In May 2024, the 73rd Annual Meeting of the Japanese Society of Acupuncture and Moxibustion, Miyagi Conference, was held in Sendai city under the title of " Acupuncture and Moxibustion in Connection, Communication, and Utilization - Exploring Diversity and Developing Cooperative Medicine-". Overcoming the "fracture of connections" caused by disasters and pandemics, this congress organized to connect people involved in acupuncture and moxibustion, deepen mutual understanding, and find a direction to contribute to society. In the future, we believe that the entire academic society will work together to raise the level of acupuncture and moxibustion from a cycle in which advanced treatment techniques are disseminated, clinical research is advanced, and research results are applied to each treatment.

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.

The number of patients with novel coronavirus infections (COVID-19) continues to increase with Omicron now the predominant strain, even amidst the three-dense (close-in, dense, and close-out) avoidance and vaccination strategies. In collaboration with the local government, Tohoku University Hospital has provided a large-scale vaccination center, drive-through outpatient PCR testing clinic, outpatient assessment, support for management of residential care facilities for the mildly ill, support for elderly care facilities, and an antibody cocktail center, to minimize deaths due to COVID-19. In residential care facilities for the mildly ill and others in need of medical support, we established an information sharing and house call system. Furthermore, we developed DX in cooperation with a wide-area IT system and have so far continued to achieve zero fatalities in residential care facilities. In addition, the Japanese Society for Oriental Medicine has conducted clinical research using Kampo medicine for the prevention of disease onset, treatment in the acute stage, and treatment of prolonged symptoms, with results suggesting that Kampo medicine has some effect in reducing disease severity in the acute stage. The COVID-19 response is a long-term effort to update the knowledge and techniques in Western, traditional, and Future Medicine. The response and updating of combined knowledge and skills will continue over the longterm. It is also necessary to continue to disseminate and share information among various professions, and give back information in the field and make steady and continuous efforts among multiple professions.

Europe has a long history with its own traditional medicines. In Germany, the practice of traditional European and Asian medicine along with modern medicine is called Integrative Medicine. The pain clinics at Munich University, TCM Klinik Bad Kotzting, Immanuel Klankenhaus and Zen Haus Klinik are well-known centers of Integrative Medicine in Germany. We visited these hospitals and clinics and report on the state of their treatment.
Four-week programs in chronic pain, traditional Chinese medicine, natural therapy, and traditional Japanese medicine with aromatherapy are given at these facilities. Moreover, Complementary and Alternative medicines are widely covered by public or private insurance. And one reason for the spread of Integrative Medicine may be these social conditions, in addition to historical background.

CD57 (synonyms: Leu-7, HNK-1) is a well-known marker of nerve elements including the conductive system of the heart, as well as natural killer cells. In lung specimens from 12 human fetuses at 10–34 weeks of gestation, we have found incidentally that segmental, subsegmental, and more peripheral arteries strongly expressed CD57. Capillaries near developing alveoli were often or sometimes positive. The CD57-positive tissue elements within intrapulmonary arteries seemed to be the endothelium, internal elastic lamina, and smooth muscle layer, which corresponded to tissue positive for a DAKO antibody reactive with smooth muscle actin we used. However, the lobar artery and pulmonary arterial trunk as well as bronchial arteries were negative. Likewise, arteries in and along any abdominal viscera, as well as the heart, thymus, and thyroid, did not express CD57. Thus, the lung-specific CD57 reactivity was not connected with either of an endodermal- or a branchial arch-origin. CD57 antigen is a sugar chain characterized by a sulfated glucuronic acid residue that is likely to exist in some glycosphingolipids. Therefore, a chemical affinity or an interaction might exist between CD57-positive arterioles and glycosphingolipids originating from alveoli, resulting in acceleration of capillary budding to make contact with the alveolar wall. CD57 might therefore be a functional marker of the developing air-blood interface that characterizes the fetal lung at the canalicular stage.
Acceleration ; Actins ; Antigens, CD57 ; Arteries* ; Arterioles ; Bronchial Arteries ; Capillaries ; Endothelium ; Fetus ; Glucuronic Acid ; Glycosphingolipids ; Heart ; Humans* ; Killer Cells, Natural ; Lung* ; Muscle, Smooth ; Pregnancy ; Thymus Gland ; Thyroid Gland ; Viscera

Fatigue is a common symptom of long COVID. Fatigue can majorly disrupt daily life and be challenging to treat. Herein, we describe the effect of saikokeishito, a Kampo medicine, on fatigue in patients with long COVID.Between October 2020 and March 2023, we prescribed saikokeishito to 22 patients with long COVID in the general medicine outpatient department of our hospital. Among them, seven patients (age: 15-58 years, two females) had fatigue, a previously confirmed diagnosis of COVID-19, and no concomitant use of other Kampo formulas. We compared their condition at the start of saikokeishito administration to that 3 months later. Five patients had a slight fever, and four had inflammatory findings on blood tests. Within 3 months, all patients had a 20% or greater reduction in fatigue on a visual analogue scale. Six patients had a 20% or greater increase in health-related QOL and were able to return to society. On the other hand, one patient required a transition to an alternative medication, and one patient's follow-up was prematurely discontinued. Fatigue after COVID-19 may be improved by saikokeishito, especially for the treatment of patients with slight fever or inflammatory findings.

"Brain fog" is a symptom of long COVID. Brain fog is suspected to be a neurocognitive dysfunction; however, the underlying pathology remains to be elucidated. To provide better medical care for patients with "brain fog", we collaborated with a hospital outpatient department that specializes in the assessment and treatment of cognitive impairment. For the establishment of the collaborative system, we devised a questionnaire for "brain fog" based on medical reports, internet resources, and clinical experiments to be used as a screening tool. The questionnaire was used to calculate a "brain fog score" (BFS). A BFS of more than 5 points was established as the criterion for patient referral. The present retrospective evaluation suggests that BFS is useful for predicting prognosis and prioritizing patients within limited outpatient appointment slots.

As part of the studies to build evidence for the coronavirus disease-2019 (COVID-19) conducted by the Japan Society for Oriental Medicine, the observational research and the clinical trials were designed to examine the effectiveness of Kampo medicine in the treatment of COVID-19. These studies were initiated in the context of limited information about the clinical findings of COVID-19 and previous clinical study. Therefore, through literature review, we compared these studies with clinical trials on oral antiviral drugs in terms of endpoint, analysis methods, and results. Results of this review showed that the rate of severe disease and time to symptoms relief, which were focused on in observational research and clinical trials of Kampo medicines, were also used in antiviral drug trials. Furthermore, we discussed that when interpreting the results of clinical studies, it was important to take into account factors that may affect the results, such as the number of cases, the characteristics of the endpoint, and the characteristics of the target population.

The Great East Japan earthquake and tsunami disaster that occurred on March 11, 2011 seriously destroyed Japanese social activities the medical system included. We provided medical support to the damaged area, and mainly performed Oriental medicine. Traditional methods using physical diagnoses and the treatments with herbs, acupuncture, and massage were effective, where any infrastructure had suffered or any modern medical facilities had been destroyed. Acute phase infectious disease, common colds, and hypothermia were dominant. Allergies increased two weeks later, and there was much mental distress, and chronic pain symptoms one month later. We prescribed Kampo herbal medicines for common colds, hypothermia, allergies, and mental distress. Moreover, we also performed acupuncture and kneaded patients' body to reduce pain, stiffness, and edema. These treatments were effective for both physical and mental distress. Thus we believe that Oriental medicine is valuable in disaster situations.

Background  The number of foreign tourists visiting Japan has increased to about 30 million people per year. 1.5% of them were injured or became sick during their travelin Japan and had to undergo medical treatment. Among the foreign tourists, 27% were not covered by travel health insurance.Case  A 40-year-old man from Southeast Asia who was visiting his relative in Japan experienced sudden hemiparesis and was diagnosed with cerebral infarction. During the initial treatment, it was found that the patient did not have health insurance and the relatives could not afford to pay the treatment costs. No other source of financial support was available to him During our consultations with the patient and his relatives about the medical treatment including medical expenses, he continued to be treated as an outpatient and it was aimed at an early return to his home country.Discussion  Foreigners, who are not covered under travel health insurance, could fall ill or sustain an injury during their stay in Japan. Appropriate medical care should be provided regardless of their ability to pay. However, a situation that could lead them to incur huge medical expenses from availing medical care should be avoided. For medical consultations of non-insured foreigners, it is better to consult the available systems and pay attention about feasible medical expenses. There is a need for a long-term vision of medical care to make a smooth transition from medical treatment in Japan to treatment in their home country.Conclusion  Although medical institutions can offer only a limited response, it is necessary to accumulate case examples from across the nation and prepare specific countermeasures and counselors.