Kampo medicine has been incorporated into Japan's medical curriculum nationwide. However, it has not been adopted into its postgraduate medical education. The present study assessed Kampo medicine educational needs for residents in Japanese postgraduate training programs. A questionnaire-based survey was conducted in residents at Japanese Red Cross Ishinomaki Hospital, regarding their experience in prescribing Kampo formulae and the Kampo medicine curriculum they expect in their postgraduate education. Twenty-one residents completed the questionnaires. Seventy-five percent of junior and all senior residents had used Kampo medications. They were mostly provided with on-the-job instruction by attending doctors, senior residents, and fellows during their residency rotations. All residents needed Kampo medicine education opportunities. They expected guidance with respect to the basics of Kampo medicine, and the treatment of common diseases with Kampo formulae. The results of our study demonstrates that residents believe Kampo medicine education should be provided in postgraduate training programs.

We often meet the patient suffer from skin pruritus caused by jaundice. Those patients are treated with various methods and care, but there therapy are often ineffective. Japanese herbal medicine Gosha‒Jinki‒Gan has been successfully used to reduce skin pruritus in two patients caused by jaundice associated with advanced cancer. Case 1： A 68‒yearold man had suffered from pruritus caused by obstructive jaundice associated with cholangioma. He had treated with endoscopic nasobiliary drainage (ENBD) and other methods, but pruritus was not reduced. Gosha‒Jinki‒Gan (7.5g/day) imploved sleep disturbance. Case 2： A 81‒year‒old man had suffered from pruritus caused by jaundice associated with liver cirrhosis and hepatoma. He had treated with various methods, but pruritus was not reduced. Gosha‒Jinki‒Gan (5.0g/day) reduced his Numeric Rating Scale (NRS) of pruritus (10→3). Gosha‒Jinki‒Gan is recommended for skin pruritus due to jaundice.

Objectives: We developed the multimodal program Nutrition and Exercise Treatment for Advanced Cancer (NEXTAC program). The aim of our study is to show algorithm of the home-based resistance training prescription and its compliance. Methods: We recruited 30 patients aged≥70 years scheduled to receive first-line chemotherapy for advanced pancreatic or non-small-cell lung cancer. Three educational sessions were planned in 8-week study period. Our resistance training consists of 3 or 5 of following 5 exercises components: (1) sit-to-stand, (2) calf raise, (3) knee extension, (4) knee raise, (5) side leg raise. Physiotherapist chose optimal prescription according to the modified Borg-scale. We assessed patient compliance, and safety. Results: Median proportion of days in which patients performed full or modified exercise program was 91%. Adverse events possibly related to the NEXTAC program were observed in 5 patients and included muscle pain (grade 1 in 2 patients), arthralgia (grade 1 in one patient), dyspnea on exertion (grade 1 in one patient), and plantar aponeurositis (grade 1 in one patient). Patient physical function and physical activity were maintained during the study period. Conclusion: Our resistance training showed excellent compliance and safety in elderly patients with newly diagnosed pancreatic and non-small-cell lung cancer receiving concurrent chemotherapy. Although this study was not designed to show the efficacy of the resistance training, our data indicate a potential protective effect on physical function and physical activity.