Excessive low-density lipoprotein (LDL) uptake in vascular endothelial cells is closely related to atherosclerosis (AS) and coronary artery disease (CAD). Our animal study shows that Gualou Xiebai Banxia Decoction (GXBD) could reduce the amount of lipid deposition on the inner wall of blood vessels and relieve symptoms caused by AS and CAD. However, the underlying mechanism of GXBD on cells has not been elucidated yet. In this study, we study the effect of medicated serum, drawn from GXBD-intervened rats, on the human umbilical vein endothelial cells (HUVECs). Our findings suggest that GXBD-medicated rat serum can effectively reduce LDL uptake through downregulating the activin receptor-like kinase 1 (ALK1), therefore decreasing the apoptosis level of HUVECs. As a result, GXBD intervention might be an accountable approach to prevent AS-related diseases.

Introduction: Motor function is essential in our daily lives. Over 70% of stroke survivors have motor or other neurological functional disabilities. However, rehabilitation of motor function suffered from a stroke is rather difficult due to various reasons. Moreover, previous evidence for the effectiveness of physiotherapy for people with stroke that recover motor function is varied and limited in the chronic phase and therefore has never been reviewed systematically. With the progress of study in neurology and development of novel tools for rehabilitation, we can easily collect data from clinical trials now, so justifying conducting a systematic review.

Methods and analysis: This systematic review protocol is developed in accordance with the methodology recommended by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, as well as the Cochrane handbook for systematic reviews of interventions. Relevant studies,including Randomized controlled trials (RCTs) published in English, published between January 2001 and January 2021, will be identified by searching the databases. We will perform searches for relevant studies in databases, including PubMed, Embase, CINAHL, and Web of Science, Physiotherapy Evidence Database and Cochrane Library databases. The reference lists of included articles and reviews will be searched manually. The GRADE (Grading of Recommendations, Assessment, Development and Evaluation system from the Cochrane Handbook for Systematic Reviews of Interventions) approach will be used to systematically appraise the quality of methodology. We will assess the risk of bias of the RCTs included using the Cochrane Collaboration’s tool and provide a qualitative synthesis and consider conducting a meta-analysis if the final data across outcomes shows sufficient homogeneity.

Ethics and dissemination: No ethical approval is needed as the proposed study does not involve the collection of primary data, and the results of this review will be disseminated via peer-reviewed publications and conference presentations.

        Trial registration number: CRD42021267069.

Strengths and limitations of this study

 • The main strength of the present study is that this is the first systematic review that different commonly used types of physiotherapy were included, which makes a big difference from the other trials that mostly focused on specific areas of physiotherapy.

• By systematic review, all relevant high-quality evidence will be identified and effect of interventions to promote motor recovery, including recovery of impairment or related function, after stroke will be investigated. Such that we can identify areas for which interventions show promise of efficacy according to the results of this review.

• It is anticipated that a limited meta-analysis may be conducted since there may be significant heterogeneity among the identified trials due to a wide range of outcome measures, the amount and methods of intervention, and the duration and frequency of training.

• It’s possible that the current review does not identify all evidence or limitations relevant to the research question because there are restrictions on both language and year of the articles included.

A patient with extensive abdominal and pelvic procedures following a motor vehicle accident who had Inferior Vena Cava Filter (IVCF) implantation due to contraindication to other anticoagulation therapies presents with severe lower abdominal and back pain, fever, left lower extremity, and subsequent right lower extremity swelling. Venous Doppler ultrasound revealed extensive deep venous thrombosis (DVT) of the left lower extremity. In addition, the abdominal CT scan illustrated suspicious erosion of IVCF to the T12 vertebral body. This case report focuses on erosion and invasion of a prolonged-dwelled IVCF to adjacent organs as a long-term complication. Our patient had the IVCF for 15 years, the longest dwell time reported in the literature.

Objective : To assess the epidemiological aspects of obstetric fistulas at the Ngaoundere Lutheran Hospital.

Methods : We carried out a hospital-based cross sectional analytic study comparing women with fistulas (subjects), and those without the condition (controls). We compared information from 166 files of fistula patients (2013-2016) with those of 269 parous women recruited prospectively (Feb- April 2017). We used a modified pretested
questionnaire with information on socio-demographic, clinical and reproductive characteristics. Crude odds ratios (OR) and their 95% CI were obtained after bivariate analysis, to determine the factors that were associated with obstetric fistula. The factors that were statistically significant (p<0.05) were modelled into final logistic regression analysis, to determine the independent association.

Results : Some characteristic were unequally distributed; socio-demographic characteristics (age, occupation, marital status, region of origin, religion and level of education) as well as clinical characteristics (age at first childbirth, parity, prenatal care, duration of labour, weight, height and BMI) p≤ 0.001. Among women who consulted the gynaecologist/ urologist, the prevalence of obstetric fistulas was 2.56% (95CI: 1.98-2.58). Factors independently associated with obstetric fistulas were; illiteracy (53% vs.
47%; AOR:7.2; 95% CI [1.8-28.2]), height <150cm (77.9% vs. 22.1%; AOR:8.7;95%CI [2.8-27.4]), inadequate prenatal care (64.9% vs. 35.1%; AOR:7.5; 95%CI [2.8-20.1]), labour duration> 24hours (71.6% vs. 28.4%; AOR:88.2; 95% CI [21.3- 364]) and no use of preventive catheter (52.4% vs.47.6%; AOR:1.7; 95% CI [0.4-3.3]).

Conclusion : Obstetric fistula is commonly associated with illiteracy, short stature, inadequate prenatal care, prolonged labour and no use of preventive catheter.