The International Research Congress on Integrative Medicine and Health (IRCIMH) 2014 was held from May 13th to 16th at Hyatt Regency in Miami, USA. The theme of the convention was "Strengthening Research in Integrative Healthcare Around the World'';IRCIMH's mission is to foster the development of new collaborations and to strengthen existing partnership.
There were 5 oral and 22 poster presentations in the field of acupuncture. Especially in North America, acupuncture plays an important role in integrative medicine and several large scale of randomized controlled studies are reported. We have to be proactive and to give more and more information about Kampo.

Jiinshihoto, a Kampo formulation described in the textbook, Wanbinhuichun, is well known as a suitable formulation for patients troubled by chronic cough with qi obstruction. The components of jiinshihoto have several effects including nourishing yin, clearing empty heat, replenishing qi, and improving digestive function. We report three cases with glossodynia and abnormal sensation in the throat which were treated successfully with jiinshihoto. We therefore recommend jiinshihoto for the treatment of glossodynia and abnormal sensation in the throat associated with signs of yin deficiency including thirst, dry mouth, and viscous sputum,and signs of qi obstruction such as a tympanic sound on the right side of the abdomen.

We investigated the relationship between daily physical activity level and response inhibition control aspect of cognitive function in older adults using event-related potentials. Twenty-eight Japanese older adults (70.6 ± 3.8 years) participated in the present study. Daily physical activity (PA) was measured using an accelerometer, including step count and the intensity of PA. Participants were divided on the basis of their step count into “Higher PA group” (more than 10,000 steps/day, n = 14) and “Lower PA group”(less than 10,000 steps/day, n = 14). Cognitive function was evaluated by performance, NoGo-N2, and NoGo-P3 while they performed a Go/NoGo task. The results indicated that the Higher PA group exhibited shorter reaction time on Go trials, relative to the Lower PA group. NoGo-P3 amplitude was larger in the Higher PA group compared to the Lower PA group, but NoGo-P3 latency did not differ between groups. PA was positively correlated with NoGo-P3 amplitude. NoGo-N2 component was not related to PA. Thus, PA was more sensitive to monitoring of the outcome of response inhibition rather than pre-motor inhibition in Go/NoGo task. These findings suggest that daily PA is associated with preservation of age-related declines in response inhibition control.

Patients with the best supportive care often get worse and worse, and it is very difficult to improve their symptoms. As cancer is currently a leading cause of death in Japan, and adequate control of the cancer-associated pain is important to improve the quality of life (QOL) in cancer patients. Pain caused by bone metastasis is particularly difficult to control, and the strong analgesic medication which it requires is generally difficult to control. Such metastases result in reduced mobility and markedly reduced activities of daily living (ADL) and the QOL of patients. Our patient was a 67-year-old man who had been treated for metastasis from the left kidney to cancer of the right pelvic bone ; palliative chemotherapy and mild treatment were provided for his sharp pain, but control of his sharp pain was insufficient. Here we expand on our experience in a patient with bone metastasis caused by renal cell carcinoma successfully treated with Kampo medicine, using acupuncture and decoction extract.

Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced enteritis or oral mucositis. It has been reported that hangeshashinto has been used for not only enteritis but also oral mucositis. This study reports the effect of hangeshashinto on enteritis or oral mucositis caused by radiotherapy. Three patients with enteritis and 5 patients with oral mucositis were treated with hangeshashinto at a dose of 7.5 g/day. The severity of enteritis or oral mucositis was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale both before and after hangeshashinto treatment. After the treatment with hangeshashinto, 3 of 5 patients with oral mucositis and 2 of 3 patients with enteritis showed apparent improvement. In conclusion, it is important to control the side effects of radiotherapy, which lead to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.

Japan introduced a mandatory residency program in 2004. Teaching hospitals are now responsible for improving patient safety and the overall teaching environment. Questionnaires were sent to teaching hospitals in Kyushu to evaluate residents' work environments and to ask them about improving patient safety. Questionnaires asked about the work environment, experience with medical errors and adverse events, self-reported work conditions, personal anxiety levels about medical errors, and personal suggestions for decreasing medical errors. One hundred eight questionnaires were mailed, and 76 (70.3%) were returned complete and were analyzed. Most residents in Japan work long hours, feel extremely busy, and are anxious about medical errors; many of them reported personal involvement in medical errors or adverse events. Their suggestions to improve patient safety included improvement of the work environment, establishment of a resident support system, and better organization of medical charts and equipment. Considering residents' viewpoints for patient safety is important to help reduce errors in teaching hospitals.

　　This study was conducted with a view to improving medication management service by reviewing renal excretory drug prescription practices in our hospital for patients with decreased kidney function without intervention of pharmacists. The subjects were the outpatients to whom the doctors had prescribed drugs containing digoxin, cibenzoline, bezafibrate, levofloxacin, valaciclovir or dabigatran. We retrospectively reviewed their serum creatinine levels, sex, age, height, weight and the amount of the drugs prescribed. It was found that there are cases in which medication had been prescribed without serum creatinine testing or prescribed in excess of the amount needed. Furthermore, there were cases in which the renal function had been judged in all probability by age and serum creatinine levels alone. Based on these findings, we concluded that pharmacists should intervene in pharmacotherapy using renal excretory drugs. For the realization of this, it would be necessary to build a system within the Department of Pharmacy to support the pharmacotherapy.

We analyzed the student self-assessment on education in cardiology using a questionnaire.
Subjects: Ninety-six 5th-year students at Saga Medical School who have completed the lectures and bedside teaching were evaluated.
Methods: A questionnaire survey of 14 topics in cardiology was performed at the finish of 3 weeks of bedside teachings. Self-assessment was categorized into 4 grades; 1) completely understood (3 points), 2) almost completely understood (2 points), 3) could be understood (1 point), and 4) could not be understood (0 point). Self-assessment scores were calculated for each topic in cardiology.
Results: Questionnaires were returned by 88 students (91.7%). Self-assessment scores were high for myocardial infarction, angina pectoris, and electrocardiogram reading. Scores were low for primary care, vascular diseases, and pericardial disease. Self-assessment scores did not significantly correlate with the length of lectures but did correlate with the number of admitted patients (r= 0.93) and scores on achievement tests (r= 0.43) in each topic.
Conclusions: Because students observed many patients with myocardial infarction and angina pectoris during bedside teaching, the self-assessment scores were high. Bedside teaching is important for medical students to understand topics in cardiology.