Efficacy and safety of intraoperative radiotherapy for pancreatic cancer: a meta-analysis / 中华放射肿瘤学杂志

Objective:To compare and analyze the efficacy and safety of intraoperative radiotherapy (IORT) combined with conventional therapy (surgery combined with radiochemotherapy) and conventional therapy alone for pancreatic cancer.Methods:Literature review was conducted from PubMed, Cochrane Library, Web of Science, Embase, Chongqing VIP, CNKI, Wanfang Data and China Biomedical Literature Service System (SinoMed). The literatures that met the inclusion criteria were screened and the data were extracted. Meta-analysis was carried out by RevMan 5.4 software.Results:A total of 11 studies consisting of 813 patients were included. According to the combined results, compared with conventional therapy, IORT combined with conventional therapy could improve the overall survival rate of pancreatic cancer ( HR=0.66, 95% CI=0.54-0.81, Z=4.03, P<0.001), and did not increase the treatment-related side effects ( OR=1.00, 95% CI=0.69-1.46, Z=0.01, P=0.99), but failed to bring benefit to the local control rate ( HR=0.56, 95% CI=0.31-1.01, Z=1.93, P=0.05). Conclusions:The overall survival rate in the IORT combined with conventional therapy group is significantly better than that in the conventional therapy group. No significant difference is found in the treatment-related adverse reactions between two groups. IORT combined with conventional therapy is worthy of clinical application.

Analysis of adverse reactions in 312 cases of gemcitabine / 药学实践杂志

Objective Based on the data of gemcitabine adverse reactions (ADR), the characteristics and patterns of ADR occurrence were analyzed. The guidance for the rational clinical use of gemcitabine was provided. Methods From our information system, the patients treated by gemcitabine chemotherapy from September 2008 to September 2018 were selected and their related ADRs were summarized and statistically analyzed by using SPSS 18.0. Results Among the 750 cases, there were 312 ADRs related to gemcitabine treatment, of which the incidence of ADR was higher in female patients than in male patients (48.68% vs 36.77%) and the highest incidence in the age group of 50-69 years (44.14%). The patients with lower status (KPS) scores were more sensitive to chemotherapeutic drugs, and more likely to develop ADR. During the combination therapy, gemcitabine+paclitaxel chemotherapy had the highest incidence of ADR (61.54%) and the highest incidence of ADR in thymic carcinoma (62.50%), followed by hematological and reproductive system tumors (58.62% and 57.14%, respectively); ADR involvement in organs/systems is mainly caused by hematological toxicity. The bone marrow suppression is common, followed by digestive system damage. The major clinical symptoms were nausea and vomit. Conclusion Gemcitabine-related ADR has a large individualized difference and is affected by many factors. Chemotherapy should be used according to individual conditions to improve clinical safety and rational use of drugs.

Prognostic value of pretreatment 18F-FDG PET/CT SUVmax on stage I-Ⅱ extranodal nasal type natural killer/T-cell lymphoma / 中华核医学与分子影像杂志

Objective To investigate the prognostic value of pretreatment 18F-fluorodeoxyglucose (FDG) PET/CT imaging on extranodal nasal type natural killer/T-cell lymphoma (ENKTL).Methods Thirtyfive patients (20 males,15 females,average age 45 years) diagnosed as Ann Arbor stage Ⅰ-Ⅱ ENKTL from February 2013 to February 2016 were retrospectively analyzed.All patients were pathologically confirmed and underwent 18F-FDG PET/CT before treatment.The maximum standardized uptake value (SUVmax),international prognostic index score (IPI),serum lactate dehydrogenase (LDH),and immunohistochemical results were recorded.Patients were followed up for 2 years.The relationships between SUVmax,progression-free survival (PFS),pathological features and IPI were assessed using Fisher exact test.Results There were 18 ENKTL patients with progression,and 17 had no progression.Patients with SUVmax ≥ 12.2 had worse prognosis than those with SUVmax＜ 12.2 (P =0.001).There were correlations between SUVmax and Ki-67 (r=0.701,P=0.001),SUVmax and CD56 (r=0.393,P=0.032),SUVmax and IPI (r=0.787,P＜0.01),respectively.It was also found that SUVmax,Ki-67,CD56 and IPI were related to PFS (all P＜0.05).Conclusion SUVmax of 18F-FDG could be used as an important prognostic indicator for early ENKTL.

From Bonghan system to primo vascular system:the thought on the substantial study on meridian points / 中国针灸

Through the systematic analysis on the primo vascular system (PVS) in recent years, we believe that in recent years, more and more studies have indicated that PVS is distributed in reticulate structure in every part of body, such as vessels, lymphangions, nerves, brain, spinal cords and internal organs, and it contains a large amount of immunocytes and has involved in the physiological or pathological process of the immunity and circulation in the body. There are the evidences to prove that in morphology and cytobiology. But, nowadays, there is no way to explain its effect characters. On the basis of the study on living matter characteristics, a breakthrough is possibly made through the systematic cooperation even though it is the difficulty to detect the life function effect. It is especially displayed in the substantial study on meridian points. Hence, the study on the law of meridian point effects on the basis of clinical practice has to be focused on in the substantial study on meridian points.

Application of medical cooperation health education after conservative surgery placed Mirena treatment with uterine gland myopathy / 中国实用护理杂志

Objective To explore the effect of medical cooperation health education after conservative surgery placed Mirena treatment with uterine gland myopathy.Methods 30 patients were collected and divided into general group and cooperation group by random number table method,with each group including 15 cases.General group accepted regular health education,while cooperation group received medical cooperation health education.6 months of home visits and telephone follow-up of two groups,statistical comparisons of menstruation,menstrual days,life satisfaction,adverse symptoms and satisfaction of diseases,Mirena,nursing methods between the two groups before and after the treatment.Results Patients' satisfaction and disease knowledge,Mirena knowledge,nursing knowledge the cooperation group scored higher than the conventional group (x2=2.184-6.184,P ＜0.05 or 0.01);the number of higher anxiety level was lower than the conventional group (x2=13.258,P ＜ 0.05);after treatment,dysmenorrhea severity score,menstrual flow,menstrual days,the quality of life the cooperation group were (0.35±0.08) points,(14.20±16.54) ml,(4.21±1.14) d,(9.01±1.36) points while the conventional group were (1.37±0.34) points,(39.64±8.62) ml,(6.74±1.07) d,(7.81±1.30) points,and the difference was statistically significant (t =2.47-11.31,P ＜0.01).the number of adverse symptoms of cooperation group was lower than that of the conventional group (x2=13.594,P ＜ 0.01).Conclusions Compared with single health education,cooperative medical health education has more advantage after conservative surgery placed Mirena treatment uterine gland myopathy which should be promoted in clinic.

Effects of acupuncture on the expression of P2X receptors in the hippocampus of mice with a telomerase gene knocked out / 中华物理医学与康复杂志

Objective To observe the expression of P2X receptors in the hippocampus of telomerase gene knockout mice after acupuncturing the bilateral ST36 acupoints.Methods Eighteen telomerase gene knockout homozygous mice were randomly divided into a blank control group (group A),a manual acupuncture group (group B) and an electric acupuncture group (group C),each of 6.Group A was not given any intervention,while groups B and C were provided with manual or electric acupuncture at point ST36 for 7 days.The expression of P2X receptors and cAMP response element bound protein (CREB) in the hippocampus were observed and compared among the 3 groups.Results The expression of P2X4 in the hippocampus was not significantly different among the 3 groups in groups B and C decreased significantly compared with group A,but there were no significant differences between group Bs and C.The expression of CREB in group C decreased significantly compared with groups A and B.Conclusion EA inhibits the expression of P2X4 receptor and CREB the hippocampus.The signaling pathway may play an important role in the mechanism of action of acupuncture in neurodegenerative diseases.

Influence of specific immunotherapy in allergic rhinitis children with different level of skin prick test with dermatophagoides allergens / 中国耳鼻咽喉头颈外科

OBJECTIVE To observe the efficacy of specific immunotherapy (SIT) with Alutard and NHD in children with allergic rhinitis due to different level of skin prick test (SPT) with dermatophagoides farinae (DF) and dermatophagoides pteronyssinus (DP). METHODS A total of 178 children with persistent allergic rhinitis were included in this study. Their age ranged from 6 to 12 years. They were divided into 3 groups according to level of SPT. Group 1: The level of skin index (SI) of DF is greater than that of DP, Group 2: The level of SI of DF is equal to that of DP and Group 3: The level of SI of DF is less than that of DP. The children in each group were randomly divided into 2 subgroups: Alutard group and NHD group. The children were given SIT with Alutard or NHD for one year. Symptom and medication scores were recorded and analyzed. RESULTS After receiving therapy for 3 months and 6 months, symptom and medication scores of the Group 1 and 2 in the NHD group were lower than those in the Alutard group (P0.05). CONCLUSION The efficacy of SIT with Alutard and NHD is different in children with allergic rhinitis with different levels of SPT due to DF and DP after 3 and 6 months, but is similar after 9 and 12 months. SIT with Alutard and NHD is effective in treating children with allergic rhinitis.

Effect of specific immunotherapy on GM-CSF and IL-5 in the tissues of recurrent nasal polyps / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the mechanism and clinical significance of specific immunotherapy (SIT) on the expression changes of GM-CSF and IL-5 in the tissue samples of recurrent nasal polyps.@*METHOD@#Perennial allergic rhinitis patients with recurrent nasal polyps were randomly divided into 2 groups. The experimental group of 19 patients was treated by SIT and standardized treatment (glucocorticoid nasal spray) , and the control group of 17 patients was only treated by standardized treatment (glucocorticoid nasal spray). We measured the expression levels of GM-CSF and IL-5 in the tissue samples of the nasal polyps by ELISA, and compared the results obtained before treatment with expression levels detected at 6 months and 1 year after the treatment.@*RESULT@#The expression of GM-CSF and IL-5 in the recurrent nasal polyps reduced significantly (P < 0.05) in both groups after 6 months and 1 year post-treatment compared with pre-treatment, and the expression of GM-CSF and IL-5 in the experimental group was much lower than that of the control group.@*CONCLUSION@#SIT decreases the expression of GM-CSF and IL-5 and reduces the inflammatory reaction in the tissue samples of recurrent nasal polyps.

Study on the reversion effect of targeting silence CXCR4 gene on Gemcitabine-resistance in non-small cell lung cancer / 中国生化药物杂志

Objective To explore the reversion effect of Gemcitabine-resistance A549 cell (A549/Gem) by silencing CXCR4.Methods A549 cell was induced by continuous stepwise exposure to Gemcitabine in order to obtain Gemcitabine-resistance A549 cell ( A549/Gem) in vitro.The CXCR4 expressions level of A549 and A549/Gem were detected by Quantitative RT-PCR ( RT-qPCR) and Western blot analyses.The CXCR4 shRNA vector was transfected into the A549/Gem cell by targeting silence CXCR4.Furthermore, MTT assay was used to explore the IC50 and RI in A549, A549/Gem and A549/Gem-CXCR4 cells.Moreover, Western blot analysis was performed to detect the expressions of phospho-JNK, phospho-p38 and phospho-ERK 1/2 in A549, A549/Gem and A549/Gem-CXCR4 cells.Results Gemcitabine-resistance A549 cell ( A549/Gem) was successful constructed by using continuous stepwise exposure to Gemcitabine in vitro.The expression level of CXCR4 was up-regulated in A549/Gem cell than in A549 cell.The CXCR4 shRNA vector could significantly decrease CXCR4 expression in A549/Gem cell.The IC50 values of Gemcitabine in A549, A549/Gem and A549/Gem-CXCR4 cell were (0.08 ±0.01)μmol/L, (14.01 ±0.21)μmol/L and (1.84 ±0.61)μmol/L, respectively.The RI value of Gemcitabine was (127.12 ±12.28) in A549/Gem cells, while the value of RI was (27.3 ±0.98) in A549/Gem-CXCR4 cells.The expression level of phospho-JNK, phospho-p38 and phospho-ERK 1/2 were also markedly inhibited in A549/Gem-CXCR4 cell than in A549/Gem cell.Conclusion CXCR4 is up-regulated in A549/Gem cell.Targeting silence CXCR4 can successfully reverse drug-resistance of Gemcitabine in A549/Gem cells, which hints CXCR4 is associated with lung cancer radiation therapy as an effective molecular target.

Efficacy of Ademetionine 1 ,4-Butanedisulfonate Enteric Coated Tables in the Treatment of Severe Intrahe-patic Cholestasis in Gestation Period and its Influence on Liver Function / 中国药师

Objective:To study the efficacy of ademetionine 1,4-butanedisulfonate enteric coated tables in the treatment of severe intrahepatic cholestasis in gestation period and its influence on liver function. Methods:From July 2013 to November 2014 in our hos-pital, 122 cases of severe intrahepatic cholestasis patients were divided into the observation group (61 cases) and the control group (61 cases) according to the admission order. The two groups of patients were given the conventional treatment, and the observation group was treated with ademetionine 1,4-butanedisulfonate enteric coated tables additionally. The clinical efficacy, pruritus, perinatal child and pregnancy outcomes were observed after the treatment. The liver function in the two groups before and after the treatment was com-pared. Results:Before the treatment, TB, TBA, DB, AST and ALT in the two groups showed no significant difference (P>0. 05). After the treatment, TB[(22.7 ±4.3) μmol·L-1], TBA [(14.3 ± 3.4) μmol·L-1], DB[(5.3 ± 0.8)μmol·L-1], AST [(73.2 ±13.2)U·L-1] and ALT [(82.5 ±10.3)U·L-1] in the observation group were significantly lower than those in the con-trol group[TB(28.3 ±4.8) μmol·L-1, TBA(21.5 ±5.2) μmol·L-1, DB(8.3 ±2.4) μmol·L-1, AST(245.1 ±38.3) U· L-1, ALT(221.4 ±37.4) U·L-1], and the difference was statistically significant(P<0.05). After the treatment, the total effec-tive rate in the observation group (96. 72%) was significantly higher than that in the control group (80. 33%), the degree of itching in the observation group was significantly lower than that in the control group, the perinatal children and pregnancy outcomes in the ob-servation group were significantly better than those in the control group, and the difference was statistically significant (P<0. 05). Conclusion:Ademetionine 1,4-butanedisulfonate enteric coated tables in the treatment of severe intrahepatic cholestasis during preg-nancy is effective with high security, which can significantly improve liver function, and is worthy of wide application.

Factor analysis of hospitalization expenses for lens surgery / 中华医院管理杂志

Objective To identify the common factor affecting hospitalization expense of lens surgery operation, and propose effective measures to curb unreasonable increase of medical costs.Methods Collection of inpatients information of the year 2014 from a tertiary hospital in Beijing, for factor analysis of the hospitalization expenses of 555 inpatients categorized as DRGs of CB39 (lens surgery), using the BJ-DRGs platform.Results The highest factor of lens surgery expenses is disposable medical surgery materials, accounting for 42.77％;followed by surgery fee and medication fee, accounting for 23.19％ and 17.15％ respectively.Conclusion For the hospitals, medicine and medical material rank the highest in cost control, and they are recommended to work on them by means of clinical pathways, medical norms and purchasing policy, and to explore new means of payment in the meantime.

Prediction of H7N9 epidemic in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In March 2013, human cases of infection with a novel A (H7N9) influenza virus emerged in China. The epidemic spread quickly and as of 6 May 2013, there were 129 confirmed cases. The purpose of this study was to analyze the epidemiology of the confirmed cases, determine the impacts of bird migration and temperature changes on the H7N9 epidemic, predict the future trends of the epidemic, explore the response patterns of the government and propose preventive suggestions.</p><p><b>METHODS</b>The geographic, temporal and population distribution of all cases reported up to 6 May 2013 were described from available records. Risk assessment standard was established by analysing the temperature and relative humidity records during the period of extensive outbreak in three epidemic regions in eastern China, including Shanghai, Zhejiang and Jiangsu provinces. Risk assessment maps were created by combining the bird migration routes in eastern China with the monthly average temperatures from May 1993 to December 2012 nationwide.</p><p><b>RESULTS</b>Among the confirmed cases, there were more men than women, and 50.4% were elderly adults (age >61 years). The major demographic groups were retirees and farmers. The temperature on the days of disease onset was concentrated in the range of 9°C-19°C; we defined 9°C-19°C as the high-risk temperature range, 0°C-9°C or 19°C-25°C as medium risk and <0°C or >25°C as low risk. The relative humidity on the days of disease onset ranged widely from 25% to 99%, but did not correlate with the incidence of infection. Based on the temperature analysis and the eastern bird migration routes, we predicted that after May, the high-risk region would move to the northeast and inland, while after September, it would move back to north China.</p><p><b>CONCLUSIONS</b>Temperature and bird migration strongly influence the spread of the H7N9 virus. In order to control the H7N9 epidemic effectively, Chinese authorities should strengthen the surveillance of migrating birds, increase poultry and environmental sampling, improve live poultry selling and husbandry patterns and move from a "passive response pattern" to an "active response pattern" in focused preventive measures.</p>

The principal component analysis of clinical symptoms in patients with Meniere's disease during acute phase / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the severity index of Meniere's disease during acute phase by a statistical method of principal component analysis (PCA).@*METHOD@#Ninety-five patients with Meniere's disease in the acute phase who saw the doctor with 24 hours after onset were included in this study and their clinical data were analyzed retrospectively. The subjective symptoms of hearing loss (X1) and ear stuffy plug (X4) were evaluated by VAS scoring system, and the impact of vertigo (X2) and tinnitus (X3) on the patients were evaluated by DHI and THI score. The principal component analysis (PCA) method was used to analyze the quantified data and construct a synthetic evaluate function of subjective symptoms.@*RESULT@#(1) The quantitative results of subjective symptoms in patients with Meniere's disease were as follow: VAS score (X1) of hearing loss was 0-91 points, with an average of 46.23 ± 18.80, DHI score (X2) of vertigo was 8-98 points, with an average of 49.66 ± 15.67, THI score (X3) of tinnitus was 10-100 points, with an average of 47.53 ± 17.44, and ear VAS score (X4) of stuffy plug feeling was 0-82 points, with an average of 21.55 ± 27.54. (2) The eigenvalue of principal components Z1, Z2 and Z3 were 1.876, 0.984 and 0.703 respectively, and the variance contribution were 46.898%, 24.592% and 17.574% respectively. (3) The constructed synthetic evaluate function of the disease was as follow: The Meniere's disease severity index ƒ = 0.213ZX1 + 0.398ZX2 + 0.370ZX3 + 0.455ZX4.@*CONCLUSION@#The method of PCA for the subjective evaluation of symptoms in Meniere's disease can be constructed as a model of comprehensive evaluation system, which may provide relatively comprehensive information of clinical original variables included in the four main symptoms, reflecting the severity of the disease.

Personnel training program establishment for higher vocational pharmacy based on professional position / 药学实践杂志

Objective To establish personnel training program for higher vocational pharmacy by investigating occupation du -ties in pharmacy graduates .Methods The employment of pharmacy graduates from higher vocational school was investigated .The pro-fessional knowledge , ability and quality in the jobs were analyzed so as to constitute the career-oriented personnel training program .Re-sults The career-oriented practical personnel training program was established .Conclusion The career-oriented personnel training program can improve the quality of education of higher vocational pharmacy major .

Effect and safety analysis of Allergovit standardized mite allergen immunotherapy in patients with allergic rhinitis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the effect and safety analysis of Allergovit standardized dust mite subcutaneous immunotherapy in patients with allergic rhinitis.@*METHOD@#From Jan 2006 to Jan 2009,425 patients with persistent were treated with Allergovit standardized dust mite allergen in 3 years, which data were retrospectively analyzed. The scores of the rhinoconjunctivitis quality of life were collected per-treatment and three years treatment. VAS (visual analogue scale) of all nasal symptoms and drug use scores were evaluated before treatment and every 6 weeks. The frequency of local and systemic reactions were recorded in the duration of dose escalation and maintenance.@*RESULT@#The Overall QOL were significantly improved after 3 years treatment [pre-treatment: 3.8 (2.9; 4.5); post-treatment: 1.1 (1.0; 2.0), P < 0.01]. VAS of all nasal symptoms and drug used scores decreased dramatically after escalation period [pro-treatment: 23. 7 (20.5; 27.8), 3.9 (3.2; 4.7); post-treatment: 2.1 (1.6; 2.2), 0(0;0), P < 0.01]. Local reaction's rate was 3.15%, the frequency systemic reaction's rate was 0.90%.@*CONCLUSION@#The standardized specific allergen immunotherapy for allergic rhinitis is safe and effective.

Using Warming and Heat-clearing Simultaneously in Treating Constipation and Diarrhea Alternating Bowel Dysfunction / 浙江中医药大学学报

[Objective]We summarized Professor Zhang Weihua’s clinical experience in treating constipation and diarrhea alternating bowel dysfunction by Chinese medicine. [Method] This paper revealed the professor Zhang Weihua ’s experience of curing constipation and diarrhea alternating bowel dysfunc-tion by analyzing the etiology and pathology ,therapeutic principles and relevant cases .[Results] The etiology and pathology of constipation and diarrhea alternating bowel dysfunction is root deficiency and tip excess ,and cold-heat complex ,the disorders of E. conduction,and the treatment should focus on using warming and heat-clearing simultaneously, tonifying spleen and kidney. [Conclusions] The experience of Professor Zhang Weihua in treating con-stipation and diarrhea alternating bowel dysfunction is effective and thought-provoking in treatment.

Effect of Epimedium Flavanoids on Neuro-inflammatory Reaction in Alzheimer Disease Model Mice Induced by Lateral Ventricle Injection of β-amyloid / 中国康复理论与实践

@# Objective To investigate the effect of Epimedium flavanoids (EF) on neuro-inflammatory reaction in Alzheimer disease (AD) mice model.Methods β-amyloid1-40 (Aβ1-40) was injected to the right lateral ventricle of 2-month-old male ICR mice to induce AD model. Morris water maze and step-through tests were used to measure the learning and memory ability of mice. The concentrations of interleukin-1β (IL-1β) and tumor necrosis factor α (TNF-α) in the hippocampus were determined by radioimmunoassay. The expression of glial fibrillary acidic protein (GFAP) positive cells (astrocytes) was detected by immunochemistry staining.Results Compared with the sham-operation group, the learning and memory ability decreased (P<0.05, P<0.01), the concentrations of IL-1β and TNF-α in the hippocampus increased (P<0.01) and the expression of astrocytes in the hippocampus elevated (P<0.05) in Aβ1-40 injection model mice. Intragastric administration of EF (100 and 300 mg/kg) for 3 weeks significantly improved the learning and memory ability (P<0.05, P<0.01), decreased IL-1β and TNF-α concentrations in the hippocampus (P<0.05, P<0.01) and inhibited the expression of astrocytes in the hippocampus (P<0.05), compared with Aβ1-40 injection model mice.Conclusion EF can decrease the inflammatory reaction in the brain of mice induced by Aβ.

Study of electroneurophysiology on Charcot-Marie-Tooth disease / 中国综合临床

Objective To explore the diagnostic value of electroneurophisology in patients with charcot-Ma-rie-Tooth disease(CMT).Methods Electromyogram(EMG),Motor nerve conduction velocity(MCV),Sensory nenre conduction velocity(SCV) and F wave were measured in 31 cases with Charcot-Marie-Tooth disease(CMT).Resuits The abnormality rate of EMG was 90%,MCV was 100%,SCV was 90%,and F wave was 34%.Conclu-sion The electroneurophysiology is very practical and valuable in diagnosing Charcot-Marie-Tooth disease.

Study of electroneurophysiology on Charcot-Marie-Tooth disease / 中国综合临床

Objective To explore the diagnostic value of electroneurophisology in patients with charcot-Ma-rie-Tooth disease(CMT).Methods Electromyogram(EMG),Motor nerve conduction velocity(MCV),Sensory nenre conduction velocity(SCV) and F wave were measured in 31 cases with Charcot-Marie-Tooth disease(CMT).Resuits The abnormality rate of EMG was 90%,MCV was 100%,SCV was 90%,and F wave was 34%.Conclu-sion The electroneurophysiology is very practical and valuable in diagnosing Charcot-Marie-Tooth disease.

Exploration of the cause of recovery failure in adopting advanced simulation system in the teaching of‘recovery of neonatal asphyxia’ / 中华医学教育探索杂志

The article explored the cause of recovery failure by adopting advanced simu-lation system(ECS) in the teaching of ‘recoveing of neonatal asphyxia’and put forward some improvement methods and counter measures.Marking full use of the advantages of ECS,designing the training course with specifit roles and objectives,paying attention to the guidance of organiza-tion and exchange as well as the training of cooperative team are the key to improve the skills of neonatal asphyxia recovery in obstetrical pediatric and the teaching quality.