Gut microbiota is the microbial community that is specifically planted in the human gut and interacts with the human body.It plays an important role in the human body by regulating the basal metabolism and immunity of the host to maintain the homeostasis of the human body.Once the intestinal flora is dysregulated,it can lead to multi-system diseases.Hashimoto's thyroiditis is an organ-specific autoimmune disease.The pathogenesis of Hashimoto's thyroiditis is complex and its incidence is increasing year by year,which is gradually becoming a serious public health disease affecting the world.In recent years,the relationship between gut microbiota and bridge onychitis has received extensive attention.A large number of studies have shown that the richness and diversity of intestinal flora in Hashimoto's thyroiditis patients are changed compared with healthy people.Studies have shown that traditional Chinese medicine therapy can play a role in treating this disease by regulating intestinal flora.This article systematically summarizes the relationship between the two and the effect of traditional Chinese medicine on the treatment of bridge onychitis by regulating intestinal flora,so as to provide some reference for research in this field.

Objective:To evaluate the effect of smoking on the sedative potency of remimazolam combined with alfentanil in patients undergoing painless gastroscopy.Methods:This was a prospecctive single-center study. American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ male patients, aged 30-75 yr, with a body mass index of 18-28 kg/m 2, undergoing elective painless gastroscopy at Baoding First Central Hospital from October to December 2023, were divided into non-smoking group, mild smoking group (smoking index≤200), moderate smoking group (200 1 after 3 min of remimazolam injection or development of bucking, swallowing, body movement and other responses that affected operations during insertion of the endoscope. Results:A total of 85 patients were finally included, with 21 in non-smoking group, 21 in mild smoking group, 20 in moderate smoking group and 23 in heavy smoking group. The ED 50 of remimazolam was significantly higher in smoking groups than in non-smoking group ( P<0.05). The ED 50 of remimazolam gradually increased in mild, moderate and heavy smoking groups ( P<0.05). Conclusions:Smoking can decrease the sedative potency of remimazolam when combined with alfentanil in patients undergoing painless gastroscopy.

Objective:To evaluate the effects of different volumes of ropivacaine for iliopsoas muscle plane block on quadriceps strength in patients undergoing hip arthroplasty.Methods:In this prospective study, 75 patients of either sex, aged 40-80 yr, with a body mass index of 18.5-30.0 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, undergoing elective hip arthroplasty from June to December 2023 at Baoding First Central Hospital, were randomized into 3 groups ( n=25 each) by using a computer-generated randomization sequence: ropivacaine 5 ml group (group Ⅰ), ropivacaine 10 ml group (group Ⅱ), and ropivacaine 15 ml group (group Ⅲ). Before induction of anesthesia, iliopsoas muscle plane block was performed with 0.5% ropivacaine 5, 10 and 15 ml in Ⅰ, Ⅱ and Ⅲ groups, respectively. The lateral femoral cutaneous nerve block was carried out using 0.5% ropivacaine 5 ml in all the three groups. The quadriceps muscle strength and status of quadriceps motor block in the affected limb were assessed on admission to postanesthesia care unit (PACU) and at 2, 4, 6, 24 and 48 h after surgery. The consumption of dezocine, score for patient′s satisfaction with analgesia, and occurrence of complications were recorded. Results:Compared with group Ⅰ, the quadriceps muscle strength scores were significantly decreased on admission to PACU and at 2, 4 and 6 h postoperatively in group Ⅲ, the rate of quadriceps motor block was significantly increased on admission to PACU in group Ⅱ, and the rate of quadriceps motor block was significantly increased on admission to PACU and at 2 and 4 h postoperatively in group Ⅲ ( P<0.05), and the consumption of dezocine was significantly decreased in group Ⅱ and group Ⅲ ( P<0.05). Conclusions:The recommended volume of ropivacaine for iliopsoas plane block is 10 ml in patients undergoing hip arthroplasty.

Gut microbiota is the microbial community that is specifically planted in the human gut and interacts with the human body.It plays an important role in the human body by regulating the basal metabolism and immunity of the host to maintain the homeostasis of the human body.Once the intestinal flora is dysregulated,it can lead to multi-system diseases.Hashimoto's thyroiditis is an organ-specific autoimmune disease.The pathogenesis of Hashimoto's thyroiditis is complex and its incidence is increasing year by year,which is gradually becoming a serious public health disease affecting the world.In recent years,the relationship between gut microbiota and bridge onychitis has received extensive attention.A large number of studies have shown that the richness and diversity of intestinal flora in Hashimoto's thyroiditis patients are changed compared with healthy people.Studies have shown that traditional Chinese medicine therapy can play a role in treating this disease by regulating intestinal flora.This article systematically summarizes the relationship between the two and the effect of traditional Chinese medicine on the treatment of bridge onychitis by regulating intestinal flora,so as to provide some reference for research in this field.

Objective:To evaluate the effect of smoking on the sedative potency of remimazolam combined with alfentanil in patients undergoing painless gastroscopy.Methods:This was a prospecctive single-center study. American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ male patients, aged 30-75 yr, with a body mass index of 18-28 kg/m 2, undergoing elective painless gastroscopy at Baoding First Central Hospital from October to December 2023, were divided into non-smoking group, mild smoking group (smoking index≤200), moderate smoking group (200 1 after 3 min of remimazolam injection or development of bucking, swallowing, body movement and other responses that affected operations during insertion of the endoscope. Results:A total of 85 patients were finally included, with 21 in non-smoking group, 21 in mild smoking group, 20 in moderate smoking group and 23 in heavy smoking group. The ED 50 of remimazolam was significantly higher in smoking groups than in non-smoking group ( P<0.05). The ED 50 of remimazolam gradually increased in mild, moderate and heavy smoking groups ( P<0.05). Conclusions:Smoking can decrease the sedative potency of remimazolam when combined with alfentanil in patients undergoing painless gastroscopy.

Objective:To evaluate the effects of different volumes of ropivacaine for iliopsoas muscle plane block on quadriceps strength in patients undergoing hip arthroplasty.Methods:In this prospective study, 75 patients of either sex, aged 40-80 yr, with a body mass index of 18.5-30.0 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, undergoing elective hip arthroplasty from June to December 2023 at Baoding First Central Hospital, were randomized into 3 groups ( n=25 each) by using a computer-generated randomization sequence: ropivacaine 5 ml group (group Ⅰ), ropivacaine 10 ml group (group Ⅱ), and ropivacaine 15 ml group (group Ⅲ). Before induction of anesthesia, iliopsoas muscle plane block was performed with 0.5% ropivacaine 5, 10 and 15 ml in Ⅰ, Ⅱ and Ⅲ groups, respectively. The lateral femoral cutaneous nerve block was carried out using 0.5% ropivacaine 5 ml in all the three groups. The quadriceps muscle strength and status of quadriceps motor block in the affected limb were assessed on admission to postanesthesia care unit (PACU) and at 2, 4, 6, 24 and 48 h after surgery. The consumption of dezocine, score for patient′s satisfaction with analgesia, and occurrence of complications were recorded. Results:Compared with group Ⅰ, the quadriceps muscle strength scores were significantly decreased on admission to PACU and at 2, 4 and 6 h postoperatively in group Ⅲ, the rate of quadriceps motor block was significantly increased on admission to PACU in group Ⅱ, and the rate of quadriceps motor block was significantly increased on admission to PACU and at 2 and 4 h postoperatively in group Ⅲ ( P<0.05), and the consumption of dezocine was significantly decreased in group Ⅱ and group Ⅲ ( P<0.05). Conclusions:The recommended volume of ropivacaine for iliopsoas plane block is 10 ml in patients undergoing hip arthroplasty.

Objective To observe the effect of ultrasound-guided iliopsoas plane block(IPB)on the quality of postoperative recovery in patients undergoing hip arthroplasty.Methods Sixty patients who underwent hip arthroplasty were selected,37 males and 23 females,aged 40-79 years,BMI 18-30 kg/m2,ASA physical status Ⅰ-Ⅲ.The patients were divided into two groups by random number table method:the iliopsoas plane block group(group IPB)and the femoral nerve block(FNB)group(group FNB),30 pa-tients in each group.Before anesthesia induction,IPB was performed with 0.5%ropivacaine 10 ml and lat-eral femoral cutaneous nerve block was performed with 0.5%ropivacaine 5 ml in group IPB.And FNB was performed with 0.5%ropivacaine 10 ml and lateral femoral cutaneous nerve block was performed with 0.5%ropivacaine 5 ml in group FNB.The dosages of propofol,remifentanil,and cis-atracurium during operation were recorded.The quality of recovery-15(QoR-15)scale was evaluated preoperatively and postoperatively 1 day,2 and 3 days.The max VAS(VASmax)pain score and manual muscle test(MMT)score of quadri-ceps muscle were recorded 12,24,and 48 hours after surgery.The time of getting out of bed for the first time,opioid dosage,and patient satisfaction were recorded.The incidence of nerve injury,vascular injury,puncture site infection,and local anesthetic poisoning were recorded.The postoperative complications of diz-ziness,nausea and vomiting,deep vein thromboses,and elirium were also recorded.Results There was no significant difference in the dosage of propofol,remifentanil,and cis-atracurium between the two groups.Compared with group FNB,the QoR-15 scale score in group IPB was significantly higher 1 day,2 and 3 days after operation(P＜0.05).Compared with group FNB,the MMT scores of quadriceps muscle was sig-nificantly higher in group IPB 12 and 24 hours after surgery(P＜0.05),and the first time of getting out of bed was shortened in group IPB(P＜0.05).However,there were no significant differences in the VASmax pain score,MMT score of quadriceps muscle 48 hours after surgery,opioid dosage,and patient satisfaction between the two groups.No nerve block related complications were found in both groups.There were no sig-nificant differences in postoperative complications between the two groups.Conclusion The iliopsoas plane block can improve the quality of postoperative recovery and accelerate the recovery of patients with hip re-placement,and the effect is better than that of femoral nerve block.

Objective:To compare the anesthetic potency of ciprofol combined with alfentanil in patients with different body mass indexes (BMIs) during gastroscopy.Methods:American Society of Anesthesiologists Physical Status classification I or Ⅱ patients, aged 18-64 yr, with a BMI of 18-36 kg/m 2, undergoing elective painless gastroscopy at Baoding First Central Hospital from October to December 2023, were divided into 3 groups: normal group (18 kg/m 2≤BMI<24 kg/m 2), overweight group (24 kg/m 2≤BMI<28 kg/m 2) and obesity group (BMI≥28 kg/m 2). The 95% effective dose (ED 95) of ciprofol during painless gastroscopy was determined by the biased coin design. Alfentanyl 5 μg/kg and ciprofol were intravenously injected for anesthesia induction. Gastroscopy was performed after the patient′s eyelash reflex disappeared, the jaw muscle was relaxed and the Modified Observer′s Assessment of Alertness/Sedation Scale score ≤ 1. The initial dose of ciprofol was 0.2 mg/kg with a dose gradient of 0.04 mg/kg. The positive response were defined as the Modified Observer′s Assessment of Alertness/Sedation Scale score still> 1 after 3 min of ciprofol injection or any other responses affecting the procedure, such as body movement, bucking, or swallowing during insertion of the endoscope. If the response was positive, the next patient received a higher dose of ciprofol, or conversely if negative, the next patient received the same dose (95% probability) or a lower dose (5% probability). Each group was completed with 40 cases. Results:The ED 95 and 95% confidence intervals of ciprofol in normal, overweight and obese groups were 0.266 (0.246, 0.285) mg/kg, 0.218 (0.189, 0.244) mg/kg, 0.191 (0.156, 0.220) mg/kg, respectively. The ED 95 of ciprofol was significantly lower in overweight and obese groups than in normal group ( P<0.05). Conclusions:Overweight and obesity can increase the anesthetic potency of ciprofol in patients undergoing gastroscopy.

Objective:To evaluate the effect of heavy smoking on the dose-effect relationship of ciprofol for painless gastroscopy when combined with alfentanil.Methods:This was a prospective study. American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ male patients, aged 18-64 yr, with body mass index of 18-28 kg/m 2, undergoing elective painless gastroscopy from October 2023 to February 2024 in Baoding First Central Hospital, were divided into non-smoking group and heavy smoking group (smoking index>400) according to the status of smoking. Alfentanil 5 μg/kg and ciprofol were intravenously injected, and gastroscopy was performed after the patient′s eyelash reflex disappeared and the jaw was relaxed. The study was performed by the Dixon′s up-and-down method, and the initial dose of ciprofol was 0.4 mg/kg. The dose of ciprofol increased or decreased by 0.04 mg/kg each time based on the positive or negative response of the previous patient. A positive response was defined as the Modified Observer′s Assessment of Alertness/Sedation Scale score being greater than 1 point at 3 min after ciprofol injection or the occurrence of coughing, swallowing, body movement, or other responses that affected the operation during the insertion of the endoscope. The median effective dose (ED 50) and 95% confidence interval of propofol for painless gastroscopy were determined by the probit analysis. Results:Twenty-five patients were finally included in non-smoking group and 23 patients in heavy smoking group. The ED 50 (95% confidence interval) of ciprofol when combined with alfentanil was 0.205 (0.159, 0.244) mg/kg in non-smoking group and 0.252 (0.184, 0.295) mg/kg in heavy smoking group. The ED 50 was significantly higher in heavy smoking group than in non-smoking group ( u=390, P=0.009). Conclusions:Heavy smoking can weaken the sedative potency of propofol for sedation when used for painless gastroscopy when combined with alfentanil.

Objective:To evaluate the effect of age on the sedative potency of remimazolam.Methods:This was a prospective study. Patients of either sex, aged 40-80 yr, with body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, scheduled for elective surgery with general anesthesia, were divided into middle age group (40-64 yr) and elderly group (65-80 yr) based on the age of the patients. The test was performed by the Dixon′s up-and-down method. The initial dose of remimazolam was 0.3 mg/kg. The Modified Observer′s Assessment of Alertness/Sedation Scale score ≤1 and bispectral index value≤60 within 3 min after administration were considered as an effective sedation. The dose of remimazolam was increased/decreased by 0.03 mg/kg based on the sedative efficacy in the previous patient. The 50% effective dose (ED 50) and 95% confidence interval ( CI) of remimazolam were calculated by the probit method. The time to the loss of consciousness was recorded. Results:The ED 50 (95% CI) of remimazolam was 0.345 (0.306-0.384) mg/kg in middle age group, while the ED 50 (95% CI) of remimazolam was 0.322 (0.303-0.339) mg/kg in elderly group. The ED 50 was significantly higher in middle age group than in elderly group ( u=417.00, P=0.022). The time to loss of consciousness was significantly longer in elderly group than in middle age group ( t=-2.96, P=0.008). Conclusions:For middle-aged and elderly patients aged 40-80 yr, the sedative potency of remimazolam increases with age.