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Remote endoscopy can improve diagnostic efficiency of gastrointestinal (GI) diseases for patients in remote areas. A novel remote magnetically controlled capsule endoscopy (MCE) system based on a 5G network was developed for real-time remote GI examinations. We aimed to evaluate the feasibility and safety of the 5G-based remote MCE for examination of the stomach and small bowel.This was a prospective, nonrandomized, comparative study. Consecutive participants enrolled in the First People's Hospital of Yinchuan underwent remote MCE examinations performed by an endoscopist located in Changhai Hospital. Consecutive participants enrolled in Changhai Hospital underwent conventional MCE examinations performed by the same endoscopist. The main outcomes included the complete visualization rate of the stomach and small bowel, safety assessment and network latency time of remote MCE examinations.From March 2021 to June 2021, 20 participants in each group were enrolled. The complete visualization rate of the stomach and small bowel was 100% in both groups (p 0.999) without any adverse event. The median network latency time of remote MCE group was 19.948 ms. Gastric examination time (8.96 vs. 8.92 min, p = 0.234), maneuverability (15.00 vs. 15.00, p = 0.317), image quality (1.00 vs. 1.00, p 0.999) and diagnostic yields in the stomach and small bowel (55% vs. 30%, 5% vs. 0%, both p 0.05) were comparable between remote and conventional MCE groups. All participants in remote MCE group considered remote MCE acceptable and necessary.5G-based remote MCE was a feasible and safe method for viewing the stomach and small bowel.

Background Chronic hepatitis B is a highly heterogeneous disease that can be divided into four phases: Immune tolerant (IT), immune active (IA), inactive carrier (IC) and hepatitis B envelope antigen (HBeAg)-negative hepatitis (ENEG). Aim To investigate the immune status of natural killer (NK) and T cells in different phases of chronic hepatitis B. Methods The frequency, phenotype and function of circulating NK cells, as well as nonantigen-specific and hepatitis B virus (HBV)-specific T cell responses were detected by flow cytometry in healthy and HBV-infected subjects. Results The ability of NK cells to produce IFN-γ was markedly attenuated in HBV-infected patients overall but was less compromised in IC patients. Patients in the IT and IA phases also displayed significantly lower TNF-α production compared to healthy subjects. NK cells were phenotypically activated in the IA and ENEG phases, as evidenced by the upregulation of NKp44 in CD56bright NK cells and CD69 in CD56dim NK cells. Furthermore, global T-cells from the ENEG phase displayed a proinflammatory cytokine profile with upregulated IFN-γ and TNF-α expression, while this profile was suppressed in IT and IA patients. Finally, core and S antigen-specific T cell responses were significantly stronger after in vitro expansion in the IC phase compared to other phases. Conclusion Our findings demonstrate the changes in immune response pattern during the natural history of HBV infection. Both NK and T cells are functionally impaired in the IT and IA phases. With the spontaneous clearance of HBeAg and hepatitis B surface antigen decline, NK cell cytokine production and HBV-specific T responses are partially restored in IC phase, and the ENEG phase is dominated by nonantigen-specific T cell responses.

Aim We aimed at investigating the effects of age on the predictive performances of noninvasive fibrosis scores for significant fibrosis in patients with chronic hepatitis B (CHB). Methods A total of 496 CHB patients who underwent liver biopsy were stratified into four age groups: ≤30, 31 to 40, 41 to 50, and ≥51 years. Receiver operating characteristic curves were used to evaluate the diagnostic performance of aspartate aminotransferase to platelet ratio index (APRI), fibrosis score-4 (Fib-4) and γ-glutamyl transpeptidase to platelet ratio (GPR) in different age groups. Results The extent of fibrosis significantly increased with age, and the percentage of significant fibrosis (≥F2) was 21.3%, 29.0%, 38.5%, and 46.1%, respectively. All three scores displayed a moderate accuracy to diagnose significant fibrosis in overall patients. However, for patients with age ≤30 years, APRI, Fib-4, and GPR performed poorly with the AUROC of 0.567, 0.627 and 0.596, respectively. Furthermore, using the established cut-off values-1.45 for Fib-4, the sensitivity for significant fibrosis increased with age, from 14.8%, 38.1%, 74.5% to 97.87% in above age groups, respectively. To improve the diagnostic accuracy for significant fibrosis, the proposed low and high cut-off points for Fib-4 were 0.41 and 1.15 in ≤30 years, 0.8 and 1.59 in 31 to 40 years, 1.17 and 1.94 in 41 to 50 years, 1.76 and 3.10 in ≥ 51 years, respectively. Conclusions Age may influence the diagnostic thresholds and performance of APRI, Fib-4, and GPR for significant fibrosis in patients with CHB. In particular, these scores performed poorly for identifying significant fibrosis in younger patients (≤30 years).

Delayed gastric transit of the capsule may lead to incomplete small bowel examination, reducing the diagnostic yield. Thus, this study was designed to determine if magnetic steering could enhance capsule gastric emptying and mucosal visualization within the duodenum.The intervention group comprised 100 patients undergoing magnetic-controlled capsule endoscopy between May to September 2017 in whom magnetic control was used to assist transpyloric passage of the capsule and duodenal inspection. A cohort of 100 patients who had undergone the procedure before May 2017 was randomly selected from the database as an historic control group in whom transpyloric movement of the capsule occurred spontaneously (without magnetic assistance). The difference in the pyloric transit time (PTT) and duodenal papilla detection rate (DPDR) between the 2 groups were compared, and related factors were also investigated.Transpyloric passage of the capsule under magnetic control was successfully performed in 59 patients (59%). Median PTT was greatly reduced in the intervention group from 58.38 minutes (range, 13.45-87.47) to 4.69 minutes (range, 1.56-55.00; P .001), and DPDR was also greatly improved with magnetic steering (30.5% vs 9%, P .001). Magnetic steering, male gender, and higher body mass index were independently associated with reduced gastric transit time and magnetic steering with an enhanced DPDR.Magnetic steering of the capsule can enhance gastric emptying of the capsule and may prove useful in nonobese and female patients who appeared to have longer gastric transit time and achieved a better DPDR than that under the action of peristalsis alone. (Clinical trial registration number: NCT03441945.).

Four starburst molecules with a triphenylamine (TPA) core through the amide group linked to the terminal triphenylamine or (N-phenyl)carbazole (NPC) unit, coded as T-3(NHCO-TPA), T-3(NHCO-NPC), T-3(CONH-TPA), and T-3(CONH-NPC), were synthesized and their electrochemistry and electropolymerization were investigated. The oxidation potential and the stability of the oxidized forms of the starbursts are affected by the orientation of amide linkage and the structure of terminal triarylamine unit. Robust polymeric films could be built onto ITO/glass surface by repetitive cyclic voltammetry (CV) of the T-3(NHCO-TPA) solution containing an electrolyte. The electrodeposited films exhibited reversible electrochemical processes and strong color changes upon electro-oxidation, which can be switched by potential modulation. The electrochromic behavior of the film was clearly interpreted on the basis of spectroelectrochemical studies. T-3(CONH-TPA) did not undergo electropolymerization effectively. T-3(CONH-NPC) also could electrochemically polymerize to polymer films upon repeated CV scans. However, their electrochromic switching stability is less than that of the polymer film from T-3(NHCO-TPA).

Three bis(triphenylamine) diimides, TPA-PMDI, TPA-NTDI and TPA-PTDI, were synthesized from condensation of 4-aminotriphenylamine with pyromellitic dianhydride (PMDA), 1,4,5,8-naphthalenetetracarboxylic dianhydride (NTDA) and 3,4,9,10-perylenetetracarboxylic dianhydride (PTDA), respectively. Redox-active poly(arylamine-imide) films coded with TPA-PMPI, TPA-NTPI, and TPA-PTPI could be electrodeposited robustly on the electrode surface in an electrolyte solution via the oxidative coupling reactions between TPA radical cations. The CVs of these elecrtrodeposited films showed an ambipolar redox behavior, with a reversible redox couple at E1/2 of 0.99–1.02 V during the anodic scanning and two pairs of redox waves during cathodic scanning. The polyimide films exhibited multicolored anodic and cathodic coloring. Electrochromic devices using the electropolymerized films as active layers were also fabricated as preliminary investigations for electrochromic applications.

A robust polyimide film was facilely fabricated on the ITO-glass substrate from the electrolyte solution of a bis(triphenylamine) perylene diimide by electrochemical polymerization. The cyclic voltammogram of the electrodeposited polyimide film shows ambipolar redox processes, with a reversible redox couple with a half wave potential (E1/2) of + 0.99 V during the anodic scanning and two pairs of redox waves at E1/2 = − 0.41 V and − 0.65 V during cathodic scanning. The electroactive film did not delaminate from the electrode upon cycling electrochemically between its oxidized/reduced and neutral states. The polyimide film exhibits stable anodic and cathodic coloring, with high optical contrast, high coloration efficiency, and good cycling stability.

Good gastric preparation is essential for magnetically controlled capsule gastroscopy (MCCG) examination. This study aims to determine if repetitive position change after dimethicone premedication could further improve gastric cleanliness for MCCG. Consecutive patients referred for MCCG in our center from May 7 to May 31, 2018 were prospectively enrolled and randomized to undergo repetitive position change for 15 min (position change group) or not (conventional group) after ingesting dimethicone. Primary outcome was gastric cleanliness score and secondary outcomes were detection rate of positive findings, number of lesions per patient, gastric examination time, and safety of MCCG. Totals of 43 and 40 were included in the position change and conventional groups, respectively. Gastric cleanliness score in the position change group was significantly higher than in the conventional group (21.2 ± 1.0 vs. 18.6 ± 2.0, P

Background: There has been considerable interest in whether old age is associated with IgA nephropathy (IgAN) progression, which is still controversial. Methods: We searched multiple databases for studies published from 1980 to 2012. The inclusion criteria were case-control, cohort studies published in any language. The included studies needed to have an older group. IgAN was proven by biopsy. Results: We included 9 studies with a total of 6,543 patients. The meta-analyses of other risk factors between the older group (>50 years old) and the non-older group (15-50 years old) found significant differences in the presence of hypertension, proteinuria, serum cholesterol levels and baseline renal function. In the overall analysis, compared to the non-older group, older age significantly increased the incidence of developing end-stage renal disease [ESRD; relative risk (RR) random model 1.95; 95% CI: 1.27-3.01]. In the subgroup analyses, we found the age limit and traditional risk factors of IgAN may be the sources of heterogeneity between studies. Moreover, the RR (2.56) of the Asian countries was much higher than the RR (1.11) of the European countries. Conclusions: This comprehensive review revealed that old age is a real risk factor for IgAN progression to ESRD. The incidence of ESRD in the older IgAN patients was 1.95 times higher than that in the non-older IgAN patients. Moreover, the risk of IgAN progression to ESRD of the older patients in Asia was higher than that of the older patients in Europe.

Background and Aims Gastric cancer (GC) is the fourth most common cancer and the fourth leading cause of cancer death worldwide. In some Asian countries, screening EGD has greatly improved the survival rate. However, patients’ discomfort and the need for sedation may limit adherence to screening programs. Previous studies have shown good tolerance and good agreement of magnetically controlled capsule gastroscopy (MCCG) with EGD. This study was designed to assess the application of MCCG in GC detection in an asymptomatic population. Methods In this observational cohort study, 3182 asymptomatic individuals undergoing MCCG in 99 participating medical examination centers from April to December 2016 were enrolled. Patients with ulcers and suspected malignancies were referred for gastroscopy and biopsy. The detection rate of GC and focal lesions were used to explore the application of MCCG in asymptomatic individuals. Results Seven patients (0.22%) were diagnosed with GC among the enrolled 3182 individuals, accounting for 0.74% (7/948) in patients over 50 years. No gender disparity was observed. EGD and biopsy confirmed adenocarcinoma in all cases of suspected malignancy. Benign polyps, gastric ulcers, and submucosal tumors were found in 10.4%, 4.9%, and 3.6% of patients, respectively. There was a trend for the prevalence of focal lesions to increase with age. MCCG examination proved to be safe. Conclusions MCCG can detect cancer and benign lesions and is safe and clinically feasible in a large population. Studies of its role in a screening program should be considered.

Objective Numerous Chinese patients with IgA nephropathy (IgAN) have benefited from Tripterygium wilfordii Hook F (TwHF) from two decades ago. However, to date there is no systematic evaluation of this remedy for IgAN. Methods We conducted a meta-analysis of all eligible randomized clinical trials (RCTs) to assess the effect of TwHF on IgAN for the first time. In August 2009 a systematic search was performed among eight electronic databases. Review Manager (RevMan) version 5.0 was used. Results (i) Four eligible RCTs with 188 participants were included; (ii) The validities of included RCTs were generally acceptable; (iii) TwHF brought about a favorable increase in complete remission (CR) (RR 1.53, 95%CI 1.09 to 2.16, I2=12%) and total remission (TR) (RR 1.27, 95%CI 1.08 to 1.48, I2=0%) compared with non-TwHF treatment; and this result was further confirmed by intention-to-treat analysis; (iv) Exploiting subgroup meta-analysis, TwHF led to significantly greater improvements of IgAN with non-nephrotic proteinuria with regard to the increase of CR (RR 1.80, 95%CI 1.21 to 2.68, I2=0%) and TR (RR 1.32, 95%CI 1.11 to 1.57, I2=0%), and decrease of urinary proteinuria excretion (UPE) (MD -467.41 mg/24h, 95%CI -633.99 to -300.82, I2=0%). Meanwhile, the renal function was well preserved (MD -2.66 μmol/L, 95%CI -9.26 to 3.94, I2=0%). Conclusion Although the results of this meta-analysis should be interpreted with caution and warrant further investigation, TwHF was certainly a valuable and promising immunosuppressive remedy for IgAN, which was in accordance with the accruing evidence from numerous large clinical and experimental studies.

Concurrent glomeruli and liver involvement in patients with Sjögren's syndrome (SS) has seldom been reported. Meanwhile, IgA nephropathy (IgAN) associated with SS is not as common as other types of glomerulonephritis, such as membranoproliferative glomerulonephritis (MPGN) and membranous nephropathy (MN). Two patients with SS and IgAN are presented. Case 1 was diagnosed as SS complicated with IgAN (Haas subclass III) and severe AIH, while case 2 was diagnosed as SS and IgAN (Haas subclass I) with serious tubulointerstitial lesions. The true prevalence of IgAN secondary to SS is certainly underestimated and the crucial pathogenetic factors may be polyclonal hypergammaglobulinemia and hypocomplementemia (especially C4). The frequent presence of multiple immunoglobulin and complement deposition in glomeruli, especially weak deposits of C4 and (or) C1q, is an immunofluorescence staining feature of IgAN secondary to SS and may be associated with disease severity and activity.

Using an acellular simulated body fluid (SBF), bone-like apatite can be formed on a variety of biomaterials, bioactive or bioinert, after these materials have undergone appropriate treatment(s). This biomimetic apatite-forming process is now applied to tissue engineering scaffolds in an attempt to make the scaffolds osteoconductive. In the current investigation, to form bone-like apatite on polymers such as poly(L-lactic acid) (PLLA) and poly(glycolic acid) (PGA) which degrade fast in aqueous environment, a solution (5SBF) of five times the ion concentrations of SBF was used so that an accelerated apatite formation could be achieved on PLLA and PGA. It was shown that indeed apatite could be formed on PLLA and PGA in 5SBF within 24 hours and that the apatite formed in 5SBF was similar in morphology and composition to that formed in the classical biomimetic process employing SBF or 2SBF. Results obtained in this investigation are very useful for producing osteoconductive scaffolds for bone tissue engineering.

In this paper, we investigated the Raman scattering and photoluminescence of Zn1-xMnxO nanowires synthesized by the vapor phase growth. The changes of E2(High) and A1(LO) phonon frequency in Raman spectra indicate that the tensile stress increases while the free carrier concentration decreases with the increase of manganese. The Raman spectra exited by the different lasers exhibit the quantum confinement effect of Zn1-xMnxO nanowires. The photoluminescence spectra reveal that the near band emission is affected by the content of manganese obviously. The values of IUV/G decrease distinctly with the manganese increase also demonstrate that more stress introduced with the more substitution of Mn for Zn.

The aims of the present study were to validate the differential diagnostic model of diabetic nephropathy (DN) and non-diabetic renal diseases (NDRD) established in 2003 and to establish a new diagnostic model suitable for the current clinical characteristics of DN.We examined 200 patients with Type 2 diabetes who underwent kidney biopsy from 2004 to 2012. The 2003 differential diagnostic model based on the data collected from 1993 to 2003 was evaluated by the diagnostic test and changes in the clinical differentiation parameters of DN and NDRD were analyzed. Logistic regression, receiver operating characteristics (ROC) curve, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) analysis were applied.The 2003 diagnostic model showed an accuracy of 77.5%. A significantly elevated incidence of hematuria, longer history of diabetes, and reduced level of glycated hemoglobin (HbA1c) were observed in the DN group from 2004 to 2012 compared with DN group from 1993 to 2003. Histories of diabetes mellitus (Dm), systolic blood pressure (Bp), HbA1c (Gh), hematuria (Hu), diabetic retinopathy (Dr), and hemoglobin (Hb) are independently related to DN. Thus, a new diagnostic model was constructed as follows: PDN = exp (0.846 + 0.022 Dm + 0.033Bp + 2.050 Gh-2.664 Hu-0.078 Hb + 2.942Dr)/[1 + exp (0.846 + 0.022 Dm + 0.033 Bp + 2.050 Gh-2.664 Hu-0.078 Hb + 2.942 Dr)].Validation tests determined that the accuracy of the new model were 90.9%.Changes in people with DN, clinical characteristics have reduced the diagnostic efficacy of the 2003 diagnostic model. The newly established model can provide a better, more current differentiation between DN and NDRD.

Background and Aim: Neutropenia is a serious adverse event for patients who are treated with cetuximab, an inhibitor of endothelial growth factor receptor. However, there is no consistent result of the relationship between cetuximab and neutropenia in randomized controlled trials (RCTs). We did a systematic review and meta-analysis of published RCTs to assess the overall risk of neutropenia associated with cetuximab. Methods: PubMed, Cochrane Central Register of Controlled Trials, EMBASE, and American Society of Clinical Oncology conferences were searched for relevant RCTs. Quantitative and qualitative analyses were carried out to evaluate the association between neutropenia and cetuximab. Both the fixed-effect model and random-effects model were used. Results: A total of 7186 patients with a variety of advanced cancers from 14 trials were included in our analysis. The overall incidence of neutropenia in patients receiving cetuximab was 33% (95% CI 26, 43). Patients treated with cetuximab had a significantly increased risk of neutropenia compared with patients treated with control medication, with a relative risk (RR) of 1.12 (95% CI 1.05, 1.19; fixed-effect model). Risk varied with tumor type. Higher risks were observed in patients with colorectal carcinoma (RR 1.17; 95% CI 1.04, 1.32; fixed-effect model) and non-small cell lung cancer (RR 1.07; 95% CI 0.99, 1.16; fixed-effect model). Conclusion: Cetuximab is associated with a significant risk of neutropenia in patients with advanced cancer receiving concurrent chemotherapy.

There is a paucity of published works that systematically evaluate gene anomalies or clinical features of patients with renal cysts and diabetes syndrome (RCAD)/maturity onset diabetes of the young type 5 (MODY5). The purpose of this review was to systematically assess the detection rate, genetic and phenotypic implications of heterozygous autosomal dominant TCF2 anomalies.MEDLINE database was searched to select articles recorded in English from 1997 to 2008. The focus was monoallelic germline TCF2 gene mutations/deletions. Biallelic inactivation, polymorphisms, DNA modification (hypomethylation and hypermethylation), loci associated with cancer risk, and somatic TCF2 anomalies were all excluded.After searching the literature, 50 articles were selected.The detection rate of TCF2 anomalies was 9.7% and varied considerably among MODY (1.4%), renal structure anomalies (RSA) (21.4%) and RSA with MODY (41.2%) subgroups. Mutations were strikingly located within the DNA binding domain and varied among exons of the DNA binding domain: exons 2 and 4 were the hottest spots, while mutations were sporadically distributed in exon 3. The consistent phenotypes were RSA (89.6%) and diabetes mellitus (DM) (45.0%). However, the concurrence of RSA and DM was relatively low (27.5%), which hinders the optimal performance of genetic testing and obtainment of timely diagnosis. Other organ involvements were complementary and necessary for the early identification of patients with TCF2 anomalies. Analysis of phenotypes of TCF2 point mutations showed significant differences in the detection rates of RSA, impaired renal function (IRF) and DM according to mutation type but not mutation location.These valuable features of TCF2 anomalies that previously did not receive sufficient attention should not be neglected.

This study first investigates the anti-metastatic effect of alpha-tomatine in the human lung adenocarcinoma cell line: A549. In this study, we first noted alpha-tomatine inhibited A549 cells invasion and migration by wound-healing assay and Boyden chamber assay. The data also showed alpha-tomatine could inhibit phosphorylation of Akt and extracellular signal-regulated kinase 1 and 2 (ERK1/2), which is involved in the up-regulating matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9) or urokinase-type plasminogen activator (u-PA), whereas it did not affect phosphorylation of c-Jun N-terminal kinase (JNK) and p38. Next, alpha-tomatine significantly decreased the nuclear levels of nuclear factor kappa B (NF-kappaB), c-Fos, and c-Jun. Also, treating A549 cells with alpha-tomatine also leads to a dose-dependent inhibition on the binding abilities of NF-kappaB and activator protein-1 (AP-1). Further, the treatment of inhibitors specific for PI3K (Wortmannin) or ERK (U0126) to A549 cells could cause reduced activities of MMP-2, MMP-9, and u-PA. These results showed alpha-tomatine could inhibit the metastatic ability of A549 cells by reducing MMP-2, MMP-9, and u-PA activities through suppressing phosphoinositide 3-kinase/Akt (PI3K/Akt) or ERK1/2 signaling pathway and inhibition NF-kappaB or AP-1 binding activities. These findings proved alpha-tomatine might be an anti-metastatic agent against human lung adenocarcinoma.

This study was aimed to explore the expression of survivin and NF-kappaB in the peripheral T-cell lymphoma and its significance. Immunohistochemistry method was used to detect the expressions of survivin and NF-kappaB in 26 cases of lymphosarcoma. 30 cases of benign reactive lymphohistiocytosis were selected as control tor analysis. The results showed that the expression of survivin in 21 patients with lymphoma was positive, the positive rate reached to 80.8%; the expression of NF-kappaB in 17 cases was positive, the positive rate reached to 65.4%. Compared with the control group, the difference was statistically significant (p0.01). In the experimental group, the expression level of survivin was positively correlated with the positive rate of NF-kappaB. It is concluded that survivin and NF-kappaB widely expressed in lymphoma cells and they play an important role in enhancing proliferation and inhibiting apoptosis of tumor cells.

To study the protective effects of beta-asarone on cultured rat cortical neurons damage induced by glutamate.The protective effects of beta-asarone on cultured rat cortical neurons after glutamate intoxication were observed with morphology, extent of damage, livability, Intracellular calcium concentration and apoptosis ratio.Morphological changes, LDH leakage and intracellular calcium concentration increasing, cell survival decreasing were observed in cultured rat cortical neurons exposured to glutamate; 7.5, 15, 30 microg/ml beta-asarone could increase cell survival, decrease LDH leakage and apoptosis ratio; 15, 30 microg/ml beta-asarone could reduce intracellular calcium concentration.The results suggest that beta-asarone prevents the toxicity of glutamate, and it maybe attribute to its effect of anticalcium.

To observe the effects of beta-asarone on the morphology and cell viability in PC12 cells and cultured neonate rat cortical neurons.The cultured neonate rat cortical neurocytes were stained immunocytochemically with NSE, GFAP antibodies, respectively; Morphological changes were observed under phase contrast microscope after PC12 cells and cultured rat cortical neurons with beta-asarone of different concentrationfor 24h in vitro, and the cell viability of PC12 and cortical neurons were examined by MTT assay.Most of the cultured neonate rat cortical neurocytes were positively stained with NSE antibody, and positively with GFAP in a less degree; Treatment of PC12 cells with concentrations of 7.5, 15, 30, 60 microg/ml beta-asarone for 24 h could facilitate the proliferation in PC12 cells, 120, 240, 480 microg/ml beta-asarone could inhibit the proliferation inversely, and with the concentration of beta-asarone increasing, the inhibition was enhanced; Treatment of cultured neonate rat cortical neurons with concentrations of 7.5, 15, 30, 60,120 nicrog/ml beta-asarone for 24 h, there were no visible effects on morphology and cell viability, 240 microg/ml beta-asarone could facilitate the proliferation obviously, but 480 microg/ml beta-asarone induced injury on neurons.beta-asarone maybe has anti-tumor and protective effects on cultured neurons.