Objective:To investigate the effect of ultrasound-guided scalp nerve block (SNB) combined with dexmedetomidine on cerebral blood flow after craniotomy in patients with acute traumatic brain injury (TBI).Methods:A randomized controlled design was conducted. Patients aged 25-65 years, with ASA physical status I–III and Glasgow Coma Scale scores of 9-12, who underwent craniotomy for acute TBI at Kunshan Traditional Chinese Medicine Hospital between January 2024 and February 2025 were selected. Patients with unstable vital signs, cranial tumors, cardiovascular diseases, local anesthetic allergies, or infections at the puncture site were excluded. Using a random number table, patients were divided into two groups: the ultrasound-guided SNB combined with dexmedetomidine group (SD group) and the dexmedetomidine-alone group (D group). General clinical data, peak systolic velocity (PSV), mean blood flow velocity (MBFV), intracranial pressure (ICP), S100 calcium-binding protein beta (S-100β protein), neuron-specific enolase (NSE) levels, and postoperative complications were compared. Dynamic changes in PSV and MBFV were analyzed using repeated measures analysis of variance, while inter-group comparisons used independent sample t-tests. Results:A total of 79 patients were included, with 40 in the SD group and 39 in the D group. There were no significant differences in general clinical data between the two groups (all P>0.05). In the D group, PSV and MBFV at T 1 and T 2 were significantly higher than at T0 [(125.04±20.43) cm/s vs. (126.83±21.76) cm/s vs. (110.63±18.49) cm/s, P=0.001; (61.75±8.34) cm/s vs. (62.81±8.54) cm/s vs. (57.82±6.93) cm/s, P=0.017], whereas no significant differences were observed in the SD group (all P>0.05). PSV, MBFV, ICP, S-100β protein, and NSE levels at T1 and T2 in the SD group were lower than those in the D group (all P<0.05). The incidence of postoperative hypertension, agitation, and the use rate of vasoactive drugs were also lower in the SD group compared to the D group (all P<0.05). Conclusion:The application of ultrasound-guided SNB combined with dexmedetomidine in TBI patients after craniotomy can help stabilize cerebral blood flow and ICP, mitigate neuronal injury, and reduce the incidence of postoperative complications.

Objective: To investigate the value of combination of A²DS² score, procalcitonin (PCT) and C-reactive protein (CRP) predicting stroke-associated pneumonia (SAP) in patients with acute ischemic stroke. Methods: Patients with acute ischemic stroke admitted to the Department of Neurology, Suqian People's Hospital of Nanjing Drum Tower Hospital Group from March 2015 to March 2019 were enrolled retrospectively. Multivariate logistic regression analysis was used to determine the independent correlation of A²DS² scores as well as PCT and CRP levels with SAP. Receiver operating characteristic (ROC) curves were used to assess the individual and combined predictive values of A²DS² scores, PCT and CRP levels for SAP. Results: A total of 332 patients with acute ischemic stroke were enrolled, and 58 of them developed SAP (17.5%). After adjusting for age, smoking, and hyperlipidemia, the A²DS² score (odds ratio [OR] 1.613, 95% confidence interval [CI] 1.092-2.389), PCT (OR 8.047, 95% CI 3.012-16.138) and CRP (OR 1.409, 95% CI 1.064-2.672) were the independent predictors of SAP occurrence. ROC curve analysis showed that the area under the curve of A²DS² score, PCT and CRP alone, and the combination of the three for predicting SAP were 0.811, 0.825, 0.804 and 0.910, respectively. When the three are jointly used to predict SAP, the area under the curve is significantly higher than the individual prediction (all P<0.001). Conclusions The combination of A²DS² score, PCT and CRP can improve the ability to predict SAP.

Objective To explore the causes of twisted or tailed DNA bands in agarose gels after electro-phoresis .Methods Prestained and poststained methods were employed to exam 3 kinds of DNA marker bands in agarose gel with GeneGreen and Ethidium Bromide ,respectively .Results Three kinds of DNA marker bands in agarose gel with 1:10000 and 1:5000 concentration of GeneGreen showed obvious distortions and trailing phenomena compared with the same concentration of Ethidium Bromide w hen the prestained method was used for electrophoresis ,which were improved when the poststained method was used in agarose gel with GeneGreen and Ethidium Bromide ,respectively .Conclusion Nucleic acid dye GeneGreen can affect the quali-ty of DNA bands in agarose gel electrophoresis .When the quality of DNA itself ,agarose gel quality ,electro-phoretic fluid quality and voltage are excluded ,the quality of nucleic acid dye should be taken into considera-tion if the bands twisting or tailing occurs when the DNA nucleic acid electrophoresis is carried out by pres-tained method .The quality of DNA electrophoresis bands can be improved by using poststained method or re-placing nucleic acid dye .