Objective:To investigate the effect of combined use of midazolam and remifentanil without muscle relaxant on tracheal intubation in female patients undergoing breast surgery.Methods:A retrospective analysis was performed on 40 female patients with breast disease who underwent tracheal intubation and general anesthesia at The First Affiliated Hospital of Zhengzhou University between January 2023 and June 2023. These patients were divided into a control group ( n = 20) and an observation group ( n = 20) based on whether muscle relaxants were applied at the time of intubation. The control group received intravenous rocuronium bromide, whereas the observation group did not use muscle relaxants. Both groups were intravenously administered midazolam (0.1 mg/kg) and remifentanil (4 μg/kg) prior to tracheal intubation. The intubation conditions were evaluated based on factors such as the ease of inserting the laryngoscope and the patient's response to intubation, including coughing. Results:There were no statistically significant differences in age, height, and body mass between the two groups (all P > 0.05). The excellent rate of intubation conditions was significantly lower in the observation group compared with the control group [45% (9/20) vs. 85% (17/20), χ2 = 7.03, P = 0.008). The good rate of intubation conditions was significantly higher in the observation group compared with the control group [40% (8/20) vs. 5% (1/20), χ2 = 7.03, P < 0.05]. There was no statistically significant difference in the excellent and good rates of intubation conditions between the observation and control groups [85% (17/20) vs. 90% (18/20), χ2 = 0.23, P > 0.05]. No significant difference in intraoperative awareness score was observed between the observation and control groups [(2.59 ± 0.44) points vs. (2.61 ± 0.31) points, P > 0.05]. None of the patients in either group exhibited any episodes of arrhythmias. Furthermore, no adverse reactions such as muscle stiffness, nausea, vomiting, or skin itching were observed in either group following the surgical procedure. Conclusion:Without the use of muscle relaxants, intravenous administration of midazolam at 0.1 mg/kg and remifentanil at 4 μg/kg for tracheal intubation in female patients undergoing breast surgery can offer excellent intubation conditions, ensuring that the patient remains unconscious throughout the surgical procedure.

Objective To describe the discovery of a residual foci of bancroftian filariasis in Fuchuan County where the disease was announced to have been eliminated, and reveal its epidemiologic feature.Methods The investigation was carried out from August 2007 to March 2008 among residents in Changtang village where the first caseof filariasiswas found and the neighboring villages.They were screened with two thick blood smears.Immunochromatographic technology(ICT) was conducted for those going out but returned and those in surrounding areas.Vector mosquitoes were collected and dissected to find filaria larvae.Historical documents were reviewed and relevant people were interviewed.Results In Changtang administrative village, 1 052 residents were screened and 19 cases with microfilaremia were found in 2 natural villages, with a Mf-positive rate of 1.8%(5.1% in Gangshang and 1.4% in Yinshan respectively).No Mf-positive case was found in 4 119 residents screened in other 3 villages.The average microfilaria density in the 19 cases was 17.37/60 ?l blood.All the 19 cases belonged to 12 families, and 13 cases were relatives to each other, which showed a feature of spatial clustering and family clustering.More patients were identified in the age groups of 20-29 and 50-59, and 57.9% of them were older than 50 years.No larvae were found in 54 Culex pipiens fatigans dissected.Conclusion The Changtang village is identified as a residual focus of bancroftian filariasis with a low, limited endemicity.More cases have been among the elderly with a low average microfilaremia.