质量流量传感器在一氧化氮吸入疗法中的应用

目的应用质量流量传感器研制一氧化氮(nirtic oxide,NO)自动配气装置。方法 通过体外膜肺实验,测定治疗气在配气、传输过程中NO浓度的稳定性和二氧化氮(nitrogen dioxide,NO2)生成量。结果 吸入装置连续运行3d,NO浓度波动小于2％,NO设定浓度与监测浓度之差小于5％。NO2生成量与NO浓度、O2浓度及NO在有氧环境中传输时间有关。当NO浓度为100 ppm,O2浓度为75％,NO2生成量小于4 ppm。结论 该装置配置NO治疗气长期稳定性好,配气精度高,使用安全、方便。

一氧化氮吸入疗法的产生、发展及应用前景

1986年Furchgott等三位美国科学家发现一氧化氮(NO)是心血管系统中传播信号的分子[1].研究表明它具有舒血管的作用,并证明它既是内皮细胞舒张因子(EDRF),从而开创了医学研究的新领域,该研究获1998年诺贝尔生理学和医学奖.实验研究表明,内源性NO除具有舒张血管作用外,尚能对维持或调节循环、呼吸、中枢神经乃至免疫等生理功能起着重要作用.临床应用研究也证实了外源性NO具有降低肺动脉高压、提高血氧饱和度的功能.同时,NO吸入方法学的研究也正逐步展开.1994年Miller等报道了在肺膜实验中NO被氧化成二氧化氮(NO2)的报道;同年,Weseel等提出了NO吸入的5种方式,从而逐步形成了NO吸入新疗法.

一氧化氮吸入疗法及护理

一氧化氮 (NO)吸入疗法是 2 0世纪 90年代呼吸医学技术理论的重大突破。人工给予适量和控制性地应用 NO可以特异性地降低肺动脉高压 ,改善氧合。目前 ,NO吸入疗法已广泛应用于新生儿呼吸医学 ,也适用于危重监护、心胸血管内外科、呼吸内科、麻醉科等临床医学领域。由于 NO吸入的潜在毒副作用 ,它的治疗浓度、适应证还需谨慎选择和不断考证 ,因此 ,治疗过程中需要严密的监测和专业性的护理 。

医用氮氧化物浓度监测仪的研制及性能鉴定

吸入低浓度一氧化氮气体已广泛用于医学临床，选择性扩张肺血管平滑肌和改善通气／血流比值促进氧合。利用一氧化氮与臭氧产生化学发光反应释放出特征光原理，我们开发研制了ＹＹ—１型医用氮氧化物浓度监测仪，并参照国家技术监督局颁布的国家计量检定规程，对其主要性能进行测试鉴定。该仪器除体积小、重量轻、预热时间短和转换室温度低、效率高适合临床应用外，其各项性能指标均超过国家技术监督局颁布的标准。其线性相关、零点漂移、跨度漂移和响应时间均优于国外同类仪器。样机在本科临床试用６个月，证实该监测仪具有性能稳定、反应灵敏、抗干扰强及采气量小等优点。

一氧化氮吸入治疗在新生儿科中的应用

观察一氧化氮吸入(iNO)疗法治疗新生儿重度肺动脉高压(PPHN)的效果。方法 将2021.4~2022.8就诊的70例PHN患儿分成传统、试验组,均给予常规机械通气治疗,试验组联合iNO疗法,观察各组治疗情况,并在组间进行对比分析。结果 和传统组相比较,试验组患儿的机械通气、氧疗及住院时间更为短暂,差异显著(P<0.05)。连续治疗1h、12h后,试验组患儿pH、MAP、OI三项指标检测值均优于传统组(P<0.05)。结论 临床医生面对PPHN患儿时,尽量采用iNO联合常规机械通气疗法,能更好地改善机体的呼吸功能,尽早撤机,早日康复出院,值得推广。

吸入一氧化氮逆转幼猪急性缺氧性肺动脉高压

目的 观察吸入不同浓度一氧化氮 (NO)是否可逆转幼猪急性缺氧性肺动脉高压。方法 选用 10头上海种白猪 ,利用低氧建立急性缺氧性肺动脉高压模型。吸入不同浓度NO(0 ,10 ,2 0 ,40 ,80 ,12 0ppm)。在各时相分别进行血液动力学指标、二氧化氮和高铁血红蛋白浓度监测。 结果 吸入不同浓度NO可明显降低肺动脉平均压 (MPAP)、肺循环阻力指数 (PVRI)、跨肺压 (TPG)、体肺动脉压之比 (Pp/Ps)、体肺循环阻力指数之比 (Rp/Rs) (P <0 .0 1)。结论 吸入NO是一种快速、有效的选择性肺血管扩张剂。

Effects of acupuncturing Tsusanli (S_T36) on expression of nitric oxide synthase in hypothalamus and adrenal gland in rats with cold stress ulcer

AIM： To study the protective effect of acupuncturing Tsusanli （ST36） on cold stress ulcer, and the expression of nitric oxide synthase （NOS） in hypothalarnus and adrenal gland. METHODS： Ulcer index in rats and RT-PCR were used to study the protective effect of acupuncture on cold stress ulcer, and the expression of NOS in hypothalamus and adrenal gland. Images were analyzed with semi-quantitative method. RESULTS： The ulcer index significantly decreased in rats with stress ulcer. Plasma cortisol concentration was up regulated during cold stress, which could be depressed by pre-acupuncture. The expression of NOS1 in hypothallamus increased after acupuncture. The increased expression of NOS2 was related with stress ulcer, which could be decreased by acupuncture. The expression of NOS3 in hypothalamus was similar to NOS2, but the effect of acupuncture was limited. The expression of NOS2 and NOS3 in adrenal gland increased after cold stress, only the expression of NOS1 could be repressed with acupuncture. There was no NOS2 expression in adrenal gland in rats with stress ulcer. CONCLUSION： The protective effect of acupuncturing Tsusanli （ST36） on the expression of NOS in hypothalamus and adrenal gland can be achieved.

“2009年高危新生儿治疗技术学习班”通知

广州市妇女儿童医疗中心、广州市儿童医院拟于2009年7月14—17日（14日报到，18日撤离）在广州举办“高危新生儿治疗技术学习班”。该学习班系国家级继续教育项目（2009—06—03—020），学习结束授予Ⅰ类学分10分。授课内容：新生儿常频机械通气，高频通气，无创辅助通气，氧疗，液体疗法，早产儿经胃肠道喂养，静脉营养，一氧化氮吸入疗法，血液净化技术，高压氧治疗，亚低温疗法，输血疗法，干细胞治疗，心脑肺复苏术，危重新生儿转运等。授课人员：开展上述技术并在全国具有较大影响力的单位的专家教授，包括复旦大学儿科医院、上海交通大学新华医院、浙江大学医学院附属儿童医院、中南大学湘雅医院、中山大学附一院、暨南大学医学院附一院、南方医科大学珠江医院、广州医学院附二院、广州市儿童医院等单位的专家、教授。学费（含资料费）800元，食宿统一安排，费用自理。

EFFECT OF ACUPUNCTURE ON BLOOD OXYGEN FREE RADICAL AND NO LEVELS IN TREATMENT OF APOPLECTIC SEQUELAE

Objective: To observe the effect of acupuncture on blood oxygen free radical (OFR) and nitric oxide (NO) levels in the treatment of apoplectic sequelae. Methods: A total of 61 cases of apoplectic patients were subjected into this study and randomly divided into "JIN San Zhen" group (n=30) and control group (n=31). Blood lipid peroxidase (LPO), superoxide dismutase (SOD), glutathione peroxidase(GSH Px) and nitric oxide (NO) contents before and after acupuncture treatment were determined with radioimmunoassay. In both groups, acupuncture was given once daily, six times a week, with 4 weeks being a therapeutic course and with the interval between two weeks being a week, 3 courses all together. In "JIN San Zhen" group, acupoints of "JIN San Zhen" were used predominately, while in control group, scalp point Motor Sensory Area (MS 8) was used as the main point. Results: Self comparison showed that after 3 courses of treatment, in both groups, LPO and NO levels decreased significantly (P<0.05-0.01), SOD and GST Px values increased considerably (P<0.05-0.01). Comparison between two groups indicated that the effects of "JIN San Zhen" group are significantly superior to those of control group in raising blood SOD and GST Px levels (P<0.05-0.01) and in lowering blood NO content (P<0.01). Analysis on the correlation between the restoration of neural function and the changes of LPO, SOD and GST Px levels suggested that the effect of acupuncture in improving neural function may be related to changes of the aforementioned indexes. Conclusion: Acupuncture therapy can significantly lower blood LPO and NO levels and evidently raise blood SOD and GST Px levels in stroke patients.

Effects of sinew-regulating bone-setting manipulations on chondrocytes,IL-1βand NO in rabbits with knee osteoarthritis

Objective To observe the therapeutic effect of sinew-regulating bone-setting manipulations for knee osteoarthritis(KOA)model rabbits and its impacts on the chondrocyte apoptosis rate and the levels of interleukin(IL)-1βand nitric oxide(NO).Methods According to the random number table method,30 New Zealand white rabbits were divided into a normal group(n=9)and a modeling group(n=21).Rabbits in the modeling group were used to establish KOA models with the modified Hulth method.At the 8th week,three rabbits were sacrificed to verify the model and the remaining 18 rabbits were randomly divided into a model group(n=9)and an intervention group(n=9).Rabbits in the normal group and model group were bred routinely without any intervention.Rabbits in the intervention group were treated with the sinew-regulating bone-setting manipulations,10 min/time,once every other day for a total of 20 times.The Lequesne MG knee function rating was used to evaluate the behavioral differences of the rabbits in each group.The Pelletier score was used to evaluate the general changes of the rabbits.The Mankin score was used to evaluate the pathology of knee cartilages.The enzyme-linked immunosorbent assay and nitrate reductase methods were used to determine the levels of IL-1βand NO in serum and synovial fluid of each group,respectively.In situ terminal deoxynucleotidyl transferase-mediated nick and labeling method was used to determine the apoptosis of chondrocytes in each group.Results Compared with the normal group,the scores of Lequesne MG,Pelletier and Mankin,and the levels of IL-1βand NO in the model group were increased(P<0.05),which indirectly indicated the success of the model.Compared with the model group,the scores of Lequesne MG,Pelletier and Mankin,IL-1βand NO levels,and chondrocyte apoptosis rate of the intervention group were decreased,and the differences were statistically significant(P<0.05).Conclusion The sinew-regulating bone-setting manipulations can reduce the levels of IL-1β,NO,and chondrocyte apoptosis rate,and delay the articular cartilage degeneration,therefore,having a good therapeutic effect on KOA.

Effects of Needle-knife Therapy on iNOS Activity and NO Content in Skeletal Muscles in the L_3 Transverse Process Syndrome Model Rat

Objective: To study on relationship of inducible nitric oxide synthase (iNOS) activity and nitric oxide (NO) content in the injured local soft tissue with injured degrees of the soft tissue in the third lumbar vertebrae (L3) transverse process syndrome model rat and to observe the effect of needle-knife therapy. Methods: One hundred and sixty male SD rats were randomly divided into normal group, model group, aminoguanidine (AG) group, needle-knife group, 40 rats in each group. The L3 transverse process syndrome rat model was established, and after treatment of needle-knife and AG, iNOS activities and NO contents and histomorpholocal changes in the soft tissues around L3 transverse process on 1, 3, 7 and 14 days were observed in the groups. Results: Compared with the normal group, iNOS activity and NO content in the model group were significantly increased (P<0.01); Compared with the model group, iNOS activities and NO contents were significantly decreased in both the needle-knife group and the AG group (both P<0.01); And both iNOS activities and NO contents were identical with both local inflammation response and injured degrees of the injured tissue in the groups. Conclusion: Needle-knife therapy can significantly inhibit generation of NO, alleviate inflammatory response and injured degree of the injured soft tissue, improve microcirculation, prevent formation of pathological scar tissue, and promote repair of the chronic soft tissue injury.

Effects of Acupuncture at Acupoint Neiguan(PC6)and Intravenous Injection of Larginine on the Improvement of Acute Myocardial Ischemia

Objective： The present study is to observe and compare the different effects of electroacupuncture（EA） at acupoint Neiguan （PC 6）, intravenous administration of L-arginine（L-Arg, a precursor of nitric oxide）, and the drug administration combined with the EA on acute myocardial ischemia（AMI） in rats. Methods. The rat model of AMI was established by occlusion of the anterior descending branch of the left coronary artery, then the animals were divided randomly into 5 groups, i.e. control group, AMI group, L-Arg treatment group, EA treatment group and L-Arg plus EA treatment group, the mean arterial pressure（MAP）, heart rate（HR） and the cardiac functions were observed and recorded. Results： The data showed that MAP, HR and all the indices of cardiac functions in the AMI group were significantly lower than those in control group, and the indices in each treatment group were all improved to different extents, especially in L-Arg plus EA treatment group. Conclusion.The combined use of L-Arg and EA had the better therapeutic effect on the AMI.

关于举办“2009年高危新生儿治疗技术学习班”的通知

广州市妇女儿童医疗中心、广州市儿童医院拟于2009年7月14～17日（14日报到，18日撤离）在广州举办“高危新生儿治疗技术学习班”，为期4天。本项目系国家级继续教育项目（2009-06-03—020），学习结束授予I类学分10分。授课内容：新生儿常频机械通气；高频通气；无创辅助通气；氧疗；液体疗法；早产儿经胃肠道喂养；静脉营养；一氧化氮吸入疗法；血液净化技术；高压氧治疗；亚低温疗法；输血疗法；干细胞治疗；心脑肺复苏术；危重新生儿转运等。授课人员：开展上述技术并在全国具有较大影响力的单位的专家教授，包括复旦大学儿科医院、上海交通大学新华医院、浙江大学医学院附属儿童医院、中南大学湘雅医院、中山大学附一院、暨南大学医学院附一院、南方医科大学珠江医院、广州医学院附二院、广州市儿童医院等单位的专家、教授。

Effect of Acupuncture on NO, NOS and Ca^(2+)-Mg^(2+)-ATPase Activity in Brain Tissue of Subacute Aging Rats Induced by D-galactose

Objective： To explore the mechanism of acupuncture in treating brain aging. Methods： Forty healthy Wistar rats were randomly divided into 4 groups with 10 rats in each group. The rats in the control group didn＇t received modeling and treatment. The rats in the model group, the Governor Vessel acupoints group （GVA group） and the body acupoints group （BA group） were induced as subacute aging rat model. The rats in the model group didn＇t take treatment. On the modeling day, the rats in the GVA group received acupuncture at Baihui （GV 20） and Dazhui （GV 14） while the rats in the BA group received acupuncture at Guanyuan （CV 3） and Zusanli （ST 36）. The contents of NO and NOS, as well as the activity of Ca^2＋-Mg^2＋-ATPase in the brain tissue of rats in each group were observed. Results： After modeling, the contents of NO and NOS of brain tissue increased significantly and the activity of Ca2^＋-Mg^2＋-ATPase decreased markedly. Acupuncture treatment could inhibit the increases of NO and NOS contents, improve the decrease of the activity of Ca^2＋-Mg^2＋-ATPase. The results of the GVA group were better than those of BA group （both P〈0.05）. Conclusion： Acupuncture improved the activity of Ca^2＋-Mg^2＋-ATPase and stabilized the NOS concentration. As a result, the NO content was balanced and the ohvsiological function of NO was fully induced for anti-a^in~, esoeciallv in the GVA group.