The standardization of acupuncture point locations has been a pending matter for ages and considered the difficult challenge ever since the nomenclature of meridians and collaterals and acupuncture points, including the eight extra meridians and extra points, was standardized internationally at the Geneva Meeting in 1989. 14 years since then, in 2003, the Informal Consultation on Development of International Standard Acupuncture Point Locations by Japan, China and Korea commenced under the initiative of the WHO Western Pacific Regional Office (WPRO).
The discussions were held 9 times in 3 years, making great progress toward accomplishing the standardization. The objective will finally reach fruition at the Meeting on Development of International Standard Acupuncture Point Locations which is to be held at Tsukuba-city, Japan, in the fall of 2006.
The developments thus far and future issues are summarized and reported.

1. Introduction
The Meeting on Development of International Standard Acupuncture Point Locations hosted by WHO/WPRO was held between Oct. 31 th and Nov. 2 nd in 2006 at the International Congress Center in Tsukuba City, Japan. The delegates came from nine countries, e.g. Australia, China, Japan, Korea, Mongolia, Singapore, UK, USA, Vietnam, and two organizations, e.g. WFAS (World Federation of Acupuncture Societies), AAOM (American Association of Oriental Medicine). The total number of delegates was twenty. The draft of Standard Acupuncture Point Locations, which had been discussed between three countries, Japan, China and Korea during the previous three years, was officially decided.
2. Agreement for Acupuncture Point Locations
Three hundred and sixty one Acupuncture Point Locations were decided at the meeting, the number is 7 more than the number that has been taught so far in the educational field of Japanese acupuncture. The points which differ from the current Japanese text book are 7. These points had been considered “extra points” located along meridians as well as points requiring special attention. 6 points had been the subject of debate, and as a result two locations for each point have been decided. These are LI 19, LI 20, CV 24, PC 8, PC 9, and GB 31.
3. Future Plan of WPRO
We attempted to standardize the Acupuncture Point Locations at the official meeting in Tsukuba. Moreover WHO/WPRO intends to standardize (1) Oriental Medical Terminology, (2) Oriental Medical Information, (3) Guidelines for research of Acupuncture and Moxibustion, and general thoughts, points of view, and an outline of Oriental Medicine. Then WHO hopes to encourage application of these standards to research and practice of Oriental Medicine.
4. The themes after deciding the Acupuncture Point Locations
Subjects for further discussion include: (1) Research on acupuncture point locations, (2). Encouraging the use of Standardized locations, (3). Clarifying “Japanese Acupuncture” and its supporting its use all over the world, etc.

The (First) Japan Acupuncture Point Committee was established in 1965 and the nomenclature for meridians and acupuncture points was standardized at the meeting in Geneva in 1989. After that the first Informal Consultation on Development of International Standard Acupuncture Points Locations was organized by WHO/WPRO and held in Beijing (2003). In Japan the (second) Japan Acupuncture Point committee started April in 2004. Japan, China and Korea held nine meetings and made a draft for the Locations of Acupuncture Points. According to the draft made at the official meeting of 'the Development of Standard Acupuncture Point Locations'held in Tsukuba, Japan (2006), Acupuncture Point Locations were further standardized. Finaly, the book "WHO Standard Acupuncture Point Locations in the Western Pacific Region"was published on May 16th, 2008. Here, we want to report on the Commemorative Lecture Meeting for Publication of WHO Standard Acupuncture Point Locations held on May 30th, 2008.

[Introduction] In 2006 the WHO and WPRO agreed on standard acupuncture point locations. To promotepagate these standards, in 2009 the Second Japan Acupuncture Standardization Committee published a Japanese edition of 'WHO STANDARD ACUPUNCTURE POINT LOCATIONS FOR THE WESTERN PACIFIC REGION.' Based on this Japanese edition, a new textbook was published by the Japan Association of Massage & Acupuncture Teachers and the Japan College Association of Oriental Medicine. Since one year has passed since the start of education based on standard acupuncture point locations at Japanese universities, colleges, vocational schools and training centers for anma (Japanese traditional massage), massage, and shiatsu (acupressure); acupuncture; and moxibustion therapies, we administered a questionnaire survey as an evaluation of international standardization and the problems of introducing standard acupuncture point locations .
[Subjects and methods] Subjects were mainly teachers and included a small number of researchers, clinicians, and other groups concerned with acupuncture and moxibustion. We used a questionnaire that we originally created at the Second Meeting of the Japan Standardization of Acupuncture Point Locations Committee.
[Results] Among the 180 institutions surveyed, we obtained answers from 149 people from 93 institutions in total. Agreement on the question of standard acupuncture points, "functional existence" (44.3%) was most common, and "anatomical existence" came next at 26.6%. For the question on acupuncture treatment, 82.4% replied with "use ofboth acupuncture points and reaction points." For the answers to agreeing with international standardization, "no opinion" was 41.7% and 51.7% for "appreciate." However, both of those groups appreciated globalization of acupuncture and moxibustion by a common　language. There were many opinions on proportional bone measurement. Specifically, opinions indicated a change "from the cubital crease to the wrist crease" (from 10B-cun to 12B-cun) and a need for proportional bone measurement of the upper arm. Whereas, for individual acupuncture points, opinions expressed the difficulty of locating application points and not understanding reasons for change and notations including body surface segments.
[Discussion] We were able to classify the opinions collected into the following groups: (1) problems that can be corrected immediately, including typographic errors, (2) problems that need to be reviewed at the next international gathering, and (3)problems that need to be understood by making full use of related documents.
[Conclusion] We were able to determine primarily for a wide range of teachers, problems understanding individual acupuncture point locations, including consideration of acupuncture points, evaluation of standardization of acupuncture point locations, and other guidelines

　　This study investigated data on cardiopulmonary exercise testing (CPX) indices in order to estimate exercise intensity and ramp load from maximum walking speed (MWS) in elderly hospitalized patients with acute coronary syndrome (ACS). Subjects were 66 male patients hospitalized with ACS (49 young-old patients and 17 old-old patients). We measured exercise intensity by CPX using a cycle ergometer and MWS over 10 m, and examined the patients’ clinical characteristics. Stepwise multiple regression analysis was performed to identify variables that most closely predicted exercise intensity. We then estimated the ramp load from the relationship between exercise load at anaerobic threshold and MWS. The results indicated that MWS was an independent predictor of exercise intensity in old-old patients (adjusted R²=0.278, p=0.037) but not in young-old patients. The regression formula predicted the proper ramp load to be 5 and 10 watts as MWS was less than 1.5m/s or more than 1.5m/s, respectively. MWS was related to exercise intensity and could be used to consider the ramp load in CPX in old-old male patients with ACS.

Purpose: To compare the effects of aging in patients with acute myocardial infarction (AMI) on their clinical background and hospitalization progress, and to examine the relationships between age and these factors.
Subject: One hundred and fifty-three patients who experienced cardiac rehabilitation after percutaneous coronary intervention (PCI) (63.8±11.1 y.o, 126 men, 27 women).
Method: The patients were divided into the middle aged group (<65 y.o, n=84), young old group (65 to 74 y.o, n=44), and old group (75 y.o≥ n=25). The differences between groups were examined in respect of 13 items about clinical backgrounds (responsibility coronary arteries, CKmax, LVEF, residual stenosis, hypertension, diabetes, hyperlipemia, smoking, and BMI) and hospitalization progress (cardiac complications, locomotorium disabilities, abnormality as 200mECG, and duration of hospitalization).
Results: Left veticular ejection fraction (LVEF) was significantly lower in the old group than in the young old group. The old group had a high rate of residual stenosis. In the coronary risk factors, all of the groups had hypertension at a high rate of 54.5% or over. The middle aged group and young old group had diabetes at about 38%. The middle aged group was prone to hyperlipemia, and had significantly a high smoking rate. Body mass index (BMI) was significantly higher in the middle aged group than in the old group. In hospitalization progress, the old group had a high rate of cardiac complications and locomotorium disability. The duration of hospitalization was significantly longer in the old group than in the other groups.
Conclusion: It would be necessary to give middle-aged persons educational guidance for the improvement of the coronary risk factors, and to provide the old persons with the suitable rehabilitation programs considering various complications.

A symposium was organized by the Meridians and Acupuncture Points Committee of the Japan Society of Acupuncture and Moxibustion (JSAM) with the theme "A detailed explanation of acupuncture points from the viewpoints of education, clinical practice and research - about SP6 (Sanyinjiao), LI4 (Hegu), and GV20 (Baihui)" at the 73rd Annual Meeting of JSAM in Miyagi. During the symposium, Commissioner Nakamura elucidated the significance of acupuncture points from an educational standpoint, highlighting their importance in the training of acupuncture and moxibustion practitioners. He expounded upon the meanings and precise locations of the three acupuncture points, emphasizing the importance of safe acupuncture practices. Additionally, he underscored the pivotal role of education in bridging the gap between clinical practice and research. From a clinical perspective, Commissioner Yamami provided an in-depth explanation of the fundamental tenets of acupuncture points, including their primary modalities, distinctive attributes, and the extraction of acupuncture points from authoritative texts on meridians and acupuncture points. He further elaborated on the specific reactions, treatment modalities, and indications of the three acupuncture points in clinical practice, noting that the ideas underpinning research originate from clinical experiences. Standardization and accuracy of education are necessary to enhance safety and effectiveness in clinical practice. From a research perspective, Commissioner Koido analyzed data from 2019 to 2023 using national and international databases to elucidate the status of target diseases and stimulation methods in clinical trials involving the three meridians. The findings revealed that the three acupuncture points are extensively employed in both national and international clinical trials across a broad spectrum of diseases, with various stimulation techniques being utilized.