In recent years,researches on drugs concentrated in the ecosystem have become a hot topic. Environmental pharmacology is a new subject studying the source and fate of drugs in the environment. It is found that a lot of pharmaceuticals and pharmaceutically active compounds are released into the environment by the pharmaceutical industry,hospitals and agricultured activities. Drugs in the environment not only affect the ecosystem,which leads to bacterial resistance,but also affect the balance of flora in the biofilm. Furthermore,such drugs may induce epigenetic changes, which may leave to the body vulnerable to diseases. The enrichment of endocrine disruptors can inter?fere with the growth and function of the human reproductive system. China is becoming concerned about environmental drugs. The development of environmental pharmacology can help clarify the interac?tions between drugs and the environment while contributing to public health and food safety in China.

Purpose: Reports showed that some of intrahepatic cholangiocarcinoma (ICC) patients with lymph node metastasis (LNM) may also gain survival benefit undergone resection. However, the effect of the extent of LNM on prognosis and surgical indication is barely discussed. Methods: From September 1994 to November 2018, primary ICC patients undergone initial curable surgery were enrolled. Based on the extent of LNM, we divided these patients into 4 groups, including patients with no LNM (group N0), LNM to hepatoduodenal ligament or common hepatic artery (region A, group A), LNM to gastrohepatic lymph nodes for left liver ICC and periduodenal and peripancreatic lymph node for right liver ICC (region B, group B), or LNM beyond these regions (region C, group C). Multivariable Cox regression analysis was performed to identify the prognostic factors for recurrencefree survival (RFS) and overall survival (OS) in all groups. Results: A total of 133 patients were enrolled. There were 56, 21, 17, and 39 patients in groups N0, A, B, and C, respectively. There was significant difference between groups N0 and C in RFS (P < 0.001) and OS (P = 0.002). When we compared group N0 + A + B with group C, we also found that RFS (P < 0.001) and OS (P = 0.007) were significantly different. In multivariable analysis, the extent of LNM was an independent risk factor for RFS (P < 0.050). Conclusion ICC patients with the LNM to regions A and B could still achieve good prognosis with resection. Surgery should be carefully considered when LNM to region C.