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1.
Expert Syst Appl ; 211: 118545, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35996556

RESUMO

The outbreak of COVID-19 has exposed the privacy of positive patients to the public, which will lead to violations of users' rights and even threaten their lives. A privacy-preserving scheme involving virus-infected positive patients is proposed by us. The traditional ciphertext policy attribute-based encryption (CP-ABE) has the features of enhanced plaintext security and fine-grained access control. However, the encryption process requires the high computational performance of the device, which puts a high strain on resource-limited devices. After semi-honest users successfully decrypt the data, they will get the real private data, which will cause serious privacy leakage problems. Traditional cloud-based data management architectures are extremely vulnerable in the face of various cyberattacks. To address the above challenges, a verifiable ABE scheme based on blockchain and local differential privacy is proposed, using LDP to perturb the original data locally to a certain extent to resist collusion attacks, outsourcing encryption and decryption to corresponding service providers to reduce the pressure on mobile terminals, and deploying smart contracts in combination with blockchain for fair execution by all parties to solve the problem of returning wrong search results in a semi-honest cloud server. Detailed security proofs are performed through the defined security goals, which shows that the proposed scheme is indeed privacy-protective. The experimental results show that the scheme is optimized in terms of data accuracy, computational overhead, storage performance, and fairness. In terms of efficiency, it greatly reduces the local load, enhances personal privacy protection, and has high practicality as well as reliability. As far as we know, it is the first case of applying the combination of LDP technology and blockchain to a tracing system, which not only mitigates poisoning attacks on user data, but also improves the accuracy of the data, thus making it easier to identify infected contacts and making a useful contribution to health prevention and control efforts.

2.
Food Chem ; 400: 133957, 2023 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-36055138

RESUMO

Emulsion gels with the mixtures of low-molecular-weight emulsifier (LME) and polymer have attracted much attention in food; however, the LME-polymer interactions in emulsion system are complex and unclear. Here, the interactions between SSL and xanthan in emulsions and the mechanisms of stabilizing emulsions were investigated by using tensiometry, zeta potential, Fourier transform infrared spectroscopy (FTIR), confocal laser scanning microscopy (CLSM), cryo-scanning electron microscopy (cryo-SEM) and rheology. SSL was more efficiently adsorbed on the oil-water interface than xanthan. Interestingly, the honeycomb structure was formed in emulsion gels, which firmly immobilized oil droplets. Furthermore, electrostatic repulsion and hydrophobic interactions between xanthan and SSL facilitated the efficient bonding at interface and in bulk. Both linear and nonlinear rheology strongly supported the fact that the interactions between xanthan and SSL enhanced gel-like viscoelastic structure of emulsion gels. This structure endows excellent stability of emulsion gels under high temperature storage, sealed conditions and pH change.


Assuntos
Polímeros , Água , Emulsões/química , Géis/química , Polissacarídeos Bacterianos , Reologia , Sódio , Água/química
3.
Asian J Pharm Sci ; 17(5): 653-665, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36382301

RESUMO

Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are a series of polypeptides broadly applied in the long-term treatment of type Ⅱ diabetes. However, administration of GLP-RA is mainly through repetitive subcutaneous injection, which may seriously decrease the compliance and safety. Herein, a bio-inspired oral delivery system was designed to enhance the oral absorption of liraglutide (Lira), a kind of GLP-1 RA, by mimicking the natural cholesterol assimilation. 25-hydroxycholesterol (25HC), a cholesterol derivative, was modified on the surfaced of Lira-loaded PLGA nanoparticles (Lira 25HC NPs) and functioned as a "top-down" actuator to facilitate unidirectional transcytosis across the intestinal epithelium. After oral delivery, Lira 25HC NPs displayed improved therapeutic effect as compared with oral free Lira on type Ⅱ diabetes db/db mice, as evidenced by multiple relieved diabetic symptoms including the enhanced glucose tolerance, repressed weight growth, improved liver glucose metabolism, decreased fasting blood glucose, HbA1c, serum lipid, and increased ß cells activity. Surprisingly, the fasting blood glucose, liver glucose metabolism, and HbA1c of oral Lira-loaded 25HC NPs were comparable to subcutaneous injection of free Lira. Further mechanisms revealed that 25HC ligand could mediate the nanoparticles to mimic natural cholesterol absorption by exerting high affinity towards apical Niemann-Pick C1 Like 1 (NPC1L1) and then basolateral ATP binding cassette transporter A1 (ABCA1) overexpressed on the opposite side of intestinal epithelium. This cholesterol assimilation-mimicking strategy achieve the unidirectional transport across the intestinal epithelium, thus improving the oral absorption of liraglutide. In general, this study established a cholesterol simulated platform and provide promising insight for the oral delivery of GLP-1 RA.

4.
Mol Ecol ; 2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36326561

RESUMO

The seasonal migration of birds is a fascinating natural wonder. Avian migratory behaviour changes are common and are probably a polygenic process as avian migration is governed by multiple correlated components with a variable genetic basis. However, the genetic and phenotypic changes involving migration changes are poorly studied. Using one annotated near-chromosomal level de novo genome assembly, 50 resequenced genomes, hundreds of morphometric data and species distribution information, we investigated population structure and genomic and phenotypic differences associated with differences in migratory behaviour in a songbird species, Yellow-throated Bunting Emberiza elegans (Aves: Emberizidae). Population genomic analyses reveal extensive gene flow between the southern resident and the northern migratory populations of this species. The hand-wing index is significantly lower in the resident populations than in the migratory populations, indicating reduced flight efficiency of the resident populations. Here, we discuss the possibility that nonmigratory populations may have originated from migratory populations though migration loss. We further infer that the alterations of genes related to energy metabolism, nervous system and circadian rhythm may have played major roles in regulating migration change. Our study sheds light on phenotypic and polygenic changes involving migration change.

5.
J Integr Complement Med ; 28(11): 887-894, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36342811

RESUMO

Background: Asymptomatic patients are unneglected sources in propagating transmission chain due to their high viral loads. However, treatments available based on symptoms seem not applicable to asymptomatic patients. In this study, the authors want to estimate the effectiveness of Lianhua Qingwen (LH) capsule on asymptomatic coronavirus disease 2019 (COVID-19) patients. Methods: A randomized controlled trial (RCT) was performed to explore the effectiveness and safety of LH capsule in treating asymptomatic COVID-19 patients. Patients were randomized to control group (isolated observation) and treatment group (LH, 4 capsules, thrice daily) for 14 days. The primary endpoints were the rate and time of nucleic acid turning negative during the isolation observation. Results: A total of 120 participants were included in the full analysis set (60 each in the control and treatment groups). Data showed that the rate of nucleic acid turning negative during the isolation observation in the treatment group was higher than that in the control group (rate difference: 21.66%, 95% confidence interval [CI]: 4.34 to 37.27, p = 0.0142). Patients in the treatment group have a shorter time of nucleic acid turning negative (7.5 vs. 14.5 days, p = 0.018). Moreover, the rate of clinical symptoms appearance in the treatment group was lower compared with that in the control group (rate difference: -31.67, 95% CI: -46.83 to -13.82, p = 0.0005). The proportion of confirmed mild and common cases in the treatment group was also lower (35.00% vs. 66.67%, p = 0.0005). No serious adverse events were documented. Conclusions: In this study, the authors illustrated that LH capsule is beneficial to asymptomatic COVID-19 patients. Considering the lack of interventions for treating asymptomatic COVID-19 patients at this stage, LH capsule could be considered as a choice. Chinese Clinical Trial Registry: ChiCTR2100042066.


Assuntos
COVID-19 , Medicamentos de Ervas Chinesas , Ácidos Nucleicos , Humanos , COVID-19/tratamento farmacológico , Medicamentos de Ervas Chinesas/efeitos adversos
6.
Medicine (Baltimore) ; 101(44): e31498, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36343078

RESUMO

BACKGROUND: Through meta-analysis of the relationship between glomerular filtration rate and major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI), we studied the impact of glomerular filtration rate on the prognosis of PCI. METHODS: We collected literature on the incidence of MACE in patients with chronic kidney disease (CKD; estimated glomerular filtration rate < 60 mL/minute/1.73 m2) and patients with nonchronic kidney disease undergoing PCI. The search period was from January 1, 2000, to November 1, 2021. The searched databases included CNKI, Chinese Wanfang Data, China Biology Medicine disc, Web of Science, PubMed, and Cochrane Library. We used subgroup analysis and meta-regression to assess heterogeneity. RESULTS: Twenty-one eligible studies were included, with 46,255 samples included, 4903 cases of MACE (10.6%), and patients with CKD had a higher risk of MACE after PCI (Risk ratios = 1.67; 95% confidence interval: 1.51-1.85). Multivariate meta regression results show that heterogeneity is related to region. The risk of MACEs in patients with CKD is different in different regions, and North America has the lowest risk, with an risk ratios value of 1.21 (95% confidence interval: 1.08-1.35). CONCLUSION: Chronic kidney disease will increase the probability of MACE in patients with myocardial infarction after PCI and affect the prognosis of PCI. Therefore, clinical attention should be given to assessing glomerular filtration rate effects while treating patients with myocardial infarction with the PCI procedure.


Assuntos
Infarto do Miocárdio , Intervenção Coronária Percutânea , Insuficiência Renal Crônica , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/métodos , Taxa de Filtração Glomerular , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/etiologia , Infarto do Miocárdio/etiologia , América do Norte , Resultado do Tratamento , Fatores de Risco
7.
Mol Med ; 28(1): 130, 2022 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-36335331

RESUMO

Obesity is one of the major public health problems threatening the world, as well as a potential risk factor for chronic metabolic diseases. There is growing evidence that iron metabolism is altered in obese people, however, the highly refined regulation of iron metabolism in obesity and obesity-related complications is still being investigated. Iron accumulation can affect the body's sensitivity to insulin, Type 2 diabetes, liver disease and cardiovascular disease. This review summarized the changes and potential mechanisms of iron metabolism in several chronic diseases related to obesity, providing new clues for future research.


Assuntos
Diabetes Mellitus Tipo 2 , Hepatopatias , Humanos , Obesidade , Doença Crônica , Hepatopatias/metabolismo , Ferro/metabolismo
8.
Breast Cancer Res ; 24(1): 81, 2022 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-36414984

RESUMO

BACKGROUND: The biological phenotype of tumours evolves during neoadjuvant chemotherapy (NAC). Accurate prediction of pathological complete response (pCR) to NAC in the early-stage or posttreatment can optimize treatment strategies or improve the breast-conserving rate. This study aimed to develop and validate an autosegmentation-based serial ultrasonography assessment system (SUAS) that incorporated serial ultrasonographic features throughout the NAC of breast cancer to predict pCR. METHODS: A total of 801 patients with biopsy-proven breast cancer were retrospectively enrolled from three institutions and were split into a training cohort (242 patients), an internal validation cohort (197 patients), and two external test cohorts (212 and 150 patients). Three imaging signatures were constructed from the serial ultrasonographic features before (pretreatment signature), during the first-second cycle of (early-stage treatment signature), and after (posttreatment signature) NAC based on autosegmentation by U-net. The SUAS was constructed by subsequently integrating the pre, early-stage, and posttreatment signatures, and the incremental performance was analysed. RESULTS: The SUAS yielded a favourable performance in predicting pCR, with areas under the receiver operating characteristic curve (AUCs) of 0.927 [95% confidence interval (CI) 0.891-0.963] and 0.914 (95% CI 0.853-0.976), compared with those of the clinicopathological prediction model [0.734 (95% CI 0.665-0.804) and 0.610 (95% CI 0.504-0.716)], and radiologist interpretation [0.632 (95% CI 0.570-0.693) and 0.724 (95% CI 0.644-0.804)] in the external test cohorts. Furthermore, similar results were also observed in the early-stage treatment of NAC [AUC 0.874 (0.793-0.955)-0.897 (0.851-0.943) in the external test cohorts]. CONCLUSIONS: We demonstrate that autosegmentation-based SAUS integrating serial ultrasonographic features throughout NAC can predict pCR with favourable performance, which can facilitate individualized treatment strategies.


Assuntos
Aprendizado Profundo , Neoplasias , Terapia Neoadjuvante/métodos , Estudos Retrospectivos , Curva ROC , Ultrassonografia
9.
Hum Brain Mapp ; 2022 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-36420833

RESUMO

The study of human brain connectivity, including structural connectivity (SC) and functional connectivity (FC), provides insights into the neurophysiological mechanism of brain function and its relationship to human behavior and cognition. Both types of connectivity measurements provide crucial yet complementary information. However, integrating these two modalities into a single framework remains a challenge, because of the differences in their quantitative interdependencies as well as their anatomical representations due to distinctive imaging mechanisms. In this study, we introduced a new method, joint connectivity matrix independent component analysis (cmICA), which provides a data-driven parcellation and automated-linking of SC and FC information simultaneously using a joint analysis of functional magnetic resonance imaging (MRI) and diffusion-weighted MRI data. We showed that these two connectivity modalities produce common cortical segregation, though with various degrees of (dis)similarity. Moreover, we show conjoint FC networks and structural white matter tracts that directly link these cortical parcellations/sources, within one analysis. Overall, data-driven joint cmICA provides a new approach for integrating or fusing structural connectivity and FC systematically and conveniently, and provides an effective tool for connectivity-based multimodal data fusion in brain.

10.
Front Med (Lausanne) ; 9: 1026931, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36425112

RESUMO

The polymerase δ-interacting protein (POLDIP) family is a new family that can interact with DNA polymerase δ (delta). The members of the POLDIP family include POLDIP1, POLDIP2, and POLDIP3. Screened by the two-hybrid method, POLDIP1, POLDIP2, and POLDIP3 were initially discovered and named for their ability to bind to the p50 subunit of DNA polymerase δ. Recent studies have confirmed that POLDIPs are involved in the regulation of signal transduction pathways in neurodevelopment, neuropsychiatric diseases, cardiovascular diseases, tumors, and other diseases. However, each protein participates in different signaling pathways. In this review, we elucidate upon the family in terms of their genes and protein structures, their biological functions, in addition to the pathways that they are involved in during the development of diverse diseases. Finally, to provide new insights to the scientific community, we used the TCGA database to analyze and summarize the gene expressions of POLDIP family members in various tumors, as well as the correlations between their expressions and the overall survival times of tumor patients. Our data summary will give researchers working on cancer new concepts.

11.
Cancers (Basel) ; 14(22)2022 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-36428660

RESUMO

BACKGROUND AND PURPOSE: The aim of this study is to develop a prognostic nomogram, quantify survival benefit, and guide risk-dependent adjuvant therapy for locally advanced esophageal squamous cell carcinoma (LA-ESCC) after esophagectomy. MATERIALS AND METHODS: This was a single-center, retrospective study of consecutive LA-ESCCs treated by curative-intent esophagectomy with internal validation and independent external validation in a randomized controlled trial. After factor selection by the least absolute shrinkage and selection operator regression, a nomogram was developed to estimate 5-year overall survival (OS) based on the Cox proportional hazards model. The area under the curve (AUC) and calibration plot were used to determine its discriminative and predictive capacities, respectively. Survival improvement from adjuvant therapy was quantified and plotted corresponding to nomogram score. RESULTS: A total of 1077, 718, and 118 patients were included for model development, internal validation, and external validation, respectively. The nomogram identified eight significant prognostic factors: gender, pathological T and N stages, differentiation, surgical margin, lymphovascular invasion, number of lymph node resection, and adjuvant therapy. The nomogram showed superior discriminative capacity than TNM stage (AUC: 0.76 vs. 0.72, p < 0.01), with significant survival differences among different risk stratifications. The calibration plot illustrated a good agreement between nomogram-predicated and actual 5-year OS. Consistent results were concluded after external validation. At least 10% 5-year OS improvement from adjuvant chemoradiotherapy and chemotherapy was expected in almost all patients (nomogram score 110 to 260) and patients mainly with high-intermediate risk (nomogram score 159 to 207), respectively. CONCLUSIONS: The clinicopathological nomogram predicting 5-year OS for LA-ESCC after esophagectomy was developed with high accuracy. The proposed nomogram showed better performance than TNM stage and provided risk-dependent and individualized adjuvant treatment recommendations.

12.
Materials (Basel) ; 15(22)2022 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-36431473

RESUMO

Phosphogypsum is an industrial byproduct from the wet preparation of phosphoric acid. Phosphorus building gypsum can be obtained from phosphogypsum after high-thermal dehydration. This study aimed to analyze the influence of ball milling with different parameters on the strength of phosphorus building gypsum. In this paper, the absolute dry flexural strength and the absolute dry compressive strength of phosphorus building gypsum were compared under different mass ratios of material to ball, ball-milling speed, and ball-milling time, and the NSGM (1,4) model was applied to model and predict the strength of phosphorus building gypsum modified by ball milling. According to the research results, under the same mass ratio of material to ball and ball-milling speed, the absolute dry flexural strength and absolute dry compressive strength of phosphorus building gypsum firstly increased and then decreased with the increase in milling time. The NSGM (1,4) model established in this paper could effectively simulate and predict the absolute dry flexural strength and the absolute dry compressive strength of the ball-milling-modified phosphorus building gypsum; the average relative simulation errors were 12.38% and 13.77%, and the average relative prediction errors were 6.30% and 12.47%.

13.
Nat Commun ; 13(1): 7095, 2022 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-36402778

RESUMO

3D photonic crystals (PCs) have attracted extensive attention due to their unique optical properties. However, fabricating 3D PCs structure by 3D printing colloidal particles is limited by control of assembly under a fast-printing speed. Here, we employ continuous digital light processing (DLP) 3D printing strategy with hydrogen bonds assisted colloidal inks for fabricating well-assembled 3D PCs structures. Stable dispersion of colloidal particles inside UV-curable system induced by hydrogen bonding and suction force induced by continuous curing manner cooperatively realize the simultaneous macroscopic printing and microscopic particle assembly, which endows volumetric color property. Structural color can be well regulated by controlling the particle diameter and printing speed, through which various complex 3D structures with desired structural color distribution and optical light-guide properties are acquired. This 3D color construction approach shows great potential in customized jewelry accessories, decoration and optical device preparation, and will innovate the development of structural color.

14.
Biosens Bioelectron ; 220: 114918, 2022 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-36413913

RESUMO

A photoelectrochemical (PEC) immunosensor based on MIL-101(Cr) and CdTe-QDs composites (M&C) was successfully synthesized to assay the carcinoembryonic antigen (CEA) in human serum and urine samples. This novel method contained three key aspects: 1), the polarity of the photocurrent based on MIL-101(Cr) itself could be altered by applying a different voltage to detect the cathode and anode photocurrent. 2), the introduction of cadmium telluride quantum dots (CdTe-QDs) greatly improved the efficiency of light utilization. 3), the photogenerated electron-hole-pairs were suppressed and their separation efficiency was improved by effective matching of energy level between MIL-101(Cr) and CdTe-QDs. Due to the inherent insulating properties of the biological matrix, the transfer of photogenerated electrons was hindered, leading to a decreased photocurrent signal. Under the optimal condition, the anodic and cathodic detection limit of the PEC immunosensor for CEA was 0.00018 ng mL-1 and 0.00023 ng mL-1, respectively. The linear range was 0.0001-10 ng mL-1. The developed PEC immunosensor showed acceptable stability and sensitivity for the analysis of human serum and urine samples. For future perspective, using PEC and 3D-printing technology, a small PEC detector was designed with the potential to detect tumor markers.

15.
Front Bioeng Biotechnol ; 10: 976706, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36213074

RESUMO

Intervertebral disc (IVD) degeneration (IDD) is a common musculoskeletal disease and its treatment remains a clinical challenge. It is characterised by reduced cell numbers and degeneration of the extracellular matrix (ECM). Nucleus pulposus (NP) cells play a crucial role in this process. The purpose of this study is to explore the role of bevacizumab, a vascular endothelial growth factor (VEGF) inhibitor, in the treatment of IDD through local drug delivery. High expression of VEGF was observed in degenerating human and rat IVDs. We demonstrated that MMP3 expression was decreased and COL II synthesis was promoted, when VEGF expression was inhibited by bevacizumab, thereby improving the degree of disc degeneration. Thus, these findings provide strong evidence that inhibition of VEGF expression by local delivery of bevacizumab is safe and effective in ameliorating disc degeneration in rats. The injectable thermosensitive PLGA-PEG-PLGA hydrogels loaded with bevacizumab is a potential therapeutic option for disc degeneration.

16.
Angew Chem Int Ed Engl ; : e202214580, 2022 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-36283956

RESUMO

The sluggish H2 O oxidation kinetics on photoanodes severely obstructs the overall solar-to-energy efficiency of photoelectrochemical (PEC) cells. Herein, we find a 10 to 55-fold increase of photocurrent by conducting ammonia oxidation reaction (AOR) on hematite (α-Fe2 O3 ) photoanodes under near-neutral pH (9-11) and moderate applied potentials (1.0-1.4 VRHE ) compared to H2 O oxidation. By rate law analysis and operando spectroscopic studies, we confirm the non-radical nucleophilic attack of NH3 molecules on high-valent surface Fe-O species (e.g., FeIV =O) and Fe-N species that produces NOx - and N2 , respectively, which overwhelms the nucleophilic attack of H2 O on surface FeIV =O and contributes to a high Faradaic efficiency of above 80 % for AOR. This work reveals a novel non-radical nucleophilic attack strategy, which is significantly different from the conventional indirect radical-mediated AOR mechanism, for the rational design of high-performance AOR photoelectrocatalysts.

18.
ACS Nano ; 2022 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-36278500

RESUMO

For gas sensors, the ultrasensitive and highly selective detection of multiple components is of great significance in a wide range of applications extending from environment to healthcare, which is still a long-term challenge due to the single sensing mechanism of most sensors. Here, we combine the advantages of microfluidic chips and surface-enhanced Raman spectroscopy (SERS) spectra to fabricate a smart single-chip for simultaneously detecting an arbitrary combination of VOCs that incorporates different detection units, working on either a physisorption or chemisorption mechanism. Full integration of microfluidic and multiplex nanostructure components on one chip permits programmable design for sensing multifarious volatile compounds, and enables on-chip signal amplifications with increased reproducibility. As a proof-of-principle experiment, we demonstrate the simultaneous identification of 9 different gases that belong to aromatic compounds, aldehydes, ketones, or sulfides in one mixture, with high sensitivity (ppb level), high selectivity, and high robustness (error ∼8%). We further evaluated the application of our universal gas sensor in two scenarios including indoor air pollution monitoring and exhaled breath-based disease diagnosis. We expect that our design will improve the various practical applications of gas sensors.

20.
Front Pediatr ; 10: 946579, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36299699

RESUMO

Objective: Flexible bronchoscopy is widely used in infants and it plays a crucial role. The aim of this study was to investigate the value and clinical safety of flexible bronchoscopy in a neonatal intensive care unit. Methods: A retrospective analysis was performed on the clinical data of 116 neonates who underwent flexible bronchoscopy and the outcomes of 147 procedures. A correlation analysis was performed on the relationship between flexible bronchoscopy findings, microscopic indications, and clinical disease. Results: The 147 procedures performed were due to the following reasons: problems related to artificial airways, 58 cases (39.45%); upper respiratory problems, 60 cases (40.81%) (recurrent dyspnea, 23 cases; upper airway obstruction, 17 cases; recurrent stridor, 14 cases; and hoarseness, six cases), lower respiratory problems, 51 cases (34.69%) (persistent pneumonia, 21 cases; suspicious airway anatomical disease, 21 cases; recurrent atelectasis, eight cases; and pneumorrhagia, one case), feeding difficulty three cases (2.04%). The 147 endoscopic examinations were performed for the following reasons: pathological changes, 141 cases (95.92%); laryngomalacia, 78 cases (53.06%); mucosal inflammation/secretions, 64 cases (43.54%); vocal cord paralysis, 29 cases (19.72%); trachea/bronchus stenosis, 17 cases (11.56%) [five cases of congenital annular constriction of the trachea, seven cases of left main tracheal stenosis, one case of the right middle bronchial stenosis, two cases of tracheal compression, and two cases of congenital tracheal stenosis]; subglottic lesions, 15 cases (10.20%) [eight cases of subglottic granulation tissue, six cases of subglottic stenosis, one cases of subglottic hemangioma]; tracheomalacia, 14 cases (9.52%); laryngeal edema, five cases (3.40%); tracheoesophageal fistula, four cases (2.72%); rhinostenosis, three cases (2.04%); tracheal bronchus, three cases (2.04%); glossoptosis, two cases (1.36%); laryngeal cyst, two cases (1.36%); laryngeal cleft, two cases (1.36%); tongue base cysts, one case (0.68%); and pneumorrhagia, one case (0.68%). Complications were rare and mild. Conclusion: Flexible bronchoscopy is safe and effective for diagnosing and differentiating neonatal respiratory disorders in neonatal intensive care units.

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