Effect of dissolved-oxygen on the flotation behavior of pyrite at high altitude area

With the continuous development of mineral resources to high altitude areas,the study of sulfide ore flotation in unconventional systems has been emphasized.There is a consensus that moderate oxidation of sulfide ore is beneficial to flotation,but the specific suitable dissolved oxygen value is inconclusive,and there are few studies on sulfide ore flotation under low dissolved oxygen environment at high altitude.In this paper,we designed and assembled an atmosphere simulation flotation equipment to simulate the flotation of pyrite at high altitude by controlling the partial pressure of N_(2)/O_(2) and dissolved oxygen under atmospheric conditions.X-ray photoelectron spec-troscopy(XPS),atomic force microscope(AFM),Fourier transform infrared spectrometer(FT-IR),UV-vis spectrophotometer,zeta po-tential,and contact angle measurements were used to reveal the effects of surface oxidation and agent adsorption on pyrite at high altitude(4600 m dissolved oxygen(DO)=4.0 mg/L).The results of pure mineral flotation indicated that the high altitude and low dissolved oxy-gen environment is favorable for pyrite flotation.Contact angle measurements and XPS analysis showed that the high altitude atmosphere nslows down the oxidation of pyrite surface,facilitates S_(n)^(2-)/S^(0) production and enhances surface hydrophobicity.Electrochemical calcula-tions and zeta potential analysis showed that the influence of atmosphere on the form of pyrite adsorption is small,and the different atmo-spheric conditions are consistent with dixanthogen electrochemical adsorption,with lower Zeta potential under high altitude atmosphere and significant potential shift after sodium isobutyl xanthate(SIBX)adsorption.The results of FT-IR,UV-vis,and AFM analysis showed that SIBX adsorbed more on the surface of pyrite under high altitude atmosphere and adsorbed on the surface in a mesh structure com-posed of column/block.The results of the experimental study revealed the reasons for the easy flotation of sulfide ores at high altitude with less collector dosage,and confirmed that the combined DO-pH regulation is beneficial to achieve more efficient flotation of pyrite.

Modification of streamer-to-leader transition model based on radial thermal expansion in the sphere-plane gap discharge at high altitude

Historically,streamer-to-leader transition studies mainly focused on the rod-plane gap and low altitude analysis,with limited attention paid to the sphere-plane gap at high altitude analysis.In this work,sphere-plane gap discharge tests were carried out under the gap distance of 5 m at the Qinghai Ultra High Voltage(UHV)test base at an altitude of 2200 m.The experiments measured the physical parameters such as the discharge current,electric field intensity and instantaneous optical power.The duration of the dark period and the critical charge of streamer-toleader transition were obtained at high altitude.Based on radial thermal expansion of the streamer stem,we established a modified streamer-to-leader transition model of the sphere-plane gap discharge at high altitude,and calculated the stem temperature,stem radii and the duration of streamer-to-leader transition.Compared with the measured duration of sphere-plane electrode discharge at an altitude of 2200 m,the error rate of the modified model was 0.94%,while the classical model was 6.97%,demonstrating the effectiveness of the modified model.From the comparisons and analysis,several suggestions are proposed to improve the numerical model for further quantitative investigations of the leader inception.

The cardiovascular system at high altitude:A bibliometric and visualization analysis

BACKGROUND When exposed to high-altitude environments,the cardiovascular system undergoes various changes,the performance and mechanisms of which remain controversial.AIM To summarize the latest research advancements and hot research points in the cardiovascular system at high altitude by conducting a bibliometric and visualization analysis.METHODS The literature was systematically retrieved and filtered using the Web of Science Core Collection of Science Citation Index Expanded.A visualization analysis of the identified publications was conducted employing CiteSpace and VOSviewer.RESULTS A total of 1674 publications were included in the study,with an observed annual increase in the number of publications spanning from 1990 to 2022.The United States of America emerged as the predominant contributor,while Universidad Peruana Cayetano Heredia stood out as the institution with the highest publication output.Notably,Jean-Paul Richalet demonstrated the highest productivity among researchers focusing on the cardiovascular system at high altitude.Furthermore,Peter Bärtsch emerged as the author with the highest number of cited articles.Keyword analysis identified hypoxia,exercise,acclimatization,acute and chronic mountain sickness,pulmonary hypertension,metabolism,and echocardiography as the primary research hot research points and emerging directions in the study of the cardiovascular system at high altitude.CONCLUSION Over the past 32 years,research on the cardiovascular system in high-altitude regions has been steadily increasing.Future research in this field may focus on areas such as hypoxia adaptation,metabolism,and cardiopulmonary exercise.Strengthening interdisciplinary and multi-team collaborations will facilitate further exploration of the pathophysiological mechanisms underlying cardiovascular changes in high-altitude environments and provide a theoretical basis for standardized disease diagnosis and treatment.

Proteomic Analysis of the Small Intestine Reveals Adaptive Strategies for Energy Restriction of Phrynocephalus vlangalii at High Altitude

The environmental characteristics of hypothermia and hypoxia exert great selective pressure on the energy metabolism of high-altitude animals,especially the ectotherms.Current research on energy-limited adaptation of high-altitude ectotherms has focused on energy expenditures.However,the mechanisms of increasing energy intake in high-altitude ectotherms have been studied rarely.In order to investigate the adaptation mechanism of the small intestine,the key part of energy acquisition for animals,to energy limitation at high altitude in ectotherms,the gut proteins of Phrynocephalus vlangalii from high-and low-altitude populations were compared using label free proteomics.GO enrichment and KEGG pathway analysis showed that proteins associated with energy intake,such as those involved in oxidation-reduction processes,glutathione metabolism,oxidoreductase activity,cofactor binding,catalytic activity and metabolic pathways,were significantly up-regulated in high-altitude populations;while proteins associated with energy expenditure,such as immune responses and processes,membrane attack complexes,natural killer pathway and other immune-related processes,were significantly down-regulated in expression.

High Altitude Adaptation and Phylogenetic Analysis of Tibetan Horse Based on the Mitochondrial Genome

To investigate genetic mechanisms of high altitude adaptations of animals living in the Tibetan Plateau, three mitochondrial genomes （mt-genome） of Tibetan horses living in Naqu （4,500 m） of Tibetan, Zhongdian （3,300 m） and Deqin （3,100 m） of Yunnan province were sequenced. The structures and lengths of these three mt-genomes are similar to the Cheju horse, which is related to Tibetan horses, but little shorter than the Swedish horse. The pair-wise identity of these three horses on nucleotide level is more than 99.3%. When the gene encoding the mitochondrial protein of Tibetan horses was analyzed, we found that NADH6 has higher non-synonymous mutation rate in all of three Tibetan horses. This implies that NADH6 may play a role in Tibetan horses＇ high altitude adaptation. NADH6 is one of the subunits of the complex I in the respiratory chain. Furthermore, 7 D-loop sequences of Tibetan horse from different areas were sequenced, and the phylogeny tree was constructed to study the origin and evolutionary history of Tibetan horses. The result showed that the genetic diverse was high among Tibetan horses. All of Tibetan horses from Naqu were clustered into one clade, and Tibetan horses from Zhongdian and Deqin were clustered into others clades. The first molecular evidence of Tibetan horses indicated in this study is that Tibetan horse population might have multiple origins.

Satellite and high altitude platform-based inter-vehicle communications in vast and desolate areas

In order to solve the problem of inter-vehicle communication （IVC） in vast and desolate areas such as the desert and the Gobi, two vehicle network models are proposed. One is based on satellite communication and the other is based on high altitude platform （ HAP ） communication. The system outline and networking modes of the two models are described. In the satellite communication based model, all the vehicles are equipped with vehicle-bone satellite communication on the move terminals and the communication signals between vehicles are forwarded by satellite. In the high altitude platform-based model, the HAPs are equipped with base station facilities to form aerial base stations, and vehicles can communicate with each other via common terrestrial mobile communication devices. Some key parameters such as path loss, link loss and system capacity are also computed. The analysis shows that both the two models can satisfy the requirement of IVC in the descriptive environment.

High altitude medicine in China in the 21st century Opportunities and challenges

China has the largest plateau, Qinghai-Tibet Plateau, where inhabited the most high altitude populations. Moreover, millions of people from plain areas come to the plateau for travel and work purposes and the number of the newcomers has been increasing every year. The hypoxic environment of plateau raised a series of related health issues in the new immigrants, so have created a special medical discipline- High Altitude Medicine. Over the past decades, researches on high altitude medicine have never being ceased in China, and lots of research findings have been reported. Application and practice of these achievements have greatly decreased the mobility and mortality of highaltitude diseases, however, there remained lots of questions to be elucidated. In view of this, the authors were granted a special project from the National Health and Family Planning Commission of China, and conducted a multi-center, prospective, on-scene high altitude medicine study for the acute mountain sickness. Some innovative findings were achieved, and the parameters for diagnosis and application conditions were proposed. Furthermore, the different diagnoses and treatment effects were compared, and a more standardized, reasonable scheme was drawn up. Regarding the unbalanced medical resources in the vast high altitude area, an application system for the public and the army has been established. In the 21 st century, innovations in China and novel research approaches have provided great opportunities for the development of high altitude medicine. It is believed that the researchers in China are able to catch the opportunities and address the challenges.

Serum testosterone levels and excessive erythrocytosis during the process of adaptation to high altitudes

Populations living at high altitudes （HAs）, particularly in the Peruvian Andes, are characterized by a mixture of subjects with erythrocytosis （16 g dl-1〈haemoglobin （Hb）≤21 gdl-1） and others with excessive erythrocytosis （EE） （Hb〉21 g dl-1）. Elevated haemoglobin values （EE） are associated with chronic mountain sickness, a condition reflecting the lack of adaptation to HA. According to current data, native men from regions of HA are not adequately adapted to live at such altitudes if they have elevated serum testosterone levels. This seems to be due to an increased conversion of dehydroepiandrosterone sulphate （DH EAS） to testosterone. Men with erythrocytosis at HAs show higher serum androstenedione levels and a lower testosterone/androstenedione ratio than men with EE, suggesting reduced 17beta-hydroxysteroid dehydrogenase （17beta-HSD） activity. Lower 17beta-HSD activity via A4-steroid production in men with erythrocytosis at HA may protect against elevated serum testosterone levels, thus preventing EE. The higher conversion of DHEAS to testosterone in subjects with EE indicates increased 17beta-HSD activity via the A5-pathway. Currently, there are various situations in which people live （human biodiversity） with low or high haemoglobin levels at HA. Antiquity could be an important adaptation component for life at HA, and testosterone seems to participate in this process.

Endothelial Nitric Oxide Synthase Gene Polymorphisms Associated with Susceptibility to High Altitude Pulmonary Edema in Chinese Railway Construction Workers at Qinghai-Tibet over 4500 Meters above Sea Level

Objective To examine whether the polymorphisms of endothelial nitric oxide synthase (eNOS) gene are associated with the susceptibility to high altitude pulmonary edema (HAPE) in Chinese railway construction workers at Qinghai-Tibet where the altitude is over 4 500 m above sea level. Methods A case-control study was conducted including 149 HAPE patients in the construction workers and 160 healthy controls randomly recruited from their co-workers, matching the patients in ethnicity, age, sex, lifestyle, and working conditions. Three polymorphisms of eNOS gene, T-786C in promoter, 894G/T in exon 7, and 27bp variable number tandem repeat (VNTR) in intron 4, were genotyped using polymerase chain reaction (PCR) and confirmed with DNA sequencing. Results The frequencies of 894T allele and heterozygous G/T of the 894G/T variant were significantly higher in HAPE patients group than in the control group (P=0.0028 and P=0.0047, respectively). However, the frequencies of the T-786C in promoter and the 27bp VNTR in intron 4 were not significantly different between the two groups. Haplotypic analysis revealed that the frequencies of two haplotypes (H3,T-T-b, b indicates 5 repeats of 27 bp VNTR; H6, C-G-a, a indicates 4 repeats of 27 bp VNTR) were significantly higher in HAPE patients (both P<0.0001). On the contrary, the frequencies of H1 (T-G-b) and H2 (T-G-a) were lower in HAPE patients than in healthy controls (both P<0.001). Conclusions Two haplotypes (T-T-b and C-G-a) may be strongly associated with susceptibility to HAPE. Compared with the individual alleles of eNOS gene, the interaction of multiple genetic markers within a haplotype may be a major determinant for the susceptibility to HAPE.

Aerobic bacterial flora of the normal conjunctiva at high altitude area of Shimla Hills in India:a hospital based study

AIM:To study the normal aerobic conjunctival flora in lower to mid Himalayan region of Shimla Hills.METHODS:Samples from normal conjunctiva of 200 individuals above the age of 13 years who visited Indira Gandhi Medical College Hospital Shimla for refraction or cataract surgery were taken by anaesthetising the conjunctival sac with sterile 4% Xylocaine solution.Samples were obtained by gently rubbing lower fornix with a sterile cotton wool swab moistened with normal saline and keeping the eye lids wide apart to avoid contamination from lid margins.It was immediately inoculated in Brain Heart infusion and subjected to standard aerobic culture and identification techniques.RESULTS:Totally,72 eyes(36%) conjunctival sacs were sterile.Predominant aerobes isolated were Staphylococcus spp.in 120(60%) followed by Haemophilus in 16(8%),diphtheroids in 10(5%),and Escherichia coli(E.coli) in 4(2%).A single aerobe was isolated from 98 eyes(49%) while 30 eyes(15%) yielded more than 1 aerobe.Staphylococcus epidermidis(S.epidermidis) was the most common bacterium,found alone in 58 eyes(29%) and in combination with another aerobe in 30 eyes(15%),followed by Staphylococcus aureus(S.aureus) in 18(9%) and 10 eyes(5%) respectively.CONCLUSION:S.epidermidis is the most common commensal organism followed by Haemophilus species.diphtheroids occupied the third position which otherwise are found more abundantly in literature.Pathogens like S.aureus,Staphylococcus citreus and E.coli were also found.Therefore,preoperative administration of topical broad spectrum antibiotics is extremely important in prophylaxis against ocular infection.The variation in microflora of normal conjunctiva in this part of world can be attributed to geographical,climatic and ethnic characteristics of the population under study.

COOPERATIVE DIRECTIONAL INTER-CELL HANDOVER SCHEME IN HIGH ALTITUDE PLATFORM COMMUNICATIONS SYSTEMS

A novel Cooperative Directional inter-cell Handover Scheme(CDHS) for High Altitude Platform(HAP) communications systems is proposed,in which the handover target cell and the two cells adjacent to this handover target cell work cooperatively to exploit the traffic fluctuation to improve handover performance.Users in the overlap area of the overloaded handover target cell will be forced to handover directionally before their optimal handover boundary in order to free up resources for the handover calls which would otherwise be dropped due to the shortage of resources and queue time out.Simulation results show that the handover call dropping probability is greatly reduced(at least 60%) compared with the general queue handover scheme,with little performance reduction to the call blocking probability,and the Not in the Best Cell(NBC) average time is only increased moderately.Moreover,an optimal cell radius can be achieved for a specific platform speed by minimizing the unified system performance,which is the linear combination of the handover call dropping probability and the NBC average time.

Genes for the high life： New genetic variants point to positive selection for high altitude hypoxia in Tibetans

People living on the high plateaus of the world have long fascinated biological anthropologists and geneticists because they live in ＂thin air＂ and epitomize an extreme of human biological adaptation.

Expression of HIF-1α and Its Target Genes in the Nanorana parkeri Heart：Implications for High Altitude Adaptation

Hypoxia-inducible factor 1 alpha（HIF-1α） and its target genes vascular endothelial growth factor（VEGF） and transferrins（TF） play an important role in native endothermic animals＇ adaptation to the high altitude environments. For ectothermic animals – especially frogs – it remains undetermined whether HIF-1α and its target genes（VEGF and TF） play an important role in high altitude adaptation, too. In this study, we compared the gene sequences and expression of HIF-1α and its target genes（VEGF and TF） between three Nanorana parkeri populations from different altitudes（3008 m a.s.l., 3440 m a.s.l. and 4312 m a.s.l.）. We observed that the c DNA sequences of HIF-1A exhibited high sequence similarity（99.38%） among the three altitudinally separated populations; but with increasing altitude, the expression of HIF-1A and its target genes（VEGF and TF） increased significantly. These results indicate that HIF-1α plays an important role in N. parkeri adaptation to the high altitude, similar to its role in endothermic animals.

Studies on monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome secondary to high altitude pulmonary edema

To study monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome (ARDS) secondary to high altitude pulmonary edema (HAPE),we performed clinic and laboratory studies in 8 patients who preliminarily developed high altitude cerebral edema (HACE) and then ARDS occurred at an altitude of 4 500 m. After an initial emergency treatment on high mountains,all the patients were rapidly transported to a hospital at a lower altitude of 2 808 m. The right cardiac catheterizations were carried out within 5 h after hospitalized. The monitoring hemodynamics and oxygen dynamics were studied via a thermodilution Swan-Gaze catheter. The results showed that before treatments at the beginning of monitoring,there presented a significant pulmonary artery hypertension with a decreased cardiac function,and a lower oxygen metabolism in all the 8 patients. However,after some effective treatments,including mechanical ventilation and using dexamethasone,furosemide,etc,four days later the result of a repeated monitoring showed that their pulmonary artery pressure had been decreased with an improved cardiac function with all the oxygen metabolic indexes increased significantly. Our studies suggested that performing monitoring hemodynamics in patients with ARDS secondary to HAPE will define the clinical therapeutic measures which will benefit the outcome.

Ataxia,acute mountain sickness,and high altitude cerebral edema

Previous investigations suggest that ataxia is common and often one of the most reliable warning signs of high altitude cerebral edema(HACE). The aim of this study was to investigate the diagnostic role of ataxia in acute mountain sickness(AMS)and HACE among mountain rescuers on the quake areas,and in approaching the relation between AMS and HACE. After the earthquake on April 14,2010,approximately 24 080 lowland rescuers were rapidly transported from sea level or lowlands to the mountainous rescue sites at 3 750 ~ 4 568 m,and extremely hardly worked for an emergency treatment after arrival. Assessments of acute altitude illness on the quake areas were using the Lake Louise Scoring System. 73 % of the rescuers were found to be developed AMS. The incidence of high altitude pulmonary edema(HAPE)and HACE was 0.73 % and 0.26 %,respectively,on the second to third day at altitude. Ataxia sign was measured by simple tests of coordination including a modified Romberg test. The clinical features of 62 patients with HACE were analyzed. It was found that the most frequent,serious neurological symptoms and signs were altered mental status(50/62,80.6 %)and truncal ataxia(47/62,75.8 %). Mental status change was rated slightly higher than ataxia,but ataxia occurred earlier than mental status change and other symptoms. The earliest sign of ataxia was a vague unsteadiness of gait,which may be present alone in association with or without AMS. Advanced ataxia was correlated with the AMS scores,but mild ataxia did not correlate with AMS scores at altitudes of 3 750~4 568 m. Of them,14 patients were further examined by computerized tomographic scanning of the brain and cerebral magnetic resonance imagines were examined in another 15 cases. These imaging studies indicated that the presence of the cerebral edema was in 97 % of cases who were clinically diagnosed as HACE(28/29). Ataxia seems to be a reliable sign of advanced AMS or HACE,so does altered mental status.

Effective administration of cranial drilling therapy in the treatment of fourth degree temporal,facial and upper limb burns at high altitude:A case report

BACKGROUND Fourth degree burns damage the full thickness of the skin and affect underlying tissues.Skin grafting after debridement is often used to cover the wounds of salvageable severe burns.A granulation wound can be formed by drilling the skull to the barrier layer to solve the problem of skull exposure.Low oxygen levels present at high altitudes aggravate ischemia and hypoxia which can negatively impact wound healing.The impaired healing in such cases can be ameliorated by hyperbaric oxygen therapy.CASE SUMMARY We describe a patient who presented with fourth degree burns to the left temporal and facial regions upon admission in December 2018.The periosteum of the skull and the deep fascia of the face were exposed.After the first stage of debridement and skin grafting,the temporal skin did not survive well.Granulation was induced by cranial drilling,and then a local flap was transferred to cover the wound.The left temporal and facial wounds were completely covered and the patient recovered well.CONCLUSION Skin grafting and flap transfer after early debridement to cover the wound and control infection were of great significance.In the later stages of the patient's treatment,survival of the skin graft and skin flap was observed.The second stage repair was performed to achieve successful skin grafting by cranial granulation.Granulation was formed by drilling the skull,and then the wound was closed,which is suitable for cases with skull exposure and wounds with poor blood supply.We consider that hyperbaric oxygen treatment and improving tissue oxygen supply were beneficial in this patient.

Prevalence of Congenital Heart Disease at Extremely High Altitudes in Tibet and the Establishment of a New Free Treatment Model

Background: This study aimed to illustrate the prevalence of CHD by screening children in extremely high-altitudeareas (over 4000 m to even 5000 m above sea level) and explore an aid model for early diagnosis and treatmentfor the Tibetan population. Methods: A total of 2242 students from different schools in Ngamring County,Xigaze City, Tibet from September 2019 to September 2020 were selected for screening. The students were examinedthrough the inquiry of their current medical history and family history, cardiac auscultation and a physicalexamination, in order to screen out the suspected cases of CHD, and then the suspected cases were confirmed bycardiac color ultrasound examinations. After that, positive patients were be transferred to Shandong Province forfree treatment. Results: The prevalence of CHD among children in Ngamring County was 3.70% (83 cases),which is the highest incidence rate ever reported. The most common type of CHD was patent ductus arteriosus(PDA), accounting for 55.42% of the total number of cases screened, followed by atrial septal defect (ASD) andventricular septal defect (VSD), accounting for 28.92% and 12.05%, respectively. The prevalence of CHD in childrenat high altitude was significantly higher than that in children at low altitude. The children with CHD weretransferred to Shandong Province for surgery, the operations were successful and their recoveries went well.Conclusions: The results show that high altitude is closely related to the prevalence of CHD, and the incidencein Ngamring County is much higher than that in previous reports.

Technologies of oxygen supply for life support during the development of mineral resources in high altitude areas

In order to fulfill the needs of life-support oxygen supply during the development of plateau mineral resources,four oxygen supply patterns suitable for the plateau mine in specific environment were developed:tunnel face diffusive oxygen supply,tunnel oxygen-bar car,carried oxygen cylinder and portable oxygen generator. Through the study of safety oxygen supply experiments in low- pressure plateau areas,the mathematical relationship between maximum integration of secure oxygen volume and altitude has been achieved. Oxygen supply safety control should follow this relationship in plateau mines during the time of executing tunnel face or in room air diffusive oxygen supply. The application results of life-support oxygen supplement technologies in the development of mineral resources in high altitude areas show that the oxygen supply for tunneling miners in plateau mines can not only effectively enhance the oxygen saturation,reduce the pulse rate and the breath rate per minute,but also improve various symptoms caused by altitude hypoxia and high-intensity physical labor.

Subclinical high altitude pulmonary edema: A clinical observation of 12 cases in Yushu

During the Yushu Earthquake on April 14,2010,a high incidence of acute high altitude illness was observed in the mountain rescuers,and 0.73 % of these patients suffered from high altitude pulmonary edema,of which 12 patients developed subclinical pulmonary edema and concomitantly contracted acute mountain sickness. Symptoms and signs were atypically high heart rate with high respiratory rate,striking cyanosis,and significantly low oxygen saturation,whereas no moist rates were heard on auscultation,and Chest X-ray showed peripheral with a patchy distribution of mottled infiltrations in one or both lung fields. We believe that subclinical high altitude pulmonary edema is an earliest stage of pulmonary edema at high altitude. The possible pathogenesis and the diagnosis were discussed.

Prevalence and Spectrum of Complex Congenital Heart Disease in the Neonatal Intensive Care Unit at High Altitude in China

Background:Previous studies from high altitudes have reported significantly higher prevalence of congenital heart disease(CHD),consisting almost solely of simple CHD.Little is known about the occurrence of complex CHD.Neonates with complex CHD are likely admitted to NICU.We examined the prevalence and spectrum of complex CHD in NICU in order to depict a truer picture of CHD at high altitude.Methods:We reviewed charts of 4,214 neonates admitted to NICU in Qinghai province(average altitude 3,000 m).Echocardiography was performed in 1,943 babies when CHD was suspected based on clinical examinations.Results:CHD was diagnosed in 1,093(56.3%of echoed babies).Mild CHD in 96.8%(1058 babies).Moderate CHD in 0.8%(9)included 1(0.1%)large secundum atrial septal defect,3(0.3%)moderate pulmonary stenosis,2(0.2%)aortic stenosis and 3(0.3%)partial anomalous pulmonary venous connection.Severe CHD in 2.4%(26)included 6(0.5%)complete atrioventricular septal defect,5(0.5%)complete transposition of the great arteries,5(0.5%)hypoplastic right heart,3(0.3%)hypoplastic left heart,3(0.3%)double outlet right ventricle,3(0.3%)tetralogy of Fallot,2(0.2%)truncus arteriosus,2(0.2%)total anomalous pulmonary venous connection,2(0.2%)severe aortic stenosis,2(0.2%)interrupted aortic arch and 2(0.2%)severe pulmonary stenosis and 1(0.1%)single-ventricle abnormality.At two-years follow-up in 737(67.4%)patients,18(90%)with severe CHD and 38(5.3%)with mild and moderate CHD died,and 15 underwent cardiac surgery with 1 early death.Conclusions:At high altitude,a wide spectrum of CHD exists,with many heretofore unreported complex CHD.There is urgent need for routine echocardiography and early interventions in newborns particularly in NICU.