Dose-dependent effects of lanthanum chloride on wear particle-induced aseptic inflammation in a murine air-pouch model

To investigate the effects of local injection of different doses of lanthanum chloride （LaCl3） on aseptic inflammation in mice stimulated by wear particles from artificial joints, the particles were prepared by vacuum ball mill in vitro and air-pouch models were performed with 45 male BALB/c mice that were randomly divided into blank control group, wear particle group and wear parti- cle ＋ LaCl3 （0.1, 0.9 and 8.1 μmol） group. All animals were sacrificed and tissue specimens were harvested 7 days after treatment. Hematoxylin and eosin （H＆E） staining, enzyme-linked immunosorbent assay （ELISA）, reverse transcription-polymerase chain reac- tion （RT-PCR） and western blot were applied to observe inflammatory reaction and detect the expression of pro-inflammatory cyto- kines （TNF-et, IL-1β） and nuclear factor-κB （NF-κB） in mRNA and protein levels in air-pouch membrances. The results showed that wear particles could stimulate aseptic inflammation in vivo effectively; 0.9 μmol LaCl3 could significantly inhibit wear parti- cle-induced gene and protein expression of pro-inflammatory cytokines and NF-Id3 （P〈0.05）; 0.1 and 8. 1 μmol LaCl3 did not exert an inflammation-inhibiting effect and even caused adverse effects at 8.1 μmol. In conclusion, LaC13 played a protective role against wear particle-induced aseptic inflammation dose-dependently, which was involved in NF-κB related signaling pathways.

Continuous epidural block of the cervical vertebrae for cervicogenic headache

Background Cervicogenic headache （CEH） is caused by a structural abnormality in the cervical spine. Available treatments for CEH include medical therapy, local botulinum toxin injection, cervical epidural corticosteroid injection, and surgery. The objective of this study was to investigate the safety and efficacy of a continuous epidural block of the cervical vertebra. Methods Medical records were retrospectively analyzed for 37 patients diagnosed with CEH treated by a continuous epidural block of the cervical vertebra with lidocaine, dexamethasone, and saline （5 ml/min） for 3-4 weeks and triamcinolone acetonide 5 mg once weekly for 3-4 weeks. Pain was measured via the visual analogue scale （VAS） in combination with quality of life assessment. Outcome measures were patient-reported days with mild or moderate pain, occurrence of severe pain, and the daily oral dosages of non-steroidal anti-inflammatory drug use （NSAID）. Results In the 3 months immediately preceding placement of the epidural catheter, the mean number of days with mild or moderate pain was 22.0±4.3. The mean occurrence of severe pain was （3.20±0.75） times and the mean oral dosage of NSAID was （1267±325） mg. During the first 6 months after epidural administration of lidocaine and corticosteroids, the mean number of days with mild or moderate pain, the mean occurrence of severe pain, and the mean daily oral dosages of NSAIDs were significantly decreased compared to 3-month period immediately preceding treatment （P 〈0.01）. By 12 months post-treatment, no significant difference in these three outcome measures was noted. Conclusions Continuous epidural block of the cervical vertebra for patients with CEH is effective for at least six months. Further research is needed to elucidate mechanisms of action and to prolong this effect.