Efficacy comparison of robotic and laparoscopic radical resection of rectal cancer for overweight and obese patients / 中华胃肠外科杂志

Objective: During laparoscopic pelvic operational procedure for obese patients with rectal cancer, the large amount of fat in the abdominal cavity often impairs the exposure of the surgical field, resulting in technical difficulty. In contrast, robotic surgery has the advantages of being more minimally invasive, precise, and flexible. This study compared the clinical efficacy of robotic and laparoscopic radical resection of rectal cancer for overweight and obese patients. Methods: A retrospective cohort study was conducted. Clinical data of 173 patients with rectal cancer and a body mass index (BMI) ≥ 25 kg/m(2) who received robotic or laparoscopic radical rectal resection at the First Affiliated Hospital of Nanchang University from January 2015 to February 2019 were retrospectively collected. Of 173 patients, 90 underwent robotic surgery and 83 underwent laparoscopic surgery. The intraoperative parameters, postoperative short-term and follow-up status were analyzed and compared between the two groups. The follow-up ended in December 2019. Results: Of 173 patients, 103 were male and 70 were female with a median age of 62 (range 29 to 86) years. The average BMI was (27.2±1.6) kg/m(2) in the robotic group and (27.3±1.5) kg/m(2) in the laparoscopic group. No significant differences in baseline data were observed between two groups (all P>0.05). As compared to the laparoscopic group, the robotic group had less intraoperative blood loss [(73.0±46.8) ml vs. (120.9±59.9) ml, t=-5.881, P<0.001] and higher postoperative hospitalization expense [(61±15) thousand yuan vs (52±13) thousand yuan, t=3.468, P=0.026]. The conversion rate in the robotic group was 1.1% (1/90), which was lower than 6.0% (5/83) in the laparoscopic group, but the difference was not statistically significant (P=0.106). There were no statistically significant differences between the two groups in operative time, number of intraoperative blood transfusion, number of harvested lymph nodes, time to the first flatus, postoperative hospital stay and morbidity of total postoperative complications (all P>0.05). Five (6.0%) patients in the laparoscopic group developed urinary dysfunction, while no case in the robotic group developed postoperative urinary dysfunction (P=0.024). The 173 patients were followed up for 8-59 months, with a median follow-up of 36 months. The 3-year overall survival rate of robotic group and laparoscopic group was 89.8% and 86.6%, respectively without significant difference between the two groups (P=0.638). The 3-year disease-free survival rate of the robotic group and the laparoscopic group was 85.6% and 81.5%, respectively without significant difference as well (P=0.638). Conclusions: Robotic radical surgery is safe and feasible for overweight and obese patients with rectal cancer. Compared with laparoscopic radical surgery, it has advantages of clear vision of surgical exposure, less intraoperative blood loss, less pelvic autonomic nerve damage, and operation in a narrow space.

Genetic Testing and Pregnancy Outcome Analysis of 362 Fetuses with Congenital Heart Disease Identified by Prenatal Ultrasound / Análise de Teste Genético e de Desfecho da Gestação de 362 Fetos com Cardiopatia Congênita Identificados por Ultrassom Pré-Natal

Abstract Background: Congenital heart defects (CHD), as the most common congenital anomaly, have been reported to be associated with chromosomal abnormalities. Currently, patients with CHD are routinely offered karyotyping and chromosomal microarray (CMA) testing, but the genotype-phenotype relationship has not yet been fully established. Objective: To determine the type and frequency of chromosomal abnormalities in fetuses with CHD and to analyze pregnancy outcomes of fetuses with heart abnormalities caused by different genetic factors. Methods: A total of 362 cases of CHD were enrolled from 2009 to 2016. Detailed ultrasound and laboratory examinations, including karyotyping and CMA, were performed. Outcome was obtained from discharge summaries. Results: Of the 362 fetuses, 220 were found with an isolated CHD, and 142 had CHD with extracardiac anomaly. Among these 362 fetuses, 140 were identified with a genetic cause, including 111 cases with aneuploidy, 10 cases with abnormality of chromosomal structure by karyotyping and 19 cases with pathogenic or likely pathogenic copy-number variations (CNVs) by CMA. The detection rate is close to 38.7%. Only one (identified as trisomy 18 syndrome) in 140 positive cases resulted in perinatal death, with the others being induced. The remaining 222 cases had negative results for both genetic testing and of these cases, 56 resulted in induced labor, and 77 had natural childbirth or caesarean births. The pregnancy outcome of the remaining 89 cases was uncertain. Conclusions: Karyotyping and CMA are effective and accurate prenatal genetic techniques for identifying fetal chromosomal abnormalities associated with cardiac defects, and this can assist clinical doctors to perform appropriate genetic counselling with regard to the etiology and outcome of CHD.

Resumo Fundamento: As cardiopatias congênitas (CCs) são as anomalias congênitas mais comuns, e têm sido associadas a anormalidades cromossômicas. Atualmente, a cariotipagem e a análise cromossômica por microarray (CMA) são oferecidas rotineiramente aos pacientes, mas a relação genótipo-fenótipo ainda não foi totalmente estabelecida. Objetivo: Determinar o tipo e a frequência das anomalias cromossômicas em fetos com CC e analisar os desfechos da gestação de fetos com anormalidades cardíacas causadas por diferentes fatores genéticos. Métodos: No total, foram admitidos 362 casos de CC entre 2009 e 2016. Ultrassonografia e exames laboratoriais detalhados foram realizados, incluindo cariotipagem e CMA. O resultado foi obtido a partir das folhas de epicrise. Resultados: Dos 362 fetos, 220 apresentaram doença coronariana isolada e 142 apresentaram doença coronariana com anomalia extracardíaca. Entre esses 362 fetos, foram identificados 140 com causa genética, incluindo 111 casos com aneuploidia, 10 casos com anormalidade da estrutura cromossômica por cariotipagem e 19 casos com variações no número de cópias (CNVs) patogênicas ou provavelmente patogênicas por CMA. A taxa de detecção é de aproximadamente 38,7%. Apenas um (identificado como síndrome da trissomia do cromossomo 18) em 140 casos positivos resultou em morte perinatal, com as demais sendo induzidas. Os 222 casos restantes tiveram resultados negativos para ambos os testes genéticos e, destes, 56 resultaram em trabalho de parto induzido e 77 tiveram partos naturais ou cesarianas. O desfecho da gravidez dos 89 casos restantes foi incerto. Conclusões: A cariotipagem e a CMA são técnicas genéticas pré-natais eficazes e precisas para a identificação de anomalias cromossômicas fetais associadas a defeitos cardíacos, e isso pode ajudar os médicos a realizar aconselhamento genético adequado com relação à etiologia e ao desfecho das cardiopatias congênitas.

ITS sequences variation and phylogenetic analysis on 31 geographical populations of Notopterygium incisum / 中国中药杂志

In this study, 31 Notopterygium incisum populations were analyzed using ITS sequences to investigate the genetic structure. The results showed that: the ITS region ranged in size from 634 to 635 bp and base composition was with high G + C content of 57.8%. Thirty-one polymorphic sites were detected from 402 sequences of 31 populations of N. incisum, and the proportion of polymorphic sites was 4.88%, in which parsimony informative sites were up to 12. And 31 haplotypes were identified based on these polymorphic sites. Molecular variance analysis (AMOVA) indicated that high genetic differentiation (57%) existed among population, and gene flow was low (N(m) = 0.38) among populations. Phylogenetic relationships of 31 haplotypes were analyzed using NJ method with N. forbesiias an out-group. Phylogenetic analysis showed that 31 haplotypes from different populations mixed together and did not form distinct geographically separated clades.

Expression of PI3-K, PKB and GSK-3 β in the skeletal muscle tissue of gestational diabetes mellitus

OBJECTIVE@#To analyze the expression of phosphatidylinositol 3 kinase (PI3-K), protein kinase B (PKB) and glycogen synthase kinase 3 beta (GSK-3 β) in skeletal muscle tissue of gestational diabetes mellitus (GDM).@*METHODS@#A total of 90 cases of pregnant women were divided into observation group and control group according to the occurrence of GDM with 45 cases in either, and the expression of PI3-K, PKB, GSK-3 β mRNA expression in skeletal muscle tissue was compared between two groups.@*RESULTS@#The total PI3-K p85 protein was significantly higher in the observation group compared with the control group, the activity of PI3-K was lower than that of the latter; The total PKB, GSK-3 β protein in skeletal tissue had no significant difference between two groups, while the serine phosphorylation levels of PKB and GSK-3β were significantly lower in observation group compared with the control group.@*CONCLUSIONS@#The downregulation of PI3-K, PKB and GSK-3βin skeletal tissue of GDM caused by phosphorylation dysfunction of signaling molecules is the reason for insulin resistance and transporter function decline which lead to GDM.

Growth and accumulation of shikonin compounds of two kinds of cells in suspension culture of Arnebia euchroma / 中国中药杂志

Via studying the phenotype, growth curve and secondary metabolites of two kinds of suspension culture cell of Arnebia euchroma, the kinetics parameters of growth and accumulation of shikonin compounds in cell suspension culture of A. euchroma was obtained through simulating and modeling. This Study found that the red high-yielding one was a fine cell line for producing shikonin compounds, and the white low-yielding one may be a mutant. The first-order and second-order derivative of the fitting function were obtained by fitting the Logistic model of growth curve to get the growth rate and growth acceleration curve of the suspended cells. It is found that the best period to subculture was the 15th day cultured in fresh medium, and the best period of the induction process was the 13th-14th day. When compared the growth rate of the red line and the shikonin compounds accumulation curve, it is found that the rapid growth of the biomass of cells was not conducive to the synthesis and accumulation of shikonin compounds.

Screening for membrane proteins differentially expressed between the lung adenocarcinoma cell lines with high- and low-metastatic potential using iTRAQ technology / 肿瘤

Objective: To screen for the membrane proteins differentially expressed between the lung adenocarcinoma cell lines with high- and low- metastatic potential, and to explore the potential targets for biomarkers and biological therapy. Methods: The membrane proteins were extracted from lung adenocarcinoma SPC-A-1 and SPC-A-1 sci cells which were generated from the same parental cell type and had low- and high- metastatic potential, respectively. The membrane proteins were labeled and the peptides were separated and analyzed by iTRAQ (isobaric tags for relative and absolute quantitation) technology combined with Nano-LC-MS/MS (nano liquid chromatography-tandem mass spectrometry). The identification and quantitation of the proteins were analyzed by Proteinpilot 4.0 solfware. The membrane proteins differentially expressed were analyzed and verified by GO (Gene Ontology) terms and real-time fluorescence quantitative-PCR in combination with Western blotting, respectively. Results: The identified numbers of proteins with FDRs (false discovery rates) < 1% were 1 413, 1 374, 1 297, and 1 351 in the experiment which were repeated four times by Nano LC-MS/MS, and the rate of labelling was above 95%. Among the 27 proteins up-regulated in total four experiments, 20 proteins were identified as membrane protein. Among the 32 proteins down-regulated in total four experiments, 25 proteins were identified as membrane protein. The GO analysis demonstrated the major molecular functions of the proteins differentially expressed including cytoskeletal protein binding, identical protein binding and enzyme binding as well as the catabolic process and cellular localization in biological processes. The expression levels of ITGA3 (integrin alpha-3), MYH9 (myosin, heavy chain 9), PLEC1 (plectin 1), HADHA (3-hydroxyacyl- CoA dehydrogenase), HK1 (hexokinase-1), KTN1 (kinectin 1), ESYT1 (extended synaptotagmin-like protein 1), ALDH18A1 (aldehyde dehydrogenase 18 family, member A1), ATP5A1 (ATP synthase alpha-subunit), LMNB2 (lamin-B2), CAV1 (caveolin-1) and CK-19 (keratin, type I cytoskeletal 19) mRNAs in SPC-A-1 sci cells were higher than those in the SPC-A-1 cells. The expression levels of CLTC (clathrin, heavy chain), HK1, LMNB2 and CK-19 in SPC-A-1 sci cells were also higher than those in SPC-A-1 cells. These results were consistent with those from quantitative mass spectrometry. Conclusion: A high-throughput screen for metastasis-related membrane proteins can be performed by a combined use of iTRAQ and Nano LCMS/ MS and may provide the potential metastasis-related biomarkers and therapeutic targets in diagnosis, prognostic prediction and treatment for patients with lung adenocarcinoma. Copyright © 2013 by TUMOR.

Metabolic engineering of terpenoids in plants / 生物工程学报

Terpenoids are present in all organisms but are especially abundant in plants, with more than 30,000 compounds. Not only do they play an important role in the life of plant, but also have high commercial values. However, the content of many important terpenoids in plant is very low. Therefore, how to improve the inefficient production of terpenoids is an urgent task. Metabolic engineering has been one of the most potential technologies to improve terpenoids production in recent years, following the study of metabolic pathway and regulation mechanism of terpenoids. Although there are some breakthroughs, metabolic engineering of terpenoids is still full of challenges because of the lack of knowledge on metabolic control of most terpenoids. Functional genomics approaches, including transcriptomics, proteomics and metabolomics, are potential tools for exploring of metabolic engineering. Integrating transcriptomics and metabolomics is an effective way to discover new genes involved in metabolic pathway. In this paper, the representative research outcomes about the metabolic engineering of terpenoids in plant were reviewed concisely and then the application of functional genomics approaches to study metabolic pathway and regulation mechanism of terpenoids and the strategies for metabolic engineering of terpenoids were discussed.

Effect of Danzhi Xiaoyao Powder on neuro-immuno-endocrine system in patients with depression / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Danzhi Xiaoyao Powder (DXP) on neuro-immuno-endocrine system in patients with depression.</p><p><b>METHODS</b>A randomized double-blinded and controlled study was conducted in 63 cases of depression. They were assigned to the DXP group (32 cases, treated with DXP) and the control group (31 cases, treated with maprotiline). The curative effect was evaluated with Hamilton's depressive scale (HAMD) before and at the end of the 2nd, 4th and 6th week of the treatment. Serum levels of serotonin (5-HT), norepinephrine (NE), brain derived neurotrophic factor (BDNF), cortisol (CORT), interleukin-6 (IL-6), and interleukin-1beta (IL-1beta) were detected before and at the 6th week of the treatment.</p><p><b>RESULTS</b>After 2 weeks of treatment, the total score of HAMD decreased remarkably in both groups (P < 0.01), and the total score, as well as the scores of the three factors, i. e. anxiety/somatization, cognitive impairment and feeling of despair, were lower in the DXP group than that in the control group respectively (P < 0.05 or P < 0.01). After 4 and 6 weeks of treatment the total score and score of the three factors all reduced significantly in both groups (P < 0.01), with insignificant difference between the groups. After 6 weeks of treatment, the serum levels of 5-HT and BDNF increased (P < 0.01), and the serum IL-6 level decreased in both groups (P < 0.05 or P < 0.01), the serum CORT level reduced in the DXP group (P < 0.01), while the serum NE level elevated in the control group (P < 0.01).</p><p><b>CONCLUSION</b>DXP is effective in improving symptoms of depression by regulating the levels of 5-HT, BDNF, CORT and IL-6.</p>

Advances in sesquiterpene synthases cyclases of Artemisia annua / 生物工程学报

Artemisinin,a new and a very potent antimalarial drug, is produced by the plant Artemisia annua L. with a very low yield ranging from 0.01% to 0.8% on a dry-weight basis. This makes artemisinin an expensive drug. Several studies reported chemical synthesis of the artemisinin, but none of them seems a viable economical alternative compared with the isolation of artemisinin from the plant. Hence, a higher artemisinin concentration in the plant is necessary for cheap antimalarial drug production. Many types of cyclic sesquiterpenes in Artemisia annua have been characterized to date, each derived from the common cyclic precursor FDP in a reaction catalyzed by a sesquiterpene synthase. Sesquiterpene synthases are widely regarded as the rate-determining regulatory enzymes in the pathways they participate, and a number of sesquiterpene synthases have been cloned from Artemisia annua up to now. This report is a brief review on the following sesquiterpene synthases: epi-cedrol synthase, amorpha-4,11-diene synthase, beta-caryophyllene synthase, (E)-beta-farnesene synthase, germacrene A synthase, as well as a new sesquiterpene synthase whose function remains largely unknown. The report is of help for a better understanding of metabolic engineering of Artemisia annua.

Clinical observation on effect of danzhi xiaoyao powder in treating depression / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect and side effect of Danzhi Xiaoyao powder (DXP) in treating depression.</p><p><b>METHODS</b>A randomized controlled and double-blinded study was conducted in 63 cases of depression by divided them into the western medicine group (WMG, 31 cases) treated with maprotiline, and the Chinese medicine group (CMG, 32 cases) treated with DXP. The effect of therapy was evaluated before and at the 2nd, 4th and 6th week of the treatment with Hamilton's depressive scale (HAMD), self-rating depression scale (SDS), self-rating anxiety scale (SAS) and the scale for TCM syndrome and symptom differentiation (TCM-SSD), and the side-effect of therapy was assessed with Asberg side-effect scale as well.</p><p><b>RESULTS</b>There was no significant difference between the two groups in scores of HAMD, SDS, SAS, and TCM-SSD. The markedly effective rate in CMG was 84% and in WMG 87%, showed no significance between them (P > 0.05). The scores of HAMD, SDS and SAS of both groups were remarkably lowered after therapy (P < 0.05). However, the score of Asberg in CMG was lower than that in WMG (P < 0.05).</p><p><b>CONCLUSION</b>DXP shows the effect equivalent to that of maprotiline, but with obviously less side-effect.</p>

Differentiation of somatoform disorders in TCM acupuncture-moxibustion outpatient service / 中国针灸

<p><b>OBJECTIVE</b>To strengthen differentiation of somatoform disorders and probe into regular rules of TCM syndrome differentiation treatment.</p><p><b>METHODS</b>Clinical data of 93 cases of somatoform disorders were collected from clinic departments of TCM acupuncture and moxibustion in general hospitals, and were divided into somatoform disorders group (n=41), depression group (n=30) and neurosis group (n=22) according to diagnostic criteria of CCMD-III. Zung's self-evaluating anxiety scale (SAS), and self-evaluating depression scale (SDS) were used for quantitative evaluation and comparison of severities of emotional disorders, and TCM syndrome type differentiation was carried out.</p><p><b>RESULTS</b>Somatoform disorders were most marked by pain, abnormal sensation of the skin mainly on the head, four limbs, etc. in TCM acupuncture and moxibustion clinic department, and the severities of anxiety and depression in the somatoform disorders group are lower than those in other two groups, and stagnation of the liver-qi is main TCM syndrome.</p><p><b>CONCLUSION</b>Strengthening differentiation of somatoform disorders, treatment based on the liver and exerting advantages of TCM in diagnosis and treatment may increase clinical therapeutic effects on somatoform disorders in TCM acupuncture and moxibustion treatment.</p>

Advances in molecular regulation of artemisinin biosynthesis / 生物工程学报

Artemisinin, a new and a very potent antimalarial drug, is produced by the Chinese medicinal herb Artemisia annua L. It is a sesquiterpene lactone with an endoperoxide bridge and is active against chloroquine resistant forms of Plasmodium falciparum. The relatively low yield (0.01% - 0.6%) of artemisinin in A. annua is a serious limitation to the commercialization of the drug. Therefore, a through understanding of the biosynthetic pathway and the characterization of the involved enzymes are important for the biology production of artemisinin. This review is focused on the recent progress in the molecular regulation of artemisinin biosynthesis from the following aspects: the biosynthetic pathway of artemisinin, the key enzymes involved in artemisinin biosynthesis, and the molecular regulation of artemisinin biosynthesis. The biosynthetic pathway of artemisinin belongs to the isoprenoid metabolite pathway, the key enzymes involved in the biosynthesis of artemisinin include: 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR), farnesyl diphosphate synthase (FDPS), and amorpha-4, 11-diene synthase, of which amorpha-4, 11-diene synthase catalyzes the cyclisation of the ubiquitous precursor farnesyl diphosphate to the highly specific olefinic sesquiter-pene skeletons and has been postulated as the regulatory step in the biosynthesis of artemisinin. Recently the gene encoding of the amorpha-4, 11-diene synthase has been cloned and the functional expressions have been studied by several research teams, therefore, the breakthroughs in production of artemisinin could hopefully be achieved by metabolic engineering of the plant, in particular, by over-expressing enzyme(s) catalyzing the rate limiting step(s) of artemisinin biosynthesis or by inhibiting the enzyme(s) of other pathway competing for its precursors. Besides, the effects of the heterogenesis isoprenoid pathway related genes on artemisinin biosynthesis of the transformed plants were also discussed.

Effect of factors on callus biomass and synthetic mass of hypericin in Hypericum perforatum / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effect of several factors on the quantity of hypericin in H. perforatum callus.</p><p><b>METHOD</b>High efficiency liquid phase chromatography and plant tissue culture were applied.</p><p><b>RESULT AND CONCLUSION</b>When the ratio of nitro-nitrogen to amina-nitrogen is 3:1, the callus biomass is 1.6-fold and the synthetic mass of hypericin rises. 0.1-0.20 mg x L(-1) mannose improves the content of total hypericin. The addition of PVP or PVPP can promote improvement of the growth and biosynthesis of callus.</p>

Comparative study of electro-acupuncture and maprotiline in treating depression / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To compare the effect of electro-acupuncture (EA) and maprotiline (Map) in treating depression.</p><p><b>METHODS</b>Thirty patients of depression were treated with EA and 31 patients with Map orally taken respectively. The therapeutic effect and side-effect were evaluated by measurement of Hamilton Depression Rating Scale (HAMD), Self-Rating Scale for Depression (SDS), Self-Rating Scale for Anxiety (SAS), Clinical Global Impression Scale (CGI) and Asberg Rating Scale for side-effects (ARS) before treatment and on the day 14, 28 and 42 of the therapeutic course.</p><p><b>RESULTS</b>After treatment, the scores of HAMD and SDS lowered significantly (P < 0.01) than before treatment, and with insignificant difference between the group (P > 0.05). For patients with somatic syndrome, the HAMD score decrease rate was obviously higher in the Map group than that in the EA group. However, for the patients with anxiety somatization syndrome, the score of SAS, ARS in the EA group were significantly lower than those in the Map group (P < 0.05). Moreover, the efficacy index was higher in the EA group (P < 0.01).</p><p><b>CONCLUSION</b>Both EA and Map are effective in treating depression.</p>

Effect of electroacupuncture with different frequencies on neuropathic pain in a rat model / 中国应用生理学杂志

<p><b>AIM</b>Our previous studies showed that electroacupuncture (EA) could inhibited radiant heat induced pain and acute or chronic inflammatory pain in rats. In the present study, we observed whether EA with different frequencies could suppress neuropathic pain.</p><p><b>METHODS</b>L5/L6 nerve ligation model was used to assess the effect of EA on neuropathic pain. Mechanical allodynia was represented by 50% withdrawal threshold, while cold-induced ongoing pain was detected by the number of paw lift in 5 min when the rat was put on a 5 degrees cold plate. Han's acupoint nerve stimulator (HANS) was connected to needles inserted into acupoints "jiaji" and "Zusanli" in both sides. The parameters were: (intensity: 0.5-1-2 mA, 10 min each; frequency 2 Hz or 100 Hz; pulse width: 0.6 ms for 2 Hz, 0.2 ms for 100 Hz).</p><p><b>RESULTS</b>EA of both 2 Hz and 100 Hz could relieve the mechanical allodynia, where 2 Hz could induce the effect with shorter latency; they could also relieve the cold-induced ongoing pain, where the effect of 2 Hz outlasted the EA session by up to 48 h after repetitive stimulations over several weeks; a significant relieving effect on cold-induced ongoing pain could also be induced by needle insertion without stimulation.</p><p><b>CONCLUSION</b>EA could relieve neuropathic pain, the analgesic effect of 2 Hz EA is higher than 100 Hz EA.</p>

Computed tomography of obstructive jaundice

It is well known that the computed tomography(CT) is very useful i the evalutaion of obstructive jaundice. Wehave studied 55 cases of obstructive jaundice with whole body scanner from Jun. 1980 to Jun. 1981. The resultswere as follows; 1. The sex distribution was 36 males and 19 females, and 40 cases of obstructive jaundice wereseen in fifth, sixth, and seventh decades. 2. Causes of obstructive jaundice were 25 cases of pancreas cancer, 8cases of common duct cancer, 4 cases of gall bladder cancer, 4 cases of ampulla vater cancer, 12 cases of commonduct stone, and 2 cases of common duct stricture. 3. Levels of obstruction were 8 cases of hepatic portion, 15cases of suprapancreatic portion, 28 cases of pancreatic portion, and 4 cases of ampullary portion. 4. In tumorouscondition, CT demonstrated metastasis of other organs, 9 cases of the liver, 1 case of the lung, 3 cases of thepancreas, 3 cases of the common bile duct, 1 case of the stomach,and 12 cases of adjacent lymph nodes. 5.Associated diseases were 12 cases of intrahepatic stone. 4 cases of clonorchiasis, 2 cases of pancreas pseudocyst,1 cases of hydronephrosis, and 1 case of renal cyst.