Objective To explore the development of new formulations new pharmaceutical cocrystal by combining hot melt extrusion and 3D printing technologies.Methods The insoluble drug ibuprofen and nicotinamide were selected as model drugs,and hot melt extrusion was applied to extrude ibuprofen-nicotinamide cocrystal by regulating the processing temperature,screw speed and residence time,etc.Hot-stage polarized light microscopy,powder X-ray diffraction,differential scanning calorimetry,Fourier transform infrared spectroscopy,and Raman spectroscopy were used for characterization analysis.The process research was carried out by investigating properties such as eutectic particle size and distribution,angle of repose,and vibrational solidity density.On this basis,two 3D printing techniques,fused deposition molding and selective laser sintering type,were selected for pharmaceutical cocrystal loaded sheet printing.Results A new formulation of pharmaceutical cocrystal tablets loaded with ibuprofen-nicotinamide was successfully printed through the combined application of hot-melt extrusion and 3D printing technologies.Conclusions Combined process of hot melt extrusion and 3D printing technology in the field of developing new pharmaceutical cocrystal formulations,laying the material foundation and scientific support for the development of new pharmaceutical cocrystal formulations with personalized and programmable release on demand.

Objective To explore the development of new formulations new pharmaceutical cocrystal by combining hot melt extrusion and 3D printing technologies.Methods The insoluble drug ibuprofen and nicotinamide were selected as model drugs,and hot melt extrusion was applied to extrude ibuprofen-nicotinamide cocrystal by regulating the processing temperature,screw speed and residence time,etc.Hot-stage polarized light microscopy,powder X-ray diffraction,differential scanning calorimetry,Fourier transform infrared spectroscopy,and Raman spectroscopy were used for characterization analysis.The process research was carried out by investigating properties such as eutectic particle size and distribution,angle of repose,and vibrational solidity density.On this basis,two 3D printing techniques,fused deposition molding and selective laser sintering type,were selected for pharmaceutical cocrystal loaded sheet printing.Results A new formulation of pharmaceutical cocrystal tablets loaded with ibuprofen-nicotinamide was successfully printed through the combined application of hot-melt extrusion and 3D printing technologies.Conclusions Combined process of hot melt extrusion and 3D printing technology in the field of developing new pharmaceutical cocrystal formulations,laying the material foundation and scientific support for the development of new pharmaceutical cocrystal formulations with personalized and programmable release on demand.

Objective To observe the curative effect of cervicogenic headache(CEH)treatment through the combination of pulse radio frequency(PRF)on the C2 dorsal rootganglion and continuous epidural space block.Methods Sixty patients with CEH in our hospital were randomly divided into groups A and B,30 cases in each group.The group A was treated with combination of PRF on cervical dorsal root ganglion and continuous epidural space block.The group B was treated with PRF on cervical dorsal root ganglion method.The pain VAS scores before treatment and at 1 week,3,6 months after treatment were compared between the two groups.Results Compared with pretreatment,the VSA scores at 1 week,3,6 wonths after treatment in the two groups had statistical difference(P＜0.05),moreover,the VAS score decrease in the group A was better than the group B.All the patients had no nerve and artery injury or infection complications.Conclusion It is safe and effective to treat cervical CEH through the combination of ganglion PRF on the cervical 2 dorsal root and continuous epidural space block.

Objective To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) combined with gabapentin for treatment of recurrent pain after trigeminal radiofrequency thermocoagulation.Methods Forty patients of both sexes suffering from recurrent pain after trigeminal radiofrequency thermocoagulation,who refused surgical treatment,aged 45-80 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with visual analog scale score ≥4,with the course of recurrent pain 0.5-17.0 months,were randomized into 2 groups (n =20 each) using a random number table:gabapentin group (group A) and gabapentin plus rTMS group (group B).The patients were treated with 2 courses of rTMS in total (5 days for 1 course,1 time per day) and with the second course at a 2-day interval in group B.Effective analgesia and pain relief were recorded within 6 months after treatment,and the therapeutic efficacy was evaluated according to the modified Macnab criteria.The daily consumption of gabapentin and development of rTMS-and gabapentin-related adverse reactions were recorded.Results No rTMS-related adverse reactions were found in group B.Compared with group A,the rates of effective analgesia and pain relief were significantly increased,the therapeutic efficacy was enhanced,the daily consumption of gabapentin was decreased,and the incidence of gabapentin-related adverse reactions was decreased in group B (P＜0.05).Conclusion Combination of rTMS and gabapentin produces better efficacy than gabapentin alone when used to treat the recurrent pain after trigeminal radiofrequency thermocoagulation,and the safety is good.

Objective To observe the effect of external application of monascus on ecchymosis caused by ablative treatment.Methods Totally 60 patients with ecchymosis caused by ablative treatment were randomly divided into the experimental group and the control group,with 30 cases in each group. All patients received cold and dry compress on the first day. On the second day,patients in the experimental group was treated with external application of monascus,while patients in the control group received hot and dry compress, and a course of treatment included 3 days. The curative effect of two groups were compared.Results The total effective rate of experimental group(100.00%)was higher than that of control group(6.67%)(χ2=24.78, P<0.01).ConclusionsThe curative effect of external application of monascus on ecchymosis caused by ablative treatment is significant in clinical treatment. Besides,this treatment is cheap and simple,and it can be widely used in clinical practice.

Objective To investigate the relationship between electrical stimulus intensity and postopera-tive complications of puncture trigeminal ganglion radiofrequency thermocoagulation (PTGRT). Methods 86 pa-tients with trigeminal neuralgia (TN) on the second and the third branch underwent trigeminal ganglion radiofre-quency thermocoagulation in Xuanwu Hospital , Capital Medical University from June 2013 to December 2015 enrolled in this study. Electrical stimulus intensity in surgery and postoperative pain VAS score , numbness score, masseter muscles score and complications were recorded at 0, 24 and 48 hours post-surgery. Correlations among electrical stimulus intensity in surgery and postoperative pain VAS score,numbness score, masseter mus-cles score were analyzed. Result The 86 patients had different degrees of facial numbness , some patients had different degrees of masseter weakness , and 2 patients had mild sialorrhea in two days after PTGRT without serve complications. Eighty-three patients (96.51%) had no pain, and VAS score wass 0 at 0, 24 and 48 hours post-PTGRT. Electrical stimulus intensity in surgery had apparent negative correlation with numbness score at 0 , 24 and 48 hours popst-PTGRT (P < 0.01), with negative correlation with masseter muscles decreasing at 48 hours post-PTGRT (P < 0.05). Conclusion Suitable temperature and time in PTGRT were needed to be chose ac-cording to the electrical stimulus intensity.

Objective To evaluate the efficacy of Disposcope endoscope for tracheal intubation in patients with difficult glottis exposure.Methods Sixty adult patients of both sexes,aged 22-68 yr,scheduled for elective oro-tracheal intubation under general anesthesia,whose glottis was not visible under Macintosh laryngoscope (grade Ⅲ or according to Cormach-Lehane Grading of laryngoscopic view),were randomized into 2 groups (n =30 each) using a random number table:group Macintosh laryngoscope-assisted Disposcope endoscope (group DM) and group Disposcope endoscope (group D).The glottis exposure condition and time,intubation condition and time,assisted lifting mandible,laryngeal mucosa bleeding and postoperative sore throat and hoarseness were recorded.Results The success rate of intubation at second attempt achieved 100％ in the two groups.Compared with group DM,the incidence of assisted lifting mandible was decreased,and no significant changes were found in the success rate of glottis exposure,glottis exposure time,intubation time,success rate of intubation at first attempt,incidence of laryngeal mucosa bleeding,and postoperative sore throat and hoarseness in group D.Conclusion Disposcope endoscope can improve the condition for tracheal intubation significantly after lifting mandible in patients with difficult glottis exposure.

Radiofrequency thermocoagulation(RFT)of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia(CTN).In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia(MTN).Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February 2009.Thirty patients had CTN,and 27 had MTN.Outcomes were measured by using the visual analog pain scale(VAS)and patients' reports of quality of life(QOL),medication usage,and complications over a follow-up period of up to 3 years.Our results showed that the patients with MTN were younger,tended to have bilaterial involvement of the first division,and were unresponsive to treatment.All surgeries were completed smoothly.About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT.The VAS scores were significantly higher in the CTN group than in MTN group(P<0.05).Kaplan-Meier curves showed that 1-year,2-year,and 3-year pain relief rates were 76.7%,73.3%,and 73.3% in the CTN group and 46.6%,41.4%,and 41.4% in the MTN group,respectively.The rates of pain relief for both groups leveled off at 2 years.Complications included numbness,dysesthesia,and anesthesia dolorosa.RFT did not cause any deaths and complications were low.The treatment was very effective for CTN and,to some degrees,effective for MTN.If numbness,dysesthesia,and anesthesia dolorosa are limited to the trigger area,QOL will be greatly improved.

Radiofrequency thermocoagulation (RFT) of the gasserian ganglion is a routine and effective technique for the treatment of classical trigeminal neuralgia (CTN). In this study we compared its efficacy in patients with CTN and atypically symptomatic or mixed trigeminal neuralgia (MTN). Fifty-seven patients were treated with RFT for trigeminal neuralgia from June 2006 to February 2009. Thirty patients had CTN, and 27 had MTN. Outcomes were measured by using the visual analog pain scale (VAS) and patients' reports of quality of life (QOL), medication usage, and complications over a follow-up period of up to 3 years. Our results showed that the patients with MTN were younger, tended to have bilaterial involvement of the first division, and were unresponsive to treatment. All surgeries were completed smoothly. About 86.7% CTN patients and 48.1% MTN patients responded immediately to RFT. The VAS scores were significantly higher in the CTN group than in MTN group (P<0.05). Kaplan-Meier curves showed that 1-year, 2-year, and 3-year pain relief rates were 76.7%, 73.3%, and 73.3% in the CTN group and 46.6%, 41.4%, and 41.4% in the MTN group, respectively. The rates of pain relief for both groups leveled off at 2 years. Complications included numbness, dysesthesia, and anesthesia dolorosa. RFT did not cause any deaths and complications were low. The treatment was very effective for CTN and, to some degrees, effective for MTN. If numbness, dysesthesia, and anesthesia dolorosa are limited to the trigger area, QOL will be greatly improved.

A growing body of research concerns about the mental psychological intervention involved in the treatment of chronic pain. It still continue reported that combining with mental psychological intervention in pain management could relieve pain level, therefore improve quality of lives. Common psychological intervention including psychological and pharmacological approach and psychological behavior approach both support their efficacy