Nourishing Yin means to moisten yin, and ultimately it is the use of a Kampo formulation to supplement body fluid. Sorting out these formulations chronologically, the first to appear was Bakumondo-to Byakko-ka-ninjin-to as a section of the Shang han lun, and the other Hachimi-gan which was regarded as Yin-Yang formulation with a tonic effect. After that there followed Seishin-renshi-in in Formulations and Pharmacopenia, and about the same time, in a textbook of pediatrics written by Qian Yi, Rokumi-gan was mentioned to be available as a sub-formulation of Hachimi-jio-gan. Subsequently in the Ming era, many formulations appeared, establishing the concept of nourishing Yin and treatment of clearing away heat-evil. Jiin-koka-to as an overall treatment, and for vernalization was representative. The diagnoses of Yin deficiency in which these drugs for nourishing Yin are indicated are as follows; thinness and skin dryness through visual observation, mouth dryness, weakness of legs and waist, and viscous sputum by interview. The easiest diagnosis is by tongue diagnosis mainly in observing the reduction of the coating of the tongue and atrophy of the tongue. Yin deficiency is generally found in aging, diabetes and chronic inflammatory diseases. This seems to take on a very important meaning for Kampo treatment in this aging society.

Many patients who receive general acupuncture treatment have many complaints concerning their autonomic nervous systems. Applying CMI and CMI type classification (Abe method-a variation of CMI) to 100 new patients who came to our clinic last year, we found vegetative dystonia in half of them. Upon this finding, the following examinations were carried out by means of an function test of autonomic nervous system developed by Kageyama et al.: the coefficient of variation (CV) of R-R interval in ECG obtained through the function test is regarded as an expression of vagal function.
(1) Using this test, the participation of the autonomic nervous system in the condition of those patients who visited our clinic was examined.
(2) Effects of acupuncture treatment on the autonomic nervous system were examined.
(3) Acupuncture stimulation was separately applied to S36 (Zusanli), P4 (Ximen) and Liv3 (Taichong) to examine the influence of the acupuncture point location on the CV obtained through the test.
Results:
(1) 15 new patients (25%-comparatively high rate) showed low CV (less than 2%) of R-R interval in ECG.
(2) In some cases, acupuncture treatment caused an increase in CV.
(3) Acupuncture caused pulse infrequens: R-R interval showed a tendency toward prolongation during the in situ needle technique and after withdrawing the needle on each of the three points (S36, P4 and Liv3). CV increased after withdrawing the needle on either S36 or Liv3 and shortly after needle insertion and after withdrawing the needle on P4.
These result suggest that many patients who receive acupuncture treatment have additional disorder in parasympathetic nervous system which can be improved through acupuncture.

A case of progressive systemic sclerosis (PSS) with peripheral circulation disturbance, pulmonary fibrosis and stenosis of esophagus-cardia (E-C) junction, was treated with acupuncture and traditional Chinese medicine. The patient had digital pitting scar due to the peripheral circulation disturbance. Effect of acupuncture was examined using laser Doppler velosimetry (LDV). Acupuncture treatment was operated 3 times a week and laser therapy, once a week. And Chinese medicine was administered. The LDV measurements were done before and after acupuncture. In the total 9 times of measurements, 8 were increased in peripheral blood flow. Two times from the measurements of peripheral blood flow after acupuncture reached in the normal flow level. After the treatment of 2 months, polyarthralgia was reducted, vomiting was disappeard, and the stenosis of the E-C junction was improved. Present data suggest that the acupuncture therapy to the PSS patient is effective.

Comparing the effects of low energy laser and acupuncture was conducted in 14 patients with gonarthrosis. Effectiveness on the pain on going up or down stairs, range of motion (ROM) of knee joint and tenderness were examined. After acupuncture treatment, the pain on going up or down stairs, and ROM of knee joint were significantly improved. Laser therapy showed the same significant effects both on the pain on going up or down stairs and ROM of knee joint. In addition, laser therapy showed a significant effect on tenderness. In the statistical evaluation, no remarkable difference was shown between acupuncture therapy and laser therapy. Present data suggest that the laser therapy is as effective as acupuncture therapy in gonarthrosis.

Laser-Doppler velocimetry was used to evaluate the effects of acupuncture stimulation on peripheral circulation disturbance in patients with collagen disease, progressive systemic sclerosis (PSS) and systemic lupus erythematosus (SLE). The response to acupuncture stimulation to shou-san-li was recorded in 8 patients with PSS and 6 patients with SLE. The digital pitting scars and Raynaud's phenomenon were observed in all the patients. The mean of laser-Doppler flow values in fingertips at room temperature 23°C was 4.83 (V) in normals (n=11), 2.82 (V) in patients (n=14). Patient group showed significantly lower values than normals (p<0.01). Ten minutes after acupuncture stimulation to shou-san-li, the flow values increased in 7, and decreased in 1 out of 13 patients (p<0.05). In normals no significant change was observed after the same stimulation. Present data suggest that the acupuncture therapy to the patients with PSS or SLE who suffered from peripheral circulation disturbance is effective.

Laser-Doppler velocimetry (LDV) was used to evaluate the effects of low energy laser irradiation on peripheral circulation disturbance in patients with collagen diseases, progressive systemic sclerosis (PSS) and systemic lupus erythematosus (SLE).
Using a commercially available LDV flometer (Periflux, Perimed KB, Sweden), the response to laser irradiation at the acupuncture points of Tian zhu, Feng chi, Jian jing, Shou san li, Jing qu, He gu, Stellate ganglion, was recorded in 4 patients with PSS and 6 with SLE. The digital pitting scars and Raynaud's phenomenon were observed in all the patients. The low energy of 10mW laser was irradiated for 1 minute at each acupuncture points, and LDV flow values ware recorded in fingertips at room temperature 25±0.5°C. Ten minutes after the laser irradiation, the LDV flow values increased significantly (p<0.5).
Present data suggest that the low energy laser irradiation to patients with PSS or SLE who suffered from circulation disturbance is effective.

　　Safe introduction of laparoscopic partial liver resection (LPLR) requires the selection of appropriate cases not exceeding the surgeon's skills as well as standardization of surgical procedures. After introduction at our institution, 60 LPLR procedures were performed between April 2010 and May 2016. To identify indices for case selection, short-term perioperative parameters were analyzed, including operative time, blood loss, postoperative complications, and postoperative hospital stay. Operative time was significantly shorter in the last 30 cases compared with the first 30 cases (182.5 min vs. 253 min; p＝0.023) and in 16 cases involving the left lobe (S2-4) compared with 44 cases involving the right lobe (S1, S5-8; 148.5 min vs. 246 min; p＝0.004). Blood loss was significantly less (0 mL vs. 50 mL; p＝0.028) and operative time was significantly shorter (185 min vs. 250 min; p＝0.048) in 27 cases with tumor diameter ＜2.5 cm compared with 33 cases with tumor diameter ≥ 2.5 cm. Operative time tended to be longer in 9 cases of multiple-site resection compared with 51 cases of single-site resection (207 min vs. 260 min; p＝0.085). BMI, pathology, and hepatitis virus status showed no significant difference in perioperative short-term results. For the introduction of LPLR, it may be preferable to select cases located in the left lobe with a tumor diameter ＜2.5 cm and to accumulate a certain amount of experience in similar cases first.