Aims: We aim to find out the factors affecting the use of anticoagulants and the intensity of their choices, and to establish a basis for improving neurologists’ effective implementation of the guidelines. Methods: A cross-sectional study is conducted in Hubei province in central China. Each neurologist completes a standard-structured anonymous questionnaire through face-to-face interviews. The problems include the attitude and options about anticoagulant therapy. Results: A total of 611 neurologists from 38 hospitals respond to this survey. For the best treatment of atrial fibrillation, more than 80% of physicians choose anticoagulant therapy. For patients with atrial fibrillation and cerebral infarction, physicians think Warfarin is the preferred drug as high as 93.8%. Among the anticoagulant drugs ever used by clinicians, the use rate of Warfarin is 93.8%, but the use rate of direct oral anticoagulants is extremely low. The use of direct oral anticoagulants is related to the educational level and the geographical location of the hospital. Bleeding risk is the first reason influencing clinicians’ choice of Warfarin, accounts for 88.9%. 97.7% of the clinicians recommend patients with Warfarin regularly monitoring the INR, but the frequency of monitoring is inconsistent. Clinicians have a high willingness to learn about AF, but the proportion of hospitals carry out appropriate training is low. Conclusions: There are still some gaps with the guidelines on the choice of anticoagulant drugs. Neurologists have positive attitude towards anticoagulant therapy and a strong willingness to learn, but the corresponding training is lacking. Continuous professional training is necessary.

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disease affecting the reproductive age women. Objective: To investigate the relationship between PCOS and breast, ovarian, and endometrial cancer. Search Strategy: Systematic search of PubMed, EMBASE using keywords ‘PCOS’, ‘ovarian cancer’, ‘breast cancer’ and ‘endometrial cancer’. Selection Criteria: The study providing the relative risk (RR) in the cohort study, odds risk(OR) in the case-control study, and 95%confidence interval (95%CI) were included. The single-case report and the non-English study were excluded. Data Collection and Analysis: This meta-analysis was performed by calculating RR, OR and 95%CI using random-effect models. Main Result: A total of 21 studies (8 cohort studies,13 case-control studies) involving 3831083 participants fulfilled the inclusion criteria. Based on the results of cohort studies and case-control studies, the prevalence of breast cancer among PCOS and non-PCOS women was not significant increased, the RR and OR were 0.959 (95%CI, 0.806-1.112) and 0.991 (95%CI, 0.626-1.35), respectively. Evidence from case-control studies showed that PCOS did not increase the risk of endometrial and ovarian cancer, the summary ORs of case-control studies were 1.288 (95%CI,0.763-1.814) and 1.219 (95%CI, 0.816-1.623). The risk of endometrial and ovarian cancer was significantly increased based on cohort studies, the overall RRs of cohort studies were 2.542 (95%CI, 1.755-3.328) and 1.818 (95%CI, 1.222-2.414). Conclusion: The meta-analysis demonstrate that PCOS will not increase the risk of breast cancer. Evidence from the cohort studies suggests that PCOS significantly increases the risk of endometrial and ovarian cancer, although the case-control studies did not.