Currently, the international environment surrounding traditional medicine, including acupuncture and moxibustion, is changing faster than we can imagine. In recent years there are some Far East Asian countries that have registered the classical medical books of traditional medicine and a part of traditional medicines in their own countries to the Memory of the World and the Intangible Cultural Heritage in UNESCO. In addition, preparations to include traditional medicine in ICD-11 have been carried out with revision of ICD-10 in WHO. Furthermore, the working of international standardization of traditional medicine of Far East Asia is underway in ISO. Also WFAS is working on the international standardization of acupuncture and moxibustion in an official relationship with WHO. Furthermore, genetic resources and traditional knowledge related to traditional medicine have been discussed in CBD. The matters concerning traditional medicine have been discussed separately elsewhere in a wide variety of international organizations such as WIPO, WTO/TRIPS and FAO.
In this panel discussion, firstly, we outlined the main points about the protection of traditional knowledge by CBD and the Nagoya Protocol, clarified the current status of discussions in WIPO about traditional medicine and registration of traditional knowledge under the Intangible Cultural Heritage in UNESCO, and examined future protection of traditional knowledge of acupuncture and moxibustion. Secondly, we summarized the current status and progress of the international standardization of acupuncture and moxibustion driven by WFAS as commissioned by WHO, clarified the viewpoint of JSAM about problems with the efforts of WFAS for the international standardization of acupuncture and moxibustion, and discussed the relationship of the international standardization of acupuncture and moxibustion in WFAS and ISO. Finally, we summarized the progress of the international standardization of acupuncture and moxibustion from the 1980s when international standardization of acupuncture and moxibustion was first initiated by WHO up until the present when international standardization of acupuncture and moxibustion is included in ISO/TC249, surveyed the present situation of the international standardization of traditional medicine in the countries that are leading the international standardization of acupuncture and moxibustion, and discussed about the aspects of the struggle for supremacy lurking behind the international standardization of traditional medicine and the issues associated with the future of the international standardization of traditional medicine.

Objective : To research reports of economic analysis of acupuncture therapy.
Method : Searches were performed in Medline for reports of cost description, economic, randomized controlled trial, cost effectiveness, or cost benefit. Studies were included if they reported original data from any form of standard economic analysis.
Results : A total of 15 papers was found. These studies were investigated as follows : angina pectoris, carpal tunnel syndrome, stroke, knee osteoarthrosis, low back pain, musculoskeletal disease, migraine, acupuncture analgesia. On the other hand, only one paper was found in Japan.
Conclusion : Almost studies were noncntrolled trial, non-rigorous and retrospective studies. In future there is a need for high quality and rigorous studies of the cost and benefits of acupuncture.

Nobody studies economic evaluation of acupuncture and moxibustion in Japan. To establish a method of economic evaluation of acupuncture and moxibustion, we introduced case study of economic evaluation of acupuncture and moxibustion at work. In addition, we examined a course of study that annex economic evaluation to a study of acupuncture and moxibustion. This manuscript introduces two case studies of economic evaluation and essential points of economic evaluation.

BACKGROUND/AIMS: Although the risk of bleeding after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is low, the safety of EUS-FNA in patients prescribed antithrom-botic agents is unclear. Therefore, this study evaluated the incidence of bleeding after EUS-FNA in those patients. METHODS: Between September 2012 and September 2015, patients who were prescribed antithrombotic agents underwent EUS-FNA at 13 institutions in Japan were prospectively enrolled in the study. The antithrombotic agents were managed according to the guidelines of the Japanese Gastrointestinal Endoscopy Society. The rate of bleeding events, thromboembolic events and other complications within 2 weeks after EUS-FNA were analyzed. RESULTS: Of the 2,629 patients who underwent EUS-FNA during the study period, 85 (62 males; median age, 74 years) patients were included in this stduy. Two patients (2.4%; 95% confidence interval [CI], 0.6% to 8.3%) experienced bleeding events. One patient required surgical intervention for hemothorax 5 hours after EUS-FNA, and the other experienced melena 8 days after EUS-FNA and required red blood cell transfusions. No thromboembolic events occurred (0%; 95% CI, 0.0% to 4.4%). Three patients (3.5%; 95% CI, 1.2% to 10.0%) experienced peri-puncture abscess formation. CONCLUSIONS: The rate of bleeding after EUS-FNA in patients prescribed antithrombotic agents might be considerable.
Abscess ; Asian Continental Ancestry Group ; Endoscopic Ultrasound-Guided Fine Needle Aspiration* ; Endoscopy, Gastrointestinal ; Erythrocyte Transfusion ; Fibrinolytic Agents* ; Hemorrhage* ; Hemothorax ; Humans ; Incidence ; Japan ; Male ; Melena ; Prospective Studies*