<strong>Background: </strong>Adenoid cystic carcinoma (ACC) refers to a salivary gland neoplasm. Tracheal adenoid cystic carcinoma that invades the tracheal prominence is a relatively rare tumor among thor...<strong>Background: </strong>Adenoid cystic carcinoma (ACC) refers to a salivary gland neoplasm. Tracheal adenoid cystic carcinoma that invades the tracheal prominence is a relatively rare tumor among thoracic diseases.<strong> Objective: </strong>To explore the epidemiology, diagnosis, treatment and future development of tracheal adenoid cystic carcinoma (TACC). <strong>Methods:</strong> With asymptomatic invasion of the tracheal prominence, a case of tracheal adenoid cystic carcinoma with asymptomatic invasion of the tracheal prominence was reported. The clinical management process and surgical methods were introduced, and related literature was reviewed and summarized. <strong>Results: </strong>The patient was admitted due to tracheal augmentation mass for half a month. Chest CT at admission displayed the soft tissue density shadow behind the tracheal augmentation process. After the completion of other examinations, tracheal tumor resection and tracheal reconstruction were performed. Postoperative routine pathology exhibited that it was TACC and without inguinal lymph node metastasis. <strong>Conclusion:</strong> TACC is a low-grade tracheal tumor with low incidence, delayed clinical manifestations and lack of specificity as well. CT and bronchoscopy are helpful for the diagnosis of suspected patients. Meanwhile, radical surgical resection is the first choice of treatment. Adjuvant therapy can improve the therapeutic effect. Targeted immunotherapy is the developing direction of treatment.展开更多
The aim of this study was to explore the inhibitory effect of histone deacetylase inhibitor (HDACI) on the proliferation of leukemia cells. The two kinds of leukemia cells (human promyelocytic leukemia cell (HL-60) an...The aim of this study was to explore the inhibitory effect of histone deacetylase inhibitor (HDACI) on the proliferation of leukemia cells. The two kinds of leukemia cells (human promyelocytic leukemia cell (HL-60) and human acute myelogenous leukemia cell (KG-1)) were selected for in vitro research. Besides, Chidamide, a kind of benzamide HDACI, was applied to induce and culture the HL-60 and KG-1 cells, and the anti-tumor cell proliferation activity of Chidamide on HL-60 and KG-1 was detected by the methyl thiazolyl tetrazolium (MTT) assay, which was 5.6 and 6.1 in turn. The cell scratch experiment verified that Chidamide had the metastasis inhibitory effect on HL-60 and KG-1 cells. Flow cytometry was employed to measure the percentage of apoptotic cells, and it was found that the percentage of apoptotic cells was 55.6% ± 1% and 48.6% ± 1% in sequence after HL-60 and KG-1 cells were treated with Chidamide for 36 hours. The number of auto-phagosomes was determined by transmission electron microscopy showing that the number of auto-phagosomes in HL-60 and KG-1 cells was 12 ± 1 and 10 ± 1, respectively after the induction process of Chidamide. The phosphorylated histone H2AX protein (γ-H2AX) recognition antibody immunofluorescence method was adopted to determine the deoxyribonucleic acid (DNA) damage, and the positive rates of HL-60 and KG-1 cells reached 28.41% and 26.35%, respectively after Chidamide treatment. Therefore, Chidamide, as a kind of HDACI, could effectively inhibit the proliferation of leukemia cells, so that the results of this experiment had a good guiding meaning for the clinical diagnosis and treatment of leukemia.展开更多
Polysubstance Abuse (PSA) greatly complicates an attempt to implicate a single drug as sole cause of an overdose death. Since PSA now occurs in the majority of cases of drug overdoses, many or most overdose deaths are...Polysubstance Abuse (PSA) greatly complicates an attempt to implicate a single drug as sole cause of an overdose death. Since PSA now occurs in the majority of cases of drug overdoses, many or most overdose deaths are polysubstance overdose deaths. And since many of the substances involved in a polysubstance Overdose Death (POD) are Central Nervous System (CNS) depressants, many of which can cause overdose death themselves, or synergistically with opioids, it is somewhat puzzling that prescription opioids have been singled out as the cause of these deaths—without reference to PSA. This is particularly puzzling in light of the fact that the issues of PSA and POD have been recognized and discussed in the literature since at least the 1960’s and before. We therefore here consider the question: are we facing an “opioid” crisis or, instead, a “polysubstance crisis”? And we wonder if the issue has been over-simplified, to the detriment of the individuals affected, and to society more broadly. There is a need for an “agnostic” respiratory stimulant that can reverse polysubstance-induced respiratory depression.展开更多
Ossified subdural chronic hematoma (OSCH) is a rare disease that accounts 0.3% to 2% of subdural chronic hematoma which is common. The surgical management depends on his clinical expression. The aim of this study is t...Ossified subdural chronic hematoma (OSCH) is a rare disease that accounts 0.3% to 2% of subdural chronic hematoma which is common. The surgical management depends on his clinical expression. The aim of this study is to highlight the surgical procedure because the management of this type of lesion has no consensus. The authors reported two cases of OSCH which were successfully excised with good outcomes. Taking care during the procedure of dissection from parenchyma is the key for this surgery.展开更多
In the literature, the management of enterocutaneous fistula of tuberculosis origin is rare. The aim of this work was to report a case of external digestive fistula of tuberculosis origin in a 10-year-old girl in nort...In the literature, the management of enterocutaneous fistula of tuberculosis origin is rare. The aim of this work was to report a case of external digestive fistula of tuberculosis origin in a 10-year-old girl in northern Mali in a situation of armed conflict. She was a 10-year-old patient who was admitted to our general surgery ward for external digestive fistula evolving for more than (4) four years, at admission the general. The karnofsky index was at 40%, she could not sit or hold a cup to drink water. A 3 cm enterocutaneous fistula deafened foul-smelling liquid stools, on clinical examination, the conjunctivas were pale, the lips were dry, the eyes were sunk in the eye sockets, the ribs visible from a distance. The paraclinical aspects (<em>Itra-Dermo-Reaction</em> (IDR) to <em>tubercria</em>, anatomopathology) were positive, specifying the place of medical treatment and evolution under medical treatment. Digestive fistula of tuberculosis origin is a rare condition in surgical settings.展开更多
<strong>Background</strong><strong>:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Type B aortic</span><b&...<strong>Background</strong><strong>:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Type B aortic</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">intramural hematoma (IMH-B) is recognized as a subset of aortic dissection. The evolution of uncomplicated IMH-B is very difficult to predict. How and when to deal with this disease is unclear. The present study constructed two models to explore this problem. One is the</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">morphology evolution model, which explored the risk factors and predictors for the IMH-B patients. Another is the predictive model confirmed the predictors and the time for invasive treatment of uncomplicated IMH-B patients.</span></span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To explore the evolution predictors and detect the time for invasive treatment of uncomplicated IMH-B patients.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">The</span><b></b><span style="font-family:Verdana;">morphology evolution model demonstrated that all 81 patients were diagnosis with CTA images. The initial and follow-up data were retrospectively studied. The evolution data were collection and measurement from initial and follow-up CTA images data. The predictive model showed that predictors of progression were detected with cox regression analysis.</span></span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">All 81IMH-B patients were followed-up ranged from 1.2 to 36 months (median, 22 months). 26 patients accepted invasive treatment (24 underwent TEVAR and 2 underwent Surgery)</span><span style="font-family:Verdana;">. </span><span style="font-family:Verdana;">55 patients received medical treatment. Invasive treatment (IT) group overall events </span><span style="font-family:Verdana;">are </span><span style="font-family:Verdana;">1</span><span style="font-family:Verdana;">/</span><span style="font-family:Verdana;">26 (3.8%)</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;"> medical treatment</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">(MT) group overall events </span><span style="font-family:Verdana;">are </span><span style="font-family:Verdana;">33</span><span style="font-family:Verdana;">/</span><span style="font-family:Verdana;">55 (60.0%)</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;"> IT group</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">vs.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">MT group</span><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> p < 0.001</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;"> Moreover,</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">we found that most events related aorta occurred within 30 days. Multivariate Cox regression analysis MDAD (hazard ratio, 3.58;95% CI, 1.25</span><span style="font-family:;" "=""></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">5.78;p < 0.001), MDAHT (hazard ratio, 4.26;95% CI, 0.85</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">7.84;p < 0.001), and IMH with PAU (hazard ratio, 3.58;95% CI, 1.02</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">5.63;p < 0.001) were confirmed as the independent predictors. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">MDAD > 45 mm, MDAHT > 10</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">mm, and IMH with PAU may be the important predictors for uncomplicated IMH-B patients. Most adverse aorta related events occurred within 30 days. It would be careful follow-up, closely observe for these patients within 30 days, and take necessary treatment strategies in time.</span>展开更多
Transcranial direct current stimulation(tDCS)has been reportedly beneficial for different neurodegenerative disorders.tDCS has been reported as a potential adjunctive or alternative treatment for auditory verbal hallu...Transcranial direct current stimulation(tDCS)has been reportedly beneficial for different neurodegenerative disorders.tDCS has been reported as a potential adjunctive or alternative treatment for auditory verbal hallucination(AVH).This study aims to review the effects of tDCS on AVH in patients with schizophrenia through combining the evidence from randomized clinical trials(RCTs).The databases of PsycINFO(2000–2019),PubMed(2000–2019),EMBASE(2000–2019),CINAHL(2000–2019),Web of Science(2000–2019),and Scopus(2000–2019)were systematically searched.The clinical trials with RCT design were selected for final analysis.A total of nine RCTs were eligible and included in the review.Nine RCTs were included in the final analysis.Among them,six RCTs reported a significant reduction of AVH after repeated sessions of tDCS,whereas three RCTs did not show any advantage of active tDCS over sham tDCS.The current studies showed an overall decrease of approximately 28%of AVH after active tDCS and 10%after sham tDCS.The tDCS protocols targeting the sensorimotor frontal-parietal network showed greater treatment effects compared with the protocols targeting other regions.In this regard,cathodal tDCS over the left temporoparietal area showed inhibitory effects on AVHs.The most effective tDCS protocol on AVHs was twice-daily sessions(2 mA,20-minute duration)over 5 consecutive days(10 sessions)with the anode over the left dorsolateral prefrontal cortex and the cathode over the left temporal area.Some patient-specific and diseasespecific factors such as young age,nonsmoking status,and higher frequencies of AVHs seemed to be the predictors of treatment response.Taken together,the results of tDCS as an alternative treatment option for AVH show controversy among current literatures,since not all studies were positive.However,the studies targeting the same site of the brain showed that the tDCS could be a promising treatment option to reduce AVH.Further RCTs,with larger sample sizes,should be conducted to reach a conclusion on the 展开更多
Prevention and treatment of cerebral palsy(CP)by regenerative medicine:Perinatal asphyxia is a well-known medical condition that can lead to CP.Several etiologies are involved in this process,but the primary cause is ...Prevention and treatment of cerebral palsy(CP)by regenerative medicine:Perinatal asphyxia is a well-known medical condition that can lead to CP.Several etiologies are involved in this process,but the primary cause is hypoxic-ischemic encephalopathy(HIE)that is characterized by reduced blood flow and oxygen supply to the baby’s brain.CP is one of the possible consequences of this neurologic injury.Once developed,CP is difficult to treat,and the role of rehabilitation in functional recovery is still limited.The Neonatal Resuscitation Program is one of the various approaches that have been tried to date.The program has been providing training courses since 2006 for midwives and nurses in addition to physicians,and we saw a marked reduction in mortality associated with birth asphyxia just after a year of the program.However,further efforts are required to achieve 0%mortality.展开更多
文摘<strong>Background: </strong>Adenoid cystic carcinoma (ACC) refers to a salivary gland neoplasm. Tracheal adenoid cystic carcinoma that invades the tracheal prominence is a relatively rare tumor among thoracic diseases.<strong> Objective: </strong>To explore the epidemiology, diagnosis, treatment and future development of tracheal adenoid cystic carcinoma (TACC). <strong>Methods:</strong> With asymptomatic invasion of the tracheal prominence, a case of tracheal adenoid cystic carcinoma with asymptomatic invasion of the tracheal prominence was reported. The clinical management process and surgical methods were introduced, and related literature was reviewed and summarized. <strong>Results: </strong>The patient was admitted due to tracheal augmentation mass for half a month. Chest CT at admission displayed the soft tissue density shadow behind the tracheal augmentation process. After the completion of other examinations, tracheal tumor resection and tracheal reconstruction were performed. Postoperative routine pathology exhibited that it was TACC and without inguinal lymph node metastasis. <strong>Conclusion:</strong> TACC is a low-grade tracheal tumor with low incidence, delayed clinical manifestations and lack of specificity as well. CT and bronchoscopy are helpful for the diagnosis of suspected patients. Meanwhile, radical surgical resection is the first choice of treatment. Adjuvant therapy can improve the therapeutic effect. Targeted immunotherapy is the developing direction of treatment.
文摘The aim of this study was to explore the inhibitory effect of histone deacetylase inhibitor (HDACI) on the proliferation of leukemia cells. The two kinds of leukemia cells (human promyelocytic leukemia cell (HL-60) and human acute myelogenous leukemia cell (KG-1)) were selected for in vitro research. Besides, Chidamide, a kind of benzamide HDACI, was applied to induce and culture the HL-60 and KG-1 cells, and the anti-tumor cell proliferation activity of Chidamide on HL-60 and KG-1 was detected by the methyl thiazolyl tetrazolium (MTT) assay, which was 5.6 and 6.1 in turn. The cell scratch experiment verified that Chidamide had the metastasis inhibitory effect on HL-60 and KG-1 cells. Flow cytometry was employed to measure the percentage of apoptotic cells, and it was found that the percentage of apoptotic cells was 55.6% ± 1% and 48.6% ± 1% in sequence after HL-60 and KG-1 cells were treated with Chidamide for 36 hours. The number of auto-phagosomes was determined by transmission electron microscopy showing that the number of auto-phagosomes in HL-60 and KG-1 cells was 12 ± 1 and 10 ± 1, respectively after the induction process of Chidamide. The phosphorylated histone H2AX protein (γ-H2AX) recognition antibody immunofluorescence method was adopted to determine the deoxyribonucleic acid (DNA) damage, and the positive rates of HL-60 and KG-1 cells reached 28.41% and 26.35%, respectively after Chidamide treatment. Therefore, Chidamide, as a kind of HDACI, could effectively inhibit the proliferation of leukemia cells, so that the results of this experiment had a good guiding meaning for the clinical diagnosis and treatment of leukemia.
文摘Polysubstance Abuse (PSA) greatly complicates an attempt to implicate a single drug as sole cause of an overdose death. Since PSA now occurs in the majority of cases of drug overdoses, many or most overdose deaths are polysubstance overdose deaths. And since many of the substances involved in a polysubstance Overdose Death (POD) are Central Nervous System (CNS) depressants, many of which can cause overdose death themselves, or synergistically with opioids, it is somewhat puzzling that prescription opioids have been singled out as the cause of these deaths—without reference to PSA. This is particularly puzzling in light of the fact that the issues of PSA and POD have been recognized and discussed in the literature since at least the 1960’s and before. We therefore here consider the question: are we facing an “opioid” crisis or, instead, a “polysubstance crisis”? And we wonder if the issue has been over-simplified, to the detriment of the individuals affected, and to society more broadly. There is a need for an “agnostic” respiratory stimulant that can reverse polysubstance-induced respiratory depression.
文摘Ossified subdural chronic hematoma (OSCH) is a rare disease that accounts 0.3% to 2% of subdural chronic hematoma which is common. The surgical management depends on his clinical expression. The aim of this study is to highlight the surgical procedure because the management of this type of lesion has no consensus. The authors reported two cases of OSCH which were successfully excised with good outcomes. Taking care during the procedure of dissection from parenchyma is the key for this surgery.
文摘In the literature, the management of enterocutaneous fistula of tuberculosis origin is rare. The aim of this work was to report a case of external digestive fistula of tuberculosis origin in a 10-year-old girl in northern Mali in a situation of armed conflict. She was a 10-year-old patient who was admitted to our general surgery ward for external digestive fistula evolving for more than (4) four years, at admission the general. The karnofsky index was at 40%, she could not sit or hold a cup to drink water. A 3 cm enterocutaneous fistula deafened foul-smelling liquid stools, on clinical examination, the conjunctivas were pale, the lips were dry, the eyes were sunk in the eye sockets, the ribs visible from a distance. The paraclinical aspects (<em>Itra-Dermo-Reaction</em> (IDR) to <em>tubercria</em>, anatomopathology) were positive, specifying the place of medical treatment and evolution under medical treatment. Digestive fistula of tuberculosis origin is a rare condition in surgical settings.
文摘<strong>Background</strong><strong>:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Type B aortic</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">intramural hematoma (IMH-B) is recognized as a subset of aortic dissection. The evolution of uncomplicated IMH-B is very difficult to predict. How and when to deal with this disease is unclear. The present study constructed two models to explore this problem. One is the</span><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">morphology evolution model, which explored the risk factors and predictors for the IMH-B patients. Another is the predictive model confirmed the predictors and the time for invasive treatment of uncomplicated IMH-B patients.</span></span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To explore the evolution predictors and detect the time for invasive treatment of uncomplicated IMH-B patients.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:;" "=""><span style="font-family:Verdana;">The</span><b></b><span style="font-family:Verdana;">morphology evolution model demonstrated that all 81 patients were diagnosis with CTA images. The initial and follow-up data were retrospectively studied. The evolution data were collection and measurement from initial and follow-up CTA images data. The predictive model showed that predictors of progression were detected with cox regression analysis.</span></span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">All 81IMH-B patients were followed-up ranged from 1.2 to 36 months (median, 22 months). 26 patients accepted invasive treatment (24 underwent TEVAR and 2 underwent Surgery)</span><span style="font-family:Verdana;">. </span><span style="font-family:Verdana;">55 patients received medical treatment. Invasive treatment (IT) group overall events </span><span style="font-family:Verdana;">are </span><span style="font-family:Verdana;">1</span><span style="font-family:Verdana;">/</span><span style="font-family:Verdana;">26 (3.8%)</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;"> medical treatment</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">(MT) group overall events </span><span style="font-family:Verdana;">are </span><span style="font-family:Verdana;">33</span><span style="font-family:Verdana;">/</span><span style="font-family:Verdana;">55 (60.0%)</span><span style="font-family:Verdana;">;</span><span style="font-family:Verdana;"> IT group</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">vs.</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">MT group</span><span style="font-family:Verdana;">:</span><span style="font-family:Verdana;"> p < 0.001</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;"> Moreover,</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">we found that most events related aorta occurred within 30 days. Multivariate Cox regression analysis MDAD (hazard ratio, 3.58;95% CI, 1.25</span><span style="font-family:;" "=""></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">5.78;p < 0.001), MDAHT (hazard ratio, 4.26;95% CI, 0.85</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">7.84;p < 0.001), and IMH with PAU (hazard ratio, 3.58;95% CI, 1.02</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;"> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">5.63;p < 0.001) were confirmed as the independent predictors. </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">MDAD > 45 mm, MDAHT > 10</span></span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">mm, and IMH with PAU may be the important predictors for uncomplicated IMH-B patients. Most adverse aorta related events occurred within 30 days. It would be careful follow-up, closely observe for these patients within 30 days, and take necessary treatment strategies in time.</span>
文摘Transcranial direct current stimulation(tDCS)has been reportedly beneficial for different neurodegenerative disorders.tDCS has been reported as a potential adjunctive or alternative treatment for auditory verbal hallucination(AVH).This study aims to review the effects of tDCS on AVH in patients with schizophrenia through combining the evidence from randomized clinical trials(RCTs).The databases of PsycINFO(2000–2019),PubMed(2000–2019),EMBASE(2000–2019),CINAHL(2000–2019),Web of Science(2000–2019),and Scopus(2000–2019)were systematically searched.The clinical trials with RCT design were selected for final analysis.A total of nine RCTs were eligible and included in the review.Nine RCTs were included in the final analysis.Among them,six RCTs reported a significant reduction of AVH after repeated sessions of tDCS,whereas three RCTs did not show any advantage of active tDCS over sham tDCS.The current studies showed an overall decrease of approximately 28%of AVH after active tDCS and 10%after sham tDCS.The tDCS protocols targeting the sensorimotor frontal-parietal network showed greater treatment effects compared with the protocols targeting other regions.In this regard,cathodal tDCS over the left temporoparietal area showed inhibitory effects on AVHs.The most effective tDCS protocol on AVHs was twice-daily sessions(2 mA,20-minute duration)over 5 consecutive days(10 sessions)with the anode over the left dorsolateral prefrontal cortex and the cathode over the left temporal area.Some patient-specific and diseasespecific factors such as young age,nonsmoking status,and higher frequencies of AVHs seemed to be the predictors of treatment response.Taken together,the results of tDCS as an alternative treatment option for AVH show controversy among current literatures,since not all studies were positive.However,the studies targeting the same site of the brain showed that the tDCS could be a promising treatment option to reduce AVH.Further RCTs,with larger sample sizes,should be conducted to reach a conclusion on the
文摘Prevention and treatment of cerebral palsy(CP)by regenerative medicine:Perinatal asphyxia is a well-known medical condition that can lead to CP.Several etiologies are involved in this process,but the primary cause is hypoxic-ischemic encephalopathy(HIE)that is characterized by reduced blood flow and oxygen supply to the baby’s brain.CP is one of the possible consequences of this neurologic injury.Once developed,CP is difficult to treat,and the role of rehabilitation in functional recovery is still limited.The Neonatal Resuscitation Program is one of the various approaches that have been tried to date.The program has been providing training courses since 2006 for midwives and nurses in addition to physicians,and we saw a marked reduction in mortality associated with birth asphyxia just after a year of the program.However,further efforts are required to achieve 0%mortality.