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BackgroundThe benefit of resuming anticoagulation in atrial fibrillation (AF) patients with prior intracranial haemorrhage (ICH) and which anticoagulant to choose are controversial.Summary of reviewPubMed, Embase, Web of Science and the Cochrane Library were searched from their inception until 13 February 2022. Thirteen eligible articles (17 600 participants) were collected, including 11 real-world studies (n=17 296) and 2 randomised controlled trials (RCTs) (n=304). Compared with no anticoagulants, oral anticoagulation (OAC) was not associated with an increased risk of ICH recurrence (HR 0.85 (95% CI 0.57 to 1.25), p=0.41), but with a significantly increased risk of major bleeding (HR 1.66 (95% CI 1.20 to 2.30), p<0.01). Meanwhile, OAC was associated with a reduced risk of ischaemic stroke/systemic thromboembolism (IS/SE) (HR 0.54 (95% CI 0.42 to 0.70), p<0.01) and all-cause death (HR 0.38 (95% CI 0.28 to 0.52), p<0.01) compared with no anticoagulants. Furthermore, compared with warfarin, non-vitamin K antagonist oral anticoagulants (NOACs) were associated with a significant reduction of ICH recurrence (HR 0.64 (95% CI 0.49 to 0.85), p<0.01), while the risk of IS/SE and all-cause mortality were comparable between warfarin and NOACs.ConclusionsFor patients with AF with prior ICH, OAC is associated with a significant reduction in IS/SE and all-cause mortality without increasing ICH recurrence, but may increase major bleeding risk. Compared with warfarin, NOACs had a better safety profile and comparable efficacy. Further larger RCTs are warranted to validate these findings.

Purpose:: The purpose of this paper is to examine how Si-shu, a traditional form of local, private education grounded in classical instruction, responded to the rapid modernization of education during the late Qing dynasty and early Republic of China and to explain why these schools, once extraordinarily adaptable, finally disappeared. Design/methodology/approach:: The authors have examined both primary and secondary sources, including government reports, education yearbooks, professional annals, public archives, and published research to analyze the social, political and institutional changes that reshaped Si-shuin the context of China's late-19th- and early-20th-century educational modernization. Findings:: Si-shuwent through four stages of institutional change during the last century. First, they faced increased competition from new-style (westernized) schools during the late Qing dynasty. Second, they engaged in a process of intense self-reform, particularly after the Xinhai Revolution of 1911. Third, they were marginalized by the new educational systems of the Republic of China, especially the Renxu School Systemof 1922 and the Wuchen School Systemof 1928. Finally, after the foundation of the People's Republic of China in 1949, they were considered remnants of feudal culture and forcibly replaced by modern schools. Originality/value:: This paper brings hitherto unexplored Chinese sources to an English-speaking audience in an effort to shed new light on the history of traditional Chinese education. The fate of Si-shuwas part of the larger modernization of Chinese education – a development that had both advantages and disadvantages.