Objective To quantitatively analyze and evaluate the content of rehabilitation policy for people with disabilities in China. Methods This study focused on ten national policies of disability rehabilitation issued from 2021 to 2023.It employed text mining techniques to process policy texts and constructed a policy modeling consistency index model for dis-ability rehabilitation policies in China.The relevant policies were evaluated and analyzed quantitatively. Results The disability rehabilitation policies in China were relatively comprehensive in terms of policy transparency,op-erational mechanisms and policy nature.However,there was still a need for optimization in terms of policy per-spectives,target groups,incentive mechanisms,and other aspects. Conclusion The overall quality of disability rehabilitation policy texts at the national level in China is relatively good.There is a need to further enhance the predictability of policy objectives,clarify the responsibilities and division of labor among various departments,and improve policy incentive mechanisms in future policy formulation,which will further refine China's disability rehabilitation policy system and contribute to high-quality develop-ment of the disability cause.

Objective:To analyze the clinical characteristics of solitary rectal ulcer syndrome (SRUS) .Methods:Retrospective analysis was performed on the data of 26 patients with SRUS diagnosed by pathology and admitted to Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from June 2015 to November 2019. A descriptive method was used to collect the general information, clinical manifestations, endoscopy, pathological examination, treatment and prognosis of patients.Results:A total of 26 patients were enrolled, including 11 males and 15 females, with average age of (41.96±13.83) years old and median duration of 21 (0.2-480) months from onset to diagnosis. The main clinical manifestations were rectal bleeding in 15 (57.69%) cases, rectal prolapse in 9 (34.62%) , perianal pain in 6 (23.08%) , body mass loss in 6 (23.08%) and rectal mucus in 5 (19.23%) . Seventeen patients underwent endoscopic examination, endoscopic features included ulcer in 6 (35.29%) cases, rectal polyp in 5 (29.41%) , protuberance in 4 (23.53%) , hyperplasia and swelling in 4 (23.53%) , erosion in 3 (17.65%) , either alone or in combination. Histological examination of rectal biopsies revealed that the characteristic features were mucosal surface erosion and ulcer in 11 (42.31%) cases, lamina propria fibrosis in 8 (30.77%) , mucosal gland deletion or decreased secretion in 6 (23.08%) , inflammatory cell infiltration in 5 (19.23%) , vascular changes in 5 (19.23%) , and crypts alteration in 4 (15.38%) . Five patients (19.23%) received medical treatment and 21 patients (80.77%) received surgery. Symptoms except rectal prolapse disappeared or were improved in all the patients after treatment.Conclusion:The clinical and endoscopic features of SRUS are variable. Pathology is crucial for diagnosis and differential diagnosis. Both the medical and surgical treatment are effective for SRUS.

Objective:To analyze the clinical characteristics of solitary rectal ulcer syndrome (SRUS) .Methods:Retrospective analysis was performed on the data of 26 patients with SRUS diagnosed by pathology and admitted to Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from June 2015 to November 2019. A descriptive method was used to collect the general information, clinical manifestations, endoscopy, pathological examination, treatment and prognosis of patients.Results:A total of 26 patients were enrolled, including 11 males and 15 females, with average age of (41.96±13.83) years old and median duration of 21 (0.2-480) months from onset to diagnosis. The main clinical manifestations were rectal bleeding in 15 (57.69%) cases, rectal prolapse in 9 (34.62%) , perianal pain in 6 (23.08%) , body mass loss in 6 (23.08%) and rectal mucus in 5 (19.23%) . Seventeen patients underwent endoscopic examination, endoscopic features included ulcer in 6 (35.29%) cases, rectal polyp in 5 (29.41%) , protuberance in 4 (23.53%) , hyperplasia and swelling in 4 (23.53%) , erosion in 3 (17.65%) , either alone or in combination. Histological examination of rectal biopsies revealed that the characteristic features were mucosal surface erosion and ulcer in 11 (42.31%) cases, lamina propria fibrosis in 8 (30.77%) , mucosal gland deletion or decreased secretion in 6 (23.08%) , inflammatory cell infiltration in 5 (19.23%) , vascular changes in 5 (19.23%) , and crypts alteration in 4 (15.38%) . Five patients (19.23%) received medical treatment and 21 patients (80.77%) received surgery. Symptoms except rectal prolapse disappeared or were improved in all the patients after treatment.Conclusion:The clinical and endoscopic features of SRUS are variable. Pathology is crucial for diagnosis and differential diagnosis. Both the medical and surgical treatment are effective for SRUS.

Background:Gastrointestinal carcinoids are prone to be neglected in clinical practice because of the poor specific symptoms in early stage. Aims:To analyze the clinicopathological characteristics,treatment modalities and prognosis of a series of cases of gastrointestinal carcinoids for strengthening the understanding of the disease. Methods:A total of 116 patients diagnosed as gastrointestinal carcinoids by pathology from Jan. 1997 to Jan. 2010 in 8 hospitals at Wuhan were enrolled in this retrospective study. Data on sex,age,major symptoms,diagnostic approaches,treatment modalities, pathological features and prognosis, etc. were collected and analyzed. Results:The most common sites of the gastrointestinal carcinoids were rectum(59. 5%)and stomach(19. 8%);the most common symptoms were abdominal pain,abdominal distention and hematochezia. The positivity rates of immunohistochemical marker NSE,Syn and CgA were 92. 7%,87. 5% and 62. 5%,respectively. The proportion of stomach carcinoids with diameter larger than 2 cm was 73. 9%, and that of rectal carcinoids was only 13. 0%(P <0. 001). Most of the gastric carcinoids(81. 8%)infiltrated into or breakthrough the serosa;the rate of lymph node involvement in gastric carcinoids was significantly higher than that in rectal carcinoids(72. 7% vs. 17. 1%,P<0. 001),while typical carcinoids were less common in stomach than in rectum(60. 9%vs. 95. 7%,P<0. 001). Only one(4. 3%)gastric carcinoid patient underwent endoscopic therapy,while that for rectal carcinoids was 24 cases(34. 8%,P=0. 003). Surgical operation was the main therapeutic method for both gastric and rectal carcinoids. The 3-and 5-year survival rates for rectal carcinoids were 92. 8% and 62. 3%,respectively,and those for gastric carcinoids were 62. 6% and 49. 2%,respectively;there were no significant differences between the two groups(P>0. 05). Conclusions:Gastrointestinal carcinoids enrolled in this study distributed mainly in rectum and stomach. As compared with rectal carcinoids,gastric carcinoids were more advanced in disease stage with poorer prognosis. Regular health checks, strengthening the understanding of the disease,and grasping the specificities of carcinoids distributed at different sites might be helpful for the early diagnosis and treatment of gastrointestinal carcinoids,thus improving the survival rate.

Objective To explore the correlation between the psychological resilience levelwith the emotional regulation modeand personality characteristicin the patientwith gastricarcinomto provide the theoretical reference fothe intervention measure.MethodOne hundred and forty-seven patientwith gastricancewere selected athe research subject(gastricancegroup) and contemporaneou150 individualwith healthy physical examination in the outpatiendepartmenwere selected athe control group .The Connoand Davidson Resilience Scale(CD-RISC) ,Eysenck Personality Questionnaire(EPQ) and Emotion Regu-lation Scale were adopted to perform the investigation .The correlation between the psychological resilience levelwith the emotional regulation modeand personality characteristicwaanalyzed .ResultThe overall CD-RISscore in the gastricancegroup wa(59 .12 ± 9 .19) point,which belonged to the poorescope ;the personality characteristic,emotional regulation modeand psycho-logical resilience had statistical differencebetween the gastricancegroup and the control group (P＜0 .05);the multivariate Lo-gistiregression analysiresultshowed thathe introversion ,extroversion ,neuroticism ,catharsiregulation and depression regula-tion had largeinfluence on the lowepsychological resilience level in the patientwith gastricance(P＜0 .05);the psychological resilience in the patientwith gastricancewapositively correlated with the catharsiregulation and the depression regulation (r=0 .287 ,0 .136 ,P＜0 .05) and negatively correlated with the introversion ,extroversion and neuroticism (r= -0 .232 ,-0 .789 , P＜0 .05) .Conclusion The introversion ,extroversion ,neuroticism ,catharsiregulation and depression regulation are the importanfactorinfluencing the psychological resilience level .The multi-angle interventional measureshould be taken to improve the psy-chological resilience level in the patientwith gastricance.

Objective To analyze and explore the clinical features,pathological characters,treatment and prognosis of rectum carcinoid.Methods From January 1997 to January 2010,69 pathologically diagnosed rectum carcinoid cases were collected from Union Hospital of Tongji Medical College,Huazhong University of Science and Technology and other 7 hospitals.The clinical features,pathological characters,treatment and prognosis were analyzed. Results Of 69 rectum carconid cases,there were 36 males and 33 females.The average age was (49.3±12.9) years.The common symptom were hemotochezia,abdominal pain,constipation,diarrhoea and abdominal distension.There were 55 cases with lesions from the anus less than 8 cm and in other patients,lesions from the anus were all more than 8 cm.66 cases were typical carcinoid,3 cases were atypical carcinoid.40 cases underwent the immunohistochemical staining.The common markers for immunohistochemical staining were Syn,CgA and NSE,the positive percentage were 90％ (36/40),75％ (30/40) and 82.5％(33/40) respectively.A total of 24 patients received endoscopic therapy,44 patients had surgery,1 patient who refused surgery received only life support and symptomatic treatment.Conclusion No specific clinical symptoms of rectum carcinoid,and most were typical carcinoid.Lesions confined to mucosa and submucosa could be considered the endoscopic therapy.

An 18-year-old female presented with painful erythema and nodules on both legs for more than 2 years.Dermatological examination showed irregularly sized,mildly indurated,tender,deep subcutaneous nodules arising in diffused infiltrated dark erythematous patches in the inner and posterior region of the left leg.Histopathology showed no significant changes in the epidermis.There were perivascular lymphoid cell infiltrates in the dermis and subcutis.Multiple sites of necrosis of blood vessel walls with vascular occlusions were noted.The lumens of some blood vessels were filled with lymphocytes,among which were many atypical cells with hyperchromatic nuclei and pathologic mitotic figures.Immunohistochemistry showed that lymphocytes in the cavities of blood vessels were positive for CD3(+++),CD3ε(+++),CD2(+),CD56(+++),granzyme B(+++),perforin(+++),CD30(+),Ki67 (+++,100％ ),but negative for CD20,CD5,CD7,CD4,CD8,TdT,anaplastic lymphoma kinase,early membrane antigen (EMA) or pan cytokeratin (pCK).The endothelial cells lining the blood vessels stained positively for CD34.The intravascular lymphocytes were also positive for EBER1/2 by in situ hybridization.A diagnosis of cutaneous intravascular NK/T cell lymphoma was made.

The effect of Smac gene on the TRAIL-induced apoptosis of the prostate cancer cell line PC-3 and the molecular mechanism were investigated. The Smac gene was transfected into PC-3 cells under the induction of liposome. The intrinsic Smac gene expression was detected by Western blotting. After treatment with TRAIL as an apoptosis inducer, in vitro cell growth activity was assayed by MTT colorimetry. The apoptosis rate of PC-3 cells was determined by annexin V-FITC and propidium iodide staining flow cytometry. The expression of cellular XIAP and caspase-3 genes was examined by Western blotting. Smac-transfected cells (PC-3/Smac group) had significantly increased Smac protein level as compared with PC-3 controls (P<0.01). After induction with 100-200 ng/mL TRAIL for 12-36 h, cellular proliferation rate in PC-3/Smac group was significantly lower than in PC-3 controls (P<0.05). After induction with 100 ng/mL TRAIL for 24 h, the apoptosis rate in PC-3/Smac group was significantly enhanced as compared with that of PC-3 controls (P<0.05). Accordingly, the XIAP expression level was down-regulated significantly (P<0.05) and caspase-3 subunit P20 was up-regulated significantly (P<0.05). It is suggested that the over-expression of cellular Smac can inhibit inhibitor of apoptosis proteins (IAPs), enhance caspases activity and the apoptosis rate of PC-3 cells induced by TRAIL, which may provide a useful experimental basis for prostate cancer therapy.

The effect of Smac gene on the TRAIL-induced apoptosis of the prostate cancer cell line PC-3 and the molecular mechanism were investigated.The Smac gene was transfected into PC-3 cells under the induction of liposome.The intrinsic Smac gene expression was detected by Western blotting.After treatment with TRAIL as an apoptosis inducer,in vitro cell growth activity was assayed by MTT colorimetry.The apoptosis rate of PC-3 cells was determined by annexin V -FITC and propidium iodide staining flow cytometry.The expression of cellular XIAP and caspase-3 genes was examined by Western blotting.Smac-transfected cells (PC-3/Smac group) had significantly increased Smac protein level as compared with PC-3 controls (P＜0.01).After induction with 100-200 ng/mL TRAIL for 12-36 h,cellular proliferation rate in PC-3/Smac group was significantly lower than in PC-3 controls (P＜0.05).After induction with 100 ng/mL TRAIL for 24 h,the apoptosis rate in PC-3/Smac group was significantly enhanced as compared with that of PC-3 controls (P＜0.05).Accordingly,the XIAP expression level was down-regulated significantly (P＜0.05) and caspase-3 subunit P20 was up-regulated significantly (P＜0.05).It is suggested that the over-expression of cellular Smac can inhibit inhibitor of apoptosis proteins (IAPs),enhance caspases activity and the apoptosis rate of PC-3 cells induced by TRAIL,which may provide a useful experimental basis for prostate cancer therapy.

A 20-year-old male patient presented with myalgia of upper limbs and myasthenia of extremities for more than 1 month. Physical examination showed diffuse erythema on the cheeks, upper eyelids, upper chest, neck and dorsa of the hands. The myodynamia of the proximal and distal muscles of upper and lower extremities was grade Ⅳ, Ⅴ, Ⅲ and Ⅴ respectively. Laboratory examinations revealed that the serum levels of creatine kinase, CK-MB and lactate dehydrogenase were 2103 U/L, 83 U/L and 489 U/L respectively, which were all above the normal range. Electromyogram revealed myopathic abnormality and normal nerve conduction velocity. Histopathology of gastrocnemius muscle showed hypertrophy and swelling of muscle fibers, disappearance or fuzziness of transverse striation, and intermuscular lymphoid cell infiltration. A biopsy of the skin lesion from the upper chest showed liquefaction degeneration of and colloid bodies in basal cell layer, perivascular lymphoid cell infiltration in the dermis. A diagnosis of dermatomyositis was established based on the clinical and laboratory findings. After management with intravenous prednisolone 80 mg once daily and symptomatic treatment for 4 weeks, the myodynamia of upper limbs was improved, serum levels of creatine kinase,CK-MB and lactate dehydrogenase reached the normal ranges. However, the myodynamia of lower limbs progressively deteriorated with the emergence of paresthesia. Enhanced MRI scan showed a tumor in the vertebral canal at the level of thoracic vertebra 11 to 12. A spherical encapsulated tumor measuring 3 cm in diameter was surgically removed. The tumor was diagnosed as paraganglioma in vertebral canal according to pathological and immunohistochemical findings. The patient was finally diagnosed with paraganglioma in vertebral canal superimposed on dermatomyositis.