Objective To explore indications, ablated targets, efficacy and complications of microelectrode-guided thalamotomy and pallidotomy for treating Parkinson's disease(PD). Methods The clinical date of 225 PD patients underwent microelectrode guided thalamotomy and/or pallidotomg were retrospectively analyzed with UPDRS scores. Results The outcome of operation was excellent.The rate of improvement for tremor, rigidity, gait, balance and bradykinesia were 98 0%, 89 0%, 72 8%, 70 5% and 47 8% respectively. Postoperative motor UPDRS scores of both "on"/"off"states significantly decreased by 54 4% and 62 6% respectively. The frequency of post-operative complications was such as the following: bleeding caused by puncturing (0 48%),transient hiccup(6 7%), temporary dysarthria(5 5%), transient somnolence(10 0%) and mental disorder(4 5%). There were no severe and permanent complications. Conclusions The thalamotomy and/or pallidotomy guided by the microelectrode were the effective and safe method for treatment of PD, but the indications of this surgery should be well familiarize. The ablated target selection and its precise localization were of key importance for a better outcome.

Objective To investigate the changes in myocardial deformation in donor and reeipient hearts in response to selective fetoscopic laser photocoagulation (SFLP) for twin-twin transfusion syndrome (TTTS).Methods Totally 25 twin pairs before 24-hour and 1 week after SFLP had fetal echocardiography and digital dynamic two-dimensional four chamber views which were interrogated off-line using velocity vector imaging (VVI) software.Global longitudinal strain (S),systolic strain rate (SRs) and diastolic strain rate (SRd) were measured off-line in the left (LV) and right (RV) ventricles.Results In the donor,SFLP resulted in increase in cardiothoracic ratio ( CTR,0.29 ± 0.03 versus 0.34 ± 0.05,P ＜ 0.01 ),with development of new onset tricupid regurgitation ( n =7 ) and pericardial effusion ( n =5 ) and worsening of all measures of myocardial deformation in both systole and diastole for LV and RV [ LV-S:( - 19.24 ± 3.68 )％ versus (-13.78±3.64)％,P＜0.01; LV-SRs:(-2.28±0.53) versus (-1.43 ±0.41) s-1,P＜ 0.01 ; LV-SRd:( 1.67 ± 0.43 ) versus ( 1.15 ± 0.70) s - 1,P ＜ 0.01 ; RV-S:( - 20.20 ± 3.19) ％ versus (-16.10±3.07)％,P＜0.01; RV-SRs:(-2.03 ±0.65) versus (-1.72±0.38) s-1,P＜0.05; RV-SRd:( 1.71 ±0.30) versus ( 1.50 ±0.36) s-1,P ＜0.05].In the recipient,CTR decreased (0.42 ± 0.04 versus 0.37 ±0.04,P ＜0.01 ) and all parameters for both LV and RV improved substantially [ LV-S:( - 10.62 ± 2.72) ％ versus ( - 16.46 ± 3.23 ) ％,LV-SRs:( - 1.09 ± 0.30) versus ( - 1.60 ± 0.31 ) s-1,LV-SRd:(0.99 ± 0.34) versus (1.53 ± 0.32) s-1,RV-S:( - 11.66 ± 4.56)％ versus ( - 17.96 ± 3.97 ) ％,RV-SRs:( - 1.26 ± 0.39) versus ( - 1.74 ± 0.45 ) s-1,RV-SRd:( 1.15 ± 0.49) versus ( 1.63 ± 0.44 ) s- 1 ; all P ＜ 0.01 ].Conclusion Myocardial deformational mechanics improve in the recipient but worsen in the donor following SFLP for TTTS.

Objective To assess the left ventricular(LV)segmental function by velocity vector imaging(VVI)in uremic patients with diffferent quantity of parathyroid hormone(PTH).Methods Sixty patients with uremia were divided into 2 groups according to the value of PTH:group A with PTH less than 3 times of upper normal limit,group B with PTH more than 3 times of upper normal limit.Normal control group was 30 healthy subj ects.All people were evaluated by VVI.The parameters,including the longitudinal systolic strain rate(SSR),diastolic strain rate(DSR),were analysed among the three groups.Results Compared with normal group,in group A and B,SSR,DSR in all segments were lower.Compared with group A,in group B,DSR were all significantly lower(P＜0.05),SSR in apex of laternal wall,medium of anterior septum wall,posterior wall,medium and apex of posterior septum wall and superior wall,base,medium and apex of anterior wall were significantly lower(P＜0.05).There was no statistically significant difference of left ventricular ejection fraction between the two groups(P＞0.05).Conclusions VVI is a viable objective tool to quantitatively assess LV segmental function damaged by different quantity of PTH.

Objective To investigate the differences in myocardial deformation between donor and recipient in twin-twin transfusion syndrome(TTTS) using vector velocity imaging( VVI). Methods Digital dynamic two-dimensional four chamber views were interrogated off-line using VVI software. Global longitudinal strain(S) , systolic strain rate(SRs) and diastolic strain rate(SRd) were measured in the left ventricles(LV) and right ventricles (RV) of 30 fetal pairs with TTTS and compared to 30 gestational age-matched normal controls. Results Donor LV-SRs was higher, while donor RV-SRd was significantly lower than controls. Recipient S, SRs and SRd were significantly lower for both LV and RV in comparison to controls. Conclusions In TTTS,donor LV systolic function is hyperdynamic while the RV diastolic function is low. Recipient RV and LV are both globally depressed with systolic and diastolic dysfunction.

Objective To evaluate regional right ventricular longitudinal function in fetus using velocity vector imaging(VVI),and establish nomogram of right ventricle,Methods One hundreed and seventy healthy fetuses were divided into 5 groups according to the gestational age.Dynamic digital views of four chamber view were collected and analyzed offline.Velocity,strain and strain rate were calculated in systolic and diastolic period,respectively.Results Normal systolic and diastolic values for velocity,strain and strain rate were established.Tissue velocity gradually decreased from the base segment to the apical segment(P＜0.05),whereas strain and strain rate were stable(P＞0.05).Tissue velocity was gestationalage dependent(P＜0.05),whereas strain and strain rate were stable throughout gestation (P＞0.05).Conclusions Fetal myocardial velocity,strain and strain rate measurements are easy to obtain and reproducible.Increase in tissue velocity throughout gestation probably reflects the growth of the fetal heart,whereas intrinsic myocardial properties as measured by strain and strain rate do not change.

Objective To investigate global cerebral blood flow perfusion in fetuses with congenital heart disease (CHD)by three-dimensional power Doppler ultrasound (3D PD).Methods The vascular index (VI),flow index (FI)and vascular/flow index (VFI)in the global cerebral were prospectively compared in 1 12 fetuses with CHD and 1 12 normal fetuses using 3D PD.Correlations between the 3D PD indices and neurodevelopment scores were assessed.Results Compared with the controls,the VI,FI and VFI of the global brain were significantly increased in fetuses with hypoplastic left heart syndrome (HLHS) and left sided obstructive lesions (LSOLs)(P <0.001).The mean psychomotor development index (PDI) and mental development index (MDI)scores were significantly lower than normal (P < 0.001 ).FI was positively correlated with PDI (r =0.342,P =0.029)and MDI (r =0.339,P =0.030).Conclusions Global cerebral blood flow perfusion was significantly increased in most fetuses with CHD and had association with neurodevelopment scores.3D PD ultrasound might help to identify cases of brain vasodilatation earlier and inform parental counseling.

Objective To investigate the clinical significance of velocity vector imaging(VVI)in evaluating the left ventricular(LV)segmental longitudinal systolic function in patients with coronary artery disease(CAD).Methods In 25 patients with myocardial ischemia,28 patients with myocardial infarction,26 patients with coronary lumen stenosis＜50%,according to coronary arteriography and electrocardiogram,the myocardial segments of LV were divided into 4 groups:ischemic segments group,infarcted segments group,non-ischemic segments group and normal segments group.Twenty-eight healthy subjects were selected as control group.Dynamic imaging of all subjects were collected,the systolic peak strain(Smax)and strain rate(SRmax),the time to peak strain(PTs)and the time to peak strain rate(PTsr)were measured respectively.Results Smax and SRmax of the ischemic segments and infracted segments were significantly lower than those of the control group respectively,PTs and PTsr of the ischemic segments and infracted segments were significantly longer than those of the control group respectively.Smax and SRmax of infarcted segments were significantly lower than those of the ischemic segments,there were no differences of PTs and PTsr between ischemic segments and infracted segments.Smax and SRmax cutoff of -14.08%,-0.83 s-1 for detecting ischemic segments and cutoff of -6.65%,-0.38 s-1 for detecting infracted segments,respectively,gave an optimal sensitivity and specificity.Conclusions VVI is a kind of novel noninvasive-tool to quantitatively assess LV regional systolic function in CAD patients.It is competent to differentiate between the ischemic segments and infarcted segments.

Objective To investigate the clinical value of VVI assessment normal fetal segmental myocardial performance and to establish a nomogram of normal fetus.Methods Digital dynamic fourchamber imaging of 151 healthy fetus(divided 5 groups according to gestation)were collected,then the longitudinal velocity,strain and strain rate of interventricular septal and left lateral wall were measured in systolic and diastolic period respectively.Results Normal systolic and diastolic values for tissue velocitv.strain,and strain rate were established.Tissue velocity was age dependent,whereas strain and strain rate were stable throughout gestation(P＞0.05).Tissue velocity was gradually decreased from the base segment to the apical segment(P＜0.01),whereas strain and strain rate were stable among all segments in every group(P＞0.05).Conclusions Fetal myocardial velocity,strain,and strain rate measuraments are easy to obtain and reproducible,VVI is a novel noninvasive tool to assess quantitatively and objectivelv regional systolic and diastolic function in fetal heart,it is providing another useful modality for evaluating cardiac function.

Objective To investigate the clinical value of velocity vector imaging in the assessment of regional left ventricular longitudinal myocardial function in fetuses with gestational diabetes mellitus (GDM). Methods Digital dynamic four-chamber views of 98 fetuses with GDM and 135 normal fetuses were collected and analyzed using velocity vector imaging. The regional tissue velocity, strain and strain rate of the interventricular septum and left lateral wall were measured in systole and diastole. Results Two hundred and seven of 233 cases were analyzed successfully. Systolic velocity(Vs) and diastolic velocity(Vd)were age-dependent, Vs and Vd were both gradually decreased from the basal segment to the apical segment in the left ventricle( P ＜0. 05). The Va after 32+0 weeks and Vd after 28+0 weeks and systolic strain(S),systolic strain rate(SRs) and diastolic strain rate(SRd) in left ventricle of fetuses with GDM after 24+0weeks were obviously lower than the corresponding parameters of normal fetuses ( P ＜0. 05). Conclusions Velocity vector imaging can evaluate the fetal regional left ventricular longitudinal myocardial function.