SS-MIX is a product of Ministry of Health's healthcare information exchange promotion project. Its standardized storage stores prescription orders, laboratory test results, diagnosed disease classifications in HL7 v2.5 format. This can be connected to any vendorʼs hospital information system, provided that the system can export these information in HL7 format. The storage software can be downloaded from site of SS-MIX consortium. The stored standardized information can be used in many effective ways. Providing the information of the patient in a referral document form is easy. The server can be set in another place for the purpose of providing backup in case of disaster, natural or man-made, like system down, or network failure. Filling case card, like adverse event report, is also easy, by picking up the prescription, lab results, etc. and filling them into appropriate space, which are formerly filled by human hand, on paper, or through EDC. In Japan, SS-MIX standardized storage is in service at more than 116 hospitals (by March 2012). The coverage of patients by these hospitals are estimated around 1,500,000 people. Hospital information system in Japan must comply safety guideline by the Ministry, so that the electronic medical records can be　used instead of paper records. Audit　trails are mandated, and many human factors are recommended. As most hospital information systems in Japan are complying this Ministry　guideline, gap between complying 21 CFR Part 11 is not a hard task for them. (Jpn J Pharmacoepidemiol 2013;18(1):49-56)

Objective: Standardized clinical data are invaluable for secondary use of medical information. We constructed a standardized database and a data warehouse called D*D, based on the Standardized Structured Medical Information Exchange(SS-MIX)scheme. D*D enables physicians and researchers to perform complex searches with combined conditions, e.g. time to event. It contains data from 1999 for approximately 400,000 individual patients. The objective of this study was to provide an overview of the features of this database system, especially from the perspective of drug safety research.
Methods: Three models of research questions were identified from established drug-risk combinations:1)gatifloxacin and hypoglycemia;2)statins and rhabdomyolysis;and 3)oral 5-fluorouracil S-1 and hepatotoxicity. D*D was searched using predefined keywords and conditions.
Results: 1)A total of 3,635 patients were treated for diabetes. Among 20 diabetic patients prescribed gatifloxacin, hypoglycemia was recorded in one patient(1/38 prescriptions). 2)Among 5,926 patients who had been prescribed any statin within 10 years in our hospital, 6 patients(0.1%)experienced rhabdomyolysis. The incidence was similar to that for fibrate (1/740, 0.1%). The most confounded diagnosis was stiff shoulder. 3)Among 244 patients prescribed S-1, 19 patients(7.8%) experienced hepatotoxicity higher than CTCAE grade3 within 2 months from the prescription.
Conclusion: With limited data items and search keys in standardized data storage, definitions of exposures and outcomes require careful assessment during protocol development. Considering that the system can be implemented at more than half of the hospitals that have already installed ordering systems, D*D can be one of the Japanese models for distributed research network.

The effects of Qi Gong health maintenance exercises were compared with a control group of walkers considered to have an equivalent amount of exercise, by measuring the changes in the pulse, systolic blood pressure, diastolic blood pressure and peripheral circulation.
Although no significant differences were seen in either the pulse or blood pressure of the control group of walkers when the before and after exercise values were compared, in the Qi Gong group, a decrease in these values was seen over time, with significant decreases from the pre-exercise values indicated in all values 30 minutes after exercise. This is consistent with the findings in a previous report that there was a significant reduction in catecholamine in the Qi Gong group 30 minutes after performing Qi Gong exercises.
When the flow rate of the peripheral circulation was measured using Doppler ultrasound equipment, in comparison with the lack of notable change over time seen in the control group, a significant improvement in the peripheral circulation was suggested for the Qi Gong group when the pre- and post- exercise values were compared. It has also been suggested that Qi Gong health maintenance exercises lower stress hormones and act to improve the peripheral blood circulation; a discussion of which is also included in this paper.

It is necessary to research constituents of moxa on the studies of moxibution.
As we analyged the essential oil in moxa with gas liquid chromatography, n-nonacosane and n-hentriacontane were detected. Several compound (ex.: tricosanol, hentricontane, arachinakohol, thujone) have been already detected in moxa. But n-nonacosane and n-hentriacontane are newly detected constituents in moxa.

The Immunosuppressive effects of prostaglandin E₁ (PGE₁) used in cardiopulmonary bypass (CPB) operation were studied. We examined 30 patients, with ischemic heart diseases. The patients were divided into 3 groups: 11 patients given PGE₁ in group PG (G-PG), 10 patients given amurinon, a phosphodiesterase inhibiter, in group A (G-A), and 9 patients not given either of those drugs in the control group (G-C). Immunologically, lymphocyte subpopulations, and adhesion molecule expression on cell membrane and phagocytosis of neutrophils were analyzed before, at the time of, and after the operation until POD 7. The prominent effects of PGE₁ were observed on neutrophils. The expression of CD 62L, an adhesion molecule designated as L-selectin, on the cell surface membrane of neutrophils significantly increased during and after CPB in G-A and G-C, but it remained unchanged in G-PG during the observation period. Moreover, CPB caused an enhancement of the phagocytic activity of neutrophils in all groups, but its degree was much less in G-PG than in the other two groups. Among lymphocyte subpopulations, the number of CD 3⁺T-cells in G-PG rather than that of CD 20⁺B-cells reduced more greatly than those values observed in G-A and G-C. The decrease of T-cell number, throughout the observation period, in G-PG seemed to be mainly due to the decrease of the number of CD 4⁺T-cells designated as helper T-cells, although the number of CD 8⁺T-cells esignated as killer/suppressor T-cells slightly decreased on PODs 3 and 7. Amurinon, as a whole, did not exert any significant effect either on lymphocytes or on neutrophils in our experiments. Taken together, these results show that the treatment of patients with PGE₁ during CPB causes suppressive effects on immunorelevant cells. It may mitigate the activity of neutrophils, which are suspected as a possible culprit causing reperfusion injury. However, these suppressive effects, including the lowered numbers of CD 4⁺T-cells, may render the patients more vulnerable to infection. Much more intensive cares is required in these patients after operations.

Myocardial oxidative stress during retrograde continuous blood cardioplegia (RCBC) was evaluated in 35 patients undergoing elective aortocoronary bypass surgery. The patients were divided into three groups: Group C (n=12) received cold (20°C) RCBC, Group T (n=11) received tepid (30°C) RCBC, and Group W (n=12) received warm (36°C) RCBC. Myocardial oxidative stress was assessed by measuring the release of oxidized glutathione (GSSG), malondialdehyde (MDA), and myeloperoxidase (MPO) in the coronary sinus plasma before aortic clamping, at 1, 5, and 10min after unclamping. Myocardial oxygen uptake and lactate release were assessed at the same times. Both the hemodynamic recovery and the creatine kinase MB (CKMB) activity were measured perioperatively until 24h after unclamping. In Group C, a significant coronary sinus release of GSSG was found in the early reperfusion period in comparison to Groups T and W. However, the peak CK-MB activity was significantly lower in Group T than in Group W. No significant difference in the release of MDA or MPO was noted in the three groups. The recovery of oxygen uptake after unclamping was rapid in Group T. The recovery in the left and right ventricular functions and the myocardial lactate release were similar in the three groups. In conclusion, tepid RCBC is considered to protect the myocardium from ischemia-reperfusion injury better than cold or warm blood cardioplegia under retrograde continuous perfusion.

No abstract available.
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Clinically, it has been recognized that moxibustion with artemisia stimulates the internal parts of the body without a burn on the skin. Recently, Matsuyama et al. reported that the maximun temperature of moxibustion varied with every change of size, mass, hardness, quality, and humidity of moxa. The purpose of this study was to investigate experimentally the temperature-changes in vivo with moxibustion by using laboratory animals.
Male mice of the C57BL/6CrSlc strain (30 weeks old) and chromel-alumel thermocouples (0.32mm diam. and 0.5Ω electric resistance) were used. Following autoclave sterilization, the chromel-alumel thermocouples were surgically set in the subcutaneous and the muscle layers of the mice. Three weeks later, the temperature-changes in the mice with 5mg of Ibuki-moxa were registered by a calibrated recorder.
As illustrated in Fig. 2, maximum temperature diminished in the following order; on the skin (A), in the subcutaneous layer (B), and in the muscle layer (C). And the time occupied on the temperature restoration in the body became longer than that on the skin. As illustrated in Fig. 3, a series of three moxa-cauterizations induced the maximum temperatures to diminish on the skin (A), and to augment in the subcutaneous (B) and muscle layer (C). The former is caused by the barriers of previous moxa tar, sap, and ash to the heat conduction, while the latter is due to the accumulation of prior moxibustion heat. These results indicate that a series of three moxibustions enhances the stimulation not to the shallow parts but to the deep parts of the body. However, it should be made to clarify whether this conclusion holds good for clinical cases.

Indirect moxibustion has been found to have the effects of thermal stimulation and pharmacological effects as we analyzed the intercalated substance with thin layer chromatography, 6-gingeol from zingiberis Rhizoma and allicin from Allis Bulbus were detected.
It is suggested that pharmacological effects of intercalated substance were significant in indirect moxibustion.

In previous report, we investigated temperature-changes in vivo with diathermic moxibustions (scarring moxibustions), and showed that the temperature in the subcutaneous layer rised over 50°C. In present study, it was recognized that indirect moxibustions (ginger or garlic moxibustions) kept longer high-temperature than those of diathermic moxibustions. Therefore, it is possible that indirect moxibustions, although it seemed to be weakly stimulation, have stronger stimulation than diathermic moxibustions. In addition, the temperature-changes in vivo with indirect moxibustion seemed to be influenced by water contents of materials for indirect moxibustion and organism skin.