Premature ejaculation (PE) is a common male sexual dysfunction that can have significant effects on a couple's relationship. Behavioral therapy and psychotherapy are both safe and effective methods of treating PE. Ancient Chinese fangzhongshu (sexual skills and methods), which reflects a summary of expert experiences in sexology, contains many therapies for sexual dysfunction that are similar to those used in behavioral therapy or psychotherapy. A brief introduction dealing with the latest definitions of PE and treatment strategies drawn from behavioral therapy and psychotherapy is provided. Typical therapies for PE from ancient Chinese fangzhongshu are listed and briefly analyzed in order to define their domain of applicability and instructions for use. Ancient Chinese fangzhongshu contains many effective and safe therapies for PE. It should be incorporated into modern medical practice after critical analysis, and its scientific aspects should be promoted as a way of improving reproductive health, both to benefit individuals affected by PE and to promote traditional Chinese culture. Based on an analysis of the condition of the individual patient, one or multiple therapies guided by fangzhongshu can be expected to have an effect on the patient. Ancient Chinese fangzhongshu is of great value and should to be popularized and applied as a remedy for PE.
Asian Continental Ancestry Group* ; Cognitive Therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Premature Ejaculation* ; Psychotherapy ; Reproductive Health ; Sexology

Background: Crawling-type gastric adenocarcinoma is a rare subtype of gastric cancer, however, the understanding on this special entity of gastric cancer is still lacking. Aims: To investigate the clinical, endoscopic and pathological characteristics of crawling-type early gastric adenocarcinoma. Methods: Patients diagnosed as crawling-type early gastric adenocarcinoma in Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2016 to December 2021 were recruited consecutively in a retrospective study. The clinical data were reviewed, the pathological specimens were collected for immunohistochemical staining, and a telephone follow-up was conducted for prognosis analysis. Results: Fourteen patients with crawling-type early gastric adenocarcinoma and fulfilling the inclusion criteria were enrolled in the study, of them, 9 were male, 5 were female, and the mean age was 65.9 years old. No family history of gastric cancer was reported. The clinical manifestations were not specific. All patients were positive for Helicobacter pylori (Hp) infection. Tumors were more likely to occur in the middle and lower thirds of the stomach, with marked atrophic background mucosa. Macroscopically, 11 lesions were superficial-depressed (0-IIc) and 3 were superficial-flat type (0-IIb+ IIc). The color of the lesions was red. Lesions with indistinct border were observed endoscopically in 10 cases. Complete resection was achieved in all 14 patients after endoscopic submucosal dissection n=10 or surgical treatment n=4. Three submucosal and 11 intramucosal infiltration were observed pathologically. Immunohistochemical results of gastric (MUC5AC and MUC6) and intestinal (MUC2, CD10 and CDX-2) markers showed that most of the patients were mixed immunophenotype; the Ki-67 index ranged mostly between 30% and 70%. In a mean follow-up time of 38 months, all 14 patients were survived. Two patients with heterochronous early gastric cancer were found by follow-up endoscopy. Conclusions: When a superficial-depressed or superficial-flat type tumor with reddish color change and atrophic background mucosa is observed endoscopically in an Hp-positive patient, the possibility of crawling-type early gastric adenocarcinoma should be considered. Adequate preoperative evaluation should be carried out to judge the extent and depth of tumor invasion, which may guide the decision of treatment strategy. Postoperative endoscopic surveillance is recommended.

ObjectiveTo investigate the difference of ultrasound characteristics between pure mucinous carcinoma （PMC） and fibroadenoma （FA） of the breast. MethodsUltrasound data of 50 continuous patients with breast PMC from January 2012 to January 2021 and 100 continuous patients with breast FA from June 2018 to January 2019 in Sun Yat-sen Memorial Hospital of Sun Yat-sen University were retrospectively reviewed. The ultrasound characteristics of the two groups were evaluated according to the 2013 BI-RADS Ultrasound Atlas， and the differences in age， maximum diameter and ultrasound characteristics between the two groups were compared. ResultsThe median age of PMC patients was 47 years and that of FA patients was 33 years. The age of PMC patients was higher than that of the FA group， and the difference between the two groups of patients was statistically significant （P<0.001）. The median maximum diameter of PMC patients was 2.4 cm， which was greater than that of the FA group （1.8 cm）， and the difference was statistically significant （P=0.001）. Of the PMC， 70% （35/50） were irregular， 82% （41/50） were parallel to the skin， 92% （46/50） had no circumscribed margin， 72% （36/50） were hypoechoic， and 68% （34/50） had enhanced posterior echo. Of the FA， 69% （69/100） were oval or round， 98% （98/100） were parallel to the skin， 54% （54/100） had circumscribed margin， 98% （98/100） were hypoechoic， and 75% （75/100） had no posterior features. The differences in the above ultrasound characteristics between the PMC and FA groups were statistically significant （P<0.001， P=0.001， P<0.001， P<0.001， P<0.001）. There was no significant difference between calcifications and blood flow. ConclusionsCompared with the FA group， patients with PMC are older and the diameter of the lesions are larger. On ultrasound， the morphology and margin of most breast PMC still show the growth characteristics of invasive cancer. Meanwhile， the posterior echo of PMC is enhanced， which is a unique manifestation.