BackgroundFew studies have been reported the potential role of N6-methyladenosine (m6A) modification in osteoarthritis (OA). We investigated the patterns of m6A modification in the immune microenvironment of OA.MethodsWe evaluated the m6A modification patterns based on 22 m6A regulators in 139 OA samples and systematically associated these modification patterns with immune cell infiltration characteristics. The function of m6A phenotype-related differentially expressed genes (DEGs) was investigated using gene enrichment analysis. An m6A score model was constructed using principal component analysis (PCA), and an OA prediction model was established based on the key m6A regulators. We used real-time PCR analysis to detect the changes of gene expression in the cell model of OA.ResultsHealthy and OA samples showed significant differences in the expression of m6A regulators. Nine key m6A regulators, two m6A modification patterns, m6A-related genes and two gene clusters were identified. Some m6A regulators had a strong correlation with each other. Gene clusters and m6A clusters have high similarity, and cluster A corresponds to a high m6A score. Immunocytes infiltration differed significantly between the two clusters, with the m6A cluster B and gene cluster B having more types of infiltrating immunocytes than cluster A. The predictive model can also predict the progression of OA through m6A regulators expression. The results of real-time PCR analysis showed that the gene expression in the cell model of OA is similar to that of the m6A cluster B.ConclusionsOur study reveals for the first time the potential regulatory mechanism of m6A modification in the immune microenvironment of OA. This study also sheds new light on the pathogenesis of OA.
Purpose
Moderate‐to‐severe postoperative pain remains a challenge for both patients and surgeons after anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to systematically review the current evidence in the literature to compare adductor canal block (ACB) with femoral nerve block (FNB) in the treatment of ACLR.
Methods
A comprehensive search of the published literature in PubMed, Scopus, EMBASE, and Cochrane Library databases was performed. Only English randomized clinical trials (RCTs) were included in this study. The primary outcome was pain score. Secondary outcome measures included opioid consumption, postoperative adverse events, patient satisfaction, and quadriceps strength.
Results
Eight RCTs with a total of 587 patients were included. No statistically
significant difference was observed between the ACB and FNB groups in pain scores at 6 h, 12 h, 24 h, or 48 h; cumulative opioid consumption at 24 h or 48 h; patient satisfaction at 24 or 48 h; and postoperative adverse event. However, ACB showed superior quadriceps strength in the early postoperative period.
Conclusions
Both treatments provided similar overall pain relief after ACLR. The
potential benefits of quadriceps preservation with ACB are worthy of future study.
Therefore, ACB is recommended as an attractive alternative to FNB as the peripheral nerve block of choice for ACLR.
Level of evidence
Meta‐analysis of Level 1 was performed in this study.
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