Our institute was established in 1979 with the mission given by the Ehime prefectural government and Medical Association to supply traditional medical care under the leadership of MDs. We developed The concept of chronological analysis for researching individual health needs and also instituted associated systems such as chronological analysis care system and chronological audit system. Through these systems, our staff of therapists developed a common integrated cognitive perspective and we established the identity of our traditional medical care as a system in which supervising physicians offer leadership of a team care system of traditional medicine. In this way we have fulfilled the heavy mission given to us by the government and medical association.
We were also given a heavy mission to research about the individuation of each traditional medical technique, by seniors such as Takeshi Itakura. For this purpose we adopted the chronological analysis care system as the field scientific method of case study. These systems have been useful to improve the care level of the staff and also useful for training program for post graduate medical and traditional medical students.

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· Since 1975 the Morishita Worldwide Longevity Regions Research Delegation has conducted in the regions of Caucusus, Hunza and Vilcabamba several times per annum.
· In 1984, we designated Xinjiang Uygur as the world's fourth longevity region.
· In 1987, we named the regions of Caucusus, Middle Asia, on the periphery of Pamir plateau (including Hunza) and the area extends for 8, 000km from east to west in latitude about 40° N “The Silk Road Lon-gevity Region”. And we presented of the results of our research at the 16th Natural Medicine International Symposium.
· In 1991, we have conducted on the spot research of Pama of Guangxi district. In the process, we designated this area as the world's fifth longevity region.
We proved that most longevitists of more than 100 years live along the Silk Road and have a lot in com-mon. That is, they eat unpolished grains as a staple diet and do not live far from the place of their birth. And they also eat crops they cultivate themselves. Life energy, the healthy condition of the earth revealing morpho-logically interdependent life pattern found in their living, has cycled in the uncivilized longevities.

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There have been not enough information about the biological effects of moxibustion. The symposiums have been opened on the meetings of Japan Society of Acupuncture and Moxibustion. Many significant results of moxibustion have been discussed on these symposiums. The symposium, “Present Research on Moxibustion”, was opened on the 52nd meeting of Japan Society of acupuncture and Moxibustion in 2003. The contents on this symposium were following.
The outline of fundamental research on moxibustion was presented by Dr. Aizawa. From his report, the various researchers have tried to elucidate the mechanism of moxibustion. These have been many presentations of moxibustion at the meeting of The Japan Society of Acupuncture and Moxibustion.
The histological investigation on treated area was presented by Dr. Menjo. From her report, the increase of cutaneous change was observed from the treated area after moxibustion. This result was significant on the decision of moxibustion-stimulation.
The immunological investigation on the effects of moxibustion was presented by Dr. Tohya. From his report, cytokines as IL-12 and IFN-γ was expressed by moxibustion. These results demonstrated that such effects are dependent on the chemical substances in moxa.
The effect of Onkyu was presented by Dr. Nakanishi. From his report, the transportation by Onkyu-stimulation is different from that by acupuncture-stimulation. His results demonstrated that chemical mediator by Onkyu-stimulation acts to the nervous system.
These presented results supposed the significant information and to contribute the development of moxibustion-medicine.

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Acupuncturists should have clinical competency, including knowledge, skill and humanity, such as attitude.
In acupuncture and moxibustion educational institutions, educational objectives and strategies have been established to develop competency as a therapist. Therefore, an evaluation was performed in order to confirm the achievement of the learners, and whether the established initial objectives and strategies were appropriate or not.
As a matter of course, the National Examination for Acupuncture and Moxibustion Therapists is an evaluation standard which assesses the social competency oftherapists completing the educational course, namely they must have significance.
However, the current National Examination can only estimate the aspect of knowledge. Each educational in-stitution should, therefore, responsibly evaluate other acupuncturists' competency including skills and attitudes toward their competency insociety.
In the Objective Structured Clinical Examination (OSCE), an adequate method to evaluate clinicians has widely been introduced for medical education.
The OSCE was introduced to educational circles of acupuncture in Japan because OSCE can evaluate competency; i.e. the psychomotor and affective domain, that is difficult to measure using a paper test.
Various difficulties still remain using OSCE for the education of acupuncture students in the view of both its adequacy and objectivity.
In the present paper, the actual condition and difficulty in using OSCE in education of acupuncture students are reviewed based on the reports presented atthe educational session of the conference.

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We evaluated the efficacy, usefulness and safety of acupuncture and moxibustion treatment in rheumatoid arthritis (RA), by the randomized, parallel-group, multi-center study with the drug-treated outpatient group as the control. The endpoints, important in the clinical assessment of acupuncture treatment, included the improvement criteria in ACR core set variables and the Japanese version of the Arthritis Impact Measurement Scales Version 2 (AIMS-2), a system of evaluation of the quality of life (QOL) of patients with RA.
Regarding intervention (therapy), a therapy chart for each stage of disease was drawn up to give local and systemic treatment in consideration of the patient's activity and disability in each stage of RA, so that generally consistent therapy adapted to the patient's condition would be provided. Result 1. Patients eligible for analysis were 80 patients of A-group (drug therapy group) (80 females, 2 males) and 90 patients of B-group (drug plus acupuncture and moxibustion group), total 170 patients. 2. Patients who satisfied the improvement criteria in ACR core set variables (improved patients) were 8 of 80 patients in A-group and 20 of 90 patients in B-group. The improvement rate was significantly higher for B-group treated by drug plus acupuncture and moxibustion versus A-group, with P=0.04 in 2 (2 table chi square test. 3. In QOL change investigated by AIMS-2 questionnaire, the improvement occurred significantly more frequently in the drug plus acupuncture and moxibustion group, with difference between groups at 12 months after the initiation of clinical study at P=0.001. 4. Changes in the subjects included in AIMS-2 questionnaire : Improvement was significantly more frequent in the drug plus acupuncture and moxibustion group versus drug therapy group in respect to the ability to walk, finger function, housework, sociableness, pain, mood, and the degree of subjective improvement. In the present randomized, parallel-group, multicenter study, a significant improvement was detected in the drug plus acupuncture and moxibustion group versus the drug therapy group in the aforesaid respect, which suggested that the use of acupuncture and moxibustion combined with the conventional therapy would prevent deterioration of physical functions, improve blood circulation, stabilize mental status, and thereby contribute to the improvement of QOL in patients with rheumatoid arthritis.

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The results of multi-center RCT of acupuncture and moxibustion for the prevention of the symptoms of common cold conducted by the financial support of the foundation for training and licensure examination in anma-massage-acupressure, acupuncture and moxibustion were briefly reviewed. Traditional acupuncture manipulation to the throat induced significant positive effects, however, more common indirect moxibustion to the neck for longer period did not induce the significant effect compared with no-treatment control. Several issues to be resolved were discussed and the shortage of duration of intervention was pointed out as one of the major issues. Then four pilot studies with long-lasting intervention of acupuncture or moxibustion were con-ducted. The effects tended to be more positive, however, they were still unclear. The selection of subjects (students in the acupuncture school) will be the next important issue to be examined.

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[Purpose] This study investigated the safety of acupuncture and moxibustion in Japan. A questionnaire about infection control was developed based on the “Guidelines on basic training and safety in acupuncture” published by the World Health Organization (WHO) in 1999.
[Method] The questionnaire was sent to the members of the Japan Society of Acupuncture and Moxibustion (JSAM) and the Japan Acupuncture and Moxibustion Association (JAMA) in August 2000 and in September 2001, respectively. The items on the questionnaire were “a clean working environment”, “clean hands of the practitioner”, “preparation of the needling sites”, “sterile needles and equipment, and appropriate storage”, “aseptic technique” and “careful management and disposal of used needles and swabs”.
[Result&Conclusion] The questionnaire response rate was 49.6% (443/894). The results suggest that approaches to infection control are better than those in our previous report in 1996. However, the rate of using disposable needles was still low and most acupucturists held the needle with bare hands during inserting. It is necessary to improve pre-and postgraduate education regarding safety in performing acupuncture and moxibustion, including the infection control.

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Case Report : Acupuncture therapy for a fibromyalgia-like syndrome (FMS-like) patient. A 44-year-old woman complained of widespread pain, fatigue and poor quality sleep. Effects of acupuncture treatment were evaluated using a visual analogue scale (VAS), pain disability assessment scale (PDAS) and pressure pain thresholds (PPT) at tender sites of FMS. After 13 whole body acupuncture treatments PPT, VAS and PDAS were almost unchanged. However, three FMS-specific acupuncture treatments (eletroacupuncture at characteristic tender sites of FMS) increased PPT and improved VAS and PDAS. These results suggest that FMS-specific acu-puncture treatment may relieve widespread pain and fatigue symptoms in FMS-like patients.

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