Angioplasty and stenting for intractable pulsatile tinnitus caused by dural venous sinus stenosis: a case series report.

OBJECTIVE: Pulsatile tinnitus caused by dural venous sinus (DVS) stenosis is a newly identified form of tinnitus. Its persistent nature can severely affect patients' sleep and quality of life, leading to depression in severe cases. The aim of this report is to investigate the efficacy and safety of angioplasty and stenting in treating this form of tinnitus. STUDY DESIGN: Retrospective review. SETTING: Chinese PLA General Hospital. METHODS: Clinical data of 46 cases of pulsatile tinnitus caused by DVS stenosis treated between December 2009 and October 2012 using angioplasty and stenting were reviewed. Diagnosis of DVS abnormality was confirmed in all cases using digital subtraction angiography (DSA). Among these cases, stenosis was located in the transverse-sigmoid sinuses junction area ipsilateral to tinnitus in 44 cases and on both sides in the remaining 2 cases. Stenosis was treated with angioplasty and stenting in all cases. RESULTS: Pulsatile tinnitus disappeared immediately after the procedure in all 46 cases. There was no procedure-related complication. During the 2 to 36 months' follow-up, there was no recurrence. CONCLUSION: These results indicate that DVS stenosis is the cause of pulsatile tinnitus in these cases and that angioplasty and stenting are an effective and safe treatment for intractable pulsatile tinnitus caused by DVS stenosis.

Treatment effect of different dialysis modalities on pruritus in elderly maintenance hemodialysis patients / 中华老年医学杂志

Objective To study the effect of different dialysis modalities on pruritus in elderly maintenance hemodialysis patients.Methods Totally 51 patients were randomly divided into hemoperfusion combined with hemodialysis group (HD+ HP),hemodiafiltration group (HDF) and hemodialysis group (HD).Plasma β2-microglobulin(β2-MG) and intact parathyroid hormone (iPTH) were measured by means of radio immunoassay at pre and post dialysis,4 weeks and 8 weeks after dialysis,cutaneous pruritus was scored.The remission rate of itching was calculated at 8 weeks after dialysis.The parameters were compared among different groups.Results The level of plasma β2-MG was lower in HD+HP group after dialysis than pre dialysis [(13.48±3.05)mg/L vs.(16.27±4.73) mg/L,t＝2.044,P＜0.05],at 4 weeks and 8 weeks after dialysis,its levels were decreased to (10.97±3.25)mg/L(t＝3.808,P＝0.002)and (6.47±2.35)mg/L(t＝7.650,P＝0.000),respectively.The levels of iPTH were also found decrease from(887.5 ± 242.7)ng/L to (688.3 ±223.4)ng/L(t＝3.384,P＝0.004)at 4 weeks and (467.2±102.5) ng/L(t＝6.578,P＝0.000) at 8weeks after dialysis in HD+HP group (all P＜0.01).There were differences of the levels of plasma β2-MG and iPTH at 4 weeks and 8 weeks after dialysis in HDF group (all P＜ 0.05),but no differences of the levels of plasma β2-MG and iPTH during every period were found in HD group(all P＞0.05).The scores of cutaneous pruritus were decreased from (21.17± 5.01) scores to (13.37±2.85) scores(t＝ 5.580,P＝0.000)at 4 weeks and (8.52±4.38) scores(t＝7.838,P＝0.000)at 8 weeks after dialysis in HD+ HP group,and also the scores at 4 and 8 weeks after dialysis in HDF group (all P＜0.01),but there were no significant differences of the scores during every period in HD group (all P＞0.05).The remission rate of itching was better in HD+ HP group than in HDF group [88.24％ (15/17 cases) vs.58.82％ (10/17 cases),x2＝14.44,P＝0.000],better in HDF group than in HD group 23.53％ (4/17 cases) (x2 ＝4.37,P＝0.037).Conclusions HD+HP is superior to HDF in efficiently clear β2-MG and iPTH,and relief cutaneous pruritus,but HD can poorly clear β2-MG and iPTH or relief itching.

The establishment of hemodialysis access with long-term venous indwelling catheter under DSA guidance / 介入放射学杂志

Objective To discuss the management, complication and effectiveness of establishing a prolonged hemodialysis access with a long-term venous indwelling catheter. Methods During the penod of July 2007-February 2009, a total of 64 long-term venous indwelling catheters for hemodialysis were placed in 62 patients with terminal chronic renal insufficiency. Results Of the total 64 catheter-placements, 62 were pereformed under DSA guidance and 2 at bed-side. Because of blocked flow, adjustment of the catheter was carried out in 4 cases, replacement of catheter in 2 cases and thrombolytic therapy in one case. In 62 patients, the arterial flow rate after the procedure reached to 230-300ml/min. In 57 cases the indwelling catheter remained in working condition so far. Five cases died within 6 months. Conclusion For establishing a prolonged hemodialysis access. The placement of a long-term venous indwelling catheter is feasible. The main complication is the blocked flow. Which is mainly related to the disposition of the catheter itself or its tip. The right intemal jugular vein is the indwelling site of choice, the tip of double-lumen catheter should be within the superior vein cava. With the help of DSA guidance, the procedure can be performed accurately, safely and easily.

Meta-analysis of fish oil in the treatment of IgA nephropathy / 中华肾脏病杂志

Objective To assess the efficacy of fish oil in the treatment of IgA nephropathy using the method of Meta-analysis. Methods Randomized controlled trials of fish oil in the treatment of IgA nephropathy were searched in the database of Cochrane library,PubMed, EMBASE and CNKI. Data extracted from the literatures were analyzed with Revman software (version 5.0). Results In comparison with the controlled group, proteinuria in the fish oil group was significantly decreased [SMD=-0.27, 95%CI (-0.52 to -0.03), P=0.03], while the renal function deteriorated [SMD=0.30,95%CI(0.05 to 0.55), P=0.02]. Conclusion Fish oil can decrease the proteinuria of IgA nephropathy, but can not prevent renal function from deterioration.

The assessment of diease progress in chronic kidney diease / 中国实用内科杂志

Objective To assess the value of serum creatinine(Scr),serum ?_2-microglobulin(?_2-MG),glomerular filtration rate(GFR),proteinuria index,and Cystatin C(Cys C)to detect impairing of expressing of diease in patients with chronic kidney disease.Methods Peripheral blood was collected from 54 chronic kidney diease:Scr was analyzed using RXL fully automated biochemistry assay instrument,then GFR was calculated;Cys C was measured using particle-enhanced nephelometric immunoassay(PENIA);?_2-MG was measured using chemiluminescent method,proteinuria index was measured by the product of duration and amount of proteinuria,nephropathological progress was measured using the degree of glomerular mesangial proliferation and the dgree of tubulointerstitial fibrosis.Results The level of serum Cys C,Scr,serum ?_2-MG,proteinuria index,and GFR of the CKD patients was correlated with nephropathological progressing.Conclusion In patients with chronic kidney disease serum creatinine,serum ?_2-micro-globulin,glomerular filtration rate,proteinuria index,and Cystatin C are markers of progessing of kidney disease.The sensitivity and correlation of GFR and serum Cys C are higher than others.