Comparative Analysis of Large Language Models in Chinese Medical Named Entity Recognition.

The emergence of large language models (LLMs) has provided robust support for application tasks across various domains, such as name entity recognition (NER) in the general domain. However, due to the particularity of the medical domain, the research on understanding and improving the effectiveness of LLMs on biomedical named entity recognition (BNER) tasks remains relatively limited, especially in the context of Chinese text. In this study, we extensively evaluate several typical LLMs, including ChatGLM2-6B, GLM-130B, GPT-3.5, and GPT-4, on the Chinese BNER task by leveraging a real-world Chinese electronic medical record (EMR) dataset and a public dataset. The experimental results demonstrate the promising yet limited performance of LLMs with zero-shot and few-shot prompt designs for Chinese BNER tasks. More importantly, instruction fine-tuning significantly enhances the performance of LLMs. The fine-tuned offline ChatGLM2-6B surpassed the performance of the task-specific model BiLSTM+CRF (BC) on the real-world dataset. The best fine-tuned model, GPT-3.5, outperforms all other LLMs on the publicly available CCKS2017 dataset, even surpassing half of the baselines; however, it still remains challenging for it to surpass the state-of-the-art task-specific models, i.e., Dictionary-guided Attention Network (DGAN). To our knowledge, this study is the first attempt to evaluate the performance of LLMs on Chinese BNER tasks, which emphasizes the prospective and transformative implications of utilizing LLMs on Chinese BNER tasks. Furthermore, we summarize our findings into a set of actionable guidelines for future researchers on how to effectively leverage LLMs to become experts in specific tasks.

Role of Galectin-3 in intervertebral disc degeneration: an experimental study.

BACKGROUND: This study investigated the role of Galectin-3 in the degeneration of intervertebral disc cartilage. METHODS: The patients who underwent lumbar spine surgery due to degenerative disc disease were recruited and divided into Modic I, Modic II, and Modic III; groups. HE staining was used to detect the pathological changes in endplates. The changes of Galectin-3, MMP3, Aggrecan, CCL3, and Col II were detected by immunohistochemistry, RT-PCR, and Western blot. MTT and flow cytometry were used to detect cartilage endplate cell proliferation, cell cycle, and apoptosis. RESULTS: With the progression of degeneration (from Modic I to III), the chondrocytes and density of the cartilage endplate of the intervertebral disc decreased, and the collagen arrangement of the cartilage endplate of the intervertebral disc was broken and calcified. Meanwhile, the expressions of Aggrecan, Col II, Galectin-3, Aggrecan, and CCL3 gradually decreased. After treatment with Galectin-3 inhibitor GB1107, the proliferation of rat cartilage end plate cells was significantly reduced (P < 0.05). GB1107 (25 µmol/L) also significantly promoted the apoptosis of cartilage endplate cells (P < 0.05). Moreover, the percentage of cartilage endplate cells in the G1 phase was significantly higher, while that in the G2 and S phases was significantly lower (P < 0.05). Additionally, the mRNA and protein expression levels of MMP3, CCL3, and Aggrecan in rat cartilage end plate cells were lower than those in the control group. CONCLUSIONS: Galectin-3 decreases with the progression of the cartilage endplate degeneration of the intervertebral disc. Galectin-3 may affect intervertebral disc degeneration by regulating the degradation of the extracellular matrix.

K63 Ubiquitination of P21 Can Facilitate Pellino-1 in the Context of Chronic Obstructive Pulmonary Disease and Lung Cellular Senescence.

Chronic obstructive pulmonary diseases (COPD) is a kind of age-related, airflow-obstruction disease mostly caused by cigarette smoke. However, the relationship between COPD and lung cellular senescence is still not fully understood. Here, we found silencing Pellino-1 could inhibit the protein level of P21. Then, through constructing cell lines expressed ubiquitin-HA, we found that the E3 ubiquitin ligase Pellino-1 could bind to senescence marker p21 and modify p21 by K63-site ubiquitination by co-IP assays. Furthermore, we found that p21-mediated lung cellular senescence could be inhibited by silencing Pellino-1 in a D-galactose senescence mice model. Moreover, by constructing a COPD mouse model with shPellino-1 adenovirus, we found that silencing Pellino-1 could inhibit COPD and inflammation via reduction of SASPs regulated by p21. Taken together, our study findings elucidated that silencing E3 ligase Pellino-1 exhibits therapeutic potential for treatment to attenuate the progression of lung cellular senescence and COPD.

Saquayamycin B1 Suppresses Proliferation, Invasion, and Migration by Inhibiting PI3K/AKT Signaling Pathway in Human Colorectal Cancer Cells.

Moromycin B (Mor B), saquayamycin B1 (Saq B1), saquayamycin B (Saq B), and landomycin N (Lan N), four angucyclines produced by the marine-derived actinomycete Streptomyces sp., are a class of polyketone compounds containing benzanthracene. Here, the structure-activity relationship of these four compounds was analyzed in human colorectal cancer (CRC) cells. Saq B1, which showed the strongest cytotoxicity with an IC50 of 0.18-0.84 µM for CRC cells in MTT assays, was employed to test underlying mechanisms of action in SW480 and SW620 cells (two invasive CRC cell lines). Our results showed that Saq B1 inhibited CRC cell proliferation in a dose- and time-dependent manner. Notably, lower cytotoxicity was measured in normal human hepatocyte cells (QSG-7701). Furthermore, we observed proapoptosis, antimigration, and anti-invasion activities of Saq B1 in CRC cells. At the same time, the protein and mRNA expression of important markers related to the epithelial-mesenchymal transition (EMT) and apoptosis changed, including N-cadherin, E-cadherin, and Bcl-2, in Saq B1-treated CRC cells. Surprisingly, the PI3K/AKT signaling pathway was shown to be involved in Saq B1-induced apoptosis, and in inhibiting invasion and migration. Computer docking models also suggested that Saq B1 might bind to PI3Kα. Collectively, these results indicate that Saq B1 effectively inhibited growth and decreased the motor ability of CRC cells by regulating the PI3K/AKT signaling pathway, which provides more possibilities for the development of drugs in the treatment of CRC.

Natural Marine Products: Anti-Colorectal Cancer In Vitro and In Vivo.

Colorectal cancer, a malignant tumor with high mortality, has a poor prognosis due to drug resistance and toxicity in clinical surgery and chemotherapy. Thus, finding safer and more efficient drugs for clinical trials is vital and urgent. Natural marine compounds, with rich resources and original chemical structures, are applied widely in anticancer treatments. We provide a systematic overview of recently reported marine compounds such as alkaloids, peptides, terpenoids, polysaccharides, and carotenoids from in vitro, in vivo, and clinical studies. The in vitro studies summarized the marine origins and pharmacological mechanisms, including anti-proliferation, anti-angiogenesis, anti-migration, anti-invasion, the acceleration of cycle arrest, and the promotion of tumor apoptosis, of various compounds. The in vivo studies outlined the antitumor effects of marine compounds on colorectal cancer model mice and evaluated their efficacy in terms of tumor inhibition, hepatotoxicity, and nephrotoxicity. The clinical studies summarized the major chemical classifications and targets of action of the clinical drugs that have entered clinical approval and completed approval for marine anticancer. In summary, we present the current situation regarding the application of natural anti-colorectal cancer marine compounds and prospects for their clinical application.

Flexible Porous Silicon/Carbon Fiber Anode for High-Performance Lithium-Ion Batteries.

We demonstrate a cross-linked, 3D conductive network structure, porous silicon@carbon nanofiber (P-Si@CNF) anode by magnesium thermal reduction (MR) and the electrospinning methods. The P-Si thermally reduced from silica (SiO2) preserved the monodisperse spheric morphology which can effectively achieve good dispersion in the carbon matrix. The mesoporous structure of P-Si and internal nanopores can effectively relieve the volume expansion to ensure the structure integrity, and its high specific surface area enhances the multi-position electrical contact with the carbon material to improve the conductivity. Additionally, the electrospun CNFs exhibited 3D conductive frameworks that provide pathways for rapid electron/ion diffusion. Through the structural design, key basic scientific problems such as electron/ion transport and the process of lithiation/delithiation can be solved to enhance the cyclic stability. As expected, the P-Si@CNFs showed a high capacity of 907.3 mAh g-1 after 100 cycles at a current density of 100 mA g-1 and excellent cycling performance, with 625.6 mAh g-1 maintained even after 300 cycles. This work develops an alternative approach to solve the key problem of Si nanoparticles' uneven dispersion in a carbon matrix.

Actinomycin V Induces Apoptosis Associated with Mitochondrial and PI3K/AKT Pathways in Human CRC Cells.

Actinomycin (Act) V, an analogue of Act D, presented stronger antitumor activity and less hepatorenal toxicity than Act D in our previous studies, which is worthy of further investigation. We hereby report that Act V induces apoptosis via mitochondrial and PI3K/AKT pathways in colorectal cancer (CRC) cells. Act V-induced apoptosis was characterized by mitochondrial dysfunction, with loss of mitochondria membrane potential (MMP) and cytochrome c release, which then activated cleaved caspase-9, cleaved caspase-3, and cleaved PARP, revealing that it was related to the mitochondrial pathway, and the apoptotic trendency can be reversed by caspase inhibitor Z-VAD-FMK. Furthermore, we proved that Act V significantly inhibited PI3K/AKT signalling in HCT-116 cells using cell experiments in vitro, and it also presented a potential targeted PI3Kα inhibition using computer docking models. Further elucidation revealed that it exhibited a 28-fold greater potency than the PI3K inhibitor LY294002 on PI3K inhibition efficacy. Taken together, Act V, as a superior potential replacement of Act D, is a potential candidate for inhibiting the PI3K/AKT pathway and is worthy of more pre-clinical studies in the therapy of CRC.

Resistomycin Induced Apoptosis and Cycle Arrest in Human Hepatocellular Carcinoma Cells by Activating p38 MAPK Pathway In Vitro and In Vivo.

Resistomycin, a quinone-related natural antibiotic, has shown strong inhibitory activity against human hepatocellular carcinoma (HCC) in vitro. Here, we investigated the role of p38 MAPK in the pro-apoptotic and G2/M phase arrest action of HCC HepG2 cells upon treatment with resistomycin in vitro and in vivo. Our results showed that resistomycin dose- and time-dependently reduced the viability of HepG2 cells and also showed lower cytotoxicity in normal human kidney cells (293T) and hepatocyte cells (HL-7702). Resistomycin treatment induced apoptosis and cell cycle arrest in HepG2 cells, accompanied by changes in the expression of related proteins, including Bax, Cyclin B1, etc. Surprisingly, resistomycin-mediated apoptotic cell death and cell cycle arrest were impeded by SB203580 (an inhibitor of p38 catalytic activity), suggesting that p38 MAPK signaling may play an important role that impedes eventual cell death. In this connection, data in vitro and in vivo demonstrated that resistomycin increased the phosphorylation of p38 and MAPKAPK-2 in HepG2 cells. Furthermore, we provided evidence that p38 signaling is involved in resistomycin-induced p38 MAPK pathway effects in HCC, using computer docking models. Our study indicated that resistomycin activates the p38 MAPK signaling pathway by which the growth of HepG2 cells is suppressed for apoptosis and G2/M phase arrest in vitro and in vivo, and it is a promising therapeutic leading compound for drug development in HCC treatment.

Flexible Carbon Nanotubes Confined Yolk-Shelled Silicon-Based Anode with Superior Conductivity for Lithium Storage.

The further deployment of silicon-based anode materials is hindered by their poor rate and cycling abilities due to the inferior electrical conductivity and large volumetric changes. Herein, we report a silicon/carbon nanotube (Si/CNT) composite made of an externally grown flexible carbon nanotube (CNT) network to confine inner multiple Silicon (Si) nanoparticles (Si NPs). The in situ generated outer CNTs networks, not only accommodate the large volume changes of inside Si NPs but also to provide fast electronic/ionic diffusion pathways, resulting in a significantly improved cycling stability and rate performance. This Si/CNT composite demonstrated outstanding cycling performance, with 912.8 mAh g-1 maintained after 100 cycles at 100 mA g-1, and excellent rate ability of 650 mAh g-1 at 1 A g-1 after 1000 cycles. Furthermore, the facial and scalable preparation method created in this work will make this new Si-based anode material promising for practical application in the next generation Li-ion batteries.

The Positive Effect of ZnS in Waste Tire Carbon as Anode for Lithium-Ion Batteries.

There is great demand for high-performance, low-cost electrode materials for anodes of lithium-ion batteries (LIBs). Herein, we report the recovery of carbon materials by treating waste tire rubber via a facile one-step carbonization process. Electrochemical studies revealed that the waste tire carbon anode had a higher reversible capacity than that of commercial graphite and shows the positive effect of ZnS in the waste tire carbon. When used as the anode for LIBs, waste tire carbon shows a high specific capacity of 510.6 mAh·g-1 at 100 mA·g-1 with almost 97% capacity retention after 100 cycles. Even at a high rate of 1 A·g-1, the carbon electrode presents an excellent cyclic capability of 255.1 mAh·g-1 after 3000 cycles. This high-performance carbon material has many potential applications in LIBs and provide an alternative avenue for the recycling of waste tires.

Combined use of intravenous and topical tranexamic acid efficiently reduces blood loss in patients aged over 60 operated with a 2-level lumbar fusion.

PURPOSE: The current study was conducted to assess the efficacy and safety of the intravenous (IV) administration combined with topical administration of tranexamic acid (TXA)in patients (aged over 60) scheduled for a 2-level lumbar fusion surgery. METHODS: Two hundred eighty patients scheduled for a 2-level lumbar fusion surgery were randomized into four groups, including an IV group, a local group, a combined group, and a control group. Patients in the combined group, in the IV group, in the topical group, and in the control group were administrated with 15 mg/kg of IV-TXA + 2 g TXA in local, 15 mg/kg IV-TXA, 2 g TXA in local, and 100 ml IV, respectively. The results of total blood loss (TBL), maximum hemoglobin drop, the transfusion rate, and the number of allogeneic blood units were compared. Deep venous thrombosis (DVT) and pulmonary embolism (PE) events were monitored and recorded. RESULTS: The TBL was 635.49 ± 143.60, 892.62 ± 166.85, 901.11 ± 186.25, and 1225.11 ± 186.25 mL for the combined group, the IV group, the topical group, and the control group, respectively (p = 0.015, p = 0.001, respectively). The average maximum hemoglobin drop in the four above groups was 2.18 ± 0.24, 2.80 ± 0.37, 2.40 ± 0.64, and 3.40 ± 1.32 g/dL, respectively. No PE event was reported during the follow-up. Although asymptomatic DVT events were reported by 1, 2, and 2 patients in the combined group, topical group, and control group, respectively, there is no intergroup difference. CONCLUSIONS: The combined use of TXA effectively reduced the total blood loss and blood transfusion rate in patients aged over 60 scheduled for a 2-level lumbar fusion, without increasing the incidence of DVT and PE formation.

Low-cost urchin-like silicon-based anode with superior conductivity for lithium storage applications.

Poor rate and cycling performance are the most critical drawbacks for Si-based anodes on account of their inferior conductivity and colossal volumetric expansion during lithiation/delithiation. Here we report the fabrication of structurally-integrated urchin-like Si anode, which provides prominent structural stability and distinguished electron and ion transmission pathways for lithium storage. The inexpensive solid Si waste from organosilane industry after acid-washed and further ball-milling serves as the pristine Si-source in this work. Carbon nanotubes (CNTs) are in-situ grown outside Si microparticles, resulting in an urchin-like structure (Si/CNTs). The optimized Si/CNTs presents ascendant invertible capacity and rate performance, achieving up to 920 mAh g-1 beyond 100 cycles at 100 mA g -1, and a capacity of 606.2 mAh g-1 at 1 A g -1 after long cycling for 1000 cycles. The proposed scalable synthesis can be adopted to advance the performance of other electrode materials with inferior conductivity and enormous volume expansions during cycling.

Comparative Transcriptional Profiling and Physiological Responses of Two Contrasting Oat Genotypes under Salt Stress.

Salinity is one of the major abiotic factors that affect productivity in oat. Here, we report a comparison of the transcriptomes of two hexaploid oat cultivars, 'Hanyou-5' and 'Huazao-2', which differ with respect to salt tolerance, in seedlings exposed to salt stress. Analysis of the assembled unigenes from the osmotically stressed and control libraries of 'Hanyou-5' and 'Huazao-2' showed that the expression of 21.92% (36,462/166,326) of the assembled unigenes was differentially regulated in the two cultivars after different durations of salt stress. Bioinformatics analysis showed that the main functional categories enriched in these DEGs were "metabolic process", "response to stresses", "plant hormone signal transduction", "MAPK signalling", "oxidative phosphorylation", and the plant-pathogen interaction pathway. Some regulatory genes, such as those encoding MYB, WRKY, bHLH, and zinc finger proteins, were also found to be differentially expressed under salt stress. Physiological measurements also detected significant differences in the activities of POD (76.24 ± 1.07 Vs 81.53 ± 1.47 U/g FW) in the two genotypes in response to osmotic stress. Furthermore, differential expression of 18 of these genes was successfully validated using RNA-seq and qRT-PCR analyses. A number of stress-responsive genes were identified in both cultivars, and candidate genes with potential roles in the adaptation to salinity were proposed.

Facile and Scalable Approach To Fabricate Granadilla-like Porous-Structured Silicon-Based Anode for Lithium Ion Batteries.

A porous silicon and carbon composite (PSi/C) with granadilla-like structure as an anode material for lithium-ion batteries has been easily fabricated by spray drying and subsequent pyrolysis treatments. For the PSi/C, yolk-shell-structured Si/C nanobeads are equably distributed inside the porous carbon framework. The key point of this work is the combination of the advantages of both the yolk-shell structure and porous structure in one system. The void space inside the yolk-shell Si/C nanobeads and the interconnected three-dimensional porous carbon frameworks can effectively enhance the cyclic stability and conductivity of this composite. As expected, PSi/C with 15.4% silicon content exhibited a specific capacity as high as 1357.43 mAh g-1 and retained 933.62 mAh g-1 beyond 100 cycles at 100 mA g-1. Moreover, it showed a reversible specific capacity as high as 610.38 mAh g-1 at 1000 mA g-1, even after 3000 cycles.

Toward Aerogel Electrodes of Superior Rate Performance in Supercapacitors through Engineered Hollow Nanoparticles of NiCo2O4.

A biomass-templated pathway is developed for scalable synthesis of NiCo2O4@carbon aerogel electrodes for supercapacitors, where NiCo2O4 hollow nanoparticles with an average outer diameter of 30-40 nm are conjoined by graphitic carbon forming a 3D aerogel structure. This kind of NiCo2O4 aerogel structure shows large specific surface area (167.8 m2 g-1), high specific capacitance (903.2 F g-1 at a current density of 1 A g-1), outstanding rate performance (96.2% capacity retention from 1 to 10 A g-1), and excellent cycling stability (nearly without capacitance loss after 3000 cycles at 10 A g-1). The unique structure of the 3D hollow aerogel synergistically contributes to the high performance. For instance, the 3D interconnected porous structure of the aerogel is beneficial for electrolyte ion diffusion and for shortening the electron transport pathways, and thus can improve the rate performance. The conductive carbon joint greatly enhances the specific capacity, and the hollow structure prohibits the volume changes during the charge-discharge process to significantly improve the cycling stability. This work represents a giant step toward the preparation of high-performance commercial supercapacitors.

New Approach to Create TiO2(B)/Carbon Core/Shell Nanotubes: Ideal Structure for Enhanced Lithium Ion Storage.

To achieve uniform carbon coating on TiO2 nanomaterials, high temperature (>500 °C) annealing treatment is a necessity. However, the annealing treatment inevitably leads to the strong phase transformation from TiO2(B) with high lithium ion storage (LIS) capacity to anatase with low LIS one as well as the damage of nanostructures. Herein, we demonstrate a new approach to create TiO2(B)/carbon core/shell nanotubes (C@TBNTs) using a long-chain silane polymethylhydrosiloxane (PMHS) to bind the TBNTs by forming Si-O-Ti bonds. The key feature of this work is that the introduction of PMHS onto TBNTs can afford TBNTs with very high thermal stability at higher than 700 °C and inhibit the phase transformation from TiO2(B) to anatase. Such a high thermal property of PMHS-TBNTs makes them easily coated with highly graphitic carbon shell via CVD process at 700 °C. The as-prepared C@TBNTs deliver outstanding rate capability and electrochemical stability, i.e., reversible capacity above 250 mAh g(-1) at 10 C and a high specific capacity of 479.2 mAh g(-1) after 1000 cycles at 1 C. As far as we know, the LIS performance of our sample is the highest among the previously reported TiO2(B) anode materials.

Nanostructured Si-Based Anodes for Lithium-Ion Batteries.

High capacity electrode materials are searched for commercial applications due to the increase in energy density and power density requirements for lithium-ion secondary cells. Silicon has triggered significant research effort because of its low Li-uptake potential and the high theoretical capacity. However, volume changes during cycling cause pulverization and capacity fade, which is an obstacle of the application of silicon as an anode. Here we present a review of research progress on silicon-based anode materials for lithium-ion batteries, focusing on the effects of the morphology and compound on the electrochemical properties. The reasons of poor cycle performance are discussed. It is pointed out that to control the huge volume change and solid electrolyte interface growth during cycling is an effective way to improve the cycle performance. Outlook for the future development of silicon-based composite anode materials for the application of silicon anodes are finally outlined.

[Using of transforaminal lumbar interbody fusion in lumbar revision surgery].

OBJECTIVE: To analyze the effectiveness of transforaminal lumbar interbody fusion (TLIF) for failed back surgery syndrome (FBSS). METHODS: Between October 2003 and December 2007, 36 patients with FBSS were treated with TLIF. There were 19 males and 17 females with an average age of 52.6 years (range, 46-68 years) and an average disease duration of 1.6 years (range, 3 months-15 years). Of 36 patients, reoperation was performed in 25, 10 received 3 operations, and 1 had 5 operations. A total of 50 segments were involved in fusion, including L4,5 in 12 cases, L5, S1 in 10 cases, L3, 4 and L4, 5 double segments in 8 cases, and L4, 5 and L5, S1 double segments in 6 cases. According to X-ray films, CT, and MRI examination, 12 patients were diagnosed as having lumbar instability secondary to total laminectomy, 18 as having recurrence of lumbar disc protrusion, and 6 as having recurrence of lumbar spondylolisthesis. RESULTS: Dural rupture occurred in 1 case and was repaired by suturing without cerebrospinal fluid leakage was observed; 1 had deep incision infection of Staphylococcus; and 1 had transient single irritation sign because of hematoma formation and was cured after symptomatic treatment. The other incisions healed by first intention. No patients had permanent nerve injury or deterioration. Thirty-three cases were followed up 18-72 months (mean, 35.2 months). At 12 months, all the operated segments reached interbody fusion, and no breakage of screw or Cage dislocation occurred. Japanese Orthopaedic Association (JOA) scores showed significant difference (t = 2.45, P = 0.01) between before operation (14.2 +/- 4.1) and 18 months after operation (23.9 +/- 2.6). The rate of clinical improvement was 90.9% (23 cases of excellent, 7 cases of good, 3 cases of acceptable). CONCLUSION: The TLIF simplifies the manipulation of lumbar revision surgery and decreases the operation risk and the operative complications for the treatment of FBSS.

Fabrication of highly-ordered nanopatterned copper nanowire arrays by photolithography.

Two different patterns, one being circular and the other being QDU, of copper (Cu) nanowire arrays were successfully produced by electrochemical deposition and photolithography. The highly-ordered patterns of Cu nanowire arrays were observed to stand freely on the substrate using scanning electron microscopy (SEM). Chemical analyses have been performed on Cu nanowires using energy dispersive X-ray spectroscopy (EDS). The results confirmed that it is mainly composed of Cu. Selected-area electron diffraction (SAED) pattern indicated the nanowires are single crystalline and the growth direction of the nanowires is along the [220] direction. With the deposition time increasing, the length of Cu nanowires increaseed.

[Anterior cervical discectomy and fusion in the treatment of Hangman's fracture].

OBJECTIVE: To evaluate the efficacies and features of treating Hangman's fracture by anterior cervical discectomy and fusion (ACDF). METHODS: Since June 2005 to December 2008, 36 cases with Hangman's fracture were analyzed with their clinical data including history, symptoms, signs, radiological findings and treatments. According to the classification system designed by Levine and Edwards depending on the radiological manifestations of Hangman's fractures, they were subdivided into type I (n = 9) (conservative therapy), type II (n = 17) and type IIA (n = 10). Conservative therapy was offered to type I in 9 cases, while ACDF with cervical gear protection for 4 weeks after surgery was performed to type II in 17 cases and type IIA in 10 cases. A combination of operation time, days of hospitalization, complications, neurological improvement and fusion rate was assessed. RESULTS: An average follow-up of 15 months (range: 10 - 36) was achieved. No vertebral redisplacement and angulation deformity occurred. Axial pain was relieved in each case. The preoperative neurological deficits in all patients got improvements. No spinal cord injury, vertebral artery injury or cerebrospinal fluid leakage occurred. No complication related to internal fixator was found. Average operative time and hospitalization were similar to those of ACDF for lower cervical spine (98 minutes vs. 9 days). Fusion was achieved within 6 months in all cases. CONCLUSION: ACDF at C2-C3 may be an effective and safe way to treat Hangman's fracture.