Objective:To observe the efficacy of enteral nutritional suspensions in the patients with severe stroke. Methods:To-tally 823 cases of severe stroke patients were divided into the observation group and the control group according to the visiting se-quence. The 423 cases in the observation group were treated with enteral nutritional suspensions, while another 400 patients in the con-trol group were given the home-made meals with nasal feeding, and relative routine treatment was given the patients according to the disease type in the two groups. Before and after the treatment, serum total protein ( TB) , hemoglobin ( HB) , serum albumin ( ALB) and TG of the two groups were recorded, neurological deficit scores ( NIHSS) , Barthel index, muscle recovery and complications were also studied and compared. Results:After the treatment, TB, HB, ALB and TG of the two groups were significantly decreased ( P<0. 05), while the nutritional indicators in the observation group were significantly higher than those in the control group (P<0. 05). After the treatment, NIHSS score of the two groups was significantly decreased (P<0. 01), Barthel index was significantly increased (P<0. 01), and those in the observation group were better than those in the control group (P<0. 05). The muscle recovery of the observation group was significantly higher than that of the control group (P<0. 05). There was no significant difference in the compli-cations between the two groups(P>0. 05). Conclusion: Enteral nutritional suspensions can improve the nutritional status of the pa-tients with severe stroke with fewer complications and better safety, which are worthy of clinical application.

Objective To compare the impact of continuous profound neuromuscular blockade versus con-ventional neuromuscular blockade on postoperative shoulder pain in patients undergoing robot-assisted laparoscopic surgery during steep Trendelenburg position.Methods This study was a single-center,randomized,double-blind clinical trial.The inclusion criteria encompassed individuals aged between 18 and 80 years,with an American Society of Anesthesiologists status of Ⅰ or Ⅱ,and a body mass index ranging from 18 kg/m2 to 30 kg/m2.A total of one hundred patients were randomly assigned to either the deep neuromuscular blockade group(D group)or the conventional neuromuscular blockade group(C group),with equal distribution of fifty cases in each group.Rocuronium dosage was titrated to achieve post-tetanic count values of 1～2 and train-of-four stimulation levels of 1～2 during surgery for D and C groups respectively.At the end of surgery,sugammadex was administered for reversal of neuromuscular blockade.The primary endpoint assessed the incidence of postoperative shoulder pain within three days after surgery.Secondary endpoints included Leiden score evaluation during intraoperative period,number of additional neuromus-cular blockers required by the surgeon,recovery time for muscle relaxation postoperatively,nausea and vomiting scores during recovery phase,visual analog scale(VAS)scores in Post-Anesthesia Care Unit(PACU)as well as within three days after surgery,incidence rate for postoperative pulmonary complications,length of hospital stay duration and patient satisfaction score.Results The incidence of postoperative shoulder pain was significantly lower in group D compared to group C(D group 32%vs.C group 56%;P<0.05).However,there were no significant differences in postoperative shoulder pain VAS scores between the two groups(P>0.05).No significant differences were observed between the groups in terms of Leiden score,surgeon's requirement for additional neuromuscular blockers,nausea and vomiting in PACU,and VAS score(P>0.05).Group D exhibited better early postoperative activity pain scores than group C(P<0.05).There were no significant differences in VAS scores between the groups at other time points(P>0.05).Furthermore,there were no significant differences in the incidence of postoperative pulmonary complications,length of stay,and satisfaction scores between the two groups.Conclusion The imple-mentation of continuous deep neuromuscular blockade in patients undergoing robot-assisted laparoscopic surgery with steep Trendelenburg position can effectively mitigate the occurrence of postoperative shoulder pain.