微型钛板置入颈椎管成形与单开门椎管扩大治疗脊髓型颈椎病的对比

背景：郑州大学第一附属医院骨科近年开展一项微创微型钛板置入颈椎管成形治疗脊髓型颈椎病,在保留颈椎重要结构的基础上对颈椎病实现脊髓减压。 目的：对比分析微创微型钛板置入颈椎管成形与颈后路单开门椎管扩大成形对脊髓型颈椎病的治疗效果。 方法：将78例脊髓型颈椎病患者随机分成2组,分别采用微创微型钛板置入颈椎管成形与颈后路单开门椎管扩大成形治疗。 结果与结论：治疗后随访3-36个月。末次随访患者日本骨科学会(JOA)评分优良率两组差异无显著性意义(P > 0.05)。治疗后轴性症状明显率微创颈椎管成形组明显低于单开门组(P < 0.05),颈曲指数丢失值微创颈椎管成形组显著低于单开门组(P < 0.05)。微创颈椎管成形组末次随访1例患者2枚钛钉轻微松动,患者无异常症状。单开门组治疗中6例开门时出现铰链侧断裂,将断裂椎板切除,脊髓表面覆盖人工硬脊膜加以保护。结果表明,微创颈椎管成形组与单开门组相比在脊髓功能恢复方面疗效无差别,但治疗后并发症远低于单开门组。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程全文链接：     

颈椎后路植入物固定修复多节段脊髓型颈椎病：可改善症状但降低了颈椎活动度

背景：颈椎后路单开门椎管成形单侧侧块内固定与全椎板切除双侧侧块内固定通过扩大椎管有效容积治疗脊髓型颈椎病,并且两种固定方法的疗效和安全性并不清楚。 目的：观察颈后路单开门椎管成形单侧侧块内固定与全椎板切除双侧侧块内固定治疗多节段脊髓型颈椎病,植入物与宿主生物相容性。 方法：回顾性分析117例多节段(≥3个)脊髓型颈椎病患者病历资料,分为单开门组65例和全椎板切除组52例,分别采用单开门椎管成形单侧侧块内固定及全椎板切除双侧侧块内固定治疗。对两组患者固定前及末次随访进行JOA评分、估算恢复率,观察神经恢复情况,并通过侧位X射线片测量颈椎曲度指数和颈椎活动度进行评估。 结果与结论：两组平均随访时间28个月(12-59个月)。两组均无C5神经根麻痹患者。两组末次随访JOA评分均高于固定前(P < 0.01)。两组间JOA评分、恢复率、末次随访颈椎曲度指数比较差异均无显著性意义(P > 0.05)。两组末次随访颈椎活动度均低于固定前(P < 0.01)。结果说明,颈后路单开门椎管成形单侧侧块内固定与全椎板切除双侧侧块内固定在改善神经功能、缓解疼痛、减少并发症上有相似的疗效,但一定程度上降低了颈椎活动度。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程      

颈后路个体化精确椎管横径测量在椎管扩大成形治疗椎板定位中的意义☆

背景：颈后路单开门椎管扩大成形传统方法采用术中解剖标志定位,定位较模糊,且容易受患者个体差异及术者经验的影响。 目的：观察颈后路个体化精确椎管横径单开门椎管扩大成形治疗颈椎病的疗效。 方法：2006-01/2009-12共施行颈后路个体化精确椎管横径单开门椎管扩大成形治疗119例,对单开门术式进行了部分改进,行个体化椎管横径测量法的单开门椎管扩大成形治疗。观察临床疗效并比较治疗前后和随访时的JOA评分和目测类比评分。 结果与结论：共112例患者获得随访,随访时间15~53个月。JOA评分治疗后6个月、末次随访时与治疗前比较显著升高(P < 0.01)。末次随访时疗效分级,优57例,良43例,优良率89.3%。目测类比评分治疗后6个月、末次随访时与治疗前比较显著下降(P < 0.01)。仅有3例患者治疗后出现C5神经根麻痹症状,发生率为2.67%。提示颈后路个体化精确椎管横径单开门椎管扩大成形治疗颈椎病减压彻底,脊髓后移充分,手术方法简单规范,治疗后C5神经根麻痹和颈肩痛症状发生较少。     

颈椎后路单开门椎管扩大成形术治疗效果的临床观察

目的探讨、对比颈椎后路单开门椎管扩大成形术对治疗几类常见颈椎病的疗效。方法收集2009年6月~2013年1月我科采用颈椎后路单开门椎管扩大成形术治疗的55例颈椎病患者资料,按病情分为4组,其中46例获得随访,用统计学方法对各组术前术后JOA评分结果、椎管矢状径数值进行统计分析,判断并比较手术疗效。结果随访时间10~31个月,平均18个月,患者无死亡,无感染,无再关门等并发症,2例术后早期出现肩部不适感,2例出现硬脊膜损伤脑脊液漏,做相应处理后症状减轻至消失。术后各组JOA评分均有提高,椎管矢状径增加(0.005),各组疗效比较无明显差异(0.05)。结论颈椎后路单开门椎管扩大成形术扩大了颈椎管的容积,直接减除颈髓神经压迫,有效地缓解了患者的症状和体征,是治疗常见颈椎病较为安全、有效的手术方法。     

钛板与丝线悬吊固定在颈椎后路单开门椎管扩大成形中应用的Meta分析

背景：目前有关颈椎后路单开门椎管扩大成形中微型钛板固定与丝线悬吊固定比较的文献较多,但大多研究的样本量存在局限,对于微型钛板应用的优缺点缺乏客观评价。 目的：系统评价颈椎后路单开门椎管扩大成形中微型钛板固定与传统丝线悬吊固定对颈椎疾患的修复效果和安全性。 方法：由2名评价员检索中/英文公开发表的随机对照试验。计算机检索the Cochrane Central Register of Controlled Trials(CENTRAL)、PubMed、EMbase、the ISI Web of Knowledge Database、CNKI、CMB、VIP、万方数据库公开发表的有关颈椎后路单开门椎管扩大成形中微型钛板固定与传统丝线悬吊固定的随机对照试验。检索时间均为建库时间至2015年3月1日。同时,手检纳入文献的参考文献。Meta分析采用Cochrane 协作网提供的Rev-Man 5.3软件进行。 结果与结论：共纳入9个研究,642例患者。Meta分析结果显示：①在安全性方面：两组手术时间[SMD=-0.02,95%CI(-0.57,0.54),P=0.95 > 0.05]、术中出血量[SMD=0.07,95%CI(-0.26,0.40),P=0.69 > 0.05]差异无显著性意义。②在有效性方面：与传统丝线悬吊固定相比,微型钛板固定术后JOA评分较高[SMD=0.26,95%CI(0.10,0.42),P=0.001< 0.05]、椎板开门角度较大[SMD=0.25,95%CI(0.02,0.48),P=0.04 < 0.05]、颈椎曲度维持较好[SMD=0.46,95%CI(0.27,0.65),P < 0.000 01]、轴性症状发生率较低[RR=0.40,95%CI(0.29,0.56),P < 0.000 01]。提示临床上采用单开门椎板扩大成形修复颈椎病时,使用微型钛板固定与丝线悬吊固定均能取得较好的临床效果,但微型钛板固定组在JOA评分、椎板开门角度方面优于丝线悬吊固定组,并能有效的防止颈椎曲度丢失及降低轴性症状的发生率;但因原始研究质量不高,样本不大,建议临床上谨慎使用,尚需要更多高质量大样本的随机对照试验进一步论证。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

改良单开门椎管扩大成形修复慢性压迫性颈脊髓病:颈椎稳定性随访

背景:颈椎单开门椎管扩大成形应用于临床治疗慢性压迫性颈脊髓病已取得确切疗效。为减少相关术后并发症的发生,学者们提出了各种改良方案,均取得了一定的疗效。目的:验证改良单开门椎管扩大成形治疗慢性压迫性颈脊髓病的临床效果。方法:回顾性分析2010年1月至2013年12月在新疆医科大学第一附属医院行后路单开门椎管扩大成形治疗的慢性压迫性颈脊髓病患者87例,其中改良组41例采用改良单开门椎管扩大成形治疗,保留C7棘突及其附着肌肉韧带组织,开门节段为C3-C6;对照组46例采用传统C3-C7单开门扩大成形治疗。记录手术时间、术中出血量,对两组患者治疗前及治疗后随访时的JOA评分(17分法)、颈椎曲度Cobb角、颈椎活动度及轴性症状严重程度等进行对比分析。结果与结论:87例患者全部获得随访,改良组手术时间(82.46±14.80)min,出血量(196.3±141.4)m L;对照组手术时间(78.41±15.43)min,出血量(220.91±128.21)m L,两组差异无显著性意义(P0.05)。JOA评分恢复率两组差异无显著性意义(P0.05)。改良组治疗后有明显轴性症状患者的比例为17%,对照组为46%,对照组显著高于改良组(P0.05)。改良组治疗后颈椎曲度丢失程度、颈椎活动度丢失程度均显著小于对照组(P0.05)。两组末次随访门轴侧均骨性愈合,无椎板塌陷和再"关门"现象。提示改良单开门椎管扩大成形治疗能获得良好的神经减压效果,同时可以最大程度维持颈后韧带复合体结构和功能的完整性,减少对颈椎稳定机制的破坏,从而保留颈椎曲度、颈椎活动度,并降低术后轴性症状的发生。     

颈椎后路单开门椎管扩大成形后发生C2、C3椎弓骨撞击:2年内颈椎侧位X射线片评估

背景:颈后路单开门椎板成形后易出现C2、C3椎弓骨撞击的现象,导致患者术后颈椎活动受限,对其相关因素分析具有重要的临床意义.目的:分析颈椎后路单开门椎管扩大成形后C2、C3椎弓骨撞击的相关因素,探讨术后C2、C3椎弓骨撞击的病因及发病机制.方法:回顾性分析行颈椎后路单开门椎管扩大成形并有完整随访资料的多节段脊髓型颈椎病...     

微型钛板在颈椎后路椎板成形中的应用:近期随访

背景:颈椎后路单开门椎管扩大成形术治疗多节段颈椎病时,椎管发生再狭窄、颈椎生理曲度的丢失、轴性症状的发生是影响疗效的重要原因,持久维持椎管的扩大状态和减少颈椎后部组织结构的干扰在临床治疗中非常有必要。目的:观察微型钛板置入内固定在颈椎后路单开门椎管扩大成形治疗过程中的临床效果及近期随访结果。方法:回顾性分析厦门大学附属中山医院2006年4月至2013年4月具有完整资料的采用颈椎后路单开门椎管扩大成形术治疗脊髓型颈椎病的患者共67例,其中微型钛板组27例使用微型钛板置入内固定,缝线组40例采用传统缝线悬吊"门轴"。两组的减压节段均为C3-7。比较两组手术时间、术中出血量、随访时JOA评分改善率、颈椎曲度变化值、轴性症状及椎板掀开角度。结果与结论:两组手术时间、术中出血量、JOA评分改善率差异均无显著性意义(P0.05)。两组曲度变化值,术后6个月微型钛板组颈椎曲度丢失不明显,缝线组颈椎曲度部分丢失(P0.05),两组差异有显著性意义(P0.05)。术后6个月轴性症状发生率微型钛板组明显低于缝线组(P0.05)。末次随访时椎板开门角度微型钛板组(35.2±6.2)°与缝线组(34.0±4.7)°比较差异无显著性意义(P0.05)。提示颈椎后路单开门椎管扩大成形治疗脊髓型颈椎病,使用微钛板与传统缝线悬吊固定方法,均能获得较好的临床效果,但微型钛板固定法能减轻术后的轴性症状以及防止颈椎曲度丢失。     

颈椎单开门扩大成形术并发症的治疗

目的探讨颈椎单开门扩大成形术并发症的治疗方法。方法回顾22例颈椎单开门扩大成形术并发症的治疗经验。结果22例颈椎单开门扩大成形术并发症:4例硬膜外血肿愈后均良好;3例脊髓损伤2例愈后良好,1例尚可;5例硬脊膜损伤均愈后良好;3例椎管扩大不充分愈后均良好;术式不当1例愈后良好;5例再关门均愈后良好;1例感染愈后良好。结论为提高颈椎单开门扩大成形术疗效,减少并发症,术前应正确选择适应证,注意手术中的各个环节,加强术后管理,三者有机结合,密不可分。     

双开门椎板成形椎管扩大术治疗多节段脊髓型颈椎病评价

目的:报道双开门式椎板成形椎管扩大术治疗多节段脊髓型颈椎病的临床疗效。方法:观察和分析作者在1999～2001年期间,采用双开门式椎板成形椎管扩大术治疗多节段脊髓型颈椎病35例患者。随访40.6个月(26～56个月)。比较患者术前术后的JOA评分和X线片及CT或MRI改变。结果:末次随访JOA评分改善率:优28.6％(10例),良37.1％(13例),一般22.9％(8例),差11.4％(4例)。JOA评分为(12.6±3.5)分(9～17分),与术前JOA评分情况比较差异有显著性(P<0.01)。神经功能改善率为88.6％,优良率为65.7％。X线片及CT或MRI显示:术后椎管矢状径和椎管面积增加,两者与术前测量结果比较差异均有显著意义(P<0.01)。结论:双开门式椎板成形椎管扩大术治疗多节段脊髓型颈椎病,可通过扩大颈椎管,使脊髓后移而获得减压;只要操作得当,可取得满意疗效。     

Immunohistochemical localization of galectin-3 in the reproductive organs of the cow

The protein levels and immunohistochemical localization of galectin-3, which is a beta-galactoside-binding protein, were studied in the cow reproductive organs. Using Western blot analysis, galectin-3 was detected at low levels in the ovary and oviduct, at moderate levels in the uterus, and at high levels in the cervix. Using immunohistochemistry, galectin-3 was immunolocalized in macrophages in the interstitium, in cells in the atretic follicles, and in luteal cells in the regressing corpus luteum, but not in the growing follicles in the ovary. In the oviduct, galectin-3 was detected in some macrophages in the lamina propria, submucosa and muscle layers, as well as in some cells in the covering epithelium. In the uterus, galectin-3 was immunolocalized in some epithelial cells and in some macrophages in the submucosa, but not in the endometrial glands at the non-pregnant stage. In the cervix, galectin-3 was immunolocalized in many mucus-secreting cells in the mucosa and in a few macrophages in the submucosa and muscle layers. Based on its localization, we postulate that galectin-3 in the covering epithelium is involved in the mucosal defense system, and that galectin-3-positive macrophages in all tissues are involved in either cell survival or death. In addition, galectin-3 plays an important role in the regression of follicles and the corpus luteum.     

Pentylenetetrazol kindling in rats: Is neurodegeneration associated with manifestations of convulsive activity?

Structural changes in neurons and measures of oxidative stress were studied in the hippocampus of rats tolerant (ST) and sensitive (SS) to developing clonic-tonic seizures in conditions of pentylenetetrazol kindling. Sequences of 11 injections of pentylenetetrazol significantly decreased the number of normal neurons in hippocampal field CA1 in SS rats, this effect being seen in both hippocampal field CA1 and the dentate fascia in ST rats. Decreases in the numbers of normal neurons were accompanied by increases in the numbers of damaged cells in field CA4 in rats of both groups. After 21 injections, decreases in the numbers of normal neurons were seen in field CA1 in both SS and ST rats, while the numbers of damaged neurons were significantly greater than control only in ST rats in fields CA1 and CA4. The glutathione level was significantly lower in the hippocampus in both groups of rats than in controls. Thus, rats “ tolerant” to developing convulsions show signs of oxidative stress and neurodegenerative changes in the hippocampus. This suggests that oxidative neuron damage leading to neurodegeneration in the pentylenetetrazol kindling model is not directly associated with convulsive activity. __________ Translated from Rossiiskii Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 91, No. 7, pp. 764–775, July, 2005.     

Effects of thyroid hormone deficiency on behavior in rat strains with different predisposition to catalepsy

The effects of thyroidectomy on anxiety-related behavior in the elevated plus-maze test, locomotor activity, and defecation in the open-field test and duration of cataleptic freezing were studied in rats of two strains differing in predisposition to catalepsy: cataleptic strain GC and its ancestor strain Wistar. Total thyroxine level was significantly decreased in control GC rats compared to that in control Wistar rats. Control Wistar and GC rats did not differ either in the percentages of open-arm entries or the time spent therein in the elevated plus-maze test or in defecation score in the open-field test. At the same time, control Wistar rats showed more locomotor activity compared to control GC rats in the open-field test. Thyroid hormone deficiency did not affect the percentages of open-arm entries and the time spent therein in the elevated plus-maze test as well as defecation score in both strains. Thyroidectomy did not alter significantly locomotor activity in Wistar rats, but produced a nearly twofold increase in locomotor activity in GC rats. The most important finding is that thyroidectomy significantly increased the expression of catalepsy in Wistar rats, which points to a role of thyroid hormones in the regulation of predisposition to cataleptic reaction.     

Distribution of galanin-binding sites in the monkey and human telencephalon: preliminary observations

Summary Using X-ray film autoradiography the distribution of ¹²⁵I-galanin binding sites was studied in the forebrain of monkey and man. In the monkey a high density was found in all areas of the neocortex, especially layer 4, and in certain subfields in the hippocampal region. Also in the human brain high activity was seen in neocortex, mainly layer 6 and in hippocampal areas, as well as in amygdala, piriform cortex and hypothalamus. These results suggest that the 29-amino acid peptide galanin may be involved in the regulation of higher cortical functions in primates.     

Subcellular and regional location of “brain” proteins BASP1 and MARCKS in kidney and testis

Proteins BASP1 and MARCKS are abundant in axonal endings of neurons. Similarly to brain-specific protein GAP-43, BASP1 and MARCKS are reversibly bound to the plasma membrane. These proteins control both actin polymerization and actin cytoskeleton binding to the membrane. Performing these functions, BASP1 and MARCKS take part in growth cone guidance during development and in neurotransmitter secretion in adults. These activities predetermine the pivotal role of BASP1 and MARCKS in learning and memory. BASP1 and MARCKS were also found in non-nerve tissues, in particular, in the kidney and testis. Evidently, the physiological roles of these proteins differ in different tissues. Correspondingly, their intracellular location and activities may not be similar to those in neurons. In this paper, we analyze subcellular fractions (cytoplasm and nuclei) of rat kidney and testis with the purpose of determining the intracellular location of BASP1 and MARCKS. Western blots demonstrated that in these tissues, as in the brain, both proteins are present in the cytoplasm of the cell. According to our immunohistochemical study, BASP1 and MARCKS are specifically distributed in the tissues studied. In kidney, both proteins are present in cells located in glomeruli. In the testicular tubules, BASP1 is mainly expressed at the late stage of spermatogenesis (in spermatids) and is preserved in mature spermatozoa, while MARCKS appears equally during all stages of spermatogenesis. MARCKS is not found in mature spermatozoa. The results indicate that study of functions of BASP1 and MARCKS in the kidney and in the reproduction system holds much promise.     

Changes in the mucosa of the stomach and duodenum during immunosuppresive therapy after renal transplantation

Upper gastrointestinal endoscopic examination of 40 patients on immunosuppressive therapy after successful kidney transplantation revealed a duodenal ulcer in four cases and duodenal erosions in six. Between four and six biopsies were collected from the antral and the fundal mucosa in each case and from the duodenal mucosa in 29. Antral superficial gastritis was found in 13 cases and fundal superficial gastritis in three. In the fundus, heterotopic calcifications were seen in eight cases and cytomegalovirus inclusion bodies in two. Parietal cells were increased in number and reached the pyloric zone in 34 cases, whilst they spread within the duodenal mucosa in 12. Multinucleate parietal cells were of common occurrence and in some cases showed mitotic figures. Duodenitis was found in 16 cases and in duodenal mucosal cells cytomegalovirus inclusion bodies were seen in nine cases. Biopsy evidence of hyperplasia of Brunner's glands was encountered in 26 cases. Of 20 patients tested for gastric acid secretion, hypersecretion occurred in 14 and normal secretion in six. Endoscopic and histological changes relate to the secretory pattern. Cytomegalovirus inclusion bodies relate to immunosuppressive therapy. An inverse temporal relationship exists between heterotopic calcification and the duration of renal transplant. Steroids seem to be responsible for gastroduodenal changes in transplanted patients.     

Type 1 metalloproteinase is selectively expressed in adult rat brain and can be rapidly up-regulated by kainate

The expression of metalloproteinase MMP-1 was traced in frontal sections of the rat brain in normal conditions and 4 h after an intraperitoneal injection of kainate. In the olfactory lobe, immunoreactivity was normally detected in the lateral olfactory tract. Kainate treatment led to the appearance of additional immunoreactivity in the neuropilar tracts. In the hippocampal part of brain, immunoreactive neurons were found exclusively after the kainate treatment in several hypothalamic and amygdalar nuclei, and in the restricted cortex areas (clusters of neurons in layers 3–4 of cortex, and a stripe of cells in layer 6). In the area between the hippocampus and cerebellum, MMP-1-like immunoreactivity was normally present in the entorhinal cortex, in the lateral periaqueductal gray, and in the pontine nucleus. After kainate treatment, the immunoreactive neurons were also found in the medial entorhinal cortex and in the dorsal raphe nucleus. In the brain stem, the immunoreactive cells were normally found in six nuclei. After kainate treatment, additional immunoreactivity appeared in the inferior olive neurons and in tracts supplying the cerebellar cortex. Thus, MMP-1 is present in several brain areas in normal conditions at a detectable level, and its expression increases after kainate-induced seizures.     

Tumor necrosis factor-alpha in the placenta is not elevated in pre-eclamptic patients despite its elevation in peripheral blood

PROBLEM: Tumor necrosis factor-alpha (TNF-alpha) is present in human placental and uterine cells at the early and late stages of gestation and promotes the regulation of trophoblast growth and invasion. We evaluated whether TNF-alpha levels in the placenta and blood of pre-eclamptic women differed from those with normal pregnancies. METHOD OF STUDY: The subjects were 39 pregnant women carrying single fetuses (21 normal-pregnant and 18 pre-eclamptic patients). Their average gestational age at entry was 38-39 weeks. Peripheral blood was collected before the onset of labor and separated serum was stored at -20 degrees C. A tissue segment of the placenta was cut and frozen in liquid nitrogen immediately after delivery at -80 degrees C. The frozen placental tissue was added to phosphate-buffered saline. The tissue was fully homogenized and centrifuged. Separated supernatant was stored at -80 degrees C. TNF-alpha levels in separated serum and TNF-alpha and total protein (TP) levels in separated supernatant were measured. The presence of TNF-alpha in the placenta was evaluated by immunohistochemistry in five pre-eclamptic and five normal-pregnant patients. RESULTS: Serum TNF-alpha levels were higher in pre-eclampsia than in normal pregnancies. However, TNF-alpha/TP levels in the placenta did not differ significantly between the two groups. As for TNF-alpha immunostaining of trophoblastic cells in the placenta, it was weak in three and moderate in two of the normal pregnancies, while it was absent in two, weak in one, and moderate in two in the pre-eclampsia group. CONCLUSIONS: We demonstrated no significant increase in TNF-alpha/TP levels in the placenta in pre-eclampsia despite a significant increase in serum TNF-alpha levels. There was no strong immunostaining for TNF-alpha detected by immunohistochemistry in the pre-eclampsia group. These findings suggest that TNF-alpha in the placenta is not a key cytokine to interfere with normal trophoblast invasion into the myometrium in pre-eclampsia, and that sources other than the placenta may contribute to the elevated levels of TNF-alpha found in the circulation of pre-eclamptic patients.     

Oleandrin-Mediated Expression of Fas Potentiates Apoptosis in Tumor Cells

Chemotherapeutic agent is characterized by its concentration in tumor cells with minimum side effects. Oleandrin, a polyphenolic cardiac glycoside is known to induce apoptosis in tumor cells. However, no report is available on its efficacy in primary cells. In this report we are providing the evidence that oleandrin induces apoptosis, not necrosis in tumor cells but not in primary cells like peripheral blood mononuclear cells (PBMC) and neutrophils. Oleandrin inhibited NF-κB activation in tumor cells but not in primary cells. It induced cell death in NF-κB-overexpressed tumor cells. Oleandrin induced Fas expression thereby inducing apoptosis in tumor cells but not in primary cells. Dominant negative FADD inhibited oleandrin-induced cell death in tumor cells. Overall, these results suggest that oleandrin mediates apoptosis in tumor cells by inducing Fas but not in primary cells indicating its potential anti-cancer property with no or slight side effect.