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??Abstract?? Objective Toinvestigatethe correlation among exhalednitric oxide??lung function and Asthma Control Test inasthmatic childrenand the clinicalsignificance. Methods A total of 136 cases of asthmatic children aged 5 to 15 years old were recruited from Shengjing Hospital of China Medical University.The fraction of exhaled nitric oxide?? lung function and ACTscore were measured??and the correlation among them was analyzed. Results Negative correlation was found between FeNOand ACT??r= -0.251??P<0.005??.Negative correlation was found between FeNOandFEV1/FVC of lung function??r=-0.206??P<0.05????but not FEV1or PEF.Positive correlation was found betweenACT scoreandFEV1/FVC of lung function ??r=0.242??P<0.01???? but not FEV1or PEF. Conclusion For all subjects??FeNO is negatively correlated with ACT score and FEV1/FVC.ACT is positively correlated with FEV1/FVC.When the subjects are grouped??the three don’t have stable correlations.FeNO is a good biomarker to evaluate the airway inflammation of asthmatic children.ACT score evaluates the level of asthma control in children.Lung function evaluates airway obstruction.FeNO??lung function andACTare different measurements that evaluate asthma in different ways.None of them can be used instead of another in clinical practice??and they are complementary.Combinedapplicationscan effectivelyimprove the diagnosis??treatment and asthmacontrol inasthmatic children.     

呼出气一氧化氮检测在缓解期儿童哮喘合并鼻炎中的价值

目的 探讨呼出气一氧化氮（FeNO）检测用于评估缓解期哮喘合并缓解期过敏性鼻炎患儿病情的价值。方法 选取214 例处于临床缓解期哮喘儿童,按照有无合并过敏性鼻炎及有无进行规范化治疗分为哮喘治疗组、哮喘合并鼻炎治疗组、哮喘未治疗组及哮喘合并鼻炎未治疗组。同时记录FeNO 及引起FEV1 下降20%时的激发剂累计浓度（PC20FEV1）数值。结果 哮喘未治疗组PC20FEV1 数值高于哮喘合并鼻炎未治疗组,差异有统计学意义;两组FeNO 差异无统计学意义。哮喘治疗组与哮喘合并鼻炎治疗组FeNO 及PC20FEV1 数值差异均无统计学意义。哮喘合并鼻炎治疗组PC20FEV1 数值明显高于未治疗组,FeNO 数值明显低于未治疗组。哮喘治疗组仅FeNO 数值明显低于未治疗组,二者PC20FEV1 数值差异无统计学意义。结论 对怀疑合并有临床缓解期过敏性鼻炎的哮喘患儿进行病情评估时,FeNO 检测具有重要的价值。     

Clinical characteristics of pulmonary arterial hypertension associated with Down syndrome

The genetic abnormalities associated with Down syndrome (DS) are still being identified. Few studies have examined the roles of CRELD1 and GATA4 in cardiac abnormalities or their association with pulmonary artery histopathology. Children with DS have an elevated risk of pulmonary arterial hypertension (PAH). This increased risk is likely mainly due to genetic background, the structural characteristics of the pulmonary vascular wall, and certain heart diseases and partly due to pulmonary hypoplasia, upper and lower airway obstructive diseases, chronic infection, and neuromuscular underdevelopment. Exposure to increased left‐to‐right shunt flow increases sheer stress on endothelium and may induce endothelial dysfunction followed by irreversible remodeling of pulmonary arteries. Pathologic changes include endothelial cell proliferation and thickening of the pulmonary arterial wall due to mechanical responses to the thinner medial smooth muscle cell layer, which includes underdevelopment of alveoli. Production of prostacyclin and nitric oxide is diminished in DS, but endothelin‐1 and thromboxane are elevated. Perioperatively, patients with DS may experience pulmonary hypertensive crisis after intracardiac repair and prolonged PAH, and have a poorer response to nitric oxide inhalation. To better manage DS, it is crucial to systematically evaluate the systemic complications of DS. Cardiac catheterization data, particularly those regarding pulmonary arterial resistance, are essential in assessing severity and response to vasodilating agents, preventing postoperative crisis, and evaluating the possibility of intracardiac repair. Advanced therapy with pulmonary vasodilating agents appears effective. Operative risk is similar for individuals with and without DS, except among patients with a complete atrioventricular canal defect.     

健康成人刺激性全唾液流速及一氧化氮含量的增龄性变化

目的:研究不同年龄阶段健康成人的刺激性全唾液流速及唾液一氧化氮含量的变化。方法:将97例健康成人分成4个年龄组,分别为青龄组(20~39岁)、中龄组(40~59岁)、老龄组(60~79岁)、长寿组(80岁以上)。在上午8:00~10:00空腹,以2.5ml/L洗必太漱口,以20ml/L柠檬酸刺激舌背前1/3,以双蒸水漱口后采集全唾液5min,记录样本容量,并计算其流速。用硝酸还原酶法检测唾液中NO浓度,并计算其唾液中NO的单位时间含量。结果:(1)青龄组刺激性全唾液流速高于中龄组、老龄组、长寿组(P<0.05);中龄组、老龄组、长寿组之间唾液流速无显著性差异(P>0.05);(2)不同年龄组间两两比较,刺激性全唾液NO浓度无显著性差异(P>0.05);青龄组NO单位时间含量显著高于中龄组、老龄组和长寿组(P<0.05),中龄组、老龄组、长寿组之间的NO单位时间含量无显著性差异(P>0.05)。结论:(1)中老年人群的刺激性全唾液流速显著低于青年人群;(2)随年龄增长,健康成人刺激性全唾液中的NO浓度未发生明显变化,但其单位时间含量呈降低趋势。