Objective To investigate the effect of intravenous lidocaine on the efficacy of sevoflurane combined with remifentanil for tracheal intubation without neuromuscular relaxants. Methods Seventy-five ASA Ⅰor Ⅱ patients, aged 18-64 yr, scheduled for elective surgery, needing tracheal intubation under general anesthesia, were randomly divided into 3 groups ( n = 25 each) : sevoflurane + remifentanil 1 μg/kg group (group A) ;sevoflurane + remifentanil 1 μg/kg + lidocaine 1 mg/kg group (group B); sevoflurane + remifentanil 2 μg/kg group (group C) . Two minutes after inhalation of 8% sevoflurane for anesthesia induction, remifentanil 1 μg/kg, remifentanil 1 μg/kg + lidocaine 1 mg/kg, and remifentanil 2 μg/kg were injected intravenously in groups A, B and C respectively. Tracheal intubation was performed after completion of remifentanil injection. Intubating conditions were assessed based on ease of laryngoscopy, position of vocal cords, activity of vocal cords, degree of coughing and limb movement. MAP and HR were also recorded before induction and immediately before and after intubation. Results Tracheal intubations were successful in all patients. The satisfactory rates of coughing were significantly higher in groups B and C, and MAP and HR were significantly lower immediately before and after intubation in group C than in group A ( P ＜ 0.05) . The satisfactory rate of coughing was significantly higher in group B than in group C ( P ＜ 0.05) . During intubation, 3 cases developed hypotension and 1 case bradycardia in group C. Conclusion When sevoflurane combined with remifentanil is used for tracheal intubation without neuromuscular relaxants, intravenous lidocaine 1 mg/kg can not only improve intubating conditions, but also decrease the consumption of remifentanil.

Objective To investigate pharmacodynamics of propofol for smooth exchange of tracheal tube for u laryngeal mask airway after surgery in elderly patients. Methods Twenty elderly patients, ASA Ⅰ or Ⅱ, aged 65-70 yr, scheduled for elective laparoscopic cholecystectomy were enrolled in this study. Anesthesia was induced with propofol, atracurium and remifentanil. The patients were mechanically ventilated after the trachea was intubated. Anesthesia was maintained with propofol combined with remifentanil. After surgery, a predetermined propofol concentration was achieved and a steady state maintained for at least 5 min. The target plasma concentration of propofol at which the laryngeal mask airway following tracheal extubation was attempted was determined by Dixon's up-and-down method with 0.5 μg/ml as the step size, The probit model was used to calculate the EC_(50) and EC_(95) and 95% confidence interval (95% CI) of propofol for inhibiting patient's response induced by smooth excharge of tracheal tube. Results The EC50 of propofol to achieve laryngeal mask airway following tracheal extubation was 2.79 μg/ml (95% CI 2.44-3.04 μg/ml) and EC_(50) 3.61 μg/ml (95% CI 3.27-4.78 μg/ml). Conclusion The target plasma concentration of propofol for laryngeal mask airway following tracheal extubation in elderly patients is 3.61 μg/ml.

s] Objective To evaluate the effect of comprehensive schistosomiasis control measures with focus on total removal of cattle and sheep in Junshan District,Yueyang City. Methods The retrospective review and field survey were implemented in the pilot villages in Junshan District. The data of Schistosoma japonicum infection status of human,cattle,sheep and Oncome-lania hupensis snails,and density of snails were gathered and modeled in the period of 2006 to 2016. Results The prevalence of schistosome infection in residents in the pilot villages decreased from 3.44％ in 2006 to 0.59％ in 2012(F = 14.501,P =0.013). After removal of all the cattle and sheep in 2013,the prevalence of schistosome infection in the residents decreased to zero in 2016(F=14.148,P=0.033). The density of living snails decreased from 0.8833/0.1 m2 in 2006 to 0.3088/0.1 m2 in 2012(F=76.250,P=0.005). Conclusion The comprehensive schistosomiasis control strategy with focus on cattle and sheep removal is remarkably effective.

Objective:To investigate the health status, health-related behaviors and health needs of elderlies in eastern, central and western China and to understand their health experience, for exploring an efficient medical service model, and optimizing allocation of medical resources.Methods:This study used the 2008-2018 database from Chinese longitudinal healthy longevity survey organized by Peking University. It described the concentration trend of medical distance by median, compared the health status, health-related behaviors and health needs of the elderly in eastern, central and western China by χ2 tests, and analyzed time-distribution trends of the poor health status, negative health behaviors and health needs by linear relation test. Results:Among 49 611 subjects included in the study, 7 881 of them self-evaluated their health status as poor, 19 445 evaluated their recent health status as deteriorated, while 14 954 lack routine physical examination, 35 141 lack physical exercise, 8 178 smoked, 7 859 drunk, 35 814 had no access to health education services in their communities, 35 676 expressed their health education needs, and 2 637 lack adequate medical services. The difference of distribution of health status, health-related behaviors and health needs of the elderly in eastern, central and western China was statistically significant ( P<0.05). The health status, negative health behaviors and health needs of the elderly in 2008-2018 presented a linear time distribution trend( P<0.05), while the overall medical distance in eastern, central and western China was 1.02 km, 1.00 km and 1.56 km respectively, and the medical distance in the rural area further than that in the urban areas. Conclusions:The health status of the elderly in China needed to be further improved, the proportion of negative health behaviors was high, and the health needs of the elderly in central and western China were large. Promoting an active medical service mode in central and western China, strengthening the interactions between medical institutions and residential communities will contribute to health needs fulfillment and medical resource utilization.