Effect of individualized nutrition interventions on clinical outcomes of pregnant women with gestational diabetes mellitus.

BACKGROUND: Gestational diabetes mellitus (GDM) can lead to excessive pregnancy weight gain (PWG), abnormal glucolipid metabolism, and delayed lactation. Therefore, it is necessary to provide appropriate and effective interventions for pregnant women with GDM. AIM: To clarify the effects of individualized nutrition interventions on PWG, glucolipid metabolism, and lactation in pregnant women with GDM. METHODS: The study population consisted of 410 pregnant women with GDM who received treatment at the Northern Jiangsu People's Hospital of Jiangsu Province and Yangzhou Maternal and Child Health Hospital between December 2020 and December 2022, including 200 who received routine in-terventions [control (Con) group] and 210 who received individualized nutrition interventions [research (Res) group]. Data on PWG, glucolipid metabolism [total cholesterol, (TC); triglycerides (TGs); fasting blood glucose (FPG); glycosylated hemoglobin (HbA1c)], lactation time, perinatal complications (cesarean section, premature rupture of membranes, postpartum hemorrhage, and pregnancy-induced hypertension), and neonatal adverse events (premature infants, fetal macrosomia, hypo-glycemia, and respiratory distress syndrome) were collected for comparative analysis. RESULTS: The data revealed markedly lower PWG in the Res group vs the Con group, as well as markedly reduced TG, TC, FPG and HbA1c levels after the intervention that were lower than those in the Con group. In addition, obviously earlier lactation and statistically lower incidences of perinatal complications and neonatal adverse events were observed in the Res group. CONCLUSION: Individualized nutrition interventions can reduce PWG in pregnant women with GDM, improve their glucolipid metabolism, and promote early lactation, which deserves clinical promotion.

[Pre-precipitation of Sewage-SNAD Granular Sludge Process Test].

Using artificial water, the simultaneous partial nitrification, ANAMMOX (anaerobic ammonium oxidation), and denitrification (SNAD) granular sludge process was started in a sequencing batch reactor (SBR), and then the ammonia concentration in the influent was reduced gradually. After stable operation for a period of time under the low ammonia concentration, sewage treated by a pre-precipitation process was used as a substrate to investigate the performance and stability of the SNAD granular sludge process. The results show that after the SNAD process was successfully started, the ammonia removal rate was greater than 98%, and total the nitrogen removal rate was about 89%. As the influent ammonia concentration decreased, the nitride-oxidizing bacteria (NOB) activity was increased and the total nitrogen removal rate gradually decreased to 75%. When the pre-precipitated domestic sewage (NH4+-N 52-63 mg·L-1, COD 99-123 mg·L-1) was used as the inflow, the average effluent removal rate of the total effluent was 73.2%, the effluent COD concentration was below 35 mg·L-1, and the maximum effluent ammonia nitrogen and total nitrogen concentration were 0.7 mg·L-1 and 12.8 mg·L-1. The ammonia and total nitrogen concentration in the continuous 30 day effluent reached the 1A level of the integrated discharge standard of water pollutants for municipal wastewater treatment, indicating that the removal of organics and nitrogen from domestic sewage was achieved efficiently and synchronously.

[Startup Strategies for the SNAD Granular Sludge Process at Low Temperature].

To study the effect of the startup strategies on the simultaneous partial nitrification, ANAMMOX, and denitrification (SNAD) granular sludge processes, these processes were initiated by starting the completely autotrophic nitrogen removal over nitrite (CANON) process and anaerobic ammonia oxidation-denitrification (SAD) process at 12.7℃ and 18.3℃, respectively. The results show that the ammonia nitrogen was almost completely removed and the total nitrogen removal rate reached 86.7% after the R1 reactor was successfully started. When the ammonia concentration was low, the total nitrogen removal rate in the effluent decreased to 75.3%, the total nitrogen concentration in the effluent was~10 mg·L-1, and excessive proliferation of the NOB was observed. The total nitrogen concentration in the effluent exceeded the 1A level of the integrated discharge standard of water pollutants applied in Beijing City. After the R2 reactor was successfully started, the effluent contained almost no ammonia nitrogen and the total nitrogen removal rate was~89.1%, that is, slightly higher than that of the R1 reactor. When the ammonia concentration was low, the concentration of ammonia nitrogen in effluent was less than 1.0 mg·L-1 and the total nitrogen concentration in the effluent was less than 6 mg·L-1. The concentrations of ammonia nitrogen and total nitrogen in the effluent reached the 1A level of the integrated discharge standard of water pollutants applied in Beijing City. First, the startup of the SAD process gradually eliminated the NOB from the system through anaerobic operation in the initial stage of the startup, maintained the stability of the system, provided a good basis for the subsequent aeration to start the SNAD process, maintained the stable operation of the reactor, and the long-term discharge of total nitrogen reached the standard.

[Lab-scale SNAD Process in Wastewater Treatment Plant].

Outside the municipal waste water treatment plant(WWTP) which located in Mentougou District, Beijing, the effluent of the anoxic/oxic(A/O) phosphorus removal process served as the substrate to operate a completely autotrophic nitrogen removal over nitrite(CANON) filter reactor.. After the reactor was successfully activated, glucose was added to the influent as the organic carbon source. The simultaneous partial nitrification, anaerobic ammonium oxidation (ANAMMOX), and denitrification (SNAD) process was started to study the effect of SNAD filter on sewage treatment. The results showed that from 119 d to 128 d, the ammonia removal rate of the CANON process was more than 95%, and the maximum total nitrogen concentration in the effluent was 13.0 mg·L-1. Total nitrogen concentration surpassed the 1A level of the Integrated Discharge Standard of Water Pollutants applied in Beijing City. The SNAD process was started by adding glucose to the influent at 129 d. The total nitrogen removal rate of this process was about 85% at 133-187 d, and the total nitrogen concentration in the effluent was 5.5-7.3 mg·L-1. The filter plugged up at 195 d, and backwash was utilized at 196 d. During the subsequent 30 d, the total nitrogen removal rate of the reactor was greater than 85%, and the total nitrogen concentration in the effluent remained at 6.2-7.2 mg·L-1. Compared with the CANON process, the SNAD process improved the total nitrogen removal rate and reduced the total nitrogen concentration of the effluent by 6 mg·L-1. The ammonia and total nitrogen concentrations in effluent satisfied the 1A level of the Integrated Discharge Standard of Water Pollutants.