Angiectatic nasal polyps with pleomorphism ‒ a diagnostic pitfall

Abstract Objective To generalise the features of PANP in case of potential clinical and pathological pitfall of diagnosis. Methods Thirteen patients diagnosed as PANP were retrospectively analyzed in the Pathology Department of Capital Medical University from August 2014 to December 2019. Immunohistochemical staining with CD34, CK, Vim, Calponin, Ki67, Bcl-2, and STAT-6 was performed with envision-two steps method. Results PANP is a benign tumor presenting with gross variegated tan to gray soft fleshy tissue with foci of obvious hemorrhage and necrosis. The imaging shows internal heterogeneous hyperintensity with a peripheral hypointense rim while postcontrast images display a strong nodular and patchy enhancement. Vimentin (Vim) stain was consistently positive, while negative for CD34, STAT-6 and Bcl-2 (focal positive in two cases). Calponin and CK stain was positive in nine cases, respectively. Conclusion PANP is a clinically rare tumor which may simulate malignancy lesion. Recognizing of characteristic features in these thirteen patients would be beneficial to avoid misdiagnosis and unnecessary aggressive treatment. Level of evidence: This work was Level 2 of evidence according to the Guide for Authors.

Characteristics of sleep among Chinese preschool children born preterm / 中国学校卫生

Objective@#To examine sleep characteristics of preschool children who were born preterm, which could provide a reference for the future intervention in the risk population.@*Methods@#This retrospective cohort study was conducted from March 2017 to November 2018 in hospitals in cities of Guangzhou, Zhongshan, and Shenzhen, Guangdong Province, China, we recruited 202 preschool children aged 4-6 years, including 40 early-and moderate preterm (gestational age <34 weeks), 56 late preterm (34-36 weeks) , and 106 full-term preschool children (≥37 weeks). Caregivers reported children’s sleep time and habits using Chinese version of Children’s Sleep Habits Questionnaire (CSHQ).@*Results@#Compared to the full-term group, the very-or-moderate-preterm group had shorter nighttime sleep duration (9.07±0.75 vs 9.33±0.59 h; adjusted β=-0.33), shorter total sleep duration (10.39±0.86 vs 11.05±1.32 h; adjusted β=-0.70), higher sleep duration score of CSHQ (4.60 ± 1.57 vs 3.97 ± 1.25 points; adjusted β=0.58), and higher sleepdisordered breathing score of CHSQ (3.78±1.27 vs 3.41±0.71 points; adjusted β=0.49). The late preterm group had lower parasomnias score of CSHQ (8.40±1.65 vs 8.75±1.72 points; adjusted β=-0.57), than the full-term group(P<0.05). When gestational age was analyzed as a continuous variable, it was positively associated with the total sleep duration (adjusted β= 0.06), while was inversely associated with sleep-disordered breathing scores of CSHQ (adjusted β=-0.06).@*Conclusion@#Very-or-moderate preterm children have shorter sleep duration and more sleep disordered breathing problems than full-term children, and have more disorders of sleeping duration and sleeping breathing than full-term children, while the late preterm children have less sleeping disorders than full-term children. The children of lower gestational age can have shorter sleep duration and more sleep-disordered breathing which should be addressed in future intervention.

Emotional and behavioral problems among children with developmental dyslexia and attention deficit hyperactivity disorder / 中国学校卫生

Objective@#To compare the differences and similarities in emotional and behavioral problems among children with developmental dyslexia (DD), attention deficit hyperactivity disorder (ADHD) or both, aiming to provide basis for targeted intervention.@*Methods@#Strengths and Difficulties Questionnaire (SDQ) was used to investigate emotional and behavioral problems among four groups of children (DD=32, ADHD=32, DD+ADHD=14, TD=32). Hierarchical regression analysis was recruited to investigate the associations of emotional and behavioral problems with spelling impairment or ADHD symptoms.@*Results@#Except for peer problems, emotional and behavioral problems varied in the four groups [prosocial DD: (641±2.75), ADHD: (5.53±2.49), combined: (7.07±2.37), control: (7.72±2.19), F=4.42, P<0.05; emotional problems DD: (1.81±1.94), ADHD: (3.66±1.66), combined: (3.21±2.33), control: (2.03±1.99), F=6.36， P<0.05; conduct problems DD: (2.31±1.23), ADHD: (3.66±1.77), combined: (2.64±1.98), control: (1.97±1.31), F=7.24, P<0.05; difficulties score DD: (6.94±2.96), ADHD: (10.28±3.90), combined: (9.07±3.17), control: (6.06±3.94), F=8.82, P<0.05 ], most serious in ADHD group. In addition, children in DD group scored higher than those in normal group in terms of prosocial behavior. Children in the combined group showed higher total scores of peer problems and difficult score than those in the normal group. Emotional symptoms were more serious among children in combined group than those in the DD group. Compared with the combined group, behavioral problems in ADHD group were more common. Hierarchical regression analysis indicated that occurrence of emotional and behavioral problems in combined group was mostly mediated by hyperactivity symptoms.@*Conclusion@#Compared with DD group, children with ADHD combined or not combined with DD show more emotional and behavioral problems. Emotional and behavioral problems are notably observed among those with hyperactivity symptoms than DD.