Chronic obstructive pulmonary disease (COPD) is characterized by chronic pulmonary inflammatory process, and the chief complaint is aggravating dyspnea. COPD itself also has significant extrapulmonary (systemic) effects that lead to comorbid conditions. Weight loss, nutritional abnormalities and skeletal muscle dysfunction are well-recognized extrapulmonary effects of COPD. The impact of the systemic manifestations of COPD on the prediction of mortality using a multidimensional index has been reported. Although not much is known regarding the underlying mechanisms of the systemic inflammation, any new therapeutic strategy would have to improve this chronic inflammatory process. The principal goals of the treatment for COPD are to reduce symptoms, improve quality of life, and increase physical and emotional participation in everyday activities. Exercise de-conditioning, relative social isolation, altered mood states (especially depression), muscle wasting, and weight loss have complex interrelationships, and improvement in any one of these interlinked processes can interrupt the vicious circle in COPD. Some Japanese traditional herbal medicines have been used to improve the physical and mental conditions of patients suffering from various diseases. Among them, hochuekkito is known as a drug for recovery from immune dysfunctions that has been reported useful in protecting infection. Hochuekkito may improve systemic inflammation as well as nutritional status in moderate to severe COPD, although the mechanisms of hochuekkito have not been defined. In addition, the incidences of common cold and its exacerbation can be decreased with administration of hochuekkito, suggesting that hochuekkito may have some biodefensive effect against viruses or bacterias.

Introduction: During their clinical clerkship (CC), Japanese medical students’ literature searching skills were ambiguous. We conducted a questionnaire survey on students’ search processes to determine whether this skill improved after a lecture on conducting searches.　Method: This study was conducted from May to December 2019. The questionnaire survey was followed by a 90-minute lecture combining information and relevant activities. The questionnaire included students’ self-evaluation of their literature searching abilities, and references from their medical summaries and reports were compared to those of students from a 2018 group who did not attend the lecture.　Results: Sixty-seven students participated in the questionnaire survey and lecture. Questionnaire results demonstrated that the most frequently used search tool was PubMed. Regularly used types of literature were Japanese textbooks medical guidelines issued by the Japanese Medical Society, and English-language medical journal articles. The two major difficulties in conducting searches were the inability to critically appraise the literature and inadequate English reading skills.　The students’ satisfaction level regarding the lecture was found to be acceptable. After attending the lecture, students’ self-evaluation of their literature searching abilities improved significantly. Furthermore, compared to the 2018 group, references in students’ summaries and reports increased. Additionally, the number of English-language medical journal articles cited in reports was higher among students in the 2019 group than the 2018 group.　Conclusions: Although CC students can conduct literature searches, they struggle with critical appraisal and English-language comprehension. Interventions such as lectures may effectively improve their searching skills during CC.