Circadian Rhythm Disorders, Clock Gene, Exosomes, General Anesthesia, Postoperative Delirium
Conditions
Keywords
Postoperative Delirium, general anesthesia, Exosomes, clock gene, Circadian Rhythm Disorders
Brief summary
Postoperative cognitive dysfunction (POCD) is a common postoperative complication in patients aged 65 and over, which refers to cognitive function changes such as memory decline and attention deficit after anesthesia and surgery. In severe cases, personality changes and social behavior decline may also occur, resulting in irreversible cognitive impairment.Previous studies have suggested that cognitive dysfunction after general anesthesia is linked to a genetic disorder of the body clock.Exosomes are cellular forms of cellular microvesicles containing complex RNA and proteins.Exosomes can mediate the expression of genes in the late transcriptional period of the clock system, and directly or indirectly participate in the negative regulation of rhythm expression of minute control genes, playing an important role in the intercellular circadian rhythm information output pathway.Rhythm disorders in the core biological clock system of urinary exosomes and the clock control genes related to kidney can early indicate circadian rhythm changes in the core biological clock system.The sorting and detection of urinary exosome clock information materials in patients has the advantages of easy access, continuous monitoring, early diagnosis and less damage, making urinary exosome a biomarker for the diagnosis and monitoring of circadian rhythm of a good kidney biological clock system.
Interventions
OTHERreceiving general anesthesia
patients receiving surgery under general anesthesia
Sponsors
Shengjing Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
Yes
Inclusion criteria
* patients whose age ≥ 18 years old and \<90 years of preoperative sleep disorder; * Primary cancer patients who had not received any radiotherapy or chemotherapy before surgery; * Surgeries expected to be performed under general anesthesia after ≧3 hours
Exclusion criteria
* a history of schizophrenia, epilepsy, Parkinson's disease, or myasthenia gravis; * inability to communicate due to coma, severe dementia, language impairment or serious illness; * critically ill (preoperative ASA (American Society of Anesthesiologists)\>III), Childe-Pugh C or severe renal insufficiency (preoperative dialysis); * Neurosurgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Neurocognitive testing | one day before the surgery | Neurocognitive testing was performed preoperatively and 6 weeks postoperatively, followed up 1 and 3 years postoperatively. |
| Core clock gene and kidney clock control gene detection | at the end of surgery | The urine exosomes were extracted by overspeed centrifugation method. The mRNA ( messenger ribonucleic acid) expression results of the core heart clock gene and the renal bell control genes in the urinary exosomes were detected by timing and quantitative PCR(Polymerase Chain Reaction) and the rhythm was analyzed |
| Blood samples and Apolipoprotein E genotyping | at the end of surgery | peripheral blood was collected from each patient for apolipoprotein E genotyping. |
Countries
China
Contacts
Primary ContactJunchao Zhu
Outcome results
None listed