Objective To apply network Meta-analysis to evaluate the clinical efficacy of 3 classical prescriptions Xuebijing,Xijiao Dihuang decoction,and Qingyuan Shenghua decoction in treating sepsis complicated with coagulation dysfunction.Methods Computer-based searches were conducted in the following databases:China National Knowledge Infrastructure(CNKI),VIP Database,Wanfang Database,PubMed Database,and the Cochrane Library,to retrieve randomized controlled trial(RCT)on the treatment of sepsis complicated with coagulation dysfunction and disseminated intravascular coagulation(DIC)using 3 classical prescriptions-Xuebijing,Xijiao Dihuang decoction,and Qingyuan Shenghua decoction.The search period was from database inception to May 1,2023.The control group received conventional Western medicine treatment alone,while the treatment group received additional therapy with Xuebijing,Xijiao Dihuang decoction,or Qingyuan Shenghua decoction.Primary outcome measures included the sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,activated partial thromboplastin time(APTT),D-dimer,fibrinogen(Fib),prothrombin time(PT)and platelet count(PLT).Two researchers evaluated and screened the included studies,performed data extraction,and assessed literature quality.The network Meta-analysis was conducted using Stata 17.0 software.Results A total of 27 RCTs were finally included,with 2268 cases enrolled.The network Meta-analysis results showed that the surface under the cumulative ranking curve(SUCRA):①In terms of improving APACHEⅡscores:Qingyuan Shenghua decoction combination group(93.2%)>Xuebijing combination group(67.9%)>Xijiao Dihuang decoction combination group(37.5%)>conventional Western medicine treatment alone group(1.4%);②In terms of improving SOFA scores:Qingyuan Shenghua decoction combination group(93.7%)>Xuebijing combination group(63.0%)>Xijiao Dihuang decoction combination group(41.8%)>conventional Western medicine treatment alone group(1.5%);③In terms of improving APTT:Qingyuan Shenghua decoction combination group(95.6%)>Xijiao Dihuang decoction combination group(57.1%)>Xuebijing combination group(46.6%)>conventional Western medicine treatment alone group(0.7%);④In terms of improving D-dimer:Xijiao Dihuang decoction combination group(86.1%)>Qingyuan Shenghua decoction combination group(80.5%)>Xuebijing combination group(33.3%)>conventional Western medicine treatment alone group(0.0%);⑤In terms of improving Fib:Xijiao Dihuang decoction combination group(97.5%)>Qingyuan Shenghua decoction combination group(63.5%)>conventional Western medicine treatment alone group(37.8%)>Xuebijing combination group(1.2%);⑥In terms of shortening PT:Qingyuan Shenghua decoction combination group(67.5%)>Xuebijing combination group(67.4%)>Xijiao Dihuang decoction combination group(63.0%)>conventional Western medicine treatment alone group(2.2%);⑦In terms of improving PLT:Xuebijing combination group(83.6%)>Qingyuan Shenghua decoction combination group(54.9%)>Xijiao Dihuang decoction combination group(49.4%)>conventional Western medicine treatment alone group(12.1%).Conclusion The 3 classical Chinese herbal prescriptions combined with conventional Western medicine all demonstrated significant improvement effects on sepsis complicated with coagulation dysfunction.Among them,Xuebijing showed the most stable clinical efficacy,improving both disease severity scores and multiple coagulation indicators.Qingyuan Shenghua decoction was more effective in improving overall prognosis compared to the other two prescriptions.As for Xijiao Dihuang decoction,its clinical efficacy in ameliorating sepsis-related thrombosis warrants further exploration.

Objective To apply network Meta-analysis to evaluate the clinical efficacy of 3 classical prescriptions Xuebijing,Xijiao Dihuang decoction,and Qingyuan Shenghua decoction in treating sepsis complicated with coagulation dysfunction.Methods Computer-based searches were conducted in the following databases:China National Knowledge Infrastructure(CNKI),VIP Database,Wanfang Database,PubMed Database,and the Cochrane Library,to retrieve randomized controlled trial(RCT)on the treatment of sepsis complicated with coagulation dysfunction and disseminated intravascular coagulation(DIC)using 3 classical prescriptions-Xuebijing,Xijiao Dihuang decoction,and Qingyuan Shenghua decoction.The search period was from database inception to May 1,2023.The control group received conventional Western medicine treatment alone,while the treatment group received additional therapy with Xuebijing,Xijiao Dihuang decoction,or Qingyuan Shenghua decoction.Primary outcome measures included the sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,activated partial thromboplastin time(APTT),D-dimer,fibrinogen(Fib),prothrombin time(PT)and platelet count(PLT).Two researchers evaluated and screened the included studies,performed data extraction,and assessed literature quality.The network Meta-analysis was conducted using Stata 17.0 software.Results A total of 27 RCTs were finally included,with 2268 cases enrolled.The network Meta-analysis results showed that the surface under the cumulative ranking curve(SUCRA):①In terms of improving APACHEⅡscores:Qingyuan Shenghua decoction combination group(93.2%)>Xuebijing combination group(67.9%)>Xijiao Dihuang decoction combination group(37.5%)>conventional Western medicine treatment alone group(1.4%);②In terms of improving SOFA scores:Qingyuan Shenghua decoction combination group(93.7%)>Xuebijing combination group(63.0%)>Xijiao Dihuang decoction combination group(41.8%)>conventional Western medicine treatment alone group(1.5%);③In terms of improving APTT:Qingyuan Shenghua decoction combination group(95.6%)>Xijiao Dihuang decoction combination group(57.1%)>Xuebijing combination group(46.6%)>conventional Western medicine treatment alone group(0.7%);④In terms of improving D-dimer:Xijiao Dihuang decoction combination group(86.1%)>Qingyuan Shenghua decoction combination group(80.5%)>Xuebijing combination group(33.3%)>conventional Western medicine treatment alone group(0.0%);⑤In terms of improving Fib:Xijiao Dihuang decoction combination group(97.5%)>Qingyuan Shenghua decoction combination group(63.5%)>conventional Western medicine treatment alone group(37.8%)>Xuebijing combination group(1.2%);⑥In terms of shortening PT:Qingyuan Shenghua decoction combination group(67.5%)>Xuebijing combination group(67.4%)>Xijiao Dihuang decoction combination group(63.0%)>conventional Western medicine treatment alone group(2.2%);⑦In terms of improving PLT:Xuebijing combination group(83.6%)>Qingyuan Shenghua decoction combination group(54.9%)>Xijiao Dihuang decoction combination group(49.4%)>conventional Western medicine treatment alone group(12.1%).Conclusion The 3 classical Chinese herbal prescriptions combined with conventional Western medicine all demonstrated significant improvement effects on sepsis complicated with coagulation dysfunction.Among them,Xuebijing showed the most stable clinical efficacy,improving both disease severity scores and multiple coagulation indicators.Qingyuan Shenghua decoction was more effective in improving overall prognosis compared to the other two prescriptions.As for Xijiao Dihuang decoction,its clinical efficacy in ameliorating sepsis-related thrombosis warrants further exploration.

ObjectiveTo analyze the clinical and epidemiological characteristics of confirmed cases of human monkeypox infection in Changning District， Shanghai， and to explore their clinical and epidemiological characteristics. MethodsClinical data from 10 reported cases of monkeypox in individuals residing in Changning District or identified by local medical institutions between July 20 and September 30， 2023， were collected. Epidemiological case investigations were conducted， and throat swabs， anal swabs， and rash swabs were collected by the treating medical institutions. Real-time fluorescence quantitative PCR was used for monkeypox virus nucleic acid testing， and descriptive epidemiological analysis was applied to analyze the epidemiological characteristics of the cases. ResultsAll 10 confirmed cases of human monkeypox infection were all young males with an average age of 35.4 years， all of whom belonged to the men who have sex with men （MSM） population， with no occupational clustering. The primary clinical symptoms included fever， rash， enlarged inguinal lymph nodes， and muscle soreness. Nine cases presented with a rash， and seven cases experienced fever symptoms. Among the 10 cases， one experienced fever， rash， enlarged lymph nodes， and muscle soreness； two had fever， rash， and enlarged lymph nodes； two had fever， rash， and systemic soreness； two had only a rash； one had fever or rash； and one was asymptomatic. Among the nine cases with a rash， the rash was mainly localized to the genital or anal area， with fewer cases presenting rashes on the limbs or trunk simultaneously. All cases reported a history of non-exclusive MSM behavior within 21 days before the onset of the disease. The interval between the last suspected high-risk exposure and the onset of symptoms was 4 to 10 days， with an average interval of 6.9 days. The time from the onset of fever to the appearance of a rash was 0 to 5 days， with an average of 1.87 days. ConclusionThe main clinical manifestations of human infection with monkeypox are fever， rash， and enlarged inguinal lymph nodes. The MSM population is a high-risk group for monkeypox infection， and its source of infection may be associated with MSM exposure. Early-stage symptoms are mild， leading to potential underdiagnosis. Additionally， patients may conceal information during the investigation process， which increases the difficulty of epidemic prevention and control.

The special trichrome stain and immunocytochemical stain were used to show neurites, Schwann's cells in cultured pe-ripheral nerve tissue. The dorsal root ganglia(DRG) of rat were cultured on polypyrrole membrane for 2 weeks. Then, the cul-tured speciments were stained by special stain, which was composed of hematoxylin, fast green FCF. ehromotrope 2R and phos-photungstic acid; or by immunocytochemical stain with anti-S-100 protein and anti-neurofilament antibodies. In the specialtrichrome stained specimen the long processes from DRG were stained aquamarine blue; part of the cell nuclei on the processes orpolypyrrole membrane were stained red or purplish red, and the cytoplasm ashen. We testified that the long processes from DRGwere neurites and the cells which were purplish red nuclei and ashen cytoplasm were Schwann's cells in immunocytochemicalstain. The special staining could differentiate neurites and Schwann's cells in cultured peripheral nerve tissue.