[Targeted therapy for malignant peripheral nerve sheath tumor: translational research and clinical application].

Malignant peripheral nerve sheath tumor (MPNST) is a rare invasive soft tissue sarcoma that originates from peripheral nerve branches and peripheral nerve sheaths. Early radical surgery is an effective treatment for MPNST. Since it is insensitive to radiotherapy and chemotherapy, the disease manifests a rapid progression, poor prognosis and high mortality. In recent years, the translational researches on the driving factors and therapeutic targets of MPNST have been rapidly developed, including the pathways of NF1-Ras, Raf-MEK-ERK, PI3K-AKT-mTOR, Wnt signaling, and abnormal expressions of apoptotic proteins, the general loss of polycomb repressive complex 2 (PRC2), upregulation of the HDAC family, abnormal expressions of receptor tyrosine kinases, expressions of programmed cell death ligand (PD-L1), aurora kinase and various microRNAs.This review summarizes the current translational researches on potential therapeutic targets of MPNST, and the clinical trials which provide helpful information for MPNST targeted therapy.

Effect of exosomes derived from MiR-133b-modified ADSCs on the recovery of neurological function after SCI.

OBJECTIVE: To investigate the recovery effect of exosomes derived from micro ribonucleic acid (miR)-133b-modified adipose-derived stem cells (ADSCs) on neurological function after spinal cord injury (SCI) and its mechanism. MATERIALS AND METHODS: The SCI model of rats was used and divided into the following 5 groups: sham-operation group, 4 d SCI group, phosphate-buffered saline (PBS) group, miR-control group and miR-133b group. At 96 h after operation, rats were euthanatized, and spinal tissues were removed. Next, the level of miR-133b was detected via reverse transcription-polymerase chain reaction (RT-PCR), and the expression of RhoA protein was measured via Western blotting. Moreover, expressions of proteins associated with the axon regeneration pathway, including phosphorylated-cAMP-response element binding protein (p-CREB), CREB, phosphorylated-signal transducer and activator of transcription 3 (p-STAT3) and STAT3, along with expressions of neurofilament (NF), growth associated protein 43 (GAP43), glial fibrillary acidic protein (GFAP) and myelin basic protein (MBP), were tested by Western blotting and immunofluorescence staining. RESULTS: The miR-133b mimics significantly upregulated the expression of miR-133b in adipose-derived stem cells (ADSCs), compared to blank group (p<0.05). The expression of miR-133b was significantly decreased in 4 d SCI group compared with that in sham-operation group (p<0.001). The RhoA expression was statistically increased in 4 d SCI group compared with that in sham-operation group (p<0.001), and it was partially impaired by using miR-133b compared with that in 4 d SCI group (p<0.001). Expressions of NF, GAP43, GFAP and MBP were remarkably higher in 4 d SCI group than those in sham-operation group (p<0.01), and they were also significantly increased in miR-133b group than those in 4 d SCI group (p<0.01). Besides, our data showed a significant increase of p-CREB/CREB, p-STAT3/STAT3, NF, GAP-43, GFAP and MBP in miR-133b group compared to those in 4 d SCI group, with statistical reduction of RhoA (p<0.05). CONCLUSIONS: We showed that exosomes derived from miR-133b-modified ADSCs can significantly promote the recovery of neurological function of SCI animals through affecting the signaling pathway related to axon regeneration and expressions of NF, GAP-43, GFAP and MBP.

Kyphoplasty for the treatment of pain distant to osteoporotic thoracolumbar compressive fractures.

Vertebral fractures are one of the most common osteoporotic fractures. We sought to investigate the incidence of distant pain after osteoporotic vertebral compressive fracture (OVCF) at the thoracolumbar junction, and to explore the effect of kyphoplasty in the treatment of distant pain post-OVCF. Eighty-seven patients diagnosed OVCF between T11 and L2 were included in the study. The region of pain and its proximity to the thoracolumbar compressive fracture was recorded. For pain management, all patients received kyphoplasty. The follow-up period was every 3 months for 1-year post-surgery. The Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used pre-operatively, post-operatively, and at 3-, 6-, and 12-month follow-ups to assess patient status. All patients completed the operation, with 72 patients having focal pain over the compression fracture. Eleven cases also had pain distal to the fracture region in the following areas: lower back, near the iliac crest (n = 6), the groin (n = 3), and the trochanteric region (n = 2). Four cases had pain in distant to the fracture: lower back, near iliac crest (n = 3), and the trochanteric region (n = 1). All patients had a significant improvement in clinical symptoms. The average VAS and the ODI decreased significantly pre-operatively to post-operatively (p < 0.05). In addition to focal tenderness, many patients with thoracolumbar compression fractures may have pain distant to the fracture. This can be successfully treated using kyphoplasty. This phenomenon also indicates that patients at risk of osteoporosis who also have lower back pain should not neglect the potential for a thoracolumbar fracture.

[Radiofrequency ablation of left-sided atrioventricular accessory tract to treat supraventricular tachycardia].

Eleven procedures of radiofrequency catheter ablation of left-sided atrioventricular accessory tract were performed in 10 patients with atrioventricular reentry tachycardia aged 13-57 (32.7 +/- 13.2) years old. 10 patients, 9 with overt preexcitation syndrome and 1 with concealed bypath tract, had paroxysmal supraventricular tachycardia refractory to drugs for 1-31 (7.8 +/- 9.8) years. The ablation was succeeded in 9 cases (90%). The accurate localization of the accessory tract and the operating skill of ablation electrode were the key factors of success in ablation and reducing exposure to x-ray.