Acupuncture treatment is one of the conditioning methods in the competition field. Athletes who are forced in regularly intensive training often induced deteriorating of condition. Good conditions are adjusted by interaction of immune system, nervous system and endocrine system. Neutrophils and lymphocytes which are blood components prevent infections of the human body in various ways. Intensive training causes an increase of neutrophils, a decrease of lymphocytes and a negative impact on the immune functions. It has been reported that acupuncture stimulation could be involved in the coordination of the immune system. Therefore, acupuncture treatment could be important to keep physical condition and participate physical activity according to the plan without deteriorating of condition. It may be useful not only for athletes but also for the general public who train for the purpose of health and sports enthusiasts. The purpose of this study was to examine the effect of acupuncture stimulation on fluctuation of neutrophils and lymphocytes by the transient high-intensity exercise.
Method : Twelve healthy men (23.6±O.3 yr [±SE]) participated in this study. Subjects exercised on bicycle ergometer for 60 minutes at 75% of their VO₂max. Acupuncture treatment was applied at LU6 (Kongzui), LI 4 (Hegu), ST 36 (Zusanli), and ST 6 (Jiache), for 30 min after the exercise. Blood samples were taken before exercise, immediately after exercise, hourly after exercise until 4 hours and 24 hours after exercise. Leukocyte, neutrophils, lymphocytes, Th cells and Tc cells were measured from the blood samples.
Result : The neutrophils significantly increased from Post 1h to Post 4h in the both trials (P < 0.05). However the neutrophils was significantly lower in the acupuncture group than in the control group at Post 1h and Post 3h (P < 0.05). The lymphocytes significantly increased from immediately after exercise to Post 24h in the control trial, and increased significantly only at Post 1h to Post 3h in the acupuncture trail (P<0.05). The Th cells significantly decreased from Post 1h to Post 24h in the control trial and decreased significantly only at Post 1h, 2h and 24h in the acupuncture trail (P < 0.05).
Conclusion : These results suggested that acupuncture stimulation may reduce the increase of neutrophils and the decrease of lymphocyte and Th cells caused by high-intensity exercise. These results indicated that acupuncture stimulation may promote the recovery from high-intensity exercise.

We report the case of an 84-year-old woman with advanced biliary tract cancer and accompanying colonic invasion and hepatic metastasis, who was successfully treated with single-agent gemcitabine chemotherapy in combination with juzentaihoto (a traditional Japanese herbal medicine). Response to this combination chemo therapy was extremely good, and the patient's tumors disappeared. There have been no reports like our case until today. These findings suggest that combined treatment with juzentaihoto and gemcitabine is effective not only for reducing tumor size, decreasing the side effects of chemotherapy, and maintaining general condition but also for mediating immune antitumor activity.

1)Continuing medical education (CME) systems were researched in 10 countries. In all countries but one CME is mandatory. Only Spain has voluntary CME, as does Japan.
2)The traditional CME systems in many countries were changed after 2000. We believe this change reflects a global revolution associated with a new wave of medical risk management.
3)To provide better medical services, we must keep improving Japan's CME system. Such improvement is an important responsibility to society.

The purpose of this study was to investigate the effects of Lactobacillus gasseri OLL2809 (MG2809) intake on salivary secretory immunoglobulin A (SIgA) secretion and incidence of upper-respiratory tract infection (URTI) symptoms among college rugby athletes. Sixty-seven subjects were assigned to a MG2809 group (n = 33) or a placebo group (n = 34) using a double-blind procedure. Each subject took MG2809 or placebo tablets for 9 weeks. Resting saliva samples were collected before (0 week) and after 2, 4, 6, 8, and 9 weeks of the MG2809 intakes. A log of URTI symptoms was kept every day during the study period. Our results showed that salivary SIgA level was significantly increased at 6 weeks in the MG2809 group (p < 0.05), although the placebo group did not show significant change. The duration of URTI symptoms episode in the MG2809 group was significantly shorter than that in the placebo (p < 0.05). These results suggest that regular intake of MG2809 may enhance oral immune function mediated by SIgA and reduce the risk of URTI in athletes.

Objective : The objective of this study was to assess the safety and efficacy of left atrial appendage (LAA) amputation during cardiovascular surgery. Methods : Fifty-seven patients underwent LAA amputation using a stapler from 2016 to 2017. The presence of remnant LAA was estimated by transesophageal echocardiography (TEE). Results : All LAA amputations were performed with the heart beating, without collapse. Additional amputation for remnant LAA was required in 14 patients. Sutures were needed to control bleeding in 7 patients. There was one case in which the coronary artery ended up being clamped with the LAA. The average duration for LAA amputation was 6.1±3.2 (1.5-15.2) min. There were 25 cases with postoperative atrial fibrillation (POAF), one case of cerebral infarction without POAF and one case of re-exploration for bleeding. Three patients died during hospitalization. Conclusion : LAA amputation using a stapler does not require cardiac arrest, and rarely requires an extended operation time. However, sufficient caution is required as there is the possibility that the coronary artery is obstructed and that remnant LAA is present.