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Importance:Nasal nitric oxide (nNO) testing is a method used in the diagnosis of primary ciliary dyskinesia (PCD).It has not been evaluated in Chinese population.Objective:To establish a reference nNO value to assist in the diagnosis of PCD in Chinese children.Methods:nNO values were measured in children with PCD (n =36),cystic fibrosis (CF) (n =20),asthma (n =45),post-infectious bronchiolitis obliterans (BO) (n =41) and non-PCD/non-CF bronchiectasis (n =32).The receiver operating characteristic nNO value for the diagnosis of PCD was plotted and the area under the curve was calculated.Results:nNO values were significantly lower in children with PCD (median 25.66 nL/min) than in children with asthma (186.26 ± 58.95 nL/min),BO (143.47 ± 49.71 nL/min) and non-PCD/non-CF bronchiectasis (173.13 ± 63.80 nL/min),but not in children with CF (90.90 ± 43.20 nL/min).Notably however,no CF patient had an nNO value ＜ 45 nL/min.A cut-offof 76 nL/min yielded the best sensitivity of 86.1％,and specificity of 91.4％,with an area under the curve of 0.920 (95％ confidence interval 0.859-0.981)for the diagnosis of PCD.If CF was ruled out the specificity increased to nearly 100％.Interpretation:nNO testing is able to discriminate between patients with PCD and those with CF,asthma,post-infectious BO and non-PCD/non-CF bronchiectasis.A cut-off of 76 nL/min could be further examined in patients suspected of PCD,to establish an nNO reference value for PCD screening in Chinese children.