Objective　 To probe into the operative methods, effects and reasons of failure for retinal detachment with choroid detachment.Methods　Thirty-one cases (31 eyes) with choroid detachment and proliferative vitreous retinopathy (PVR) were given vitreoretinal surgery, stripping of pre-membrane and injection of inert gas or silicone oil into vitreous body. Results　The retina was totally reattached in 22 cases (22 eyes), partly reattached in 5 cases (5 eyes),unattached in 4 cases (4 eyes),which was accounted for 70.9%,16.1% and 12.9% in 31 cases (31 eyes) respectively. Visual acuity improved in 25 eyes and no change in 5 eyes and decreased in 1 eye. The main cause of operation failure was possibly related to the severe anterior PVR. Conclusion　Vitreoretinal surgery can improve the successful rate of retinal detachment with choroid detachment.

Objective:To explore the effects of double circumferential fibrotomy(CF)in the improvement of periodontal attachment of the teeth with periodontal disease.Methods:22 migrated incisors of 4 adults were randomly assigned to one-time CF group (T1 )and double CF group(T2)by center line.Periapical intraoral radiographic examination was performed using paralleling technique at pre-and post-leveling-alignment stage of the teeth.Root length,crown-root ratio and the distance of CEJ-AC were measured.The periodontal in-dicators were also recorded during the orthodontic treatment.Data were statistically analysed by comparative t-test.Results:CEJ-AC and crown root ratio reduction was greater in T2 group than those in T1 group(P <0.01 ),but the periodontal indices did not show sig-nificant difference between the 2 groups(P >0.05).Conclusion:Double circumferential fibrotomy can improve periodontal attachment, reasonable orthodontic force does not lead to remarkable root resorption of the periodontitis inflicted teeth.

In accordance with students' learning needs and future professional development, individualized practices of formative assessment are analyzed in terms of diverse evaluators, accumula-tive learning contents, after-class tutoring, thus to maximize student's learning potentials, to be capa-bility-oriented, to make students highly qualified and competent for their future clinical position and academically developed. Additionally, the assessing competence of teachers is vital to the successful implementation of formative assessment. Importantly, each medical university can explore further into the practice of formative evaluation, based on the orientation of itself.

Based on the educational structure theory, the difference between mass education and elite education is probed at the macroscopic level to make it clear that the essence of Physician education and training program of excellence is elite education for occupational purposes; at the mi-croscopic level the orientation of English teaching for the class ofexcellent physicians is determined as English for occupational purposes. Moreover, the curriculum system of medical English is designed, and teaching materials associated with clinical medicine are selected, the language laboratory simulat-ing hospital scenes is constructed, and the transboundary team of teachers is built comprising university teachers and doctors in hospitals. At the level of individual, the competency model of English forexcellent physicianshas been developed, English competence requirements in medical industry being clearly established . In a word , the study of macrostructure points out the direction and target of English teaching for excellent physicians; the study of microstructure perfects the mode of English teaching forexcellent physicians;and the study of individual structure indicates the ultimate foothold of English education forexcellent physicians. Three aspects are integrated into an organic whole.

Objective To observe the effects of melatonin on synaptic plasticity impaired by spinal cord injury in rats. Methods A total of 54 female Sprague-Dawley rats were divided into sham group (n=18), control group (n=18) and melatonin group (n=18). Spinal cord inju-ry model was established with modified Allen's method at T10 (10 g from 25 mm height). The number of neurons and the expression of the Nissl body were detected with immunofluorescence and Nissl staining. The expression of neurofilament-200 (NF-200), brain-derived neuro-trophic factors (BDNF), Synapsin I and growth-associated protein-43 (GAP-43) was detected with Western blotting. Results Seven days af-ter injury, the number of motoneurons, the expression of Nissl body in motoneurons, and the expression of BDNF, Synapsin I and GAP-43 decreased in the control group compared with those in the sham group, and they increased in the melatonin group compared with those in the control group. Conclusion Melatonin can repair the impaired synaptic plasticity, which might promote the functional recovery after spi-nal cord injury.

Innovation of cultivation mode and concepts for medical English should be suited to the requirements of making university academically outstanding by its individualized school-running,requirements of strengthening distinguished majors as well as needs for qualified medical English graduates.Through combining undergraduate tutorial system of lower grades with undergraduate tutorial system of higher grades,continuing implementing concepts of team cooperation,strengthening holistic education concept and guiding the development of students' individual personality and academic study based on stages,tutors and tutorial team can play their central roles in the training and molding of qualified medical English undergraduates,ultimately realizing the unity of process cultivation and objective cultivation.

Background Neovascular glaucoma (NVG) is secondary to retinal ischemia and hypoxia.Iris fluorescein angiography (IFA) can be used for early detection of NVG,but it can not reflect the condition of retinal blood vessels comprehensively.IFA combined with fundus fluorescein angiography (FFA) can detect the condition of retina and iris neovascularization comprehensively,but its application on diabetic retinopathy(DR) with NVG was rare in China.Objective This study was to evaluate the clinical application of IFA combined with FFA in proliferative diabetic retinopathy (PDR) patients with NVG.Methods A retrospectively study was designed.One hundred and thirty-three eyes with PDR were enrolled in Henan Eye Hospital from February 2013 to January 2016,including 100 eyes with no iris diseases,21 eyes with rubeosis iridis,and 12 eyes with NVG.All eyes underwent ophthalmic examinations that included best-corrected visual acuity,intraocular pressure,slit lamp,IFA and FFA.The differences of IFA examination and slit lamp examination in the eyes with rubeosis iridis were compared and statistical analyzed by McNemar nonparametric test.Results In this study,100 eyes with no iris leakage were identified by IFA,32 eyes with panretinal photocoagulation (PRP) treatment history had no retinal neovascularization and 68 eyes had retinal neovascularization;21 rubeosis iridis eyes with iris leakage at pupillary border or on iris surface were observed at the early stage of IFA,and all the eyes were identified having retinal neovascularization according to FFA images;12 NVG eyes were observed having iris neovascular leakage on iris surface at the early stage of IFA,and all the eyes were identified having retinal neovascularization according to FFA images.The detection rate of IFA examination on rubeosis iridis was 100％ (21/21),which was higher than 71.43％ (15/21) of slit lamp examination,and there was a significant difference between the two detection methods (P =0.03).Conclusions IFA combined with FFA can detect PDR with rubeosis iridis early,and it is helpful to guide the treatment timely.

Objective To explore the characteristics of defense mechanism in patients with obsessive-compulsive disorder(OCD).Methods Outpatients diagnosed as OCD were tested by Yale-Brown obsessive Compulsive Scale. Among them, 40 patients with score beyond or equal to 16 were selected as research group. 33 healthy individuals were selected as normal group. They were tested with Defense Style Questionnaire.Results ①The factor score of immature defense mechanisms in the OCD group is much higher than that in the normal group (P<0.01); the factor score of mature defense mechanisms in the OCD group is lower than that in the normal group (P<0.05); the factor score of middle defense mechanisms in the OCD group is much higher than that in the normal group (P<0.01). ②Passive aggression, acting out, splitting, regression, somatization in the immature defense mechanisms and relief, false altruism, isolation in the middle defense mechanisms are much more used by the OCD group than that in the normal group; but suppression and humor in the mature defense mechanisms are less used by the OCD group than that of the normal group(P<0.05 or P<0.01). ③Sublimation, suppression and consuming tendency are much more used in male patients than female ones in OCD group(P<0.05).Conclusion The patients with OCD tend to use the immature defense mechanisms and middle defense mechanisms, and there is some difference between male and female patients in using defense mechanisms.

Background It is thought in recently that photodynamic therapy (PDT) is an effective treatment method for chronic central serous chorioretinopathy (CSC), but the dosage of verteporfin and its long-term efficacy and complications is rarely elucidated ever before.Objective This study was to observe the long-term efficacy and safety of 60％ dose verteporfin PDT for chronic CSC.Methods This is a retrospective study and a self-controlled design was used.The clinical data of 25 eyes of 21 chronic CSC patients who received 60％-dose verteporfin PDT in Henan Eye Institute from January 2009 to May 2010 were reviewed, with the male 18 (85.71％) and female 3 (14.29％) as well as monocular CSC 17 patients and binocular CSC 4 patients.The average ages of the patients were (43±5) years.Fundus fluorescein angiography (FFA) , indocyanine green angiography (ICGA), optical coherence tomography(OCT) and best corrected visual acuity (BCVA) were examined in all the patients before and after treatment.PDT with the 60％-dose verteporfin (3.6 mg/m2) was carried out on the CSC eyes.The treated eyes were examined 2 weeks, 1 month and 3 months after PDT.The BCVA,subfoveal choroid thickness,FFA and ICGA findings before and after PDT were compared.The following-up duration was 5 years or more.Results The BCVA before and 3 months after PDT were 0.5 ±0.1 and 0.9±0.2, respectively, with a statistically significant difference between them (t =19.17,P =0.00).The subfoveal choroidal thickness value 3 months after PDT was (326.56±39.47) μm,which was significantly reduced in comparison with (486.24 ±47.53) μm before PDT (t =25.17, P =0.00).FFA and ICGA showed that the leakage of fluorescein (hyperfluorescence) was disappeared in all the treated eyes.No systemic or local adverse effects and recurrence were observed during the follow-up period.Conclusions On the basis of the results of this study and available information,60％-dose verteporfin PDT seems to have a better long-term efficacy and safety than full-dose verteporfin in treating chronic CSC.

Objective To investigate effect of early enteral nutrition supplemented with probiotics on gastrointestinal motility disturbance and nutritional status in patients with severe craniocerebral trauma.Methods Forty patients with severe craniocerebral trauma were randomized into study group (18patients) and control group (22 patients).Patients of both groups received enteral nutrition via nasogastric tube at 24-72 hours after admission,but the patients of study group were also supplemented with probiotics simultaneously.Rate of abdominal distention,vomiting,gastro-oesophageal reflux,gastric retention,constipation and diarrhea were recorded during the whole study.Time to first defecation and time to targeted nutritional goals were also recorded.Prealbumin and transferrin in serum were detected at days 0,4,7,and 15 after the beginning of enteral nutrition.Length of ICU stay was compared between groups.Results There were no significant differences of the two groups in terms of rate of abdominal distention,vomiting,gastric retention and diarrhea.However,less gastro-oesophageal reflux or constipation patients were observed in study group,as compared with control group (P ＜ 0.05).Time to first defecation and time to targeted nutritional goals were shorter in study group,as compared with control group (P ＜ 0.05).Levels of prealbumin and transferrin had no significant differences between the two groups at days 0,4,and 7,but study group showed both were higher than control group at day 15 (P＜0.05).Moreover,length of ICU stay showed no significant difference between the two groups.Conclusions Compared with simple enteral nutrition,early enteral nutrition with probiotics improves gastrointestinal motility,facilitates the delivery of enteral nutrition,and further ameliorates nutritional status in patients with severe craniocerebral trauma.