Purpose: We identified the risk factors for remnant gastric cancer (RGC) based on remnant gastric mucosal characteristics and gastritis morphology in patients undergoing distal gastrectomy. Materials and Methods: This multicenter retrospective study included 100 patients with RGC after distal gastrectomy and 550 patients without RGC treated between 2013 and 2020.Endoscopic findings, including anastomotic redness, red streaks, enlarged folds, bile reflux as anastomotic findings, as well as disappearance of the regular arrangement of collecting venules (RAC), atrophic gastritis, and intestinal metaplasia as background gastric mucosal findings, were evaluated. Disease risk score matching (1:1) was adjusted for baseline characteristics. Logistic regression analysis was used to develop a risk score model to stratify RGC risk into low, moderate, and high categories. Results: After matching, 96 patients with RGC and 96 controls were analyzed. Anastomotic redness and red streaks, as well as the disappearance of RAC and atrophic gastritis, were significantly more frequent in the RGC group than in the control group, whereas enlarged folds and bile reflux showed no significant differences. Risk scores were assigned as follows:anastomotic redness, 2; red streaks, 3; disappearance of RAC, 7; and atrophic gastritis, 3. The total score stratified patients into high (≥15), moderate (7–14), and low risk (≤6). The positive and negative predictive values were 67.7% and 83.3%, respectively. Conclusions The endoscopic findings of anastomotic redness, red streaks, RAC disappearance, and atrophic gastritis were significantly associated with RGC development.The proposed risk-scoring model could serve as a stratification tool for RGC surveillance.

Following the Japan-Korea Symposium at the 37th ICMART World Congress in Jeju, Korea, September 27-29, 2024, another international symposium was held in Daegu on November 17, 2024, by three countries, including not only Japan and Korea but also the Chinese Medical Association of Acupuncture in Taiwan. In addition, a Korean domestic symposium was held by three societies under the Society of Korean Medicine.　Korea has been actively inviting such international symposiums in recent years, and international exchanges in the field of acupuncture and moxibustion has been progressing further than ever before. Academia of traditional medicine in Japan needs to respond actively to this trend, including human resource development.

Case reports are an indispensable research format in the advancement of medicine. They play a significant role in accumulating medical knowledge on new or rare diseases and evaluating the efficacy and safety of therapeutic interventions. Furthermore, case reports provide a critical opportunity for generating new research hypotheses and are widely recognized for their value as essential educational tools for healthcare professionals. However, some case reports fail to include sufficient essential information, and their incompleteness or lack of transparency may lead to misinterpretation by readers. To address these issues, the CARE (CAse REport) guidelines were established in 2013, providing standards to improve the completeness and transparency of case reports. The CARE guidelines comprehensively cover essential reporting items for case reports in various fields. By adhering to these guidelines, authors can ensure the completeness of information and achieve transparent reporting. However, there still does not seem to be sufficient recognition and dissemination of the CARE guidelines in Japan. Therefore, this article introduces the key components of the CARE guidelines and discusses their application, particularly in the field of acupuncture practice. It is hoped that the wider use of the CARE guidelines in case reports related to acupuncture will enhance reporting quality and facilitate the provision of more reliable and credible information.

[Objective] This study aimed to collect, analyse, and examine the literature on adverse events in acupuncture and moxibustionin order to improve safety.[Subjects and Methods] A literature search was conducted using Ichushi Web and PubMed to identify reports of adverse eventsrelated to acupuncture and moxibustion published in domestic and international medical journals from 2020 to 2023. The searchkeywords included 'acupuncture', 'moxibustion', and various terms related to adverse events associated with them.[Results] We identified 33 papers describing acupuncture-related adverse events in Japan. The reported adverse events includedinfections (9 papers), organ injuries (11), neurological injuries (2), dermatological problems (2), and needle breakage, retainedneedles, or foreign bodies (9). We also identified 56 papers reporting adverse events that occurred abroad, including infections(17); organ injuries (23); neurological injuries (1); dermatological problems (6); needle breakage, retained needles or foreignbodies (3); others (4); and moxibustion-related adverse events (2).[Conclusion] Consistent with previous surveys, various adverse events related to acupuncture and moxibustion occurred bothdomestically and internationally. These findings highlight the importance of learning from the reported cases and implementingsafety education on acupuncture and moxibustion.Zen Nihon Shinkyu Gakkai Zasshi (Journal of the Japan Society of Acupuncture and Moxibustion: JJSAM).2025; 75(4): 442-462. Received 29 Jun, 2025 Accepted 13 Jul, 2025

The Korean Acupuncture and Moxibustion Medicine Society (KAMMS) celebrated its 50th anniversary with a commemoration ceremony and a Japan-Korea Symposium held in Seoul in November 2023. This report outlines the participation and highlights from the commemoration ceremony celebrating the 50th anniversary of KAMMS on November 11 (Saturday), along with insights shared during the Japan-Korea Symposium held as a special session within KAMMS' Fall Academic Conference 2023 on November 12 (Sunday). The summary includes presentations delivered by four speakers during the symposium. The Korean session focused on "Collaborative-Based Integrated Healthcare," discussing endeavors in integrated medicine involving Western medicine and Korean medicine. Meanwhile, the Japanese session titled "Introduction of Acupuncture Clinics in Japanese University Hospital" highlighted efforts in acupuncture and moxibustion education within the Tohoku University Hospital in Japan.

[Objective] To clarify the utilization of characteristics and reactions of acupuncture points, and the frequency of using acupuncture points in acupuncture and moxibustion treatment in Japan.[Methods] We conducted a questionnaire survey involving members of the Japan Society for Oriental Medicine and those of the Japan Society of Acupuncture Course in Universities. The contents of the questions included age, sex, profession, length of clinical experience of acupuncture/moxibustion, treatment method, utilization of characteristics and reactions of acupuncture points, and frequency of using acupuncture points in both acupuncture and moxibustion treatment.[Results] The number of valid questionnaires was 59 (59 for acupuncture treatment and 50 for moxibustion treatment). The respondents were as follows : average age of 52 ± 12 years, 45 males and 14 females, 13 medical doctors and 46 acupuncturists, clinical experience of 21.1 ± 11.5 years. Most practitioners utilized ill ness-specific features of acupuncture points, de qi, and reactions they feel with their needling and pressing hands. Ten acupuncture points were used in 50% of patients in acupuncture treatment, and ST 36 and SP 6 were the most frequently used. On the other hand, no single acupuncture point was used in more than 50% of patients in moxibustion treatment. Thirteen acupuncture points were used in 30% of patients in moxibustion treatment, and BL 23, SP 6, and ST 36 were the most frequently used.[Conclusion] Our survey clarified the usage of acupuncture points in acupuncture and moxibustion treatment in Japan.

Purpose: Naldemedine is a peripheral µ-opioid receptor antagonist, including the treatment of opioid-induced constipation (OIC) . However, diarrhea is known as its side effect. We conducted a study focusing on the administration period of opioid analgesics before the start of naldemedine to clear predictors of diarrhea due to Naldemedine. Method: All data were retrospectively collected from the electronic medical record system. We investigated patients who initially administrated naldemedine at Nagasaki University Hospital from June 1 2017 to March 31 2019. Result: One hundred thirty-two patients were subject of investigation. The incidence of diarrhea was 25.0%. The result of the multivariate analysis showed that significant predictors of diarrhea were associated with the opioid analgesics usage period longer than 7 days before naldemedine initiation (odds ratio: 3.76, 95% confidence interval: 1.53-9.20, p=0.004). Discussion: When naldemedine was used for OIC, diarrhea may be avoided by using within 7 days after opioid analgesics.

Ikki-Ryo was a moxibustion clinic established as part of a national project facility that belonged to the Uchihara Training Camp (1938-1945) for the Japanese Youth Volunteer Brigade for Reclamation of Manchuria and Mongolia. Since such a case is extremely rare in the modern medical history of Japan, this article summarizes the information on Ikki-Ryo obtained through documents collection and analysis, interviews, and fieldwork investigation. Ikki-Ryo was proposed by acupuncturists Bunshi Shirota and Kyohei Tanaka, and was established under the directorship of Kanji Kato. It played a role in the clinical practice and training of moxibustion techniques. The data suggests that Ikki-Ryo provided advantageous clinical effects in the promotion of good health and in the treatment of some diseases (e.g. enuresis, suspected tuberculosis) for the trainees, while it is indicated that this clinic had a certain geographical, organizational, and emotional distance from other medical or healthcare departments at the camp. Although the role of moxibustion has changed throughout history, the concept and activities of Ikki-Ryo are still thought-provoking from the perspective of the diversity, versatility, complementarity, and sustainability of healthcare tools.

The "Japanese Orthopaedic Association (JOA) Clinical Practice Guidelines on the Management of Low Back Pain 2019, 2nd Edition" was published in May, 2019. We found multiple issues of serious misinformation on acupuncture; these included, but are not limited to inappropriate conclusions due to errors in literature selection, data extraction and data input. Accordingly we point out each error and provide the correct information. 1. A published paper of meta-analysis of randomized controlled trials (RCTs) on Japanese acupuncture for low back pain in Japanese patients is ignored. 2. Regarding acupuncture for acute low back pain, some RCT data has been incorrectly inputted and analyzed. The wrong numbers have been mistakenly inserted into the analysis software (plus instead of minus) leading to the opposite and incorrect conclusion that acupuncture is not superior to the control group. Furthermore, in a meta-analysis on the effect of acupuncture on functional disorder, data on pain are incorrectly inputted and analyzed. 3. The Guidelines' meta-analysis on acupuncture for chronic low back pain included five RCT papers. The papers included acupuncture (1 article), auricular point acupressure (2 articles), laser acupuncture (1 article) and acupressure backrest (1 article). Only one article in the meta-analysis used needle-inserting acupuncture, therefore, this is not a meta-analysis on acupuncture. There are also many errors in data input. Moreover, there is mislabeling of the forest plot figures: Figure 7 is incorrectly labelled "pain", but actually shows data on "functional disorder" (Figure 8), and vice versa. 4. A published paper of meta-analysis on the cost-effectiveness of acupuncture is ignored. Additionally, although a paper of "meta-analysis on the health economic effects of yoga" is cited, the health economic effects of yoga are not actually addressed or mentioned in that paper. Although the Guidelines state they have fully complied with "Minds Manual for Guideline Development 2014" (Minds: Medical Information Network Distribution Service, Japan Council for Quality Health Care), they did not set up a systematic review team, and do not state whether or not they organized an external review committee. Such circumstances may have contributed to the serious errors in the Guidelines. Because we have also recognized many errors regarding other therapies addressed in the Guidelines, we fear that the present Guidelines may destroy the credibility of the entire clinical practice guidelines published in Japan. We strongly hope that a corrected and revised version is published as soon as possible.