Objective:To conduct a scoping review of the content, formats, outcome indicators, and application effects of decision aids used for stroke prevention in patients with atrial fibrillation, in order to inform future development and implementation of such tools.Methods:Following the 2020 methodology guidelines for scoping reviews from the Joanna Briggs Institute, a systematic search was performed in PubMed, Web of Science, Embase, CINAHL, Wanfang Data, China National Knowledge Infrastructure, VIP, and China Biology Medicine disc from inception to October 11, 2024.Results:A total of 13 studies were included, comprising 7 randomized controlled trials, 3 quasi-experimental studies, and 3 mixed-methods studies. The formats of decision aids included paper-based tools, web-based platforms, and mobile applications. The content involved disease education, risk prediction, comparison of preventive options, exploration of patient values, and personalized communication. Multiple studies reported that decision aids reduced decisional conflict, improved patient satisfaction with decision-making, positively influenced patient health, and were highly feasible.Conclusions:Decision aids for stroke prevention in patients with atrial fibrillation are effective in enhancing decision quality and facilitating shared decision-making. Future research should further focus on the impact of such tools on patients' stroke prevention strategy choices, long-term treatment adherence, and clinical outcomes, thereby improving the effectiveness of stroke prevention in this population.

Objective:To conduct a scoping review of the content, formats, outcome indicators, and application effects of decision aids used for stroke prevention in patients with atrial fibrillation, in order to inform future development and implementation of such tools.Methods:Following the 2020 methodology guidelines for scoping reviews from the Joanna Briggs Institute, a systematic search was performed in PubMed, Web of Science, Embase, CINAHL, Wanfang Data, China National Knowledge Infrastructure, VIP, and China Biology Medicine disc from inception to October 11, 2024.Results:A total of 13 studies were included, comprising 7 randomized controlled trials, 3 quasi-experimental studies, and 3 mixed-methods studies. The formats of decision aids included paper-based tools, web-based platforms, and mobile applications. The content involved disease education, risk prediction, comparison of preventive options, exploration of patient values, and personalized communication. Multiple studies reported that decision aids reduced decisional conflict, improved patient satisfaction with decision-making, positively influenced patient health, and were highly feasible.Conclusions:Decision aids for stroke prevention in patients with atrial fibrillation are effective in enhancing decision quality and facilitating shared decision-making. Future research should further focus on the impact of such tools on patients' stroke prevention strategy choices, long-term treatment adherence, and clinical outcomes, thereby improving the effectiveness of stroke prevention in this population.

Objective: To explore the relationship among dark triad, peer relationship, and cyber bullying of middle school students, and to provide suggestions for intervention of cyberbullying behavior of middle school students. Methods: Peer Relationship Scale (PRS), Dirty Dozen (DD) and Cyberbullying Questionnaire (CBQ) were administrated to 1 934 middle school students in Beijing and Yunnan by cluster sampling. Results: Middle school boys scored significantly higher on the dark triad and cyber-bullying than girls ( F =13.45, 50.20, P <0.01). The dark triad of middle school students was positively correlated with cyber-bullying ( r =0.38, 0.40, 0.21, P <0.01), while negative dimensions of peer relationship were positively correlated with cyber-bullying ( r = -0.10 , -0.22, -0.16, P <0.01). Peer relationship had a moderating effect on the relationship between dark triad and cyber-bullying ( β =-0.07， t =-3.24，Δ R 2=0.00， P <0.01). Conclusion Positive peer relationship can reduce the cyber-bullying behavior of middle school students with high dark triad which should be emphasized among middle school students.

Objective:To investigate the clinical efficacy of Sun's procedure and debranching hybrid procedure in the treatment of elderly acute Stanford type A aortic dissection.Methods:53 elderly patients(aged over 60 years old) with acute Stanford type A aortic dissection admitted to Tianjin Chest hospital from January 2017 to June 2018 were selected and divided into Sun's procedure group of 35 patients and debranching hybrid procedure group of 18 patients. The history of cerebral infarction before operation was more in the hybridization operation group than in the Sun's operation group, and the difference of other preoperative data was not statistically significant. The brain protection strategy was adopted in both groups. During Sun's procedure, bilateral anterograde cerebral perfusion and descending aorta balloon occlusion were performed to maintain the blood supply of lower limbs.And the total aortic arch and branch blood vessels were closed by stent-graft in debranching hybrid procedure.The basic data and perioperative conditions of the patients were statistically analyzed, and the postoperative results and short-term prognosis were compared between the two groups after 1 year of follow-up.Results:The hybrid group avoided circulatory arrest, and the lowest intraoperative nasopharyngeal temperature was slightly higher than that of the Sun' s group[(25.1±0.4)℃ ratio(27.7±0.6)℃)]. However, there were no significant difference in the operation time[(178.9±43.5)min ratio(166.9±95.4)min] and intraoperative blood loss[(1 724.9±1 394.2)ml ratio(1 590.7±920.5)ml] between the two groups, and no significant difference in postoperative renal failure(20% ratio 11.1%), cerebrovascular accident(cerebral infarction/cerebral hemorrhage)(11.4% ratio 5.6%), cognitive dysfunction(17.1% ratio 11.1%), ventilator assistance time[84.0(25.0, 160.0) hours ratio 61.7(17.3, 90.5) hours], ICU stay time[6.5(2.9, 14.3) days ratio 4.4(2.0, 6.1) days] and so on. There were 3 perioperative deaths in Sun's group and 2 perioperative deaths in hybrid group.The mean follow-up time of the two groups was 14.8 months. During the follow-up period of Sun's group, no new cerebrovascular event and 1 case of distal false lumen of the descending thoracic aorta active blood flow occurred and 1 case died 2 months after the operation.There was 1 case of new cerebrovascular events in hybrid group and no death. The 1-year survival rate was similar between the two groups.Conclusion:For patients over 60 years old with acute Stanford type A aortic dissection, Sun's procedure and hybrid procedure are safe and effective.

Objective　To improve intracardiac operation skil ls on bea-ting-heart with mild hypothermic cardiopulmonary bypass (On pump beating-heart technique), and to review the clinical experience in 1 032 c ases. Methods　A total of 1 032 cases of intracardiac operatio ns on pump beating-heart from November 1997 to September 2000 were reviewed. Of them, 714 cases were congenital heart diseases (CHD), and 318 cases were valvul ar heart diseases (VHD). The technique was improved by establishing simultaneous left atrium and ventricle suction and integrating sequential de-airing procedu re. Results　The operative mortality was 2.33% (24/1 032), the m ortality was 2.7% (19/714) in cases with CHD, and 1.6% (5/318) in those with VHD. There was no pati ent complicated with systemic air embolism or permanent atrioventricular conduct ion block. Conclusion　Results suggested that intracardiac procedures on pump beating-heart with mild hypothermic cardiopnlmonary bypass is safe and available in patients with CHD or VHD. It might extenuate the heart and lung injury by hypothermia and ischemia-reperfusion during cardiopulmonary bypass. Cardiac conducting block might be prevented during operation.