【Introduction】Thumbtack needles for skin stimulation are used in the field of sports medicine. Their primary therapeutic mechanism is believed to be the increase in regional blood flow mediated by the axon reflex. However, it is not clear at this time whether a medical device (acupuncture device) for skin stimulation significantly increases regional blood flow at the stimulation site. Furthermore, sterile acupuncture needles in which the acupuncture needle body is inserted into the skin with multiple needles (hereafter referred to as Multi-core thumbtack needle) have not been manufactured to date, and their usefulness and potential application for blinding is unknown.【Materials and Methods】A single-blind randomized crossover trial was conducted in 16 healthy adult males. A multi-core thumbtack needle (needle length 0.55 mm, needle base diameter 0.3 mm, number of needles 37, pitch 1.0 mm, made of biosafe resin) was placed in the center of the palmar side of the forearm for 30 seconds, and then one week later they were randomly assigned in a 1:1 ratio to one group to receive stimulation in the same way with a sham needle (a flat disk made of the same material), or one group to receive stimulation in the opposite order. The primary endpoints were the change in regional blood flow (5 min post-stimulation vs. pre-stimulation) and the rate of change at the stimulation site, which were measured using a laser perfusion meter. The secondary endpoint was heart rate. A linear mixed model was used as the statistical method, with a significance level of 5%.【Results】Regarding the amount of change in regional blood flow, sham needles showed a mean of -0.09 (95% confidence interval [CI]: -0.39 to 0.21) mL/min/100g, whereas multi-core thumbtack needles showed a mean of 8.83 (95% CI: 5.86 to 11.79) mL/min/100g, indicating a significant intervention effect (P < 0.001), with no significant period effect (P = 0.474) or carryover effect (P = 0.441). There was no intervention effect on heart rate (P = 0.95).【Conclusion】A significant increase in local blood flow was observed with the use of the multi-core thumbtack needle employed in this study. As this response was not accompanied by a significant increase in heart rate, it is speculated that the effect is primarily mediated by the axonal reflex and the involvement of nitric oxide, as well as somatic-autonomic reflex mechanisms.

"Brain fog" is a symptom of long COVID. Brain fog is suspected to be a neurocognitive dysfunction; however, the underlying pathology remains to be elucidated. To provide better medical care for patients with "brain fog", we collaborated with a hospital outpatient department that specializes in the assessment and treatment of cognitive impairment. For the establishment of the collaborative system, we devised a questionnaire for "brain fog" based on medical reports, internet resources, and clinical experiments to be used as a screening tool. The questionnaire was used to calculate a "brain fog score" (BFS). A BFS of more than 5 points was established as the criterion for patient referral. The present retrospective evaluation suggests that BFS is useful for predicting prognosis and prioritizing patients within limited outpatient appointment slots.

[Introduction] The domestic market for medical devices is expected to increase steadily against the backdrop of growing medical needs due to the aging population. This will create more business opportunities for medical device manufacturers. However, clarity regarding the domestic market for the medical device category "acupuncture and moxibustion apparatus" is poor, and information is lacking for companies to use when considering implementing new business development strategies.[Materials and Methods] Data from the "Statistics of Production by Pharmaceutical Industry" for the last five years (2019-2023) were used as the information source, and medical devices categorized as "acupuncture and moxibustion apparatus" were analyzed.[Results] The average domestic market size (production value + import value - export value) for acupuncture and moxibustion devices over the past five years was 7,141,948,800 JPY (95% confidence interval: 6,095,584,238-8,112,805,362), and the average annual growth rate was -4.29%. In terms of the average annual growth rate by generic name, "home-use affixed contact grains" (12.8%) had the largest growth rate; "warm moxibustion devices" (9.3%) and "non-invasive home-use acupuncture and moxibustion devices" (5.7%) showed positive growth; while "reusable acupuncture needles" (-1.3%), sterilized needles" (-5.8%), and "non-active contact needles" (-23.8%) showed negative growth.[Conclusion] Among devices in the category "acupuncture and moxibustion devices", "home-use affixed contact grains", "warm moxibustion devices", and "non-invasive home-use acupuncture and moxibustion devices" showed positive growth over the past five years. Thus, these are the medical device categories for which new business development can be expected.

Prolonged cough in coronavirus disease 2019 (COVID-19) is not only uncomfortable for patients, but also prolongs the length of stay in an isolation facility. This results in delays in patients' return to their daily life. Therefore, the prompt treatment of cough is important. In this report, we used Japanese traditional (Kampo) medicine, chikujountanto for the treatment of cases with residual cough, airway secretions, slight fever, anxiety, and insomnia, several days after the onset of coronavirus. From October 2020 to September 2021, we prescribed chikujountanto for thirty-three COVID-19 patients with prolonged cough in an isolation facility. Seven patients (6 women and 1 man with ages ranging 37-70 years) were treated with no other medication. Comorbid symptoms included slight fever, sputum, sore throat, nasal discharge, headache, anxiety/insomnia, and taste/olfactory disorders. The start date of treatment ranged from 9 to 21 days after the onset of COVID-19, and the time until cough and comorbid symptoms improved to values less than NRS 2 or less, was 2 to 6 days after treatment. Three patients had persistent cough and needed to switch to other medication. In COVID-19, chikujountanto may be useful for coughing during the period when the peak of the viral proliferative phase has passed but airway inflammation is still present.