Objective To investigate the effect of precision nutrition management on the weight gain and pregnancy outcome in the patients with rapid gestational weight gain (GWG).Methods A total of 121 pregnant women with regular antenatal check-up and rapid GWG in this hospital from July 2022 to May 2023 were selected as the study subjects and divided into the observation group (n=58) and control group (n=63) by the random number table method.The two groups all received the conventional antenatal check-up,health-care and health education.The observation group simultaneously received the precision nutrition intervention for 4 weeks,in which one extra meal was replaced with 30 g of low glycaemic index nutritional formula pow-der.The diet situation and physical activity levels in the observation group were investigated before interven-tion and during the intervention period.The baseline information,post-intervention body weight,delivery body weight and pregnant maternal and neonate outcomes were collected in the two groups.Results Compared with before intervention,whole grains and miscellaneous beans[0(0,30.0)g/d vs.0(0,2.5)g/d],fish and shrimp[65.0(0,130.0)g/d vs.0(0,100.0)g/d],vegetables[(310.5±98.9)g/d vs.(248.2±117.9)g/d],iron[20.30(18.70,23.90)mg/d vs.18.75(14.80,22.80)mg/d]intake and weekly activity time[350(280,420) min vs.210(150,280)min]during the intervention period in the observation group were increased,fruits[179.0(145.0,238.0)g/d vs.200.0(179.0,366.0)g/d],total energy[1702(1608,1837)kcal/d vs.2055 (1848,2327)kcal/d],saturated fatty acids[11.50(8.20,15.80)g/d vs.15.75(12.30,19.00)g/d]intake and proportion of fat calories[(31.71±5.22)％ vs.(35.12±6.17)％]were decreased,the differences were statis-tically significant (P<0.05).Compared with the control group,the intervention period[0.45(0.29,0.63)kg/week vs.0.63(0.50,0.88)kg/week]and the weekly weight gain in 4 weeks after the intervention[0.50 (0.34,0.64)kg/week vs.0.70(0.50,0.93)kg/week],GWG excess ratio (60.3％ vs.77.8％) in the observa-tion group were lower,and the differences were statistically significant (P<0.05).Compared with the control group,complicating anemia during pregnancy (15.5％ vs.31.7％),macrosomia (5.2％ vs.17.2％),incidence rate of adverse delivery outcomes (1.7％ vs.12.7％) and neonatal birth weight[(3292.2±420.9)g vs. (3497.6±454.7)g]in the observation group were lower,and the natural labor process was shorter[5.17 (3.33,9.15)h vs.10.00(6.37,18.00)h],the differences were statistically significant (P<0.05).Conclusion Preci-sion nutrition management could effectively control rapid GWG and the increasing velocity of gestational weight.

OBJECTIVE: To investigate the efficacy and safety of the bladder training in male patients before urinary catheter removal after mid-low rectal cancer surgery. METHODS: This was a prospective, open, randomized controlled study. INCLUSION CRITERIA: male patients; pathologically diagnosed as mid-low rectal adenocarcinoma; distance from tumor lower edge to anal margin ≤10 cm; standard radical surgery for rectal cancer, including intestinal resection and regional lymph node dissection. EXCLUSION CRITERIA: previous history of benign prostatic hyperplasia or history of prostate surgery; bladder dysfunction such as dysuria and urinary retention before surgery; local resection of rectal tumor or extended resection. According to the above criteria, 92 patients who underwent colorectal surgery at the Union Hospital of Fujian Medical University from June to December 2016 were prospectively included. The patients were randomly divided into bladder training group (n=43) and bladder non-training group (n=49) according to the random number table method. The study was approved by the Ethics Committee of the Union Hospital of Fujian Medical University (ethical approval number: 2016KY005) and registered with the China Clinical Trial Registration Center (ChiCTR) (registration No.ChiCTR-IOR-16007995). The implementation of patient's treatment measures, the data collection and analysis were based on the three-blind principle, using envelopes for distribution concealment. In the bladder training group, bladder training was routinely performed from the first day after operation to catheter removal, and in bladder non-training group the catheter was kept open till its removal. The catheter was removed in the early morning at the 5th day after surgery, and the spontaneous urine output was recorded and the residual urine volume of the bladder was measured after the first urination. The international prostate symptom score (IPSS) was applied to evaluate the patient's urinary function before and after surgery. RESULTS: The age of whole group was (58.6±10.9) years old, the body mass index was (22.4±2.7) kg/m , and the distance from tumor lower edge to anal margin was (6.5±1.9) cm. The baseline data, such as age, body mass index, distance from tumor lower edge to anal margin, preoperative IPSS score, preoperative bladder residual urine volume, neoadjuvant radiotherapy and chemotherapy, preventive ileostomy and surgical procedure were not significantly different between two groups (all P>0.05). There was no significant difference in IPSS scores evaluated at the second day (3.6±4.0 vs. 3.5±3.4, t=0.128, P=0.899) and one month (3.7±2.9 vs. 3.0±3.1, t=1.113, P=0.269) after catheter removal between the bladder training group and bladder non-training group. No significant difference in the postoperative residual urine volume of bladder (media 44 ml vs. 24 ml, Z=-1.466, P=0.143), the first spontaneous urination volume (median 200 ml vs. 150 ml, Z=-1.228, P=0.219) after catheter removal, and postoperative hospital stay [(8.2±4.5) days vs. (9.1±5.5) days, t=-0.805, P=0.423] was found. Urinary infection rate was 20.9%(9/43) in the training group, which was even higher than 8.2%(4/49) in the non-training group, but the difference was not significant(χ²=3.077, P=0.079). No patient needed re-catheterization in either group. CONCLUSIONS The routine bladder training after mid-low rectal cancer surgery does not improve the urinary function, and can not reduce the residual urine volume of bladder after catheter removal. This routine clinical practice is not helpful for the bladder function recovery after rectal cancer surgery.
Aged ; China ; Humans ; Laparoscopy ; Male ; Middle Aged ; Prospective Studies ; Recovery of Function ; Rectal Neoplasms ; surgery ; therapy ; Treatment Outcome ; Urinary Bladder ; surgery ; Urinary Retention ; therapy