Effect of Exercise and Enteral Nutrition on Survival (ENERGY)

Inclusion Criteria:（1) 18 years ≤ age ≤ 70 years (2) Preoperative Karnofsky physical condition score: 0 or 1 or 2 (3) Preoperative pathological biopsy by gastroscope, histologically confirmed as adenocarcinoma (papillary adenocarcinoma, tubular adenocarcinoma, mucinous adenocarcinoma, Signet ring cell carcinoma, poorly differentiated adenocarcinoma, mixed adenocarcinoma) (4) Gastric cancer patients diagnosed with clinical stage Ib IIIc through CT, MRI, gastroscopy, and pathology (based on the 8th edition of UICC/AJCC staging) (5) Abdominal enhanced CT/MRI examination showed a clinical staging of cT2-4aN0-3M0 (based on AJCC-8thTNM tumor staging), and standard D2 radical surgery for gastric cancer was performed; (6) Have not received any radiotherapy, chemotherapy or immunotherapy; (7) Hemoglobin ≥ 80g/L; (8) Absolute neutrophil count (ANC) ≥ 1.5 × 109/L; (9) Platelets ≥ 75 × 109/L; (10) ALT ≤ 2.5 times the normal upper limit value; (11) AST ≤ 2.5 times the normal upper limit value; (12) ALP ≤ 2.5 times the normal upper limit value; (13) Serum total bilirubin<1.5 times the upper normal limit value; (14) Serum creatinine<1 times the upper normal limit value; (15) Sign written informed consent; Exclusion Criteria: Patients diagnosed with distant metastasis through abdominal lung CT/MRI or PET-CT Pregnant or lactating women People with uncontrolled epilepsy, Central nervous system disease or mental disorders Patients with combined limb disabilities or motor dysfunction; Patients with other malignant diseases in the past five years, excluding cured skin cancer and cervical Carcinoma in situ Clinically severe (i.e. active) heart disease, such as symptomatic coronary heart disease, New York Heart Association (NYHA) grade II or more severe congestive heart failure, or severe arrhythmia requiring medication intervention, or a history of myocardial infarction within the past 6 months Have a history of cerebral infarction or cerebral hemorrhage in the past 6 months Organ transplantation requires immunosuppressive therapy Serious uncontrolled recurrent infections or other serious uncontrolled concomitant diseases The patient has complications of Grade III or above in Clavien Dindo classification or has been hospitalized for more than 14 days after surgery due to various reasons; Urgent surgery required due to tumor emergencies (bleeding, perforation, obstruction) Pulmonary function test FEV1<expected value 50% Received radiotherapy, chemotherapy, or other neoadjuvant treatment before surgery