Pollution， human exposure and harmful effects of neonicotinoid pesticides / 上海预防医学

Neonicotinoid is a kind of neuroactive pesticide， and it has become the most widely used pesticide in the world. In recent years， neonicotinoid has been detected in the environment and food， suggesting that human can be exposed to this kind of pesticide through drinking water， ingestion and respiration， which poses potential health hazards to human. However， there is no comprehensive report on the pollution level of neonicotinoid pesticides in the environment and food and the impact on human health. In this paper， the pollution status， population exposure level and potential health risks of neonicotinoid pesticides in water， air and food were reviewed. We found that neonicotinoid residues are widespread in fruits and vegetables， of which imidacloprid has the highest detection rate. Except for a few samples with excessive neonicotinoid detection， the detection level in most samples did not exceed national food safety standards. A variety of neonicotinoid pesticides have been detected in the air， surface water， tap water and drinking water. External exposure studies in the population have shown that ingestion is the main route of exposure to neonicotinoid， and the external exposure level is much lower than its chronic reference dose. The internal exposure study mainly detected the concentration of neonicotinoid pesticides and their metabolites in urine. A variety of neonicotinoid pesticides and their metabolites are detected in urine， and the concentration range is ng/ml level. Internal exposure studies found that the detection rate of thiamethoxam and dinotefuran in urine is higher， and the detection rate of neonicotinoid in Asian countries is higher than that in European and American countries. Occupational exposure studies found that neonicotinoid exposure levels increased after pesticide spraying， and the exposure levels in rural areas where pesticides were commonly used were higher than those in neighboring urban areas. Animal experiments have found that neonicotinoid pesticides have reproductive toxicity， genetic toxicity， neurotoxicity， immunotoxicity， liver toxicity and nephrotoxicity to non-target organisms. Cell experiments suggest that neonicotinoid is an endocrine disruptor. The symptoms of acute exposure in humans are related to the exposure dose， route and physical condition of the exposed person， which ranges from mild symptoms （nausea， vomiting， headache and diarrhea） to death. Population epidemiological studies have shown that chronic exposure to neonicotinoid pesticides is associated with adverse health effects in humans such as neonatal tetralogy of Fallot， anencephaly， and adverse mental symptoms.

The Effect of Oral Cola Ingestion for Endoscopic Inspection of Remnant Stomach: Randomized Case Control Study

BACKGROUND/AIMS: Nasogastric administration of cola for dissolution of phytobezoar was reported but the mechanism is not well understood. We aimed to evaluate the efficacy of cola ingestion for upper gastrointestinal endoscopy in patients who have had distal gastrectomy. MATERIALS AND METHODS: Patients were enrolled from July 2007 to October 2007 and all previously received subtotal gastrectomy. We conducted a randomized case-control study which the patients were randomly assigned to two groups. Group A had preparation with cola and group B had no preparation. Cola preparation group ingested about 1,500 mL of cola between 7 PM to 10 PM in the evening before the procedure. Two examiners who were blinded to the type of preparation performed the endoscopy. We assessed the degree of food residue and bile reflux by Japanese classification. RESULTS: A total of 70 patients were included. The comparison of clinical and laboratory characteristics between the two groups showed no statistically significant difference. During endoscopy, food residue was less found in group A than B, but without statistically significance (group A=12.1%, group B=21.6%, P=0.087). However, bile reflux was significantly less found in group A than B (group A=36.4%, group B=67.6%, P=0.015). Multivariate analysis, cola preparation significantly reduced food residue (OR, 0.032; P=0.001) and bile reflux (OR, 0.102; P=0.001). CONCLUSIONS: Preparation with cola in the evening before endoscopic examination may provide a good quality of preparation in patient with remnant stomach after distal gastrectomy.

Risk Factors for Food Residue after Distal Gastrectomy and a New Effective Preparation for Endoscopy: The Water-Intake Method

BACKGROUND/AIMS: Food residue is frequently observed in the gastric remnant after distal gastrectomy, despite adequate preparation. We devised a water-intake method to reduce food residue in the gastric remnant by drinking large quantities of water in a short time. The aims of this study were to identify the risk factors for food residue and to study the effectiveness of this new method for endoscopy preparation. METHODS: A cohort of 708 patients who underwent distal gastrectomy for gastric cancer was reviewed prospectively. Sixty patients with large amounts of food residue were randomly divided into two groups: a water-intake group (n=40) and a prolonged fasting group (n=20). RESULTS: The incidences of a large amount of food residue were 15.7%, 5.8%, 7.5%, and 2.8% at 3, 12, 24, and 36 months, respectively, after distal gastrectomy. Independent risk factors for food residue were endoscopy at 3 months, diabetes mellitus, a body mass index of <19.5, and laparoscopic surgery. The proportion of successful preparations at follow-up endoscopy was higher for the water-intake group (70%) than for the prolonged fasting group (40%, p=0.025). CONCLUSIONS: The water-intake method can be recommended as a preparation for endoscopy in patients who have had repetitive food residue or risk factors after distal gastrectomy.