This paper discusses the limitations of current NO inhalation systems, based on the research in collocation of NO, inspection of NO/NO2 and synchronous working of NO inhalation systems with ventilators. And then, the developing trend of NO inhalation systems is put forward here too.
Administration, Inhalation ; Nitric Oxide ; administration & dosage ; Ventilators, Mechanical ; trends

College of Environmental Science and Engineering, Huazhong University of Science and Technology, Wuhan,430074 Inhaled nitric oxide (INO) is increasingly being used in medical treatments of high blood pressure, acute respiratory distress syndrome (ARDS) and some diseases related with lungs. In this paper, in view of the problems in the current supply systems of NO for the treatments of respiratory failure, an INO system for clinical applications is designed based on experimental studies. Its continuous trial run shows that the outlet concentration of NO can be supplied constantly, and the ratio of NO2/NO is about 2.7%. So it satisfies the clinical requirements (NO2/NO<5%). In comparison of the conventional NO supply systems, this system has significant advantages, it can work so long as the air and the electricity exist.
Administration, Inhalation ; Equipment Design ; Humans ; Nebulizers and Vaporizers ; Nitric Oxide ; administration & dosage ; therapeutic use ; Respiratory Insufficiency ; therapy

OBJECTIVE: To study the effect of intermittent versus daily inhalation of budesonide on pulmonary function and fractional exhaled nitric oxide (FeNO) in children with mild persistent asthma. METHODS: A total of 120 children, aged 6-14 years, with mild persistent asthma who attended the hospital from January 2016 to January 2018 were enrolled. The children were divided into an intermittent inhalation group with 60 children (inhalation of budesonide 200 μg/day for 6 weeks when symptoms of asthma appeared) and a daily inhalation group with 60 children (continuous inhalation of budesonide 200 μg/day) by stratified randomization. The children were followed up at months 3, 6, 9, and 12 of treatment. The two groups were compared in terms of baseline data, changes in FeNO and pulmonary function parameters, amount of glucocorticoid used, number of asthma attacks, and asthma control. RESULTS: At the start of treatment, there were no significant differences in baseline data, FeNO, and pulmonary function between the two groups (P>0.05). Over the time of treatment, FeNO gradually decreased and pulmonary function parameters were gradually improved in both groups (P<0.001). Compared with the intermittent inhalation group, the daily inhalation group had a better effect in reducing FeNO and increasing the predicted percentage of forced expiratory volume in 1 second (FEV1%pred) (P<0.001). The inhalation method and treatment time had an interaction effect on FeNO and pulmonary function parameters (P<0.001). In the daily inhalation group, FeNO and lung function parameters were improved rapidly and stabilized after 3 months of treatment, while those in the intermittent inhalation group stabilized after 6 months. After 12 months of treatment, there were no significant differences in the increases in body height and body weight and the degree of disease control between the two groups (P>0.05). Compared with the daily inhalation group, the intermittent inhalation group had a significantly lower amount of budesonide inhaled (P<0.05) and a significantly higher number of asthma attacks (P<0.05). CONCLUSIONS Intermittent inhalation and daily inhalation of budesonide can achieve the same level of asthma control in children with mild persistent asthma and both have no influence on the increases in body height and body weight. Daily inhalation of budesonide can produce a better efficiency in reduing FeNO and increasing FEV1%pred. Although intermittent inhalation can reduce the amount of glucocorticoid used, it may lead to a higher risk of asthma attacks.
Administration, Inhalation ; Adolescent ; Asthma ; drug therapy ; Budesonide ; therapeutic use ; Child ; Forced Expiratory Volume ; Humans ; Nitric Oxide

OBJECTIVETo observe the effects of training on plasma content of NO, ET and NO/ET system in rats fed with high methionine diets.

METHODSMale Wistar rats were randomly divided into normal diet group (CR), high methionine diet group (MR) and high methionine diet plus 90 min swimming group (T+ MR). Rats in MR and T+ MR group were fed with the diet which contained 3%of methionine for eight weeks, but rats in control group were fed with ordinary diet. After breeding for eight weeks homocysteine (Hcy) level, T-NOS, NO and ET were measured.

RESULTSPlasma homocysteine of MR increased twofold as compared with that of CR,whereas plasma NO/ET of MR descended significantly (P < 0.05), suggesting that hyperhomocysteinemia was induced by the high methionine diet, and plasma NO/ET system was out of balance. Plasma homocysteine content of T+ MR obviously descended, plasma T-NOS, NO and NO/ET ascended obviously (P < 0.05) as compared with that of MR, and the above indicators of group T + MR were not different as compared with that of CR (P > 0.05).

CONCLUSIONProper training can descend plasma homocysteine level of rats fed with high methionine diet and better balance between NO and ET to prevent developing of hyperhomocysteinemia.

Animals ; Dietary Supplements ; Endothelins ; blood ; Hyperhomocysteinemia ; prevention & control ; Male ; Methionine ; administration & dosage ; Nitric Oxide ; blood ; Nitric Oxide Synthase ; blood ; Physical Conditioning, Animal ; physiology ; Rats ; Rats, Wistar ; Swimming ; physiology

Advanced age is one of the risk factors for vascular diseases that are mainly caused by impaired nitric oxide (NO) production. It has been demonstrated that endothelial arginase constrains the activity of endothelial nitric oxide synthase (eNOS) and limits NO generation. Hence, arginase inhibition is suggested to be vasoprotective in aging. In this study, we examined the effects of intravenous injection of Piceatannol, an arginase inhibitor, on aged mice. Our results show that Piceatannol administration reduced the blood pressure in aged mice by inhibiting arginase activity, which was associated with NO production and reactive oxygen species generation. In addition, Piceatannol administration recovered Ca²⁺/calmodulin-dependent protein kinase II phosphorylation, eNOS phosphorylation and eNOS dimer stability in the aged mice. The improved NO signaling was shown to be effective in attenuating the phenylephrine-dependent contractile response and in enhancing the acetylcholine-dependent vasorelaxation response in aortic rings from the aged mice. These data suggest Piceatannol as a potential treatment for vascular disease.
Administration, Intravenous* ; Aging ; Animals ; Arginase* ; Blood Pressure ; Injections, Intravenous ; Mice* ; Nitric Oxide ; Nitric Oxide Synthase Type III ; Phosphorylation ; Protein Kinases ; Reactive Oxygen Species ; Risk Factors ; Vascular Diseases ; Vasodilation

OBJECTIVEMeconium aspiration syndrome (MAS) is a disease of the term and near-term infant that is associated with considerable respiratory morbidity. The purpose of this study was to investigate effects of inhaled nitric oxide (iNO) in oxygenation and outcome of newborns with MAS.

METHODSEligible patients diagnosed as severe MAS admitted consecutively to the neonatal intensive care unit (NICU) of Hebei Children's Hospital from January 2004 to June 2006 were included in the study. The patients with an oxygenation index (OI) > or = 15 were randomized in a nonblinded manner to receive either iNO (NO group, n = 21) or no NO (control group, n = 25). Patients with an OI > or = 15 after enrollment were treated with iNO at 15 ppm initially. The response to iNO was assessed according to the increase in arterial PaO(2) and oxygen saturation (SpO(2)) after exposure to the starting concentration for 60 minutes. A response of 10 mm Hg (1 mm Hg = 0.133 kPa) increase in PaO(2) and a 10% increase in SpO(2) was assessed responsive to iNO. All patients were treated in the same neonatal unit and received the same standard therapy throughout the study period. Arterial blood gas tensions, pulmonary arterial pressure and systemic arterial blood pressures were recorded at baseline, 1 hour, and 24 hours in all patients. Methemoglobin levels were obtained at 12 - 24 hours after inhaled NO treatment. Parameters of fraction of inspired oxygen (FiO(2)), OI, mortality, ventilation time, and incidence of intraventricular hemorrhage (IVH, grade III-IV) were recorded. Informed consent was obtained from parents before enrollment. The protocol and the informed consent forms were approved by the ethic committee of the hospital before patient enrollment.

RESULTSThere was no significant difference in gestational age, birth weight, gender ratio, age at admission in hours, c-section delivery between the two groups, and no significant difference was found in respiratory mechanics parameters between the two groups at baseline. The duration of iNO was 34.90 +/- 16.41 hours. At the beginning of the treatment, no significant differences were detected in the OI and PAP between the two groups. One hour later, OI and PAP of NO group decreased significantly (OI, F = 35.27, P < 0.01, PAP, F = 24.30, P < 0.01), while in control group the difference was not found until 24 hours (OI, F = 20.16, P < 0.01, PAP, F = 101.22, P < 0.01). There were significant differences in PAP at 1, 24 hours between the two groups (1 h, t = 2.41, P < 0.05; 24 h, t = 3.11, P < 0.01). The methemoglobin levels were normal. Compared to the controls, hospital stay (t = 2.86, P < 0.05), duration of the need for oxygen supplement (t = 2.53, P < 0.05) and ventilation time were shorter (t = 2.41, P < 0.05), whereas mortality (chi(2) = 0.21, P > 0.05) and incidence of IVH (chi(2) = 0.00, P > 0.05) were not significantly different between the groups.

CONCLUSIONSiNO could effectively improve the oxygenation and shorten the ventilation time and hospital stay without augmentation of risk of IVH and pneumothorax in these neonatal patients.

Administration, Inhalation ; Female ; Humans ; Infant, Newborn ; Male ; Meconium Aspiration Syndrome ; therapy ; Nitric Oxide ; administration & dosage ; therapeutic use ; Treatment Outcome

Inhaled NO (iNO) has been shown to have beneficial effects on decreasing pulmonary inflammation, increasing function of surfactant and improving lung growth in prematurely born animal models. iNO has been gradually applied in the neonatal intensive care unit since its first use for persistent pulmonary hypertension (PPHN) in the early 1990's. Although many research findings have shown the benefits of iNO for hypoxic respiratory failure (HRF) of preterm infants, there is no certain evidence to support the routine use of iNO in premature infants. According to recent literature, the mechanism of iNO therapy, treatment scheme, iNO effectiveness and safety in premature infants were reviewed in this article, so as to provide bases for the clinical use of this treatment.
Administration, Inhalation ; Humans ; Hypoxia ; complications ; Infant, Newborn ; Infant, Premature ; Nitric Oxide ; administration & dosage ; adverse effects ; Respiratory Insufficiency ; drug therapy

Administration, Inhalation ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Methemoglobin ; analysis ; Nitric Oxide ; administration & dosage

Administration, Inhalation ; Female ; Humans ; Infant, Newborn ; Male ; Nitric Oxide ; administration & dosage ; Oxygen ; blood ; Respiratory Insufficiency ; drug therapy

Acute Disease ; Administration, Inhalation ; Animals ; Disease Models, Animal ; Hypertension, Pulmonary ; drug therapy ; Male ; Nitric Oxide ; administration & dosage ; therapeutic use ; Nitrites ; administration & dosage ; therapeutic use ; Rats ; Rats, Sprague-Dawley