[Objective]Although warm-tube moxibustion is easy-to-use in acupuncture therapy, the timing of moxa removal varies among practitioners. In the present study, we used near infrared spectroscopy (NIRS) to compare effects of different durations of moxibustion stimulation on improvement in local circulation as measured by changes in blood oxygenation dynamics in muscle tissue.
[Methods]Twelve healthy adults underwent warm-tube moxibustion with a single cone applied to the upper right shoulder region;measurements of tissue blood oxygenation dynamics (ΔOxy-Hb, ΔTotal-Hb) were obtained at intervals of 0.5 s. Control measurements were first taken for 15 min without intervention (Control);then, subjects received moxibustion 2 min after the start of measurement and had the moxa removed at the following time points: 30 s after patients experienced heat pain (Removal 30, moxibustion group); 45 s after heat pain (Removal 45, moxibustion group);or did not have the moxa removed (Continuous moxibustion group). These 4 different conditions were compared. Additionally, we determined the burning temperature of moxa and the skin temperature and intensity of heat pain sensation at the site of moxibustion.
[Results]Compared with the Control, the Removal 30, Removal 45, and Continuous moxibustion groups had significant increases in ΔOxy-Hb, ΔTotal-Hb, and skin temperature, with no significant differences among the moxibustion groups. No significant difference in the intensity of heat pain sensation was observed among the moxibustion groups. All moxibustion groups began to show rapid increases in both ΔTotal-Hb and ΔOxy-Hb around the time when subjects began to feel heat pain, suggesting that the axon reflex evoked by noxious stimuli of heat pain increased blood volume and arterial blood flow.
[Conclusion]Hemodynamic improvement in muscle tissue through the use of continuous warm-tube moxibustion for 30 s or longer after the occurrence of heat pain was confirmed.

A double blind randomized control trial was performed to clarify the effects of acupuncture using a press needle on muscle pain, serum creatine kinase (CK) activity and muscle stiffness that resulted from running a marathon race. Sham press needles (placebo needles), which have the same package but without a needle tip, were developed by the acupuncture study authors. The subjects were 15 university students who participated in a marathon for the first time. Subjects were randomly assigned to two groups: the real acupuncture group and the placebo acupuncture group.
Both the real and the sham needles were applied to eight traditional Chinese acupoints in the lower limbs. They were applied before the start of the race and removed five days after the race.
Physical and biochemical examinations to determine the degree of muscle pain, CK activity, LDH isozyme, body flexion in standing position and muscle hardness were evaluated three times-before the start, after the finish, and five days after the finish.
Result: 1) The real acupuncture group showed less muscle pain than the placebo acupuncture group. 2) CK activity and LDH4-5 showed higher levels after the finish than before the start, but no significant difference was obtained among the groups. 3) No significant difference in time course change of the body flexion was obtained among the groups. 4) Hardness of vastus lateralis and vastus medialis showed higher levels after the finish than before the start, but no significant difference was obtained among the groups.

Objective：Since there are few surveys of higher brain dysfunction (HBD) support coordinators regarding HBD diagnosis in Japan, we conducted a questionnaire survey to better understand the challenges in the current clinical practices of HBD diagnosis.Methods：Questionnaires were sent to 114 HBD support centers, handling approximately 100,000 consultations annually.Results：The overall response rate was 73.7％．The average number of consultation seekers per center who experienced difficulties in receiving HBD diagnosis was 15.6 (range 0-368), with approximately half of the centers reporting 1-10 consultation seekers. Regarding causes, approximately 30％ of respondents reported “patients or their family members were unaware that they had HBD” and “patients or their families suspected HBD but were told by their doctors that they did not meet the diagnostic criteria.” Furthermore, the most commonly reported difficulty in receiving HBD diagnosis was “a lack of doctors who could make an appropriate diagnosis,” followed by “a lack of knowledge of HBD among medical professionals” and “a lack of knowledge of HBD among administrative officers and welfare professionals.”Conclusion：Many respondents shared their thoughts on their current diagnostic status. These results will serve as foundational material for addressing difficulties related to late HBD diagnosis.