Gastric cancer with peritoneal metastasis (GCPM) is a common and lethal manifestation of advanced gastric cancer, with a median survival of only 5-11 months. This consensus was developed by 30 experts from Asia (China, Japan, Korea, and Singapore) using the Delphi method and the GRADE evidence grading system. A total of 29 statements were formulated, covering the diagnosis and assessment of GCPM, indications for laparoscopic exploration and NIPS (normothermic intraperitoneal and systemic treatment), treatment regimens, prevention and management of complications, criteria for conversion surgery, and postoperative intraperitoneal therapy. The consensus aims to standardize clinical practice and improve the prognosis of patients with GCPM.

[Objective]To research a effect of prevention against cold syndrome by acupuncture
[Methods]I questioned 215 patients who come to the acupuncture and moxibustion clinic to oriental medical center group.
Contents of the question
From when you come to needle therapy
A:your body is strong for cold syndrome
B:no change
C:you are weak for cold syndrome
[Results]63.4%of the patients marked "A:your body is strong for cold syndrome ".Percentage of answered A.Come to oriental medical center group for
less than 2 years: 45.9%
over 2 years and less than 4 years: 63.3%
over 4 years: 82.8%
[Conclusions]Acupuncture is a good way for prevention against cold syndrome. And the result say that the more you come to acupuncture, the more you are strong for cold syndrome.

[Objective] We performed a multi-center randomized controlled trial using sham acupuncture as a control in the 11 institutions of Aichi and Shizuoka prefecture at which we practice our original acupuncture method.
[Design · Methods] Patients were randomly allocated to four groups : A group, “Taikyoku-Ryoho” (whole body acupuncture method) pole treatment combined with low frequency electroacupuncture; B group, “TaikyokuRyoho” pole treatment; C group, low frequency electroacupuncture; D group, sham acupuncture. Therapeutic effectiveness was evaluated using a visual analogue scale (VAS) and criteria of the Japanese Orthopedic Association for low back pain (JOA score). After these evaluations, patients in B group received low frequency electroacupuncture and patients in C group received “Taikyoku-Ryoho” pole treatment. Patients in D group received both therapies. Thus, all patients eventually received the entire series of therapies. [Results] Significant improvement (P<0.05) in VAS and JOA scores was recognized after one acupuncture treatment in A, B and C groups, but not in D group. There were no differences in terms of the effectiveness among A, B and C groups.
[Conclusion] Our original acupuncture method of “Taikyoku-Ryoho” combined with low frequency electroacupuncture was superior to sham acupuncture. However, the definition of sham acupuncture needs to be more clearly defined in future research.

Research on pulse diagnosis conducted so far by Kurono et al. includes a study on pulse diagnosis and six basic pulses and a study on the application of AMI (an apparatus for measuring the function of the meridian and corresponding internal organs) to pulse diagnosis.
In this study, fluctuation of the meridian functions with or without acupuncture treatment according to the law of the five elements were examined objectively using BP values measured by AMI. When BP values were measured for 10 times without acupuncture treatment, the values for the respective meridiansfluctuated in a stable manner, averaging 4% or less. As a result of testing 6 subjects using this meridian treatment according to the law of the five elements, fluctuation of the meridian functions increased in the oriental medical diagnosis of all the subjects.
Thus, the results of this study showed the feasibility of using AMI for objectively evaluating the fluctuation of meridian functions. The authors intend to continue to examine the relationship between diagnosis and acupuncture using AMI.

With the aim of investigating the effect of drop in blood pressure of the Zusanli (ST36), a multi-center randomized controlled trial was conducted with the envelope method. Patients showing the high blood pressure condition were divided into 2 of the group treated with use of the Zusanli point and the group with non-use of Zusanli point.Changes in blood pressure were then measured.The present results show no significant difference was seen between the 2 groups, thus did not find the Zusanli point to be effective.

At the 45th Japanese National Acupuncture and Moxibustion Conference, Kitakoji et al. of the Research Committee's Urology Group reported the results of controlled clinical trials, using the envelope method, on the effectiveness of acupuncture for urinary dysfunction. This was presented as a case in which the “Guidelines and Recommendations for clinical Trials in Acupuncture” were applied in actual clinical research. A controlled investigation was carried out by the Information and Evaluation Group, Research Section, Aichi Regional Association, at multiple institutions (9 hospitals and clinics) on the effectiveness of the zhongji (cv-3) point for urinary dysfunction, using the envelope method of Kitakoji et al. Although the zhongji (cv-3) point was not found to be effective against urinary dysfunction, we were able to demonstrate that it is possible to conduct controlled clinical trials at multiple institutions based on soft data.

Although the efficacy of acupuncture in treatment of various diseases has been empirically established, systematic demonstration of this point has been rarely made. Our animal experiments designed to prove the efficacy of acupuncture on a scientific basis are reviewed here.
Each of the following experiments was carried out on two to five groups of mice. Mice in acupuncture group (A-animals) were acupunctured at four to seventeen points on every second or third day beginning with the first experimental day.
Exp. I. The preventive effect of acupuncture on acute poisoning by carbon tetrachloride-With carbon tetrachloride (4.16g/kg body weight) injected in the abdominal cavity on the 18th exp. day, all the non-acupunctured mice (N-animals) died in 72 hours after the administration, while 16% of the A-animals survived.
Exp. II. The curative effect of acupuncture on subacute liver injury induced by carbon tetrachloride. -Carbon tetrachloride (3.47g/kg b. w.) was administered on the 17th exp. day in the same manner as Exp. I. Levallorphan tartrate (antagonist to narcotics) was given to half of the A-animals (L+A-animals) and control animals (L-animals) before each session of acupuncture. Electron microscopic examination revealed severely injured liver cells in the N-animals and very little changes in the A-animals. The liver of L+A-animals was injured to some extent. Since the explanation of toxicity of levallorphan was refuted by the L-animals, this result suggests that some narcotic substances play a role in the process.
Exp. III. The effect of acupuncture on alloxan diabetes. -Alloxan (6mg) was administered on the 8th exp. day, and the animals were sacrificed on the 30th or 46th exp. day for examination. The N-animals showed extremely high blood sugar, though the A-animals did not. Ultrastructural study revealed that characteristic changes of alloxan diabetes in the pancreas had almost disappeared from the A-animals.
Exp. IV. The effect of acupuncture on renal injury induced by mercuric chloride. -With mercuric chloride (0.2mg/100g b. w.) administered three times a week, 10% of the N-animals and none of the A-animals died during the three-month period. Fairly heavy proteinuria (30-100mg/ml) was detected in the N-animals, though uria of A-animals was almost normal. After a one-month period, the N-animals showed a significant weight loss compared to the A-animals. Through the use of the electron microscope, severe injuries were seen in the epithelium of the renal tubules of the N-animals, and healed injuries in that of the A-animals.
Ultrastructural evidence has been presented that acupuncture is effective in (1) preventing and curing liver injury induced by carbon tetrachloride, (2) curing alloxan diabetes, (3) curing nephritis induced by mercuric chloride. Our hypothesis suggesting the possible mechanism that underlies these effects produced by acupuncture has been briefly explained.

It is well known that acupuncture has a curative effect for some chronic diseases such as neuralgy or lumbago, if it is administered carefully in terms of the patient. However, the mechanism of acupuncture's effectiveness remains obscure.
In this experiment, using mice of the ICR strain, the protective effect of acupuncture against mouse liver injury was investigated following the administration of carbon tetrachloride.
Experiment I (Fig. 1): One hundred mice were divided into two groups. The first group of animals was administered carbon tetrachloride ip on day 18. The second group was treated a total of six times with acupuncture every three days from the first experimental day to day 18 at the points of Tienshu (ST-25), Feishu (BL-13), Hsinshu (BL-15), Kanshu (BL-18), Pishu (BL-20), Weishu (BL-21), Chimen (LV-14), Chihai (CV-6), Chungwan (CV-12) and Chuchueh (CV-14) (Figs. 3, 4). Fllowing the administration of carbon tetrachloride, the mouse mortality was checked. All of the animals of the first group (carbon tetrachloride administration only) died within 72 hours, but only 84% of the animals of the second group (carbon tetrachloride and acupuncture treatments) died (Fig. 2).
Experiment II (Fig. 1): One hundred and 60 mice were divided into 5 groups. The first group was used for the control (Fig. 5). The second group was injected ip with carbon tetrachloride of 3.47g/Kg BW on day 17. The third group was given a total of 5 acupuncture treatments every three days at the points as mentioned in Experiment I, and carbon tetrachloride was injected as in the second group.
The fourth group was injected a total of 5 times with 0.0004mg levallorphan (an anti-opiate) every three days. The fifth group was given acupuncture treatments like the third group; levallorphan was injected before the acupuncture, and also carbon tetrachloride was injected on day 17 as in the second or third, group.
The animals were sacrificed on day 20, and the liver tissues were treated as usual and then observed by electron microscopy.
The hepatocytes of the second group (carbon tetrachloride only) were heavily injured, and contained, a number of fat droplets, autophagic vacuoles and degenerated cell organelles (Figs. 6, 7, 8, 9). On the other hand, the hepatocytes of the third group (carbon tetrachloride and acupuncture treatments) were almost normal, and without any cell injury (Figs. 10, 11, 12).
The hepatocytes of the fourth group were not injured with levallorphan, suggesting that levallorphan has no cell toxicity (Fig. 13).
The fifth group showed hepatic cell injury similar to the second group (Fig. 14). Levallorphan thus might have an antagonistic action for the acupuncture effectiveness.
In summary, it was concluded that acupuncture has a protective effect against liver injury caused by carbon tetrachloride administration, and prevents not only animal death but also hepatic cell injury. The mechanism of the acupuncture effectiveness is speculated to be as follows. The stimulus of the acupuncture is conducted to the central nervous system and then the central nervous system secretes some neural hormonal substances such as endorphin or enkephalin, which might regulate or accelerate the autonomic nervous system, and then the viscerae functions are accelerated and thus might repair the injuries or dieseases.
In the above-mentioned experiments, levellorphan may have disturbed the secretion or action of endorphin or enkephalin from the central vervous system, which was said to be secreted following the acupuncture treatments, resulting in the ineffectiveness of acupuncture treatments.
Fig. 1. Schedules of the experiments.
Fig. 2. The mortality rate of mice following carbon tetrachloride administration (Experiment I).
Fig. 3. Acupuncture points on the mouse belly.
Fig. 4. Acupuncture points on the mouse back.
Fig. 5. A part of the hepatic cell from a normal mouse. The nucleus (N) and nucleolus (NO) are morphologic