The study focuses on the concept of multifunctional traditional Chinese medicine (TCM) formulas and aims to evaluate the efficacy of the classical formula Xiaoyao San (逍遥散). Study employs the integrated evidence chain (Eff-iEC) method to organize, integrate, and evaluate its therapeutic efficacy in treating different diseases with the same therapy, and to investigate the feasibility of using Eff-iEC to evaluate the multifunctionality of TCM formulas. The evaluation covered Xiaoyao San's therapeutic effects on depression, premenstrual syndrome, chronic hepatitis, irritable bowel syndrome, dyspepsia, and menopausal syndrome. Concurrently, the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for evaluation, and authoritative medical documents were incorporated to corroborate the recognition of Xiaoyao San within the medical community. Depression and menopausal syndrome received higher ratings than other conditions in the Eff-iEC, GRADE, and Medical Community Recognition assessments. The Eff-iEC evidence grade for Xiaoyao San was rated as "High" or above for chronic hepatitis, irritable bowel syndrome, dyspepsia, and menopausal syndrome. Premenstrual syndrome received a "Moderate ⁺" rating. The GRADE evidence level was "Low-〇〇⨁⨁" for depression, premenstrual syndrome, and chronic hepatitis; "Moderate-〇⨁⨁⨁" for dyspepsia and menopausal syndrome; and "Very Low-〇〇〇⨁" for irritable bowel syndrome. Depression and menopausal syndrome had the highest inclusion frequency, appearing in all 4 categories. Premenstrual syndrome, chronic hepatitis, and dyspepsia are not recommended in Western medical guidelines, but they are included in TCM guidelines, the China National Basic Medical Insurance Drug List, and the China National Essential Drug List. Irritable bowel syndrome appears only in the China National Basic Medical Insurance Drug List and China National Essential Drug List. The evaluation results obtained using the Eff-iEC method align with Medical Community Recognition, providing an objective and comprehensive assessment of Xiaoyao San's efficacy. The findings suggest that Xiaoyao San has strong evidence for treating depression and menopausal syndrome. However, further experimental and clinical trials are needed to assess its efficacy in treating premenstrual syndrome, chronic hepatitis, irritable bowel syndrome, and dyspepsia. These results support the clinical efficacy and rational use of Xiaoyao San, expand the application scope of the Eff-iEC method, and offer valuable insights and methodological references for the comparative evaluation of multifunctional TCM formulas.

OBJECTIVE: To study the combined effect of noise and hydrogen cyanide on noise-induced hearing loss( NIHL)in a metal electroplating enterprise. METHODS: The judgment sampling method was used to select 663 workers in a largescale metal electroplating enterprise as the study subjects. Among them,186 workers exposed to noise alone were designated as noise group; 138 workers exposed to hydrogen cyanide alone were designated as hydrogen cyanide group; and161 workers exposed to noise and hydrogen cyanide were designated as combined effect group,and 178 workers without exposure from occupational disease risk factors were designated as control group. Questionnaires survey and pure tone audiometry were used for analyzing the effects of combined noise and hydrogen cyanide exposure on NIHL. RESULTS: The hearing loss detection rate of the study subjects was 40. 4%. The hearing loss detection rates in the control group,noise group,hydrogen cyanide group,and combined effect group were 17. 4%,47. 8%,32. 6% and 64. 0%,respectively. The detection rate of hearing loss in the control group was lower than that in the other three groups( P < 0. 008). The NIHL detection rates in the combined effect group and the noise group were higher than that in the hydrogen cyanide group( P <0. 008). The hearing loss detection rate of the combined effect group was higher than that of the noise group and the hydrogen cyanide group( P < 0. 008). Ordinal multi-categorical logistic regression model results showed that after adjusting confounding factors such as age,length of service,gender,marital status,smoking,alcohol drinking,we found hydrogen cyanide exposure,noise exposure,and combined exposure to hydrogen cyanide and noise had effects on workers' hearing(P < 0. 05). The risk of hearing loss in workers exposed to noise and hydrogen cyanide was higher than that of workers exposed to noise alone or hydrogen cyanide alone. CONCLUSION: There is a combined effect of noise and hydrogen cyanide in this metal electroplating enterprise,which can increase the risk of NIHL in workers.

Objective To explore the application value of single-door laminoplasty via Y type nano-bone plate in treating multilevel cervical spondylotic myelopathy (MCSM) and analyze the short-term efficacy.Methods From January 2013 to December 2016,79 cases of MCSM were treated with single-door laminoplasty via Y type nano-bone plate to evaluate the improvement of post-operative neurological function by the Japanese Orthopaedic Association (JOA) evaluation system.We also measured cervical curvature of cervical X-ray and C5 sagittal diameter of the spinal canal before operation and 6 months after operation to understand the maintenance and enlargement of the spinal canal.The improvement degree of spinal cord compression was evaluated by preoperative and postoperative cervical MRI.Osseous healing on the open door side and the door shaft side was observed with the aid of three-dimensional spiral CT.Results Follow-up ranged from 6 to 36 months,with an average of (20.4±7.9)months.Preoperative JOA score was (8.6 ± 1.3) points and JOA score 6 months after operation was (14.3 ± 1.5)points (P ＜ 0.05).JOA improvement rate was (68.6 ± 15.8)％;postoperative follow-up X-ray and threedimensional spiral CT showed that the spinal canal had satisfying enlargement,the door shaft side all had osseous healing,the open door side osseous healing was not obvious,and there was no lamina collapse or reclosing.Sagittal diameter of theC spinal canal was (8.9±l.1)mm before operation and (15.1±l.1)mm 6 months after operation (P＜0.05).The spinal canal enlargement rate was (70.8±22.3)％,cervical curvature was (14.8± 7.0)°preoperatively and (15.1±6.7)°postoperatively with no significant difference (P＞0.05).Conclusion EOLP via Y type nano-bone plate is safe and efficacious in treating MCSM.It not only provides a good immediate fixation,but also provides the possibility for the open door side lateral osseous fusion.

Rotavirus is an important pathogen, which can cause severe diarrhea in infants and children.Because of lacking of specific therapy, an effective vaccine is particularly urgently needed. Vaccine safety,efficacy of the vaccine, possible outcomes of continuous expression of the vaccine' s exogenous antigens and vaccine' s induction on the immune response of bodies are the key factors to rotavirus vaccine, Present review discussed and analyzed the related characteristics of rotavirus vaccine abroad, in order to put forward further guidance on the research, and promote the development of rotavirus vaccine in China.