Acute kidney injury (AKI) has a negative impact on long-term renal function and prognosis. However, the association between acute renal dysfunction and long-term effects on bone disorders has not yet been characterized. Using a population-based cohort study, we aimed to evaluate associations between AKI and long-term effects on bone fractures. We identified relevant data of all hospitalized patients aged >18 years with histories of dialysis-requiring AKI, with subsequent recovery and discharge, from the claim records of the Taiwan National Health Insurance database between 2000 and 2008. We determined long-term de novo bone fracture and all-cause mortality after patients' index-hospitalization discharge using propensity score-adjusted Cox proportional hazard model. Varyingtime models were used to adjust for long-term effects of end-stage renal disease (ESRD) on main outcomes. Among 448 AKI patients who had dialysis and survived 90 days after index-hospitalization discharge without reentering dialysis, 273 were male (60.9%) with a mean age of 61.4 AE 16.6 years. Controls included 1792 hospitalized patients without AKI, dialysis, or bone fracture history. In the AKI recovery group, bone fracture incidence was 320 per 10,000 person-years and hazard ratio (HR) of long-term bone fracture was 1.25 (p ¼ 0.049) compared with the control group, independent of subsequent ESRD status (HR ¼ 1.55; p ¼ 0.01). Both AKI recovery status (HR ¼ 2.31; p < 0.001) and time varying factor of bone fracture (HR ¼ 1.43; p < 0.001) were independent predictors of mortality compared with controls. In conclusion, AKI requiring temporary dialysis independently increases long-term risk of bone fracture, regardless of subsequent progression to ESRD. Long-term bone fractures may negatively impact patient mortality.

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tVNOTEH can be safely performed for large and nonprolapsed uterus. Besides, as uterine weight increased, the operative efficiency of tVNOTEH increases compared with LAVH.

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In this study, the effect of mushroom extracellular polysaccharides on fatty acid composition and liver peroxisome proliferator-activated receptor-alpha (PPAR-α) expression in obese-diabetic rats was investigated, and distinguished the association among anti-obesity, hypoglycemic and hypolipidemic properties. Extracellular polysaccharides from three different strains of Pleurotus tuber-regium were extracted and labeled as HP (high-percentage), MP (medium-percentage) and LP (low-percentage). Obese- diabetes (OD) was induced by chronic high-fat diet plus streptozotocin (STZ) injections. Simultaneously to the diet, polysaccharides were orally administered to OD groups (20 mg/kg body weight/8-week), and categorized into OD+HP, OD+MP and OD+LP groups (n = 10/group), respectively. High-fat diet plus STZ-induced hyperglycemia was prominently attenuated by polysaccharides. Increased fatty acid component n-6/n-3 ratio in liver and plasma of obese-diabetic rats was attenuated, while, reduced MUFA/ PUFA and MUFA/SFA ratios were restored (P < 0.01) with polysaccharides treatment. Furthermore, elevated serum total cholesterol, triglycerides and low-density lipoprotein (LDL) concentrations were controlled, and parallel restoration of decreased high-density lipoprotein (HDL) levels were found with polysaccharides supplementation. This hypolipidemic property might be associated with up-regulated liver PPAR-α mRNA expression and protein levels (P < 0.01). These findings concluded that stable fatty acid components and activated PPAR-α by polysaccharides may contribute to its hypoglycemic and hypolipidemic properties. Therefore, P. tuber-regium could be considered as nutritional supplement to treat diabetic complications.

To elucidate the mechanism of stimuli-responsive permeability and to optimize the design, the nanostructure of polymeric composite membranes, developed in our laboratory, was characterized. The membranes were prepared to contain various amounts of stimuli-responsive nanoparticles of poly(N-isopropylacrylamide-co-methacrylic acid), with or without polyelectrolyte coating. Scanning electron microscopy and X-ray photoelectron spectroscopy were used respectively to examine the morphology and surface chemical composition, whereas atomic force microscopy and laser scanning confocal microscopy were employed to characterize the in situ surface and internal structure of the membranes in aqueous media of various pHs. The porous structure was evidenced in the presence of the nanoparticles. The surface content of the nanoparticles increased with increasing particle concentration while the polyelectrolyte coating was nearly undetectable. AFM images revealed that the particles in the membranes shrank with a concomitant increase in pore size as the buffer pH decreased. LSCM results indicated that particles were distributed through the membrane as interconnected clusters.

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