【Objective】Acupuncture and moxibustion are ancient analgesic modalities. The two modalities are often grouped together as acupunctural/moxibustion medicine. However, acupuncture is a cathartic method, whereas moxibustion is a complementary method. Thus, the indications of the two modalities differ. Acupuncture is a relatively commonly performed modality, while the use of moxibustion is rarer. The reason for this is the risk of burns due to moxibustion's use of fire. In the present study, we developed a novel type of moxibustion (“Hot Q™”), which only increases the temperature to 50°C, thereby bearing no risk of burns. Additionally, the effects of such treatment were assessed.

【Methods】The subjects (patients) were individuals who primarily complained of pain and had visited the clinics or acupuncture and moxibustion offices with which the members of the Study Group of Acupunctural Medicine were affiliated (n=14). Moxibustion was performed three times a week over a one-month period (12 times in total). The subjects'blood-stasis (Oketsu) score (Terasawa), hematologic functioning, hemodynamics, and pain visual analogue scale (VAS) score were examined before and after the treatments.

【Results】A comparison of the aforementioned parameters before and after the treatment revealed that the subjects' pain VAS score and blood-stasis score improved. Additionally, their diastolic blood pressure in the lying position significantly decreased. There were no aggravated items that appeared in the hematologic examination and no patients experienced burns.

【Conclusions】Since no patients experienced burns and the hematologic findings were normal, the procedure was deemed safe. A decreased pain VAS score, improved blood-stasis score, and improved diastolic blood pressure were observed. The examined type of moxibustion appeared to have analgesic effects, relaxation effects, and influenced the subjects'blood stasis. Thus, it may be an effective analgesic modality. Since moxibustion can be performed at home and without assistance, it might serve as a modality for the autonomous control of pain.

Inflammation and pain occur as autoimmune responses to stress acting on the body. The stress-induced autoimmune response, which manifests as microinflammation at its early stage, is a risk factor for aging-related diseases, such as arteriosclerosis. The interaction between oxidative stress and glycative stress affects the human body's immune response. Glycative stress follows two pathways that entail the nonphysiological and post-translational modification of proteins. The first pathway includes an intermediate glycative reaction that involves the reduction of aldehydes, sugars, lipids, and alcohols by carbonylated proteins; the product, i.e., glycation advanced end products (AGEs), binds to RAGE(receptors for AGEs)on macrophages, thus enhancing inflammatory cytokine production. The second pathway alters the mitochondrial TCA cycle and causes the excessive production of fumarate and generation of S-(2-succinyl)cysteine(2SC) by succination of cysteine residues. It is clear that these altered cycles are malignant and worsen inflammation and pain, which further increases glycative stress. Now is the time to find ways to minimize glycative stress. In the future, it is important to learn more about glycative stress and establish and implement appropriate countermeasures.

In the past, the diagnosis of diabetes was made by a doctorʼs sensuality. Glucose tolerance tests have been developed to distinguish between diabetes, borderline diabetes, and normoglycemia. In recent years, Flash Glucose Monitoring(FGM)has been introduced. It has been developed and it has become easy to understand the daily profile of patient-specific blood glucose levels. Therefore, hypoglycemia/blood glucose spikes have become a problem. These are the backgrounds of fibromyalgia and chronic fatigue syndrome. It has become clear that glucose metabolism abnormalities are latent. Hypoglycemia refers to less than 80 mg/dl, and blood glucose spikes indicate the difference between the postprandial maximum blood glucose level and the minimum blood glucose level of 60 mg/dl or more. In the FGM era, the hypoglycemia is classified as follows. 1. Diabetic hypoglycemia-urgent hypoglycemic attack 2. Non-diabetic hypoglycemia(spontaneous hypoglycemia) (1) Functional hypoglycemia-non-reactive hypoglycemia, reactive hypoglycemia(blood glucose spike),neonatal hypoglycemia (2) Organic hypoglycemia-insulinoma, after gastric resection like damping syndrome, insulin autoimmune syndrome (3) Drug-induced hypoglycemia (4) Pseudohypoglycemia/false hypoglycemia

Pseudoptyalism encountered in daily practice is an obsessive pathologic condition whereby patients cannot normally swallow saliva unconsciously despite the absence of actual excessive saliva production or swallowing dysfunction, and are constantly aware of swallowing with a feeling of excessive saliva production. For this disease, there is no established consensus on the treatment method. In this study, we introduce the present status of treatment for pseudoptyalism in our department, report patients who achieved complete remission after treatment such as Outpatient Morita Therapy and logotherapy, and discuss this disease in comparison with drooling and aerophagia.

Myalgic Encephalopathy/Chronic Fatigue Syndrome (ME/CFS) is a disease that has kinds of various symptoms including chronic and severe fatigue, widespread pain and sleep impediment. We report a case of Myalgic Encephalopathy/Chronic Fatigue Syndrome (ME/CFS) associated with Neurodevelopmental Disorders with comorbid Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD).

【case】 14-year-old boy with Neurodevelopmental Disorders had various physical symptoms following the cold, and he was diagnosed as ME/CFS. Nocturnal hypoglycemia and glucose spikes were observed. We applied tonifying method and dietary guidance. We supported playing marimba as his existential resource.【Clinical course】 5 months after onset, his symptoms improved after adjusting the learning environment, and he was able to get out the onset of ME/CFS. Hypoglycemia and glucose spikes were reduced.【Discussion】 For a case of ME/CFS associated with Neurodevelopmental Disorders, the most effective treatment was to adjust the learning environment to reduce social stress, and to gain the understanding from the surroundings. It was thought that dietary guidance to improve hypoglycemia and glucose spikes, which may be involved in impulsivity, could be established on this basis.

Humans exhibit a variety of stress resistance that helps them to maintain a healthy state. The term “Frailty” refers to the weakened state of the reserve capacity for stress from physical, psychological, and social aspects, due to aging and the like. This condition is reversible, indicating that one return to normal health through appropriate nutrition and exercise interventions.

In terms of physical frail, sarcopenia is said to be highly related to aging and malnutrition. This is due to a decrease in the amount of activity, being infected/diagnosed with various diseases, etc. In my clinical practice, diabetic patients often have both medical problems and locomotive syndrome. The lack of exercise and indefinite complaints of “pain” are common among diabetic patients. Thus, “immobile body and immobile heart” needs to be converted to “moving body and moving heart”. Exercise therapy can help such patients to break away from diabetes and Frailty. The proposed exercise therapy is based on the understanding that skeletal muscle is an endocrine organ. Introduce the specific practices, including the initiatives.

According to Michael Balint, the purpose of whole-person medicine is to enable patients to understand themselves, discover enhanced solutions to problems they encounter, and integrate disabilities with their environment. He employed unique verbal expressions to explain the characteristics of doctors and the doctor-patient relationship. On the contrary, Aaron Antonovsky used the theory of salutogenesis to explain that sense of coherence (SOC) is important to ensure relative health at any stage of life. SOC comprises three elements: comprehensibility, manageability, and meaningfulness. It is believed that the enhancement of patient power may result in them creating their own relative health regardless of the medical society. Accordingly, it is imperative that patients first understand their surrounding medical society, especially doctors' characteristics and those of the doctor-patient relationship. We are of the view that employing Michael Balint's unique verbal expressions will help create relative health, i.e., improve SOC.