Objective To compare the effects of different doses of vitamin D supplementation on vita-min D deficiency and insufficiency in premature infants.Methods A total of 126 premature infants hospital-ized in the pediatrics department of this hospital from March 25,2021 to December 30,2022 were selected as the study subjects and began to supplement different doses of vitamin D on 3 d after birth under the intestinal tract tolerance.They were divided into 500,900 and 2 100 IU/d groups according to vitamin D supplementary dose.The differences in vitamin D levels at beginning and after supplementation were compared among the groups.Results Among 126 premature infants,there were 52 cases of vitamin D deficiency and 74 cases of vi-tamin D insufficiency.Compared with vitamin D insufficiency,the proportion of vitamin D supplementation in the mothers of the premature infants with vitamin D deficiency was lower(P＜0.05).The serum calcium,phosphorus,alkaline phosphatase and 25-hydroxyvitamin D levels after birth had no statistical difference a-mong 3 groups(P＞0.05).The 25-hydroxyvitamin D level after supplementation had statistical difference a-mong 3 groups(P＜0.05),moreover the 500 IU/d group was lower than the 2 100 IU/d group(P＜0.05).The longest duration of vitamin D supplementation in the 2 100 IU/d group was 90 d,its highest 25-hydroxyvitamin D level after supplementation was 48.3 ng/mL,no vitamin D poisoning condition appeared,there were still 40 cases(85.1％)of vitamin D deficiency and insufficiency after supplementation in the 900 IU/d group,and 17 cases(25.8％)in the 2 100 IU/d group.Conclusion Giving vitamin D 2 100 IU/d in pre-term infants is recommended after birth to prevent the vitamin D deficiency.

Objective::To determine the role of regular diet recovery after restoration of normal muscle strength of both lower extremities in promoting postoperative recovery in women undergoing elective cesarean section.Methods::This was a prospective observational cohort study. Patients who underwent elective cesarean section at Xiangya Hospital, Central South University, from October 2022 to December 2022, were categorized into two groups based on the duration of postoperative fasting: the observation group resumed eating after regaining lower extremity muscle strength, while the control group adhered to traditional postoperative fasting guidelines, waiting 6 hours before eating. Primary outcomes included postoperative pain levels assessed by visual analog scale (VAS) pain scores and time to first flatus. Demographic characteristics, time to first lactation, hospital stay length, and patient satisfaction were also assessed. Statistical analysis was conducted using Student’s t test and Chi-squared test, with significance set at P < 0.05. Results::Out of a total of 300 patients, 240 were included in the analysis, comprising 112 in the control group and 128 in the observation group. There were no significant differences in baseline demographic characteristics. The median values of the first flatus time and the first lactation time were 33.37 ± 1.22 vs. 18.06 ± 6.34 hours ( P = 0.003) and 26.34 ± 8.21 vs. 7.05 ± 1.26 hours ( P = 0.001) in the control and observation groups, respectively. The median hospital stay duration in the control and observation groups was 6.54 ± 0.53 vs. 4.84 ± 0.18 days ( P = 0.000), respectively. Median postoperative VAS pain scores and patient satisfaction values were 8.57 ± 0.11 vs. 4.91 ± 0.27 ( P = 0.000) and 9.36 ± 0.16 vs. 9.72 ± 0.08 ( P = 0.005) in the control and observation groups, respectively. There were no statistically significant differences in other postoperative outcomes, such as intestinal obstruction, infection, and readmission within 42 days ( P > 0.05). Conclusion::Food intake after restoration of lower extremity muscle strength improves first flatus, relieves postoperative pain, shortens hospital stay, and enhances satisfaction after elective cesarean section, without adverse effects. It is crucial for postoperative rehabilitation and should be encouraged.

Objective::To determine the role of regular diet recovery after restoration of normal muscle strength of both lower extremities in promoting postoperative recovery in women undergoing elective cesarean section.Methods::This was a prospective observational cohort study. Patients who underwent elective cesarean section at Xiangya Hospital, Central South University, from October 2022 to December 2022, were categorized into two groups based on the duration of postoperative fasting: the observation group resumed eating after regaining lower extremity muscle strength, while the control group adhered to traditional postoperative fasting guidelines, waiting 6 hours before eating. Primary outcomes included postoperative pain levels assessed by visual analog scale (VAS) pain scores and time to first flatus. Demographic characteristics, time to first lactation, hospital stay length, and patient satisfaction were also assessed. Statistical analysis was conducted using Student’s t test and Chi-squared test, with significance set at P < 0.05. Results::Out of a total of 300 patients, 240 were included in the analysis, comprising 112 in the control group and 128 in the observation group. There were no significant differences in baseline demographic characteristics. The median values of the first flatus time and the first lactation time were 33.37 ± 1.22 vs. 18.06 ± 6.34 hours ( P = 0.003) and 26.34 ± 8.21 vs. 7.05 ± 1.26 hours ( P = 0.001) in the control and observation groups, respectively. The median hospital stay duration in the control and observation groups was 6.54 ± 0.53 vs. 4.84 ± 0.18 days ( P = 0.000), respectively. Median postoperative VAS pain scores and patient satisfaction values were 8.57 ± 0.11 vs. 4.91 ± 0.27 ( P = 0.000) and 9.36 ± 0.16 vs. 9.72 ± 0.08 ( P = 0.005) in the control and observation groups, respectively. There were no statistically significant differences in other postoperative outcomes, such as intestinal obstruction, infection, and readmission within 42 days ( P > 0.05). Conclusion::Food intake after restoration of lower extremity muscle strength improves first flatus, relieves postoperative pain, shortens hospital stay, and enhances satisfaction after elective cesarean section, without adverse effects. It is crucial for postoperative rehabilitation and should be encouraged.

Placental and maternal-fetal circulation Doppler ultrasound are the main noninvasive means for maternal-fetal monitoring. However, Doppler studies on placental abnormalities are not well studied yet. Doppler monitoring of the maternal-fetal circulation, involving uterine arteries, umbilical arteries, and fetal vessels, is still used to screen diseases related to placental dysfunction (such as preeclampsia and fetal growth restriction) and to guide clinical management. This article reviews the advances in the clinical application of placental and maternal-fetal circulation Doppler in obstetrics to optimize the clinical management of disorders associated with abnormal placental structure and function.