Objective:To compare the operation time,peroperative and long-term postoperative complications of percutaneous tracheotomy with or without the guidance by fiberoptic broncho-scopy in intensive care unit(ICU).Methods:The clinical data of 73 patients who were performed percutaneous tracheotomy in ICU of Changshu First People's Hospital from Nov 2010 to Jan 2014 were retrospectively analyzed.Forty-three patients who accepted percutaneous tracheotomy guided by fiberoptic bronchos-copy were assigned to Group A,while the other 30 patients were assigned to Group B.The status of intraoperative and short-term and long-term postoperative complications were compared between the two groups.Results:The operation time had no significant difference between the two groups(P >0.05).Four cases(9.3%)in Group A got perioperative complications,inclu-ding 1 case of postoperative bleeding >48 h,1 case of wound infection and 2 cases of subcutaneous emphysema.Fifteen cases (50%)in Group B got perioperative complications,including 1 case of wound infection,1 case of pneumothorax,3 cases of postoperative bleeding >48 h,5 cases of subcutaneous emphysema,and 5 cases of tracheal damage on posterior wall or side wall.The differences in rate of complications between the two groups were statistically significant(P <0.05).Among the 73 patients,33 cases had be followed up,2 cases from the 18 cases who had be followed up in Group A had complications,inclu-ding 1 case of hoarseness,1 case of foreign body sensation in the throat.Two cases from the 15 cases who had be followed up in Group B had complications,including 1 case of hoarseness,1 case of dysphagia.The long-term complications rates had no significant difference between the two groups(P > 0.05).Conclusions:The percutaneous tracheotomy guided by fiberoptic bronchoscopy does not increase operation time,but can reduce the incidence of perioperative complications.

AIM:To explore the effects of moderate-altitude exposure on intestinal flora in healthy individuals.METHODS:The aid-Tibet cadres,who were sent to work from Guangdong(average altitude<50 m)to Nyingchi(average altitude of 2 900 m),were recruited.A total of 76 samples were collected,including 42 samples from healthy adults with plateau living for 0 day and 34 samples from healthy adults with plateau living for 6 months.Fecal samples DNA were ex-tracted,sequenced by the 16S rDNA high-throughput sequencing technology and analyzed bioinformatically.RESULTS:Compared with the base group,α diversity was increased(P=4.00×10-4)and β diversity was decreased(P=1.00×10-3).After moderate altitude exposure,the relative abundance of phylum Proteobacteria(|LDA|>4,P<0.05),genus Escherich-ia-Shigella,species Enterococcus_faecalis,Haemophilus_influenzae and Helicobacter_sp._UNSW1.7sp decreased(adjust-ed P<0.05),wheras the relative abundance of phylum Bacteroidetes(|LDA|>4,P<0.05),genus Butyricimona,species Lactobacillus_sp._RA2113(s)and Butyricimonas_sp._Marseille-P2440(s)increased(adjusted P<0.05).The function-al prediction by PICRUSt showed a decrease in the relative abundance of pathway related to xenobiotics biodegradation and metabolism,membrane transport and amino acid metabolism(adjusted P<0.05).Conversely,the relative abundance of pathway related to biosynthesis of other secondary metabolites and nucleotide metabolism was increased(adjusted P<0.05).Finally,the results of microbiome phenotype prediction by BugBase showed that moderate altitude exposure im-proves the gut microbiota functions involving anaerobic oxygen tolerance and gram positive(adjusted P<0.05).And bacte-ria containing facultatively anaerobic oxygen tolerance,oxidative stress tolerance,gram negative and biofilm formation in the six-group decreased significantly compared with those in base group(adjusted P<0.05).CONCLUSION:Moderate altitude exposure impacts the diversity,abundance and function of intestinal flora in healthy population,suggesting that al-titude factors may have some influence on gut microbiota.