For the purpose of studying the systematization of community health care in the rural district, we made health examinations and investigations into labor conditions and daily life of women working in grape farms.
The health conditions of the women working in grape farms were considerably unfavorable. They were compelled extremely busy lives including agricultural labor, households, childcare and nursing of the elderly who were lying ill in bed.
The health examinations revealed the high prevalence of cervicobrachial disorder, lumbago, fatigue of the sensory-nervous system and some health hazards by agricultural chemicals, in addition to anemia and hypertention which show generally higher prevalence among farmers in Japan. Taking into account that the new technical know-how and agricultural chemicals will be more and more introduced to the intensive agricultural system, it will become important to raise the health level both through approaches of the community health and through industrial hygiene.
The cooperative activities which we carried out with the Agricultural Cooperative Association, Municipality, Health Center, the Agricultural Mutual Benefit Association and the Agricultural Guide Center, improved the health condition, health care delivery system and participation of workers in the activities. These effects also proved the necessity of improving living conditions in parallel with the promotion of the comprehensive health care system.

A health examination and an occupational health investigation were executed to find health problems of workingwomen in a rural factory which produces the disposable medical tools on the line. The results were as follows
1) Most of workingwomen complain of fatigue of muscle and neuro-sensory systems which is due to simple work of assembly-line operation. Mild hypertension, anemia, backpain and eyestrain are also prevalent.
2) The exposure to organic solvents was scarcely defined by our occupational environmental investigation, but an attention should be paid to the chronic intoxication by long-term, trace exposure to organic solvents. Recently organic solvents are so often used in factories in rural districts that it is very important to arrange the health check system for the intoxication by organic solvents, and to call special attentions of workingwomen to the occupational disease through the health education.
3) As many workingwomen must work hard not only at the factory but also at their homes after their duties, carrying on agricultural cultivation, household and nursing of infants, they are usually fatigued and are chronically in anemic condition. To promote the health level of workingwomen in rural district, it is very important to realize the comprehensive health care. from the standpoint of promoting community health and occupational health care.

Medical students at Kurume University begin practical training in clinical skills in their fourth year. At that time, students use the skills laboratory to improve their clinical skills. Medical education resources in the skills laboratory include simulators for emergency resuscitation and heart diseases, wireless stethoscopes, and videotapes. All students use the skills laboratory for 2 months, and its usefulness was evaluated with questionnaires after practical training. More than 50 % of students approved of their practice in the skills laboratory. However, some students were unsatisfied because they were unable to make effective use of the simulators. In the future, an improved skills laboratory will be necessary to improve practical training in the clinical skills for medical students.

We analyzed the scores of objective structured clinical examinations (OSCEs) and written examinations administered to fourth-year medical students after practical training in clinical skills and to fifth-year medical students after clinical training and scores of graduation examinations taken by sixth-year medical students. Correlations were analyzed among the scores of 96 students who had taken all 3 examinations during a 3-year period. Mean scores on examinations in the fourth, fifth, and sixth years were compared between sixth-year students who did or did not graduate and between graduating students who did or did not pass the national examination for medical practitioners in Japan. Significant correlations in the scores were found between 1) OSCEs and written examinations for fourth-year students versus those for the fifth-year students; 2) OSCE and written examinations for fourth-year students versus graduation examination scores for the sixth-year students; and 3) OSCE and written examinations for fifth-year students versus graduation examination scores for sixth-year students. In addition, the mean scores in the fourth and fifth years were significantly higher for sixth-year students who graduated and passed the national examination than for students who did not graduate or who graduated but failed the national examination. These results suggest that the practical training in clinical skills given to fourth-year students and the clinical training given to fifth-year students strongly affect the overall evaluation of the ability of sixth-year students and success on the national examination.

History of Mongolian medicine could be traced back to 2000 years ago. Mongolian traditional medicine has been built over many years. We traveled Mongolia to visit a hospital and a private clinic where traditional Mongolian medicine is in practice, and visited National University of Medical Sciences. In this paper, we report the current status of traditional medicine in Mongolia. We visited Mongolian National University of Medical Sciences and conversed with the president, vicepresident, and director of the traditional medical department. We visited a clinic where Mongolian traditional medicine is performed and a hospital where mainly traditional therapies and practical development are carried out. In the hospital, they mainly provide acupuncture and moxibustion treatment, cupping therapy, herbal therapy, and thermotherapy. It cannot be denied that moxibustion treatment came from Mongolia, because it is also said that ‘the north' in “Huangdi Neijing Suwen” chapter 12 means Mongolia. However, as there is a background once traditional medicine has been kept away from the national health care system, it is difficult to find a specific medical practice for Mongolian medicine as far as we have viewed the present status of medical practice in Mongolia. Considering that the cultural exchange with Japan is being carried out in many other fields, we expect that a number of new facts will come to light in the near future.

The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as grade 1 (strong) or grade 2 (weak) according to the concepts of the grading of recommendations assessment, development, and evaluation system. The 31 CQs covered the six topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, and (6) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded. This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence.