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Background: This study aims to investigate the impact and safety of combining maternal voice stimulation with gravity feeding on low-birth-weight preterm infants. The research focuses on key outcomes such as gastric tube indwelling time, feeding transition time, adequate gastrointestinal nutrition time, recovery of birth weight time, length of hospital stay, and oral motor function in preterm infants. Methods: A total of 150 low birth weight preterm infants meeting inclusion criteria were recruited from the neonatal care unit and randomly assigned to three groups: traditional nasal feeding, gravity feeding with a homemade bracket, and a combined group receiving both gravity feeding and maternal voice stimulation. The groups were compared using parameters such as feeding intolerance incidence, gastric tube indwelling time, feeding transition time, adequate gastrointestinal nutrition time, recovery of birth weight time, hospital stay, and oral motor function. Results: The combined group exhibited a significantly lower incidence of feeding intolerance (26% lower than traditional nasal feeding, 18% lower than gravity feeding, P < .001). The traditional nasal feeding group had the highest incidence at 62%. The combined group showed a shorter indwelling time (19.01 ± 11.67 days), compared to the gravity feeding group (23.50 ± 13.04 days) and the traditional nasogastric feeding group (27.43 ± 11.91 days, P = .001). The combined group had a shorter hospital stay (27.09 ± 14.16 days) compared to the gravity feeding group (32.74 ± 13.32 days) and the traditional nasogastric feeding group (33.84 ± 12.42 days, P = .013). The combined group demonstrated a slightly longer recovery time (11.56 ± 4.08 days) than the gravity feeding group (11.14 ± 4.76 days) but significantly shorter than the traditional nasogastric feeding group (14.44 ± 5.42 days, P = .003). The combined group exhibited the highest improvement in oral motor function at 4 weeks after feeding (17.81 ± 0.39 points), surpassing both the gravity feeding group (16.10 ± 0.23 points) and the traditional nasogastric feeding group (15.15 ± 0.07 points, P < .001). The combined group demonstrated a significantly lower feeding transition time than the traditional nasal feeding group (P < .05) and comparable time to the gravity feeding group (P > .05). All the comparison results were statistically significant. Conclusion: Maternal voice stimulation combined with gravity feeding shows promising positive effects and high safety for low-birth-weight preterm infants. The combined approach outperformed both gravity feeding alone and traditional nasogastric feeding across various critical parameters. These findings support the potential clinical applicability and merit further consideration for wider implementation as a feeding method in neonatal care settings. Clinical Significance: The observed reductions in feeding intolerance, shortened gastric tube indwelling time, and enhanced oral motor function in low-birth-weight preterm infants receiving combined maternal voice stimulation and gravity feeding highlight a promising clinical approach. These improvements signify the potential for earlier oral feeding initiation, shorter hospital stays, and better overall outcomes in the care of these vulnerable infants. Limitations: This study is limited by its single-center design, potential selection bias, and the absence of blinding. Uncontrolled confounding factors may influence results, and long-term outcomes were not assessed. Implications for Practice: Healthcare professionals should cautiously consider the observed benefits of combining maternal voice stimulation with gravity feeding, recognizing the study's limitations. Further research is warranted to validate these findings and explore long-term implications for the care of low-birth-weight preterm infants.
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BACKGROUND: Diabetes mellitus-induced erectile dysfunction is a common diabetic complication, and new therapeutics and the pathogenesis of diabetes mellitus-induced erectile dysfunction need to be investigated. OBJECTIVES: The aim was to investigate the pathogenesis of diabetes mellitus-induced erectile dysfunction and the pharmacological mechanism of simvastatin treatment in diabetes mellitus-induced erectile dysfunction model rats. MATERIALS AND METHODS: A total of 86 male Sprague Dawley rats aged 8 weeks old were used in this study. The rats were divided into three groups: control (normal), diabetes mellitus-induced erectile dysfunction (streptozotocin-injected), and diabetes mellitus-induced erectile dysfunction + simvastatin (sim). Each group was subdivided into two subgroups for in vitro and in vivo analyses. A bioinformatics method was used to detect differences in gene expression in the corpus cavernosum between normal and diabetes mellitus-induced erectile dysfunction rats. Erectile function was measured by a cavernous nerve electrostimulation test. Corpus cavernosum fibrosis was assessed by Masson staining and Western blotting. Immunofluorescence and Western blotting were performed to explore the differential expression of autophagy-related genes and the AMPK-SKP2-CARM1 pathway genes in rat cavernous smooth muscle cells and the corpus cavernosum. The autophagosomes of the corpus cavernosum tissue were observed by transmission electron microscopy. RESULTS: Autophagy-related genes and pathways (the AMPK and FoxO pathway) were identified by bioinformatics analysis and confirmed at the protein level. Simvastatin, an AMPK agonist, was used to treat diabetes mellitus-induced erectile dysfunction rats for 8 weeks, demonstrating that erectile function was improved for 80.5% (P < .05) of rats. Corpus cavernosum fibrosis was alleviated (P < .05), and autophagy was further enhanced (P < .05); these results might be partially caused by AMPK-SKP2-CARM1 pathway activation (P < .05). DISCUSSION AND CONCLUSION: Simvastatin could enhance protective autophagy by activating the AMPK-SKP2-CARM1 pathway to improve erectile function in diabetes mellitus-induced erectile dysfunction rats.