Objective To explore the value of multi-model reconstruction of 16-slice spiral CT in diagnosis of rib fractures.Methods 16-slice spiral CT volumetric scanning was performed in 72 patients with rib fracture proved by clinical,all images were reconstructed in thin slice and transferred into ADW4.1 workstation.Images such as multiplanar reconstruction(MPR),maximum intensity projection(MIP)and volume rendering(VR)were performed,then the reconstructed images of injured ribs were observed and analyzed by two experienced radiologists and compared with radiographs.Results In 72 cases,there were 217 rib fracture and 7 costal cartilage fracture depicted on MSCT.The location and number of fracture and displacement of fracture could be showed clearly on images of multi-model reconstruction.VR images were betten in demonstration of the anatomical structure,MPR images were better to show the minor lesion of rib fracture,MIP was the best imaging method in detecting the costal cartilage fracture,while axial image was the basic CT scanning section.Radiographs revealed 169 rib fractures but no costal cartilage fracture.Conclusion 16-slice spiral CT of multi-model reconstruction is superior to radiography in diagnosis of rib fracture and costal cartilage fracture.But the combinalion of various reconstruction techniques should be acquired.

Objective To analyze the adverse drug reaction of intravitreal conbercept injection for the security of conbercept injection in clinical application.Methods From 2014 to 2016,248 cases of adverse drug reaction caused by intravitreal conbercept injection were monitored by 62 medical institutions from National Center for Adverse Drug Reaction Monitoring China,and analyzed in this study.Results The adverse drug reactions caused by conbercept were mainly observed in the ophthalmology system,skin system,musculoskeletal system and cardiovascular system.The adverse drug reactions mainly occurred in the early stage of injection.Among those patients,the reported treatment results were cured in 126 cases,improved in 120 cases,unchanged in 1 case,unknown in 1 case,and no anyone died.Conclusion It should give a great attention to the serious adverse reaction that caused by conbercept injection,especially for endophthalmitis,retinal detachment and vitreous hemorrhage.The incidence of serious and newly observed adverse drug reaction should be two important portions of post-marketing safety surveillance.Moreover,the quality of adverse drug reaction reports from different medical institutions needs to be improved.Their assessment and management should be enhanced.

Objective To stuay CT findings of adrenal gland trauma(AGT).Methods The CT images of adrenal gland trauma which were found in 1712 patients who had emergency abdominal CT examinations for assessment of blunt force trauma were analyzed restrospectively.Results Among 1712 cases.we identified 29 patients(1.7%)with adrenal gland traumatic lesions.A total of 32 lesions were found.Twenty-six lesions were unilateral(23 right-sided,3 left-sided),and 3 cases were bilateral(6 lesions).Main CT findings were as followed:(1)Adrenal hematomas appeared as discrete round or oval masses expanding the adrenal gland in 22 patients with 25 lesions.The lesions were hyperdense or of homogeneous density in plain scan and did not enhance in three-phase contrast-enhanced dynamic scan.The splayed adrenal limbs around hematoma were enhanced significantly as eurvilinear structures.(2)Mild to moderate uniform swelling of gland was shown in 4 cases.(3)Diffuse irregular hemorrhage obliterating the gland was shown in 3 cases.Contrast extravasation was shown in 1 case,which was active bleeding from the broken adrenal gland proven by operation.Associated CT findings included strand-like hemorrhage of the periadrenal fat and posterior pararenal hemorrhage mimicking thickened diaphragmatic crus.The concurrent injuries of ipsilateral thorax or/and abdomen were found in 25 patients.Conclusion The AGT has typical CT findings.Familiarity with characteristic CT findings of adrenal trauma is essential for the radiologist to avoid misdiagnosis.

Objective To explore the imaging appearances and the value of multi-slice CT (MSCT)with post-processing tech-niques in diagnosis and treatment of lumbar hernia (LH).Methods The imaging and clinical data of 1 6 patients with LH which were confirmed by surgery were analyzed retrospectively.Results In 1 6 patients,1 7 lesions of LH were revealed by MSCT.There were superior lumbar hernias in 13 (76.5%),inferior lumbar hernias in 3 (1 7.6%)and diffuse lumbar hernia in 1 (5.9%).Hernia ring in diameter ranged from 1.5 to 9.3 cm,and the hernia sac size ranged from 1.8 cm×2.4 cm to 1 1.3 cm× 6.2 cm.MSCT showed oval or flask shaped mass of extraperitioneal fat with or without peritoneum and visceral contents protruded through the de-fecting fascia floor into lumbar triangle.Superior lumbar hernia was bounded by the 12th rib superiorly,the erector spine muscle medially and the internal oblique muscle laterally.Inferior lumbar hernia was bounded by latissimus dorsi muscle medially,the ex-ternal oblique muscle laterally and the iliac crest inferiorly.Hernia contents included colon in 3 patients and small bowel in 2 with in-carcerated hernia with small bowel obstruction in 1,and adipose tissue and mesentery in other 12.All patients received surgery treatment,and the appropriate surgical methods were selected according to the MSCT findings.The surgical findings were consistent with MSCT results.No recurrence was found during follow-up.Conclusion LH has characteristic CT manifestations.MSCT volu-metric scanning with post-processing techniques can clearly display the type of LH,the size of abdominal wall defect,hernia contents and their complications.It is helpful for diagnosis of the LH and differentiation from other diseases,which may provide important information for clinical surgery.

OBJECTIVE:To observe the clinical efficacy and safety of cyclocryosurgery,intravitreal injection of conbercept combined with Ahmed glaucoma drainage valve implantation,intravitreal injection of conbercept combined with compound trabeculectomy in the treatment of neovascular glaucoma(NVG). METHODS:A total of 39 NVG patients(40 eyes)selected from Sichuan People's Hospital during Jun. 2014-Aug. 2016 were divided into group A(16 cases,16 eyes),B(13 cases,14 eyes),C (10 cases,10 eyes)according to different treatment methods. Group A received cyclocryosurgery;group B received Ahmed glaucoma drainage valve implantation after given intravitreal injection of Conbercept ophthalmic injection(0.05 mL,for consecutive 7 d);group C received compound trabeculectomy after given intravitreal injection of Conbercept ophthalmic injection (0.05 mL,for consecutive 7 d). The intraocular pressures of 3 groups were observed before and after treatment,and the rate of intraocular pressure control,visual changes and the incidence of complications were observed after treatment. The occurrence of ADR was recorded. RESULTS:Before treatment,there was no statistical significance in intraocular pressure among 3 groups(P>0.05). Seven days,one month,three months and six months after treatment,intraocular pressures of 3 groups were decreased significantly compared to before treatment;intraocular pressure of group B was significantly lower than those of group A and C;group C was significantly lower than group A,with statistical significance(P<0.05). There was no statistical significance in intraocular pressure among 3 groups three and six months after treatment(P>0.05). The rates of intraocular pressure control in 3 groups were 62.5%,85.7% and 70.0% six months after treatment. Vision of 16 eyes in group A kept stable;vision of 3 eyes in group B were improved,that of 1 eye was decreased and those of 10 eyes kept stable;vision of 1 eye in group C was improved, that of 1 eye was decreased,and those of 8 eyes kept stable;there was no statistical significance in rate of intraocular pressure or vision among 3 groups(P>0.05).The incidence of exudation of anterior chamber in group A was significantly higher than group B and C,with statistical significance(P<0.05). There was no statistical significance in the incidence of other complications(P>0.05). Two patients of group A suffered from the increase of blood pressure during the operation,and recovered to normal after symptomatic treatment. No obvious ADR was found in other patients during treatment. CONCLUSIONS:Three kinds of therapy plans can effectively reduce intraocular pressure of NVG patients,and do not influence vision with less adverse reactions. Intravitreal injection of conbercept combined with Ahmed glaucoma drainage valve implantation or compound trabeculectomy can effectively reduce intraocular pressure in short time and the fromer is better than the latter. Above 2 regimens cause low incidence of complications.