In recent years, due to the rapid changing social structure, thedemands for medical services are also changing. There is a need to explore the future direction of acupuncture and moxibustion. Therefore, using the keyword "patient"as the focus of medicalservices, we discussed the question, "What is meant by 'patient-centered'Acupuncture and Moxibustion?"
Our results indicate that the numerous clinical treatments, education, and research that occurred throughout the long history of acupuncture and moxibustion in Japan were in fact all done "for the patient."However, we note that there is still room for improvement in verification method and cooperation between each field, and we confirmed that there is a need to build Acupuncture and Moxibustion methods that truly represent "patient-centered medicine."

[Introduction] In 2006 the WHO and WPRO agreed on standard acupuncture point locations. To promotepagate these standards, in 2009 the Second Japan Acupuncture Standardization Committee published a Japanese edition of 'WHO STANDARD ACUPUNCTURE POINT LOCATIONS FOR THE WESTERN PACIFIC REGION.' Based on this Japanese edition, a new textbook was published by the Japan Association of Massage & Acupuncture Teachers and the Japan College Association of Oriental Medicine. Since one year has passed since the start of education based on standard acupuncture point locations at Japanese universities, colleges, vocational schools and training centers for anma (Japanese traditional massage), massage, and shiatsu (acupressure); acupuncture; and moxibustion therapies, we administered a questionnaire survey as an evaluation of international standardization and the problems of introducing standard acupuncture point locations .
[Subjects and methods] Subjects were mainly teachers and included a small number of researchers, clinicians, and other groups concerned with acupuncture and moxibustion. We used a questionnaire that we originally created at the Second Meeting of the Japan Standardization of Acupuncture Point Locations Committee.
[Results] Among the 180 institutions surveyed, we obtained answers from 149 people from 93 institutions in total. Agreement on the question of standard acupuncture points, "functional existence" (44.3%) was most common, and "anatomical existence" came next at 26.6%. For the question on acupuncture treatment, 82.4% replied with "use ofboth acupuncture points and reaction points." For the answers to agreeing with international standardization, "no opinion" was 41.7% and 51.7% for "appreciate." However, both of those groups appreciated globalization of acupuncture and moxibustion by a common　language. There were many opinions on proportional bone measurement. Specifically, opinions indicated a change "from the cubital crease to the wrist crease" (from 10B-cun to 12B-cun) and a need for proportional bone measurement of the upper arm. Whereas, for individual acupuncture points, opinions expressed the difficulty of locating application points and not understanding reasons for change and notations including body surface segments.
[Discussion] We were able to classify the opinions collected into the following groups: (1) problems that can be corrected immediately, including typographic errors, (2) problems that need to be reviewed at the next international gathering, and (3)problems that need to be understood by making full use of related documents.
[Conclusion] We were able to determine primarily for a wide range of teachers, problems understanding individual acupuncture point locations, including consideration of acupuncture points, evaluation of standardization of acupuncture point locations, and other guidelines

Along with clinical practice and education, research is among the most important activities for medical doctors. The same is true in cardiovascular surgery: Young cardiovascular surgeons are expected to improve their surgical techniques and prioritize their clinical practice. However, their perspective on the role of research in their field of expertise is unknown. Therefore, we conducted a survey of and discussion with young cardiovascular surgeons to clarify their thoughts and concerns about performing research. Here we review and report the survey and discussion results.

BACKGROUND: Streptococcus pneumoniae causes pneumonia, sepsis, and meningitis. This study aimed to investigate the clinical characteristics of mucoid and non-mucoid isolates of S. pneumoniae, and to explore the relationship between the isolate phenotypes and their antibiotic susceptibility. METHODS: Clinical isolates from 3,453 non-repetitive S. pneumoniae (189 mucoid and 3,264 non-mucoid) infections obtained between January 2008 and December 2012 from outpatients at the Kimitsu-Central Hospital were evaluated. RESULTS: Compared to the non-mucoid isolates, the mucoid phenotypes were more susceptible to certain antibiotics such as erythromycin, clarithromycin, and tetracycline as opposed to clindamycin, chloramphenicol, and rifampicin. The mucoid phenotype was isolated more frequently from schoolchildren, adults, and elderly adults in a variety of clinical sites, including otorrhea, genitalia, pus, and eye discharge than the non-mucoid phenotype. This suggested that mucoid isolates are more likely to be involved than non-mucoid isolates in various local infections. Systemic infection, which indicates invasiveness, was not associated with the mucoid or non-mucoid phenotype. CONCLUSIONS: The results of this study suggest that mucoid isolates tend to have higher susceptibility than non-mucoid isolates to antibiotics. To the best of our knowledge, mucoid and non-mucoid S. pneumoniae isolates considerably differ in terms of clinical isolation site and age-specific prevalence.
Adult ; Aged ; Anti-Bacterial Agents ; Chloramphenicol ; Clarithromycin ; Clindamycin ; Erythromycin ; Genitalia ; Humans ; Meningitis ; Outpatients* ; Phenotype ; Pneumonia ; Prevalence ; Rifampin ; Sepsis ; Streptococcus pneumoniae* ; Suppuration ; Tetracycline

Objective: Hospitals throughout Japan are being integrated and reorganized under the government's regional medical care plan. However, the effects on cardiovascular surgery practice remain unknown. In the year 2016, our institution employed hospital integration; we report its effects on patients with type A acute aortic dissection who underwent emergency surgery. Methods: This study included 89 patients who underwent emergency surgery for type A acute aortic dissection from May 2012 to December 2020. Evaluation items included preoperative patient factors, number of surgeries, surgical mortality, referral rate, patient transport time, transport distance, number of surgeries performed by young cardiovascular surgeons, and overtime work for surgery. Patients were categorized into pre-(group P: 29 patients) and post-integration (group A: 60 patients) groups, which were retrospectively compared. Results: Preoperative factors were not significantly different between the two groups. Operations accounted for 29 and 60 in groups P and A, respectively; they increased significantly after integration (p=0.005). Surgical mortality was 27.6 and 15% in groups P and A, respectively, with no significant difference (p=0.2). The referral rate was 17 (58.6%) and 21 (35%) patients in groups P and A, respectively; group A displayed a significantly lower referral rate (p=0.04). The interval from the onset of symptoms to arrival at the surgery cite was significantly reduced (p=0.01) in group A (112±140 min) compared to group P (206±201 min). There was no significant difference in the transfer distance between groups P (13.9±14.8 km) and A (13.5±16.2 km). The number of surgeries performed by young surgeons increased in 9 cases (31%) in group P and 34 cases (56.7%) in group A (p=0.02). Overtime work was substantially reduced:446±154 min in group P and 349±112 min in group A. Conclusion: Hospital integration resulted in increased number of acute aortic dissection surgeries and decreased interval time from the onset of symptoms to arrival at the surgery cite. The young surgeons performed more surgeries and reduced their overtime work.