· h, AUCinf为(359.65 ±259.29)ng· mL-1· h,清除率为(188.58 ±109.10)L· h-1,表观分布容积为(3031.36 ±4029.78 )L.高脂餐后单次口服琥珀酸美托洛尔缓释片后的药代动力学参数如下: Cmax为( 19.56 ±14.89 ) ng· mL-1, tmax (6.00 ±1.07)h,t1／2为(6.27 ±1.37)h,AUC0-t为(391.07 ±307.06)ng· mL-1· h, AUCinf为(395.84 ±311.42)ng· mL-1· h,清除率为(225.97 ±201.53)L· h-1,表观分布容积为(2022.20 ±1842.51 )L.结论 高脂餐后给予琥珀酸美托洛尔缓释片,tmax较空腹给药提前,暴露量未见明显差异.

Objective To develop a LC-MS/MS method for the determination of antofloxacin in human plasma and to study the pharmacokinetic characteristics of antofloxacin after oral administration of antofloxacin hydrochloride tablets.Methods The samples were precipitated by acetonitrile and ornidazole was selected as the internal standard.The separation was carried on a Agilent Poroshell 120 SB-C18(2.1 mm × 50 mm,2.7 μm) column with a mobile phase of acetonitrile:5 mmol · L-1 ammonium formate (containing 0.1％ formic acid) =12∶88 at a flow of 0.4 mL · min-1 12 healthy subjects were given orally single dose of antofloxacin hydrochloride 400 mg dose,blood samples were collected at different time points,the concentration of antofloxacin in human plasma was measured,and the main pharmacokinetic parameters were calculated by DAS 2.1.1 and Excel 2003.Results All the analytes showed good linearity over their concentration ranges on 0.01-15.00 μg · mL-1 The accuracy,inter-run and intra-run precisions were all below 15％.Analytes were stable during the study.The main pharmacokinetic parameters after antofloxacin 400 mg single drug administration:Cmax was (3.57 ±0.54) μg · mL-1,tmaxwas (2.25 ±0.92) h,t1/2 was (11.76 ± 1.64) h,AUC0-1 was (60.38 ± 7.47)μg · mL-1 · h.Conclusion This method can be used to determine the concentration of antofloxacin in human plasma and to study the pharmacokinetics of antofloxacin hydrochloride tablets.

Objective To investigate the clinical risk factors of diabetic ketoacidosis (DKA ) combined with elevated serum amylase(AMS). Methods Totally 263 patients with DKA were enrolled in our study. They were divided into 2 groups according to the level of AMS:DKA with normal AMS (DKA,n=188);DKA with elevated AMS(HAMS,n = 75 ). HAMS patients then were divided into two subgroups according to the diagnosis with acute pancreatitis(AP)(HAMS+ AP,n = 25 )and without AP (HAMS,n = 50 ). TG,FPG and AMS were measured and analyzed with univariate analysis and multivariate analysis. Results HAMS group patients had a ratio of 28.5％ with elevated AMS and 9.5％ with AP.HAMS group had higher FPG,TG,HbA1 c,Na+ ,osmolality,BUN and Scr than DKA group(P <0.05).The levels of FPG,TG,osmolality,BUN and the time of CO2 CP recovery in HAMS+AP subgroup were all significantly higher than those in HAMS patients without AP (P < 0.05 ). Correlation analysis showed that HAMS was positively correlated with TG,FPG,Na+ ,Osmolality and BUN(P <0.05).Logistic regression analysis showed that hypertriglyceridemia was the independent risk factor of DKA combined with HAMS(OR 1.244,P <0.01),and was the independent risk factor of DKA combined with AP(OR 1.211,P <0.05). Conclusion Hypertriglyceridemia is the related risk factor of DKA combined with HAMS and AP. This study provides a theoretical basis to early screen patients with hyperamylasemia in DKA.

目的：探讨利拉鲁肽对糖尿病大鼠肾损伤的影响及其作用机制。方法将40只雄性SD大鼠随机均分为四组，模型组及观察组给予一次性腹腔注射链脲佐菌素（60 mg／kg）建立糖尿病模型，观察组、利拉鲁肽组给予腹腔注射利拉鲁肽200μg／（ kg· d），模型组和对照组腹腔注射等量生理盐水，均连续注射8周。药物干预8周结束时收集各组24 h尿液，计算尿白蛋白／肌酐、体质量及血清糖化血红蛋白（ HbA1 c），采用HE、六胺银染色观察肾组织形态，采用免疫组化法检测肾小球及肾小管CD14阳性细胞的累积光密度（ IOD ）值，采用ELISA法检测血清TNF-α、IL-1β、IL-6，采用Western blotting法检测核转录因子κB（NF-κB）、细胞黏附因子1（ICAM-1）及胰高血糖素样肽1受体（GLP-1R）蛋白表达。结果与对照组和利拉鲁肽组比较，模型组和观察组体质量减低、血清HbA1c水平及尿白蛋白／肌酐升高（P均＜0．01），且观察组尿白蛋白／肌酐低于模型组（P＜0．01）。光镜下观察到模型组肾小球体积增大，肾小球及肾小管细胞数目增多；观察组肾小管和肾小球损害明显减轻，肾小球及肾小管细胞数量下降，银染颗粒明显减少。模型组肾组织CD14的IOD值及血清TNF-α、1L-6、IL-1β水平均较对照组、利拉鲁肽组升高，观察组上述指标均较模型组降低（P＜0．05或＜0．01）。与模型组比较，观察组肾组织NF-κB、ICAM-1蛋白相对表达量减低，GLP-1R蛋白相对表达量升高；组间比较P均＜0．05。结论利拉鲁肽可抑制糖尿病大鼠肾损伤，抑制NF-κB活化后介导的炎症反应、促进GLP-1R分泌可能是其作用机制。

Objective To explore the effects of glucagon-like peptide-1 (GLP-1) analogues liraglutide on renal tissues of diabetic rats and its mechanism.Methods Forty male SD rats were randomly divided into four groups:normal control rats (NC group),normal control rats with liraglutide treatment (NCL group),diabetic rats (DM group) and diabetic rats with liraglutide treatment.The body weight,glycosylated hemoglobin (HbA1c),albuminuria/creatinine (A/C),kidney index (KI,kidney mass/body mass) were detected after 8 weeks treatment.The gene expression of tumor necrosis factor-or (TNF-α),and interleukin-6 (IL-6),interleukin-1β (IL-1β),monocyte chemotactic protein-1 (MCP-1),type Ⅳ collagen,and transforming growth factor-β1 (TGF-β1) were measured by real time PCR.The protein expression of COL-Ⅳ,NF-κB,GLP-1R and phosphorylation levels of ERK,JNK and p38MAPK were evaluated by Western blotting.Results Compared to NC group,the body weight in DM group was reduced,and HbAlc,KI,A/C levels were significantly increased (P ＜ 0.05).The gene expression of TNF-α,IL-6,IL-1β,MCP-1,TGF-β1 and COL-Ⅳ was increased (P ＜ 0.05).Moreover,the protein expression of NF-κB in the nucleus of the kidney tissues and the phosphorylation levels of ERK,JNK and p38MAPK were significantly increased in DM group,accompanied by the decline of GLP-1R protein level (P ＜ 0.05).After 8 weeks of liraglutide treatment,the urinary protein excretion was reduced,and the gene expressions of TNF-α,IL-6,IL-1β,MCP-1,TGF-β1,COL-Ⅳ were inhibited.Importantly,the phosphorylation levels of ERK and JNK were significantly inhibited and the expression of NF-κB protein in the nucleus of the kidney tissue was reduced (P ＜ 0.05).These changes may be associated with the increased expression of GLP-1R after liraglutide treatment.However,blood glucose and the body weight in DML group rats had no significant changes after liraglutide treatment.Conclusion Liraglutide has a protective effect on renal tissues through inhibiting ERK and JNK phosphorylation and related inflammation in diabetic rats.

Objective To explore the effects and mechanism of exendin-4 on the secretion of extracellular matrix in high glucose-cultured glomerular mesangial cells (GMCs).Methods GMCs were cultured in vitro and divided into 4 groups:normal control (NC) group,normal control with exendin-4 (NCE)group,high glucose (HG) group,high glucose with exendin-4 (HGE) group.Cells in HGE group were treated with 3,5,10,15 or 30 nmol/L exendin-4 for about 12,24 or 48 hours,respectively.The proliferation and cell activity of GMCs were used to assess the most suitable culture time and concentration using Cell Counting Kit-8.The levels of fibronectin (FN) and collagen type Ⅳ in the cell supernatant were measured by ELISA.The levels of collagen type Ⅳ,FN,monocyte chemotactic protein-1 (MCP-1),tumor necrosis factor (TNF)-or,intercellular cell adhesion molecule-1 (ICAM-1),transforming growth factor-β1 (TGF-β1)were evaluated by RT-PCR.The expression of nuclear factor-κB (NF-κB) in each group was analyzed by Western blotting.Results (1) After treated by 10 nmol/L exendin-4 for 24 hours,the growth rate of GMCs cultured in high glucose was significantly decreased compared with 3 nmol/L or 5 nmol/L(F =120.808,P ＜ 0.05),but not different from 15 nmol/L or 20 nmol/L (all P ＞ 0.05).(2) Compared with NC group and NCE group,the expression of FN,collagen type Ⅳ,as well as their mRNA level and the inflammatory mediators such as MCP-1,TNF-α,ICAM-1 and TGF-β1 were significantly increased in HG group(F =6.894-166.914,all P ＜ 0.05).Compared with HG group,the protein and mRNA level of FN and collagen type Ⅳ,and the expression of TNF-α,MCP-1,ICAM-1 and TGF-β1 were inhibited greatly in HGE group (F =6.894-166.914,all P ＜ 0.05).(3) Compared with NC group and NCE group,the expression of NF-κB increased significantly in HG group (F =133.1,P ＜ 0.05).Compared with HG group,the expression of NF-κB was suppressed significantly in HGE group (F =133.1,P ＜ 0.05).Conclusion Exendin-4 inhibits the secretion of extracellular matrix of GMCs cultured in high glucose,and the mechanism is associated with the inhibition of inflammation induced by NF-κB.

糖尿病与骨代谢疾病密切相关,糖尿病患者易发生骨质疏松,糖尿病性骨质疏松(DOP)发病率高、易致骨折,严重威胁老年人的健康.胰高血糖素样肽1(GLP-1)是一种主要由肠道L细胞分泌的肠促胰素,具有葡萄糖浓度依赖性降糖作用,其受体激动剂已用于糖尿病治疗.近年来研究发现,GLP-1不仅在调节体内葡萄糖稳态中起重要作用,还对DOP有间接或直接的改善作用,这将为临床治疗DOP提供新的途径和方法.

冠心病联合瓣膜病近年来一直呈上升趋势发展.此类病人多数病史长、病情重、手术风险高、护理难度大,而同期施行冠状动脉旁路移植和心脏瓣膜置换术是治疗该联合病变的有效方法.我科在2007年1月～2009年1月,两年共完成冠状动脉旁路移植术249例,其中40例同期行瓣膜置换术.现将护理体会报道如下.

冠心病合并糖尿病患者常因年龄偏大、病程长,易并发其他系统合并症致术后机体恢复慢,并发症发生率较高,特别是伤口的愈合不良,属手术高危人群.非体外循环冠脉搭桥术是一种微创心脏外科手术,不需体外循环,具有出血少、拔管早、进食早、恢复快等优点[1].因此,非体外循环冠脉搭桥术(OPCAB)是冠心病患者外科治疗的最佳手术方法.我科从2000年5月～2005年12月共完成OPCAB合并糖尿病患者199例获得满意疗效,现将术后护理总结如下。

Objective: To investigate the relationship between the colonic dysfunction and the heme oxygenase-2(HO-2) expression in the diabetic rat colons. Methods: The level of heme oxygenase-2 in the proximal and distal colon of diabetic and normal rats was detected by immunohistochemistry and the expression of heme oxygenase-2 mRNA was analyzed by RT-PCR. Results: The HO-2 positive cells were mainly localized in neuronal cell in the intermuscular plexus and submucous plexus. Compared to the normal rats, The number of HO-2 positive cells and the level of HO-2 mRNA significantly declined in diabetic rats.(P 0.05) .Conclusion : The abnormal expression of HO-2 suggests that carbon monoxide may play an important role in the pathogenesis of diabetic colon dysfunction.

Objective: To investigate the changes of interstitial cells of Cajal and the expression of substance P in colon tissue of diabetic rats with gastrointestinal dysfunction and to discuss the possible mechanism of gastrointestinal dysfunction associated with diabetes mellitus.Methods: Thirty SD rats were randomly divided into normal control group(n = 10) and diabetic model group(n = 20).Rats in diabetic model group were made into diabetic models with intraperitoneal injection of streptozotocin(STZ)(80 mg/kg) for only one time.and those in normal control group were intraperitoneally injected with the equal Citric Acid buffer.The distribution of interstitial cells of Cajal and the expression of substance P in the proximal and distal colon tissue were detected by immunohistochemistry.Results: The immunoreaction positive products of interstitial cells of Cajal and substance P were mainly distributed in the myenteric plexus of the colon tissue,and the expression of interstitial cells of Cajal and substance P in the proximal and distal colon tissue of diabetic rats were decreased(P 0.05).Conclusion: Decreased expression of interstitial cells of Cajal and substance P in the colon tissue might play an important role in the gastrointestinal dysfunction associated with diabetic mellitus.