The authors performed a survey of the treatment of fracture and the prognosis and described about the importance of rehabilitation for improving the result of treatment of fracture.
Eight hundred and forty-six cases of fractures (included 324 cases of open fracture and 181 cases of pseudoarthrosis) were observed in this report. The main point of treatment of fracture is to avoid the sequels and to reduce a period of therapy.
The systematic treatment fo fracture should include a detailed plan of treatment a proper therapy and an appropriate after-treatment with the concept of rehabilitation. Namely, it has to keep a principle of treatment of fracture and needs to carry out autokinesis, the subject of after-treatment, constructively.
In 233 cases of fractures 17% of them showed dysfunction after treatment and the average period of admission was 4 months. At this point the authors realized an impostance of rehabilitation in cure of fracture.
On the after-treatment of fracture patients enforced to do isotonic muscular contraction and cross-education even in the time of fixation.
After removal of fixation, they received physical therapy, such as supported active movement, autokinesis and duplicated motion (or movement against resistance.) The hydrotherapy was more effective in the early muscular training.

Acupuncture, which was originated and developed in the East Asian countries, has been globalized today. In Japan, acupuncture is more popular than the West, but lagging behind in terms of medical policy, research funding and evidence-based clinical research. Evidence-based approach such as randomized controlled trial has brought new developments in acupuncture research scene. On the other hand, clinical implication of acupuncture “system” seems to have been underestimated in evidence-based clinical research until recently.

Unresolved problems remain in the clinical research methodology of acupuncture. In particular, the creation of placebo group in randomized controlled trial (RCT) is controversial: sham and / or minimal acupuncture may appear more powerful than placebo treatments in trials. Hence, in the future more emphasis should be placed on pragmatic RCTs, which compare typical treatment vs typical treatment plus acupuncture.
In order to more effectively integrate acupuncture therapy into modern Western medicine, evidence of efficacy, safety and cost-effectiveness should be clearly shown from both rational and clinical points of view. At the same time, we should reassess whether or not the present research methodology appropriately evaluates the essence of acupuncture therapy.

We introduce the current research on complementary and alternative medicine (CAM) in the West, which we refer to as Evidence-based CAM (EBCAM), and discuss its characteristics, problems, and perspectives. Compared with the common attitude of CAM researchers in Japan, that of EBCAM researchers is more objective and often self-critical. EBCAM research is still developing because randomized controlled trials on CAM have many methodological flaws. Caution should be employed in interpreting provisional conclusions of relevant systematic reviews. CAM researchers in Japan should view the case report method from a perspective other than efficacy. Also, they will have to prepare evidence in response to demands from CAM consumers. Priority of research subjects from various kinds of CAM should be decided according to their popularity. Therefore, a large-scale survey on CAM use in Japan is essential.

On this coming June 12, 2009, the 2nd JSAM International Symposium on Evidence-based Acupuncture on "Evidence of the Effectiveness of Acupuncture for Low Back Pain"is to be held in Saitama. We briefly outline the background and expected controversial points in this symposium.
There are three sessions including 1) Present status of RCT research on low back pain, 2) Treatment method for low back pain in China, Korea and Japan based on the database research, and 3) Sham acupuncture. When we assess the effectiveness of acupuncture for low back pain within the realm of Evidence-Based Medicine, the following discussions may be expected:
1) Therapeutic effect of sham needling -are we able to distinguish placebo effect?
2) Masking using sham needle -are we able to conduct double-blind trials on acupuncture?
3) Specific treatment technique -which factors contribute to "more effective acupuncture technique"?
Most of invited speakers are specialists who published their papers on RCT or sham needle in top medical journals in the world. We hope that issues, such as working together with other medical professionals and reflecting evidence to medical policies, to be tackled in the future for the development of acupuncture will become clearer in this symposium.

The inhibitory effects of the freeze-dried powder of the aqueous extract of black tea leaf (JAT) on α-glucosidase activity were investigated. We initially examined the effects of JAT addition on yeast α-glucosidase activity. JAT significantly and dose-dependently inhibited α-glucosidase activity and more strongly inhibited the activity than acarbose, the positive control. Then, we examined the effects of oral administration of JAT on sucrose tolerance in type 2 diabetes mellitus model db/db mice. Both JAT and acarbose administered groups showed a dose-dependent decrease in plasma glucose levels after the sucrose loading compared with the control group. Notable was that the plasma glucose levels of the 500 mg/kg JAT administered group exhibited a significant decrease 30 min or longer after the sucrose loading. On the other hand, no significant difference in plasma insulin levels was seen between the JAT administered group and the control group. We also measured small intestinal sucrase activity in db/db mouse at 30 min after JAT oral administration. Compared to control mice, small intestinal sucrase activity was significantly decreased in the 500 mg/kg JAT administered mice. These findings indicate that JAT may be a useful natural material for the prevention and therapy of type 2 diabetes mellitus.