Triclosan (TCS) and triclocarban (TCC) are widely used synthetic broad-spectrum antibacterial agents that can enter the human body through the skin, gastrointestinal tract, and other pathways. More and more studies have found that exposure to TCS and TCC can affect human health, but currently, review reports on the health effects of human exposure to TCS and TCC are limited. Therefore, this study reviewed population studies on the relationship between TCS and TCC exposure and health effects by searching the PubMed database, summarized the associated health outcomes, and elucidated the biological mechanisms. A total of 56 studies were retrieved, among which cross-sectional studies (25 studies, 44.64%) and cohort studies (25 studies, 44.64%) accounted for a relatively large proportion, while case-control studies (6 studies, 10.72%) were relatively few. Studies on TCS exposure (48 studies, 85.71%) were far more prevalent than those on TCC exposure (2 studies, 3.57%). The remaining 6 studies involved both TCS and TCC exposure. The research results revealed that TCS exposure was associated with male and female abnormal reproductive functions, fetal growth restriction, abnormal behavior development in children, obesity, gestational diabetes mellitus (GDM), and immune-related diseases. Although the results of different studies show significant differences, they have indicated that exposure to TCS is a potential risk factor for these health problems. Due to the limited number of studies, the evidence for the relationship between TCC exposure and most of the aforementioned health effects is insufficient. Population studies and in vitro and in vivo studies have shown that exposure to TCS and TCC can interfere with the microbial homeostasis, the endocrine system, oxidative stress and immune function of the body, which are potential mechanisms causing adverse health effects. In the future, large-scale prospective cohort studies, as well as in vivo and in vitro studies, are still needed to further clarify the associations between TCS and TCC exposure and health effects, and to deeply explore its mechanism of action. These efforts will provide references for clarifying the human health hazards of TCS and TCC exposure and formulating targeted prevention and control strategies.

Objective:To explore whether perioperative oral probiotic therapy reduces infectious complications following pancreaticoduodenectomy (PD), aiming to obtain higher-level evidence for clinical practice.Methods:A total of 81 participants undergoing PD at the Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital & Affiliated Hospital of Medical School, Nanjing University, from May 2024 to December 2024 were enrolled in this single-center, prospective, randomized controlled trial. The participants were randomly divided into a probiotic treatment group and a control group (receiving conventional treatment without probiotics) using a random number method. The primary outcomes included the incidence of postoperative infectious complications and intra-abdominal infection, and the secondary outcomes were the recovery of gastrointestinal function, postoperative hospital stay, and duration and costs of antibiotic use. The hematological indicators including inflammation and immune markers on postoperative days (POD) 1, 3, 5, and 7 were also compared between these two groups.Results:Finally 72 cases (39 males and 33 females) were analyzed, with 36 patients in the probiotic treatment group and 36 patients in the control group. Compared to the control group, the probiotic treatment group showed statistically significant reductions in the incidence of infectious complications (33.3% vs. 66.7%, P=0.029), intra-abdominal infection (27.8% vs. 58.3%, P=0.030), and incidence of delayed gastric emptying (0 vs. 16.7%, P=0.033). Also, the probiotic treatment group exhibited significantly faster recovery in postoperative bowel movements and shorter time to defecation, liquid diet, and semi-liquid diet (all P<0.05). Additionally, the probiotic treatment group had significantly shorter hospital stay, reduced duration of antibiotic use, and lower antibiotic costs (all P<0.05). Finally, the probiotic treatment group had significantly higher lymphocyte counts on POD 1 ( P<0.05) and showed a significant downward trend in inflammatory markers such as interleukin-6 on PODs 3 and 5 and C-reactive protein on POD 7 (all P<0.05). Conclusions:Perioperative application of probiotic preparations in PD may reduce the incidence of postoperative infectious complications, especially intra-abdominal infection. Additionally, it can prevent delayed gastric emptying, promote the recovery of postoperative gastrointestinal function, shorten hospital stay, and reduce the use of antibiotics. These benefits may be related to the improvement of postoperative inflammatory status.

Objective:To explore whether perioperative oral probiotic therapy reduces infectious complications following pancreaticoduodenectomy (PD), aiming to obtain higher-level evidence for clinical practice.Methods:A total of 81 participants undergoing PD at the Department of Pancreatic and Metabolic Surgery, Nanjing Drum Tower Hospital & Affiliated Hospital of Medical School, Nanjing University, from May 2024 to December 2024 were enrolled in this single-center, prospective, randomized controlled trial. The participants were randomly divided into a probiotic treatment group and a control group (receiving conventional treatment without probiotics) using a random number method. The primary outcomes included the incidence of postoperative infectious complications and intra-abdominal infection, and the secondary outcomes were the recovery of gastrointestinal function, postoperative hospital stay, and duration and costs of antibiotic use. The hematological indicators including inflammation and immune markers on postoperative days (POD) 1, 3, 5, and 7 were also compared between these two groups.Results:Finally 72 cases (39 males and 33 females) were analyzed, with 36 patients in the probiotic treatment group and 36 patients in the control group. Compared to the control group, the probiotic treatment group showed statistically significant reductions in the incidence of infectious complications (33.3% vs. 66.7%, P=0.029), intra-abdominal infection (27.8% vs. 58.3%, P=0.030), and incidence of delayed gastric emptying (0 vs. 16.7%, P=0.033). Also, the probiotic treatment group exhibited significantly faster recovery in postoperative bowel movements and shorter time to defecation, liquid diet, and semi-liquid diet (all P<0.05). Additionally, the probiotic treatment group had significantly shorter hospital stay, reduced duration of antibiotic use, and lower antibiotic costs (all P<0.05). Finally, the probiotic treatment group had significantly higher lymphocyte counts on POD 1 ( P<0.05) and showed a significant downward trend in inflammatory markers such as interleukin-6 on PODs 3 and 5 and C-reactive protein on POD 7 (all P<0.05). Conclusions:Perioperative application of probiotic preparations in PD may reduce the incidence of postoperative infectious complications, especially intra-abdominal infection. Additionally, it can prevent delayed gastric emptying, promote the recovery of postoperative gastrointestinal function, shorten hospital stay, and reduce the use of antibiotics. These benefits may be related to the improvement of postoperative inflammatory status.

Objective: To evaluate the long-term effectiveness of an intelligent blood transfusion system in intraoperative blood management by comparing its performance with clinicians' decisions. Methods: A retrospective analysis of 26 760 surgical cases (2017-2024) was conducted, comparing pre- and post-implementation (2017-2019 vs 2020-2024) metrics, including transfusion prediction accuracy, rationality of blood use, and clinical outcomes. The system, powered by XGBoost, integrated patient demographics, laboratory results, and surgical data to predict red blood cell transfusion needs. Results: The intelligent blood transfusion systems achieved an accuracy of 80.62% in predicting transfusion necessity, significantly outperforming clinicians (24.83%, P<0.001). Its blood-use rationality rate was 83.92% vs 18.02% for clinicians (P<0.001). Post-implementation, major surgeries (grades Ⅲ-Ⅳ) increased while the requested blood units decreased. High physician compliance (>75%) correlated with 88.18% rationality. Conclusion: The intelligent blood transfusion system significantly improves the accuracy of transfusion decision-making, reduces excessive red blood cell use, optimizes perioperative transfusion management, and enhances the utilization of blood medical resources.

Objective: To investigate the dietary lead exposure level among children aged 3 to 4 years in Jiading District, Shanghai Municipality, and assess the health risk caused by lead exposure, so as to provide the basis for the management of children's food safety. Methods: Based on the 2023 Dietary and Health Status Surveillance Project in Jiading District, children aged 3 to 4 years from 12 streets (townships) in Jiading District were selected as the subjects using a multi-stage stratified random sampling method. The consumption frequency and daily intake of seven subcategories of four major food groups (beans, tofu), cereals (wheat, rice), meat (animal viscera), and aquatic products (mantis shrimps, bivalves) consumed by children over the past three months were collected using a food frequency questionnaire. Food samples were collected according to the food safety risk monitoring plan in Jiading District, and the lead content was detected. The health risks of dietary lead exposure among 3-4-year-old children were quantitatively assessed using the single-factor pollution index method, the Nemerow comprehensive pollution index method, and the margin of safety (MOS) method. Results: A total of 143 3-4-year-old children were surveyed, including 69 boys (48.25%) and 74 girls (51.75%). A total of 317 food samples were tested, and lead was detected in all seven subcategories of food samples, with an overall detection rate of 77.29%. The detection rates of lead in bivalves and mantis shrimps of aquatic products were relatively high (98.75% and 100.00%, respectively). The mean lead content of various foods ranged from 0.003 4 to 0.090 7, with the highest level found in bivalves. The lead content of all food samples did not exceed the standard. The single-factor pollution index of seven subcategories ranged from 0.017 2 to 0.148 0, and the Nemerow comprehensive pollution index ranged from 0.116 5 to 0.424 4, both of which were less than 0.7. The MOS (mean) ranged from 0.000 3 to 0.003 9, with an overall MOS (mean) of 0.012 2. The MOS (P95) ranged from 0.005 7 to 0.055 9, with an overall MOS (P95) of 0.112 4, both of which were less than 1. Conclusions The lead pollution level in the diet among children aged 3 to 4 years in Jiading District is safe and clean, with an acceptable impact on food safety. However, the detection rate of lead is relatively high, and the main source of dietary lead exposure is aquatic products.

To investigate the temporal trend of antibiotic use among children in Shanghai from 2017 to 2020. The stratified cluster sampling method was used to establish a dynamic cohort of healthy children based on primary schools in Changning District, Shanghai. In the cohort, there were 282 children from 2017, 287 children from 2018, 294 from 2019 and 301 from 2020. A total of 700 children aged 7-11 years were included in the study. The basic information and antibiotic use of children were investigated by questionnaire every year, and their height and weight were measured at the same time. Chi-square test was used to analyze the difference of antibiotic use rate in each year and generalized estimation equation was used to analyze the temporal trend of antibiotic use. The results showed that the use rates of all antibiotics, cephalosporins, azithromycin and other antibiotics (including penicillin, lincomycin, quinolones, etc.) of children between 2017 and 2020 were 15.6%, 10.5%, 2.7%, and 2.4%, respectively. In 2017, 2018, 2019, and 2020, there were significant differences for the use rates of total antibiotics and other antibiotics in children ( P=0.033, P=0.040), and there were no significant differences for the use rates of cephalosporins and azithromycin ( P=0.274, P=0.455). After adjusting for children′s basic characteristics, the generalized estimation equation showed that the annual use rate of all antibiotics, cephalosporins, and other antibiotics decreased over time.

To investigate the temporal trend of antibiotic use among children in Shanghai from 2017 to 2020. The stratified cluster sampling method was used to establish a dynamic cohort of healthy children based on primary schools in Changning District, Shanghai. In the cohort, there were 282 children from 2017, 287 children from 2018, 294 from 2019 and 301 from 2020. A total of 700 children aged 7-11 years were included in the study. The basic information and antibiotic use of children were investigated by questionnaire every year, and their height and weight were measured at the same time. Chi-square test was used to analyze the difference of antibiotic use rate in each year and generalized estimation equation was used to analyze the temporal trend of antibiotic use. The results showed that the use rates of all antibiotics, cephalosporins, azithromycin and other antibiotics (including penicillin, lincomycin, quinolones, etc.) of children between 2017 and 2020 were 15.6%, 10.5%, 2.7%, and 2.4%, respectively. In 2017, 2018, 2019, and 2020, there were significant differences for the use rates of total antibiotics and other antibiotics in children ( P=0.033, P=0.040), and there were no significant differences for the use rates of cephalosporins and azithromycin ( P=0.274, P=0.455). After adjusting for children′s basic characteristics, the generalized estimation equation showed that the annual use rate of all antibiotics, cephalosporins, and other antibiotics decreased over time.

ObjectiveTo study the relationship between the exposure to two kinds of phthalate esters （PAEs） ［Di-N-butyl phthalate，（DBP） and Di-（2-ethylhexyl）phthalate （DEHP）］ and estrogen homeostasis in pregnant women. MethodsIn 2021， we classified the Jiading District of Shanghai into five geographical areas， east， west， south， north and central. A total of 151 pregnant women from each area were selected for questionnaire survey， with random urine samples during first， second， and third trimesters collected. A DBP metabolite ［Mono-N-butyl phthalate （MBP）］ and two DEHP metabolites ［Mono（2-ethylhexyl） phthalate （MEHP）， Mono（2-ethyl5-oxohexyl） phthalate， （MEOHP）］ and three estrogens ［estrone （E₁）， 17β -estradiol （E₂）， and estriol （E₃）］ in urine were determined by ultra-performance liquid chromatography tandem quadrupole time-of-flight mass spectrometry. After a natural logarithmic transformation of PAEs metabolite levels and estrogen concentration， multivariable linear regression was used to control potential confounders and determine the relationship between PAEs metabolite levels and estrogen concentration. ResultsThe detection rates of three PAEs metabolites in urine of pregnant women were more than 98%. The median corrected concentrations of MBP， MEHP and MEOHP were 5.18， 0.59 and 4.23 mg·kg^-1， respectively. During the whole pregnancy， MEOHP was positively correlated with E₁ （β=0.450， 95%CI： 0.057‒0.844）， and MBP was positively correlated with E₃ （β=0.250， 95%CI： 0.034‒0.465）. Stratified by trimesters， MBP was positively correlated with E₃ in the first trimester （β=0.428， 95%CI： 0.103‒0.752）. MEOHP was positively correlated with E₁ in the second trimester （β=0.734， 95%CI： 0.130‒0.752）， and had a possitive trend with E₁ in the third trimester （β=0.744， 95%CI： -0.140‒1.629）. In addition， MEHP had a negative correlation with E₁ in the second trimester （β=-0.498， 95%CI： -1.063‒0.066）. MEOHP had a positive correlation trend with E₂ （β=0.628， 95%CI： -0.101‒1.356） in the third trimester. ConclusionPAEs exposure may interfere with estrogen homeostasis during pregnancy and differs by trimesters. Given the cross-sectional nature of this study， it warrants further study to validate the findings.

Child ; China ; Humans ; Iodine ; urine ; Sodium Chloride, Dietary

Objective To evaluate the expression of transient receptor potential melastatin 7(TRPM7)in cholangiocarcinoma and its correlation with prognosis.Methods The expressions of TRPM7 were detected by SP immunohistochemical in 49 cases of cholangiocarcinoma,7 cases of benign bile duct lesions and 36 cases of adjacent histologically noncancerous bile duct tissues,and to analysis its relationship with the clinical pathological characteristics of cholangiocarcinoma.Results The positive expression rate of TRPM7 in cholangiocarcinoma was 77.6%(38/49),which was higher than that in benign bile duct lesions(0,0/7)and adjacent his-tologically noncancerous bile duct tissues(2.8%,1/36),the difference was statistically significant(P <0.05).The positive expres-sion of TRPM7 in cholangiocarcinoma was correlated with the TNM stage of tumor,lymph node metastasis and organ metastasis (P <0.05),but not related to patients′age,gender,site,differentiation and hepatitis(P >0.05).Kaplan-Meier analysis showed that increased expression of TRPM7 was associated with shorted overall survival (P <0.05).Cox regression analysis showed that the expression level of TRPM7 was significantly associated with prognosis and an independent risk factor for prognosis(P <0.05 ). Conclusion TRPM7 plays an important role in the tumorigenesis progression,invasion,and metastasis of cholangiocarcinoma,and is an important factor for prognosis in patients with cholangiocarcinoma.