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The clinical study of triple pre-rehabilitation before operation to improve the prognosis of elderly patients with colorectal tumors

ABSTRACT: Intervention group:Nutritional intervention: NRS2002 assessment scale = 3 points; it is recommended that patients consume 1.2g/kg protein per day; on the basis of general diet, the corresponding ONS will be given according to the patient’s basic disease and intestinal function;Intervention group:Sports intervention: 1) Grip exercise: Provide a 10kg grip dynamometer, and ask patients to exercise 20 times a day for the left and right hands.;Intervention group:Exercise intervention: 2) Aerobic exercise: walking: provide patients with step counting devices, and recommend patients to walk at least 7,500 steps (about 1 hour) a day.;Intervention group:Exercise intervention: 3) Resistance exercise: Climbing stairs exercise: It is recommended that patients climb stairs 3 times a day, up and down 5 floors each time.;Intervention group:Sports intervention: 4) Spinning exercise: It is recommended that patients ride the bicycle 3 times a day for 30 minutes each time.;Intervention group:Sports intervention: 5) Respiratory function exercise: Provide patients with balloons and require patients to perform balloon blowing exercises at least 30 times a day.;Intervention group:Mental sleep intervention: daily before going to bed: ? 2 minutes of breathing exercises, 10 minutes of progressive muscle relaxation exercises and 15 minutes of pleasant guided imagination training.;Intervention group:Psychological sleep intervention: daily before going to bed: ?Combined with the patient’s usual preferences, choose light music, 15-30 minutes before going to bed every day.;Intervention group:Psychological sleep intervention: daily before going to bed: ?Use sedative and sleeping drugs for patients with difficulty falling asleep and sleep disorders.;Control group:Nutritional evaluation before surgery: assess the nutritional status of the patient, instruct the patient to eat a high-protein, high-calorie, high-vitamin diet; eat a small amount of meals, and give supplementary parenteral nutrition su Primary outcome(s): Complications within 30 days after surgery Study Design: Parallel

DISEASE(S): Colorectal Neoplasms

PROVIDER: 2701118 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:We aimed to investigate the human skeletal muscle (SkM) DNA methylome after exercise in low carbohydrate (CHO) energy balance (with high fat) compared with exercise in low-CHO energy deficit (with low fat) conditions. The objective to identify novel epigenetically regulated genes and pathways associated with ‘train-low sleep-low’ paradigms. The sleep-low conditions included 9 males that cycled to deplete muscle glycogen while reaching a set energy expenditure. Post-exercise, low-CHO meals (protein-matched) completely replaced (using high-fat) or only partially replaced (low-fat) the energy expended. The following morning resting baseline biopsies were taken and the participants then undertook 75 minutes of cycling exercise, with skeletal muscle biopsies collected 30 minutes and 3.5 hours post exercise. Discovery of genome-wide DNA methylation was undertaken using Illumina EPIC arrays and targeted gene expression analysis was conducted by RT-qPCR. At baseline participants under energy balance (high fat) demonstrated a predominantly hypermethylated (60%) profile across the genome compared to energy deficit-low fat conditions. However, post exercise performed in energy balance (with high fat) elicited a more prominent hypomethylation signature 30 minutes post-exercise in gene regulatory regions important for transcription (CpG islands within promoter regions) compared with exercise in energy deficit (with low fat) conditions. Such hypomethylation was enriched within pathways related to: IL6-JAK-STAT signalling, metabolic processes, p53 / cell cycle and oxidative / fatty acid metabolism. Hypomethylation within the promoter regions of genes: HDAC2, MECR, IGF2 and c13orf16 were associated with significant increases in gene expression in the post-exercise period in energy balance compared with energy deficit. Furthermore, histone deacetylase, HDAC11 was oppositely regulated at the gene expression level compared with HDAC2, where HDAC11 was hypomethylated yet increased in energy deficit compared with energy balance conditions. Overall, we identify some novel epigenetically regulated genes associated with train-low sleep-low paradigms.

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The clinical study of triple pre-rehabilitation before operation to improve the prognosis of elderly patients with colorectal tumors

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