目的 探析慢性阻塞性肺疾病急性加重（AECOPD）患者在全身糖皮质激素（激素）使用过程中检测呼出气一氧化氮（FeNO）的价值。方法 于2019年1月—2021年12月梅州市人民医院采集病例展开随机对照研究,实施对象为58例AECOPD患者,均检测FeNO水平,根据FeNO水平是否>25 ppb,分组为FeNO高水平组和FeNO低水平组,根据是否接受全身激素治疗分为治疗组和对照组,对照组予以常规治疗,治疗组实行常规+全身激素治疗;检测治疗前后FeNO、肺功能指标水平变化,判定COPD评估测试（CAT）评分,对比组间差异。结果 FeNO高水平组全身激素治疗后（治疗组）FeNO降低（P<0.05）,高水平组常规治疗后（对照组）FeNO前后比较差异无统计学意义（P>0.05）,低水平组中治疗组和对照组治疗前后FeNO比较差异无统计学意义（P>0.05）;FeNO高水平组治疗后第一秒用力呼气容积（FEV₁）、第一秒用力呼气量占用力肺活量比值（FEV₁/FVC）均升高,且治疗组升高程度较对照组更大（均P<0.05）,FeNO低水平组治疗后FEV₁、FEV₁/FVC均升高（均P<0.05）,但治疗组与对照组相比无差异（P>0.05）;FeNO高水平组、低水平组治疗后CAT评分较治疗前均下降（均P<0.05）,FeNO高水平组下降更明显。结论 AECOPD患者实施FeNO测定,其水平变化在一定程度上可反映气道炎症,并预测激素治疗反应,指导合理有效地应用全身激素,避免出现激素过度使用情况。

Objective To explore the value of detecting exhaled nitric oxide(FeNO)during systemic glucocorticoid use in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods A randomized controlled study was conducted from January 2019 to December 2021 at the People's Hospital of Meizhou City. The subjects were 58 AECOPD patients,all of whom were tested for FeNO levels. Based on whether the FeNO levels were>25 ppb,they were divided into a high level FeNO group and a low level FeNO group. They were divided into a treatment group and a control group based on whether they received systemic glucocorticoid therapy. The control group received routine treatment,while the treatment group received routine and systemic glucocorticoid therapy. Changes in FeNO and lung function indicators before and after treatment were detected,COPD assessment test(CAT)scores were determined,and differences between groups were compared. Results After systemic glucocorticoid therapy,the high level group of FeNO showed a decrease in FeNO(P<0. 05),while the high level group showed no statistically significant difference in FeNO before and after routine treatment(P>0. 05). The low level group showed no statistically significant difference in FeNO between the treatment group and the control group before and after treatment(P>0. 05). The first second forced expiratory volume(FEV₁)and the ratio of first second forced expiratory volume to forced vital capacity(FEV₁/FVC)in the high level group of FeNO significantly increased after treatment,and the degree of increase in the treatment group was greater than that in the control group(all P<0. 05). The FEV₁ and FEV₁/FVC in low level group of FeNO significantly increased after treatment(all P<0. 05),but the difference between the treatment group and the control group was not significant(P>0. 05). The CAT scores of the high and low levels of FeNO groups decreased after treatment compared to before treatment(all P<0. 05),and the decrease was more significant in the high level FeNO group. Conclusions The implementation of FeNO measurement in AECOPD patients can reflect airway inflammation to a certain extent,predict glucocorticoid treatment response,guide the rational and effective application of systemic glucocorticoid and avoid excessive glucocorticoid use.

目的 探讨先天性肥厚性幽门狭窄(congenital hypertrophic pyloric stenosis,IHPS)中神经元型一氧化氮合酶(neuronal nitric oxide synthase,nNOS)的表达情况,以进一步研究IHPS的发病机制。方法 选取4只Beagle孕犬按3:1分为模型组和对照组,自孕期第1天至分娩前1天,模型组孕犬每天腹腔注射一次L-NAME 6 mg/(kg.d),对照组给予同样方式注射等量的生理盐水。所有新生犬均在生后第31天、38天、45天及52天分别称重,生后52天,选取模型组中体质量增长缓慢的新生犬和对照组新生犬各5只作为实验对象,取幽门组织HE染色后显微镜下测量幽门环肌厚度,免疫组化后运用图像分析技术测定nNOS表达量。结果 与对照组新生犬比较,模型组中新生犬体质量增长慢,幽门环肌增厚,nNOS表达量减少,两组间有差异(P<0.01,P<0.01,P<0.05)。结论 幽门区nNOS表达减少与CHPS相关。

Objective To further study the pathogenesis of infantile hypertrophic pyloric stenosis(IHPS) by analyzing the expression of neuronal nitric oxide synthase(nNOS) in pylorus of CHPS. Methods According to 3:1,four Beagle pregnant dogs were selected and divided into model group and control group,from the first day of pregnancy to the first day before delivery, L-NAME was intraperitoneally injected into pregnant dogs in the model group, dose for 6mg/(kg.d),while normal saline was intraperitoneally injected into pregnant dogs in the control group.The two groups newborn dogs were weighed at 31, 38, 45 and 52 days after birth,At 52 days after birth, 5 newborn dogs were selected respectively between model group and control group as experimental subjects, obtained pyloric tissue for HE staining and measured the muscular thickness of pyloric,The expression of nNOS was determined by image analysis after immunohistochemistry. Results Compared with newborn dogs in the control group, newborn dogs in the model group had slow weight growth, increased pyloric annulus muscle thickness, and decreased expression of nNOS(P<0.01,P<0.01,P<0.05). Conclusion The decreased expression of nNOS in the pyloric region associated with IHPS.

目的 观察并评估内毒素性急性肺损伤大鼠吸入一氧化氮后外周血中内皮祖细胞和炎症介质的变化情况。方法 90只SPF级健康大鼠分为3组,A组为正常对照组(n=30),B组为急性肺损伤组(ALI)(n=30), C组为一氧化氮(NO)组(n=30)。分别计算各组外周血内皮祖细胞(Endothelial progenitor cells,EPCs) 数量,同时监测肺组织中白细胞介素-10(Interleukin-10,IL-10)水平和髓过氧化物酶(Myeloperoxidase,MPO)活性。结果 我们成功建立了大鼠的ALI肺损伤模型, C组EPCs数量、MPO活性上升幅度均小于B组、而IL-10上升水平均高于B组,差异有统计学意义(P<0.05)。结论 大鼠吸入一氧化氮可减轻内毒素所致急性肺损伤程度,其机制可能与外周血中内皮祖细胞数量及MPO水平下降和IL-10水平上升有关。

Objective To investigate the effect of nitric oxide(NO) inhalation in endotoxin-induced acute lung injury mice. Methods Ninety SPF mice were randomly assigned to the normal group(group A), ALI group(group B)and ALI+NO group(group C). The number of endothelial progenitor cells was counted and the level of Interleukin-10(IL-10) and myeloperoxidase (MPO) were measured. Results Endotoxin administration resulted in pulmonary edema. The pulmonedema was lightened and the level of MPO were decreased by the inhalation of nitric oxide while the level of IL-10 increased. Conclusion NO inhalation can mitigate acute lung injure. The decline of EPCs and MPO and the increase of IL-10 may be one of the mechanism.

      目的   探讨神经元型一氧化氮合酶（nNOS）在抑制剂N-硝基-左旋精氨酸甲酯（L-NAME）抑制作用下与新生鼠胃肠道疾病的相关性研究，以进一步研究婴儿肥厚性幽门狭窄（IHPS）等疾病的致病机制。方法   对40只成熟雌性wistar大鼠随机均分4组，怀孕后予怀孕母鼠灌胃，对照组给予生理盐水，低剂量组、中剂量组、高剂量组分别给予L-NAME 60、300、600 mg/（kg·d）L-NAME。新生鼠皮下注射方式，予对照组皮下注射生理盐水，在低剂量组、中剂量组、高剂量组皮下注射L-NAME 25、125、250 mg/（kg·d）L-NAME。统计分析新生鼠幽门中的nNOS表达量、体质量增长情况、胃潴留情况、幽门肌层厚度。结果 （1）低剂量组、中剂量组、高剂量组新生鼠幽门肌层厚度在出生后第1、7、14日龄高于对照组，但组间比较差异无统计学意义（P＞0.05）。（2）与对照组相比，低剂量组、中剂量组、高剂量组的新生鼠出生后第1周体质量增加量更少，胃潴留更明显（P＞0.05）；在出生后的第2周各组体质量增加量差异无统计学意义（P＞0.05）。（3）新生鼠出生后第14天，中剂量组的胃体积大于低剂量组，但低剂量组和对照组之间、中剂量组和高剂量组之间比较差异无统计学意义（P＞0.05）。（4）新生鼠生后第1天，幽门中nNOS的表达被L-NAME以剂量依赖的方式被抑制，随着新生鼠日龄的增长，这种效应逐渐消失。（5）在不同剂量L-NAME的作用下，新生鼠幽门中nNOS表达量、趋势在不同时间点不同。结论 （1）nNOS可以导致新生鼠胃潴留、幽门梗阻，与IHPS相关症状之间存在相关性，但可能不是IHPS病因的唯一分子机制。（2）在新生鼠胃、幽门组织中，nNOS的表达量可以通过负反馈调节机制调节。（3）nNOS表达量上调可能有助于幽门舒张，但可能无法完全逆转IHPS中幽门的进一步肥厚和阻塞。

    Objective  To explore the effect of nNOS on the early postnatal pylorus of neonatal rats under the inhibition of the inhibitor N-nitro-L-arginine methyl ester hydrochloride（L-NAME），in order to further investigate the pathogenic mechanism of infantile hypertrophic pyloric stenosis（IHPS）．Methods  Pregnant female mice were grouped randomly and administered by gavage，with the control group receiving physiological saline，the low-dose，medium-dose and high-dose groups  receiving different doses of L-NAME．For the neonatal rats，the control group was subcutaneously injected with physiological saline，while the low-dose group，medium-dose group，and high-dose group were subcutaneously injected with different doses of L-NAME．The expression of nNOS in the pylorus，weight gain，gastric retention，and pyloric muscle thickness of newborn  rats were statistically analyzed．Results   (1) The thickness of the pyloric muscle layer in the low-dose group，medium-dose group，and high-dose group of newborn rats was higher than that in the control group on the 1st，7th，and 14th day after birth，but there was no significant difference．（2）Compared with the control group，the neonatal rats in the low-dose group，the middle-dose group and the high-dose group gained less weight in the first week after birth，and the gastric retention was more significant．There was no significant difference in weight gain among the groups in the second week after birth．（3）On the 14th day after birth，the gastric volume of the medium-dose group was larger than that of the low-dose group，but there was no statistical difference between the low-dose group and the control group，or between the medium-dose group and the high-dose group．（4）On the first day after birth，the expression of nNOS in the pylorus of neonatal rats was significantly inhibited by L-NAME with dose-dependence，and this effect gradually disappeared with increasing age of neonatal rats．(5) Under the action of different doses of L-NAME，the expression level and trend of nNOS in the pylorus of neonatal mice vary at different time points．Conclusions   (1) nNOS can cause gastric  retention and pyloric obstruction in newborn rats，which is related to IHPS related symptoms，but may not be the only molecular mechanism of IHPS etiology．(2) The expression level of nNOS in the pyloric tissue of newborn mice can be regulated through a negative feedback regulatory mechanism．(3) Upregulation of nNOS expression may contribute to pyloric dilation，but may not completely  reverse thickening and obstruction of the pylorus in IHPS．